The sensitivity to change of the cluster headache quality of life scale assessed before and after deep brain stimulation of the ventral tegmental area

Background Cluster headache (CH) is a trigeminal autonomic cephalalgia (TAC) characterized by a highly disabling headache that negatively impacts quality of life and causes limitations in daily functioning as well as social functioning and family life. Since specific measures to assess the quality of life (QoL) in TACs are lacking, we recently developed and validated the cluster headache quality of life scale (CH-QoL). The sensitivity of CH-QoL to change after a medical intervention has not been evaluated yet. Methods This study aimed to test the sensitivity to change of the CH-QoL in CH. Specifically we aimed to (i) assess the sensitivity of CH-QoL to change before and following deep brain stimulation of the ventral tegmental area (VTA-DBS), (ii) evaluate the relationship of changes on CH-QoL with changes in other generic measures of quality of life, as well as indices of mood and pain. Ten consecutive CH patients completed the CH-QoL and underwent neuropsychological assessment before and after VTA-DBS. The patients were evaluated on headache frequency, severity, and load (HAL) as well as on tests of generic quality of life (Short Form-36 (SF-36)), mood (Beck Depression Inventory, Hospital Anxiety and Depression Rating Scale), and pain (McGill Pain Questionnaire, Headache Impact Test, Pain Behaviour Checklist). Results The CH-QoL total score was significantly reduced after compared to before VTA-DBS. Changes in the CH-QoL total score correlated significantly and negatively with changes in HAL, the SF-36, and positively and significantly with depression and the evaluative domain on the McGill Pain Questionnaire. Conclusions Our findings demonstrate that changes after VTA-DBS in CH-QoL total scores are associated with the reduction of frequency, duration, and severity of headache attacks after surgery. Moreover, post VTA-DBS improvement in CH-QoL scores is associated with an amelioration in quality of life assessed with generic measures, a reduction of depressive symptoms, and evaluative pain experience after VTA-DBS. These results support the sensitivity to change of the CH-QoL and further demonstrate the validity and applicability of CH-QoL as a disease specific measure of quality of life for CH.

Tradition-Specific Measures of Spiritual Well-Being

Spiritual well-being (SWB) is an often-overlooked aspect of a person’s overall well-being. Existing generic measures of SWB are not sufficiently specific to capture the principal ends and concerns of most particular religious communities; tradition-specific measures are needed. To that end, the authors provide conceptual background and develop a set of items for a measure of Christian SWB. Within the Christian religion, the measure is intended to be ecumenical in being broadly applicable across Catholic, Protestant, and Orthodox traditions. The chapter discusses ways in which such a measure might be of use both for research purposes and for religious communities themselves to advance their own ends. The authors discuss the possible development of other tradition-specific measures of SWB in the context of a pluralistic society. These measures may be of use in ensuring that research on religion and well-being is not only of academic interest, but also serves the ends of religious communities themselves.

Religious Authority in a Democratic Society: Clergy and Citizen Evidence from a New Measure

A persistent concern for democratic theorists is the degree to which religious authority trumps democratic authority. This is often assessed using generic measures of religiosity or religious beliefs ill-suited to the task. Moreover, while religion is linked to dogmatism and authoritarianism, this begs the question how much influence religion has independent of psychological dispositions. We attempt to add to these debates with a new measure of religious authority. We draw on data gathered from three samples—a sample of Christian clergy from 2014, a national sample of 1,000 Americans from Spring 2016, and a national sample of 1,010 Protestants from 2019. We examine the distribution of the religious authority measure and then compare its effects of the measure in the context of authoritarian child-rearing values, deliberative values, and democratic norms. The results indicate religious authority values represent a distinct measurement of how people connect to religion in politically salient ways.

Subsystems of transitive subshifts with linear complexity

We bound the number of distinct minimal subsystems of a given transitive subshift of linear complexity, continuing work of Ormes and Pavlov [On the complexity function for sequences which are not uniformly recurrent. Dynamical Systems and Random Processes (Contemporary Mathematics, 736). American Mathematical Society, Providence, RI, 2019, pp. 125--137]. We also bound the number of generic measures such a subshift can support based on its complexity function. Our measure-theoretic bounds generalize those of Boshernitzan [A unique ergodicity of minimal symbolic flows with linear block growth. J. Anal. Math.44(1) (1984), 77–96] and are closely related to those of Cyr and Kra [Counting generic measures for a subshift of linear growth. J. Eur. Math. Soc.21(2) (2019), 355–380].

The Measurement of Individual Differences in Cognitive Biases: A Review and Improvement

Individual differences have been neglected in decision-making research on heuristics and cognitive biases. Addressing that issue requires having reliable measures. The author first reviewed the research on the measurement of individual differences in cognitive biases. While reliable measures of a dozen biases are currently available, our review revealed that some measures require improvement and measures of other key biases are still lacking (e.g., confirmation bias). We then conducted empirical work showing that adjustments produced a significant improvement of some measures and that confirmation bias can be reliably measured. Overall, our review and findings highlight that the measurement of individual differences in cognitive biases is still in its infancy. In particular, we suggest that contextualized (in addition to generic) measures need to be improved or developed.

The Sensitivity to Change of the Cluster Headache Quality of Life Scale Assessed Before and After Deep Brain Stimulation of the Ventral Tegmental Area

Background: Cluster headache (CH) is a trigeminal autonomic cephalalgia (TAC) characterized by a highly disabling headache that negatively impacts quality of life and causes limitations in daily functioning as well as social functioning and family life. Since specific measures to assess the quality of life (QoL) in TACs are lacking, we recently developed and validated the cluster headache quality of life scale (CH-QoL). The sensitivity of CH-QoL to change after a medical intervention has not been evaluated yet.Methods: This study aimed to test the sensitivity to change of the CH-QoL in CH. Specifically our aim was to i) assess the sensitivity of CH-QoL to change before and following deep brain stimulation of the ventral tegmental area (VTA-DBS), ii) evaluate the relationship of changes on CH-QoL with changes in other generic measures of quality of life, as well as indices of mood and pain. Ten consecutive CH patients completed the CH-QoL and underwent neuropsychological assessment before and after VTA-DBS. The patients were evaluated on headache frequency, severity and load (HAL) as well as on tests of generic quality of life (Short Form-36 (SF-36)), mood (Beck Depression Inventory, Hospital Anxiety and Depression Rating Scale), and pain (McGill Pain Questionnaire, Headache Impact Test, Pain Behaviour Checklist). Results: The CH-QoL total score was significantly reduced after compared to before VTA-DBS. Changes in the CH-QoL total score correlated significantly and negatively with changes in HAL, the SF-36, and positively and significantly with depression and the evaluative domain on the McGill Pain Questionnaire.Conclusion: Our findings demonstrate that changes after VTA-DBS in CH-QoL total scores are associated with the reduction of frequency, duration, and severity of headache attacks after surgery. Moreover, post VTA-DBS improvement in CH-QoL scores are associated with an amelioration in quality of life assessed with generic measures, a reduction of depressive symptoms, and evaluative pain experience after VTA-DBS. These results support the sensitivity to change of the CH-QoL and further demonstrate the validity and applicability of CH-QoL as a disease specific measure of quality of life for CH.

Typical Ground States for Large Sets of Interactions

We discuss what ground states for generic interactions look like. We note that a recent result, due to Morris, implies that the behaviour of ground-state measures for generic interactions is similar to that of generic measures. In particular, it follows from his observation that they have singular spectrum and that they are weak mixing, but not mixing.

Development and validation of the disease-specific QOL-CD quality of life questionnaire for patients with Cushing’s disease

OBJECTIVECushing’s disease (CD) patients experience a range of debilitating symptoms that impair quality of life (QOL) as assessed using generic measures. These generic measures are inadequate to capture the disease-specific burden of illness. The development of the CD-specific QOL-CD measure of QOL using items generated by CD patients and healthcare professionals will provide a holistic assessment of patient outcomes and efficacy of novel therapies.METHODSA total of 96 CD patients participated. A list of 177 items (version 1.0) was generated by treated CD patients (n = 9), caregivers (n = 2), healthcare providers (n = 7), and results of a MEDLINE search. Item reduction was performed through content analysis and dual scaling. Patients’ rating of importance was incorporated to reduce to a final version of 56 items (version 3.0). Evidence for test-retest reliability was sought through administering the QOL-CD 1 week apart and Cronbach’s α of each subscale. Construct validity was assessed through extreme group analysis and comparison with the normal Canadian population. Concurrent validity was sought through comparison with the SF-36, Functional Assessment of Cancer Therapy–Brain (FACT-Br), and Karnofsky Performance Status (KPS). Perioperative testing was conducted on CD patients (n = 25) against nonfunctioning pituitary adenoma controls (n = 25) through pre- and postoperative testing.RESULTSA total of 96 CD patients (86 females and 10 males; mean age 45.23 ± 14.16 years) participated. The QOL-CD was feasible (mean completion time 15 minutes, with 70% believing accurate capture of QOL), reliable (CD 1 week apart: r = 0.86; control 1 week apart: r = 0.83; Cronbach’s α: general health = 0.73, emotional health = 0.85, physical health = 0.78, mental status = 0.82, social well-being = 0.63, medical treatment = 0.54), and valid (extreme group testing p < 0.001; SF-36 and QOL-CD general health: r = 0.56, social well-being: r = 0.21, emotional health: r = 0.61, total score: r = 0.58; FACT-Br and QOL-CD physical health: r = 0.47, social well-being: r = 0.21, emotional health: r = 0.34, total score: r = 0.68; KPS and QOL-CD general health: r = 0.32, total score: r = 0.14). Perioperative testing of CD patients (n = 25) demonstrated improvement in all subscales postoperatively, with a significant difference in emotional health (p < 0.001) and physical health (p < 0.001).CONCLUSIONSThe QOL-CD questionnaire has been developed for patients with CD and has demonstrated evidence for validity and reliability.