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Objective: This study aimed to investigate the influence of periodontal status, clinical data, and serum markers on salivary leptin levels in patients with systemic lupus erythematosus (SLE). Methods: A case-control study was conducted with 38 patients with SLE and 29 healthy controls. Periodontal data included periodontal probing depth (PPD), clinical attachment level (CAL), and gingival bleeding on probing (BOP). Stimulated saliva samples were collected to analyze salivary leptin levels. Clinical and serum data were collected from the SLE group. Statistical analysis included the t-test, Mann-Whitney test, Spearman correlation coefficient, and a structural equation model. Results: The SLE group had a lower salivary leptin level than the control group (P = 0.002). The model revealed that SLE had an inverse and independent effect on salivary leptin (standardized estimate = - 0.289, P = 0.023). Moreover, salivary leptin level negatively correlated with the serum levels of triglyceride, creatinine, and leukocytes, positively correlated with the serum total cholesterol, but was not significantly correlated with the periodontal status. Conclusion: These findings suggest that patients with SLE have a lower salivary leptin level. In addition, the level of salivary leptin does not appear to be related to periodontal status in patients with SLE.
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BACKGROUND: Higher levels of stress and negative emotions such as anxiety and depression have been reported since the beginning of the COVID-19 pandemic, but it remains less clear how positive emotions, such as hedonic capacity, may be affected. Further, during lockdowns, the ability to learn new pleasurable activities (hedonic learning) may be particularly relevant. Here, we investigated if state hedonia and/or hedonic learning mediated the relationship between COVID-19 stress and mental health. Moreover, we explored whether positive appraisal style (PAS), a major resilience factor, influenced these relationships. METHODS: Using a cross-sectional design, 5000 German-speaking participants filled out online questionnaires targeting stressors, mental health, state hedonia, hedonic learning, and PAS between April 9 and May 15, 2020. After confirming the factor structure of our constructs, we applied latent structural equation modeling to test mediation as well as moderated mediation models. RESULTS: Stress showed a positive association with mental health symptoms, which was buffered by both state hedonia and hedonic learning. While higher stress was related to lower state hedonia, participants reported more hedonic learning with greater stressor load. The latter effect was greater for individuals with high PAS. LIMITATIONS: The present results should be replicated in longitudinal designs with representative samples to confirm the directionality and generalizability of effects. CONCLUSIONS: Both state hedonia and hedonic learning buffered the effect of stress on mental health in an early phase of the COVID-19 pandemic. Learning new rewarding activities in combination with a PAS may be especially relevant for maintaining mental health during lockdowns.
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OBJECTIVE: To investigate structural relationships of latent constructs such as occupational wellbeing, resilience, work meaningfulness, and psychological empowerment with affective and cognitive clinical empathy among a community of physicians and advanced practice providers. METHODS: We conducted a cross-sectional observational study. We gathered data by an anonymous self-administered multidimensional questionnaire disseminated electronically between March and May 2016. Participants were physicians and advanced practice providers belonging to the Health Texas Provider Network, a group private practice affiliated with the Baylor Scott and White Health system. We excluded allied health care staff (eg, nurses) and trainees (eg, residents, medical students). We pursued a 3-step strategy: (1) confirmatory factor analysis of a theory-driven measurement model, (2) a modified structural equation model from which pathways with nonsignificant path coefficients were deleted, and (3) multigroup analyses of the modified model. RESULTS: Cognitive empathy was the strongest predictor of affective empathy. We observed modest positive associations of resilience with cognitive and affective empathy and of well-being and meaning with affective but not with cognitive empathy. Resilience, meaning, and psychological empowerment were surprisingly negatively associated with well-being, suggesting diminished self-care among practitioners. Effects of psychological empowerment on empathy and well-being were mediated by resilience and meaning. CONCLUSION: Cognitive empathy directly influenced affective empathy; well-being and meaningfulness exerted direct positive effects on affective but not on cognitive empathy, whereas resilience had direct positive associations with both empathy dimensions. Resilience and meaning manifested direct, negative associations with well-being, revealing clinicians' disproportionate focus on patient care at the expense of self-care.
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The implementation of mandatory stay-at-home and isolation policies during the COVID-19 pandemic has resulted in people relying more on smartphone use to obtain the latest developments regarding the pandemic, interact with people, and for entertainment. Unfortunately, as people spend more time participating in Internet activities, they are more likely to encounter problematic internet use (PIU) issues. The main purpose of this study was to examine the association between two kinds of PIU [problematic smartphone use (PSU) and problematic social media use (PSMU)], psychological distress, and sleep problems. In addition, the moderating effect of sleep problems was examined. A total of 11014 school teachers completed the online survey. The participants were divided into two (high and low sleep problem) groups, according to the severity of their sleep problems, for comparison. The research conducted a comparison between the degree of PIU and psychological distress, and then provided correction for the two groups separately. The results indicated that the high sleep problem group exhibited significantly greater psychological distress [mean (SD) = 12.94 (11.29)] than the low sleep problem group [(mean (SD) = 3.42 (6.57)]. Both PSU and PSMU were positively correlated with psychological distress in the two groups. The moderating effect of sleep problems was supported and PSMU was more harmful to psychological distress in the high sleep problem group, while the effect of PSU on psychological distress was not significantly different between the two groups.
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Spiritual health is established as an important protective health asset in child populations. Measurement and assessment of this elusive concept are, however, challenging. Brief and age-appropriate instruments are required for surveys and related population health research. One longstanding model describing child spirituality suggests that scales and measures consider four standard domains describing connections to self, others, nature, and the transcendent. In this validation study, we tested the structural validity and internal consistency of a brief, literacy-level appropriate instrument for adolescents that was based on prior adaptations of this model. The 2018 cross-national study population included 47,180 children aged 11-15 years from 9 countries. Based upon theory, factor pattern matrices, and Scree plots, the exploratory factor analysis best supported the four-factor model, with items organized according to the original four domains. Internal consistency of the items was acceptable (alpha>.7) to good (alpha>.8) within domains, again within each of the 9 countries. The confirmatory factor analysis again supported the four-factor model (by country, SRMR: 0.020 to 0.042; and AGFI and NFI fit: >0.98). Model fit indices for the four-factor model were improved compared with its unidimensional version. Moving forward, our analysis establishes the structural validity and internal consistency of this adapted brief spiritual health instrument to be used in surveys of adolescents.
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OBJECTIVE: To examine the relationships among various organizational values, employee engagement, and patient satisfaction in an academic medical center. PARTICIPANTS AND METHODS: Organizational values and engagement data were retrieved from 2015 all-staff survey results from 1876 clinical units at Mayo Clinic. For patient satisfaction data, Press Ganey scores from visits from July 1, 2015, through January 1, 2016, were matched with data for 26 outpatient units from the all-staff survey. The study was performed from January 1, 2016, through December 31, 2017. RESULTS: From the all-staff survey results, we identified seven constructs related to values and employee engagement, all of which showed high positive correlation with each other. We were able to determine a structural equation model for values and engagement that had an excellent fit (comparative fit index, 0.957). Empowering leadership was positively correlated with the largest number of patient satisfaction items, followed by employee engagement and psychological safety/trust. All items from the care provider category had positive correlations with empowering leadership and psychological safety/trust. CONCLUSION: All the organizational values studied showed positive correlation with employee engagement, and all the organizational values and engagement were predictors of excellence and innovation either directly or indirectly. This affirms that honoring organizational values related to respect, psychological safety/trust, empowering leadership, and fairness has a positive influence on employee engagement and desire to pursue excellence. Organizational values, engagement, and empowering leadership behavior were positively correlated with many patient satisfaction items.
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IntroductionThe Health Belief Model (HBM) can be used as a guide in enhancing the peoples' awareness, improving the motivation, and providing tools that address beliefs and attitudes toward general disaster preparedness (GDP). METHODS: The aim of this study was to improve and re-test all psychometric properties of the published General Disaster Preparedness Belief (GDPB) scale based on HBM carried out in the general population. This scale development study measured by 58 items was prepared under the same structure of the developed GDPB scale that measured 31 items before. This expanded scale was applied to 973 individuals. Firstly, the data from application of the expanded scale was examined under Exploratory Factor Analysis (EFA). Then, the estimations obtained from Confirmatory Factor Analysis (CFA) for the expanded scale with 45 items were compared with the estimations obtained from the previous scale with 31 items. RESULTS: The EFA lead to the removal of 13 items and the retention of 45 items. The items which the factor loadings were below 0.30 and which gave the factor loadings for more dimension were excluded from the data set. A model measured six dimensions with 45 items was hypothesized: six items under perceived susceptibility, four items under perceived severity, six items under perceived benefits, 14 items under perceived barriers, five items under cues to action, and 10 items under self-efficacy. For CFA results, all estimations for factor loadings were significant. The scale with 45 items obtained in this study fit because Comparative Fit Index (CFI), Goodness of Fit Index (GFI), and Adjusted Goodness of Fit Index (AGFI) were over 0.95. CONCLUSION: These results suggest that the scale with 45 items shows improvement in the scale with 31 items. This study indicates that the GDPB scale with 45 items based on HBM has acceptable validity and reliability. This tool can be used in disaster preparedness surveys. InalE, DoganN. Improvement of General Disaster Preparedness Belief scale based on Health Belief Model. Prehosp Disaster Med. 2018;33(6):627-636.
