Effects of Sex and Gender on Adaptation to Space: Musculoskeletal Health

There is considerable variability among individuals in musculoskeletal response to long-duration spaceflight. The specific origin of the individual variability is unknown but is almost certainly influenced by the details of other mission conditions such as individual differences in exercise countermeasures, particularly intensity of exercise, dietary intake, medication use, stress, sleep, psychological profiles, and actual mission task demands. In addition to variations in mission conditions, genetic differences may account for some aspect of individual variability. Generally, this individual variability exceeds the variability between sexes that adds to the complexity of understanding sex differences alone. Research specifically related to sex differences of the musculoskeletal system during unloading is presented and discussed

What do they tell us about drinking cultures in European countries?

Aim: A drinking pattern is not only a major drinking variable, but is also one indicator of a country’s drinking culture. In the present study, we examine drinking patterns within and across the neighbouring countries of Denmark and Germany. The aim of the research is to determine to what extent drinking patterns differ or are shared at the sub-national level in the two countries. Method: Data came from the German 2012 Epidemiological Survey of Substance Use (n = 9084) 18–64 years (response rate 54%), and the Centre for Alcohol and Drug Research’s 2011 Danish national survey (n = 5133) 15–79 years (response rate 64%), which was reduced to a common age range, producing a final n = 4016. The drinking pattern variable included abstention, moderate drinking, heavy drinking, risky single occasion drinking (RSOD), and was investigated with bivariate statistics and gender-specific hierarchical cluster analysis. Results: For men three clusters emerged: one highlighting abstention and RSOD, moderate/heavy drinking, RSOD and RSOD + heavy drinking. For women, two clusters appeared: one highlighting abstention and moderate/heavy drinking and the other highlighting RSOD and RSDO + heavy drinking. The clusters revealed different geographical patterning: for men, a west vs. east divide; for women, a north–south gradient. Conclusions: The analysis could identify for each gender clusters representing both separate and shared drinking patterns as well as distinctive geographical placements. This new knowledge can contribute to a new understanding of the dynamics of drinking cultures and could indicate new approaches to prevention efforts and policy initiatives

Validation of the Korean Version of the Community Assessment of Psychic Experiences in General Population

OBJECTIVE: The Community Assessment of Psychic Experiences has been widely translated and commonly used as a measure for psychotic experiences and psychosis proneness in clinical and research environments worldwide. This study aimed to establish the psychometric properties (reliability and validity) and factor structure of a Korean version of the Community Assessment of Psychic Experiences (K-CAPE) in the general population. METHODS: A total of 1,467 healthy participants completed K-CAPE and other psychiatric symptom-related scales (Paranoia scale, Patient Health Questionnaire-9, Dissociative Experiences Scale-II, and Oxford-Liverpool Inventory of Feelings and Experiences) via online survey. K-CAPE's internal reliability was analyzed using Cronbach's alpha coefficient. Confirmatory factor analysis (CFA) was performed to investigate whether the original three-factor model (positive, negative, and depressive) and other hypothesized multidimensional models (including positive and negative subfactors) were suitable for our data. Exploratory factor analysis (EFA) was conducted to explore better alternative factor solutions with a follow-up CFA. To assess convergent and discriminant validity, we examined correlations between KCAPE subscales with other established measures of psychiatric symptoms. RESULTS: K-CAPE showed good internal consistency in all original three subscales (all greater than α=0.827). The CFA demonstrated that the multidimensional models exhibited relatively better quality than the original three-dimensional model. Although the model fit indices did not reach their respective optimal thresholds, they were within an acceptable range. Results from the EFA indicated 3-5 factor solutions. In 3-factor solution, "negative-avolition" items were founded to be loaded more consistently with depressive items than with the negative dimension. In 4-factor solution, positive items were divided into two subfactors: "positive-bizarre experiences" and "positive-delusional thoughts," while negative symptoms were separated into two distinct subfactors in 5-factor solution: "negative-avolition (expressive)," and "negative-social (experiential)." The correlation coefficients between K-CAPE subscales and corresponding measurements were significant (p<0.001), confirming the convergent and discriminant validity. CONCLUSION: Our study provides evidence to support the reliability and validity of the K-CAPE and its use as a measure of psychotic symptoms in the Korean population. Although alternative factor structures did not improve the model fit, our EFA findings implicate the use of subfactors to investigate more specific domains of positive and negative symptoms. Given the heterogeneous nature of psychotic symptoms, this may be useful in capturing their different underlying mechanisms

Alcohol consumption and social inequality at the individual and country levels—results from an international study

Background: International comparisons of social inequalities in alcohol use have not been extensively investigated. The purpose of this study was to examine the relationship of country-level characteristics and individual socio-economic status (SES) on individual alcohol consumption in 33 countries. Methods: Data on 101 525 men and women collected by cross-sectional surveys in 33 countries of the GENACIS study were used. Individual SES was measured by highest attained educational level. Alcohol use measures included drinking status and monthly risky single occasion drinking (RSOD). The relationship between individuals' education and drinking indicators was examined by meta-analysis. In a second step the individual level data and country data were combined and tested in multilevel models. As country level indicators we used the Purchasing Power Parity of the gross national income, the Gini coefficient and the Gender Gap Index. Results: For both genders and all countries higher individual SES was positively associated with drinking status. Also higher country level SES was associated with higher proportions of drinkers. Lower SES was associated with RSOD among men. Women of higher SES in low income countries were more often RSO drinkers than women of lower SES. The opposite was true in higher income countries. Conclusion: For the most part, findings regarding SES and drinking in higher income countries were as expected. However, women of higher SES in low and middle income countries appear at higher risk of engaging in RSOD. This finding should be kept in mind when developing new policy and prevention initiative

A COMPARISON OF THE ALCOHOL USE DISORDER IDENTIFICATION TEST (AUDIT) IN GENERAL POPULATION SURVEYS IN NINE EUROPEAN COUNTRIES

Aims: This study explored the suitability of the Alcohol Use Disorder Identification Test (AUDIT) for cross-national comparable estimates of problem drinking in general populations. On the item level the focus is on responsiveness to cross-national and gender differences. For the set of items the focus is on intercorrelations between items, indicating to what extent the AUDIT constitutes a scale. Methods: General population surveys from nine European countries were included. Cross-tabulations were used to analyse cross-national and gender differences in scores on the items. Reliability analysis was used to analyse intercorrelations between the items. Results: The items ‘blackouts' (men and women) and ‘guilt and remorse' (women) are the most frequently reported consequences. Gender differences tended to be smaller for ‘guilt and remorse' and ‘concern of others', and largest for ‘morning drinking'. The reliability analysis shows that in eight of the nine countries frequency of drinking lowers the alpha. Injury and concern of others lead to a lower internal consistency in three countries. Conclusions: There was sufficient variation between countries in the pattern of responses and variation in gender differences to conclude that the set of consequence items was responsive to national and gender differences in problem drinking. Frequency of drinking was not a good indicator of problem drinking. The country differences in item total correlations of consequences might be due to differences in how these items are interpreted. Decisions on which items to include in an instrument to allow comparison of estimates of problem drinking cross-nationally require studies on how these items are interpreted in general populations of different countrie

Improving measurement of harms from others’ drinking: Using item-response theory to scale harms from others’ heavy drinking in 10 countries

Introduction: The heavy drinking of others may negatively affect an individual on several dimensions of life. Until now, there is scarce research about how to judge the severity of various experiences of such harms. This study aims to empirically scale the severity of such harm items and to determine who is at most risk of these harms. Methods: We used population-based survey data from 10 countries of the GENAHTO project (Gender and Alcohol's Harms to Others, data collection: 2011-2016). Questions about harms from others' drinking asked about verbal and physical harm, damage of belongings, traffic accidents, harassment, threatening behaviour, family and financial problems. We used item response theory methods (IRT) to scale severity of the aforementioned items. To acknowledge culturally based variations in different countries, we assessed 'differential item functioning'. Results: The items 'family problems', 'financial problems' and 'clothes and property damage' as well as 'physical harm' were scaled as more severe in most countries compared to other items. Substantial differential item functioning was present in more than half of the country pairings. The item 'financial problems' was most often differentially scaled. Younger people who drank more, as well as women (compared to men), reported more harm. Discussion and conclusions: Using IRT, we were able to evaluate grades of severity in harms from others' drinking. IRT scaling yielded in similar rankings of items as reported from other studies. However, empirical scaling allows for more differentiated severity scaling than simple summary scores and is more sensitive to cultural differences

A survey of parental self-efficacy experiences: maximising potential through health visiting and universal parenting support

Aims: To examine parental self-efficacy experiences for users of a parenting support programme and consider the pertinence of self-efficacy theory to health visiting (public health nursing) practice. Background: Commonly, successful parenting training programmes are underpinned by social learning principles and aim to strengthen parental self-efficacy. However, research examining programme effectiveness rarely discusses how self-efficacy outcomes are achieved. Design: A descriptive survey was completed as the first part of a realistic evaluation study examining how a UK parenting support programme worked. Method: The first part of the realistic evaluation involved validating outcome measures (the Parenting Self-Agency Measure and Self-Efficacy for Parenting Tasks Index subscales) and administering a questionnaire survey. The questionnaire was completed by adults accessing a parenting support programme during a 10-month period (n = 168). Data were analysed using descriptive and inferential statistics. Results. Women were the main users of the programme, which included informal drop-in groups as well as more formalised health visiting services and parenting training courses. The Parenting Self-Agency Measure results indicated good general parental self-efficacy; however, the task-specific Self-Efficacy for Parenting Tasks Indexes scales suggested that parents were less self-efficacious in disciplining children. Lower self-efficacy scores correlated with high ratings for ‘feeling tired’, ‘receiving negative comments’ and ‘giving-in to a child’s demands’. Conclusions: Study results indicate that the domain general and task-specific measures provide different, but helpful, insights into parental self-efficacy experiences. By identifying factors associated with the levels of general and task-specific parental self-efficacy, health visitors can gain a fuller appreciation of support needs. Relevance to practice: To maximise potential through parenting support, attention should be given to addressing factors associated with poorer self-efficacy experiences, including parental tiredness. Equally, practice should be directed at developing community environments that offer exposure to positive praise and the opportunity to practice new skills without facing criticism

Associations between post-traumatic stress disorders and psychotic symptom severity in adult survivors of developmental trauma: a multisite cross-sectional study in the UK and South Korea

BACKGROUND: Childhood maltreatment is a risk factor for the development of post-traumatic stress disorders and psychosis. However, the association between post-traumatic stress disorder (PTSD), including complex PTSD, and psychotic symptoms is unknown. We investigated whether the presence of PTSD and complex PTSD was associated with psychotic symptom severity within survivors of developmental trauma. METHODS: As part of the Investigating Mechanisms underlying Psychosis Associated with Childhood Trauma (IMPACT) study, from Aug 20, 2020, to Jan 24, 2021, and from Sept 9, 2022, to Feb 21, 2023, using study advertisement on online platforms we recruited adult (≥18 years) participants who had experienced developmental trauma without a psychiatric diagnosis in the UK and South Korea. We measured whether participants met diagnostic thresholds for PTSD and complex PTSD using the self-reported International Trauma Questionnaire, and psychotic symptoms using the self-reported Community Assessment of Psychic Experiences. We used linear regression, adjusting for sociodemographic variables such as age, sex, ethnicity, educational attainment, and socioeconomic status, to examine whether there was an association between PTSD and complex PTSD and psychotic symptoms. The study is registered in the UK (University College London Research Ethics Committee [14317/001] and the National Health Service Research Ethics Committee [22/YH/0096]) and South Korea (Institutional Review Board of Seoul National University Bundang Hospital [B-2011-648-306]), and is ongoing. FINDINGS: Of the 2675 participants who took part in the study, 1273 had experienced developmental trauma and were included in the study in the UK (n=475) and South Korea (n=798), comprising 422 (33%) men and 851 (67%) women with a mean age of 26·9 years (SD 6, range 18-40), mostly of White British (n=328) or South Korean (n=798) ethnicity. We found no significant association between PTSD and psychotic symptom severity (total severity β=-2·40 [SE 3·28], p=0·47), compared with participants who did not meet PTSD or complex PTSD caseness. We found a significant relationship between complex PTSD and psychotic symptom severity (total severity β=22·62 [SE 1·65], p<0·0001), including for positive (β=12·07 [SE 0·99], p<0·0001) and negative symptoms (β=10·5 [SE 0·95], p<0·0001), compared with participants who did not meet PTSD or complex PTSD caseness. INTERPRETATION: Health systems must assess individuals with previous developmental trauma for complex PTSD and treat those affected. These individuals should also be assessed for psychotic symptoms, and if necessary, preventative measures should be taken to reduce risk of conversion. Further work should assess whether treating complex PTSD modifies the risk of conversion to psychosis. FUNDING: UKRI Future Leaders Fellowship, British Medical Association Margaret Temple Award for Schizophrenia Research, and the National Research Foundation of Korea-Korea Government

Supernovae Ia Constraints on a Time-Variable Cosmological "Constant"

The energy density of a scalar field $\phi$ with potential $V(\phi) \propto \phi^{-\alpha}$, $\alpha > 0$, behaves like a time-variable cosmological constant that could contribute significantly to the present energy density. Predictions of this spatially-flat model are compared to recent Type Ia supernovae apparent magnitude versus redshift data. A large region of model parameter space is consistent with current observations. (These constraints are based on the exact scalar field model equations of motion, not on the widely used time-independent equation of state fluid approximation equations of motion.) We examine the consequences of also incorporating constraints from recent measurements of the Hubble parameter and the age of the universe in the constant and time-variable cosmological constant models. We also study the effect of using a non-informative prior for the density parameter.Comment: Accepted for publication in Ap