Short-form measures of diabetes-related emotional distress: The Problem Areas in Diabetes Scale (PAID)-5 and PAID-1

Aims/hypothesis: We wanted to identify a five-item short form of the Problem Areas in Diabetes Scale and a single-item measure for rapid screening of diabetes-related emotional distress. Methods: Using an existing database of 1,153 patients with diabetes, we conducted a principal-components analysis to identify a set of five items and then conducted a reliability analysis and validity checks. From those five items, we identified the item with the strongest psychometric properties as a one-item screening tool. Results: We identified a reliable and valid short version of the Problem Areas in Diabetes Scale (PAID) comprising five of the emotional-distress questions of the full PAID items (PAID-5, with items 3, 6, 12, 16, 19). The PAID-5 has satisfactory sensitivity (94%) and specificity (89%) for recognition of diabetes-related emotional distress. We also identified a one-item screening tool, the PAID-1 (Question 12: Worrying about the future and the possibility of serious complications), which has concurrent sensitivity and specificity of about 80% for the recognition of diabetes-related emotional distress. Conclusions/ interpretation: The PAID-5 and PAID-1 appear to be psychometrically robust short-form measures of diabetes-related emotional distress.Centro de Endocrinología Experimental y Aplicad

Evaluating use cases for human challenge trials in accelerating SARS-CoV-2 vaccine development

Human challenge trials (HCTs) have been proposed as a means to accelerate SARS-CoV-2 vaccine development. We identify and discuss three potential use cases of HCTs in the current pandemic: evaluating efficacy, converging on correlates of protection, and improving understanding of pathogenesis and the human immune response. We outline the limitations of HCTs and find that HCTs are likely to be most useful for vaccine candidates currently in preclinical stages of development. We conclude that, while currently limited in their application, there are scenarios in which HCTs would be extremely beneficial. Therefore, the option of conducting HCTs to accelerate SARS-CoV-2 vaccine development should be preserved. As HCTs require many months of preparation, we recommend an immediate effort to (1) establish guidelines for HCTs for COVID-19; (2) take the first steps toward HCTs, including preparing challenge virus and making preliminary logistical arrangements; and (3) commit to periodically re-evaluating the utility of HCTs

ASCA and RXTE Observations of Non-Thermal X-ray Emission from Galactic Supernova Remnants: G156.2+5.7

(Abridged) We are conducting a survey of Galactic shell-type supernova remnants (SNRs) known or suspected to possess non-thermal components to their X-ray emission using new and archived observations made with such X-ray satellites as ROSAT, ASCA, RXTE, Chandra and XMM-Newton. This research is intended to probe the phenomenon of cosmic-ray acceleration by Galactic SNRs and estimate the maximum energy of cosmic-ray electrons accelerated by these sources. To illustrate this work, we examine the X-ray spectrum of the northwestern rim of an SNR suspected to have a non-thermal component to its X-ray emission, G156.2+5.7 (RX J04591+5147), over the energy range of approximately 0.7-12.0 keV using observations made by the ASCA GIS and the RXTE PCA. We compare fits made to the non-thermal component using two models, a simple power law and SRCUT. Both models give acceptable fits: the photon index derived from the fit made with the power law model, 2.0 (+0.2, -0.5), is comparable to values obtained for the bright rims of other SNRs with hard X-ray spectra. Using the SRCUT model, we derive a value of 2.42 (+0.24, -0.23) x 10^17 Hz for the cutoff frequency: based on this value and assuming a mean magnetic field strength of 14 microGauss, we estimate the cutoff energy of cosmic-ray electrons accelerated by G156.2+5.7 to be approximately 32 TeV. This energy value is well short of the "knee" feature of the cosmic-ray spectrum.Comment: 6 pages with 2 figures. This tex file uses the style file cospar.sty from Elvesier Science Publishers. To be published in Advances in Space Research, Proceedings of 34th COSPAR Assembly (October 2002), Symposium E1.4, "High Energy Studies of Supernova Remnants and Neutron Stars," eds. W. Hermsen and W. Becker (2003

Short-form measures of diabetes-related emotional distress: The Problem Areas in Diabetes Scale (PAID)-5 and PAID-1

Aims/hypothesis: We wanted to identify a five-item short form of the Problem Areas in Diabetes Scale and a single-item measure for rapid screening of diabetes-related emotional distress. Methods: Using an existing database of 1,153 patients with diabetes, we conducted a principal-components analysis to identify a set of five items and then conducted a reliability analysis and validity checks. From those five items, we identified the item with the strongest psychometric properties as a one-item screening tool. Results: We identified a reliable and valid short version of the Problem Areas in Diabetes Scale (PAID) comprising five of the emotional-distress questions of the full PAID items (PAID-5, with items 3, 6, 12, 16, 19). The PAID-5 has satisfactory sensitivity (94%) and specificity (89%) for recognition of diabetes-related emotional distress. We also identified a one-item screening tool, the PAID-1 (Question 12: Worrying about the future and the possibility of serious complications), which has concurrent sensitivity and specificity of about 80% for the recognition of diabetes-related emotional distress. Conclusions/ interpretation: The PAID-5 and PAID-1 appear to be psychometrically robust short-form measures of diabetes-related emotional distress.Centro de Endocrinología Experimental y Aplicad

Hidden, visceral and traumatic: a dramaturgical approach to men talking about their penis after surgery for penile cancer

YesDrawing upon concepts of expressive equipment and body image, the aim of this study is to explore how men diagnosed and treated for penile cancer construct their penis and its surgical disfigurement (penectomy). Using maximum variation sampling with the intention to acquire the broadest range of experiences of stage of disease and treatment, 27 cisgender men (aged 48-83, x=63) who had surgical treatment consented for their data to be archived for analysis. From a dramaturgical perspective, the constructionist thematic analysis explored direct and indirect talk about the penis after surgery. The analysis showed that through graphic and sequential narratives of dismemberment revealed, participants constructed a post-surgery period in which they both wanted and did-not-want to see their penis. Additionally, participants constructed themselves managing difficult emotions through others and seeing themselves being rejected by a potentially desiring (female) Other. The findings extend research on male genitals by showing how the post-surgery penis can function as something hidden but visceral and traumatic when revealed. Importantly, this paper illustrates body image as expressive equipment where body and identity are formed in the image of manhood, which is an intersubjective (sexual) object between self and other.This paper presents independent research commissioned by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0808-17158).Research Development Fund Publication Prize Award winner, October 2019

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362