The initial psychometric evaluation of a new Emergency Department Patient-Reported Experience Measure (ED PREM)

Patient-reported experience measures (PREMs) are critical to evaluating the person-centeredness, safety, and quality of healthcare services internationally. The aim of this study was to describe the initial psychometric evaluation of a new Emergency Department (ED) PREM. Adult patients presenting to the ED of a tertiary hospital in southeast Queensland, Australia during January 2022 were recruited in-person. Participants selected their preferred ED PREM mode of administration from online, telephone, or postal, and had 14 days from recruitment to complete the survey. Item reduction, structural validity, discriminant validity, and internal consistency reliability were assessed. A sample of 349 (68.4%) was achieved. Item reduction analysis indicated ceiling effects for all ED PREM items (ranging between 34.4-79.7%). Exploratory factor analysis revealed a 4-factor solution comprising 26-items that explained 55% of model variance. Cronbach’s α ranged between 0.84-0.97 per factor, demonstrating internal consistency reliability. Known groups analysis demonstrated the ED PREMs’ ability to discriminate experiences based on gender, age, and ED length of stay. The ED PREM is a valid and reliable instrument for capturing patient experiences in the ED. The content of the ED PREM emphasizes person-centeredness and shared decision making, making it suitable for use in clinical practice evaluation and health service performance measurement. The factor structure of the ED PREM should be confirmed in future research, and item redundancy addressed. Experience Framework This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens

Expectancies regarding the interaction between smoking and substance use in alcohol-dependent smokers in early recovery.

The purpose of this study was to investigate expectancies regarding the interaction between cigarette smoking and use of alcohol among alcohol-dependent smokers in early recovery, using the Nicotine and Other Substances Interaction Expectancies Questionnaire (NOSIE). Participants were 162 veterans, 97% male, with a mean age of 50 years, enrolled in a clinical trial aimed at determining the efficacy of an intensive smoking cessation intervention versus usual care. At baseline, participants were assessed on measures of smoking behavior, abstinence thoughts about alcohol and tobacco use, symptoms of depression, and smoking-substance use interaction expectancies. In addition, biologically verified abstinence from tobacco and alcohol was assessed at 26 weeks. Participants reported that they expected smoking to have less of an impact on substance use than substance use has on smoking (p < .001). Severity of depressive symptoms was significantly associated with the expectancy that smoking provides a way of coping with the urge to use other substances (p < .01). The expectation that smoking increases substance urges/use was predictive of prospectively measured and biologically verified abstinence from smoking at 26 weeks (p < .03). The results add to our knowledge of smoking-substance use interaction expectancies among alcohol-dependent smokers in early recovery and will inform the development of more effective counseling interventions for concurrent alcohol and tobacco use disorders

Journal of Women in Educational Leadership

1 Miep Gies (1909-2010): Her Legacy Endures- Marilyn L. Grady 3 Gender Differences in Research Mentorship and Pretenured Counselor Educators- Suzanne Campbell, Kathryn Mueller and Jane M. Souz

Mice Lacking Gpr37 Exhibit Decreased Expression of the Myelin-Associated Glycoprotein Mag and Increased Susceptibility to Demyelination

GPR37 is an orphan G protein-coupled receptor that is predominantly expressed in the brain and found at particularly high levels in oligodendrocytes. GPR37 has been shown to exert effects on oligodendrocyte differentiation and myelination during development, but the molecular basis of these actions is incompletely understood and moreover nothing is known about the potential role(s) of this receptor under demyelinating conditions. To shed light on the fundamental biology of GPR37, we performed proteomic studies comparing protein expression levels in the brains of mice lacking GPR37 and its close relative GPR37-like 1 (GPR37L1). These studies revealed that one of the proteins most sharply decreased in the brains of Gpr37/Gpr37L1 double knockout mice is the myelin-associated glycoprotein MAG. Follow-up Western blot studies confirmed this finding and demonstrated that genetic deletion of Gpr37, but not Gpr37L1, results in strikingly decreased brain expression of MAG. Further in vitro studies demonstrated that GPR37 and MAG form a complex when expressed together in cells. As loss of MAG has previously been shown to result in increased susceptibility to brain insults, we additionally assessed Gpr37-knockout (Gpr37−/−) vs. wild-type mice in the cuprizone model of demyelination. These studies revealed that Gpr37−/− mice exhibit dramatically increased loss of myelin in response to cuprizone, yet do not show any increased loss of oligodendrocyte precursor cells or mature oligodendrocytes. These findings reveal that loss of GPR37 alters oligodendrocyte physiology and increases susceptibility to demyelination, indicating that GPR37 could be a potential drug target for the treatment of demyelinating diseases such as multiple sclerosis

Emotional Climate, Feeding Practices, and Feeding Styles: An Observational Analysis of the Dinner Meal in Head Start Families

BACKGROUND: A number of studies conducted with ethnically diverse, low-income samples have found that parents with indulgent feeding styles had children with a higher weight status. Indulgent parents are those who are responsive to their child\u27s emotional states but have problems setting appropriate boundaries with their child. Because the processes through which styles impact child weight are poorly understood, the aim of this study was to observe differences in the emotional climate created by parents (including affect, tone of voice, and gestures) and behavioral feeding practices among those reporting different feeding styles on the Caregiver\u27s Feeding Styles Questionnaire. A secondary aim was to examine differences on child weight status across the feeding styles. METHODS: Participants were 177 Head Start families from Houston, Texas (45% African-American; 55% Hispanic). Using an observational approach, the relationship between the observed emotional climate of the meal, behavioral feeding practices, and self-reported parent feeding styles were examined. Mean age of the children was 4.4 years (SD = 0.7) equally distributed across gender. Families were observed on 3 separate dinner occasions. Heights and weight were measured on the parents and children. RESULTS: Parents with self-reported indulgent feeding styles made fewer demands on their children to eat during dinner and showed lower levels of negative affect and intrusiveness. Surprisingly, these parents also showed higher levels of emotional detachment with their children during dinner. Hispanic boys with indulgent parents had significantly higher BMI z scores compared to Hispanic boys in the other three feeding style groups. No other differences were found on child weight status. CONCLUSIONS: Results suggest that the emotional climate created by indulgent parents during dinner and their lack of demands on their children to eat may play an important role in how young children become overweight. Numerous observed emotional climate and behavioral differences were found between the other self-reported feeding styles as well. Results suggest that parents\u27 self-reported feeding styles may be a proxy for the emotional climate of the dinner meal, which may in turn influence the child\u27s eating behaviors and weight status

Quantitative Proteomics Reveal an Altered Pattern of Protein Expression in Brain Tissue from Mice Lacking Gpr37 and Gpr37l1

GPR37 and GPR37L1 are glia-enriched G protein-coupled receptors that have been implicated in several neurological and neurodegenerative diseases. To gain insight into the potential molecular mechanisms by which GPR37 and GPR37L1 regulate cellular physiology, proteomic analyses of whole mouse brain tissue from wild-type (WT) versus GPR37/GPR37L1 double knockout (DKO) mice were performed in order to identify proteins regulated by the absence versus presence of these receptors (data are available via ProteomeXchange with identifier PXD015202). These analyses revealed a number of proteins that were significantly increased or decreased by the absence of GPR37 and GPR37L1. One of the most decreased proteins in the DKO versus WT brain tissue was S100A5, a calcium-binding protein, and the reduction of S100A5 expression in KO brain tissue was validated via Western blot. Coexpression of S100A5 with either GPR37 or GPR37L1 in HEK293T cells did not result in any change in S100A5 expression but did robustly increase secretion of S100A5. To dissect the mechanism by which S100A5 secretion was enhanced, cells coexpressing S100A5 with the receptors were treated with different pharmacological reagents. These studies revealed that calcium is essential for the secretion of S100A5 downstream of GPR37 and GPR37L1 signaling, as treatment with BAPTA-AM, an intracellular Ca2+ chelator, reduced S100A5 secretion from transfected HEK293T cells. Collectively, these findings provide a panoramic view of proteomic changes resulting from loss of GPR37 and GPR37L1 and also impart mechanistic insight into the regulation of S100A5 by these receptors, thereby shedding light on the functions of GPR37 and GPR37L1 in brain tissue

Depression and stages of change for smoking in psychiatric outpatients

Abstract This article reports on the relations between depression and stages of change for smoking cessation. A convenience sample of 205 psychiatric outpatients (68% female, mean age 41) completed measures of depression Primary Care Evaluation of Mental Disorders [PRIME-MD] and Beck Depression Inventory-II [BDI-II]), all transtheoretical model constructs related to smoking (stages and processes of change, pros and cons of smoking, and situational temptations), and thoughts about abstinence. As hypothesized, patients who had never smoked showed substantially lower rates of currently diagnosed major depressive disorder (MDD) than those who had ever smoked. Patients in early stages of change did not show more MDD or depressive symptoms but, as hypothesized, showed more negative thoughts about abstinence. Findings are consistent with the documented association between smoking and depression and suggest the appropriateness of building smoking cessation interventions based on the transtheoretical model of change for use with psychiatric populations.

Cognitive training for freezing of gait in Parkinson's disease: a randomized controlled trial.

The pathophysiological mechanism of freezing of gait (FoG) has been linked to executive dysfunction. Cognitive training (CT) is a non-pharmacological intervention which has been shown to improve executive functioning in Parkinson's disease (PD). This study aimed to explore whether targeted CT can reduce the severity of FoG in PD. Patients with PD who self-reported FoG and were free from dementia were randomly allocated to receive either a CT intervention or an active control. Both groups were clinician-facilitated and conducted twice-weekly for seven weeks. The primary outcome was percentage of time spent frozen during a Timed Up and Go task, assessed both on and off dopaminergic medications. Secondary outcomes included multiple neuropsychological and psychosocial measures. A full analysis was first conducted on all participants randomized, followed by a sample of interest including only those who had objective FoG at baseline, and completed the intervention. Sixty-five patients were randomized into the study. The sample of interest included 20 in the CT group and 18 in the active control group. The primary outcome of percentage time spent frozen during a gait task was significantly improved in the CT group compared to active controls in the on-state. There were no differences in the off-state. Patients who received CT also demonstrated improved processing speed and reduced daytime sleepiness compared to those in the active control. The findings suggest that CT can reduce the severity of FoG in the on-state, however replication in a larger sample is required