Cognitive remediation therapy for patients with eating disorders: a qualitative study.

BACKGROUND: Transdiagnostic Cognitive Remediation Therapy (TCRT) is a new adaptation of cognitive remediation therapy for eating disorders (EDs) developed to address common cognitive difficulties across ED diagnoses (i.e., cognitive flexibility, central coherence, and impulsivity). This is the first evaluation of this novel treatment. The aim of this study was to explore acceptability and patients' experience of TCRT. METHODS: Thirteen patients diagnosed with restrictive or binge/purge subtypes of EDs and concurrent cognitive difficulties completed semi-structured qualitative interviews after receiving TCRT. Interview transcripts were analyzed using reflexive thematic analysis. RESULTS: The analysis resulted in four main themes: (1) Treatment fit (2), Treatment experience (3), Perceived outcomes, and (4) Future recommendations. Eleven of the thirteen patients evaluated the treatment positively, found the focus relevant and expressed how it contributed to new insights related to thinking style. Seven of the patients also described it as a starting point for making changes and using new strategies. Importantly, experiencing some challenges related to the cognitive difficulties addressed in the treatment seemed essential for engagement. CONCLUSION: Offering TCRT as an adjunctive treatment for patients with EDs and concurrent cognitive difficulties can be a way to engage patients in treatment, build therapeutic alliances and provide important awareness and strategies to handle challenges related to thinking style. TRIAL REGISTRATION: This study is part of a larger randomized controlled trial, ClinicalTrials.gov Id: NCT03808467.

Cognitive difficulties are thought to be one of several factors contributing to the development and maintenance of eating disorders (ED), but are rarely addressed in ED treatments. Cognitive remediation therapy (CRT) for EDs is a supplementary treatment originally developed for patients with anorexia nervosa (AN) that specifically targets cognitive difficulties. However, cognitive difficulties are found across ED diagnoses and not only in patients with AN. In this study, we have adapted CRT to address cognitive difficulties across ED diagnoses. The goal of this study was to explore patients' experiences of this novel transdiagnostic CRT. We interviewed 13 individuals with various eating disorders after they had received the treatment. Eleven of the participants rated the treatment positively, expressed that it was engaging, offered something new and made them more aware of their thought processes. Seven participants also reported using new strategies to handle challenges related to cognitive difficulties. Importantly, one participant expressed that she did not experience cognitive difficulties and chose to drop out of the treatment, highlighting the importance of finding the treatment relevant to foster engagement.

The relationship between the Hopkins symptom checklist-10 and diagnoses of anxiety and depression among inpatients with substance use disorders.

INTRODUCTION: The Hopkins Symptom Checklist-10 (HSCL-10) is a self-report inventory of anxiety and depression symptoms that may assist clinicians in screening for clinical conditions among patients with substance use disorder (SUD). We examined the HSCL-10 as a screening tool for anxiety and depressive disorders within a general population of SUD inpatients. METHODS: We used data from a cohort study of 611 SUD inpatients. Receiver operating characteristic (ROC) analyses were conducted, with and without covariates, to evaluate the potential of the HSCL-10 as a screening tool. This was explored using any anxiety disorder, especially posttraumatic stress disorder (PTSD), and any mood disorder, especially major depressive disorders, as the outcome criteria. Candidate covariates included gender, age, education, polydrug use and treatment center.Results: The HSCL-10 had a moderate ability to identify caseness (i.e. having or not having a clinical diagnosis) according to each outcome criterion, with the area under the ROC curve (AUC) varying from 0.64 to 0.66. Adding relevant covariates markedly enhanced the instrument's ability to identify those who met the criteria for any anxiety disorder (AUC = 0.77), especially PTSD (AUC = 0.82). CONCLUSION: In a real-world clinical setting, the HSCL-10 has fair-to-good clinical utility for identifying SUD inpatients who have comorbid clinical symptoms of anxiety disorders or PTSD, when combined with common background variables. The HSCL-10, a brief self-report screening tool, may serve as an efficient proxy for comprehensive interviews used in research and for clinical anxiety symptom screening among patients with SUD.

Who Returns to work? Exploring the Role of Interpersonal Problems in Occupational Rehabilitation.

PURPOSE: Current interventions designed to facilitate return to work (RTW) after long-term sick leave show weak effects, indicating the need for new approaches to the RTW process. The importance of social relationships in the workplace is widely recognized in existing RTW literature, but very little is known about the role of the interpersonal problems of the returning worker. Current research indicates that a subset of these - hostile-dominant interpersonal problems - give particular disadvantages in several life areas. This prospective cohort study aims to test whether higher levels of interpersonal problems predict lower likelihood of RTW when controlling for symptom levels (H1); and whether higher levels of hostile-dominant interpersonal problems specifically predict lower likelihood of RTW (H2). METHODS: 189 patients on long-term sick leave completed a 3½-week transdiagnostic RTW program. Before treatment, self-reported interpersonal problems, chronic pain, insomnia, fatigue levels, anxiety and depression were collected. RTW data for the following year were collected from the Norwegian Labour and Welfare Administration. RESULTS: A multivariable binary logistic regression analysis found that (H2) hostile-dominant interpersonal problems significantly predicted RTW (OR = 0.44, [95% CI: 0.19, 0.98], p = .045), while a corresponding analysis (H1) found that general interpersonal problems did not. CONCLUSION: Hostile-dominant interpersonal problems negatively predict RTW after long-term sick leave, suggesting an overlooked factor in the field of occupational rehabilitation. The findings could open up new avenues for research and interventions entailed to individuals in the field of occupational rehabilitation.

Inpatients in substance use treatment with co-occurring psychiatric disorders: a prospective cohort study of characteristics and relapse predictors.

BACKGROUND: The characteristics of substance use disorder (SUD) inpatients with co-occurring psychiatric disorders (COD) have been scantly described in the extant literature. This study investigated psychological, demographic and substance use characteristics in these patients, along with predictors of relapse 3 months post-treatment. METHODS: Prospective data from a cohort of 611 inpatients were analyzed for demographics, motivation, mental distress, SUD diagnosis, psychiatric diagnoses (ICD-10) and relapse rate at 3 months post-treatment (retention rate = 70%). RESULTS: Compared to patients without COD (n = 322), those with COD (n = 289) were younger, had higher mental distress, lower education and higher likelihood of no permanent residence. The relapse rate was also higher in patients with COD (39.8%) relative to patients without COD (26.4%) (OR = 1.85, 95% CI: 1.23-2.78). The relapse rate was particularly high for patients with COD who were diagnosed with cannabis use disorder (53.3%). Multivariate analysis revealed that among patients with COD, relapse was more likely for individuals with a cannabis use disorder (OR = 2.31, 95% CI: 1.34-4.00), and less likely for older ages (OR = 0.97, 95% CI: 0.94-1.00), females (OR = 0.56, 95% CI: 0.33-0.98) and for those with higher intrinsic motivation (OR = 0.58, 95% CI: 0.42-0.81). CONCLUSION: This study showed that among SUD inpatients, those with COD had relatively persistent high levels of mental distress and an increased risk of relapse. Enhanced measures aimed at COD patients' mental health problems during the inpatient stay, along with close and personalized follow-up after discharge from residential SUD treatment may reduce the probability of relapse in this group.

Investigating the role of health belief model on seat belt use for front seat passengers on urban and rural roads.

What makes a vehicle user buckle up? Considering the strong effect of seat belt use in reducing injuries and fatalities in a vehicle crash, we investigated the role of the health belief model on seat belt use among front-seat passengers on urban and rural roads. A questionnaire based on the theory components was randomly distributed in public areas of Sari, Iran. Structural equation model was used to test the study hypotheses. The results revealed that anticipated severity and perceived susceptibility directly affected seat belt use on urban roads, whereas perceived barriers had a reverse effect on seat belt use on urban roads. Perceived barriers with an indirect and perceived susceptibility with a direct effect, played an essential role in explaining seat belts use on rural roads. Outcomes of this study extend the knowledge of seat belts use behavior among front seat passengers by introducing new factors of potential influence, which could lead to practical solutions aimed to enhance seat belts utilization among these vehicle users and decrease the rate of injuries and fatalities in road crashes.

Drunk or Sober? Number of alcohol units perceived to be safe before riding e-scooter.

Riding an e-scooter under the influence of alcohol is one of the most frequently reported risky behaviours among riders in various countries, especially in the Nordic countries. What is the Number of Alcohol Units perceived to be Safe (NAUS) before riding an e-scooter? Who is more likely to report higher perceived alcohol tolerance before riding an e-scooter? What is the level of risk perception in this transport domain? The current study advances the literature by aiming to address these questions. Using a cross-sectional survey (n = 395) in Trondheim, Norway we developed an integrated model combining a path analysis with negative binomial regression to predict NAUS before riding an e-scooter. Results show that (i) around 56 % of participants reported that it is safe to consume one or more units of alcohol prior to riding an e-scooter, (ii) younger people, frequent users of e-scooters, individuals with low education, and people with lower perceived risks of an accident were more likely to report higher NAUS. Alcohol health warnings and random blood alcohol concentration tests on e-scooter sites could be prioritised among these segments of the population, and (iii) there is a rather high risk perception in this transport domain. We found that there are strong connections between higher risk perception, worry and fewer NAUS. Policymakers could highlight risks of accidents by e-scooters under the influence of alcohol.

Explaining trip generation during the COVID-19 pandemic: A psychological perspective.

Introduction: The present study investigated the extent of reduction in the generation of non-essential trips (i.e., for shopping, personal, social, and entertainment reasons) due to the COVID-19 pandemic and the role of psychological factors (including deliberate planning and personal moral obligations) in explaining the change. Method: We collected data through an internet survey conducted from April to June 2020. We recruited the respondents (N = 369) from a young segment of the population in Iran. The hypothesised model framework included the components of the theory of planned behaviour (including attitudes, subjective norms, perceived behavioural control, and intention to reduce non-essential trips) along with personal moral obligation. The framework also consisted of socio-demographic characteristics of age, gender, income, car ownership and trip distance. A structural equation model was developed to explain trip reduction at an aggregated level for four non-essential trip purposes (i.e., shopping, personal, social, and entertainment). In the aggregated model, trip-reducing behaviour represents the change in the number of trips for all non-essential purposes. We also tested the same framework, to explain trip reduction for each of the trip purposes, separately. Results: On average, the study participants reduced their non-essential trips by 60% during the pandemic compared with in the pre-COVID-19 period. Men were less likely than women to reduce the rate of their trips during the pandemic. The SEM demonstrated that the theory of planned behaviour predicted trip-generation behaviour during the abnormal situation represented by the pandemic. Perceived behavioural control both directly and indirectly impacted trip reduction. However, personal moral obligations failed to provide a direct explanation for trip generation reduction. According to the hypothesised model, the results for different trip purposes were also mostly in line with those from the aggregated model. Conclusions: The findings imply that participants in our sample made deliberate and planned psychological decisions (aligned with the theory of planned behaviour) regarding potential travel behavioural decisions during the COVID-19 pandemic. The findings also highlighted that perceived behavioural control grows in importance alongside growth in difficult circumstances.

Suicidal ideation among inpatients with substance use disorders: Prevalence, correlates and gender differences.

We examined the prevalence of suicidal ideation (SI) among inpatients with substance use disorders (SUD) and investigated the association between SI and demographic (age, education, gender) and clinical factors (SUD, psychiatric disorders, anxiety/depression symptoms, substance use onset age). We collected medical record data including types of ICD-10 SUD and psychiatric diagnoses (i.e. mood: F30-39; anxiety: F40-48; personality: F60-F60.9; F61.0; F62; ADHD: F90-F90.9) and patient-reported data from 563 patients admitted to inpatient SUD treatment. Lifetime SI was measured by one question from the Addiction Severity Index (ASI). Gender differences in SI rates were examined using Chi-square tests. To determine variables that were uniquely associated with SI we conducted hierarchical regression analyses. The overall prevalence of SI was 50%, and it occurred more frequently among females (61.9%) than males (45.4%). SI was associated with female gender, younger age of substance use onset, mood and personality disorders, and higher anxiety/depression symptoms. Male gender accounted for the significant association between younger age of onset and SI. Diagnostic information on mood and personality disorders, and screening of patient-reported anxiety/depression symptoms at treatment intake may be useful for clinicians in identifying and providing personalized treatment for SUD inpatients who are at increased risk of SI.

The importance of interdisciplinarity in accommodating patient needs among norwegian nurses.

WHAT IS KNOWN ON THE SUBJECT: Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors. Mental health nurses often describe role confusion in relation to other health professionals. Opportunities for interdisciplinary communication with other professionals may benefit health care. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: The current large-scale study is the first to investigate whether mental health and SUD nurses' perceptions of their opportunities to accommodate patients' needs are related to interdisciplinarity in the treatment unit and a nursing role with clearly defined responsibilities. Strong interdisciplinarity was associated with greater perceived opportunities to accommodate patients' psychosocial, somatic, and economic and legal needs, while strictly defined nursing roles/responsibilities were related to weaker opportunities to do so. WHAT ARE THE IMPLICATIONS OF PRACTICE: The findings highlight the need to address how mental health and SUD nurses organize practice to meet patients' diverse needs Interdisciplinary teamwork could strengthen nurses' ability to address patient needs Finding the best possible balance of providing service in teams or individually could improve resource utilization at the same time as strengthening patient care, and making sure that the patients' various needs are met. ABSTRACT: INTRODUCTION: Nurses' roles in specialist mental health and substance use disorder (SUD) treatment services are multidimensional and complex. Their responsibility, autonomy and interdisciplinary collaboration may be of importance for their perceived opportunities to accommodate patients' health needs. Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors, and included relatively small samples. The studies have also mainly been conducted in other sectors than the mental health and SUD nursing sectors. AIM/QUESTION: The aim of this study is to examine the associations between nurses' roles, interdisciplinarity and their perceived opportunities to accommodate patients' psychosocial, somatic and economic/legal needs. METHOD: A cross-sectional web-based questionnaire survey was conducted in a nationwide sample of Norwegian nurses in the mental health, SUD treatment and combined mental health and SUD treatment sectors. Of 5,501 contactable nurses (74% of the population), 1918 (35%) responded. RESULTS: The results revealed that interdisciplinarity was significantly associated with greater perceived opportunity to accommodate patient needs, whereas strictly defined nursing roles/responsibilities were associated with less opportunity to accommodate these needs. DISCUSSION/IMPLICATION FOR PRACTICE: Facilitation of interdisciplinary collaboration may improve quality of care for patients in mental health and SUD treatment services.

Demand for mitigating the risk of COVID-19 infection in public transport: The role of social trust and fatalistic beliefs.

The rapid surge of COVID-19 cases worldwide drew attention to COVID-19 infection as a new source of risk in transport. The virus introduced a need for viral transmission mitigation as a major priority when selecting a mode of travel, and caused a significant drop in public transport use. The recovery of public transport use in the post-COVID period requires that the transport authorities favourably address people's demand for mitigation of the risk of COVID-19 transmission in public transport. The present study aims to explore the role of risk perception, worry and priority of COVID-19 risk reduction along with fatalistic beliefs and public trust in authorities in explaining public demand for risk mitigation. The present study is among the first to investigate the role of fatalistic beliefs, social trust and risk perception for public transport and public demand for risk mitigation. The link between priority of infection prevention and demand for risk mitigation has also been less explored in public transport research. An online survey was conducted among university students in Iran between 19th April and 16th June 2020, during the first wave of the pandemic, when the country was a major epicentre of the disease. A total of 271 out of 370 respondents whose dominant mode on university travels was public transport were included in the analysis. Results of structural equation modelling confirmed the paradox of trust, indicating that social trust is negatively associated with perceived risk of COVID-19 infection, which in turn may lead people to place less importance on COVID-19 prevention as a priority in travel mode choice, and consequently demand less risk mitigation efforts to prevent COVID-19 infection in public transport. Dissimilar to trust, however, the results revealed no relationship between fatalistic beliefs and risk perception, but a significant direct effect of fatalistic beliefs on demand for risk mitigation. To reinforce public demand for mitigating the risk of COVID-19 in public transport, the study calls on policymakers to exploit public trust resources for more effective risk communication, through disseminating the gradually accumulating evidence-based information regarding the infectivity and the virulence of COVID-19 and the scientific risk of infection. The study also underlined the potential importance of considering fatalistic beliefs when developing effective risk communication policies and practices to enhance public support for COVID-19 risk mitigation in public transport.

Erratum: Johannessen et al. Work-Related Satisfaction among Clinicians Working at Inpatient Treatment Facilities for Substance Use Disorder: The Role of Recovery Orientation. Int. J. Environ. Res. Public Health 2021, 18, 7423.

In the published article [...].

Work-Related Satisfaction among Clinicians Working at Inpatient Treatment Facilities for Substance Use Disorder: The Role of Recovery Orientation.

Several psychosocial factors have been suggested as facilitators of change among inpatients treated for substance use disorder (SUD). Research suggests that staff members are also influenced by the practice in which they are involved, and by contextual psychosocial factors at their treatment facilities. This cross-sectional questionnaire survey study was conducted to investigate the role of recovery-orientated interventions in describing work-related satisfaction among clinicians at inpatient SUD treatment facilities. The respondents (n = 407) rated items indicating work-related satisfaction and the degree of recovery orientation at their treatment facilities. The main findings of two block regression analyses indicated that clinicians' work-related satisfaction was positively influenced by inpatients' opportunities to pursue their goals and choices, and negatively influenced by inpatient involvement. The change in clinicians' work-related satisfaction could not be described by the degree of individually tailored and varied interventions at the treatment facility. Clinicians should be supported and involved in the process of implementing measures to increase inpatient involvement in the treatment programmes, and treatment measures that enable inpatients to pursue their goals and choices should be enhanced. The findings of this and previous studies indicate that a recovery-oriented framework promotes clinicians' work-related satisfaction and has an enabling influence on both inpatients and clinicians.

Social Psychology of Coronavirus Disease 2019: Do Fatalism and Comparative Optimism Affect Attitudes and Adherence to Sanitary Protocols?

The potential of mitigating the spreading rate and consequences of the coronavirus disease 2019 (COVID-19) currently depends on adherence to sanitary protocols (e.g., hand hygiene and social distancing). The current study aimed to investigate the role of fatalism and comparative optimism for adherence to COVID-19 protocols. We also tested whether these factors are directly associated with adherence or associated through attitudinal mediation. The results were based on a web survey conducted among university students (n = 370) in Tehran, Iran. The respondents completed a multidimensional measure of fatalism (general fatalism, internality, and luck) and measures of comparative optimism, attitudes toward COVID-19 health measures, and adherence. The estimated structural equation model explained approximately 40% of the total variance in attitudes toward COVID-19 protocols and adherence. As expected, high internality was associated with stronger adherence, whereas luck was associated with weaker adherence. Comparative optimism was more strongly associated with adherence than fatalism, and somewhat unexpectedly comparative optimism was associated with stronger adherence. Analyses of direct and indirect effects suggested that fatalism was mainly mediated through attitudes, whereas comparative optimism had both direct and mediated effects. The findings are discussed in relation to the role of these social psychological factors for COVID-19 mitigation.

Analysis of pedestrians' behaviour: A segmentation approach based on latent variables.

Crash statistics indicate that the number of pedestrian fatalities has been increasing at an alarming rate in Iran. Crossing over non-designed places is a main cause of traffic crashes among pedestrians. This study aimed to investigate how perceptions about walking facilities and risk-taking affect pedestrians' crossing behaviour. A stated preference questionnaire was designed and a random sample of 390 pedestrians were interviewed face-to-face in two regions of Tehran with three options for pedestrians to cross (overpass, zebra crossing, and non-designed places (NDP)). Exploratory factor analysis (EFA) resulted in three latent dimensions: risk-taking/conformity, pedestrians' perception of overpass, and NDP. Then, data were classified based on latent variables using K-means cluster analysis. Clustering resulted in four groups: group 1 (Cautious; negative perception of overpasses; positive perception of NDP), group 2 (Cautious; negative perception of overpasses; negative perception of NDP), group 3 (Cautious; positive perception of overpasses; negative perception of NDP), and group 4 (Risk-taker; negative perception of overpasses; negative perception of NDP). Finally, a Multinomial Logit Model (MNL) was developed for four groups of pedestrians. The results show that pedestrians' behaviour differentiate based on latent variables. It was found that being accompanied by a child increases the probability of using an overpass even for pedestrians in group 4 with high risk-taking propensity, but it was more important for pedestrians in group 3 who held positive perceptions of overpasses and negative perceptions of NDP. Also, during congestion, group 4 was more inclined to cross at NDP. It was concluded that in the first group, unsafe choices among student respondents could be associated with their facility perceptions rather than their risk-taking/conformity. Results of this study can be helpful in selecting more appropriate locations for overpasses and crosswalks installation based on pedestrians' behaviour.

Investigating the factor structure of a translated recovery-orientation instrument in inpatient treatment for substance use disorder.

BACKGROUND: Recovery has been outlined as a process of change through which involvement and empowerment enables individuals to reach their goals and aspirations. Recovery self-assessment (RSA) is an instrument that has been acknowledged as an applicable measure of recovery-orientation in services for people with mental health problems or substance use disorder (SUD). This study aimed to translate RSA from US English to Norwegian and to investigate the factor structure of the translated version (RSA-N). METHODS: A translate/back-translate procedure was used. Confirmatory factor analysis (CFA) was applied to investigate the factor structure of RSA-N in a sample of clinicians (n = 407) working in inpatient SUD treatment facilities. RESULTS: The results suggested that the hypothesised five-factor structure originally obtained by the developers showed an inadequate fit with the current data sample. RSA-N was modified and restructured by removing twelve misfitting items and combining factors with high covariance using data from one subsample. The alternative three-factor structure yielded an acceptable fit for the data from a second subsample. Acceptable alpha coefficients, suggesting good internal consistency, supported the adequacy of the three-factor structure. CONCLUSIONS: Results from the present study are in line with previous findings, which have failed to replicate the hypothesised five-factor structure without modifications. Knowledge about the degree to which SUD services are recovery-oriented may contribute to SUD services' pursuit of establishing an inpatient treatment environment that fosters change and development of inpatients. The present study's findings imply RSA-N's potential as an instrument to assess recovery-orientation in inpatient SUD treatment.

Structural equation modelling of potential risk factors for pedestrian accidents in rural and urban roads.

Although several previous studies have focused on pedestrian safety, most of the studies have focused on urban roads. This study investigated accident data among 1358 pedestrians from 2012 to 2018 on urban, suburban, and rural roads in 16 cities in the Gilan province of Iran using structural equation modelling (SEM). Factor analysis showed that four exogenous latent variables had a significant relationship with fatal accidents among pedestrians. Factors related to roads (coefficient: 0.968), vehicles (coefficient: 0.632), humans (coefficient: 0.306), and the environment (coefficient: 0.194) were respectively the most important for pedestrian safety status. The main findings also proclaim that the poor quality of cars manufactured in Iran in addition to the poor design of intersections and major roads (urban) and ring roads (suburban) may be important reasons of the increased fatal accidents in the studied areas. A potential cause for these accidents may be rooted in less attention towards giving behavioural instructions to road users, and underdeveloped driver education procedures. Finally, the data-model fit of the SEM was validated using different indicators, and suggestions to improve safety were pointed out.

Emerging Adults in Inpatient Substance Use Treatment: A Prospective Cohort Study of Patient Characteristics and Treatment Outcomes.

INTRODUCTION: Compared to older adults, emerging adults treated for substance use disorders (SUDs) are more likely to have unfavorable outcomes. However, few studies have investigated the baseline characteristics and treatment outcomes of emerging adults in inpatient SUD treatment. AIMS: This study investigated differences in demographic and clinical characteristics and treatment outcomes (relapse or treatment discontinuation) among emerging adult and adult inpatients. Prospective associations between baseline characteristics and unfavorable treatment outcomes were also analyzed across both patient groups. METHODS: A prospective cohort study was conducted among inpatients (n = 499) at 4 SUD treatment centers in Norway. The sample included emerging adult patients aged 18-25 years (n = 149) and adult patients above 25 years (n = 350). Medical records provided data on sociodemographic variables, substance use characteristics, diagnoses, and treatment completion status. Self-reported measures, including age of onset of substance use, motivation, and mental distress, were completed within 2 weeks of admission to treatment. A telephone interview 3 months after discharge provided information about relapses. RESULTS: Emerging adults had a more adverse risk profile in terms of demographic characteristics, clinical variables, and treatment outcomes. Multivariable results showed that polysubstance use and an attention deficit hyperactivity disorder (ADHD) diagnosis were the strongest predictors of unfavorable treatment outcomes for emerging adults. For older adults, only baseline mental distress was a significant predictor of unfavorable treatment outcomes. CONCLUSIONS: Treatment and follow-up initiatives could be better tailored for emerging adults. Identification of treatment needs among emerging adults manifesting polysubstance use and ADHD may reduce the likelihood of unfavorable treatment outcomes in this patient group.

Factors associated with quality of life trajectories among inpatients treated for alcohol use disorders: A prospective cohort study.

AIMS: The main study purpose was to investigate patient- and treatment-related factors associated with overall quality of life (OQOL) trajectories during and after inpatient alcohol use disorder (AUD) treatment. DESIGN: A large-scale prospective multicenter cohort study of patients with different substance use disorder (SUD) types who were consecutively admitted for inpatient SUD treatment. Data were obtained at treatment entry (T1), discharge (T2), three months after discharge (T3), and one year after discharge (T4). The inclusion criterion was that the patient be dependent solely on alcohol. OQOL data were collected at all four time points. Independent variables included demographics, mental distress, psychiatric disorders, substance use, treatment history, and patient satisfaction. RESULTS: Among the 611 patients available, 236 met the AUD inclusion criterion and completed T1 assessments. A linear mixed model showed substantial co-occurrence between higher mental distress and lower OQOL. Higher patient satisfaction with inpatient treatment (T2) was associated with higher trajectories of OQOL, whereas abstinence (T3) was not. There was a substantial increase in OQOL from T1 to T2, which then remained stable during the last two assessment time points. CONCLUSIONS: Routine OQOL screening at treatment entry, and targeting mental distress both during and after inpatient treatment, may be associated with improved OQOL among individuals with AUD. Further research should investigate inpatient treatment factors that contribute to OQOL improvement and those that moderate the relationship between patient satisfaction and OQOL.

"If I know when you will arrive, I will let you walk to school:" The role of information technology.

INTRODUCTION: Providing a sense of supervision for parents may facilitate their children's involvement in physical outdoor activities, such as walking to school. Information technology (IT) solutions could bring more parental supervision, which in turn has the potential to enhance the proportion of walking trips to school. This study aimed to examine the role of a proposed hypothetical IT solution that gives parents real-time information about children's entrance to and exit from the school, for the intention of parents letting their children walk to school. METHOD: A total of 820 questionnaires were distributed among pupils aged 7-9-years across 28 elementary schools to be completed by their parents (82% return rate). RESULTS: Compared to the group of walking pupils, increased parental intention to let their children walk to school under the proposed solution could be explained by considerably more variables in the group of pupils who did not walk to school. The findings revealed that increased parental intention was higher among the walking pupils compared to the non-walking pupils. For the non-walking pupils, enhancement of walking facilities across the school area could potentiate the use of the proposed solution by the parents, which in turn may increase the proportion of walking on school trips. In addition, boy pupils, the pupils whose parents evaluated walking more favorable, those from lower socioeconomic backgrounds, and those living in close proximity to the school could more likely benefit by shifting from non-walking to walking modes of travel, after implementation of the solution.