Opinions of Cancer Patients, Their Relatives, and Nurses on Good Death

The study sample consists of participants as the patient, patient relatives, and nurse. In our study, a significant relationship was found between the ages of patients, and fear of death, avoidance of death, accepting approach, non-acceptance, and the DAP-R scale total score. A positive moderate correlation was found between the fear of death and death avoidance among my nurses who participated in the study. The nurse, the patient, and patient relatives had a good perception of death and had a higher attitude toward death. Additionally, that found to nurses’ fear of death and death avoidance behavior are higher than patients and their relatives.

A double-blind, placebo-controlled, randomized trial of PXT3003 for the treatment of Charcot–Marie–Tooth type 1A

Background Charcot–Marie–Tooth disease type 1A (CMT1A) is a rare, orphan, hereditary neuromuscular disorder with no cure and for which only symptomatic treatment is currently available. A previous phase 2 trial has shown preliminary evidence of efficacy for PXT3003 in treating CMT1A. This phase 3, international, randomized, double-blind, placebo-controlled study further investigated the efficacy and safety of high- or low-dose PXT3003 (baclofen/naltrexone/D-sorbitol [mg]: 6/0.70/210 or 3/0.35/105) in treating subjects with mild to moderate CMT1A. Methods In this study, 323 subjects with mild-to-moderate CMT1A were randomly assigned in a 1:1:1 ratio to receive 5 mL of high- or low-dose PXT3003, or placebo, orally twice daily for up to 15 months. Efficacy was assessed using the change in Overall Neuropathy Limitations Scale total score from baseline to months 12 and 15 (primary endpoint). Secondary endpoints included the 10-m walk test and other assessments. The high-dose group was discontinued early due to unexpected crystal formation in the high-dose formulation, which resulted in an unanticipated high discontinuation rate, overall and especially in the high-dose group. The statistical analysis plan was adapted to account for the large amount of missing data before database lock, and a modified full analysis set was used in the main analyses. Two sensitivity analyses were performed to check the interpretation based on the use of the modified full analysis set. Results High-dose PXT3003 demonstrated significant improvement in the Overall Neuropathy Limitations Scale total score vs placebo (mean difference: − 0.37 points; 97.5% CI [− 0.68 to − 0.06]; p = 0.008), and consistent treatment effects were shown in the sensitivity analyses. Both PXT3003 doses were safe and well-tolerated. Conclusion The high-dose group demonstrated a statistically significant improvement in the primary endpoint and a good safety profile. Overall, high-dose PXT3003 is a promising treatment option for patients with Charcot–Marie–Tooth disease type 1A.

Validity of the Severity of Dependence Scale for detecting dependence behaviours in chronic migraine with medication overuse

Aims In this study, we tested the validity of the Severity of Dependence Scale in detecting dependence behaviours in patients with chronic migraine and medication overuse (CM + MO) using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the Leeds Dependence Questionnaire as gold standard measures. Methods Four hundred and fifty-four patients with CM + MO filled in the Severity of Dependence Scale and the Leeds Dependence Questionnaire and underwent a psychological evaluation for the diagnosis of substance dependence according to the DSM-IV criteria. Results Sixty-nine percent of subjects (n = 313) presented substance dependence according to the DSM-IV criteria. These patients scored significantly higher than those without substance dependence in Severity of Dependence Scale total score ( Z = −3.29, p = 0.001), and in items 1 ( Z = −2.44, p = 0.015), 2 ( Z = −2.50, p = 0.012), 4 ( Z = −2.05, p = 0.04), and 5 ( Z = −3.39, p = 0.001). Severity of Dependence Scale total score ( β = 0.13, SE = 0.04, z = 3.49, p < 0.001) was a significant predictor for substance dependence. Receiver Operating Characteristic (ROC) curves showed that Severity of Dependence Scale discriminated patients with or without substance dependence. Conclusion Severity of Dependence Scale could represent an interesting screening tool for dependency-like behaviors in CM + MO patients.

Determining the Homophobia Level of Individuals in Different Countries: A Case Study of Community in Turkey, Nigeria, Pakistan, India, Bangladesh and Nepal

Objective: To determine the homophobia level of ındividuals in different countries. Material and methods: A descriptive cross-sectional study among 518 individuals of ages 18 years and above living in Turkey (Agri), Nigeria (Ibadan), Pakistan (Charsadda), India (Punjab), Bangladesh (Chittagong) and Nepal (Kathmandu). Using google form they completed a demographic characteristics form and Hudson and Ricketts Homophobia Scale Results: The homophobia scale total score mean was 92.97 ± 27.47. The total score means the homophobia scale was statistically significantly higher among Nigeria nationality, religious belief Christian, male, health personnel and those who do not have a homosexual acquaintance (p <0.05). A statistically significant relationship was also found between homophobia scale total score mean and age (p <0.05). Conclusion: Nationality, religion, gender, occupation, age and whether or not one has homosexual acquaintances are key demographic correlates of homophobia level. However, the study recommends that further investigation should be conducted with a larger group for a proper inference of causation to be drawn.

Clinical Utility of Wearable Sensors and Patient-Reported Surveys in Patients With Schizophrenia: Noninterventional, Observational Study

Background Relapse in schizophrenia may be preceded by early warning signs of biological, sensory, and clinical status. Early detection of warning signs may facilitate intervention and prevent relapses. Objective This study aims to investigate the feasibility of using wearable devices and self-reported technologies to identify symptom exacerbation correlates and relapse in patients with schizophrenia. Methods In this observational study, patients with schizophrenia were provided with remote sensing devices to continuously monitor activity (Garmin vivofit) and sleep (Philips Actiwatch), and smartphones were used to record patient-reported outcomes. Clinical assessments of symptoms (Positive and Negative Syndrome Scale and Brief Psychiatric Rating Scale) were performed biweekly, and other clinical scales on symptoms (Clinical Global Impression-Schizophrenia, Calgary Depression Scale), psychosocial functioning, physical activity (Yale Physical Activity Survey), and sleep (Pittsburgh Sleep Quality Index) were assessed every 4 weeks. Patients were observed for 4 months, and correlations between clinical assessments and aggregated device metrics data were assessed using a mixed-effect model. An elastic net model was used to predict the clinical symptoms based on the device features. Results Of the 40 patients enrolled, 1 patient relapsed after being stable with evaluable postbaseline data. Weekly patient-reported outcomes were moderately correlated with psychiatric symptoms (Brief Psychiatric Rating Scale total score, r=0.29; Calgary Depression Scale total score, r=0.37; and Positive and Negative Syndrome Scale total score, r=0.3). In the elastic net model, sleep and activity features derived from Philips Actigraph and Garmin vivofit were predictive of the sitting index of the Yale Physical Activity Survey and sleep duration component of the Pittsburgh Sleep Quality Index. On the basis of the combined patient data, a high percentage of data coverage and compliance (>80%) was observed for each device. Conclusions This study demonstrated that wearable devices and smartphones could be effectively deployed and potentially used to monitor patients with schizophrenia. Furthermore, metrics-based prediction models can assist in detecting earlier signs of symptom changes. The operational learnings from this study may provide insights to conduct future studies. Trial Registration ClinicalTrials.gov NCT02224430; https://www.clinicaltrials.gov/ct2/show/NCT02224430

Losing the Self in Near-Death Experiences: The Experience of Ego-Dissolution

Many people who have had a near-death experience (NDE) describe, as part of it, a disturbed sense of having a “distinct self”. However, no empirical studies have been conducted to explore the frequency or intensity of these effects. We surveyed 100 NDE experiencers (Near-Death-Experience Content [NDE-C] scale total score ≥27/80). Eighty participants had their NDEs in life-threatening situations and 20 had theirs not related to life-threatening situations. Participants completed the Ego-Dissolution Inventory (EDI) and the Ego-Inflation Inventory (EII) to assess the experience of ego dissolution and inflation potentially experienced during their NDE, respectively. They also completed the Nature-Relatedness Scale (NR-6) which measures the trait-like construct of one’s self-identification with nature. Based on prior hypotheses, ratings of specific NDE-C items pertaining to out-of-body experiences and a sense of unity were used for correlational analyses. We found higher EDI total scores compared with EII total scores in our sample. Total scores of the NDE-C scale were positively correlated with EDI total scores and, although less strongly, the EII and NR-6 scores. EDI total scores were also positively correlated with the intensity of OBE and a sense of unity. This study suggests that the experience of dissolved ego-boundaries is a common feature of NDEs.

The Association of Oral Stimulant Medication Adherence with Work Productivity among Adults with ADHD

Objective: Examine associations between oral psychostimulant pharmacotherapy adherence, work productivity, and related indirect costs among US adults with ADHD. Methods: Medication adherence (Medication Adherence Reasons Scale [MAR-Scale]), work productivity and activity impairment (Work Productivity and Activity Impairment–General Health questionnaire), and ADHD symptom level (Adult ADHD Self-Report Scale version 1.1 Symptom Checklist) were assessed in this noninterventional online survey of adults who self-reported having an ADHD diagnosis and were currently receiving oral psychostimulant treatment for ≥3 months. Results: Of 602 respondents, 395 had low/medium adherence (LMA: MAR-Scale total score ≥1) and 207 had high adherence (HA: MAR-Scale total score 0). After adjusting for covariates, the LMA group had significantly greater levels of absenteeism, absenteeism-related indirect costs, and total indirect costs (all p < .01) than the HA group. Conclusion: In adults with ADHD using oral psychostimulants, lower medication adherence was associated with greater absenteeism and indirect costs.

Identifying Healthcare Professionals' Fear of COVID-19 and Their Attitudes towards Being Vaccinated

Objective: This study was conducted to determine healthcare professionals’ fear of COVID-19 in and their attitudes towards being vaccinated against COVID-19. Method: The sample of this descriptive study was composed of 302 healthcare professionals working in a university research and training hospital. The data were collected with the help of an online survey method created with the help of Google Forms using the “Form for Determining Healthcare Professionals’ Attitudes towards Being Vaccinated” and “The Fear of COVID-19 Scale” between December 28, 2020 and January 13, 2021. Results: The mean total Fear of COVID-19 Scale score of the healthcare professionals participating in the study was found to be 17.20 ± 6.015. A significant relationship was found between the Fear of COVID-19 Scale total score and participating healthcare professionals’ gender, status of education, status of flu vaccination and status of being diagnosed with COVID-19 (p <0.005). Conclusion: According to research results, it was found that healthcare professionals experienced moderate fear, almost half of them were undecided about the COVID-19 vaccine, their thoughts about vaccination were positive and they were mostly concerned about the side effects of the vaccine.

Portuguese validation of the Adult Separation Anxiety—Questionnaire (ASA-27)

Adult separation anxiety disorder (ASAD) is characterized by developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached. Despite the high rates of this diagnosis among Portuguese adults, there is a lack of measures to assess it. In this study, we assessed the psychometric properties of a Portuguese adaptation of the Adult Separation Anxiety questionnaire (ASA-27) on a sample of 267 adults (72.7% women) aged 18–80 years (M = 40.5, SD = 13.1). Factor structure, internal consistency, and convergence validity were examined. This study confirmed the single-factor structure of the Portuguese version of ASA-27. Consistency was high for the total sample (ω = .92) and by gender (ω = .93 and 92, men and women groups, respectively). The scale was positively related to the Portuguese version of State-Trait Anxiety Inventory (STAI) (r = .57, p< .001, for both State and trait anxiety scales) and Composite Codependency Scale total score (r = .29, p< .001). In addition, the ASA-27 total score showed incremental validity in the explanation of anxiety measured by STAI. In conclusion, results show that the Portuguese version of the ASA-27 is a reliable and valid measure of ASAD.