Background: The use of ecological momentary assessment (EMA) designs has been on the rise in mental health epidemiology. However, there is a lack of knowledge of the determinants of participation in and compliance with EMA studies, reliability of measures, and underreporting of methodological details and data quality indicators. Objective: This study aims to evaluate the quality of EMA data in a large sample of university students by estimating participation rate and mean compliance, identifying predictors of individual-level participation and compliance, evaluating between- and within-person reliability of measures of negative and positive affect, and identifying potential careless responding. Methods: A total of 1259 university students were invited to participate in a 15-day EMA study on mental health problems. Logistic and Poisson regressions were used to investigate the associations between sociodemographic factors, lifetime adverse experiences, stressful events in the previous 12 months, and mental disorder screens and EMA participation and compliance. Multilevel reliability and intraclass correlation coefficients were obtained for positive and negative affect measures. Careless responders were identified based on low compliance or individual reliability coefficients. Results: Of those invited, 62.1% (782/1259) participated in the EMA study, with a mean compliance of 76.9% (SD 27.7%). Participation was higher among female individuals (odds ratio [OR] 1.41, 95% CI 1.06-1.87) and lower among those aged ≥30 years (OR 0.20, 95% CI 0.08-0.43 vs those aged 18-21 years) and those who had experienced the death of a friend or family member in the previous 12 months (OR 0.73, 95% CI 0.57-0.94) or had a suicide attempt in the previous 12 months (OR 0.26, 95% CI 0.10-0.64). Compliance was particularly low among those exposed to sexual abuse before the age of 18 years (exponential of β=0.87) or to sexual assault or rape in the previous year (exponential of β=0.80) and among those with 12-month positive alcohol use disorder screens (exponential of β=0.89). Between-person reliability of negative and positive affect was strong (RkRn>0.97), whereas within-person reliability was fair to moderate (Rcn>0.43). Of all answered assessments, 0.86% (291/33,626) were flagged as careless responses because the response time per item was <1 second or the participants gave the same response to all items. Of the participants, 17.5% (137/782) could be considered careless responders due to low compliance (<25/56, 45%) or very low to null individual reliability (raw Cronbach α<0.11) for either negative or positive affect. Conclusions: Data quality assessments should be carried out in EMA studies in a standardized manner to provide robust conclusions to advance the field. Future EMA research should implement strategies to mitigate nonresponse bias as well as conduct sensitivity analyses to assess possible exclusion of careless responders.

The current article examined stoma self-care and health-related quality of life in patients with drainage enterostomy, described clinical and sociodemographic variables and analyzed the relationship between all of them. Trained interviewers collected data using a standardized form that queried sociodemographic and clinical variables. In addition, Self-Care (SC) was measured through a specific questionnaire for Ostomized Patients (CAESPO) and Health-Related Quality of Life (HRQoL) through the Stoma Quality of Life questionnaire (S-QoL), which are not included in the electronic medical record. This was a multicenter, cross sectional study conducted in four hospitals of the province of Castellon (Spain), where 139 participants were studied. As novel findings, it was found that the level of SC of the stoma was high and was positively correlated with health-related quality of life. In relation to SC and sociodemographic variables studied in the research, women, married patients and active workers presented significantly higher scores than the rest. In relation to the clinical variables, we highlight the highest scores of the autonomous patients in the care of their stoma and those who used irrigations regularly. The lowest scores were the patients with complications in their stoma. We can highlight the validity and reliability of the CAESPO scale for biomedical and social research, and the importance of skills related to self-care of ostomy patients for a good level of HRQoL.

Fecal biomarkers, especially fecal calprotectin, are useful for predicting endoscopic activity in Crohn's disease; however, the cut-off point remains unclear. The aim of this paper was to analyze whether faecal calprotectin and M2 pyruvate kinase are good tools for generating highly accurate scores for the prediction of the state of endoscopic activity and mucosal healing. The simple endoscopic score for Crohn's disease and the Crohn's disease activity index was calculated for 71 patients diagnosed with Crohn's. Fecal calprotectin and M2-PK were measured by the enzyme-linked immunosorbent assay test. A fecal calprotectin cut-off concentration of ≥ 170 µg/g (sensitivity 77.6%, specificity 95.5% and likelihood ratio +17.06) predicts a high probability of endoscopic activity, and a fecal calprotectin cut-off of ≤ 71 µg/g (sensitivity 95.9%, specificity 52.3% and likelihood ratio -0.08) predicts a high probability of mucosal healing. Three clinical groups were identified according to the data obtained: endoscopic activity (calprotectin ≥ 170), mucosal healing (calprotectin ≤ 71) and uncertainty (71 > calprotectin < 170), with significant differences in endoscopic values (F = 26.407, p < 0.01). Clinical activity or remission modified the probabilities of presenting endoscopic activity (100% vs 89%) or mucosal healing (75% vs 87%) in the diagnostic scores generated. M2-PK was insufficiently accurate to determine scores. The highly accurate scores for fecal calprotectin provide a useful tool for interpreting the probabilities of presenting endoscopic activity or mucosal healing, and are valuable in the specific clinical context.

There is a growing body of literature that recognises how music perception affects first-language learning, but much less is known about its influence on foreign-language reading skills. The purpose of this paper is to examine the effect of music perception abilities on the acquisition of some foreign early reading skills based on their transference from first language. Data for this study were collected from 63 Spanish-speaking English-language learners studying second grade of primary school. We used a music perception test and the Early Grade Reading Assessment battery, which measures early reading skills in both languages. A mediation analysis using structural equation modelling was performed, integrating music perception and letter-sound knowledge, initial sound identification, and familiar word and pseudoword reading in Spanish and English. This research provides new insights into how music perception affects early reading skills in both languages. These findings indicate a transfer of music perception abilities to first-language alphabetic principle, phonemic awareness and word recognition skills that affect foreign language early reading abilities.

PURPOSE: The purpose of this study was to describe development of the Specific Self-Care for Ostomized Patients Questionnaire (CAESPO) instrument and evaluate its construct validity, internal reliability, and test-retest reliability (temporal stability). DESIGN: Prospective evaluation of psychometric properties of the instrument. SUBJECTS AND SETTING: The study sample comprised 125 persons (n = 89, 71.2% men) with a temporary (n = 42, 33.6%) and permanent (n = 83, 66.4%) colostomy (n = 102, 81.6%) and ileostomy (n = 23, 18.4%). Their mean age was 66.72 years; all had undergone ostomy surgery at least 3 months prior to study participation. Participants were drawn from 4 acute care facilities in the province of Castellon, Spain. INSTRUMENT: The CAESPO Questionnaire is completed by a nurse or health care provider. It comprises 3 sections: the first queries sociodemographic data, the second queries pertinent clinical data, and the third contains 58 scored items with 4 ordinal responses. Possible cumulative scores ranged from 58 to 232 points; scores are reported based on a derived percentage score that varies from 0 to 100, where a score of 0 indicates lower self-care and 100 indicates a high level of self-care. METHODS: Data were collected at baseline and retesting was completed 6 months later. Internal consistency of the CAESPO was evaluated using the Cronbach α coefficient; temporal stability (test-retest reliability) was evaluated using the test-retest procedure; confirmatory factor analysis based on conceptually hypothesized factor structure was performed to evaluate construct validity. RESULTS: Initial assessment of the construct validity of the CAESPO using confirmatory factory analysis revealed a poor fit, resulting in removal of multiple items from each of the subscales owing to low-factor loading values. The final model comprised 58 scored items; it was found to have a good fit based on standard indices (χ²= 43.132, P < .001; root mean square error of approximation = 0.155 [0.107-0.204]; Bentler-Bonett normed fit index = 0.957; comparative fit index = 0.967; incremental fit index = 0.968), indicating adequate construct validity. The internal consistency of the CAESPO total score was acceptable at α = 0.889. Test-retest reliability (temporal stability) was deemed excellent (α = 0.987). CONCLUSIONS: Psychometric tests indicate that the CAESPO is a valid and reliable instrument for measuring self-care in persons living with a fecal ostomy.

Introduction: Intraoperative arterial hypotension is associated with poor postoperative outcomes. The Hypotension Prediction Index (HPI) developed using machine learning techniques, allows the prediction of arterial hypotension analysing the arterial pressure waveform. The use of this index may reduce the duration and severity of intraoperative hypotension in adults undergoing non-cardiac surgery. This study aims to determine whether a treatment protocol based on the prevention of arterial hypotension using the HPI algorithm reduces the duration and severity of intraoperative hypotension compared with the recommended goal-directed fluid therapy strategy and may improve tissue oxygenation and organ perfusion. Methods and analysis: We will conduct a multicentre, randomised, controlled trial (N=80) in high-risk surgical patients scheduled for elective major abdominal surgery. All participants will be randomly assigned to a control or intervention group. Haemodynamic management in the control group will be based on standard haemodynamic parameters. Haemodynamic management of patients in the intervention group will be based on functional haemodynamic parameters provided by the HemoSphere platform (Edwards Lifesciences), including dynamic arterial elastance, dP/dt_max and the HPI. Tissue oxygen saturation will be recorded non-invasively and continuously by using near-infrared spectroscopy technology. Biomarkers of acute kidney stress (cTIMP2 and IGFBP7) will be obtained before and after surgery. The primary outcome will be the intraoperative time-weighted average of a mean arterial pressure <65 mm Hg. Ethics and dissemination: Ethics committee approval was obtained from the Ethics Committee of Hospital Gregorio Marañón (Meeting of 27 July 2020, minutes 18/2020, Madrid, Spain). Findings will be widely disseminated through peer-reviewed publications and conference presentations. Trial registration number: NCT04301102.