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Cover page of Severity of Financial Toxicity for Patients Receiving Palliative Radiation Therapy

Severity of Financial Toxicity for Patients Receiving Palliative Radiation Therapy

(2024)

Introduction: Financial toxicity has negative implications for patient well-being and health outcomes. There is a gap in understanding financial toxicity for patients undergoing palliative radiotherapy (RT). Methods: A review of patients treated with palliative RT was conducted from January 2021 to December 2022. The FACIT-COST (COST) was measured (higher scores implying better financial well-being). Financial toxicity was graded according to previously suggested cutoffs: Grade 0 (score ≥26), Grade 1 (14-25), Grade 2 (1-13), and Grade 3 (0). FACIT-TS-G was used for treatment satisfaction, and EORTC QLQ-C30 was assessed for global health status and functional scales. Results: 53 patients were identified. Median COST was 25 (range 0-44), 49% had Grade 0 financial toxicity, 32% Grade 1, 15% Grade 2, and 4% Grade 3. Overall, cancer caused financial hardship among 45%. Higher COST was weakly associated with higher global health status/Quality of Life (QoL), physical functioning, role functioning, and cognitive functioning; moderately associated with higher social functioning; and strongly associated with improved emotional functioning. Higher income or Medicare or private coverage (rather than Medicaid) was associated with less financial toxicity, whereas an underrepresented minority background or a non-English language preference was associated with greater financial toxicity. A multivariate model found that higher area income (HR .80, P = .007) and higher cognitive functioning (HR .96, P = .01) were significantly associated with financial toxicity. Conclusions: Financial toxicity was seen in approximately half of patients receiving palliative RT. The highest risk groups were those with lower income and lower cognitive functioning. This study supports the measurement of financial toxicity by clinicians.

Cover page of Physiological and emotional assessment of college students using wearable and mobile devices during the 2020 COVID-19 lockdown: An intensive, longitudinal dataset

Physiological and emotional assessment of college students using wearable and mobile devices during the 2020 COVID-19 lockdown: An intensive, longitudinal dataset

(2024)

This dataset was collected from university students before, during, and after the COVID-19 lockdown in Southern California. Data collection happened continuously for the average of 7.8 months (SD=3.8, MIN=1.0, MAX=13.4) from a population of 21 students of which 12 have also completed an exit survey, and 7 started before the California COVID-19 lockdown order. This multimodal dataset included different means of data collection such as Samsung Galaxy Watch, Oura Ring, a Life-logger app named Personicle, a questionnaire mobile app named Personicle Questions, and periodical and personalised surveys. The dataset contains raw data from Photoplethysmogram (PPG), Inertial measurement unit (IMU), and pressure sensors in addition to processed data on heart rate, heart rate variability, sleep (bedtime, sleep stages, quality), and physical activity (step, active calories, type of activity). Ecological momentary assessments were collected from participants on daily and weekly bases containing their Positive and Negative Affect Schedule (PANAS) questionnaire and their emotional responses to COVID-19 and their health. Subjective data was also collected through monthly surveys containing standard mood and mental health surveys such as Beck Depression Inventory II (BDI-II), Brief Symptom Inventory (BSI), GAD-7, Inclusion of Other in the Self Scale (IOS-Partner), Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), Feasibility of Intervention Measure (FIM), Experiences in Close Relationships Scale Short Form (ECR-S), UCLA Three-Item Loneliness Scale (ULS), Multidimensional Scale of Perceived Social Support (MSPSS), Investment Model Scale (IMS), Conflict Management Scale (CMS), etc in addition to their response to important events and COVID-19. This dataset can be used to study emotions, mood, physical activity, and lifestyle of young adults through longitudinal subjective and objective measures. This dataset also contains valuable data regarding adjustment of lifestyle and emotions during the events of 2020 and 2021 including COVID-19 discovery and lockdown, Black Life Matter movement, 2020 US presidential elections, etc. On average, participants engaged in the EMA collection study at a rate of 86% (SD=10, MIN=65, MAX=99). Smartwatch usage saw an average participation rate of 51% (SD=20, MIN=16, MAX=88), while engagement with the Oura ring averaged at 85% (SD=12, MIN=60, MAX=99).

Cover page of Longitudinal Associations Between Support and Prosocial Behavior Across Adolescence: The Roles of Fathers, Mothers, Siblings, and Friends.

Longitudinal Associations Between Support and Prosocial Behavior Across Adolescence: The Roles of Fathers, Mothers, Siblings, and Friends.

(2024)

Family members and friends can play an important role in adolescents prosocial behavior. To better understand the relation between support and prosocial behavior in adolescence, its important to conduct longitudinal studies that distinguish between within-dyad variance and between-dyad variance. The current study investigated longitudinal associations between adolescents prosocial behavior, autonomy support, and emotional support from family and friends across adolescence. Across six annual years, 497 Dutch adolescents (284 boys; mean age T1 = 13.03 years, SDage = 0.46), fathers, mothers, siblings, and friends reported on their prosocial behavior. Adolescents also reported on perceived autonomy and emotional support. Between-dyads almost all associations of support and prosocial behavior of family members and friends with adolescents prosocial behavior were significant, with higher levels of adolescents prosocial behavior being associated with higher levels of prosocial behavior and support from fathers, mothers and friends. Within-dyads, several concurrent associations were significant, but within-dyads links between prosocial behavior and autonomy support are particularly driven by adolescent-mother or adolescent-sibling effects. This study highlights processes that occurred either at the between-dyad level or at the within-dyad level, but that varied per relationship type and that adolescents are the main catalysts in within-dyads changes in prosocial behavior and support. Preregistration: This study was preregistered on 20 January 2020 at https://osf.io/vxkm3/?view_only=dca87fd1585c444ba5cd5a00c22280ae .

Cover page of A cluster-randomized trial of water, sanitation, handwashing and nutritional interventions on stress and epigenetic programming.

A cluster-randomized trial of water, sanitation, handwashing and nutritional interventions on stress and epigenetic programming.

(2024)

A regulated stress response is essential for healthy child growth and development trajectories. We conducted a cluster-randomized trial in rural Bangladesh (funded by the Bill & Melinda Gates Foundation, ClinicalTrials.gov NCT01590095) to assess the effects of an integrated nutritional, water, sanitation, and handwashing intervention on child health. We previously reported on the primary outcomes of the trial, linear growth and caregiver-reported diarrhea. Here, we assessed additional prespecified outcomes: physiological stress response, oxidative stress, and DNA methylation (N = 759, ages 1-2 years). Eight neighboring pregnant women were grouped into a study cluster. Eight geographically adjacent clusters were block-randomized into the control or the combined nutrition, water, sanitation, and handwashing (N + WSH) intervention group (receiving nutritional counseling and lipid-based nutrient supplements, chlorinated drinking water, upgraded sanitation, and handwashing with soap). Participants and data collectors were not masked, but analyses were masked. There were 358 children (68 clusters) in the control group and 401 children (63 clusters) in the intervention group. We measured four F2-isoprostanes isomers (iPF(2α)-III; 2,3-dinor-iPF(2α)-III; iPF(2α)-VI; 8,12-iso-iPF(2α)-VI), salivary alpha-amylase and cortisol, and methylation of the glucocorticoid receptor (NR3C1) exon 1F promoter including the NGFI-A binding site. Compared with control, the N + WSH group had lower concentrations of F2-isoprostanes isomers (differences ranging from -0.16 to -0.19 log ng/mg of creatinine, P < 0.01), elevated post-stressor cortisol (0.24 log µg/dl; P < 0.01), higher cortisol residualized gain scores (0.06 µg/dl; P = 0.023), and decreased methylation of the NGFI-A binding site (-0.04; P = 0.037). The N + WSH intervention enhanced adaptive responses of the physiological stress system in early childhood.

Enhancing Epilepsy Awareness and Cooperative Care in Elementary and Middle Schools

(2024)

Epilepsy, a prevalent chronic neurological disorder, presents numerous challenges for people with epilepsy (PWEs) and their caregivers. They experience difficulties in receiving proper care and support due to stigma and misconceptions. Promoting public awareness in early education would be critical to reduce the stigma and to properly support them. We conducted 145 surveys and 21 interviews with teachers, school nurses, and parents of elementary and middle school students. While the participants exhibited slightly positive attitudes towards PWEs, we identified obstacles that hinder learning about epilepsy and seizure first aid: inadequate education and limited information sharing among school stakeholders. Moreover, there is a pressing need for age-appropriate education that considers the students' ages and perceptual levels. Considering the current limitations and needs, we propose potential implications for future information and communication technologies (ICTs) designs, including knowledge-sharing systems and an educational game aimed at enhancing epilepsy awareness and fostering collaborative care in elementary and middle school environments.

Cover page of Culturally adapting relational savoring: A therapeutic approach to improve relationship quality

Culturally adapting relational savoring: A therapeutic approach to improve relationship quality

(2024)

Relational savoring (RS) is a brief, strengths-based approach to heightening attentional focus to moments of positive connectedness within relationships. RS can be administered preventatively or within an intervention context when a therapist aspires to foster more optimal relational functioning. Typically administered within a one-on-one therapy setting, RS has demonstrated efficacy in enhancing intra- and interpersonal outcomes. To increase access to mental health services, the developers of RS are committed to engaging in an iterative approach of enhancing the cultural congruence and accessibility of this intervention within various cultural contexts, beginning with Latine groups in Southern California. In this article, we describe relational savoring and its theoretical and empirical support, including the process of culturally adapting the intervention within the context of three major studies, each with a distinct focus on Latine groups, a community that is underserved in mental health care settings. We then provide a vision for future research to improve upon the intervention's compatibility for Latine families and other populations.

Cover page of Heart rate and breathing effects on attention and memory (HeartBEAM): study protocol for a randomized controlled trial in older adults.

Heart rate and breathing effects on attention and memory (HeartBEAM): study protocol for a randomized controlled trial in older adults.

(2024)

BACKGROUND: In healthy people, the fight-or-flight sympathetic system is counterbalanced by the rest-and-digest parasympathetic system. As we grow older, the parasympathetic system declines as the sympathetic system becomes hyperactive. In our prior heart rate variability biofeedback and emotion regulation (HRV-ER) clinical trial, we found that increasing parasympathetic activity through daily practice of slow-paced breathing significantly decreased plasma amyloid-β (Aβ) in healthy younger and older adults. In healthy adults, higher plasma Aβ is associated with greater risk of Alzheimers disease (AD). Our primary goal of this trial is to reproduce and extend our initial findings regarding effects of slow-paced breathing on Aβ. Our secondary objectives are to examine the effects of daily slow-paced breathing on brain structure and the rate of learning. METHODS: Adults aged 50-70 have been randomized to practice one of two breathing protocols twice daily for 9 weeks: (1) slow-paced breathing condition involving daily cognitive training followed by slow-paced breathing designed to maximize heart rate oscillations or (2) random-paced breathing condition involving daily cognitive training followed by random-paced breathing to avoid increasing heart rate oscillations. The primary outcomes are plasma Aβ40 and Aβ42 levels and plasma Aβ42/40 ratio. The secondary outcomes are brain perivascular space volume, hippocampal volume, and learning rates measured by cognitive training performance. Other pre-registered outcomes include plasma pTau-181/tTau ratio and urine Aβ42. Recruitment began in January 2023. Interventions are ongoing and will be completed by the end of 2023. DISCUSSION: Our HRV-ER trial was groundbreaking in demonstrating that a behavioral intervention can reduce plasma Aβ levels relative to a randomized control group. We aim to reproduce these findings while testing effects on brain clearance pathways and cognition. TRIAL REGISTRATION: ClinicalTrials.gov NCT05602220. Registered on January 12, 2023.

Cover page of Online and offline effects of parietal 10 Hz repetitive transcranial magnetic stimulation on working memory in healthy controls.

Online and offline effects of parietal 10 Hz repetitive transcranial magnetic stimulation on working memory in healthy controls.

(2024)

Parietal alpha activity shows a specific pattern of phasic changes during working memory. It decreases during the encoding and recall phases but increases during the maintenance phase. This study tested whether online rTMS delivered to the parietal cortex during the maintenance phase of a working memory task would increase alpha activity and hence improve working memory. Then, 46 healthy volunteers were randomly assigned to two groups to receive 3-day parietal 10 Hz online rTMS (either real or sham, 3600 pulses in total) that were time-locked to the maintenance phase of a spatial span task (180 trials in total). Behavioral performance on another spatial span task and EEG signals during a change detection task were recorded on the day before the first rTMS (pretest) and the day after the last rTMS (posttest). We found that rTMS improved performance on both online and offline spatial span tasks. For the offline change detection task, rTMS enhanced alpha activity within the maintenance phase and improved interference control of working memory at both behavioral (K score) and neural (contralateral delay activity) levels. These results suggested that rTMS with alpha frequency time-locked to the maintenance phase is a promising way to boost working memory.

Cover page of Attachment-Based Mentalization Profiles of Iranian Children: A Mixed-Method Approach.

Attachment-Based Mentalization Profiles of Iranian Children: A Mixed-Method Approach.

(2024)

Mentalization, operationalized as reflective functioning (RF), is the ability to understand ones own and anothers mental world implicitly or explicitly. RF is a newly discovered research field in Iran and is largely under-studied in Eastern cultures in general, underscoring the high need for cross-cultural studies in this field of research. A qualitative method was used to examine the ability to understand, process, and respond to high-arousal attachment situations in typical and clinical populations of Iranian children recruited from a Tehran primary school. A well-known semi-structured interview commonly used to assess RF in children was used to collect data. Required information on internalizing and externalizing symptoms, demographic information, and all formal diagnoses of children were collected by parents. The results indicated the identification of four different profiles of RF in children, one of which was adaptive, while the other three were maladaptive. Also, the results showed that typically developing children and those having a high social and economic status (SES) were characterized as having a more adaptive profile of RF, while children from the clinical population and those with a low SES reported a more maladaptive profile (passive mentalizing, helpless mentalizing, narcissistic mentalizing) of RF. The present study is an important step in increasing our understanding of the development of mentalization in children and has significant educational and clinical implications.