Rasmussen et al. (2019) described the proliferation of factors for posttraumatic stress disorder (PTSD) measures and raised concerns about the construct validity of factors that include two or three items. In this brief report, we describe how the pattern of covariation among the responses to items of well-established measures, such as the PTSD Checklist for DSM-5 (PCL-5), can give the appearance of multidimensionality. We evaluated whether the structure of the 20-item PCL-5 is unidimensional, using the methods of multidimensional item response theory (MIRT) and the concept of a testlet. These analyses were done using a sample of trauma-exposed urban firefighters. A unidimensional and a bifactor model, which includes a general factor composed of all items and four specific factors mirroring the DSM-5 conceptualization, were evaluated for both Likert-type multiple-category and binary coding system of the PCL-5 item response data. Seven testlets were created from the 20 PCL-5 items following the seven-factor model (Armour et al., 2015) presented in Table 1 of Rasmussen et al. (2019). Findings using the unidimensional nominal item response theory model for the seven testlets indicated that the PCL-5 may be considered unidimensional with a single score representing individual differences on a continuum that ranges from low to high. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Theory of change (ToC) is an approach widely used to guide planning, implementing, and evaluating change initiatives. While there is substantial guidance, there has been little attention on equity within ToC research and practice. We propose and illustrate the metaphor of \'knots\' to frame practical and ethical challenges that arise when centering equity within ToC processes. Drawing on our experiences using a ToC approach in two case examples, we identify and illustrate five equity-related knots: (a) clarify root causes, pathways, and success; (b) facilitate participation across power and perspective differences; (c) integrate research evidence and practitioner knowledge; (d) represent complex change visually; and (e) creatively navigate constraints. We show why framing these as knots can help practitioners make wise judgments within the circumstances and close with recommendations for including knots in ToC processes, reporting, and guidance.

Meta-regulation - the rules that govern how individual policies are developed and reviewed - has not received much attention in the study of health policy. We argue that these rules, far from value-free and objective, have significant potential to shape policy outputs and, as such, health outcomes. Channelling and operationalising wider paradigms like neoliberalism, they determine, for instance, what is considered \'good\' policy, how decisions are made, based on which evidence, and whose voices matter. Exploring an archetypal example of meta-regulation, the European Union\'s Better Regulation agenda, we illustrate why meta-regulatory tools such as impact assessment, stakeholder consultation, and evaluation - and the norms that underlie their application - matter for health. In so doing, we concentrate especially on the ways in which Better Regulation may affect interest groups\' ability to exert influence and, conversely, how actors have sought to shape Better Regulation. We argue that attention to meta-regulation contributes to counter-balancing the focus on agency within debates at the intersection of globalisation and health, and notably those on regulatory practices and coordination. Whilst research has noted, for instance, the origins of frameworks like Better Regulation and the increasing inclusion of \'good regulatory practice\' provisions within trade and investment agreements, less attention is directed to the role that these frameworks play once institutionalised. Yet, as we illustrate, there is considerable scope for meta-regulation to enhance our understanding of the forces shaping health policy via, for instance, conceptualisations of the (social, economic, political, commercial) determinants of health. As such, we call for increased attention to the role of meta-regulation in research and practice aimed at improving human and planetary health.

Reflective case discussion (RCD) is a reflective activity conducted by nurses, midwives, and other healthcare workers to enhance their skills, critical thinking, and knowledge. This systematic review follows the PRISMA Guideline checklist and includes articles from various databases, such as Scopus, PubMed, ProQuest, and ScienceDirect. The quality assessment of each article was performed using the Critical Appraisal Skills Program (CASP). During the initial database search, we retrieved 997 articles from Scopus, 700 articles from ProQuest, 357,554 articles from PubMed, and 1,526 articles from ScienceDirect. The search was conducted using relevant keywords, including \"reflective case discussion,\" \"nursing,\" \"critical thinking,\" \"skills,\" and \"knowledge.\" Following the inclusion and exclusion criteria, eight relevant articles were identified, excluding duplicate studies, limited to full papers, open access, conducted in a hospital setting, and written in English. The findings demonstrate that RCD effectively enhances nurses\' skills, critical thinking, and knowledge, contributing to their professionalism in patient care. RCD also proved beneficial in preventing repetitive mistakes and promoting teamwork among nurses. Thus, RCD should be embraced as a valuable form of Continuing Professional Development (CPD) and integrated into nurses\' ongoing learning processes.

UNASSIGNED: Time-limited didactic interventions have been shown to be effective in developing \"generic\" case conceptualization skills. The objective of this study is to test whether similar interventions can be used to develop case conceptualization skills that are \"specific\" to a treatment modality.
UNASSIGNED: University psychology students were randomized to a target (n = 62) or a control group (n = 62). The target group received a training on psychoanalytic case conceptualization skills based on the newly-developed operators model. The control group received a training on generic case conceptualization skills based on the well-established 5 Ps model.
UNASSIGNED: The students\' self-efficacy for case conceptualization significantly increased in both groups. However, students in the target group reported a significantly greater increase in psychoanalytic case conceptualization skills and in their ability to make clinical inferences. The teaching method, as well as the case conceptualization models, were acceptable to students. However, the 5 Ps model was significantly more acceptable to students than the operators model.
UNASSIGNED: This is the first RCT to provide evidence that psychoanalytic case conceptualization skills can be developed through didactic teaching and that they constitute a specific set of skills that are not developed by learning generic case conceptualization skills.

Alzheimer\'s Disease (AD) provides an excellent case study to investigate emerging conceptions of health, disease, pre-disease, and risk. Two scientific working groups have recently reconceptualized AD and created a new category of asymptomatic biomarker positive persons, who are either said to have preclinical AD, or to be at risk for AD. This article examines how prominent theories of health and disease would classify this condition: healthy or diseased? Next, the notion of being \"at risk\"-a state somewhere in-between health and disease-is considered from various angles. It is concluded that medical-scientific developments urge us to let go of dichotomous ways of understanding disease, that the notion of \"risk,\" conceptualized as an increased chance of getting a symptomatic disease, might be a useful addition to our conceptual framework, and that we should pay more attention to the practical usefulness and implications of the ways in which we draw lines and define concepts.

Current \"gold standard\" treatments for social anxiety disorder (SAD) are limited by the limited emphasis of key etiological factors in conceptualization, and many individuals with SAD experience residual symptoms posttreatment. Hence, the novel application of the Schema Therapy Mode Model may provide a helpful framework for extending clinical understanding and treatment options for SAD. This exploratory study aimed to investigate the presence and pattern of schema modes among SAD individuals.
Forty individuals with SAD completed questionnaire measures of symptomatology, social anxiety-relevant cognitions, schema modes, childhood trauma, and parental style.
Key maladaptive schema modes identified in SAD were Vulnerable Child, Punitive Critic, Demanding Critic, Compliant Surrender, and Detached Self-Soother.
Outcomes provide the basis for a proposed schema mode case conceptualization for SAD and are hoped to provide a rationale for testing the applicability of Schema Therapy as a novel treatment for SAD. Key limitations are discussed.

Eating disorders are serious psychiatric illnesses with treatments ineffective for about 50% of individuals due to high heterogeneity of symptom presentation even within the same diagnoses, a lack of personalized treatments to address this heterogeneity, and the fact that clinicians are left to rely upon their own judgment to decide how to personalize treatment. Idiographic (personalized) networks can be estimated from ecological momentary assessment data, and have been used to investigate central symptoms, which are theorized to be fruitful treatment targets. However, both efficacy of treatment target selection and implementation with \'real world\' clinicians could be maximized if clinician input is integrated into such networks. An emerging line of research is therefore proposing to integrate case conceptualizations and statistical routines, tying together the benefits from clinical expertise as well as patient experience and idiographic networks. The current pilot compares personalized treatment implications from different approaches to constructing idiographic networks. For two patients with a diagnosis of anorexia nervosa, we compared idiographic networks 1) based on the case conceptualization from clinician and patient, 2) estimated from patient EMA data (the current default in the literature), and 3) based on a combination of case conceptualization and patient EMA data networks, drawing on informative priors in Bayesian inference. Centrality-based treatment recommendations differed to varying extent between these approaches for patients. We discuss implications from these findings, as well as how these models may inform clinical practice by pairing evidence-based treatments with identified treatment targets.

This study proposes a land-sea convergenomics model based on analyses of marine and terrestrial economies. A viscosity-based system of indices was constructed to evaluate the land-sea convergenomics of Bohai Economic Rim (BER) cities and was applied to analyse the viscosities of BER cities from 2009 to 2019. BER cities\' viscosities trended upward, although with significant disparities. The developmental fundamentals were high at the system level and grew steadily during the study period. Resource development was low with a slow growth rate. Industrial linkages grew significantly but exhibited minor fluctuations. Outcome creation began at a low level but grew steadily. Cluster analyses revealed that, overall, the development of land-sea convergenomics in the BER occurred in clusters, with viscosity distribution centred around three core cities: Tianjin, Qingdao, and Dalian. Due to regional disparities, the effects of labour productivity, science and technology investment, economic fundamentals, and energy efficiency on land-sea convergenomics were significantly differentiated.

Nonhuman animals and preschoolers struggle with Relational-Match-to-Sample (RMTS), a classic test of the capacity for second-order relational, analogical, and reasoning. These failures are often explained by limitations in representational or computational capacities. Drawing on recent evidence for robust spontaneous RMTS success (i.e., without error-feedback) in crows and parrots after minimal second-order training, we present five experiments with human adults consistent with the possibility that population differences sometimes instead derive from differences in inductive biases alone. Experiment 1 confirms human adults have the capacities and requisite representations to succeed spontaneously on RMTS. Experiments 2-5 utilize a modified RMTS task in which adults make relational matches only about half of the time. Experiment 3 tests whether eight trials of various MTS tasks, nonsecond-order training featured in the aforementioned comparative studies, can increase spontaneous second-order relational responding in human adults. Two of the MTS tasks (Number, Size MTS) do so, demonstrating that MTS training can, in fact, increase relational responding by changing inductive biases alone. The other MTS tasks (Identity, Color MTS) do not do so, evidence that the facilitating effect is not a result of matching involved in MTS per se. Experiments 4 and 5 test one hypothesized mechanism by which specifically Number/Size MTS tasks may have led to increased relational responding, that is, by inhibiting preexisting biases to match on shape and/or color, making relational matches relatively more likely. We close by discussing the importance of research into inductive biases to the project of understanding relational reasoning. (PsycInfo Database Record (c) 2022 APA, all rights reserved).