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Early conversations about the end of life can contribute to patient-centered care at the end of life. Too often, however, these conversations do not take place or if they do, they are too late. The aim of this qualitative research was to identify the prerequisites, difficulties and usefulness of such conversations from the point of view of healthy older adults. The findings might be of use in primary health care to provide early and open end-of-life discussions.
The interviews stem from an experimental study concerning the readiness of end-of-life conversations with healthy adults. Six transcripts (2 male and 4 female participants, 65-78 years) were evaluated by using the thematic analysis by Braun and Clarke.
Conditions for the initiation of conversations were thematically separated into beliefs and attitudes, intrinsic motivation, experience, family communication and practical realization. Difficulties were found in the areas of cognitive barriers, practical realization, emotional barriers, relationalin the sense of preventive care in a low-threshold way. Providers of primary health care can identify a "need to talk", reduce communication barriers and encourage confrontation with one's own mortality. Adequate information should be provided if necessary, and a structured communication approach should be employed.
The aim of the study was to evaluate the psychometric properties of the 13-item Pathological Buying Screener (PBS, [1]) in a clinical sample.
The PBS was administered to a total sample of 413 treatment-seeking patients (buying-shopping disorder n=151, gambling disorder n=59, alcohol dependency n=60, other mental disorders [anxiety, depressive, eating, somatoform disorders] n=143). Factor structure was tested in the total sample using confirmatory factor analysis (CFA), reliability was determined by means of Cronbach's α. Group comparisons were used to determine to which degree the PBS discriminates between patients with BSD and other clinical groups. The BSD-group completed a battery of other measures to explore convergent and divergent validity. A subgroup (n=29) answered the PBS before and after psychotherapy to investigate sensitivity to change. A receiver operating characteristic (ROC) curve analysis with PBS data of patients with buying-shopping disorder and those from a previous community sample 1 was performed to define a cut-off point for buying-shopping disorder.
The CFA showed a good model fit for both a one-factor and a two-factor structure with the subscales "loss of control/consequences" (10 items) and "excessive buying behavior" (3 items). The subscales were highly intercorrelated (r=0.92). A hierarchical regression analysis with another BSD measure as dependent variable did not indicate an own incremental validity of the subscale "excessive buying behavior". Good convergent, divergent and discriminative capacity was obtained for the PBS total score. At its recommended cut-off point of ≥29 the PBS has a sensitivity of 98% and a specificity of 94.7%.
The findings indicate good psychometric properties of the PBS and suggest that the PBS total score can be used in clinical settings.
The findings indicate good psychometric properties of the PBS and suggest that the PBS total score can be used in clinical settings.
Social support is an important resource for coping with serious chronic diseases such as cancer. The available questionnaires for the measurement of social support are usually extensive. So far, available short versions do not completely aim at situation-specific requirements of the social environment of chronically ill patients. Therefore, a short form of a measure of perceived social support was developed consisting of only 4 items the SUCE-4.
A sample of cancer patients (N=424) was examined at 2 time points. The factor structure was evaluated using exploratory and confirmatory factor analysis (CFA) and reliability and validity were examined.
The expected factor structure was confirmed (for CFA RMSEA=0.028). The short questionnaire revealed a good internal consistency (Cronbach's α>0.86). In terms of the first indications of validity, significant and expected correlations with psychological quality of life, self-efficacy expectations, depression and anxiety were found at both time points.
The SUCE-4 is an economical, reliable and valid instrument for the assessment of perceived social support in the context of severe chronic diseases such as cancer.
The SUCE-4 is an economical, reliable and valid instrument for the assessment of perceived social support in the context of severe chronic diseases such as cancer.Our study compared the psychometric properties of two broad scope symptom questionnaires, the Brief Symptom Inventory [7] and the ICD-10 Symptom Rating Scale [8], in a naturalistic data set of 507 patients in outpatient psychotherapeutic treatment. Reliability of total scores and subscale scores were estimated via internal consistency coefficients Cronbach's α and McDonald's ω. Measurement precision was operationalized via the uncertainty interval. Validity of the total scores as measures of symptom load was operationalized via convergence analysis with measures similar and dissimilar to that concept. Validity of the internal structure of each scale was operationalized via confirmatory factor analysis of multiple models established in literature. Reliability and measurement precision were comparable for the two questionnaires. The convergent and discriminant validity of both instruments appear to be similarly sufficient. The ISR clearly showed good factorial validity, whereas the BSI was found to have poor factorial validity. Due to its uncertain factorial structure, interpretation of the BSI subscales is not advised. In sum, the ISR and BSI have comparable reliability and measurement precision, but ISR has superior validity and better time efficiency and therefore can be considered a valid alternative to the BSI.The changes of metabolite profiles in preterm birth have been demonstrated using newborn screening data. However, little is known about the holistic metabolic model in preterm neonates. The aim was to investigate the holistic metabolic model in preterm neonates. All metabolite values were obtained from a cohort data of routine newborn screening. A total of 261 758 newborns were recruited and randomly divided into a training subset and a testing subset. Using the training subset, 949 variates were considered to establish a logistic regression model for identifying preterm birth (32 weeks, it had a robust performance with nearly 95% accuracy in both subsets. In summary, we have established an excellent metabolic model in preterm neonates. CDK activation These findings could provide new insights for more efficient nutrient supplements and etiology of preterm birth.
Website: https://www.selleckchem.com/CDK.html
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