Instruments Measuring Spirituality in Clinical Research: A Systematic Review

ABSTRACT: INTRODUCTION: Numerous instruments have been developed to assess spirituality and measure its association with health outcomes. This study's aims were to identify instruments used in clinical research that measure spirituality; to propose a classification of these instruments; and to identify those instruments that could provide information on the need for spiritual intervention. METHODS: A systematic literature search in MEDLINE, CINHAL, PsycINFO, ATLA, and EMBASE databases, using the terms "spirituality" and "adult$," and limited to journal articles was performed to identify clinical studies that used a spiritual assessment instrument. For each instrument identified, measured constructs, intended goals, and data on psychometric properties were retrieved. A conceptual and a functional classification of instruments were developed. RESULTS: Thirty-five instruments were retrieved and classified into measures of general spirituality (N = 22), spiritual well-being (N = 5), spiritual coping (N = 4), and spiritual needs (N = 4) according to the conceptual classification. Instruments most frequently used in clinical research were the FACIT-Sp and the Spiritual Well-Being Scale. Data on psychometric properties were mostly limited to content validity and inter-item reliability. According to the functional classification, 16 instruments were identified that included at least one item measuring a current spiritual state, but only three of those appeared suitable to address the need for spiritual intervention. CONCLUSIONS: Instruments identified in this systematic review assess multiple dimensions of spirituality, and the proposed classifications should help clinical researchers interested in investigating the complex relationship between spirituality and health. Findings underscore the scarcity of instruments specifically designed to measure a patient's current spiritual state. Moreover, the relatively limited data available on psychometric properties of these instruments highlight the need for additional research to determine whether they are suitable in identifying the need for spiritual intervention

Vulnerability in high-functioning persons aged 65 to 70 years: the importance of the fear factor

Background and aims: Falls efficacy has been shown to predict functional decline, but whether it is independently associated with frailty is still unclear. This study investigated the cross-sectional association between falls efficacy and the frailty pheno-type in high-functioning older persons. Methods: Subjects (n=861) were a sub-sample of community-dwelling persons aged 65 to 70 years enrolled in the "Lc65+” cohort, who had gait assessment. Data included demographics, functional, cognitive, affective and health status, as well as measures of physical performance. Falls efficacy was measured with the Falls Efficacy Scale-International (FES-I) and frailty with Fried's criteria. Participants were categorized into robust (no frailty criterion) and vulnerable (1 or more criteria). Low falls efficacy was defined as a FES-I score in the lowest quartile. Results: Overall, 23.9% of participants were vulnerable. Compared with robust participants, they were more likely to report low falls efficacy (43.3% vs 19.1%, p<0.001) and had poorer health and functional and mental status. They had slower gait speed (1.07±0.18 vs 1.15±0.15 m/s, p<0.001) and increased gait speed variability (coefficient of variation 4.10±4.03 vs 3.33±1.45%, p<0.001), although only 6 participants (0.7%) fulfilled Fried's slow walking criterion. In multivariate analysis, low falls efficacy remained associated with being vulnerable (adjusted OR 1.80, 95%, CI 1.19-2.74, p=0.006), independent of comorbidity, functional status, falls history and gait performance. Conclusion: In high-functioning older persons, low falls efficacy was associated with vulnerability, even after controlling for gait performance and falls history. Whether low falls efficacy is a potential target on the pathway leading to frailty should be further examined prospectivel

Measurement invariance of the Marijuana Motives Measure among men and women using Stop Cannabis App

Motives to use cannabis play a central role in the development and maintenance of problematic cannabis use and previous studies stressed sex-related differences on motives to use cannabis. However, motives cannot be validly compared in men and women without first establishing the measurement invariance across sex. Therefore, the aim of the study is to (1) examine for the first time the measurement and structural invariance of the Marijuana Motives Measure (MMM) across sex, and (2) to investigate the motives for cannabis use that best explain problematic use. 2951 (41.7% women) users of the "Stop cannabis" smartphone app of which 99.8% reported having used cannabis in the last three months completed an online MMM and ASSIST to assess the severity of their problematic cannabis use. Multigroup confirmatory factor analyses supported measurement invariance across sex, whereas structural invariance was not confirmed. Indeed, group comparisons indicated that women reported greater coping motives then men whereas men showed greater social motives than women. A multiple linear regression analysis showed that only coping and conformity motives were significantly associated with greater problematic cannabis use, whereas neither sex nor the sex by motives interactions were significantly related to problematic cannabis use. The MMM appears to function comparably across men and women. Therefore, sex-related comparisons on the questionnaire can be considered valid. Coping and conformity motives may play a central role part in the development of marijuana use problems which may hold implications for intervention development and public policy

Impact of the urbanization process on connectivity and genetic diversity - a spatially explicit simulation approach

Urbanization leads to fragmentation, degradation or loss of natural environments and reduces connectivity between remaining habitat patches. This affects dispersal and establishment of species and their genes and might have adverse effects on biodiversity in urban areas. Here we assess functional connectivity between green spaces for one plant (Plantago major) and one insect (Pieris rapae) model species in the Geneva urban area. We also estimate the impact of future urbanization projects planned until 2030 in Geneva (constructions and road projects) on the connectivity network. We show that the connectivity between small green spaces in the urban centres and larger ones in peripheral areas is fragile and unstable. Potential barriers to dispersal for the study species are mainly buildings, roads, but also large areas of forests, crops and vineyards. Furthermore and based on spatially explicit simulations of gene flow, we test how the distribution of genetic variation among populations along rural-urban gradients is affected by urban landscape elements. We compare these results to empirically observed population responses of the butterfly species P. rapae in the region of Marseille, France. For different dispersal scenarios and taking into account the effect of future intensification of urbanization, results show a decrease in genetic diversity in areas characterized by medium to high urban densities. In order to conserve and promote genetically stable and diverse populations, it is therefore important to maintain or increase landscape connectivity, especially between green spaces in dense urban centres and those in more natural peripheral areas

Design of Magnetic Switchable Device (MSD) and applications in climbing robot

A Magnetic Switchable Device (MSD) is a ferromagnetic circuit using permanent magnets where the flux can circulate between different paths when its configuration is changed. This routes or cancels the flux through specific surfaces, and thus turns on or off adhesion forces.We present classic and innovative magnetic configuration to realize powerful MSD. We designed and prototyped some miniature systems and give their characteristics. Finally various robotics applications for gripper, anchor and climbing robot are unveiled where the MSD solution has proved to be advantageous

Spatial Areas of Genotype Probability of Cattle Genomic Variants Involved in the Resistance to East Coast Fever: A Tool to Predict Future Disease-Vulnerable Geographical Regions

East Coast Fever (ECF) is a livestock disease caused by Theileria parva, a protozoan transmitted by the vector tick Rhipicephalus appendiculatus. This disease causes high mortality in cattle populations of Central and Eastern Africa, especially in exotic breeds. Here, we highlight genomic regions likely involved into tolerance/resistance mechanisms against ECF, and we introduce the estimation of their Spatial Area of Genotype Probability (SPAG) to delimit areas where the concerned genotypes are predicted to be present. During the NEXTGEN project, 803 Ugandan cattle were geo-referenced and genotyped (54K SNPs), while 532 tick occurrences were retrieved from a published database. To get a proxy of the parasite selective pressure, we used WorldClim bioclimatic variables to model vector ecological niche. Landscape genomics models were then used to detect cattle genotypes associated with vector probability of presence, and to estimate their SPAGs. Finally, climate change scenarios for 2070 were considered to compare the predicted shift in the vector niche with the estimated current SPAG. The analysis revealed two main areas of presence of possibly resistance-related genotypes, one South and one East of Lake Victoria. Climate change will probably shift tick niche southwards in the Eastern regions of Lake Victoria, inducing a critical area that currently does not show the candidate genotypes, but where disease will likely spread in the future. The combined use of SPAGs and niche maps could therefore facilitate the identification of regions of concern and to direct future targeted breeding schemes