Clinical and Hemodynamic Outcomes with Enalapril Orodispersible Minitablets in Young Children with Heart Failure Due to Congenital Heart Disease.

Background: The angiotensin-converting enzyme inhibitor (ACEI) enalapril is often administered to infants and young children with heart failure (HF) in various dosing regimens and formulations not adapted for their age. Methods: This prospective, two-center, open-label 8-week study evaluated an age-appropriate formulation of orodispersible minitablets (ODMTs) of enalapril (0.25 mg and 1 mg) in children aged 0 to 6 years with HF due to congenital heart disease. An age/weight-based dosing schedule was followed. Measures of echocardiographic parameters, blood pressure, heart rate, modified Ross score, and biochemistry were obtained over the 8-week period. The following two groups were assessed: ACEI-naïve and ACEI-pretreated patients. Results: In total, 53 children (age range of 0.05 to 4.8 years) were enrolled and 29 were ACEI-naïve. The average enalapril dose was 0.098 mg/kg (0.06-0.17 mg/kg) in the naïve group and 0.15 mg/kg (0.07-0.3 mg/kg) in pretreated patients. After 8 weeks, the modified Ross score and left ventricular diastolic dimension (LVD) z-score showed a significant decrease in both groups (p < 0.005). During 8 weeks follow-up, there were no difference in the z-scores for the systolic blood pressure (p = 0.071) or heart rate (p = 0.146). Conclusions: Pediatric patients treated with ODMTs of enalapril for 8 weeks had favorable improvements in LVD and HF symptoms.

Aspects of Identity Questionnaire-IV: An Examination of Structural Validity, Gender Invariance, and Relationships with Mental Health and Basic Psychological Needs Among Adolescents.

The present research evaluated evidence for structural and convergent validity and measurement invariance across gender of the Aspects of Identity Questionnaire-IV (AIQ-IV), which is designed to measure four identity orientations: Personal, Relational, Public, and Collective. We recruited two independent samples of Serbian adolescents aged 15-19 years (n1 = 436, n2 = 452). Both exploratory structural equation modeling (ESEM) and confirmatory factor analyses (CFA) were applied to examine the factor structure of the AIQ-IV. The ESEM model with four factors demonstrated a superior fit to the data in both samples and resulted in well-defined factors and deflated latent factor correlations compared to the CFA model. Multiple-group analysis supported the scalar invariance of the four-factor ESEM model across gender. The evidence for the convergent validity of the ESEM AIQ-IV factors was supported by meaningful correlations with various mental health indicators (life satisfaction, positive affect, negative affect, internalizing behaviors, and externalizing behaviors) and basic psychological needs (autonomy, relatedness, and competence) satisfaction and frustration. Our findings support the use of AIQ-IV as a multidimensional measure of identity orientations among adolescents and confirm the usefulness of applying the ESEM framework to evaluate the validity aspects of this scale.

The role of basic psychological needs in the relationships between identity orientations and adolescent mental health: A protocol for a longitudinal study.

Research into the role of identity orientations (the relative importance an individual places on different personal and social attributes and characteristics when defining her or his identity) in adolescent mental health is extremely limited. Furthermore, the potential mechanisms that might explain the associations between identity orientations and adolescent mental health are poorly understood. This study protocol describes a one-year longitudinal study across three time points to be initiated with the purpose of investigating the mediating role of basic psychological needs satisfaction and frustration in the relationship between identity orientations and various mental health indicators in adolescence. We aim to recruit a large sample of Serbian adolescents (N = 2,000 at Time 1), using a two-stage stratified random sampling. The data will be analyzed using the random intercept cross-lagged panel model (RI-CLPM), and the results will be contrasted with the traditional CLPM. The goal of this study is to make a theoretical contribution to research in the fields of identity, self-determination theory, and adolescent mental health, as well as to provide insights towards the development of evidence-based recommendations for creating prevention and promotion programs aimed at improving the well-being of adolescents.

Psychological Factors of Vaccination Intent among Healthcare Providers, Parents, and Laypeople.

The interrelatedness of social-structural aspects and psychological features with vaccination intention provides the context to explore personal psychological features related to vaccination. Specifically, we focused on general decision making and vaccine-related dispositions, and their contribution to the intention to vaccinate, within post-pandemic circumstances, after the imposed possibility of choosing a vaccine brand. Our study aimed to map the function (promotive, protective, risk, vulnerability) of a set of personal psychological aspects in the intention to vaccinate among people holding different social roles regarding the vaccination. We surveyed three samples of people: healthcare providers (HPs), parents, and laypeople, within the post-pandemic context. Negative vaccine attitudes lower intention to vaccinate in all regression models (all ßs ranging from -0.128 to -0.983, all ps < 0.01). The main results indicate that, regardless of the sample/social role, there is a shared attitudinal core for positive vaccination intention. This core consists of [high] trust in large corporations, government, and healthcare systems, as well as perceived consensus on vaccine safety/efficacy and experience of freedom (protective factors), and [low] vaccination conspiracy beliefs, trust in social media, and choice overload (risk and vulnerability factors, respectively). There are no common promotive factors of intention to vaccinate: for parents, perceived consensus on vaccines, and trust in corporations and the healthcare system, play such roles; for HPs, the experience of freedom is obtained as a unique promotive factor. In contrast, for laypeople, no unique promotive factors were found. Our findings provide insights into the function of psychological factors of vaccination intention across different social roles, particularly healthcare providers, parents, and laypeople, and emphasize the need for tailored immunization interventions in the post-pandemic landscape.

Vaccination Attitudes Examination (VAX) Scale: a Bifactor-ESEM approach in a youth sample (15-24 years).

BACKGROUND: The Vaccination Attitudes Examination (VAX) Scale is a widely used scale designed to measure general attitudes toward vaccinations. However, evidence for the VAX's structural, convergent, and discriminant validity is still limited, especially in youth samples. METHODS: The present study examined the psychometric multidimensionality and evidence of convergent and discriminant validity of the VAX using the bifactor-exploratory structural equation modeling approach (bifactor-ESEM). Using a sample of 803 Serbian adolescents and young adults (Mage = 18.23, SDage = 2.66, age range = 15-24 years, 59.2% female), we contrasted the original four-factor model of the VAX with alternative solutions (ESEM, bifactor-CFA, and bifactor-ESEM), and investigated associations between vaccination attitudes and a variety of external criteria. RESULTS: The results supported the bifactor-ESEM solution with one general factor of vaccination attitudes and four specific factors (Mistrust of vaccine benefit, Worries about unforeseen future effects, Concerns about commercial profiteering, and Preference for natural immunity) as the best representation of the data. The general factor was well-defined, and three specific factors showed good validity and specificity after the general factor was taken into account. The results of convergent validity analyses showed that the general factor of vaccine attitudes and one specific factor (Mistrust of vaccine benefit) were good predictors of vaccine conspiracy beliefs, attitudes towards COVID-19 vaccination, intention to get vaccinated against COVID-19, and trust in healthcare. The remaining three specific factors' contributions to external criteria were generally weak and nonsignificant. Evidence of the discriminant validity of the VAX scores was supported by weak positive associations of the general factor with medical fears and paranoid worry. CONCLUSIONS: The present findings indicate that distinguishing general and specific components of vaccination attitudes offers a more nuanced assessment and understanding of vaccination attitudes.

Vaccine Conspiracy Beliefs Scale: Validation and Measurement Invariance in a Youth Sample.

The Vaccine Conspiracy Beliefs Scale (VCBS) is a widely used measure of conspiracy beliefs about vaccines, but evidence of its validity and measurement invariance, especially in youth samples, is still largely missing. The present study examined VCBS scores' factor structure, measurement invariance, convergent and discriminant validity, and incremental predictive validity. A sample of 803 Serbian youths (age range 15-24; 59.2% females) was recruited for the study. A modified single-factor model of the VCBS was supported, and showed evidence of full scalar invariance across gender, age, vaccination status, and personal history of COVID-19. Evidence of the VCBS scores' convergent and discriminant validity was obtained by examining associations with general conspiracy beliefs, vaccination attitudes, vaccination knowledge, intentions to get vaccinated against COVID-19, paranoia worries, fear of injections and blood draws, importance of God, self-rated health, and self-rated family's financial situation. The VCBS scores predicted a unique variance in the intention to get vaccinated against COVID-19, over and above vaccination attitudes and vaccination knowledge. The results suggest that the VCBS is a valid measure of vaccine conspiracy beliefs in youth.

Well-Being and the Pandemic: Trust in People Matters More Than Trust in Institutions.

Trust is an important correlate of well-being, and it plays an important moderating role against adversity. But does this conclusion also hold during pandemics? We address this question by investigating the role of interpersonal and institutional trust for well-being, as measured by five proxies, during the COVID-19 pandemic in Serbia. We also examined age and gender differences in the relationship between trust and well-being, and tested the protective role of trust among individuals whose well-being might be at risk during the pandemic. The sample included a total of 5776 Serbian adults (Mage = 37.00 years, 75% female). The results showed that interpersonal trust has a small but significant relationship with well-being, whereas institutional trust has negligible effects. We also found some evidence for the protective role of general interpersonal trust on well-being among individuals with poorer self-rated health and in a poorer financial situation. Our findings confirm the role of interpersonal trust for well-being in times of crisis, and support previous evidence indicating that promoting interpersonal trust should be a core goal of public policy.

Burnout among psychotherapists: a cross-cultural value survey among 12 European countries during the coronavirus disease pandemic.

The aim of this study was to examine cross-cultural differences, as operationalized by Schwartz's refined theory of basic values, in burnout levels among psychotherapists from 12 European countries during the coronavirus disease (COVID-19) pandemic. We focused on the multilevel approach to investigate if individual- and country-aggregated level values could explain differences in burnout intensity after controlling for sociodemographic, work-related characteristics and COVID-19-related distress among participants. 2915 psychotherapists from 12 countries (Austria, Bulgaria, Cyprus, Finland, Great Britain, Serbia, Spain, Norway, Poland, Romania, Sweden, and Switzerland) participated in this study. The participants completed the Maslach Burnout Inventory-Human Service Survey, the revised version of the Portrait Values Questionnaire, and a survey questionnaire on sociodemographic, work-related factors and the COVID-19 related distress. In general, the lowest mean level of burnout was noted for Romania, whereas the highest mean burnout intensity was reported for Cyprus. Multilevel analysis revealed that burnout at the individual level was negatively related to self-transcendence and openness-to-change but positively related to self-enhancement and conservation values. However, no significant effects on any values were observed at the country level. Male sex, younger age, being single, and reporting higher COVID-19-related distress were significant burnout correlates. Burnout among psychotherapists may be a transcultural phenomenon, where individual differences among psychotherapists are likely to be more important than differences between the countries of their practice. This finding enriches the discussion on training in psychotherapy in an international context and draws attention to the neglected issue of mental health among psychotherapists in the context of their professional functioning.

Subjective well-being among psychotherapists during the coronavirus disease pandemic: A cross-cultural survey from 12 european countries.

OBJECTIVE: The aim of this study is to examine the amount of the total variance of the subjective well-being (SWB) of psychotherapists from 12 European countries explained by between-country vs. between-person differences regarding its cognitive (life satisfaction) and affective components (positive affect [PA] and negative affect [NA]). Second, we explored a link between the SWB and their personal (self-efficacy) and social resources (social support) after controlling for sociodemographics, work characteristics, and COVID-19-related distress. METHODS: In total, 2915 psychotherapists from 12 countries (Austria, Bulgaria, Cyprus, Finland, Great Britain, Serbia, Spain, Norway, Poland, Romania, Sweden, and Switzerland) participated in this study. The participants completed the Satisfaction with Life Scale (SWLS), the International Positive and Negative Affect Schedule Short Form (I-PANAS-SF), the General Self-Efficacy Scale, and the Multidimensional Scale of Perceived Social Support. RESULTS: Cognitive well-being (CWB; satisfaction with life) was a more country-dependent component of SWB than affective well-being (AWB). Consequently, at the individual level, significant correlates were found only for AWB but not for CWB. Higher AWB was linked to being female, older age, higher weekly workload, and lower COVID-19-related distress. Self-efficacy and social support explained AWB only, including their main effects and the moderating effect of self-efficacy. CONCLUSIONS: The results highlight more individual characteristics of AWB compared to CWB, with a more critical role of low self-efficacy for the link between social support and PA rather than NA. This finding suggests the need for greater self-care among psychotherapists regarding their AWB and the more complex conditions underlying their CWB.

Access to Vaccination among Disadvantaged, Isolated and Difficult-to-Reach Communities in the WHO European Region: A Systematic Review.

Vaccination has a significant impact on morbidity and mortality. High vaccination coverage rates are required to achieve herd protection against vaccine-preventable diseases. However, limited vaccine access and hesitancy among specific communities represent significant obstacles to this goal. This review provides an overview of critical factors associated with vaccination among disadvantaged groups in World Health Organisation European countries. Initial searches yielded 18,109 publications from four databases, and 104 studies from 19 out of 53 countries reporting 22 vaccine-preventable diseases were included. Nine groups representing the populations of interest were identified, and most of the studies focused on asylum seekers, refugees, migrants and deprived communities. Recall of previous vaccinations received was poor, and serology was conducted in some cases to confirm protection for those who received prior vaccinations. Vaccination coverage was lower among study populations compared to the general population or national average. Factors that influenced uptake, which presented differently at different population levels, included health service accessibility, language and vaccine literacy, including risk perception, disease severity and vaccination benefits. Strategies that could be implemented in vaccination policy and programs were also identified. Overall, interventions specific to target communities are vital to improving uptake. More innovative strategies need to be deployed to improve vaccination coverage among disadvantaged groups.

Physical Activity, Eating Habits and Mental Health during COVID-19 Lockdown Period in Serbian Adolescents.

The COVID-19 pandemic has impacted almost every aspect of life, especially daily physical activity and healthy eating habits but also mental health. Our study aimed to examine the relationship between the physical activity level, eating habits and mental health of Serbian adolescents during the COVID-19 pandemic. A total of 3506 students from the territory of the Republic of Serbia participated in this study. IPAQ-short version and HBSC-FFQ were used to assess physical activity level and eating habits, along with self-rated health. Moderate correlations were identified between physical activity, eating habits and mental health, along with average physical activity, very high life satisfaction (ß = 0.177, p < 0.01) and very low emotional distress (ß = −0.150, p < 0.01). A significant predictor of mental health was the frequency of breakfast on weekdays (ß = 0.167, p < 0.01 for life satisfaction and ß = −0.153, p < 0.01 for emotional distress), but not on weekends. Since the pandemic's course is uncertain, the focus should be on maintaining good physical activity, nutrition and well-being.

A person-centered evaluation of subjective well-being using a latent profile analysis: Associations with negative life events, distress, and emotion regulation strategies.

The present study examined the structure of subjective well-being (SWB) using a person-centered approach, and tested whether SWB profiles differed in a number of self-reported negative life events, emotional distress, and cognitive emotion regulation strategies. The sample included a total of 945 undergraduate students from Serbia (78% female, Mage  = 20.14 years). A 3-step latent profile analysis with partial conditional independence revealed four profiles, which have been tentatively labeled: low SWB (a combination of low life satisfaction, low positive affect, and high negative affect), mixed SWB (moderate to high life satisfaction, moderate to low positive affect, high negative affect), moderately low SWB (low life satisfaction, moderate to low positive affect, moderate negative affect), high SWB (high life satisfaction, high positive affect, low negative affect). A comparison of SWB profiles applied to symptoms of emotional distress, along with the number of self-reported negative life events and emotion regulation strategies, offered support to the validity of four SWB profiles. Our findings suggest that a person-centered perspective might be a valuable tool for understanding the structure of SWB.

Measuring life satisfaction among psychiatric patients: Measurement invariance and validity of the Satisfaction with Life Scale.

The main aim of the present study was to evaluate the measurement invariance and the convergent validity of the Satisfaction with Life Scale (SWLS) across clinical and nonclinical samples. A total of 216 psychiatric patients (47.7% females; Mage = 44.56) and 235 participants from the general population (54.5% females; Mage = 43.11 years) were recruited. The measurement invariance was tested by a multi-group confirmatory factor analysis. Full scalar invariance of the SWLS was supported. Psychiatric patients reported substantially lower life satisfaction than participants from the general population. The SWLS demonstrated good convergent validity in both samples. The present study supported the use of the SWLS as a measure of life satisfaction among psychiatric patients.

Differentiation of Cognitive Deficit Profiles in Multiple Sclerosis Patients: Latent Profile Analysis.

OBJECTIVE: The purpose of this study was to ascertain whether the application of the Audio Recorded Cognitive Screen (ARCS) in cognitive functioning screening of persons with multiple sclerosis (MS) differentiates profiles of existing cognitive deficits (CDs) and whether this instrument can discriminate accurately between subjects who are cognitively intact (CI) and those with a cognitive disorder. SUBJECTS AND METHODS: The research was conducted on a sample of 359 subjects, with two subsets of participants: 108 persons with a relapsing-remitting form of MS and 251 persons from the general population. RESULTS: We labeled the three profiles obtained by applying the ARCS questionnaire: the CI profile, the profile of CI with visuospatial difficulties, and the profile of persons with CD. CONCLUSION: ARCS has the ability to differentiate persons with a CD from those without, both in a sample of persons suffering from MS and in a sample of persons from the general population. This finding indicates that this instrument is well suited for profiling the cognitive status into specific categories, which puts it among the instruments with a wide range of implementation.

The Dimensions of Ruminative Thinking: One for All or All for One.

The Ruminative Thought Scale (RTS) was developed to measure the ruminative thinking style, presumably common to various psychopathological disorders. However, prior factor-analytic research was inconclusive regarding unidimensionality versus multidimensionality of the RTS. The present study was conducted on a large, heterogeneous Serbian sample ( N = 838). A subsample was retested 6 months later providing information about symptoms of depression and various anxiety symptoms. Results showed that a bifactor model of the RTS (representing one general and four group factors) had a better fit than the second-order and one-factor models. The subscale scores were not prospective predictors of symptoms of depression and anxiety, over and above the contribution of the total score. The RTS is a reliable transdiagnostic measure of repetitive thinking. Although there is some clustering of more homogeneous items, there is not enough evidence to support interpretation of the subscales.