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Electric shortages and mental health in Maracaibo, Venezuela: A cross-sectional study
Journal of Community Psychology
Abstract
For the past 10 years, Venezuela has undergone a severe electric crisis. However, not all regions have been equally affected. The city of Maracaibo has endured more blackouts than other cities, and they have now become routine. This article sought to study the impact of electric shortages on the mental health of Maracaibo's inhabitants. Using a sample from all districts in the city, the study sought to test if there are correlations between the number of hours without electricity (per week), and four dimensions of mental health: anxiety, depression, poor sleep quality, and boredom. Results came out showing that there are moderate correlations across all four variables.
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Background:
Anxiety during pregnancy is one of the most common mental health problems and a significant risk factor for postpartum depression. The Generalized Anxiety Disorder-7 (GAD-7) is one of the most widely used self-report measures of anxiety symptoms available in multiple languages. This study evaluates the psychometric properties and underlying factor structures of the Spanish GAD-7 among pregnant women in Spain.
Method:
Spanish-speaking pregnant women (N = 385) were recruited from an urban obstetrics setting in Northern Spain. Women completed the GAD-7 and the anxiety subscale of the Symptom Checklist (SCL90-R) at three time points, once per trimester. The reliability, concurrent validity, and factor analyses were conducted to evaluate the psychometric properties and factor structure, respectively.
Results:
In the first trimester, the GAD-7 demonstrated good internal consistency (a = 0.89). GAD-7 is positively correlated with SCL90-R (anxiety subscale; r=0.75; p < 0.001). The proposed one-factor structure is found using exploratory factor analysis -FACTOR program - with Unweighted Least Squares procedure and optimal implementation of parallel analysis (GFI = 0.99).
Conclusions:
Health providers should screen for anxiety using the GAD-7 during pregnancy among urban Spanish-speaking samples to provide appropriate follow-up care.
OBJECTIVE: The seven-item Generalized Anxiety Disorder scale (GAD-7) is a practical self-report measure that screens for the severity of Generalized Anxiety Disorder in primary care. Previous studies have shown that the GAD-7 is theoretically sound, but the results regarding its psychometric properties have been somewhat inconsistent with both adult and student samples. Despite these findings, the psychometric properties of the GAD-7 have remained untested among Korean university students, for whom the identification of efficient measures of these constructs is especially important. To determine the psychometric properties of the GAD-7, the present study examined the internal consistency, convergent validity, and underlying factor structure of the GAD-7 with a sample of Korean university students.
METHODS: The sample consisted of 582 students attending a four-year university in South Korea. All participants completed the Korean version of the GAD-7, the Depression Anxiety, and Stress Scale–21 (DASS-21), and the Patient Health Questionnaire (PHQ-9). The factor structure of the GAD-7 was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and its convergent validity was determined by investigating its correlations with the DASS-21 and PHQ-9.
RESULTS: CFA procedures confirmed that a modified one-factor model was an acceptable solution. The internal consistency of the scale was excellent. The GAD-7 showed a moderate to strong correlation with the three subscales of the DASS-21 and with the PHQ-9, confirming convergent validity.
CONCLUSIONS: The findings indicate that the modified GAD-7 is a reliable and valid instrument for assessing generalized anxiety symptoms in university students. Its use for research and health care practice is warranted.
Objetivo: Evaluar la duración del sueño y fenotipos circadianos y su asociación con variables sociodemográficas y clínicas, de estilo de vida e indicadores de riesgo cardiometabólico en mujeres adultas. Materiales y métodos: Estudio transversal de 108 mujeres adultas residentes de la ciudad de Valencia, Venezuela atendidas en jornadas de salud. Se establecieron variables sociodemográficas, clínicas y estilo de vida, duración de sueño autoinformada durante la semana, fin de semana y ponderada (corta: < 7 h o larga: > 9 h) y fenotipo circadiano o cronotipo mediante la versión reducida del cuestionario de matutinidad de Horne y Östberg. Se midieron presión arterial, peso, talla, circunferencia de cintura y biomarcadores en sangre venosa. Se calcularon tres puntajes de estatus cardiometabólico. Se estableció hipertensión arterial (HTA) y síndrome metabólico (SM). Resultados: Se encontró duración corta de sueño ponderada en 21,3 % de las mujeres y duración larga ponderada en 16,7 %. El 28,7 % mostró cronotipo claramente matutino; 38 %, moderadamente matutino; 32,4 %, indefinido y 0,9 %, moderadamente vespertino, sin casos de cronotipo claramente vespertino. La duración corta de sueño y los cronotipos matutinos fueron más frecuentes en mujeres mayores de 40 años. La duración de sueño se asoció a estado civil, ocupación y condición de exfumadora; los cronotipos se asociaron a posmenopausia. La duración corta se asoció a obesidad abdominal e hipertensión arterial (HTA), elevación de gamma-glutamil transferasa y ácido úrico. La duración larga se asoció a glicemia y transaminasas más elevadas. El cronotipo claramente matutino se asoció a HTA, SM y número de componentes del SM presentes. La duración corta de sueño y el cronotipo claramente matutino predijeron elevado riesgo cardiometabólico, al ajustar por edad y posmenopausia esta asociación desapareció. Conclusiones: La duración subóptima del sueño y los fenotipos circadianos se asociaron a variables socio demográficas, clínicas y de riesgo cardiometabólico. La duración corta de sueño y el cronotipo claramente matutino predijeron elevado riesgo cardiometabólico.
We here consider the relationship between the individual time profile of crime victimisation and sleep quality. Sleep quality worsens with contemporaneous crime victimisation, with physical violence having a larger effect than property crime. But crime history also matters, and past victimisation experience continues to reduce current sleep quality. Last, there is some evidence that the order of victimisation spells plays a role: consecutive years of crime victimisation affect sleep quality more adversely than the same number of years when not contiguous.
Background
Semantic, technical, content, criterion and conceptual equivalence must be examined in order to validate a psychological rating scale in a new cultural setting. Few validation studies have been conducted in sub-Saharan Africa for scales seeking to detect depression in pregnant women. The aim of this study is to validate the 9-item Patient Health Questionnaire (PHQ-9) as a screening instrument for depression among Afaan Oromo speaking pregnant Ethiopian women.
Methods
A random sample of 246 pregnant women were recruited in Seka Chekorsa District, Ethiopia during their first, second or third trimester. One week later, 29 participants were selected to answer the questionnaire for a second time to evaluate test retest reliability. The Mini International Neuropsychiatric Interview (MINI-Plus) scale was used as a gold standard to evaluate validity. PHQ-9 was compared with MINI-Plus and sensitivity, specificity, accuracy, positive likelihood ratio, negative likelihood ratio and Receiver Operating Characteristic Curves (ROC) for PHQ-9 were calculated. Rasch analysis was also carried out using Winsteps version 3.81.0.
Results
The reliability coefficient, Cronbach's alpha, for the PHQ-9 total score was 0.84. Both the agreement and consistency Intra-class Correlation coefficients (ICC) for the one-week test-retest reliability were 0.98. The cut-off point of a summed score of eight resulted in a sensitivity of 80.8% and a specificity of 79.5%. The calculated area under the curve (AUC) for the PHQ-9 score versus the MINI-Plus was excellent, 0.88 (SE = 0.04; CI = 0.81–0.95). The PHQ-9 meets the criteria established by Linacre for rating scale effectiveness.
Conclusions
The PHQ-9 proved to be a reliable and valid instrument that may be used to screen major depressive disorders among Afaan Oromo speaking Ethiopian pregnant women.
Background:
Depressive disorders are frequently under diagnosed in resource-limited settings because of lack of access to mental health care or the inability of healthcare providers to recognize them. The Patient Health Questionnaire (PHQ)-2 and the PHQ-9 have been widely used for screening and diagnosis of depression in primary care settings; however, the validity of their use in rural, Spanish-speaking populations is unknown.
Method:
We used a cross-sectional design to assess the psychometric properties of the PHQ-9 for depression diagnosis and estimated the sensitivity and specificity of the PHQ-2 for depression screening. Data were collected from 223 adults in a rural community of Chiapas, Mexico, using the PHQ-2, the PHQ-9, and the World Health Organization Quality of Life BREF Scale (WHOQOL- BREF).
Results:
Confirmatory factor analysis suggested that the 1-factor structure fit reasonably well. The internal consistency of the PHQ-9 was good (Cronbach's alpha > = 0.8) overall and for subgroups defined by gender, literacy, and age. The PHQ-9 demonstrated good predictive validity: Participants with a PHQ-9 diagnosis of depression had lower quality of life scores on the overall WHOQOL-BREF Scale and each of its domains. Using the PHQ-9 results as a gold standard, the optimal PHQ-2 cutoff score for screening of depression was 3 (sensitivity 80.00%, specificity 86.88%, area under receiver operating characteristic curve = 0.89; 95% confidence interval [0.84, 0.94]).
Conclusion:
The PHQ-2 and PHQ-9 demonstrated good psychometric properties, suggesting their potential benefit as tools for depression screening and diagnosis in rural, Spanish-speaking populations.
The Multidimensional State Boredom Scale (MSBS) is a promising new self-report measure of state boredom. Two condensed versions of the scale have also been introduced. This study helped explore the psychometric qualities of these scales, using a large sample of Australian adults (N = 1,716), as well as two smaller samples (N = 199 and N = 422). Data analyses indicated strong convergent validity and very high internal consistency for the scales. Test–retest reliability over a 6- to 8-day period was moderately high. Confirmatory factor analyses of the MSBS authors’ suggested factor structure indicated good fit for this model. However, some of the data analyses raise questions as to whether the scale includes meaningful subfactors. Overall, the MSBS (and Short Form) is recommended for researchers who wish to assess state boredom.
Objectives:
This study describes findings of the impacts of Hurricane Sandy on environmental factors including power outages, air quality, water quality, and weather factors and how these affected mental health during the hurricane.
Methods:
An ecological study was conducted at the county level to describe changes in environmental factors-especially power outages-and their relationships to emergency department (ED) visits for mental health problems by use of a Poisson regression model.
Results:
We found that many environmental hazards occurred as co-exposures during Hurricane Sandy in addition to flooding. Mental health ED visits corresponded with the peak of maximum daily power blackouts, with a 3-day lag, and were positively associated with power blackouts in Bronx (prevalence ratio [PR]: 8.82, 95% confidence interval [CI]: 1.27-61.42) and Queens (PR: 2.47, 95% CI: 1.05-5.82) counties. A possible dose-response relationship was found between the quantile of maximum blackout percentage and the risk of mental health in the Bronx.
Conclusion:
We found that multiple co-environmental hazards occurred during Hurricane Sandy, especially power blackouts that mediated this disaster's impacts. The effects of power outage on mental health had large geographic variations and were substantial, especially in communities with low sociodemographic status. These findings may provide new insights for future disaster response and preparedness efforts. (Disaster Med Public Health Preparedness. 2016;page 1 of 6).
Most commonly used correlation coefficients are Pearson's product moment correlation coefficient and Spearman's rank correlation coefficient. The aim of this paper is to compare a Pearson’s and Spearman’s coefficient of correlation on the same data set. The winter wheat grain cadmium (Cd) concentration was correlated to grain zinc (Zn) concentration, plant height, plant weight, number of spikelets per spike and 1000 kernel weight. Data were collected from the experiment carried out in semi controlled conditions, where genotypic specificity of winter wheat varieties was tested on the grain Cd and Zn accumulation on uncontaminated and Cd contaminated soil. Results showed that selection of most convenient correlation coefficient mostly depends on the type of variables, presence of outliers normality and linearity of relationship.
A detailed review of the psychometric measures of boredom was published approximately 12 years ago (Vodanovich, 2003). Since that time, numerous studies have been conducted on existing scales, and new measures of boredom have been developed. Given these assessment advancements, an updated review of self-report boredom scales is warranted. The primary focus of the current review is research published since 2003, and it includes a total of 16 boredom scales. The measures reviewed consist of two trait assessments (Boredom Proneness Scale, Boredom Susceptibility subscale of the Sensation Seeking Scale), five context-specific trait boredom scales (Boredom Coping Scale, Leisure Boredom Scale, Free Time Boredom Scale, Sexual Boredom Scale, Relational Boredom Scale), three assessments of state boredom (Multidimensional State Boredom Scale, State Boredom Measure, Boredom Experience Scale), and six context-specific state boredom measures-Lee's Job Boredom Scale, Dutch Boredom Scale, Boredom Coping Scale (Academic), the Boredom subscale of the Achievement Emotions Questionnaire, Academic Boredom Scale, Precursors to Boredom Scale. In addition to providing a review of these measures, a brief critique of each scale is included, as well as suggestions for needed research focus.
Background
Boredom, which is a common problem in the general population, has been associated with several psychiatric disorders. The Multidimensional State Boredom Scale (MSBS) was developed, based on a theoretically and empirically grounded definition of boredom, to assess this construct. The aim of the present study was to assess the psychometric properties of the Spanish validated version of the MSBS in a multi-age sample recruited from the general population.
Methods
The patients (N = 303) were recruited from primary care settings. In addition to the sociodemographic variables and the MSBS, the General Health Questionnaire 28 items (GHQ-28), Positive and Negative Affect Scale (PANAS), Negative subscale and the Mindful Attention Awareness Scale (MAAS) were administered. We used confirmatory factor analysis (CFA) to analyse the dimensionality of the MSBS. Cronbach’s α coefficient was used to analyse the internal consistency of the scale. The consistency of the MSBS over time (test-retest reliability) was assessed using the intra-class correlation coefficient. The construct validity was examined by calculating Pearson’s r correlations between the MSBS with theoretically related and unrelated constructs. Cronbach’s α for MSBS was 0.89 (95 % CI, 0.87–0.92), ranging from 0.75 to 0.83 for the 5 subscales.
Results
The characteristics of the final sample (N = 303) were that the participants were primarily female (66.77 %) with a mean age of 49.32 years (SD, 11.46) and primarily European (94.71 %). The CFA of the MSBS confirmed that the original five-factor model showed good fit indices: CFI = .96; GFI = .94; SRMR = .05; and RMSEA = .06 [.05–.08]. Cronbach’s α for MSBS was 0.89 (95 % CI, 0.87–0.92), ranging from 0.75 to 0.83 for the 5 subscales. The MSBS showed a test-retest coefficient measured with an ICC of 0.90 (95 % CI, 0.88–0.92). The ICC for the 5 subscales ranged from 0.81 to 0.89. The MSBS showed a significant negative correlation with MAAS and a significant positive correlation with the GHQ (total score and subscales) and PANAS-Negative Affect.
Conclusions
The Spanish version of the MSBS has been validated as a reliable instrument for measuring boredom in the general population. This study will facilitate the assessment of boredom for clinical and research purposes in Spanish-speaking populations.
This review appraises the process of development and the measurement properties of the Pittsburgh sleep quality index (PSQI), gauging its potential as a screening tool for sleep dysfunction in non-clinical and clinical samples; it also compares non-clinical and clinical populations in terms of PSQI scores. MEDLINE, Embase, PsycINFO, and HAPI databases were searched. Critical appraisal of studies of measurement properties was performed using COSMIN. Of 37 reviewed studies, 22 examined construct validity, 19 - known-group validity, 15 - internal consistency, and three - test-retest reliability. Study quality ranged from poor to excellent, with the majority designated fair. Internal consistency, based on Cronbach's alpha, was good. Discrepancies were observed in factor analytic studies. In non-clinical and clinical samples with known differences in sleep quality, the PSQI global scores and all subscale scores, with the exception of sleep disturbance, differed significantly. The best evidence synthesis for the PSQI showed strong reliability and validity, and moderate structural validity in a variety of samples, suggesting the tool fulfills its intended utility. A taxonometric analysis can contribute to better understanding of sleep dysfunction as either a dichotomous or continuous construct.
Copyright © 2015 Elsevier Ltd. All rights reserved.
Fibromyalgia (FM) is recognized as a common condition, characterized by widespread pain and associated with sleep disturbances and poor-quality sleep. The Pittsburgh Sleep Questionnaire Index (PSQI) is one of the most recommended instruments to measure sleep quality and sleep disorders. The purpose of our study was to translate the questionnaire into Spanish and to assess the psychometric properties of the Spanish version of the PSQI. A total of 138 women with FM belonging to a FM association (AFIXA, Andalusia, Spain) completed the study. Internal consistency and test-retest reliability were analyzed. Factorial analysis was performed for the PSQI components. Convergent validity of the PSQI was evaluated using Spearman's rank correlation coefficient with the Spanish versions of the Fibromyalgia Impact Questionnaire (FIQ) and the health survey short form-36 (SF-36). In our analysis, the Spanish version of the PSQI has shown a good internal consistency of the total score, with a Cronbach's alpha of 0.805, and an acceptable test-retest reliability, with a Spearman's correlation coefficient of 0.773 (p < 0.001), for the total score. A two-factor structure was generated by exploratory factor analysis, with a Cronbach's alpha of 0.866 for factor 1 and of 0.712 for factor 2. In convergent validity analysis, the PSQI total score showed a significant correlation (p < 0.01) with the FIQ total score and with the mental and physical health summaries scores of the SF-36. Our results show that the Spanish version of the PSQI provides a reliable instrument, with a good convergent validity for measuring sleep quality among Spanish FM patients.
The increase in leisure time over the last century is well documented. We know much less, however, about the quality of the use of leisure time. Quite divergent predictions exist in this regard: Some authors have argued that the new, extensive free time will lead to new forms of time pressure and stress; others have foreseen an expansion of boredom. This is the first paper that systematically investigates the quality of leisure time in 36 countries around the world. It uses the 2007 ISSP-survey “Leisure Time and Sport”. We investigate stress and boredom during leisure time by making use of four general theories about international and intercultural differences. The theories relate to the level of socio-economic development, religious–cultural systems, types of welfare states, and to the emergence of specific “time regimes”. In addition, we control for the effect of relevant individual level variables. At the macro level, significant differences emerge concerning the level of development, the dominant religion, and the extent of welfare benefits. The most interesting finding, however, was that a typology of leisure time regimes is the most suited to explain the considerable differences between the 36 countries compared. Implications of this finding for time policy and further research are discussed in the concluding section.
The peripheral humidity detector/detection is not clear though there are
comprehensive reports of subjective perception. High relative humidity at
ambient temperatures above thermo-neutral zone has deleterious effect on sleep.
Humidity affects heat transfer rate by affecting evaporation and thereby
disturbing the Tc and Ts dynamics. The effect is discernible across a host of
sleep, body temperature, and microclimate indices. A number of hypotheses have
been proposed to explain the sleep structure regulation of which circadian–
homeostatic interaction model is the most accepted one. Humid heat may affect
sleep through homeostatic pathway possibly interfering with adenosine accumulation
in basal forebrain and thereby affecting non-rapid eye movement (NREM)
sleep switch point. It may also have a circadian element by interfering with
thermo-regulatory feedback loop and/or by affecting Ts change input to sleep
regulation.
Entropy, a concept derived from thermodynamics and information theory, describes the amount of uncertainty and disorder within a system. Self-organizing systems engage in a continual dialogue with the environment and must adapt themselves to changing circumstances to keep internal entropy at a manageable level. We propose the entropy model of uncertainty (EMU), an integrative theoretical framework that applies the idea of entropy to the human information system to understand uncertainty-related anxiety. Four major tenets of EMU are proposed: (a) Uncertainty poses a critical adaptive challenge for any organism, so individuals are motivated to keep it at a manageable level; (b) uncertainty emerges as a function of the conflict between competing perceptual and behavioral affordances; (c) adopting clear goals and belief structures helps to constrain the experience of uncertainty by reducing the spread of competing affordances; and (d) uncertainty is experienced subjectively as anxiety and is associated with activity in the anterior cingulate cortex and with heightened noradrenaline release. By placing the discussion of uncertainty management, a fundamental biological necessity, within the framework of information theory and self-organizing systems, our model helps to situate key psychological processes within a broader physical, conceptual, and evolutionary context.
This article describes the development and validation of the Multidimensional State Boredom Scale (MSBS)—the first and only full-scale measure of state boredom. It was developed based on a theoretically and empirically grounded definition of boredom. A five-factor structure of the scale (Disengagement, High Arousal, Low Arousal, Inattention, and Time Perception) was supported by exploratory factor analyses and confirmatory factor analyses of two independent samples. Furthermore, all subscales were significantly related to a single, second-order factor. The MSBS factor structure was shown to be invariant across gender. MSBS scores were significantly correlated with measures of trait boredom, depression, anxiety, anger, inattention, impulsivity, neuroticism, life satisfaction, and purpose in life. Finally, MSBS scores distinguished between participants who were experimentally manipulated into a state of boredom and those who were not, above and beyond measures of trait boredom, negative affect, and depression.
Reviewers of research reports frequently criticize the choice of statistical methods. While some of these criticisms are well-founded, frequently the use of various parametric methods such as analysis of variance, regression, correlation are faulted because: (a) the sample size is too small, (b) the data may not be normally distributed, or (c) The data are from Likert scales, which are ordinal, so parametric statistics cannot be used. In this paper, I dissect these arguments, and show that many studies, dating back to the 1930s consistently show that parametric statistics are robust with respect to violations of these assumptions. Hence, challenges like those above are unfounded, and parametric methods can be utilized without concern for "getting the wrong answer".
to estimate the prevalence of the most common sleep related symptoms (SRS) in the metropolitan areas of Mexico City, Montevideo (Uruguay), Santiago (Chile), and Caracas (Venezuela).
The study consisted of a multistage cluster sampling of adults aged > or = 40 years living in metropolitan areas. All participants completed a questionnaire on sleep related symptoms. Simplified respiratory polygraphy during sleep was conducted on 188 subjects from Mexico City. Obstructive sleep apnea syndrome was defined as Epworth Sleepiness Scale score > or = 11 and respiratory disturbance index (RDI) > or = 15 events/h; a cut-off of 15 was chosen because of its high sensitivity and specificity in association with the portable monitor used in the study.
The study included 4,533 subjects (1,062 in Mexico City, 941 in Montevideo, 1,173 in Santiago, and 1,357 in Caracas). Snoring was reported by 60.2% (95% CI 58.8% to 61.6%), excessive daytime sleepiness by 16.4% (15.3% to 17.5%), observed apneas by 12.3% (11.4% to 13.3%), insomnia by 34.7% (33.3% to 36%), sedative use by 15.1% (14.1% to 16.2%), daytime napping by 29.2% (27.7% to 30.6%), and a combination of snoring, sleepiness, and observed apneas by 3.4% (2.9% to 4%). Men had a higher frequency of snoring and daytime napping, whereas women reported more insomnia and sedative use. Prevalence of OSAS varied from 2.9% among subjects who denied snoring, excessive daytime sleepiness, and observed apneas, to 23.5% among those reporting these 3 symptoms.
A high prevalence of sleep related symptoms and undiagnosed obstructive sleep apnea in Latin America was observed.
El repunte de los trastornos de la salud mental de los estudiantes universitarios y sus consecuencias en el tiempo ha llamado poderosamente el interés del quehacer psicológico y psiquiátrico a nivel mundial, en donde los estados depresivos juegan un papel fundamental como causa y/o efecto en la evolución de los mismos. El artículo presenta un estudio tipo descriptivo, diseño de campo, corte transversal en una población de 1052 estudiantes cursantes del ciclo básico de la carrera, entre las etapas de adolescencia media y adultez temprana, mediante aplicación del Beck Depression Inventory (BID-1967). Cuyos resultados arrojaron: 47% de manifestación depresiva, con predominio al sexo femenino, distribución de su intensidad según: Leve 73.1%, moderada 18%, moderada/grave 7.3% y severa 1.6%, con tendencia estadísticamente significativa hacia los semestres iniciales de la carrera en Depresión leve/I semestre (X2=16.19, Co-Yt=15.07, P=0.0001); Depresión moderada/I semestre (X2=5.84, Co-Yt=4.80, P=0.01); Depresión leve/II semestre (X2=16.79, Co-Yt=15.25, P=0.0000). Se concluye la importancia de diseñar y aplicar un plan de intervención psicológica confines de salvaguardar la salud mental de los jóvenes universitarios.
Background:
Effective treatment requires regular follow-up and monitoring of symptoms. We investigated sensitivity to change and minimal clinically important difference of the Generalized Anxiety Disorder Scale (GAD-7).
Methods:
This study included all participants from a multisite trial of chronic depression. Baseline and follow-up (12 and 48 weeks) data were used to assess treatment response. Effect sizes (ES) and standardized response means (SRM) of pre- and post-GAD-7 mean changes were calculated for subgroups of patients, who did or did not improve according to ratings in the Hamilton Rating Scale for Depression (HRSD-24).
Results:
N = 261 patients were included in the analyses. In the subgroup of patients who improved according to HRSD-24, GAD-7 scores were significantly lower after 12 weeks (t = -6.31, df = 120, p < .001; ES = -0.51, SRM = -0.57), and 48 weeks of treatment (t = -12.68, df = 141, p < .001; ES = -1.0, SRM = -1.7), when compared to admission. In the group who worsened, GAD-7 scores were significantly higher after 12 weeks (t = 2.96, df = 41, p = .005; ES = 0.30, SRM = 0.46), and increased after 48 weeks (t = 1.99, df = 21, p = .059; ES = 0.37, SRM = 0.43), when compared to baseline. The unchanged group showed no significant difference between baseline and follow-up. MCID was estimated 4 points on the GAD-7 total score.
Limitations:
Confirmation of these findings and further investigation of the GAD-7 in populations and trials focusing on anxiety-specific treatment is highly recommended.
Conclusions:
Results show that the GAD-7 is sensitive to detect change in psychopathology over the course of treatment.
Widespread electrical power outages pose a serious risk to modern societies. During an outage, the behavioural and psychological responses of members of the public will influence the overall health, economic and social impacts. In this review, we identified 47 studies containing data relating to public reactions after a major loss of electricity. These highlighted eight key messages: 1) Preparing the public should reduce the impact of an outage; 2) Specific vulnerable groups including older adults and those with psychiatric or medical conditions will require targeted help to prepare; 3) Clear public health communications will be needed to reduce, for example, carbon monoxide or food poisoning; 4) The loss of communication infrastructure is likely to be an important stressor among the public; 5) Panic is unlikely; 6) Acts of altruism will, probably, outweigh acts of criminality; 7) The public's information needs will focus on ‘what has happened’ and ‘when will power be restored’;
This paper analyses the current political crisis in Venezuela after the proclamation of Juan Guaido as interim President in January 2019. The main argument here is that current crisis is the most recent chapter a long political crisis that began with rise to power of Hugo Chávez in 1999. A brief historical analysis of the previous chapters of the crisis is done as well an evaluation about the extent to which those previous events influence on current ones. The paper ends with an evalution of the possible scenarios of solution of the crisis and the role that Venezuelan domestic actors and international actors will play.
Objective:
Anxiety in cancer patients may represent a normal psychological reaction. To detect patients with pathological levels, appropriate screeners with established cut-offs are needed. Given that previous research is sparse, we investigated the diagnostic accuracy of two frequently used screening tools in detecting generalized anxiety disorder (GAD).
Methods:
We used data of a multi-center study including 2141 cancer patients. Diagnostic accuracy was investigated for the Generalized Anxiety Disorder Screener (GAD-7) and the anxiety module of the Hospital Anxiety and Depression Scale (HADS-A). GAD, assessed with the Composite International Diagnostic Interview for Oncology, served as a reference standard. Overall accuracy was measured with the area under the receiver operating characteristics curve (AUC). The AUC of the two screeners were statistically compared. We also calculated accuracy measures for selected cut-offs.
Results:
Diagnostic accuracy could be interpreted as adequate for both screeners, with an identical AUC of .81 (95 % CI: .79 - .82). Consequently, the two screeners did not differ in their performance (p = .86). The best balance between sensitivity and specificity was found for cut-offs ≥ 7 (GAD-7) and ≥ 8 (HADS-A). The officially recommended thresholds for the GAD-7 (≥ 10) and the HADS-A (≥11) showed low sensitivities of 55 % and 48 %, respectively.
Conclusions:
The GAD-7 and HADS-A showed AUC of adequate diagnostic accuracy and hence are applicable for GAD screening in cancer patients. Nevertheless, the choice of optimal cut-offs should be carefully evaluated.
In Zambia, privately-owned copper mines consume more than half of the electrical energy produced. By contrast, only 22% of private households are connected to the national grid. Against this background, the paper analyses energy distribution in Zambia’s Northwestern Province, where new copper mines have opened following the hike in copper prices during the 2000’s. Unlike rural families, residents in the three new urban centres in theory have access to electricity. Since 2015, however, the country suffers from an electricity crisis partly as a result of poor rainfalls in the 2014/2015 season. In a situation of undersupply, the mine keeps unlimited access to electricity which privileges its operations and the housing areas. Daily blackouts for the rest of the town entrench existing inequalities and produce new ones.
Based on long-term ethnographic research, the paper examines how electrical infrastructure and the possibility for forms of sociality relate both in the everyday and in the political discourse. I show how unequal electrical infrastructure contributes to the structuring of people into new social classes, and how, consequently, infrastructure is political from the start. By reflecting on the political and social consequences of unequal electricity supply, I provide preliminary thoughts on an energy distribution ethic.
This review appraises the process of development and the measurement properties of the Pittsburgh sleep quality index (PSQI), gauging it’s potential as a screening tool for sleep dysfunction in non-clinical and clinical populations; it also compares non-clinical and clinical populations in terms of PSQI scores. MEDLINE, EMBASE, PsycINFO, and HAPI databases were searched. Critical appraisal of measurement properties was performed using COSMIN. Of 37 reviewed studies, 22 examined construct validity, 19 - known-group validity, 15 - internal consistency, and three - test-retest reliability. Study quality ranged from poor to excellent, with the majority designated fair. Internal consistency, based on Cronbach’s alpha, was good. Discrepancies were observed in factor analytic studies. In non-clinical and clinical samples with known differences in sleep quality, the PSQI global scores and all subscale scores, with the exception of sleep disturbance, differed significantly. The best evidence synthesis for the PSQI showed strong reliability and validity, and moderate structural validity in a variety of samples, suggesting the tool fulfills its intended utility. A taxonometric analysis can contribute to better understanding of sleep dysfunction as either a dichotomous or continuous construct.
People in Pakistan are facing many problems due to load shedding which is a result of electricity shortages. This study investigated the consequences of electricity shortage on daily routines and overall performance of people in Pakistan. Data has been collected through video recorded interviews and written comment-based interviews using a social network of "Face Book" as suggested by QSR-International (2012). Sample includes students, housewives, professional workers and businessmen who are living in Pakistan. The study identified 22 different results of electricity shortage in daily routines of people in Pakistan. Sleeplessness, incompletion of tasks, use of alternative resources and inefficient learning have been found to be the more critical results of electricity shortage. Furthermore, these consequences of electricity shortage can be divided into social and psychological problems. It is concluded that the shortage of electricity has changed the lives of people in Pakistan irrespective of their professions.
Determining whether power outages have significant fertility effects is an important policy question in developing countries, where blackouts are common and modern forms of family planning are scarce. Using birth records from Zanzibar, this study shows that a month-long blackout in 2008 caused a significant increase in the number of births 8 to 10 months later. The increase was similar across villages that had electricity, regardless of the level of electrification; villages with no electricity connections saw no changes in birth numbers. The large fertility increase in communities with very low levels of electricity suggests that the outage affected the fertility of households not connected to the grid through some spillover effect. Whether the baby boom is likely to translate to a permanent increase in the population remains unclear, but this article highlights an important hidden consequence of power instability in developing countries. It also suggests that electricity imposes significant externality effects on rural populations that have little exposure to it.
Objective:
While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity.
Measurements:
The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients.
Results:
As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples.
Conclusion:
In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
OBJECTIVE: While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity.
MEASUREMENTS: The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as “0” (not at all) to “3” (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients.
RESULTS: As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score ≥10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples.
CONCLUSION: In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.
Emerging research suggests that perceptions of injustice after musculoskeletal injury can have a significant impact on a number of pain-related outcomes.
The purpose of this paper is to review evidence linking perceptions of injustice to adverse pain outcomes. For the purposes of this paper, perceived injustice is defined as an appraisal cognition comprising elements of the severity of loss consequent to injury ("Most people don't understand how severe my condition is"), blame ("I am suffering because of someone else's negligence"), a sense of unfairness ("It all seems so unfair"), and irreparability of loss ("My life will never be the same").
Cross-sectional studies show that high scores on perceptions of injustice are correlated with pain catastrophizing, fear of movement, and depression. Prospective studies show that high scores on perceived injustice are a prognostic indicator of poor rehabilitation outcomes and prolonged work disability. Research shows that perceptions of injustice interfere not only with physical recovery after injury, but perceptions of injustice also impact negatively on recovery of the mental health problems that might arise subsequent to traumatic injury. Although research has yet to address the process by which perceptions of injustice impact on pain-related outcomes systematically; possible mechanisms include attentional disengagement difficulties, emotional distress, maladaptive coping, heightened displays of pain behavior, anger, and revenge motives.
Perceived injustice appears to be associated with problematic health and mental health recovery trajectories after the onset of a pain condition. Future directions for research and treatment are addressed.
Intolerance of uncertainty (IU) - a dispositional characteristic resulting from negative beliefs about uncertainty and its implications - may be an important construct in anxiety disorders and depression. Despite the potential importance of IU, clinical data on the construct remains relatively scant and focused on generalized anxiety disorder and obsessive-compulsive disorder. The present study systematically investigated IU, as measured by the Intolerance of Uncertainty Scale-12 (IUS-12), across groups diagnosed with anxiety disorders (i.e., social anxiety disorder, panic disorder, generalized anxiety disorder, obsessive-compulsive disorder) or depression (clinical sample: n=376; 61% women), as well as undergraduate (n=428; 76% women) and community samples (n=571; 67% women). Analysis of variance revealed only one statistically significant difference in IUS-12 scores across diagnostic groups in the clinical sample; specifically, people with social anxiety disorder reported higher scores (p<.01; η(2)=.03) than people with panic disorder. People diagnosed with an anxiety disorder or depression reported significantly and substantially higher IUS-12 scores relative to community and undergraduate samples. Furthermore, IUS-12 score distributions were similar across diagnostic groups as demonstrated by Kernel density estimations, with the exception of panic disorder, which may have a relatively flat distribution of IU. Response patterns were invariant across diagnostic groups as demonstrated by multi-group confirmatory factor analyses, but varied between clinical and nonclinical samples. Overall, the findings suggest IU may serve as an important transdiagnostic feature across anxiety disorders and depression. In addition, robust support was found for the proposed 2-factor model of the IUS-12. Comprehensive findings, implications, and future research directions are discussed.
The Pittsburgh Sleep Quality Index (PSQI) measures sleep quality and disturbance retrospectively over a 1-month period using self-reports. Although the PSQI has been used in a variety of populations, published psychometric data are limited. The goal of this study was to examine psychometric properties of the PSQI among four populations: bone marrow transplant patients (n=155); renal transplant patients (n=56); women with breast cancer (n=102); and women with benign breast problems (n=159). Results supported PSQI internal consistency reliability and construct validity. Cronbach's alphas were 0.80 across groups and correlations between global and component scores were moderate to high. PSQI scores were moderately to highly correlated with measures of sleep quality and sleep problems, and poorly correlated with unrelated constructs. Individuals with sleep problems, poor sleep quality, and sleep restlessness had significantly higher PSQI scores in comparison to individuals without such problems.
The aim of this study was to assess the validity of the Patient Health Questionnaire depression module (PHQ-9). It has been subject to studies in medical settings, but its validity as a screening for depression in the general population is unknown.
A representative population sample (2,066 subjects, 14-93 years) filled in the PHQ-9 for diagnosis [major depressive disorder, other depressive disorder, depression screen-positive (DS+) and depression screen-negative (DS-)] and other measures for distress (GHQ-12), depression (Brief-BDI) and subjective health perception (EuroQOL; SF-36).
A prevalence rate of 9.2% of a current PHQ depressive disorder (major depression 3.8%, subthreshold other depressive disorder 5.4%) was identified. The two depression groups had higher Brief-BDI and GHQ-12 scores, and reported lower health status (EuroQOL) and health-related quality of life (SF-36) than did the DS- group (P's < .001). Strong associations between PHQ-9 depression severity and convergent variables were found (with BDI r = .73, with GHQ-12 r = .59).
The results support the construct validity of the PHQ depression scale, which seems to be a useful tool to recognize not only major depression but also subthreshold depressive disorder in the general population.
La salud mental en Venezuela a un año del inicio de la pandemia
- Acosta Y. J.
Depression in the 2013‐2017 period in Venezuela: A psychosocial approach
- Bernard J. E. R.
Effect of temperature and relative humidity on storage of eggs of Zulia colombiana Lallemand (Homoptera: Cercopidae) under laboratory conditions
- S. A. Chávez
- S. L. Lapointe
- J. I. Zuluaga
La guerra eléctrica de Maduro,Maduro, mentiras y verdades
- Martín A. G.
Effect of temperature and relative humidity on storage of eggs of Zulia colombiana Lallemand (Homoptera: Cercopidae) under laboratory conditions
- Chávez S. A.