Parental risk factors and children entering out-of-home care: The effects of cumulative risk and parent’s sex

BackgroundParental difficulties, including mental ill health, substance misuse, domestic violence and learning disability have been associated with children entering out-of-home care. There is also evidence that these issues may co-occur within families. Understanding how the co-occurrence of these difficulties is associated with care entry is complex because they may co-occur in the same or different household members and have different impacts on the likelihood of care entry when they occur in mothers, fathers or in single parent households.MethodAdministrative data from local authority children’s services in Wales were linked with demographic data to identify households in which children lived prior to entering care. Linkage to birth data identified biological mothers. Linkage with primary care, emergency department, hospital admissions and substance misuse services data enabled indicators of substance misuse, mental health, assaults in the home, learning disability and neurodivergence in the adults in those households to be identified. A series of multilevel binary logistic regression models were used to explore the odds of a household having one or more children entering care if risk factors were present. These considered the effects of individual risks, and cumulative risk both in individual adults in the household, and across the whole household. The effects of the number of adults, having adults with no risks and the differential impacts of risks in biological mothers, other women or men were also explored. Additional models explored these factors in single adult households.ResultsCumulative risks increased the likelihood of care entry, however this effect disappeared when individual risks were controlled for. The presence of an individual with no risks in the household acted as a protective factor. Overall, the impact of the risks on the odds of care entry was substantially greater if the risks were present in the biological mother than if they occurred in other adults (men or women) in the household. In single adult households risk factors had a much greater impact when they occurred in households headed by women as opposed to men.ConclusionSubstantial differences in the effects of risk factors in female and male adults are apparent and further research is needed to understand why this is occurring to ensure that parents are treated equally in terms of support and statutory intervention regardless of their sex

Longitudinal and sex measurement invariance of the affective neuroscience personality scales

The Affective Neuroscience Personality Scales (ANPS) is a personality instrument based on six evolutionary-related brain systems that are at the foundation of human emotions and behaviors: SEEKING, CARING, PLAYFULNESS, FEAR, ANGER, and SADNESS. We sought to assess for the short and long versions of the ANPS: (a) the longitudinal measurement invariance and long-term (4-year) stability and (b) the sex measurement invariance. Using data from a Canadian cohort (N = 518), we used single-group confirmatory factor analysis to assess longitudinal invariance and multiple-group confirmatory factor analysis to assess sex invariance, according to a five-step approach evaluating five invariance levels (configural, metric, scalar, residual, and complete). Results supported full longitudinal invariance for both versions for all invariance levels. Partial residual invariance was supported for sex invariance. The long-term stability of both versions was good to excellent. Implications for personality assessment and ANPS development are discussed

Identifying affective personality profiles: A latent profile analysis of the Affective Neuroscience Personality Scales

Based on evolutionary theory, a recent model in affective neuroscience delineated six emotional brain systems at the core of human personality: SEEKING, CARING, PLAYFULNESS, FEAR, ANGER, SADNESS. The Affective Neuroscience Personality Scales (ANPS) assess their functioning. Using a person-centred approach of the ANPS, this study: (i) examined the existence of latent personality profiles, (ii) studied their gender invariance, (iii) assessed their longitudinal (4 years) stability, and (iv) explored how they relate to several intrapersonal, interpersonal, and emotion regulation skills. Latent Profile Analysis in 2 samples (Canadian, longitudinal, N = 520; French, cross-sectional, N = 830) found that, qualitatively, 3 profiles characterized both populations and genders, with one distinction for the second profile where the French women endorsed slightly higher and lower scores for, respectively, the negative and positive emotions. Whilst not being quantitatively similar across genders, the personality profiles remained consistent across time in the longitudinal sample. Associations between profiles and intrapersonal (e.g. depression), interpersonal (e.g. empathy), and emotion regulation skills measures (e.g. emotional intelligence) offered concurrent validity evidence. This person centred approach to ANPS offers a holistic and parsimonious way to study affective personality dimensions. It opens promising avenues for future studies on the predictive value of ANPS profiles, and for personality-targeted interventions

Harsh parenting practices mediate the association between parent affective profiles and child adjustment outcomes:Differential associations for mothers and fathers

Children’s early emotional environment strongly influences their later behavioural development. Yet, besides maternal depression, limited knowledge exists about the effect of other emotions and the role of fathers. Using 290 triads (mother/father/child), we investigated how positive (SEEKING, CARING, PLAYFULNESS) and negative (FEAR, ANGER, SADNESS) dimensions of mothers’ and fathers’ affectivity relate to their offspring’s externalizing and internalizing behaviours directly as well as indirectly via parenting practices. Parental variables were measured when children were 4 years old and children’s behaviours were measured at 8 years of age. Latent Profile Analysis identified three parental affective profiles: low negative emotions, balanced, and high emotional. Structural equation models showed that, for boys, mothers’ low negative emotions and high emotional profiles predicted later internalizing behaviours (direct effect; β = −0.21 and β = 0.23), while fathers’ low negative emotions profile predicted externalizing behaviours indirectly (β = −0.10). For girls, mothers’ profiles (low negative emotions and high emotional) predicted both internalizing (β = −0.04 and β = 0.07) and externalizing (β = −0.05 and β = 0.09) behaviours indirectly, but no effects of fathers’ profiles were found. Mothers’ and fathers’ affective profiles contributed to the behavioural development of their offspring in different ways, according to the type of behaviour (internalizing or externalizing) and the child’s sex. These findings may help in tailoring existing parenting interventions on affective profiles, thus enhancing their efficacy

Psychometric properties of the Mental Health and Social Inadaptation Assessment for Adolescents (MIA) in a population-based sample

We report on the psychometric properties of the Mental Health and Social Inadaptation Assessment for Adolescents (MIA), a self‐report instrument for quantifying the frequency of mental health and psychosocial adaptation problems using a dimensional approach and based on the DSM‐5. The instrument includes 113 questions, takes 20–25 minutes to answer, and covers the past 12 months. A population‐based cohort of adolescents (n = 1443, age = 15 years; 48% males) rated the frequency at which they experienced symptoms of Attention Deficit Hyperactivity Disorder (ADHD), Conduct Disorder, Oppositional Defiant Disorder, Depression, Generalized Anxiety, Social Phobia, Eating Disorders (i.e. DSM disorders), Self‐harm, Delinquency, Psychopathy as well as social adaptation problems (e.g. aggression). They also rated interference with functioning in four contexts (family, friends, school, daily life). Reliability analyses indicated good to excellent internal consistency for most scales (alpha = 0.70–0.97) except Psychopathy (alpha = 0.46). The hypothesized structure of the instrument showed acceptable fit according to confirmatory factor analysis (CFA) [Chi‐square (4155) = 9776.2, p = 0.000; Chi‐square/DF = 2.35; root mean square error of approximation (RMSEA) = 0.031; Comparative Fit Index (CFI) = 0.864], and good convergent and discriminant validity according to multitrait‐multimethods analysis. This initial study showed adequate internal validity and reliability of the MIA. Our findings open the way for further studies investigating other validity aspects, which are necessary before recommending the wide use of the MIA in research and clinical settings

Revue systématique des mesures de littératie en santé numérique pour les patients : résultats préliminaires

Introduction : L’utilisation de services numériques en santé (e-santé) a le potentiel d’améliorer la participation des patients aux soins et à l’autogestion des maladies chroniques. Dès lors, les professionnels de la santé doivent tenir compte de la littératie en santé numérique (LSN) des patients lorsqu’ils dispensent des soins à l’aide de technologies d’e-santé. L’objectif de cette revue est d’identifier les instruments de mesure auto-rapportés de la littératie en santé numérique disponibles dans la littérature et rassembler les informations concernant leurs propriétés psychométriques pour aider les chercheurs et cliniciens à choisir un instrument. Méthode : Une revue systématique de la littérature des instruments de mesure de la LSN a été réalisée en appliquant la méthodologie COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments). Résultats : Dix instruments ont été identifiés à partir de 41 articles provenant de quatre bases de données (PubMed, CINAHL, PsycInfo et Web of Science). Le plus utilisé, le eHEALS, instrument unidimensionnel, a été développé avant l’essor de l’e-santé. Quatre instruments, le HLSI, le e-Health Literacy Scale 2.0, le e-HLS et le eHEALS-E ont démontré une validité du contenu (pertinence, exhaustivité et compréhensibilité) inadéquate. Les cinq instruments multidimensionnels développés reflètent le concept de littératie en santé numérique de façon plus large, mais les preuves de leurs qualités psychométriques sont insuffisantes. Discussion et conclusion : Il est fortement recommandé de mettre à jour le contenu des instruments afin de refléter les aptitudes des patients à utiliser les services numériques pour leur santé. En outre, l’étude des qualités psychométriques des instruments utilisés doit être réalisée de façon systématique.Introduction : L’utilisation de services numériques en santé (e-santé) a le potentiel d’améliorer la participation des patients aux soins et à l’autogestion des maladies chroniques. Dès lors, les professionnels de la santé doivent tenir compte de la littératie en santé numérique (LSN) des patients lorsqu’ils dispensent des soins à l’aide de technologies d’e-santé. L’objectif de cette revue est d’identifier les instruments de mesure auto-rapportés de la littératie en santé numérique disponibles dans la littérature et rassembler les informations concernant leurs propriétés psychométriques pour aider les chercheurs et cliniciens à choisir un instrument. Méthode : Une revue systématique de la littérature des instruments de mesure de la LSN a été réalisée en appliquant la méthodologie COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments). Résultats : Dix instruments ont été identifiés à partir de 41 articles provenant de quatre bases de données (PubMed, CINAHL, PsycInfo et Web of Science). Le plus utilisé, le eHEALS, instrument unidimensionnel, a été développé avant l’essor de l’e-santé. Quatre instruments, le HLSI, le e-Health Literacy Scale 2.0, le e-HLS et le eHEALS-E ont démontré une validité du contenu (pertinence, exhaustivité et compréhensibilité) inadéquate. Les cinq instruments multidimensionnels développés reflètent le concept de littératie en santé numérique de façon plus large, mais les preuves de leurs qualités psychométriques sont insuffisantes. Discussion et conclusion : Il est fortement recommandé de mettre à jour le contenu des instruments afin de refléter les aptitudes des patients à utiliser les services numériques pour leur santé. En outre, l’étude des qualités psychométriques des instruments utilisés doit être réalisée de façon systématique

Test sur le terrain de la version préliminaire de l’instrument de littératie en santé numérique (Lisane) pour l’adulte vivant avec une maladie chronique

Introduction: The use of digital health devices (e-health) would improve certain patient’s clinical outcomes. Proposing effective “online” interventions to improve patients’ adaptation to chronic conditions requires a validated measure of digital health literacy. The “Lisane” self-report measure was developed and validated by experts. Objectives: This article describes the field-testing of the preliminary version of the tool, more specifically the non-response rate, ceiling and floor effects, item redundancy and the preliminary assessment of its internal consistency. Method: The Lisane tool, consisting of 14 items divided into five domains (e-literacy, reliability of information on the Internet, relevance of information to personal health, protection of privacy, empowerment), was applied to a convenience sample (29 participants) recruited in Quebec (patient communities) and Switzerland (clinical setting). The non-response rate and the ceiling and floor effects were evaluated. Item redundancy was described for exploratory purposes. Internal consistency was assessed using Cronbach's alpha coefficient.  Results: The rate of missing results > 15% and a redundancy (r = 0.94, p<0.05) on power to act’s items were noted. A floor effect was identified. Cronbach’s alpha was α= 0.90, 95% CI [0.78 – 1.03]. Discussion and Conclusion: The field test of the Lisane tool has limitations such as a ceiling effect and the indication of redundancy in certain items, but good preliminary evidence of internal consistency. Continued analysis of its psychometric properties (validity, reliability) is necessary. Introduction : L’utilisation des dispositifs numériques en santé améliorerait certains résultats cliniques. Proposer des interventions « en ligne » efficaces visant l’amélioration du processus d’adaptation des patients vivant avec une maladie chronique nécessite de disposer d’une mesure validée de la littératie en santé numérique. La mesure autorapportée « Lisane » a été construite et validée par des experts. Objectifs : Décrire le test sur le terrain de la version préliminaire de l’outil, plus spécifiquement le taux de non-réponse, les effets plafond et plancher, la redondance d’items et l’évaluation préliminaire de sa cohérence interne. Méthode : L’outil Lisane, composé de 14 items divisés en 5 domaines (e-littératie, fiabilité de l’information sur Internet, pertinence de l’information pour la santé personnelle, protection de la vie privée, pouvoir d’agir), a été appliqué auprès d’un échantillon de convenance (29 participants) recruté au Québec (communautés de patients) et en Suisse (milieu clinique). Le taux de non-réponse, les effets plafond et plancher ont été évalués. La redondance d’items a été décrite à titre exploratoire. La cohérence interne a été évaluée par le coefficient alpha de Cronbach. Résultats : Le taux de résultats manquants > 15% et une redondance (r = 0,94, p<0,05) des items du pouvoir d’agir ont été relevés. Un effet plancher a été identifié. L’alpha de Cronbach était de : α= 0,90, IC 95% [0.78 – 1.03]. Discussion et conclusion : Le test sur le terrain indique des limites dans l’outil comme un effet plancher et l’indication de redondance de certains items, mais une bonne évidence préliminaire de cohérence interne. La continuité d’analyse de ses propriétés psychométriques (validité, fidélité) s’avère nécessaire

Front Public Health

OBJECTIVE: To examine the relationship between young adults' labor force participation and depression in the context of the COVID-19 pandemic. DESIGN SETTING PARTICIPANTS: Data come from the nationally-representative EPICOV cohort study set up in France, and were collected in 2020 and 2021 (3 waves of online or telephone interviews: 02/05/2020-12/06/2020; 26/10/2020-14/12/2020; 24/06/2021-09/08/2021) among 2,217 participants aged 18-30 years. Participants with prior mental health disorder (n = 50) were excluded from the statistical analyses. RESULTS: Using Generalized Estimating Equation (GEE) models controlled for participants' socio-demographic and health characteristics and weighted to be nationally-representative, we found that compared to young adults who were employed, those who were studying or unemployed were significantly more likely to experience depression assessed using the PHQ-9 (multivariable ORs, respectively: OR: 1.29, 95% CI 1.05-1.60 and OR: 1.50, 1.13-1.99). Stratifying the analyses by age, we observed that unemployment was more strongly associated with depression among participants 25-30 years than among those who were 18-24 years (multivariable ORs, respectively, 1.78, 95% CI 1.17-2.71 and 1.41, 95% CI 0.96-2.09). Being out of the labor force was, to the contrary, more significantly associated with depression among participants 18-24 years (multivariable OR: 1.71, 95% CI 1.04-2.82, vs. 1.00, 95% CI 0.53-1.87 among participants 25-30 years). Stratifying the analyses by sex, we found no significant differences in the relationships between labor market characteristics and depression (compared to participants who were employed, multivariable ORs associated with being a student: men: 1.33, 95% CI 1.01-1.76; women: 1.19, 95% CI 0.85-1.67, multivariable ORs associated with being unemployed: men: 1.60, 95% CI 1.04-2.45; women: 1.47, 95% CI 1.01-2.15). CONCLUSIONS AND RELEVANCE: Our study shows that in addition to students, young adults who are unemployed also experience elevated levels of depression in the context of the COVID-19 pandemic. These two groups should be the focus of specific attention in terms of prevention and mental health treatment. Supporting employment could also be a propitious way of reducing the burden of the COVID-19 pandemic on the mental health of young adults.Connecting European Cohorts to Increase Common and Effective Response to SARS-CoV-2 Pandemic: ORCHESTR

Routine molecular profiling of cancer: results of a one-year nationwide program of the French Cooperative Thoracic Intergroup (IFCT) for advanced non-small cell lung cancer (NSCLC) patients.

International audienceBackground: The molecular profiling of patients with advanced non-small-cell lung cancer (NSCLC) for known oncogenic drivers is recommended during routine care. Nationally, however, the feasibility and effects on outcomes of this policy are unknown. We aimed to assess the characteristics, molecular profiles, and clinical outcomes of patients who were screened during a 1-year period by a nationwide programme funded by the French National Cancer Institute. Methods This study included patients with advanced NSCLC, who were routinely screened for EGFR mutations, ALK rearrangements, as well as HER2 (ERBB2), KRAS, BRAF, and PIK3CA mutations by 28 certified regional genetics centres in France. Patients were assessed consecutively during a 1-year period from April, 2012, to April, 2013. We measured the frequency of molecular alterations in the six routinely screened genes, the turnaround time in obtaining molecular results, and patients' clinical outcomes. This study is registered with ClinicalTrials.gov, number NCT01700582. Findings 18 679 molecular analyses of 17 664 patients with NSCLC were done (of patients with known data, median age was 64·5 years [range 18–98], 65% were men, 81% were smokers or former smokers, and 76% had adenocarcinoma). The median interval between the initiation of analysis and provision of the written report was 11 days (IQR 7–16). A genetic alteration was recorded in about 50% of the analyses; EGFR mutations were reported in 1947 (11%) of 17 706 analyses for which data were available, HER2 mutations in 98 (1%) of 11 723, KRAS mutations in 4894 (29%) of 17 001, BRAF mutations in 262 (2%) of 13 906, and PIK3CA mutations in 252 (2%) of 10 678; ALK rearrangements were reported in 388 (5%) of 8134 analyses. The median duration of follow-up at the time of analysis was 24·9 months (95% CI 24·8–25·0). The presence of a genetic alteration affected first-line treatment for 4176 (51%) of 8147 patients and was associated with a significant improvement in the proportion of patients achieving an overall response in first-line treatment (37% [95% CI 34·7–38·2] for presence of a genetic alteration vs 33% [29·5–35·6] for absence of a genetic alteration; p=0·03) and in second-line treatment (17% [15·0–18·8] vs 9% [6·7–11·9]; p<0·0001). Presence of a genetic alteration was also associated with improved first-line progression-free survival (10·0 months [95% CI 9·2–10·7] vs 7·1 months [6·1–7·9]; p<0·0001) and overall survival (16·5 months [15·0–18·3] vs 11·8 months [10·1–13·5]; p<0·0001) compared with absence of a genetic alteration. Interpretation Routine nationwide molecular profiling of patients with advanced NSCLC is feasible. The frequency of genetic alterations, acceptable turnaround times in obtaining analysis results, and the clinical advantage provided by detection of a genetic alteration suggest that this policy provides a clinical benefit