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Abstract Prevention programs, such as mindfulness-based interventions (MBIs), are often implemented in schools to prevent psychological disorders from emerging in children and to support their mental health. This study used a randomized cluster design to evaluate the impact of a MBI, called Mission Méditation, on the well-being and the mental health of elementary school children’s. 13 classrooms of an elementary school were randomly allocated to the experimental condition (7 classrooms, n = 127 students) or the waitlist control condition (6 classrooms, n = 104 students). Participants in the experimental condition received a 10-week MBI. Regression analyses revealed significant differences between conditions for inattention. Participants in the MBI condition reported no change in pre- to post-intervention, whereas participants in the control condition reported pre- to post-intervention increases. Results also showed significant differences in perceived competence. Participants in the MBI condition reported a non-significant decrease in perceive competence, whereas participants in the control condition reported significantly higher perceive competence scores from pre- to post-intervention. Results do not indicate that the MBI had a significant impact on participant’s well-being and mental health. This suggests that MBIs may not have an added value when compared to other preventive interventions geared towards well-being and mental health promotion in school settings.

The studies described in this paper investigated whether cultural hierarchy plays a moderating role in the association between parental autonomy support and child psychosocial adjustment, employing samples presenting a wide range of cultural variability (parents born in 71 different nations). The participants’ cultural backgrounds, based on the parents’ birth country, were rated in terms of emphasis on hierarchical power using Schwartz’s dimensional coding system. Structural equation modelling analyses revealed no moderation effect of cultural hierarchy on the relation between parental autonomy support and child outcomes, with the exception of the relation between parental autonomy support and adolescents’ autonomous self-regulation. As expected, parental autonomy support and cultural hierarchy were significantly and negatively correlated. Parental autonomy support was often associated with indicators of youth psychosocial adjustment, whereas cultural hierarchy was generally unrelated to adjustment. These results support self-determination theory’s position on the universal benefits of autonomy support.

Abstract Background Current guidelines for adult patients with pneumococcal meningitis (PM) recommend initial management in intermediate or intensive care units (ICU), but evidence to support these recommendations is limited. We aimed to describe ICU admission practices of patients with PM. Methods We conducted a retrospective analysis of the French medico administrative database of consecutive adult patients with PM and sepsis criteria hospitalized between 2011 and 2020. We defined two groups, “Direct ICU” corresponding to a direct ICU admission and “Delayed ICU” corresponding to a secondary ICU admission. Results We identified 4052 patients hospitalized for a first episode of PM, including 2006 “Direct ICU” patients (50%) and 2046 “delayed ICU” patients (50%). The patients were mainly males [n = 2260 (56%)] with median age of 61 years [IQR 50–71] and a median Charlson index of 1 [0–3]. Among them, median SAPS II on admission was 46 [33–62], 2173 (54%) had a neurological failure on admission with 2133 (53%) in coma, 654 (16%) with brainstem failure, 488 (12%) with seizures and 779 (19%) with focal signs without coma. PM was frequently associated with pneumonia [n = 1411 (35%)], and less frequently with endocarditis [n = 317 (8%)]. The median ICU length of stay and hospital length of stay were 6 days [2–14] and 21 days [13–38], respectively. In-hospital mortality was 27% (n = 1100) and 640 (16%) patients were secondarily transferred to rehabilitation care unit. Direct ICU group was significantly more severe but after adjustment for age, sex, comorbidities, organ failures on admission and admission from home, direct ICU admission was significantly associated with a lower mortality (Odds ratio 0.67 [0.56–0.80], p

Abstract Emerging evidence on the coronavirus disease 2019 (COVID‐19) pandemic suggests that children are experiencing a deterioration in mental health, namely, an increase in anxiety, depression, and hyperactivity symptoms. To address this rising issue, preventive strategies and mental health interventions need to be evaluated to help children in their school setting. Recent studies have suggested that art‐based interventions could increase children's well‐being and be easily implemented in schools. The goal of this study was to assess the effects of an emotion‐based directed drawing intervention, compared to a mandala drawing intervention, on elementary school children's (n = 165) mental health, in the context of the COVID‐19 pandemic. An experimental design was used to compare the effects of the two interventions on primary school students' anxiety, depression, and inattention symptoms. All drawing activities were led by an online facilitator, while children and teachers attended school in‐person. Mixed analyses of variance revealed a significant effect of time on students' levels of anxiety. Post hoc sensitivity analyses indicated that children from both groups reported lower levels of anxiety pre‐ to postintervention. Results from this study showed that, in the context of the COVID‐19 pandemic, both emotion‐based and mandala drawing interventions could improve certain mental health aspects of elementary school children, by reducing their anxiety levels. Informal evidence indicates that implementing these interventions online and remotely through a videoconferencing platform is feasible and well received by children and their teachers. Nevertheless, future studies should include an inactive control group, explore the acceptability of the intervention, and use longitudinal methods to better document if the positive impacts on mental health can be maintained through time.

Background: Cheating at the post-secondary level is a skewed phenomenon. While personality and environmental factors are associated with cheating, few studies account for the zero inflation when predicting cheating behaviour. Aim: In this study, we explore a person-situation interaction hypothesis where teacher autonomy support (AS) could modify the relation between students' honesty trait and premeditated cheating. Sample: Participants were 710 college students and 31 teachers. Methods: Teacher and student reports of teacher AS were collected and students also completed self-reports of honesty and premeditated cheating. Results: Given that cheating had a zero-inflated negative binomial distribution, we can investigate two separate outcomes--likelihood of cheating and magnitude of cheating. Predictably, student honesty trait predicted lower likelihood and magnitude of cheating. AS, whether student- or teacher-reported, moderated the relation between honesty and likelihood of cheating. In low perceived AS teaching environments, student honesty was associated with cheating likelihood. However, there was no such relation in high perceived AS teaching environments. Conclusions: Students' honesty generally predicts lower cheating. However, the educational environment provided by the teacher influences the strength of this association. The less autonomy-supportive students perceive the educational environment, the more their personality is important in predicting the likelihood of cheating.

The emergence of rituximab biosimilars offers the prospect of significant savings to the healthcare system. However, these drugs have never been evaluated for treating immune thrombocytopenia (ITP). This was an observational, matched study. We included adults who received a rituximab biosimilar for ITP. Each rituximab-naïve biosimilar patient was matched with two controls from the historic ITP-ritux registry. For non-naïve patients, we compared the response to the biosimilar with that observed with the reference product. Response status was defined according to international criteria. We included 107 patients; 55 receiving Rixathon™ and 52 Truxima™. Three months after the first infusion of rituximab biosimilars, the overall response rate was 47/74 (63.5%) versus 76/142 (53.5%) for the matched controls receiving the reference product (p = .13). The 3-month overall response rate was 76.5% for Rixathon™ versus 51.5% for the matched control group (p = .01) and 21/40 (52.5%) for Truxima™ versus 41/74 (55.4%) for the matched controls (p = .81). For non-naïve patients, the response pattern was similar to that observed previously with the reference product. Safety was analogous to that observed with the reference product. Rituximab biosimilars seemed safe and effective for ITP treatment.

Abstract IFNα and anti-IFNα autoantibodies have been implicated in susceptibility both for systemic lupus erythematosus (SLE) and viral infection. We aimed to analyze the SLE disease phenotype and risk for infection associated with anti-IFN-α IgG autoantibodies in SLE patients In this multidisciplinary retrospective single referral center study, all consecutive patients with SLE admitted between January 1st and November 30th 2020 were considered. All subjects fulfilled the ACR/EULAR 2019 criteria for SLE. Anti-IFNα IgG autoantibodies were quantified at admission by ELISA. Demographic, medical history, laboratory, treatment, and outcome data were extracted from electronic medical records using a standardized data collection form. 180 patients [female 87.2%, median age of 44.4 (34–54.2) years] were included. The median disease duration was 10 years [4–20] with a median SLEDAI score of 2 [0–4] at study time. Fifty-four (30%) patients had a past-history of lupus nephritis. One hundred and forty-four (80%) had received long-term glucocorticoids and 99 (55%) immunosuppressive drugs. Overall, 127 infections—mostly bacterial and viral—were reported in 95 (52.8%) patients. Twenty SLE patients (11.1%) had positive anti-IFNα IgG autoantibodies with a titer ranging from 10 to 103 UA/mL. Age, sex, SLE phenotype and treatment did not significantly differ between SLE patients with or without anti-IFNα. Infection rate was similar in both groups except for tuberculosis which was more frequent in patients with anti-IFNα (20% vs. 3.1%, p = 0.01). The prevalence of autoantibodies against IFNα is high in SLE and associated with a higher frequency of tuberculosis.

The purpose of this study was to evaluate coaches' experience of the reROOT program, a program aiming to increase coaches' autonomy-supportive skills, structure, and involvement. We delivered the program to 32 university sports coaches, and of these coaches, 13 participated in three semistructured focus groups 2 weeks postprogram and discussed their experience of the program. Guiding questions aimed at assessing participants' responsiveness to the program and its perceived usefulness. Classical content analyses were performed and organized based on the guiding questions when applicable. Results suggest that coaches appreciated the program, believed that they could implement its skills in their day-to-day coaching, and observed positive impacts on themselves and their athletes despite the COVID-19 pandemic. It thus appears that coaches are responsive to the reROOT program and that it could be a useful part of their training. [ABSTRACT FROM AUTHOR]

Objective: To analyze the risk of systemic lupus erythematosus (SLE) flare after admission for COVID-19. Methods: We performed a matched cohort study using the Assistance Publique—Hôpitaux de Paris Clinical Data Warehouse which collects structured medical, biological and administrative information from 11 million patients in Paris area, France. Each SLE patient hospitalized with a COVID-19 diagnosis code between March 2020 and December 2021 was matched to one SLE control patient with an exact matching procedure using age ±3 years, gender, chronic kidney disease, end-stage renal disease, and serological activity. The main outcome was a lupus flare during the 6 months follow-up. A flare was considered if a) documented by the treating physician in the patient's EHR and b) justifying a change in SLE treatment. The electronic health records (EHRs) were individually checked for data accuracy. Results: Among 4,533 SLE patients retrieved from the database, 81 (2.8%) have been admitted for COVID-19 between March 2020 and December 31, 2021, and 79 (n = 79/81,97.5%) were matched to a unique unexposed SLE. During follow-up, a flare occurred in 14 (17.7%) patients from the COVID-19 group as compared to 5 (6.3%) in the unexposed control group, including 4 lupus nephritis in the exposed group and 1 in the control group. After adjusting for HCQ use at index date and history of lupus nephritis, the risk of flare was higher in exposed SLE patients (hazard ratio [95% confidence interval] of 3.79 [1.49–9.65]). Conclusions: COVID-19 hospitalization is associated with an increased risk of flare in SLE. [ABSTRACT FROM AUTHOR]

Objectives: To describe the uptake of anti-SARS-CoV2 vaccination in 2021 and investigate vaccine effectiveness in systemic lupus erythematosus (SLE) patients in Sweden. Methods: The cumulative incidence of first anti-SARS-CoV2 vaccination was estimated among SLE patients from the Swedish National Patient Register and matched comparators living in Sweden on January 1, 2021. To assess vaccine effectiveness, we included the individuals who received two doses of anti-SARS-CoV2 mRNA vaccines before year 2022, with no COVID-19 diagnosis code before the 2nd vaccine dose. Hospitalization rates with COVID-19 as main diagnosis during the year after second dose were compared between SLE patients and comparators in multivariable-adjusted marginal Cox models, overall and stratified by immunosuppressive treatment received during the year before second vaccine dose. Results: Vaccination uptake was similar between SLE patients and comparators. By December 2021, 9% of both SLE and comparators had not received any vaccine doses. Among 5585 SLE patients and 37,102 comparators, 11 COVID-19 hospitalizations in the SLE group and 20 in the comparators occurred. SLE was associated with a higher risk of COVID-19 hospitalization (HR = 3.47, 95%CI 1.63-7.39). The HR was higher for immunosuppressive-treated SLE (7.03 95%CI 3.00-16.46) than for immunosuppressive-untreated (1.50 95%CI 0.34-6.60). Vaccination of immunosuppressive-untreated SLE patients had similar effectiveness as comparators. Conclusion: Anti-SARS-CoV2 vaccination coverage was similar between SLE patients and the general population in Sweden. Even though the incidence of post-vaccination COVID-19 hospitalization was very low, vaccine effectiveness was diminished in SLE patients compared to the general population and lowest in those treated with immunosuppressants. [ABSTRACT FROM AUTHOR]

IntroductionWe investigated whether initial risk classes and heterogeneous trajectories of self-compassion over the course of the pandemic may impact well-being outcomes 1 year into the pandemic.MethodsA large, representative sample of Canadians (N = 3,613; 50.6% women) was sampled longitudinally over 11 waves (April 2020–April 2021), using a rolling cross-sectional survey design. Analyses were conducted in three steps: (1) latent class analysis to identify heterogeneity in risk factors (sociodemographic, cognitive-personality, health-related) early in the pandemic, (2) latent class growth analysis (LCGA) to identify longitudinal self-compassion trajectories, and (3) GLM to examine effects of risk factor classes and self-compassion trajectories, as well as their interaction, on later well-being (mental health, perceived control, life satisfaction).Results and DiscussionFour risk factor classes emerged, with 50.9% of participants experiencing low risk, 14.3% experiencing multiple risks, 20.8% experiencing Cognitive-Personality and Health risks, and 14.0% experiencing sociodemographic and Cognitive-Personality risks. Four self-compassion trajectories also emerged, with 47.7% of participants experiencing moderate-high self-compassion that decreased then stabilized, 32.0% experiencing moderate self-compassion that decreased then stabilized, 17.3% experiencing high and stable self-compassion across time, and 3.0% experiencing low and decreasing self-compassion. Comparisons of well-being outcomes 1 year post-pandemic indicated that higher levels of self-compassion over time may protect against the impact of initial risk on well-being outcomes. Further work is still needed on heterogeneity in experiences of risk and protective factors during stressful life events.

Abstract Background The potential relationship between intravascular catheter infections with their insertion during weekend or night-time (i.e., off-hours or not regular business hours) remains an open issue. Our primary aim was to describe differences between patients and catheters inserted during on- versus off-hours. Our secondary aim was to investigate whether insertions during off-hours influenced the intravascular catheter infectious risks. Methods We performed a post hoc analysis using the databases from four large randomized-controlled trials. Adult patients were recruited in French ICUs as soon as they required central venous catheters or peripheral arterial (AC) catheter insertion. Off-hours started at 6 P.M. until 8:30 A.M. during the week; at weekend, we defined off-hours from 1 P.M. on Saturday to 8.30 A.M. on Monday. We performed multivariable marginal Cox models to estimate the effect of off-hours (versus on-hours) on major catheter-related infections (MCRI) and catheter-related bloodstream infections (CRBSIs). Results We included 7241 patients in 25 different ICUs, and 15,208 catheters, including 7226 and 7982 catheters inserted during off- and on-hours, respectively. Catheters inserted during off-hours were removed after 4 days (IQR 2, 9) in median, whereas catheters inserted during on-hours remained in place for 6 days (IQR 3,10; p 4 or > 6 days, we found a similar risk for MCRI and CRBSI between off- and on-hours. Similar results were observed for ACs. Conclusions Off-hours did not increase the risk of intravascular catheter infections compared to on-hours. Off-hours insertion is not a sufficient reason for early catheter removal, even if femoral route has been selected.

BackgroundReliable and interpretable automatic extraction of clinical phenotypes from large electronic medical record databases remains a challenge, especially in a language other than English. ObjectiveWe aimed to provide an automated end-to-end extraction of cohorts of similar patients from electronic health records for systemic diseases. MethodsOur multistep algorithm includes a named-entity recognition step, a multilabel classification using medical subject headings ontology, and the computation of patient similarity. A selection of cohorts of similar patients on a priori annotated phenotypes was performed. Six phenotypes were selected for their clinical significance: P1, osteoporosis; P2, nephritis in systemic erythematosus lupus; P3, interstitial lung disease in systemic sclerosis; P4, lung infection; P5, obstetric antiphospholipid syndrome; and P6, Takayasu arteritis. We used a training set of 151 clinical notes and an independent validation set of 256 clinical notes, with annotated phenotypes, both extracted from the Assistance Publique-Hôpitaux de Paris data warehouse. We evaluated the precision of the 3 patients closest to the index patient for each phenotype with precision-at-3 and recall and average precision. ResultsFor P1-P4, the precision-at-3 ranged from 0.85 (95% CI 0.75-0.95) to 0.99 (95% CI 0.98-1), the recall ranged from 0.53 (95% CI 0.50-0.55) to 0.83 (95% CI 0.81-0.84), and the average precision ranged from 0.58 (95% CI 0.54-0.62) to 0.88 (95% CI 0.85-0.90). P5-P6 phenotypes could not be analyzed due to the limited number of phenotypes. ConclusionsUsing a method close to clinical reasoning, we built a scalable and interpretable end-to-end algorithm for extracting cohorts of similar patients.

Summary: Creativity is a highly valued and beneficial skill that empirical research typically probes using “divergent thinking” (DT) tasks such as problem solving and novel idea generation. Here, in contrast, we examine the perceptual aspect of creativity by asking whether creative individuals are more likely to perceive recognizable forms in ambiguous stimuli –a phenomenon known as pareidolia. To this end, we designed a visual task in which participants were asked to identify as many recognizable forms as possible in cloud-like fractal images. We found that pareidolic perceptions arise more often and more rapidly in highly creative individuals. Furthermore, high-creatives report pareidolia across a broader range of image contrasts and fractal dimensions than do low creatives. These results extend the established body of work on DT by introducing divergent perception as a complementary manifestation of the creative mind, thus clarifying the perception-creation link while opening new paths for studying creative behavior in humans.