Personality: A potentially untapped resource in the selection of postgraduate pharmacy residents

Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose This study assessed whether personality testing of postgraduate year 1 (PGY1) pharmacy residency applicants was feasible and predicted important selection outcomes, including interview offers. Methods Applicants to the PGY1 pharmacy residency program at a large academic medical center were invited to complete a 50-item online personality test based on the 5-factor model (ie, the “Big Five”). Scores were sealed until after matching, at which point they were compared to screening, interview, and ranking and match outcomes. Endpoints of interest included the feasibility of the test (eg, time required for completion, completion rate) and whether personality predicted the odds of an interview offer. Results The personality test was taken by 137 PGY1 applicants (69.5%) and required a median of 6.8 minutes to complete. Openness to experience was associated with decreased odds of an interview offer (adjusted odds ratio [OR], 0.86; 95% confidence interval [CI], 0.75-0.98), whereas conscientiousness and extraversion were associated with increased odds of an interview offer (conscientiousness: adjusted OR, 1.26; 95% CI, 1.02-1.55; extraversion: OR, 1.16; 95% CI, 1.03-1.31). When combined with traditional screening criteria (eg, awards, leadership positions), openness to experience and extraversion remained predictors of an interview offer (in the directions specified above), whereas conscientiousness did not. In an exploratory analysis of interviewees, agreeableness was a negative predictor of interview score. Personality did not predict screening scores or final ranking. Conclusion Personality testing, based on the traits desired at individual residency programs, could be a valuable addition to the methods used for selecting PGY1 pharmacy residents.

Differential Relationships Between the Montreal Cognitive Assessment and Informant-Rated Cognitive Decline Among Mexican Americans and Non-Hispanic Whites

Objectives: We compared the concurrent validity of the Montreal Cognitive Assessment (MoCA) with other cognitive screening instruments among Mexican Americans (MA) and non-Hispanic whites (NHW). Methods: In a community-based study in Nueces county, Texas (5/2/18-2/26/20), participants 65+ with MoCA ≤25 completed the Harmonized Cognitive Assessment Protocol. Regressions examined associations between MoCA and: 1) Mini Mental State Examination (MMSE); 2) abbreviated Community Screening Interview for Dementia (CSI-D); 3) Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Results: MA (n = 229) and NHW (n = 81) differed by education but not age or sex. MoCA and cognitive performance associations (MMSE, CSI-D-Respondent) did not differ between MA and NHW (p’s > .16). MoCA and informant rating associations (IQCODE, CSI-D-Informant) were stronger in NHW than MA (NHW R2 = 0.39 and 0.38, respectively; MA R2 = 0.30 and 0.28, respectively). Discussion: Our findings suggest non-equivalence across cognitive screening instruments among MAs and NHWs.

Evaluation of the German biographic screening interview for fetal alcohol spectrum disorder (BSI-FASD)

Alcohol consumption during pregnancy may lead to permanent damage in the offspring, including fetal alcohol spectrum disorders (FASD), which have an estimated prevalence of 1–8% worldwide. In adulthood, diagnosing FASD is time-consuming and costly. This study aimed to evaluate the discriminatory power of a German screening instrument for FASD in adults—the biographic screening interview (BSI-FASD). In an open-label comparative cohort study wherein a one-time survey was administered per participant, we compared 22 subjects with confirmed FASD with control groups of 15 subjects diagnosed with attention deficit hyperactivity disorder (ADHD), 20 subjects with alcohol or opiate dependence, 18 subjects with depression, and 31 controls without prenatal alcohol exposure. The BSI-FASD was found to be resource-efficient, user-friendly, comprehensible, and easily applicable. It provided an overall good convergent and discriminant validity with a sensitivity of 0.77 (adapted 0.86) and specificities between 0.70 and 1.00. The BSI-FASD subdomains differed in their power to differentiate FASD from the groups. This study established that the BSI-FASD is an efficient instrument to screen adults with suspected FASD. The BSI-FASD may facilitate future diagnostic evaluation and thereby contribute to improved treatment of affected individuals.

Evaluating expectancies: Do community-recruited adults believe that cannabis is an effective stress reliever?

There is growing interest in using cannabis or specific cannabinoids (e.g., THC, CBD) as therapeutic agents for various stress-related psychiatric disorders (e.g., PTSD, anxiety). While beliefs about a drug, such as expecting to feel a certain way, have strong influences over the actual effects experienced by individuals, they are rarely evaluated in clinical research. In the present exploratory report, we sought to (1) evaluate the extent to which individuals believe that cannabis relieves stress, and (2) examine whether individual characteristics (i.e., age, sex, psychiatric illness, cannabis use frequency) are related to these beliefs. A sample of 234 adults (54.7% female; Mean age=31.37, SD=11.03, 19-69 years old) from the Halifax Regional Municipality community took part in a brief telephone screening interview to assess their eligibility for a larger study (in progress). Information was gathered about the frequency of current (i.e., past month) cannabis use (days per week), the presence of current psychiatric disorder(s) ("yes"/"no"), and the extent to which they believed that cannabis was an effective stress reliever (rating scale from 1 (“not at all”) to 10 (“extremely”)). Subjects reported a mean belief rating of 6.39 (SD=2.26). A multiple regression analysis was run to evaluate whether the belief that cannabis relieves stress was related to age, sex, psychiatric illness, and frequency of current cannabis use. Overall, the model significantly predicted cannabis belief ratings (p<.001, adjusted R2=.17). Among all variables, only frequency of cannabis use contributed significantly to this prediction (B=.544, 95% CI: [.387, .701], p<.001). In general, the present sample of community-recruited adults believed that cannabis was somewhat effective at relieving stress. Additionally, cannabis use frequency was the only variable that predicted the strength of this belief, such that more frequent use was associated with higher belief ratings. This is consistent with prior research indicating that heavier cannabis use is linked to positive cannabis expectancies. Given that stimulus expectancies influence substance-related responses, such findings would further the case for evaluating and controlling for these expectancies in clinical work with cannabis for stress-related conditions. Indeed, clinical cannabis research evaluating samples of heavy or frequent cannabis users may be subject to bias due to higher positive expectancies.

Smartphone-Based Virtual Agents to Help Individuals With Sleep Concerns During COVID-19 Confinement: Feasibility Study

Background The COVID-19 crisis and consequent confinement restrictions have caused significant psychosocial stress and reports of sleep complaints, which require early management, have increased during recent months. To help individuals concerned about their sleep, we developed a smartphone-based app called KANOPEE that allows users to interact with a virtual agent dedicated to autonomous screening and delivering digital behavioral interventions. Objective Our objective was to assess the feasibility of this app, in terms of inclusion rate, follow-up rate, perceived trust and acceptance of the virtual agent, and effects of the intervention program, in the context of COVID-19 confinement in France. Methods The virtual agent is an artificial intelligence program using decision tree architecture and interacting through natural body motion and natural voice. A total of 2069 users aged 18 years and above downloaded the free app during the study period (April 22 to May 5, 2020). These users first completed a screening interview based on the Insomnia Severity Index (ISI) conducted by the virtual agent. If the users were positive for insomnia complaints (ISI score >14), they were eligible to join the 2-stage intervention program: (1) complete an electronic sleep diary for 1 week and (2) follow personalized sleep recommendations for 10 days. We collected and analyzed the following measures: sociodemographic information, ISI scores and sleep/wake schedules, and acceptance and trust of the agent. Results Approximately 76% (1574/2069) of the app users completed the screening interview with the virtual agent. The virtual agent was well accepted by 27.4% (431/1574) of the users who answered the acceptance and trust questionnaires on its usability, satisfaction, benevolence, and credibility. Of the 773 screened users who reported sleep complaints (ISI score >14), 166 (21.5%) followed Step 1 of the intervention, and only 47 of those (28.3%) followed Step 2. Users who completed Step 1 found that their insomnia complaints (baseline mean ISI score 18.56, mean ISI score after Step 1 15.99; P<.001) and nocturnal sleep quality improved significantly after 1 week. Users who completed Step 2 also showed an improvement compared to the initial measures (baseline mean ISI score 18.87, mean ISI score after Step 2 14.68; P<.001). Users that were most severely affected (ISI score >21) did not respond to either intervention. Conclusions These preliminary results suggest that the KANOPEE app is a promising solution to screen populations for sleep complaints and that it provides acceptable and practical behavioral advice for individuals reporting moderately severe insomnia.

Favorite Activity Patterns Among Older Adults With and Without Dementia: Findings From the NHATS

Favorite activities are usually meaningful and valuable to older adults. However, information on favorite activity patterns and their relationship with cognitive function from large samples is still limited. Using Round 1 data from the National Health and Aging Trends Study, we examined favorite activity patterns among community-dwelling older adults with and without dementia (N=6,565). Based on the 8-item Ascertain Dementia (AD8) dementia screening interview, participants were classified into no dementia, possible dementia, and probable dementia. Favorite activity was assessed by asking participants, “What their favorite activity they are currently able to do?” Multinomial logistic regression models were used to examine the association between each of the top three favorite activities and the cognitive impairment categories, controlling for demographics and general health. The sample was on average, 77±7.45 years old, non-Hispanic White (69.8%), female (57.3%), and 35.0% had high school education. The three most popular favorite activities among probable dementia participants were watching TV, walking, and outdoor maintenance. Participants who liked watching TV most were more likely associated with possible dementia (Relative Risk Ratio [RRR] = 1.49, p=0.044) compared to participants without favorite activities. Participants who liked walking most were less associated with possible dementia (RRR=0.58, p=0.003) and probable dementia (RRR=0.39, p&lt;0.001) compared to those without favorite activities. Similarly, participants who liked outdoor maintenance most were less likely to develop possible dementia (RRR=0.48, p&lt;0.001) and probable dementia (RRR=0.27, p&lt;0.001) than participants without favorite activities. Researchers may use older adults’ “active” favorite activities to create tailored interventions to slow dementia progression.

De conflictscheiding als complexe gezinsproblematiek : Waarom screening op huiselijk geweld essentieel is1

High Conflict Divorce as a Complex Family Problem: Why Domestic Violence Screening is EssentialHigh Conflict Divorce form 20% of separations that involve children. These parents continue to litigate child custody and parenting arrangements, and accuse each other of child abuse, intimate partner violence, and mental health problems. The children suffer because of longstanding animosity. In this contribution, we report on a pilot study among 102 parents in a high conflict divorce, assessed at the Child Protection Council, Safe Home, or a child welfare service. The MASIC, a structured screening interview for intimate partner violence (IPV), was administered to each parent separately. Results revealed that the prevalence of different types of IPV was extremely high in our sample, and the violence kept occurring after the divorce, albeit somewhat less frequently. Our findings largely concur with international research in this area. In particular, the presence of coercive controlling violence perpetrated by one of the ex-partners, should prompt the professional to conduct further evaluation of parental and child safety. The type of IPV that emerges from the MASIC screening has implications for the advice to the parents and the family court.

Smartphone-Based Virtual Agents to Help Individuals With Sleep Concerns During COVID-19 Confinement: Feasibility Study (Preprint)

BACKGROUND The COVID-19 crisis and consequent confinement restrictions have caused significant psychosocial stress and reports of sleep complaints, which require early management, have increased during recent months. To help individuals concerned about their sleep, we developed a smartphone-based app called KANOPEE that allows users to interact with a virtual agent dedicated to autonomous screening and delivering digital behavioral interventions. OBJECTIVE Our objective was to assess the feasibility of this app, in terms of inclusion rate, follow-up rate, perceived trust and acceptance of the virtual agent, and effects of the intervention program, in the context of COVID-19 confinement in France. METHODS The virtual agent is an artificial intelligence program using decision tree architecture and interacting through natural body motion and natural voice. A total of 2069 users aged 18 years and above downloaded the free app during the study period (April 22 to May 5, 2020). These users first completed a screening interview based on the Insomnia Severity Index (ISI) conducted by the virtual agent. If the users were positive for insomnia complaints (ISI score &gt;14), they were eligible to join the 2-stage intervention program: (1) complete an electronic sleep diary for 1 week and (2) follow personalized sleep recommendations for 10 days. We collected and analyzed the following measures: sociodemographic information, ISI scores and sleep/wake schedules, and acceptance and trust of the agent. RESULTS Approximately 76% (1574/2069) of the app users completed the screening interview with the virtual agent. The virtual agent was well accepted by 27.4% (431/1574) of the users who answered the acceptance and trust questionnaires on its usability, satisfaction, benevolence, and credibility. Of the 773 screened users who reported sleep complaints (ISI score &gt;14), 166 (21.5%) followed Step 1 of the intervention, and only 47 of those (28.3%) followed Step 2. Users who completed Step 1 found that their insomnia complaints (baseline mean ISI score 18.56, mean ISI score after Step 1 15.99; <i>P</i>&lt;.001) and nocturnal sleep quality improved significantly after 1 week. Users who completed Step 2 also showed an improvement compared to the initial measures (baseline mean ISI score 18.87, mean ISI score after Step 2 14.68; <i>P</i>&lt;.001). Users that were most severely affected (ISI score &gt;21) did not respond to either intervention. CONCLUSIONS These preliminary results suggest that the KANOPEE app is a promising solution to screen populations for sleep complaints and that it provides acceptable and practical behavioral advice for individuals reporting moderately severe insomnia.

Incorporating an advance care planning screening tool into routine health assessments with older people

General practice is arguably the ideal setting to initiate advance care planning (ACP), but there are many barriers. This pilot study was designed to assess the feasibility, acceptability and perceived utility of a nurse-facilitated screening interview to initiate ACP with older patients in general practice. Patients were recruited from four general practices in Sydney, Australia. General practice nurses administered the ACP screening interview during routine health assessments. Patients and nurses completed a follow-up questionnaire consisting of questions with Likert responses, as well as open-ended questions. Descriptive statistics and content analysis were used to analyse the data. Twenty-four patients participated; 17 completed the follow-up questionnaire. All patients found the ACP screening interview useful and most felt it would encourage them to discuss their wishes further with their family and general practitioner. Several patients were prompted to consider legally appointing their preferred substitute decision-maker. All six participating nurses found the screening interview tool useful for initiating discussions about ACP and substitute decision-making. This nurse facilitated screening tool provides a simple, acceptable and feasible approach to introducing ACP to older general practice patients during routine health assessments.