Psychometric properties of the Shared Decision-Making Questionnaire (SDM-Q-9) in oncology practicePropiedades psicométricas del Questionnaire Shared Decision-Making (SDM-Q-9) en oncología

Background/Objective: This study sought to assess the psychometric properties of the 9-item Shared Decision-Making Questionnaire (SDM-Q-9) in patients with resected, non-metastatic cancer and eligible for adjuvant chemotherapy. Method: A total of 568 patients were recruited from a multi-institutional, prospective, transversal study. Patients answered the SDM-Q-9 after visiting their medical oncologist who, in turn, completed the SDM-Q–Physician version. Reliability, factorial structures [exploratory factor analysis (EFA), confirmatory factor analysis (CFA)], and convergent validity of the SDM-Q-9 scores were explored. Results: SDM-Q-9 showed a clear factorial structure, compatible with a strong and replicable general factor and a secondary group factor, in patients with resected, non-metastatic cancer. Total sum scores derived from the general factor showed good reliability in terms of omega coefficient: .90. The association between patient and physician perception of SDM was weak and failed to reach statistical significance. Males and patients over 60 years of age displayed the greatest satisfaction with SDM. Conclusions: SDM-Q-9 can aid in evaluating SDM from the cancer patients’ perspective. SDM-Q-9 is helpful in studies examining patient perspectives of SDM and as an indicator of the degree of quality and satisfaction with health care and patient-physician relationship.     

Acceptance versus distraction: brief instructions, metaphors and exercises in increasing tolerance for self-delivered electric shocks

The current study compared the effects of an acceptance versus distraction rationale on coping with experimentally induced pain. Eighty participants were randomly assigned to one of five conditions: Full-Acceptance, Full-Distraction, Instruction-only-Acceptance, Instruction-only-Distraction and No-Instructions. Participants completed a simple matching task and were intermittently given the choice either to receive an electric shock and continue, or to avoid the shock and terminate the task. Only the Full-Acceptance strategy (that included experiential exercises and a metaphor) had a significant effect on task tolerance as measured by an increase in the number of shocks delivered post-intervention relative to baseline. In addition, the participants in both of the acceptance conditions showed lower levels of believability in that they were more likely to continue with the task even when reporting more pain. The results support the prediction that acceptance-based interventions work by undermining the behavioural-control functions of pain-related thoughts and feelings, and call for a systematic analysis of how metaphors and exercises work in analogue research.     

Extreme Values of Maternal Serum Analytes in Second Trimester Screening: Looking Beyond Trisomy and NTD’s

Second trimester maternal serum screening can identify high risk pregnancies and fetuses at risk for birth defects (in addition to those in the standard interpretation). The purpose of this study was to quantify such risks to improve counseling. We compared outcomes of 692 pregnancies that had abnormal levels of at least one analyte with a cohort of 713 pregnancies with normal analytes. Increased risks include: demise with high AFP and low uE3; intrauterine growth restriction with high AFP, high and low hCG, and low uE3; placental abnormalities with high AFP; fetal stress with high AFP and high hCG. Birth defects are increased with high AFP, high hCG, and low hCG. When two or more analytes are abnormal, 46% have a poor outcome. Abnormal levels of maternal serum analytes provide information in addition to the risks for neural tube defects, Down syndrome, and trisomy 18. This information is important for counseling and pregnancy management.     

Amygdala upregulation of NCAM polysialylation induced by auditory fear conditioning is not required for memory formation, but plays a role in fear extinction

There is much interest to understand the mechanisms leading to the establishment, maintenance, and extinction of fear memories. The amygdala has been critically involved in the processing of fear memories and a number of molecular changes have been implicated in this brain region in relation to fear learning. Although neural cell adhesion molecules (NCAMs) have been hypothesized to play a role, information available about their contribution to fear memories is scarce. We investigate here whether polysialylated NCAM (PSA-NCAM) contributes to auditory fear conditioning in the amygdala. First, PSA-NCAM expression was evaluated in different amygdala nuclei after auditory fear conditioning at two different shock intensities. Results showed that PSA-NCAM expression was increased 24 h post-training only in animals subjected to the highest shock intensity (1mA). Second, PSA-NCAM was cleaved in the basolateral amygdaloid complex through micro-infusions of the enzyme endoneuraminidase N, and the consequences of such treatment were investigated on the acquisition, consolidation, remote memory expression, and extinction of conditioned fear memories. Intra-amygdaloid cleavage of PSA-NCAM did not affect acquisition, consolidation or expression of remote fear memories. However, intra-amygdaloid PSA-NCAM cleavage enhanced fear extinction processes. These results suggest that upregulation of PSA-NCAM is a correlate of fear conditioning that is not necessary for the establishment of fear memory in the amygdala, but participates in mechanisms precluding fear extinction. These findings point out PSA-NCAM as a potential target for the treatment of psychopathologies that involve impairment in fear extinction.     

Revisión del constructo lugar de control a partir de sus instrumentos de evaluación sobre poblaciones infantiles

Resumen

Se realiza una revisión de las principales escalas de evaluación de las Expectativas de Lugar de Control existentes para niños y adolescentes, tanto en lo concerniente a sus características formales como a su fiabilidad y validez de constructo. El objetivo doble que se persigue reside, en primer lugar, en ofrecer una información que permita al lector escoger la escala más apropiada en función de los intereses que persiga. En segundo lugar, analizar el constructo a partir del cumplimiento de las predicciones realizadas por los autores de las mismas. Se discuten, al final, los hallazgos revisados en el contexto de la teoría del Aprendizaje Social y de la naturaleza y capacidad predictiva del constructo.     

Inventory of Overburden in Alzheimer's Patient Family Caregivers with no Specialized Training

Background/Objective: Alzheimer-type dementia is one of the most frequent causes of dependence in an aging population, which combines with a considerable demand for care. Furthermore, when the caregiver is a family member or person without specialized training, such care impacts on that person's health. The Inventory of Overburden in Alzheimer's Patient Family Caregivers with no Specialized Training (IPSO-CA24) was designed to find out the needs of these caregivers and evaluate the caregiver's burden or distress. Method: The psychometric properties of the questionnaire were analyzed (in a reliability analysis, exploratory factor analysis and confirmatory analysis) based on the responses of 255 caregivers. Results: The factor analyses showed a six-factor structure (Reaction to diagnosis, Physical health, Psychological symptomatology (caretaker), Behavioral symptomatology (patient), Knowledge of the illness, and Level of dependence) explaining 66.52% of the total variance with a reliability of .75 to .93. Support was also found for its convergent validity. Conclusions: The IPSO-CA24 responds to the need for an instrument enabling multidimensional evaluation of the burden on the family caregiver without specialized training.     

Reciprocal Associations Between Depressive Symptoms and Disordered Eating Among Adolescent Girls and Boys: A Multiwave,Prospective Study

Symptoms of depression and eating disorders increase during adolescence, particularly among girls, and they tend to co-occur. Despite this evidence, there is meager research on whether depression increases the risk of future eating pathology, or vice versa, and we do not know whether these processes are different for adolescent girls and boys. Accordingly, this study explored the prospective reciprocal associations between depressive symptoms and disordered eating at different time points from preadolescence to mid-adolescence and tested the moderator effect of gender on these associations. A community-based sample of Spanish youth (N?=?942, 49 % female) was assessed at ages of approximately 10-11 (T1), 12-13 (T2), 14-15 (T3), and 16-17 (T4) years. The bidirectional relationships between depressive symptoms and disordered eating were estimated in an autoregressive cross-lagged model with latent variables. A unidirectional, age-specific association between depressive symptoms at T1 and disordered eating at T2 was found. No other significant cross-lagged effect emerged, but the stability of the constructs was considerable. Gender did not moderate any of the links examined. Regardless of gender, the transition from childhood to adolescence appears to be a key period when depressive symptoms foster the development of disordered eating. These findings suggest that early prevention and treatment of depression targeting both girls and boys may result in lower levels of depressive symptoms and disordered eating in adolescence.     

Effects of subchronic administration of gammahydroxybutyrate (GHB) on spatial working memory in rats

GHB, a popularly known drug as "liquid ecstasy", is a substance with abuse potential. Among the possible described side-effects after the continued consumption of GHB are amnesia and deterioration of memory. Likewise, recent studies indicate the existence of neurotoxicity in certain brain regions after its prolonged treatment. The aim of this study was to examine the effect of the subchronic administration of GHB (10 and 100 mg/kg) on spatial memory and sensoriomotor reflexes in male rats, using the Morris water maze and a battery of sensoriomotor tests, respectively. The results indicated that animals treated with GHB (10 mg/kg) showed a greater latency of escape during the phase of acquisition in the days first and third of tests, as compared with the control group (p<0.05), as well as a deterioration of grasping reflex with the two doses of GHB (p<0.01). Numerous studies indicated that the medial prefrontal cortex is a crucial neuronal substrate in the working memory and grasping reflex modulation. These results suggest that prolonged administration of GHB could alter structure and/or function of the medial prefrontal cortex, as well as its interconnections with other brain regions involved in the evaluated cognitive and neurological processes.     

Fragment difficulty in priming on word-completion tests

Word-fragment completion is a frequently used test in implicit memory research. In this test priming is the relevant variable. Priming is obtained by subtracting the proportion of nonstudied word fragments correctly completed (called "completion difficulty baseline") from the studied word fragments correctly completed. Since completion difficulty can spuriously vary greatly between experimental conditions, its effect on magnitude of priming is studied. Normative frequency of occurrence of target words was considered because their influence over performance is known. In an experiment using a word-fragment completion test, participants' completion of fragments at three levels of completion difficulty and two levels of frequency was tested. Analysis showed that completion difficulty had a significant effect on global priming. The priming magnitude was higher for Difficult and Moderately Difficult fragments than for Easy ones. An interaction between fragment difficulty and normative word frequency was observed. When the fragments were easy to complete, the expected effect of higher priming for low-frequency words than for high-frequency words was not observed.     

Optimization of sample size in controlled experiments: The CLAST rule

Sequential rules are explored in the context of null hypothesis significance testing. Several studies have demonstrated that the fixed-sample stopping rule, in which the sample size used by researchers is determined in advance, is less practical and less efficient than sequential stopping rules. It is proposed that a sequential stopping rule called CLAST (composite limited adaptive sequential test) is a superior variant of COAST (composite open adaptive sequential test), a sequential rule proposed by Frick (1998). Simulation studies are conducted to test the efficiency of the proposed rule in terms of sample size and power. Two statistical tests are used: the one-tailed t test of mean differences with two matched samples, and the chi-square independence test for twofold contingency tables. The results show that the CLAST rule is more efficient than the COAST rule and reflects more realistically the practice of experimental psychology researchers.