Validity Evidence for the Brief Self-Control Scale in the Spanish Adult Population: A Systematic Study.

The Brief Self-Control Scale (BSCS) has been widely studied across languages and populations. However, research examining the Spanish version is scant and limited to the adolescent population. Our aim here was to provide validity evidence for use of the BSCS with Spanish adults by analyzing and comparing the psychometric properties of different versions of the scale (13-item, 10-item, 9-item, 8-item, and 7-item). Confirmatory factor analysis was used to test the internal structure based on one-factor and two-factor models. Results obtained in a sample of 676 Spanish adults showed adequate fit indices for the two-factor structure of the 9-item, 8-item, and 7-item versions of the BSCS, although only the 9-item and 8-item BSCS were found to be invariant across gender. Item homogeneity and reliability of factor scores for these two versions (9-item and 8-item) were satisfactory. We also provide novel validity evidence based on relationships with indicators of psychological adjustment and wellbeing. Scores on the 9-item and 8-item BSCS correlated with life satisfaction, flourishing, self-esteem, distress, depression, and loneliness, and hence both may be suitable for use in mental health assessment contexts.

Cognition in informal caregivers: evidence from an English population study.

BACKGROUND AND OBJECTIVES: The relationship between caregiving and cognition remains unclear. We investigate this association comparing four cognitive tasks and exploring the role of potential explanatory pathways such as healthy behaviours (healthy caregiver hypothesis) and depression (stress process model). RESEARCH DESIGN AND METHODS: Respondents were from English Longitudinal Study of Ageing (ELSA) (N = 8910). Cognitive tasks included immediate and delayed word recall, verbal fluency and serial 7 subtraction. Series of hierarchical linear regressions were performed. Adjustments included socio-demographics, health related variables, health behaviours and depression. RESULTS: Being a caregiver was positively associated with immediate and delayed recall, verbal fluency but not with serial 7. For immediate and delayed recall, these associations were partially attenuated when adjusting for health behaviours, and depression. For verbal fluency, associations were partially attenuated when adjusting for depression but fully attenuated when adjusting for health behaviours. No associations were found for serial 7. DISCUSSION AND IMPLICATIONS: Our findings show that caregivers have higher level of memory and executive function compared to non-caregivers. For memory, we found that although health behaviours and depression can have a role in this association, they do not fully explain it. However, health behaviours seem to have a clear role in the association with executive function. Public health and policy do not need to target specifically cognitive function but other areas as the promotion of healthy behaviours and psychological adjustment such as preventing depression and promoting physical activity in caregivers.

The role of character strengths in predicting gains in informal caregivers of dementia.

OBJECTIVES: Although providing care to a person with dementia can have a negative impact, caregivers may also perceive certain benefits and gains through the tasks they perform. Our aim here was to study caregiver gains within the framework of positive psychology, exploring the predictive power of character strengths, while controlling for sociodemographic variables and variables related to the dementia and caring. METHODS: A sample of 105 main caregivers of people diagnosed with dementia completed a sociodemographic questionnaire, the Gain in Alzheimer care Instrument and the Values in Action Inventory of Strengths. Correlational analysis and hierarchical regression were conducted. RESULTS: Eighteen character strengths were positively and significantly correlated with gain scores. Regression analysis indicated that level of education was negatively related to gain scores. In addition, hope was the character strength which best predicted the gain score, such that caregivers who scored higher on hope tended to perceive greater benefits from their role. CONCLUSION: The results suggest that hope may play an important role in relation to the perceived gains of caregiving. Intervention programmes based on positive psychology and aimed at enhancing character strengths, especially hope, could help caregivers to identify the positive aspects of their caring role.

Identifying pulmonary nodules or masses on chest radiography using deep learning: external validation and strategies to improve clinical practice.

AIM: To test the diagnostic performance of a deep learning-based system for the detection of clinically significant pulmonary nodules/masses on chest radiographs. MATERIALS AND METHODS: Using a retrospective study of 100 patients (47 with clinically significant pulmonary nodules/masses and 53 control subjects without pulmonary nodules), two radiologists verified clinically significantly pulmonary nodules/masses according to chest computed tomography (CT) findings. A computer-aided diagnosis (CAD) software using a deep-learning approach was used to detect pulmonary nodules/masses to determine the diagnostic performance in four algorithms (heat map, abnormal probability, nodule probability, and mass probability). RESULTS: A total of 100 cases were included in the analysis. Among the four algorithms, mass algorithm could achieve a 76.6% sensitivity (36/47, 11 false negative) and 88.68% specificity (47/53, six false-positive) in the detection of pulmonary nodules/masses at the optimal probability score cut-off of 0.2884. Compared to the other three algorithms, mass probability algorithm had best predictive ability for pulmonary nodule/mass detection at the optimal probability score cut-off of 0.2884 (AUCMass: 0.916 versus AUCHeat map: 0.682, p<0.001; AUCMass: 0.916 versus AUCAbnormal: 0.810, p=0.002; AUCMass: 0.916 versus AUCNodule: 0.813, p=0.014). CONCLUSION: In conclusion, the deep-learning based computer-aided diagnosis system will likely play a vital role in the early detection and diagnosis of pulmonary nodules/masses on chest radiographs. In future applications, these algorithms could support triage workflow via double reading to improve sensitivity and specificity during the diagnostic process.

Differences in multi-echo chemical shift encoded MRI proton density fat fraction estimation based on multifrequency fat peaks selection in non-alcoholic fatty liver disease patients.

AIM: To compare the performance of multi-echo chemical-shift-encoded (MECSE) magnetic resonance imaging (MRI) proton density fat fraction (PDFF) estimation, considering three different fat frequency peak combinations, for the quantification of steatosis in patients with non-alcoholic fatty liver disease (NAFLD). MATERIALS AND METHODS: The present study was a prospective cross-sectional research of 121 patients with metabolic syndrome and evidence of hepatic steatosis on ultrasound, who underwent a 3 T MRI examination. All patients were studied with a multifrequency MECSE sequence. The PDFF was calculated using six peaks (MECSEp123456), three peaks (MECSEp456), and a single peak (MECSEp5) model. The two simpler fat peak models were compared to the six peaks model, which was considered the reference standard. Linearity was evaluated using linear regression while agreement was described using Bland-Altman analysis. RESULTS: The mean age was 47 (±9) years and BMI was 29.9 (±2.9) kg/m2. Steatosis distribution was 15%/31%/54% (S1/S2/S3, respectively). Compared to MECSEp123456, both models provided linear PDFF measurements (R2= 0.99 and 0.97, MECSEp456 and MECSEp5 respectively). Regression slope (0.92; p<0.001) and mean Bland-Altman bias (-1.5%; 95% limits of agreement: -3.19%, 0.22%) indicated minimal underestimation by using PDFF-MECSEp456. Nonetheless, mean differences in PDFF estimations varied from -1.5% (MECSEp456,p=0.006) to -2.2% (MECSEp5,p<0.001) when compared to full six fat frequencies model. CONCLUSION: Although simpler spectral fat MECSE analysis shows a linear relationship with the standard six peaks model, their variation in estimated PDFF values introduces a low but clinically significant bias in fat quantification and steatosis grading in NAFLD patients.

Neuroinflammation in obesity: circulating lipopolysaccharide-binding protein associates with brain structure and cognitive performance.

BACKGROUND/OBJECTIVES: Growing evidence implicates neuroinflammation in the pathogenesis of diet-induced obesity and cognitive dysfunction in rodent models. Obesity is associated with reduced white matter integrity and cognitive decline. Circulating lipopolysaccharide binding protein (LBP) concentration is known to be increased in patients with obesity. Here, we aimed to evaluate whether circulating LBP is associated longitudinally with white matter structure and cognitive performance according to obesity status. SUBJECTS/METHODS: This longitudinal study analyzed circulating LBP (ELISA), DTI-metrics (axial diffusivity (L1), fractional anisotropy (FA) and radial diffusivity (RD)) in specific regions of the white matter of 24 consecutive middle-aged obese subjects (13 women) and 20 healthy volunteers (10 women) at baseline and two years later. Digit Span Test (DST) was used as a measure of working memory/short-term verbal memory. RESULTS: Circulating LBP concentration was associated with FA and L1 values of several white matter regions both at baseline and follow-up. The associations remained significant after controlling for age, BMI, fat mass and plasma high sensitivity C-reactive protein. Importantly, the increase in LBP over time impacted negatively on FA and L1 values and on DST performance. CONCLUSIONS: Circulating LBP associates with brain white matter integrity and working memory/short-term verbal memory in both obese and non-obese subjects.

Repeated measures ANOVA and adjusted F-tests when sphericity is violated: which procedure is best?

Introduction: One-way repeated measures ANOVA requires sphericity. Research indicates that violation of this assumption has an important impact on Type I error. Although more advanced alternative procedures exist, most classical texts recommend the use of adjusted F-tests, which are frequently employed because they are intuitive, easy to apply, and available in most statistical software. Adjusted F-tests differ in the procedure used to estimate the corrective factor ε, the most common being the Greenhouse-Geisser (F-GG) and Huynh-Feldt (F-HF) adjustments. Although numerous studies have analyzed the robustness of these procedures, the results are inconsistent, thus highlighting the need for further research. Methods: The aim of this simulation study was to analyze the performance of the F-statistic, F-GG, and F-HF in terms of Type I error and power in one-way designs with normal data under a variety of conditions that may be encountered in real research practice. Values of ε were fixed according to the Greenhouse-Geisser procedure (ε^). We manipulated the number of repeated measures (3, 4, and 6) and sample size (from 10 to 300), with ε^ values ranging from the lower to its upper limit. Results: Overall, the results showed that the F-statistic becomes more liberal as sphericity violation increases, whereas both F-HF and F-GG control Type I error; of the two, F-GG is more conservative, especially with large values of ε^ and small samples. Discussion: If different statistical conclusions follow from application of the two tests, we recommend using F-GG for ε^ values below 0.60, and F-HF for ε^ values equal to or above 0.60.

Non-normal Data in Repeated Measures ANOVA: Impact on Type I Error and Power.

BACKGROUND: Repeated measures designs are commonly used in health and social sciences research. Although there are other, more advanced, statistical analyses, the F-statistic of repeated measures analysis of variance (RM-ANOVA) remains the most widely used procedure for analyzing differences in means. The impact of the violation of normality has been extensively studied for between-subjects ANOVA, but this is not the case for RM-ANOVA. Therefore, studies that extensively and systematically analyze the robustness of RM-ANOVA under the violation of normality are needed. This paper reports the results of two simulation studies aimed at analyzing the Type I error and power of RM-ANOVA when the normality assumption is violated but sphericity is fulfilled. METHOD: Study 1 considered 20 distributions, both known and unknown, and we manipulated the number of repeated measures (3, 4, 6, and 8) and sample size (from 10 to 300). Study 2 involved unequal distributions in each repeated measure. The distributions analyzed represent slight, moderate, and severe deviation from normality. RESULTS: Overall, the results show that the Type I error and power of the F-statistic are not altered by the violation of normality. CONCLUSIONS: RM-ANOVA is generally robust to non-normality when the sphericity assumption is met.

Measurement Invariance and Validity of the Satisfaction With Life Scale in Informal Caregivers.

BACKGROUND: The number of informal caregivers within ageing population is increasing and there is a growing research interest to promote their well-being, and therefore there is a need for adequate measurement tools. We aim to provide validity evidence of the Satisfaction with Life Scale (SWLS) in a representative sample of British older adults, including measurement invariance across caregivers and non-caregivers. METHOD: Data was drawn from English Longitudinal Study of Ageing (ELSA). The sample consisted of 3,754 caregivers and 4,036 non-caregivers. The structure and measurement invariance were tested through a confirmatory factor analysis. Reliability and validity evidence based on relationships with other variables were also analysed. RESULTS: Our results supported the one-factor structure of the SWLS, CFI = .996; NNFI = .993; RMSEA = 0.081, and measurement invariance across caregiving status. McDonald´s omega was .93. Scores on the SWLS were positively correlated with quality of life, positive social support, and self-reported health, and negatively with loneliness, depression, negative social support, difficulties in activities and instrumental activities of daily living, and number of health conditions. CONCLUSIONS: These findings provide new psychometric evidence to support the use of the SWLS in research which focuses on caregivers and on the comparison with non-caregiver samples.

The Phubbing Scale (PS-8) in the Portuguese population: psychometric properties.

Phubbing is defined as ignoring other individuals by using a mobile phone during a face-to-face conversation. The Phubbing Scale (PS) was developed to assess this practice. In this study, we analyze the psychometric properties of the 8-item version of the PS (PS-8) in the Portuguese population, providing validity evidence based on internal structure and on relationships with other variables, and examining item properties, reliability, and measurement invariance across gender. Participants were 391 Portuguese adults (132 men, 259 women) who completed a battery of questionnaires. Confirmatory factor analysis yielded satisfactory goodness-of-fit indices for the two-factor structure (communication disturbance and phone obsession), which was invariant across gender. Item homogeneity and reliability of factor scores (McDonald's omega) were satisfactory. Validity evidence based on relationships with other variables was provided by positive associations with time spent on the Internet on weekdays and at the weekend, time spent on social networking sites, number of social networks used, Internet addiction, problematic mobile phone use, Facebook intrusion, fear of missing out, and depression. These associations show the addictive component of phubbing and its relationship with mental health. The PS-8 is a short and easy-to-administer scale with adequate psychometric properties for measuring phubbing in the Portuguese population.

New Evidence for the Psychometric Properties of the Spanish Version of the Gain in Alzheimer Care Instrument.

The aim was to analyze the psychometric properties of the Spanish version of the Gain in Alzheimer Care Instrument (GAIN), providing validity evidence based on its internal structure, reliability, item analysis, and relationships with other variables. A sample of 113 informal caregivers of people with dementia completed the GAIN, along with questionnaires assessing burden, general mental health, stress, anxiety, depression, and life satisfaction. Confirmatory factor analysis showed a single-factor structure with adequate fit indices. Reliability of GAIN scores was satisfactory, with McDonald's omega equal to .91. Items yielded adequate homogeneity indices. Validity evidence based on relationships with other variables was provided by positive correlations between GAIN scores and life satisfaction, and negative correlations with burden, general mental health problems, stress, anxiety, and depression. All these correlations were statistically significant, and most of them were of moderate magnitude. The Spanish version of the GAIN has a single-factor structure and satisfactory psychometric properties. It is quick and easy to apply and given the association between GAIN scores and other variables, it may be used to provide information about a caregiver's psychological health status.

The Phubbing Scale (PS-8) in the Portuguese population: psychometric properties

Phubbing is defined as ignoring other individuals by using a mobile phone during a face-to-face conversation. The Phubbing Scale (PS) was developed to assess this practice. In this study, we analyze the psychometric properties of the 8-item version of the PS (PS-8) in the Portuguese population, providing validity evidence based on internal structure and on relationships with other variables, and examining item properties, reliability, and measurement invariance across gender. Participants were 391 Portuguese adults (132 men, 259 women) who completed a battery of questionnaires. Confirmatory factor analysis yielded satisfactory goodness-of-fit indices for the two-factor structure (communication disturbance and phone obsession), which was invariant across gender. Item homogeneity and reliability of factor scores (McDonald's omega) were satisfactory. Validity evidence based on relationships with other variables was provided by positive associations with time spent on the Internet on weekdays and at the weekend, time spent on social networking sites, number of social networks used, Internet addiction, problematic mobile phone use, Facebook intrusion, fear of missing out, and depression. These associations show the addictive component of phubbing and its relationship with mental health. The PS-8 is a short and easy-to-administer scale with adequate psychometric properties for measuring phubbing in the Portuguese population. (AU)

[Efficacy of parenteral glutamine in patients undergoing bone marrow transplantation]. / Eficacia de la glutamina parenteral en pacientes sometidos a trasplante autólogo de médula ósea.

INTRODUCTION: Autologous bone marrow transplant (ABMT) represents a high metabolic stress. Glutamine has proven to be effective in severe catabolic states, although there are controversial studies. OBJECTIVES: To assess the effect of parenteral nutrition (PN) therapy supplemented with glutamine on the occurrence of mucositis and mean hospital stay in patients submitted to ABMT. METHODS: Retrospective study of patients submitted to ABMT between 2006 and 2009. In 2008, one vial of L-alanyl-L-glutamine (20 g) was added by protocol to the PN formulations of these patients. Thirteen clinical charts since that date (glutamine group) and 13 previous charts (control group) were randomly selected (n = 26). We compared the degree of mucositis and hospital stay in both groups. In the subgroup of glutamine-treated patients, we compare the glutamine dose in the patients developing some degree of mucositis with that of those not having this complication. RESULTS: Mean hospital stay: 27.8 ± 7.4 days (control group) vs. 20.3 ± 5.3 days (glutamine group) (p = 0.01). The severity of mucositis was lower in the glutaminetreated group (p = 0.02). The weight-adjusted dose of L-alanyl-L-glutamine in the patients not developing mucositis was higher than in the other ones (0.32 vs. 0.24 g/kg/day; p = 0.02). CONCLUSIONS: Glutamine supplementation reduces the degree of mucositis and hospital stay in patients submitted to autologous bone marrow transplantation. The degree of mucositis is lower in the subgroup of patients receiving higher doses of glutamine.