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Background Hybrid SPECT/CT systems allow the shortening of lead time for investigation of cancer patients, since a complementary CT for radiological characterization of focally increased isotope uptake of unclear origin in bone scintigraphy can be performed simultaneously. The use of low-dose CT (sub-mSv CT) reduces radiation dose compared to standard-dose CT and facilitates the application of complementary CT. Purpose To test the feasibility of sub-mSv CT for the characterization of non-specific findings in the bone scintigraphy of oncological patients. Material and Methods Nineteen oncological patients with a total of 50 findings of unclear origin on bone scintigraphy which required further correlation with morphologic data were included in the study. Each patient underwent two CT scan series consecutively: one low-dose CT and one standard-dose CT. The CT studies were randomized and each finding was rated by four blinded experienced radiologists. A shift in ratings between standard-dose and low-dose images were assessed using the Stuart–Maxwell chi-squared test. Inter-observer agreement and intra-observer agreement was assessed using Light’s kappa and Cohen’s kappa, respectively. Results The mean effective dose of low-dose CT scans was 0.8 mSv compared to 4.2 mSv for the standard-dose CT scans. No statistically significant shift in ratings was observed ( P = 0.62). There was no statistically significant difference in the inter-observer agreements: the values for the standard-dose and low-dose groups were 0.68 (95% confidence interval [CI] 0.57–0.79) and 0.60 (95% CI 0.47–0.72), respectively. Conclusion These results indicate that sub-mSv CT for characterization of non-specific findings in bone scintigraphy of oncological patients is feasible.

BackgroundX-ray tube voltage (kVp) reduction increases intravenous contrast medium (CM) attenuation at computed tomography (CT), but tube output limits its use in large patients.PurposeTo evaluate the feasibility and image quality of reducing CM dose by low kVp and using dual X-ray source at liver CT.Material and MethodsPatients with estimated glomerular filtration rate (eGFR) 65 years with eGFR > 45 mL/min scanned using a standard abdominal protocol at 120 kVp after receiving 0.5 gI/kg.ResultsThere was no statistically significant difference in CNR, liver noise, or muscle noise at reduced CM protocols compared to the standard protocol: CNR was 4.6 (95% CI = 4.2–5.0) vs. 5.0 (95% CI = 4.5–5.5), liver noise was 11.1 (95% CI = 10.7–11.6) vs. 11.0 (95% CI = 10.5–11.6), muscle noise was 11.7 (95% CI = 11.2–12.1) vs. 10.8 (95% CI = 10.1–11.4). The mean SSDE was 70% higher with the reduced CM protocol.ConclusionCM dosage can be reduced by 40–50% with maintained measured noise and CNR in patients with BMIs of 15–36 kg/m2by lowering the tube voltage and dual-source CT scanning of the liver.

Purpose: To evaluate the potential of low tube voltage dual source (DS) single energy (SE) and dual energy (DE) computed tomography (CT) to reduce contrast media (CM) dose in adult abdominal examinations of various sizes while maintaining soft tissue and iodine contrast-to-noise ratio (CNR). Methods: Four abdominal phantoms simulating a body mass index of 16 to 35 kg/m2 with four inserted syringes of 0, 2, 4, and 8 mgI/ml CM were scanned using a 64-slice DS-CT scanner. Six imaging protocols were used; one single source (SS) reference protocol (120 kV, 180 reference mAs), four low kV SE protocols (70 and 80 kV using both SS and DS), and one DE protocol at 80/140 kV. Potential CM reduction with unchanged CNRs relative to the 120 kV protocol was calculated along with the corresponding increase in radiation dose. Results: The potential contrast media reductions were determined to be approximately 53% for DS 70 kV, 51% for SS 70 kV, 44% for DS 80 kV, 40% for SS 80 kV, and 20% for DE (all differences were significant, P < 0.05). Constant CNR could be achieved by using DS 70 kV for small to medium phantom sizes (16–26 kg/m2) and for all sizes (16–35 kg/m2) when using DS 80 kV and DE. Corresponding radiation doses increased by 60%–107%, 23%–83%, and 6%–12%, respectively. Conclusions: DS single energy CT can be used to reduce CM dose by 44%–53% with maintained CNR in adult abdominal examinations at the cost of an increased radiation dose. DS dual-energy CT allows reduction of CM dose by 20% at similar radiation dose as compared to a standard 120 kV single source.

Background The development of transdiagnostic standardized measures of psychological distress have contributed to the development of practice-based evidence networks. The translation and validation of such measures cross culturally is important if such research is to be generalized across health care systems in different countries. Method Translation of the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM) from English into Icelandic was undertaken according to recommended protocols. The resulting instrument was evaluated for reliability and validity in three groups: patients undergoing psychological treatment in general practice (n = 289), psychiatric outpatients (n = 98) and student controls (n = 207). The Mini-International Neuropsychiatric Interview was administered to the clinical participants. They also completed the CORE-OM and the Beck depression and anxiety inventories before and after treatment. The transdiagnostic relationship between CORE-OM scores and scores on those diagnostic measures was assessed. Results Good levels of validity, reliability and internal consistency were found for the CORE-OM and its domains and sensitivity to change over treatment shown. As anticipated, the risk domain had different characteristics than other domains. CORE-OM scores correlated strongly with both Beck Depression Inventory–Second edition and Beck Anxiety Inventory, particularly the problem domain. Conclusion The Icelandic translation of the CORE-OM is psychometrically sound and can be applied in Icelandic mental health studies as it has been in English speaking settings. Nevertheless, the validity of the Icelandic version of the CORE-OM needs to be further investigated in larger and more diverse samples. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message The psychometric properties of the Icelandic version of the CORE-OM are comparable with the original English version. The results indicate transdiagnostic utility of the CORE-OM. The CORE-OM is a valuable instrument in outcome research on psychological treatment, specifically transdiagnostic treatment.

The distressed (Type D) personality (the combination of negative affectivity and social inhibition traits) has been associated with adverse health outcomes. This study investigated the validity of the Type D construct against the Five-Factor Model (FFM) of personality, and its association with emotional control and distress. In total 498 university students (mean age 28.9 ± 8.4 years) completed the Type D scale (DS14), and measurements for the FFM of personality, emotional control, anxiety, depression and stress. The construct validity of the Icelandic DS14 was confirmed. The Type D components negative affectivity and social inhibition were strongly associated with neuroticism and extraversion of the FFM (r = 0.82 and r = −0.67, respectively). Negative affectivity also correlated with rehearsal/rumination (r = 0.58) and social inhibition with emotional inhibition (r = 0.54), indicative of emotional control. Type D personality (40% of sample) was associated with higher levels of anxiety, depression and stress. The Type D personality components were associated with the FFM of personality, emotional control and emotional distress. Importantly, social and emotional inhibition were closely related, providing novel information about the presence of emotional inhibition within the social inhibition trait.Highlights► This study examined the validity of Type D personality in young, healthy adults. ► The Type D subcomponents correspond well with the Five-Factor Model of personality. ► The presence of emotional inhibition in the social inhibition trait was confirmed. ► Type D personality was related to elevated anxiety, depression and stress scores.Keywords: Type D personality, Five-Factor Model of personality, Emotional control, Emotional distress, Validity

This study compared children with early and late diagnosis of autism spectrum disorder (ASD). All children in four consecutive birth cohorts in Iceland diagnosed with ASD were divided into two groups based on their age at initial ASD diagnosis: 58 children were diagnosed before age 6 (group 1) and 41 children after age 6 (group 2). Children in group 1 were more likely to receive a diagnosis of childhood autism ( p ≤ 0.001), their average IQ/DQ was lower ( p p p p p = 0.224), frequency of associated medical conditions ( p = 0.640), age of first parental concern ( p = 0.244), and age of first autistic symptoms on hindsight ( p = 0.540). The majority of parents (76.2%) had developmental concerns before age 3, and with hindsight 83.3% thought that autistic symptoms had been present before age 2.

This study reports findings on Internet gambling and problem gambling among Icelandic youth. Participants were 1.537 13-18 year-old students, 786 boys and 747 girls. Results revealed that 56.6% had gambled at least once in the past 12 months and 24.3% on the Internet. Gender and developmental differences were found for Internet gambling, as boys and older age-groups were more likely to gamble on the Internet than girls or younger age groups. Problem gambling for the total sample was 2.2%, but Internet gamblers were more likely to be classified as problem gamblers (7.7%) than non-Internet gamblers (1.1%). A comparison of the findings of this study to earlier studies on adolescents conducted in 2003 and 2004 reveals that Icelandic adolescents are gambling less in land-based types of gambling and more on the Internet. In general, the results of this study thus suggest that the gambling habits of Icelandic youth are changing.

Neuroticism (N) assesses emotional sensitivity or lability, but the construct is poorly defined and instruments used to assess N are marred by a number of psychometric shortcomings. Neuroticism is also described in an overtly pejorative way, with items keyed for themes reflecting low self-esteem, anxiety, and depression. The present paper presents a revised model based on a new questionnaire entitled the Emotional Sensitivity Scale (ESS). Using an innovative scenario technique to generate items, exploratory factor analysis of the responses of 242 participants yielded orthogonal dimensions for positive (other-oriented) and negative (self-centered) emotional sensitivity, and the structure was confirmed using confirmatory factor analysis. Validation studies showed that the ESS dimensions were related in systematic ways to related psychometric instruments and that, as predicted, participants scoring high on the positive dimension were better able to recognize displayed emotions. The new scale offers a basis for extending the research on emotional sensitivity using empirically discriminable positive and negative components.

The aim of the present study was to explore cross-cultural differences in emotion control, using the Emotion Control Questionnaire [ECQ — Roger, D., & Najarian, B. (1989). The construction and validation of a new scale for measuring emotional control. Personality and Individual Differences, 10 , 845–853]. The ECQ has been extensively validated on English samples, but rather than using the original published factor structure to derive mean scores, the study was based on comparisons between new factor analyses of ECQ data obtained from comparable samples of English, Spanish and Korean subjects. Consistent differences emerged, suggesting that the Korean subjects in particular differed in the way they construed emotional behaviour. Subsequent confirmatory factor analyses suggested that a two-factor model comprising emotional inhibition and emotional rumination offered the best fit for the data across all three samples, and new scales based on these findings are proposed.

Type D personality has been associated with poor prognosis in cardiac patients. This study investigated the validity of the Type D construct in Iceland and its association with disease severity and health-related risk markers in cardiac patients. A sample of 1,452 cardiac patients completed the Type D scale (DS14), and a subgroup of 161 patients completed measurements for the five-factor model of personality, emotional control, anxiety, depression, stress and lifestyle factors. The Icelandic DS14 had good psychometric properties and its construct validity was confirmed. Prevalence of Type D was 26-29%, and assessment of Type D personality was not confounded by severity of underlying coronary artery disease. Regarding risk markers, Type D patients reported more psychopharmacological medication use and smoking, but frequency of previous mental problems was similar across groups. Type D is a valid personality construct in Iceland, and is associated with health-related risk markers, but not cardiac disease severity.

In the wake of rapid expansion of legal gambling internationally, studies of adolescent gambling involvement and problem gambling prevalence have been carried out in numerous jurisdictions. This paper reviews adolescent gambling prevalence studies that have been carried out in North America, Europe, and Oceania. Based on this review, work is clearly needed to assess the impact of survey methods on identified prevalence rates and to improve the measurement of problem gambling among adolescents. From a substantive perspective, several clear demographic and behavioral characteristics are associated with gambling involvement and problem gambling among youth. However, early assumptions about youth gambling and problem gambling must give way to more nuanced understandings of how these phenomena change in response to changes in the social and cultural environment. We may have traveled some distance down the road toward understanding the determinants as well as the distribution of youth gambling and problem gambling, but we still have a long way to go.

This study aimed to develop a new psychometric instrument to assess vulnerability to risk of suicide and nonfatal self-harm behaviour in young adult male and female offenders. In total three studies were conducted to assess the psychometric properties of the new instrument using both exploratory and confirmatory factor analysis in different samples. Participants in all three studies included a total of 1,166 young adult offenders across six Her Majesty's Prisons. The new instrument, Suicide Concerns for Offenders in Prison Environment (SCOPE), contained 28 items scoring on two subscales. The factorial structure of the new instrument initially obtained with exploratory factor analysis was subsequently confirmed in a new sample. The internal consistency of the two subscales were acceptable but the test—retest reliability coefficients were moderate. Concurrent validation with the Beck Hopelessness Scale was acceptable and SCOPE showed the ability to discriminate between those at risk and those with no known history of attempted suicide and nonfatal self-harm behaviour ( p < 0.01).

In the present study, the psychometric properties of the Obsessive Compulsive Inventory-Revised (OCI-R) (Foa, et al., 2002) were investigated. The OCI-R was administered to a total of 816 Icelandic college students. The Maudsley Obsessive Compulsive Inventory (MOCI) and the Penn State Worry Questionnaire (PSWQ) were administered to a subsample of 304 students, and the PI-WSUR (Padua Inventory Washington State University Revision), the PSWQ and the Multidimensional Perfectionism Scale (MPS) to another subsample of 212 students. Also, 89 students filled in the OCI-R twice with two weeks in between. The factor structure of the instrument was replicated in a confirmatory factor analysis. Cronbach's alpha and test-retest reliabilities of the OCI-R total scale and all subscales were satisfactory. Further, the OCI-R total score showed a significantly higher correlation with the PI-WSUR and the MOCI than with the PSWQ or the MPS. Finally, conceptually similar scales of the OCI-R and the MOCI as well as the PI-WSUR showed higher inter-correlations than the correlations that were observed between conceptually more distinct scales. It is concluded that the Icelandic version of the OCI-R has strong psychometric properties in a student population.

The aim of this study was to estimate gambling participation and problem gambling among Icelandic adolescents. Participants were 750 16-18-year-old students, 371 girls and 379 boys. The rate of problem gambling was estimated with the SOGS-RA and DSM-IV-MR-J. Results indicated that 96% of adolescents had gambled in their lifetime, 79% at least once in the preceding year and about 10% gamble at least once a week. A psychometric evaluation of the two screening scales revealed satisfactory reliabilities and factor structures for both scales. The DSM-IV-MR-J identified 2% of the participants as problem gamblers while SOGS-RA identified 2.7%, and problem gambling was more common among boys than girls. It was concluded that problem gambling among adolescents is an area of concern for the Icelandic community that needs to be further investigated.

A psychometric assessment of the Icelandic version of the Multidimensional Anxiety Scale for Children (MASC) was undertaken among Icelandic schoolchildren, between 10 and 15 years of age. In a first study 625 children between 10 and 15 years of age filled in the MASC. A confirmatory factor analysis indicated that the four-factor structure of the instrument was justified. Further, means and standard deviations of the total scale and the subscales were similar to the original normative data reported by March (1997). In a second study the MASC, the Children Depression Inventory (CDI) and the Revised Children's Manifest Anxiety Scale (RCMAS) were administered to a sample of 249 schoolchildren between 10 and 15 years of age. The results supported the convergent and divergent validity of the MASC. Together the two studies show satisfactory psychometric properties of the Icelandic version of the MASC in a normal population.

This paper reports the main findings from a prevalence study of adolescent gambling and problem gambling among Icelandic adolescents. The final sample consisted of 3,511 pupils aged 13 to 15 in 25 primary schools in Reykjavík. The results indicated that 93% of adolescents had gambled some time in their life and 70% at least once in the preceding year. Problem gambling prevalence rates were evaluated with two gambling screens, American Psychological Association Diagnostic and Statistical Manual, 4th edition, Multiple-Response-Junior (DSM-IV-MR-J) and the South Oaks Gambling Screen Revised for Adolescents (SOGS-RA). The DSM-IV-MR-J identified 1.9% as problem gamblers, while SOGS-RA identified 2.8% as problem gamblers. The results also showed that problem gamblers reported more difficulties in school and used alcohol and other drugs more frequently than adolescents who gambled socially or not at all. Finally, evaluation of electronic gambling machine (EGM) accessibility revealed that gambling on low-stakes EGMs in public places was more common than on EGMs in arcades or bars and restaurants. The potential implications of these findings are discussed.