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The impact of social determinants of health (SDOH) on mental health is increasingly realized. A comprehensive study examining the associations of SDOH with mental health disorders has yet to be accomplished. This study evaluated the associations between five domains of SDOH and the SDOH summary score and mental health disorders in the United States.
Methods
We analyzed data from a diverse group of participants enrolled in the All of Us research programme, a research programme to gather data from one million people living in the United States, in a cross-sectional design. The primary exposure was SDOH based on Healthy People 2030: education access and quality, economic stability, healthcare access and quality, social and community context, and neighbourhood and built environment. A summary SDOH score was calculated by adding each adverse SDOH risk (any SDOH vs. no SDOH). Our primary outcomes were diagnoses of major depression (MD) (i.e., major depressive disorder, recurrent MD or MD in remission) and anxiety disorders (AD) (i.e., generalized AD and other anxiety-related disorders). Multiple logistic regression models were used to determine adjusted odd ratios (aORs) for MD and/or ADs after controlling for covariates.
Results
A total of 63,162 participants with MD were identified (22,277 [35.3%] age 50–64 years old; 41,876 [66.3%] female). A total of 77,624 participants with AD were identified (25,268 [32.6%] age 50–64 years old; 52,224 [67.3%] female). Factors associated with greater odds of MD and AD included having less than a college degree, annual household income less than 200% of federal poverty level, housing concerns, lack of transportation, food insecurity, and unsafe neighbourhoods. Having no health insurance was associated with lower odds of both MD and AD (aOR, 0.48; 95% confidence interval [CI], 0.46–0.51 and aOR, 0.44; 95% CI, 0.42–0.47, respectively). SDOH summary score was strongly associated with the likelihood of having MD and AD (aOR, 1.97; 95% CI, 1.89–2.06 and aOR, 1.69; 95% CI, 1.63–1.75, respectively).
Conclusions
This study found associations between all five domains of SDOH and the higher odds of having MD and/or AD. The strong correlations between the SDOH summary score and mental health disorders indicate a possible use of the summary score as a measure of risk of developing mental health disorders.
Successfully educating urgent care patients on appropriate use and risks of antibiotics can be challenging. We assessed the conscious and subconscious impact various educational materials (informational handout, priming poster, and commitment poster) had on urgent care patients’ knowledge and expectations regarding antibiotics.
Design:
Stratified Block Randomized Control Trial.
Setting:
Urgent care centers (UCCs) in Colorado, Florida, Georgia, and New Jersey.
Participants:
Urgent care patients.
Methods:
We randomized 29 UCCs across six study arms to display specific educational materials (informational handout, priming poster, and commitment poster). The primary intention-to-treat (ITT) analysis evaluated whether the materials impacted patient knowledge or expectations of antibiotic prescribing by assigned study arm. The secondary as-treated analysis evaluated the same outcome comparing patients who recalled seeing the assigned educational material and patients who either did not recall seeing an assigned material or were in the control arm.
Results:
Twenty-seven centers returned 2,919 questionnaires across six study arms. Only 27.2% of participants in the intervention arms recalled seeing any educational materials. In our primary ITT analysis, no difference in knowledge or expectations of antibiotic prescribing was noted between groups. However, in the as-treated analysis, the handout and commitment poster were associated with higher antibiotic knowledge scores.
Conclusions:
Educational materials in UCCs are associated with increased antibiotic-related knowledge among patients when they are seen and recalled; however, most patients do not recall passively displayed materials. More emphasis should be placed on creating and drawing attention to memorable patient educational materials.
Whole genome sequencing (WGS) can help identify transmission of pathogens causing healthcare-associated infections (HAIs). However, the current gold standard of short-read, Illumina-based WGS is labor and time intensive. Given recent improvements in long-read Oxford Nanopore Technologies (ONT) sequencing, we sought to establish a low resource approach providing accurate WGS-pathogen comparison within a time frame allowing for infection prevention and control (IPC) interventions.
Methods:
WGS was prospectively performed on pathogens at increased risk of potential healthcare transmission using the ONT MinION sequencer with R10.4.1 flow cells and Dorado basecaller. Potential transmission was assessed via Ridom SeqSphere+ for core genome multilocus sequence typing and MINTyper for reference-based core genome single nucleotide polymorphisms using previously published cutoff values. The accuracy of our ONT pipeline was determined relative to Illumina.
Results:
Over a six-month period, 242 bacterial isolates from 216 patients were sequenced by a single operator. Compared to the Illumina gold standard, our ONT pipeline achieved a mean identity score of Q60 for assembled genomes, even with a coverage rate as low as 40×. The mean time from initiating DNA extraction to complete analysis was 2 days (IQR 2–3.25 days). We identified five potential transmission clusters comprising 21 isolates (8.7% of sequenced strains). Integrating ONT with epidemiological data, >70% (15/21) of putative transmission cluster isolates originated from patients with potential healthcare transmission links.
Conclusions:
Via a stand-alone ONT pipeline, we detected potentially transmitted HAI pathogens rapidly and accurately, aligning closely with epidemiological data. Our low-resource method has the potential to assist in IPC efforts.
Certain patient populations requiring sedation for procedures present the clinician with challenging decisions regarding their care and management. Some underlying medical disease states, airway abnormalities, or extremes of age require cautious pre-procedural assessment and planning when sedation is required to minimize the incidence of morbidity or mortality. It should be noted that some of these higher-risk patients should only be sedated by trained anesthesia providers. The following commonly encountered conditions are considered high risk and are associated with a higher rate of complications: old age, obesity, chronic obstructive pulmonary disease, coronary artery disease, and chronic renal failure. This chapter discusses important features of these higher-risk patients and practice management when sedation is required. In all cases, appropriate monitoring, prudent selection and dosing of sedative agents, and careful assessment are important to ensure the best outcome for these higher-risk patients.
The Magellanic Stream (MS), a tail of diffuse gas formed from tidal and ram pressure interactions between the Small and Large Magellanic Clouds (SMC and LMC) and the Halo of the Milky Way, is primarily composed of neutral atomic hydrogen (HI). The deficiency of dust and the diffuse nature of the present gas make molecular formation rare and difficult, but if present, could lead to regions potentially suitable for star formation, thereby allowing us to probe conditions of star formation similar to those at high redshifts. We search for $\text{HCO}^{+}$, HCN, HNC, and C$_2$H using the highest sensitivity observations of molecular absorption data from the Atacama Large Millimeter Array (ALMA) to trace these regions, comparing with HI archival data from the Galactic Arecibo L-Band Feed Array (GALFA) HI Survey and the Galactic All Sky Survey (GASS) to compare these environments in the MS to the HI column density threshold for molecular formation in the Milky Way. We also compare the line of sight locations with confirmed locations of stars, molecular hydrogen, and OI detections, though at higher sensitivities than the observations presented here.
We find no detections to a 3$\sigma$ significance, despite four sightlines having column densities surpassing the threshold for molecular formation in the diffuse regions of the Milky Way. Here we present our calculations for the upper limits of the column densities of each of these molecular absorption lines, ranging from $3 \times 10^{10}$ to $1 \times 10^{13}$ cm$^{-2}$. The non-detection of $\text{HCO}^{+}$ suggests that at least one of the following is true: (i) $X_{\text{HCO}^{+}{}, \mathrm{MS}}$ is significantly lower than the Milky Way value; (ii) that the widespread diffuse molecular gas observed by Rybarczyk (2022b, ApJ, 928, 79) in the Milky Way’s diffuse interstellar medium (ISM) does not have a direct analogue in the MS; (iii) the HI-to-$\text{H}_{2}$ transition occurs in the MS at a higher surface density in the MS than in the LMC or SMC; or (iv) molecular gas exists in the MS, but only in small, dense clumps.
Weeds are one of the greatest challenges to snap bean production. Anecdotal observation posits certain species frequently escape the weed management system by the time of crop harvest, hereafter called residual weeds. The objectives of this work were to 1) quantify the residual weed community in snap bean (Phaseolus vulgaris L.) grown for processing across the major growing regions in the U.S., and 2) investigate linkages between the density of residual weeds and their contributions to weed canopy cover. In surveys of 358 fields across the Northwest (NW), Midwest (MW), and Northeast (NE), residual weeds were observed in 95% of the fields. While a total of 109 species or species-group were identified, one to three species dominated the residual weed community of individual fields in most cases. It was not uncommon to have >10 weeds m-2 with a weed canopy covering >5% of the field’s surface area. Some of the most abundant and problematic species or species-group escaping control included amaranth species (such as smooth pigweed (Amaranthus hybridus L.), Palmer amaranth (Amaranthus palmeri S. Watson), redroot pigweed (Amaranthus retroflexus L.), and waterhemp [Amaranthus tuberculatus (Moq.) J. D. Sauer]), common lambsquarters (Chenopodium album L.), large crabgrass [Digitaria sanguinalis (L.) Scop.], and ivyleaf morningglory (Ipomoea hederacea Jacq.). Emerging threats include hophornbeam copperleaf (Acalypha ostryifolia Riddell) in the MW and sharppoint fluvellin [Kickxia elatine (L.) Dumort.] in the NW. Beyond crop losses due to weed interference, the weed canopy at harvest poses a risk to contaminating snap bean products with foreign material. Random forest modeling predicts the residual weed canopy is dominated by common lambsquarters, large crabgrass, carpetweed (Mollugo verticillata L.), I. hederacea, amaranth species, and A. ostryifolia. This is the first quantitative report on the weed community escaping control in U.S. snap bean production.
To explore the source, message, channel, and receiver effects on patient concern for antibiotic resistance, willingness to reduce antibiotic use, and expectations for an antibiotic prescription in a prepandemic sample.
Methods:
We used data reported from a national cross-sectional survey of adults who had visited an urgent care center within the last year. Data were collected from April 4 to April 9, 2017. The survey included an embedded experimental design to test changing effects before versus after message exposure.
Participants:
A national sample of adult participants (n = 610) who had used urgent care at least once in the past year were recruited through GfK’s KnowledgePanelTM. KnowledgePanel survey response rates are typically about 65%. Respondents ranged in age from 18 to 85 and were more likely to be female (377/610; 62%), White (408/610; 67%), and covered by private insurance (414/610; 68%).
Results:
Outcome variables were measured on 4-point scales 1–4 scale, and t-tests were conducted for measures that were collected pre and postmessaging. The majority of participants trusted their doctor and desired them as the source for information regarding antibiotic resistance, followed by field experts (eg, CDC). Direct messaging (eg, email) and targeted advertisements were least preferred.
Conclusions:
This study provides foundational data on patient communication preferences in terms of source, message content, and channel when receiving information on antibiotics and antibiotic resistance, as well as how these factors affect patient concern, willingness, and expectations. Follow-up work is needed to replicate these findings in a postpandemic sample.
Bird strike accidents are critical threats for aviation safety especially in airport airspaces. Environment friendly solutions are preferred for wildlife managements to achieve harmonic coexistence between airports and surrounding environments. Avian radar systems are the most effective remote sensing approach for long-range and all-weather birds monitoring. Massive historical avian radar datasets and other data sources provide an opportunity to explore relevance between bird behaviour and environments. This paper proposes a bird behaviour characterisation and prediction method to reveal bird behaviour dependency with weather parameters. Bird behaviours are modelled as indices and grades from selected avian radar datasets. Weather dependence are studied from single parameter to multivariable parameters. The random forest model is selected as a behaviour grade prediction model taking four weather parameters as system inputs. Radar datasets for diurnal and nocturnal birds are constructed to validate their behaviour characters and prediction performance, respectively. Experiment results verify the feasibility of bird behaviour prediction using weather parameters, but also reflect some insufficiencies within the proposed method. Data sufficiency and severe weather considerations are also discussed to analyse their impact on prediction accuracy. A more comprehensive prediction model with standardised avian radar data quality and enhanced weather information accuracy is promising to further elevate the application significance of the proposed method.
Background: Hyperacute stroke care demands rapid, coordinated care. Traditional metrics like Door-to-Needle time are pivotal but insufficient for capturing the complexity of endovascular stroke interventions. The SMILES collaboration aims to standardize and optimize protocols for door-to-intervention times, incorporating Crew Resource Management (CRM). Methods: The multidisciplinary initiative integrates both hospitals, ED, neurology, and QI teams. We employed a comprehensive approach: stakeholder engagement, simulation-based learning, process mapping, and literature review. Emphasis was placed on enhancing situational awareness, triage and prioritization, cognitive load management, role clarity, effective communication, and debriefing. Results: The collaboration led to PDSA cycles and development of refined stroke protocols. Interventions included: 1) A ’zero point survey’ for team pre-arrival briefings, enhancing situational awareness and role clarity; 2) Streamlined patient registration to reduce cognitive load and improve triage efficiency; 3) Direct transfer of patients to imaging. Additionally, digital tools were implemented to facilitate communication. Simulation sessions reinforced CRM principles, leading to improved team cohesion and operational performance. Conclusions: The SMILES initiative is grounded in CRM principles by standardizing protocols and emphasizing non-technical skills crucial for high-stakes environments. This improves outcomes but also fosters a culture of safety and efficiency. Future directions include an evaluation of these protocols’ impact on patient factors.
Background: The fragility index (FI) is the minimum number of patients whose status would have to change from a nonevent to an event to turn a statistically significant result to a non-significant result. We used this to measure the robustness of trials comparing carotid endarterectomy (CEA) to carotid artery stenting (CAS). Methods: A search was conducted in MEDLINE, Embase, and PubMed on RCTs comparing CEA to CAS. The trials need to have statistically significant results and dichotomous primary endpoints to be included. Results: Our literature search identified 10 RCTs which included 9382 patients (4734 CEA, 4648 CAS). The primary end points of all included trials favoured CEA over CAS. The median FI was 9.5 (interquartile range 2.25 - 21.25). All of the studies that reported lost-to-follow-up (LTFU) had LTFU greater than its fragility index, which raises concern that the missing data could change the results of the trial from statistically significant to statistically insignificant. Conclusions: A small number of events (FI, median 9.5) were required to render the results of carotid artery stenosis RCTs comparing CEA to CAS statistically insignificant. All of the studies that reported LTFU had LTFU greater than its fragility index.
Background: Meningiomas are the most common intracranial tumor with surgery, dural margin treatment, and radiotherapy as cornerstones of therapy. Response to treatment continues to be highly heterogeneous even across tumors of the same grade. Methods: Using a cohort of 2490 meningiomas in addition to 100 cases from the prospective RTOG-0539 phase II clinical trial, we define molecular biomarkers of response across multiple different, recently defined molecular classifications and use propensity score matching to mimic a randomized controlled trial to evaluate the role of extent of resection, dural marginal resection, and adjuvant radiotherapy on clinical outcome. Results: Gross tumor resection led to improved progression-free-survival (PFS) across all molecular groups (MG) and improved overall survival in proliferative meningiomas (HR 0.52, 95%CI 0.30-0.93). Dural margin treatment (Simpson grade 1/2) improved PFS versus complete tumor removal alone (Simpson 3). MG reliably predicted response to radiotherapy, including in the RTOG-0539 cohort. A molecular model developed using clinical trial cases discriminated response to radiotherapy better than standard of care grading in multiple cohorts (ΔAUC 0.12, 95%CI 0.10-0.14). Conclusions: We elucidate biological and molecular classifications of meningioma that influence response to surgery and radiotherapy in addition to introducing a novel molecular-based prediction model of response to radiation to guide treatment decisions.
Ultrafast optical probing is a widely used method of underdense plasma diagnostic. In relativistic plasma, the motion blur limits spatial resolution in the direction of motion. For many high-power lasers the initial pulse duration of 30–50 fs results in a 10–15 μm motion blur, which can be reduced by probe pulse post-compression. Here we used the compression after compressor approach [Phys.-Usp. 62, 1096 (2019); JINST 17 P07035 (2022)], where spectral broadening is performed in thin optical plates and is followed by reflections from negative-dispersion mirrors. Our initially low-intensity probe beam was down-collimated for a more efficient spectral broadening and higher probe-to-self-emission intensity ratio. The setup is compact, fits in a vacuum chamber and can be implemented within a short experimental time slot. We proved that the compressed pulse retained the high quality necessary for plasma probing.
It is well-known that many modern lifestyles, including the use of artificial light, shift work, irregular or short sleep, sedentary activity, and unhealthy diet can disrupt the circadian rhythm. This disruption can result in the so-called Circadian Syndrome (CircS) which has been identified as a risk factor for a variety of chronic diseases. The concept of Circadian Syndrome (CircS) was first proposed by Zimmet et al in 2019. CircS has been shown to be a better predictor for cardiovascular diseases (CVD) than the metabolic syndrome (MetS) in adults in China and USA 1,2. Dietary patterns are found to be associated with CircS 3, whereby western dietary pattern was positively related, while prudent pattern was inversely associated, with CircS in the US adults. However, no prior study has investigated the association between fiber intake and CircS. We, thus, aimed to fill this research gap. We analysed data from 10,486 adults aged 20 years and above years who attended the 2005-2016 National Health and Nutrition Examination Survey (NHANES). Fiber and other nutrients intake were assessed using two days 24 hours recall. CircS was derived from all five components of MetS (i.e. central obesity, elevated fasting glucose, elevated triglyceride, reduced HDL-Cholesterol and elevated blood pressure), in addition to short sleep (sleep duration <6 hours/day) and depressive symptoms (PHQ-9 score ≥5). A cut-off for CircS was set as ≥ 4 components. Multivariable logistic regression was used to assess the association between fiber intake and CircS. Mean age of participants was 50.3(SD 17.6) years, and 41.3% had CircS. The mean (SD) fiber intake was 7.8 (2.1), 12.9 (1.3), 17.9 (1.7), and 28.9 (8.2) g/day across the quartiles of fiber intake. The prevalence of CircS decreased across quartiles of fiber intake (44.5% in Q4 and 37.1% in Q1). In the multivariable logistic model adjusting for age, gender, ethnicity, energy intake, education and lifestyle factors, across the quartiles of fiber intake, the odds ratios (ORs) (95%CI) for CircS were: 1.00, 0.91 (0.76-1.08), 0.82 (0.70-0.96), 0.79 (0.63-0.98) (p trend 0.012), respectively. No significant interactions were found between fiber intake and race, gender, smoking, alcohol drinking, and physical activity, in relation to CircS. In conclusion, a high fiber intake was associated with a lower prevalence of CircS among US adults. The findings highlight the importance of fiber intake for the prevention of metabolic and circadian syndrome, suggesting a potentially accessible and cost-effective lifestyle approach to improve public health. Our results underscore the concern that most of the US adults had fiber intake below the recommended level. Longitudinal studies are needed to validate the findings in different populations.
Plant growth requires the integration of internal and external cues, perceived and transduced into a developmental programme of cell division, elongation and wall thickening. Mechanical forces contribute to this regulation, and thigmomorphogenesis typically includes reducing stem height, increasing stem diameter, and a canonical transcriptomic response. We present data on a bZIP transcription factor involved in this process in grasses. Brachypodium distachyon SECONDARY WALL INTERACTING bZIP (SWIZ) protein translocated into the nucleus following mechanostimulation. Classical touch-responsive genes were upregulated in B. distachyon roots following touch, including significant induction of the glycoside hydrolase 17 family, which may be unique to grass thigmomorphogenesis. SWIZ protein binding to an E-box variant in exons and introns was associated with immediate activation followed by repression of gene expression. SWIZ overexpression resulted in plants with reduced stem and root elongation. These data further define plant touch-responsive transcriptomics and physiology, offering insights into grass mechanotranduction dynamics.
Nasal septoplasty is one of the most performed procedures within ENT. Nasal obstruction secondary to a deviated nasal septum is the primary indication for functional septoplasty. Since the coronavirus disease 2019 pandemic, waiting lists have increased and are now long. This study assessed patients on the waiting list for septoplasty and/or inferior turbinate reduction surgery using the Nasal Obstruction Symptom Evaluation instrument.
Method
Patients on our waiting list for septoplasty and/or inferior turbinate reduction surgery were reviewed using a validated patient-reported outcome measure tool to assess symptom severity.
Results
Eighty-six out of a total of 88 patients (98 per cent) had Nasal Obstruction Symptom Evaluation scores of 30 or more. In addition, 78 (89 per cent) and 50 (57 per cent) patients were classified as having ‘severe’ or ‘extreme’ nasal obstruction, respectively. Two patients scored less than 30 and were classified as having non-significant nasal obstruction.
Conclusion
The Nasal Obstruction Symptom Evaluation instrument is a quick and easy way to validate septoplasty waiting lists. In this study, two patients were identified who no longer required surgery.
Prior research supports retirement may negatively impact cognitive functioning. The current study examined the relationship between retirement status and the level of cognitive dysfunction amongst individuals with Alzheimer’s disease (AD). For the purpose of this study, it was predicted that there would be significantly higher levels of cognitive dysfunction in retired participants after controlling for age.
Participants and Methods:
Participants (ages 65 to 91) were drawn from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). The sample included 110 participants who were retired and 111 participants who were not retired. Cognitive dysfunction was assessed using the cognitive subscale of the modified Alzheimer’s Disease Assessment Scale (ADAS). A one-way ANCOVA analysis was conducted with cognitive dysfunction as the dependent variable and the age of the participants as a covariate.
Results:
The results of the one-way ANCOVA showed being retired was a significant predictor of greater cognitive dysfunction amongst individuals with AD after controlling for age (F(df=1, 218) = 231.143, p = < .001, p < .05) and accounted for 52% of the variance in the level of cognitive dysfunction.
Conclusions:
Being retired is associated with higher levels of cognitive dysfunction in AD after accounting for the effects of age. As such, continued cognitive activity may slow the progression of cognitive declines amongst individuals with AD who are retired. There is a need for future longitudinal research to determine how late retirement may delay the progression of cognitive decline in AD by controlling for other moderator factors such as genetics and work-related stress.
REAP-2 is an interactive dose-response curve estimation tool for Robust and Efficient Assessment of drug Potency. It provides user-friendly dose-response curve estimation for in vitro studies and conducts statistical testing for model comparisons with a redesigned user interface. We also make a major update of the underlying estimation method with penalized beta regression, which demonstrates great reliability and accuracy in dose estimation and uncertainty quantification. In this note, we describe the method and implementation of REAP-2 with a highlight on potency estimation and drug comparison.
Background: In meningiomas, CDKN2A/B deletions are associated with poor outcomes but are rare in most cohorts (1-5%). Large molecular datasets are therefore required to explore these deletions and their relationship to other prognostic CDKN2A alterations. Methods: We utilized multidimensional molecular data of 560 meningiomas from 5 independent cohorts to comprehensively interrogate the spectrum of CDKN2A alterations through DNA methylation, copy number variation, transcriptomics, and proteomics using an integrated molecular approach. Results: Meningiomas with either CDKN2A/B deletions (partial or homozygous loss) or an intact CDKN2A gene locus but elevated mRNA expression (CDKN2Ahigh) both had poor clinical outcomes. Increased CDKN2A mRNA expression was a poor prognostic factor independent of CDKN2A deletion. CDKN2A expression and p16 protein increased with tumor grade and more aggressive molecular and methylation groups. CDKN2Ahigh meningiomas and meningiomas with CDKN2A deletions were enriched for similar cell cycling pathways dysregulated at different checkpoints. p16 immunohistochemistry was unreliable in differentiating between meningiomas with and without CDKN2A deletions, but increased positivity was associated with increased mRNA expression. CDKN2Ahigh meningiomas were associated with gene hypermethylation, Rb-deficiency, and lack of response to CDK inhibition. Conclusions: These findings support the role of CDKN2A mRNA expression as a biomarker of clinically aggressive meningiomas with potential therapeutic implications.
It is unknown how much variation in adult mental health problems is associated with differences between societal/cultural groups, over and above differences between individuals.
Methods
To test these relative contributions, a consortium of indigenous researchers collected Adult Self-Report (ASR) ratings from 16 906 18- to 59-year-olds in 28 societies that represented seven culture clusters identified in the Global Leadership and Organizational Behavioral Effectiveness study (e.g. Confucian, Anglo). The ASR is scored on 17 problem scales, plus a personal strengths scale. Hierarchical linear modeling estimated variance accounted for by individual differences (including measurement error), society, and culture cluster. Multi-level analyses of covariance tested age and gender effects.
Results
Across the 17 problem scales, the variance accounted for by individual differences ranged from 80.3% for DSM-oriented anxiety problems to 95.2% for DSM-oriented avoidant personality (mean = 90.7%); by society: 3.2% for DSM-oriented somatic problems to 8.0% for DSM-oriented anxiety problems (mean = 6.3%); and by culture cluster: 0.0% for DSM-oriented avoidant personality to 11.6% for DSM-oriented anxiety problems (mean = 3.0%). For strengths, individual differences accounted for 80.8% of variance, societal differences 10.5%, and cultural differences 8.7%. Age and gender had very small effects.
Conclusions
Overall, adults' self-ratings of mental health problems and strengths were associated much more with individual differences than societal/cultural differences, although this varied across scales. These findings support cross-cultural use of standardized measures to assess mental health problems, but urge caution in assessment of personal strengths.
We studied how patient beliefs regarding the need for antibiotics, as measured by expectation scores, and antibiotic prescribing outcome affect patient satisfaction using data from 2,710 urgent-care visits. Satisfaction was affected by antibiotic prescribing among patients with medium–high expectation scores but not among patients with low expectation scores.