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Sample records for positive psychosocial outcomes

  1. Psychosocial determinants of outcomes in knee replacement.

    Science.gov (United States)

    Lopez-Olivo, Maria A; Landon, Glenn C; Siff, Sherwin J; Edelstein, David; Pak, Chong; Kallen, Michael A; Stanley, Melinda; Zhang, Hong; Robinson, Kausha C; Suarez-Almazor, Maria E

    2011-10-01

    To identify potential psychosocial and educational barriers to clinical success following knee replacement. The authors evaluated 241 patients undergoing total knee replacement, preoperatively and 6 months after surgery. Outcomes included the Western Ontario McMaster (WOMAC) scale and the Knee Society rating system (KSRS). Independent variables included: the medical outcome study-social support scale; depression, anxiety and stress scale; brief COPE inventory; health locus of control; arthritis self-efficacy scale and the life orientation test-revised. Multiple regression models evaluated associations of baseline demographic and psychosocial variables with outcomes at 6 months, controlling for body mass index, comorbidities and baseline outcome scores. Patients' mean age was 65 ± 9 years; 65% were women. Most patients improved outcomes after surgery. Several psychosocial variables were associated with outcomes. Regression analyses indicated lower education, less tangible support, depression, less problem-solving coping, more dysfunctional coping, lower internal locus of control were associated with worse WOMAC scores (R(2) contribution of psychosocial variables for pain 0.07; for function, 0.14). Older age, lower education, depression and less problem-solving coping were associated with poorer total KSRS scores (R(2) contribution of psychosocial variables to total KSRS model 0.09). Psychosocial variables as a set contributed from 25% to 74% of total explained variance across the models tested. Patients' level of education, tangible support, depression, problem-solving coping, dysfunctional coping and internal locus of control were associated with pain and functional outcomes after knee replacement. The findings suggest that, in addition to medical management, perioperative psychosocial evaluation and intervention are crucial in enhancing knee replacement outcomes.

  2. Family Structure and Children's Psychosocial Outcomes

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    Wu, Zheng; Hou, Feng; Schimmele, Christoph M.

    2008-01-01

    This article examines the influence of family structure on children's short-term psychosocial behavioral outcomes, including emotional disorder, conduct disorder, and prosocial behavior. The analysis uses five waves of data (1994-2003) from Canada's National Longitudinal Survey of Children and Youth to model how living in a cohabitational…

  3. Adiposity and psychosocial outcomes at ages 30 and 35.

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    McLeod, Geraldine F H; Fergusson, David M; John Horwood, L; Carter, Frances A

    2016-02-01

    To examine associations between adiposity and adult psychosocial outcomes (depressive symptoms, life satisfaction, self-esteem, household income, personal income, savings/investments) in a New Zealand birth cohort, by gender. Adiposity was assessed using Body Mass Index scores classified on a 3-point scale of BMI: depressive symptoms, life satisfaction, equivalized household income and savings/investments) remaining statistically significant (p < 0.05). In contrast, for males there was a significant (p = 0.008) positive association between adiposity and higher personal net weekly income after covariate adjustment. The findings suggest evidence of gender differences in the associations between adiposity and psychosocial outcomes. For females, there were small but pervasive tendencies for increasing adiposity to be related to more adverse mental health, psychological well-being and economic outcomes; whereas for males adiposity was either unrelated to these outcomes, or in the case of personal income, associated with greater economic advantage. The implications of these findings are discussed.

  4. The comparative effects of group prenatal care on psychosocial outcomes.

    Science.gov (United States)

    Heberlein, Emily C; Picklesimer, Amy H; Billings, Deborah L; Covington-Kolb, Sarah; Farber, Naomi; Frongillo, Edward A

    2016-04-01

    To compare the psychosocial outcomes of the CenteringPregnancy (CP) model of group prenatal care to individual prenatal care, we conducted a prospective cohort study of women who chose CP group (N = 124) or individual prenatal care (N = 124). Study participants completed the first survey at study recruitment (mean gestational age 12.5 weeks), with 89% completing the second survey (mean gestational age 32.7 weeks) and 84% completing the third survey (6 weeks' postpartum). Multiple linear regression models compared changes by prenatal care model in pregnancy-specific distress, prenatal planning-preparation and avoidance coping, perceived stress, affect and depressive symptoms, pregnancy-related empowerment, and postpartum maternal-infant attachment and maternal functioning. Using intention-to-treat models, group prenatal care participants demonstrated a 3.2 point greater increase (p prenatal planning-preparation coping strategies. While group participants did not demonstrate significantly greater positive outcomes in other measures, women who were at greater psychosocial risk benefitted from participation in group prenatal care. Among women reporting inadequate social support in early pregnancy, group participants demonstrated a 2.9 point greater decrease (p = 0.03) in pregnancy-specific distress in late pregnancy and 5.6 point higher mean maternal functioning scores postpartum (p = 0.03). Among women with high pregnancy-specific distress in early pregnancy, group participants had an 8.3 point greater increase (p prenatal planning-preparation coping strategies in late pregnancy and a 4.9 point greater decrease (p = 0.02) in postpartum depressive symptom scores. This study provides further evidence that group prenatal care positively impacts the psychosocial well-being of women with greater stress or lower personal coping resources. Large randomized studies are needed to establish conclusively the biological and psychosocial benefits of group

  5. Diagnostic Invasiveness and Psychosocial Consequences of False-Positive Mammography

    DEFF Research Database (Denmark)

    Heleno, Bruno M.; Siersma, Volkert Dirk; Brodersen, John

    2015-01-01

    PURPOSE: We undertook a study to assess whether women with false-positivemammography have worse psychosocial consequences if managed with aworkup that involves a biopsy (invasive group) than if managed with only additional imaging (noninvasive group). METHODS: We performed subgroup analysis...... of a cohort study of 454 womenwith abnormal screening mammography and 908 matched control women withnormal results. Using a condition-specific questionnaire (Consequences of Screening in Breast Cancer), we assessed 12 psychosocial consequences at 5 time points (0, 1, 6, 18, and 36 months after final diagnosis......) and compared the 2 groups of women with false-positives (invasive and noninvasive management groups). RESULTS: Among the 252 women with false-positive mammography eligible forthis study, psychosocial consequences were similar for those managed invasivelyand those managed noninvasively during the 36 months...

  6. Psychosocial predictors of treatment outcome for trauma-affected refugees

    DEFF Research Database (Denmark)

    Sonne, Charlotte Kærgaard; Mortensen, Erik Lykke; Carlsson, Jessica

    2016-01-01

    outcome. Objective The objective of the study was to examine possible psychosocial predictors of treatment outcome for trauma-affected refugees. Method The participants were 195 adult refugees with posttraumatic stress disorder (PTSD) who were enrolled in a 6- to 7-month treatment programme...

  7. Systematic review of psychosocial outcomes for patients with advanced melanoma.

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    Dunn, Jeff; Watson, Maggie; Aitken, Joanne F; Hyde, Melissa K

    2017-11-01

    New advanced melanoma therapies are associated with improved survival; however, quality of survivorship, particularly psychosocial outcomes, for patients overall and those treated with newer therapies is unclear. Synthesize qualitative and quantitative evidence about psychosocial outcomes for advanced (stage III/IV) melanoma patients. Five databases were searched (01/01/1980 to 31/01/2016). Inclusion criteria were as follows: advanced melanoma patients or sub-group analysis; assessed psychosocial outcomes; and English language. Fifty-two studies met review criteria (4 qualitative, 48 quantitative). Trials comprise mostly medical not psychosocial interventions, with psychosocial outcomes assessed within broader quality of life measures. Patients receiving chemotherapy or IFN-alpha showed decreased emotional and social function and increased distress. Five trials of newer therapies appeared to show improvements in emotional and social function. Descriptive studies suggest that patients with advanced, versus localized disease, had decreased emotional and social function and increased distress. Contributors to distress were largely unexplored, and no clear framework described coping/adjustment trajectories. Patients with advanced versus localized disease had more supportive care needs, particularly amount, quality, and timing of melanoma-related information, communication with and emotional support from clinicians. Limitations included: lack of theoretical underpinnings guiding study design; inconsistent measurement approaches; small sample sizes; non-representative sampling; and cross-sectional design. Quality trial evidence is needed to clarify the impact of treatment innovations for advanced melanoma on patients' psychosocial well-being. Survivorship research and subsequent translation of that knowledge into programs and services currently lags behind gains in the medical treatment of advanced melanoma, a troubling circumstance that requires immediate and focused

  8. Psychosocial outcomes in a cohort of perinatally HIV-infected adolescents in Western Jamaica.

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    Evans-Gilbert, Tracy; Kasimbie, Kazie; Reid, Gail; Williams, Shelly Ann

    2018-02-05

    Background Psychosocial factors interact with adolescent development and affect the ability of HIV-infected adolescents to cope with and adhere to treatment. Aim To evaluate psychosocial outcomes in perinatally HIV-infected adolescents (PHIVAs) in Western Jamaica after psychosocial intervention. Methods The Bright Futures Paediatric Symptom Checklist (BF-PSC) was used for psychological screening of PHIVAs in Western Jamaica. Referred patients were evaluated using the Youth version of the Columbia Impairment Scale (CIS). Demographic, laboratory and clinical data obtained between July 2014 and June 2016 were evaluated retrospectively and outcomes were reviewed before and after psychosocial intervention. Results Sixty PHIVAs were enrolled and 36 (60%) had a positive BF-PSC score that necessitated referral. The BF-PSC correctly identified 89% of patients with impaired psychosocial assessment by CIS scores. Referred patients were less likely to adhere to treatment, to be virologically suppressed or to have a CD4+ count of >500 cells/μl, and were more likely to be in the late teenage group or to be of orphan status. After intervention, the prevalence of viral suppression increased and median viral load decreased. A difference in mean CD4+ cell count was detected before but not after intervention in teenage and orphan groups. Conclusions The BF-PSC identified at-risk PHIVAs with impaired psychosocial functioning. Increased vulnerability was noted in orphans and older teenagers. Psychosocial interventions (including family therapy) reduced psychosocial impairment and improved virological suppression. Mental health intervention should be instituted to facilitate improved clinical outcomes, autonomy of care and transition to adult care.

  9. Improving Outcome of Psychosocial Treatments by Enhancing Memory and Learning

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    Harvey, Allison G.; Lee, Jason; Williams, Joseph; Hollon, Steven D.; Walker, Matthew P.; Thompson, Monique A.; Smith, Rita

    2014-01-01

    Mental disorders are prevalent and lead to significant impairment. Progress toward establishing treatments has been good. However, effect sizes are small to moderate, gains may not persist, and many patients derive no benefit. Our goal is to highlight the potential for empirically-supported psychosocial treatments to be improved by incorporating insights from cognitive psychology and research on education. Our central question is: If it were possible to improve memory for content of sessions of psychosocial treatments, would outcome substantially improve? This question arises from five lines of evidence: (a) mental illness is often characterized by memory impairment, (b) memory impairment is modifiable, (c) psychosocial treatments often involve the activation of emotion, (d) emotion can bias memory and (e) memory for psychosocial treatment sessions is poor. Insights from scientific knowledge on learning and memory are leveraged to derive strategies for a transdiagnostic and transtreatment cognitive support intervention. These strategies can be applied within and between sessions and to interventions delivered via computer, the internet and text message. Additional novel pathways to improving memory include improving sleep, engaging in exercise and imagery. Given that memory processes change across the lifespan, services to children and older adults may benefit from cognitive support. PMID:25544856

  10. Psycho-social outcome in liver transplanted children: beware of emotional self-assessment!

    Science.gov (United States)

    Calinescu, Ana Maria; McLin, Valérie A; Belli, Dominque; Wildhaber, Barbara E

    2012-08-10

    Psycho-social outcome in children after liver transplantation (LT) is known to be inferior to age-related peers. Yet, when children and their parents are questioned by their nurse or physician about the child's psycho-social well-being, the answers usually are very positive. We hypothesized that patients and their parents after LT report their psycho-social well-being too enthusiastically when enquired by their personal care takers. LT at the Children's University Hospital of Geneva 1992-2007, age >3 years, 2 years. Children and their parents were questioned by their well-known, familiar nurse at the annual follow up visit about their personal well-being. To allow for evaluation of answers, scores (good, medium, bad) were attributed to the different questions. 46 children were included in the study. Mean age at enquiry was 9.7 years (SD 4 years), mean time after LT was 7.5 years (SD 4.2 years). The different themes were reported as good for: parent-child relationship (83%), relationship with peers (98%), relation with siblings (39%), sport activities (54%), play activities (78%), school performance (87%), expression skills (67%), and general behavior (89%). Most of our LT children and their parents consider, during a personal interview with a closely related, familiar nurse, that the child's psycho-social outcome is good. Yet, it is generally acknowledged that children after LT have negatively altered psycho-social outcomes. Thus, emotionally influenced reports about psycho-social outcome in children after LT must be looked at with care.

  11. Enhancing psychosocial support for HIV positive adolescents in Harare, Zimbabwe.

    Directory of Open Access Journals (Sweden)

    Webster Mavhu

    Full Text Available There is a recognized gap in the evidence base relating to the nature and components of interventions to address the psycho-social needs of HIV positive young people. We used mixed methods research to strengthen a community support group intervention for HIV positive young people based in Harare, Zimbabwe.A quantitative questionnaire was administered to HIV positive Africaid support group attendees. Afterwards, qualitative data were collected from young people aged 15-18 through tape-recorded in-depth interviews (n=10, 3 focus group discussions (FGDs and 16 life history narratives. Data were also collected from caregivers, health care workers, and community members through FGDs (n=6 groups and in-depth interviews (n=12. Quantitative data were processed and analysed using STATA 10. Qualitative data were analysed using thematic analysis.229/310 young people completed the quantitative questionnaire (74% participation. Median age was 14 (range 6-18 years; 59% were female. Self-reported adherence to antiretrovirals was sub-optimal. Psychological well being was poor (median score on Shona Symptom Questionnaire 9/14; 63% were at risk of depression. Qualitative findings suggested that challenges faced by positive children include verbal abuse, stigma, and discrimination. While data showed that support group attendance is helpful, young people stressed that life outside the confines of the group was more challenging. Caregivers felt ill-equipped to support the children in their care. These data, combined with a previously validated conceptual framework for family-centred interventions, were used to guide the development of the existing programme of adolescent support groups into a more comprehensive evidence-based psychosocial support programme encompassing caregiver and household members.This study allowed us to describe the lived experiences of HIV positive young people and their caregivers in Zimbabwe. The findings contributed to the enhancement of

  12. The readability of psychosocial wellness patient resources: improving surgical outcomes.

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    Kugar, Meredith A; Cohen, Adam C; Wooden, William; Tholpady, Sunil S; Chu, Michael W

    2017-10-01

    Patient education is increasingly accessed with online resources and is essential for patient satisfaction and clinical outcomes. The average American adult reads at a seventh grade level, and the National Institute of Health (NIH) and the American Medical Association (AMA) recommend that information be written at a sixth-grade reading level. Health literacy plays an important role in the disease course and outcomes of all patients, including those with depression and likely other psychiatric disorders, although this is an area in need of further study. The purpose of this study was to collect and analyze written, online mental health resources on the Veterans Health Administration (VA) website, and other websites, using readability assessment instruments. An internet search was performed to identify written patient education information regarding mental health from the VA (the VA Mental Health Website) and top-rated psychiatric hospitals. Seven mental health topics were included in the analysis: generalized anxiety disorder, bipolar, major depressive disorder, posttraumatic stress disorder, schizophrenia, substance abuse, and suicide. Readability analyses were performed using the Gunning Fog Index, the Flesch-Kincaid Grade Level, the Coleman-Liau Index, the SMOG Readability Formula, and the Automated Readability Index. These scores were then combined into a Readability Consensus score. A two-tailed t-test was used to compare the mean values, and statistical significance was set at P readability consensus than six of the top psychiatric hospitals (P readability consensus for mental health information on all websites analyzed was 9.52. Online resources for mental health disorders are more complex than recommended by the NIH and AMA. Efforts to improve readability of mental health and psychosocial wellness resources could benefit patient understanding and outcomes, especially in patients with lower literacy. Surgical outcomes are correlated with patient mental

  13. Associations between nine family dinner frequency measures and child weight, dietary and psychosocial outcomes

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    Fulkerson, Jayne A.; Friend, Sarah E.; Neumark-Sztainer, Dianne

    2015-01-01

    Background Family meal frequency has been consistently and significantly associated with positive youth dietary and psychosocial outcomes but less consistently associated with weight outcomes. Family meal frequency measurement has varied widely and it is unclear how this variation may impact relationships with youth weight, dietary, and psychosocial outcomes. Objective This study assesses how five parent/caregiver-reported and four child-reported family dinner frequency measures correlate with each other and are associated with health-related outcomes. Design/Participants This secondary, cross-sectional analysis uses baseline, parent/caregiver (n=160) and 8–12 year old child (n=160) data from the Healthy Home Offerings via the Mealtime Environment (HOME) Plus trial (collected 2011–2012). Data were obtained from objective measurements, dietary recall interviews, and psychosocial surveys. Outcome measures Outcomes included child body mass index z-scores (BMIz), fruit, vegetable and sugar-sweetened beverage intake, dietary quality (Healthy Eating Index-2010 [HEI-2010]), family connectedness, and meal conversations. Statistical analyses performed Pearson correlations and general linear models were used to assess associations between family dinner frequency measures and outcomes. Results All family dinner frequency measures had comparable means and were correlated within and across parent/caregiver- and child-reporters (r=0.17–0.94, pdinner frequency measures were significantly associated with BMIz scores and 100% were significantly associated with fruit/vegetable intake and HEI-2010. In adjusted models, most significant associations with dietary and psychosocial outcomes remained but associations with child BMIz remained significant only for parent/caregiver- (β±SE= −0.07±0.03; pdinner frequency measures asking about ‘sitting and eating’ dinner. Conclusions In spite of phrasing variations in family dinner frequency measures (e.g., which family members

  14. Psychosocial predictors of treatment outcome for trauma-affected refugees

    Directory of Open Access Journals (Sweden)

    Charlotte Sonne

    2016-05-01

    Full Text Available Background: The effects of treatment in trials with trauma-affected refugees vary considerably not only between studies but also between patients within a single study. However, we know little about why some patients benefit more from treatment, as few studies have analysed predictors of treatment outcome. Objective: The objective of the study was to examine possible psychosocial predictors of treatment outcome for trauma-affected refugees. Method: The participants were 195 adult refugees with posttraumatic stress disorder (PTSD who were enrolled in a 6- to 7-month treatment programme at the Competence Centre for Transcultural Psychiatry (CTP, Denmark. The CTP Predictor Index used in the study included 15 different possible outcome predictors concerning the patients’ past, chronicity of mental health problems, pain, treatment motivation, prerequisites for engaging in psychotherapy, and social situation. The primary outcome measure was PTSD symptoms measured on the Harvard Trauma Questionnaire (HTQ. Other outcome measures included the Hopkins Symptom Check List-25, the WHO-5 Well-being Index, Sheehan Disability Scale, Hamilton Depression and Anxiety Scales, the somatisation scale of the Symptoms Checklist-90, Global Assessment of Functioning scales, and pain rated on visual analogue scales. The relations between treatment outcomes and the total score as well as subscores of the CTP Predictor Index were analysed. Results: Overall, the total score of the CTP Predictor Index was significantly correlated to pre- to post treatment score changes on the majority of the ratings mentioned above. While employment status was the only single item significantly correlated to HTQ-score changes, a number of single items from the CTP Predictor Index correlated significantly with changes in depression and anxiety symptoms, but the size of the correlation coefficients were modest. Conclusions: The total score of the CTP Predictor Index correlated significantly

  15. A Systematic Review of Animal-Assisted Therapy on Psychosocial Outcomes in People with Intellectual Disability.

    Science.gov (United States)

    Maber-Aleksandrowicz, Sarah; Avent, Cerian; Hassiotis, Angela

    2016-01-01

    The aim of the study was to review the literature on animal assisted therapy (AAT) in people with intellectual disabilities (ID) measuring psychosocial outcomes (behavioural, social, cognitive and emotional). Quantitative studies were found through a systematic search that identified studies using AAT in people with ID and measuring psychosocial outcomes (behavioural, cognitive, emotional and social). The quality of studies was assessed using a standardised tool and rated as strong, moderate or weak. Only published articles from peer-reviewed journals were included. No language or age restrictions were applied. Over half of the included studies were identified outside standard database searches (e.g. hand searching reference lists from included articles, references from AAT websites and using Google Scholar and a Grey Literature Database). Ten studies were included in the final review; two were rated as moderate quality and eight were rated as weak quality. Overall there was a positive improvement reported from studies for all psychosocial outcomes (with some cognitive, behavioural, social, emotional components reaching statistical significance p ≤ 0.01). Despite having no age restrictions, the included studies had participants that were mainly children and adolescents, in particular favouring male participants, which may limit generalisation. More rigorous methodology is required to improve the quality of future studies including in the main multicentre randomised designs and improved reporting according to CONSORT criteria. Further research should expand to include adults with ID and specific disorders such as challenging behaviour or mental illness. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Psychosocial factors in GP work: the effects of taking a GP position or leaving GP work.

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    Heponiemi, Tarja; Kouvonen, Anne; Aalto, Anna-Mari; Elovainio, Marko

    2013-06-01

    We examined the effects of leaving public sector general practitioner (GP) work and of taking a GP position on changes in work-related psychosocial factors, such as time pressure, patient-related stress, distress and work interference with family. In addition, we examined whether changes in time pressure and patient-related stress mediated the association of employment change with changes of distress and work interference with family. Participants were 1705 Finnish physicians (60% women) who responded to surveys in 2006 and 2010. Analyses of covariance were conducted to examine the effect of employment change to outcome changes adjusted for gender, age and response format. Mediational effects were tested following the procedures outlined by Baron and Kenny. Employment change was significantly associated with all the outcomes. Leaving public sector GP work was associated with substantially decreased time pressure, patient-related stress, distress and work interference with family. In contrast, taking a position as a public sector GP was associated with an increase in these factors. Mediation tests suggested that the associations of employment change with distress change and work interference with family change were partially explained by the changes in time pressure and patient-related stress. Our results showed that leaving public sector GP work is associated with favourable outcomes, whereas taking a GP position in the public sector is associated with adverse effects. Primary health-care organizations should pay more attention to the working conditions of their GPs, in particular, to time pressure and patient-related stress.

  17. Physiotherapy and low back pain - part iii: outcomes research utilising the biosychosocial model: psychosocial outcomes

    Directory of Open Access Journals (Sweden)

    L. D. Bardin

    2003-02-01

    has evolved that necessitates the use of a biopsychosocial model, focusing on illness rather than disease and incorporating the biological, psychological and social aspects that are important to understand and to study LBP in its chronic form. Traditional outcome measures that measure elements within the biological component are limited to assess the spectrum of impacts caused by chronic low back pain (CLBP and the validity, reliability and sensitivity of some of these measures has been questioned.Few physiologic tests of spine function are clinically meaningful to patients, objective physical findings can be absent, and in CLBP disability and activity intolerance are often disproportional to the original injury. Biological outcomes should be complemented by outcomes of the psychosocial aspects of back pain that measure the considerable functional and emotional impact on the quality of life of patients experiencing low back dysfunction. Outcomes research is an analysis of clinical practice as it actually occurs and can  make a valuable contribution to understanding the multidimensional impact of LBP. Psychosocial aspects of the biopsychosocial model for outcomes research are discussed in part III: functional status/disability, psychological impairment, patient satisfaction, health related quality of life

  18. Community health worker interventions to promote psychosocial outcomes among people living with HIV-A systematic review.

    Directory of Open Access Journals (Sweden)

    Hae-Ra Han

    Full Text Available Community health worker (CHW interventions are a successful strategy to promote health among HIV-negative and persons living with HIV (PLWH. Psychosocial factors are critical dimensions of HIV/AIDS care contributing to prognosis of the disease, yet it is unclear how CHW interventions improve psychosocial outcomes in PLWH. The purpose of this study was to critically appraise the types, scope, and nature of CHW interventions designed to address psychosocial outcomes in PLWH.We performed database searches-PubMed, EMBASE, CINAHL, and Cochrane-to identify randomized controlled trials published in English before April 2017. Fourteen articles met the eligibility criteria.Half of the studies were conducted in the United States. Social cognitive theory was used more than once in nine theory-guided studies. CHW interventions were largely focused on reducing depression (n = 6 or stigma related to HIV (n = 4, or promoting quality of life (n = 4, social support (n = 4, and self-efficacy (n = 4. Didactic methods and role-playing were used to train CHWs. CHWs played multiple roles in delivering intervention, including a counselor and a supporter (n = 10, educator (n = 5, or a navigator (n = 3. CHW intervention fidelity was assessed in 4 studies. Five studies found positive changes in six psychosocial outcomes including quality of life (2 of 4 and self-efficacy (2 of 4. CHW interventions had no effect on social support in 2 of 4 studies, and stigma in 3 of 4 studies. None of the CHW interventions were successful in reducing depressive symptoms among PLWH.Evidence partially supported the use of CHWs in promoting psychosocial outcomes in PLWH. Future CHW intervention should be expanded in scope to address key psychosocial determinants of HIV/AIDS outcomes such as health literacy. Further, fidelity measures should be incorporated into intervention delivery.

  19. The effect of antenatal education in small classes on obstetric and psycho-social outcomes

    DEFF Research Database (Denmark)

    Brixval, Carina Sjöberg; Axelsen, Solveig Forberg; Lauemøller, Stine Glenstrup

    2015-01-01

    of small group antenatal education on obstetric and psycho-social outcomes. CONCLUSIONS: Insufficient evidence exists as to whether antenatal education in small classes is effective in regard to obstetric and psycho-social outcomes. We recommend updating this review following the emergence of well......, with participation of a small number of participants, may differ from the effect of other forms of antenatal education due to, for example, group dynamic. The objective of this systematic review is to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes. METHODS...

  20. Friendship Quality and Psychosocial Outcomes among Children with Traumatic Brain Injury

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    Heverly-Fitt, Sara; Wimsatt, Maureen A.; Menzer, Melissa M.; Rubin, Kenneth H.; Dennis, Maureen; Taylor, Gerry; Stancin, Terry; Gerhardt, Cynthia A.; Vannatta, Kathryn; Bigler, Erin D.; Yeates, Keith Owen

    2014-01-01

    This study examined differences in friendship quality between children with traumatic brain injury (TBI) and orthopedic injury (OI) and behavioral outcomes for children from both groups. Participants were 41 children with TBI and 43 children with OI (M age = 10.4). Data were collected using peer- and teacher-reported measures of participants’ social adjustment and parent-reported measures of children’s post-injury behaviors. Participants and their mutually nominated best friends also completed a measure of the quality of their friendships. Children with TBI reported significantly more support and satisfaction in their friendships than children with OI. Children with TBI and their mutual best friend were more similar in their reports of friendship quality compared to children with OI and their mutual best friends. Additionally, for children with TBI who were rejected by peers, friendship support buffered against maladaptive psychosocial outcomes, and predicted skills related to social competence. Friendship satisfaction was related to higher teacher ratings of social skills for the TBI group only. Positive and supportive friendships play an important role for children with TBI, especially for those not accepted by peers. Such friendships may protect children with TBI who are rejected against maladaptive psychosocial outcomes, and promote skills related to social competence. PMID:24840021

  1. Mechanisms underlying the effects of prenatal psychosocial stress on child outcomes: beyond the HPA axis

    NARCIS (Netherlands)

    Beijers, R.; Buitelaar, J.K.; Weerth, C. de

    2014-01-01

    Accumulating evidence from preclinical and clinical studies indicates that maternal psychosocial stress and anxiety during pregnancy adversely affect child outcomes. However, knowledge on the possible mechanisms underlying these relations is limited. In the present paper, we review the most often

  2. Positive and negative meanings are simultaneously ascribed to colorectal cancer: relationship to quality of life and psychosocial adjustment.

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    Camacho, Aldo Aguirre; Garland, Sheila N; Martopullo, Celestina; Pelletier, Guy

    2014-08-01

    Experiencing cancer can give rise to existential concerns causing great distress, and consequently drive individuals to make sense of what cancer may mean to their lives. To date, meaning-based research in the context of cancer has largely focused on one possible outcome of this process, the emergence of positive meanings (e.g. post-traumatic growth). However, negative meanings may also be ascribed to cancer, simultaneously with positive meanings. This study focused on the nature of the co-existence of positive and negative meanings in a sample of individuals diagnosed with colorectal cancer to find out whether negative meaning had an impact on quality of life and psychosocial adjustment above and beyond positive meaning. Participants were given questionnaires measuring meaning-made, quality of life, and psychological distress. Semi structured interviews were conducted with a subgroup from the original sample. Hierarchical multiple regression analyses revealed that negative meaning-made (i.e. helplessness) was a significant predictor of poor quality of life and increased levels of depression/anxiety above and beyond positive meaning-made (i.e. life meaningfulness, acceptance, and perceived benefits). Correlational analyses and interview data revealed that negative meaning-made was mainly associated with physical and functional disability, while positive meaning-made was mostly related to emotional and psychological well-being. Meanings of varying valence may simultaneously be ascribed to cancer as it impacts different life dimensions, and they may independently influence quality of life and psychosocial adjustment. The presence of positive meaning was not enough to prevent the detrimental effects of negative meaning on psychosocial adjustment and quality of life among individuals taking part in this study. Future attention to negative meaning is warranted, as it may be at least as important as positive meaning in predicting psychosocial adjustment and quality of

  3. Achievement for All: improving psychosocial outcomes for students with special educational needs and disabilities.

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    Humphrey, Neil; Lendrum, Ann; Barlow, Alexandra; Wigelsworth, Michael; Squires, Garry

    2013-04-01

    Students with special educational needs and disabilities (SEND) are at a greatly increased risk of experiencing poor psychosocial outcomes. Developing effective interventions that address the cause of these outcomes has therefore become a major policy priority in recent years. We report on a national evaluation of the Achievement for All (AfA) programme that was designed to improve outcomes for students with SEND through: (1) academic assessment, tracking and intervention, (2) structured conversations with parents, and (3) developing provision to improve wider outcomes (e.g. positive relationships). Using a quasi-experimental, pre-test-post-test control group design, we assessed the impact of AfA on teacher ratings of the behaviour problems, positive relationships and bullying of students with SEND over an 18-month period. Participants were 4758 students with SEND drawn from 323 schools across England. Our main impact analysis demonstrated that AfA had a significant impact on all three response variables when compared to usual practice. Hierarchical linear modelling of data from the intervention group highlighted a range of school-level contextual factors and implementation activities and student-level individual differences that moderated the impact of AfA on our study outcomes. The implications of our findings are discussed, and study strengths and limitations are noted. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  4. Waiting time and the psychosocial consequences of false-positive mammography

    DEFF Research Database (Denmark)

    Heleno, Bruno M.; Siersma, Volkert; Brodersen, John

    2015-01-01

    Background: There is wide variation in the psychosocial response to false-positive mammography. We aimed to assess whether women having to wait longer to exclude cancer had increased psychosocial consequences that persisted after cancer was ruled out. Findings: We selected women with false......-positive mammography (n = 272), screened for breast cancer in Copenhagen and Funen (Denmark) over a 1-year period. We measured psychosocial consequences immediately before women attended their recall visit and 1, 6, 18 and 36 months after women received their final diagnosis. After women were told that cancer had been...... ruled out, adverse psychosocial consequences decreased with time. We found no statistically significant differences between women who had cancer ruled out immediately at the recall visit (waiting time of 0) and women who had to wait longer before cancer was ruled out (waiting times 1-30, 30...

  5. Psychosocial outcome and psychiatric comorbidity in older adolescents with Tourette syndrome: controlled study

    DEFF Research Database (Denmark)

    Gorman, Daniel A; Thompson, Nancy; Plessen, Kerstin J

    2010-01-01

    BACKGROUND: Children with Tourette syndrome generally experience improvement of tics by age 18 years, but psychosocial and comorbidity outcomes at this age are unclear. AIMS: To compare psychosocial outcomes and lifetime comorbidity rates in older adolescents with Tourette syndrome and controls. We...... hypothesised a priori that individuals with Tourette syndrome would have lower Children's Global Assessment Scale (CGAS) scores. METHOD: A total of 65 individuals with Tourette syndrome, identified in childhood, and 65 matched community controls without tic or obsessive-compulsive disorder (OCD) symptoms were......, learning disorder and conduct disorder (Ptic severity. CONCLUSIONS: Clinically ascertained children with Tourette syndrome typically have impaired psychosocial functioning...

  6. Impact of Psychosocial Risk on Outcomes among Families Seeking Treatment for Obesity.

    Science.gov (United States)

    Phan, Thao-Ly T; Chen, Fang Fang; Pinto, Alison Taggi; Cox, Courtney; Robbins, Jennifer; Kazak, Anne E

    2018-04-02

    To test the hypothesis that children with elevated psychosocial risk would have increased attrition and worse weight outcomes in weight management treatment. This was a prospective cohort study of 100 new patients, aged 4-12 years, in a weight management clinic. Parents completed the Psychosocial Assessment Tool. Logistic regression analyses were conducted to calculate the odds of attrition from the clinic and a nonmeaningful change in body mass index (BMI) z-score (ie, psychosocial risk category, adjusting for child demographics and baseline weight category. The majority of patients were male (59%), black (36%) or white (43%), and had severe obesity (55%), and 59% of families were categorized as having moderate or high psychosocial risk. Over the 6-month period, 53% of families were lost to follow-up, and 67% did not have a clinically meaningful decrease in BMI z-score. Compared with children of families with low psychosocial risk, children of families with moderate or high psychosocial risk were 3.1 times (95% CI, 1.3-7.2 times) more likely to be lost to follow-up and 2.9 times (95% CI, 1.1-7.9 times) more likely to have a non-clinically meaningful change in BMI z-score. Children presenting with increased psychosocial risk have higher attrition and poorer weight outcomes, supporting the need for psychosocial screening as a standard component of pediatric weight management treatment. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. Effect of Physical and Psychosocial Interventions on Hormone and Performance Outcomes in Professional Rugby Union Players: A Systematic Review.

    Science.gov (United States)

    Strahorn, Joshua; Serpell, Benjamin G; McKune, Andrew; Pumpa, Kate L

    2017-11-01

    Strahorn, J, Serpell, BG, McKune, A, and Pumpa, KL. Effect of physical and psychosocial interventions on hormone and performance outcomes in professional rugby union players: a systematic review. J Strength Cond Res 31(11): 3158-3169, 2017-This systematic review investigates the acute effects of physical or psychosocial interventions on testosterone and cortisol responses in elite male rugby union players, and the subsequent association with physical performance areas (e.g., strength, power, sprint performance) or key performance indicators (e.g., coach-identified skills). Medline (via EBSCO), SPORTDiscus, Web of Science, InformIT, ProQuest, Cochrane, and Scopus were searched for relevant articles. Nine articles met the inclusion criteria, with 6 articles examining the effect of speed, strength or power training, and the remaining 3 psychosocial interventions. Quality assessment of the articles as determined by their PEDro score was either 6 or 7 out of 11. This review found that both physical and psychosocial interventions can alter testosterone and cortisol, and physical performance areas important for rugby union are affected by these changes. The limited literature in the field supports the notion that physical interventions of short duration and high intensity, and psychosocial interventions that create a positive environment may elicit a hormonal response that is associated with favorable performance outcomes. Studies that reported psychosocial interventions suggest that testosterone and cortisol may be altered in elite rugby players without metabolic stress, something of great interest to elite athletes and coaches who are looking to elicit a performance advantage without increasing athlete load. Overall, this review identified that when the testosterone responses to an intervention are notably greater than that of cortisol, favorable outcomes are likely. Further research is required to improve our understanding on how to best manipulate training to induce

  8. Psychosocial Adaptation to Disability Within the Context of Positive Psychology: Philosophical Aspects and Historical Roots.

    Science.gov (United States)

    Livneh, Hanoch; Martz, Erin

    2016-03-01

    The purpose of this article is to review the conceptual and clinical similarities that exist between the principles of positive psychology and those underlying rehabilitation counseling and psychology, occupational rehabilitation, and those espoused by the field of psychosocial adaptation to chronic illness and disability (CID). Three themes were selected for review. These included the historical contributions of early scholars in the area of psychosocial adaptation to CID that later were indirectly infused into mainstream positive psychology; state and trait constructs that constitute much of the infrastructure of positive psychology and psychosocial adaptation to CID; and, finally, the philosophical congruencies between positive psychology and psychosocial adaptation to CID. The existing literature indicates that there is a substantial philosophical and conceptual overlap between the fields of positive psychology and psychosocial adaptation to CID. Since theoreticians and researchers, from both fields, often use differing terminology and definitions to describe similar concepts, as well as seek similar research goals, it would behoove both fields to seek a closer partnership in order to establish a meaningful dialogue that focuses on human strengths and virtues in the lives of people with CID.

  9. Pre-liver transplant psychosocial evaluation predicts post-transplantation outcomes.

    Science.gov (United States)

    Benson, Ariel A; Rowe, Mina; Eid, Ahmad; Bluth, Keren; Merhav, Hadar; Khalaileh, Abed; Safadi, Rifaat

    2018-08-01

    Psychosocial factors greatly impact the course of patients throughout the liver transplantation process. A retrospective chart review was performed of patients who underwent liver transplantation at Hadassah-Hebrew University Medical Center between 2002 and 2012. A composite psychosocial score was computed based on the patient's pre-transplant evaluation. Patients were divided into two groups based on compliance, support and insight: Optimal psychosocial score and Non-optimal psychosocial score. Post-liver transplantation survival and complication rates were evaluated. Out of 100 patients who underwent liver transplantation at the Hadassah-Hebrew University Medical Center between 2002 and 2012, 93% had a complete pre-liver transplant psychosocial evaluation in the medical record performed by professional psychologists and social workers. Post-liver transplantation survival was significantly higher in the Optimal group (85%) as compared to the Non-optimal group (56%, p = .002). Post-liver transplantation rate of renal failure was significantly lower in the Optimal group. No significant differences were observed between the groups in other post-transplant complications. A patient's psychosocial status may impact outcomes following transplantation as inferior psychosocial grades were associated with lower overall survival and increased rates of complications. Pre-liver transplant psychosocial evaluations are an important tool to help predict survival following transplantation.

  10. Psychosocial outcome and psychiatric comorbidity in older adolescents with Tourette syndrome: controlled study.

    Science.gov (United States)

    Gorman, Daniel A; Thompson, Nancy; Plessen, Kerstin J; Robertson, Mary M; Leckman, James F; Peterson, Bradley S

    2010-07-01

    Children with Tourette syndrome generally experience improvement of tics by age 18 years, but psychosocial and comorbidity outcomes at this age are unclear. To compare psychosocial outcomes and lifetime comorbidity rates in older adolescents with Tourette syndrome and controls. We hypothesised a priori that individuals with Tourette syndrome would have lower Children's Global Assessment Scale (CGAS) scores. A total of 65 individuals with Tourette syndrome, identified in childhood, and 65 matched community controls without tic or obsessive-compulsive disorder (OCD) symptoms were assessed around 18 years of age regarding psychosocial functioning and lifetime psychiatric disorders. Compared with controls, individuals with Tourette syndrome had substantially lower CGAS scores (P = 10(-8)) and higher rates of attention-deficit hyperactivity disorder (ADHD), major depression, learning disorder and conduct disorder (Ptic severity. Clinically ascertained children with Tourette syndrome typically have impaired psychosocial functioning and high comorbidity rates in late adolescence.

  11. Unemployment and psychosocial outcomes to age 30: A fixed-effects regression analysis.

    Science.gov (United States)

    Fergusson, David M; McLeod, Geraldine F; Horwood, L John

    2014-08-01

    We aimed to examine the associations between exposure to unemployment and psychosocial outcomes over the period from 16 to 30 years, using data from a well-studied birth cohort. Data were collected over the course of the Christchurch Health and Development Study, a longitudinal study of a birth cohort of 1265 children, born in Christchurch in 1977, who have been studied to age 30. Assessments of unemployment and psychosocial outcomes (mental health, substance abuse/dependence, criminal offending, adverse life events and life satisfaction) were obtained at ages 18, 21, 25 and 30. Prior to adjustment, an increasing duration of unemployment was associated with significant increases in the risk of all psychosocial outcomes. These associations were adjusted for confounding using conditional, fixed-effects regression techniques. The analyses showed significant (p unemployment and major depression (p = 0.05), alcohol abuse/dependence (p = 0.043), illicit substance abuse/dependence (p = 0.017), property/violent offending (p unemployment. The findings suggested that the association between unemployment and psychosocial outcomes was likely to involve a causal process in which unemployment led to increased risks of adverse psychosocial outcomes. Effect sizes were estimated using attributable risk; exposure to unemployment accounted for between 4.2 and 14.0% (median 10.8%) of the risk of experiencing the significant psychosocial outcomes. The findings of this study suggest that exposure to unemployment had small but pervasive effects on psychosocial adjustment in adolescence and young adulthood. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  12. The perceived importance of physical activity: associations with psychosocial and health-related outcomes.

    Science.gov (United States)

    Wójcicki, Thomas R; Szabo, Amanda N; White, Siobhan M; Mailey, Emily L; Kramer, Arthur F; McAuley, Edward

    2013-03-01

    The purpose of this study was to assess the extent to which participation in a 12-month exercise program changed the degree of importance that older adults attached to physical activity. In addition, associations among changes in physical activity importance and health-related and psychosocial outcomes were examined. Community-dwelling older adults (N = 179) were recruited to participate in a 12-month exercise trial examining the association between changes in physical activity and fitness with changes in brain structure and psychological health. Participants were randomly assigned to a walking condition or a flexibility, toning, and balance condition. Physical, psychological, and cognitive assessments were taken at months 0, 6, and 12. Involvement in a 12-month exercise program increased the importance that participants placed on physical activity; this positive change was similar across exercise condition and sex. Changes in importance, however, were only associated with changes in physical health status and outcome expectations for exercise midway through the intervention. There were no significant associations at the end of the program. Regular participation in physical activity can positively influence the perceived importance of the behavior itself. Yet, the implications of such changes on physical activity-related outcomes remain equivocal and warrant further investigation.

  13. Age of Menarche and Psychosocial Outcomes in a New Zealand Birth Cohort

    Science.gov (United States)

    Boden, Joseph M.; Fergusson, David M.; Horwood, L. John

    2011-01-01

    Objective: This study examined associations between age of menarche and psychosocial outcomes in early adulthood, including sexual behavior, mental health, criminal behavior, and education/employment, to identify the possible causal role of earlier age of menarche in increasing risks of adverse outcomes. Method: Data were gathered from 497 female…

  14. Nondepressive Psychosocial Factors and CKD Outcomes in Black Americans.

    Science.gov (United States)

    Lunyera, Joseph; Davenport, Clemontina A; Bhavsar, Nrupen A; Sims, Mario; Scialla, Julia; Pendergast, Jane; Hall, Rasheeda; Tyson, Crystal C; Russell, Jennifer St Clair; Wang, Wei; Correa, Adolfo; Boulware, L Ebony; Diamantidis, Clarissa J

    2018-02-07

    Established risk factors for CKD do not fully account for risk of CKD in black Americans. We studied the association of nondepressive psychosocial factors with risk of CKD in the Jackson Heart Study. We used principal component analysis to identify underlying constructs from 12 psychosocial baseline variables (perceived daily, lifetime, and burden of lifetime discrimination; stress; anger in; anger out; hostility; pessimism; John Henryism; spirituality; perceived social status; and social support). Using multivariable models adjusted for demographics and comorbidity, we examined the association of psychosocial variables with baseline CKD prevalence, eGFR decline, and incident CKD during follow-up. Of 3390 (64%) Jackson Heart Study participants with the required data, 656 (19%) had prevalent CKD. Those with CKD (versus no CKD) had lower perceived daily (mean [SD] score =7.6 [8.5] versus 9.7 [9.0]) and lifetime discrimination (2.5 [2.0] versus 3.1 [2.2]), lower perceived stress (4.2 [4.0] versus 5.2 [4.4]), higher hostility (12.1 [5.2] versus 11.5 [4.8]), higher John Henryism (30.0 [4.8] versus 29.7 [4.4]), and higher pessimism (2.3 [2.2] versus 2.0 [2.1]; all P psychosocial variables: factor 1, life stressors (perceived discrimination, stress); factor 2, moods (anger, hostility); and, factor 3, coping strategies (John Henryism, spirituality, social status, social support). After adjustments, factor 1 (life stressors) was negatively associated with prevalent CKD at baseline among women only: odds ratio, 0.76 (95% confidence interval, 0.65 to 0.89). After a median follow-up of 8 years, identified psychosocial factors were not significantly associated with eGFR decline (life stressors: β =0.08; 95% confidence interval, -0.02 to 0.17; moods: β =0.03; 95% confidence interval, -0.06 to 0.13; coping: β =-0.02; 95% confidence interval, -0.12 to 0.08) or incident CKD (life stressors: odds ratio, 1.07; 95% confidence interval, 0.88 to 1.29; moods: odds ratio, 1.02; 95

  15. Preoperative psychosocial risk factors for poor outcomes at 1 and 5 years after total knee replacement.

    Science.gov (United States)

    Wylde, Vikki; Trela-Larsen, Lea; Whitehouse, Michael R; Blom, Ashley W

    2017-10-01

    Background and purpose - Psychosocial factors are important risk factors for poor outcomes in the first year after total knee replacement (TKR), however their impact on long-term outcomes is unclear. We aimed to identify preoperative psychosocial risk factors for poor outcomes at 1 year and 5 years after TKR. Patients and methods - 266 patients were recruited prior to TKR surgery. Knee pain and function were assessed preoperatively and at 1 and 5 years postoperative using the WOMAC Pain score, WOMAC Function score and American Knee Society Score (AKSS) Knee score. Preoperative depression, anxiety, catastrophizing, pain self-efficacy and social support were assessed. Statistical analyses involved multiple linear regression and mixed effect linear regression. Results - Higher anxiety was a risk factor for worse pain at 1 year postoperative. No psychosocial factors were associated with any outcomes at 5 years postoperative. Analysis of change over time found that patients with higher pain self-efficacy had lower preoperative pain and experienced less improvement in pain up to 1 year postoperative. Higher pain self-efficacy was associated with less improvement in the AKSS up to 1 year postoperative but more improvement between 1 and 5 years postoperative. Interpretation - Preoperative anxiety was found to influence pain at 1 year after TKR. However, none of the psychosocial variables were risk factors for a poor outcome at 5 years post-operative, suggesting that the negative effects of anxiety on outcome do not persist in the longer-term.

  16. Testing the association between psychosocial job strain and adverse birth outcomes--design and methods

    DEFF Research Database (Denmark)

    Larsen, Ann D; Hannerz, Harald; Obel, Carsten

    2011-01-01

    A number of studies have examined the effects of prenatal exposure to stress on birth outcomes but few have specifically focused on psychosocial job strain. In the present protocol, we aim to examine if work characterised by high demands and low control, during pregnancy, is associated with the r......A number of studies have examined the effects of prenatal exposure to stress on birth outcomes but few have specifically focused on psychosocial job strain. In the present protocol, we aim to examine if work characterised by high demands and low control, during pregnancy, is associated...... with the risk of giving birth to a child born preterm or small for gestational age....

  17. The effect of antenatal education in small classes on obstetric and psycho-social outcomes

    DEFF Research Database (Denmark)

    Brixval, Carina Sjöberg; Axelsen, Solveig Forberg; Andersen, Stig Krøger

    2014-01-01

    The aims of antenatal education contain both outcomes related to pregnancy, birth and parenthood. Both content and methods of antenatal education have changed over time without evidence of effects on relevant outcomes. The effect of antenatal education in groups, with participation of a small num......-analysis aims to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes....

  18. Subthreshold and threshold attention deficit hyperactivity disorder symptoms in childhood: psychosocial outcomes in adolescence in boys and girls.

    Science.gov (United States)

    Norén Selinus, E; Molero, Y; Lichtenstein, P; Anckarsäter, H; Lundström, S; Bottai, M; Hellner Gumpert, C

    2016-12-01

    To examine the association between different levels of childhood attention deficit hyperactivity disorder (ADHD) symptoms and sex differences in psychosocial outcomes during adolescence. Swedish children (n = 4635) were screened for neuropsychiatric symptoms at age 9 or 12. ADHD symptoms were divided into three levels: screen-negative, screen-intermediate, and screen-positive. At follow-up (age 15), parents and teenagers filled out questionnaires regarding (i) hyperactivity/inattention, (ii) peer problems, (iii) school problems, (iv) internalizing problems, (v) antisocial behaviour, (vi) alcohol misuse, and (vii) drug misuse. All outcomes were controlled for symptoms of diagnostic categories other than ADHD. Increasing levels of ADHD symptoms in childhood were associated with higher proportions of adolescents who displayed negative psychosocial outcomes. More girls than boys reported internalizing problems (all levels) and risky drug use (screen-intermediate and screen-positive only). More boys reported antisocial behaviour at the screen-negative and screen-intermediate levels, but at the screen-positive level, similar proportions of girls and boys displayed antisocial behaviour. The findings support the view that ADHD symptoms, as well as their negative outcomes, are dimensionally distributed in the population and that adolescent girls and boys display different risk profiles. The findings confirm that ADHD symptoms are associated with higher risk of drug misuse in girls. © 2016 The Authors. Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd.

  19. Psychosocial functioning and depressive symptoms among HIV-positive persons receiving care and treatment in Kenya, Namibia, and Tanzania.

    Science.gov (United States)

    Seth, Puja; Kidder, Daniel; Pals, Sherri; Parent, Julie; Mbatia, Redempta; Chesang, Kipruto; Mbilinyi, Deogratius; Koech, Emily; Nkingwa, Mathias; Katuta, Frieda; Ng'ang'a, Anne; Bachanas, Pamela

    2014-06-01

    In sub-Saharan Africa, the prevalence of depressive symptoms among people living with HIV (PLHIV) is considerably greater than that among members of the general population. It is particularly important to treat depressive symptoms among PLHIV because they have been associated with poorer HIV care-related outcomes. This study describes overall psychosocial functioning and factors associated with depressive symptoms among PLHIV attending HIV care and treatment clinics in Kenya, Namibia, and Tanzania. Eighteen HIV care and treatment clinics (six per country) enrolled approximately 200 HIV-positive patients (for a total of 3,538 participants) and collected data on patients' physical and mental well-being, medical/health status, and psychosocial functioning. Although the majority of participants did not report clinically significant depressive symptoms (72 %), 28 % reported mild to severe depressive symptoms, with 12 % reporting severe depressive symptoms. Regression models indicated that greater levels of depressive symptoms were associated with: (1) being female, (2) younger age, (3) not being completely adherent to HIV medications, (4) likely dependence on alcohol, (5) disclosure to three or more people (versus one person), (6) experiences of recent violence, (7) less social support, and (8) poorer physical functioning. Participants from Kenya and Namibia reported greater depressive symptoms than those from Tanzania. Approximately 28 % of PLHIV reported clinically significant depressive symptoms. The scale-up of care and treatment services in sub-Saharan Africa provides an opportunity to address psychosocial and mental health needs for PLHIV as part of comprehensive care.

  20. A prospective study of the psychosocial impact of a positive Chlamydia trachomatis laboratory test.

    Science.gov (United States)

    Gottlieb, Sami L; Stoner, Bradley P; Zaidi, Akbar A; Buckel, Christina; Tran, Molly; Leichliter, Jami S; Berman, Stuart M; Markowitz, Lauri E

    2011-11-01

    Few data exist on potential harms of chlamydia screening. We assessed the psychosocial impact of receiving a positive Chlamydia trachomatis test result. We prospectively studied women ≥16 years of age undergoing chlamydia testing in 2 Midwestern family planning clinics. We surveyed women at baseline and about 1 month after receiving test results, using 9 validated psychosocial scales/subscales and chlamydia-specific questions. Changes in scale scores were calculated for each woman. Mean percent changes in scores for chlamydia-positive and -negative women were compared using a t test. We enrolled 1807 women (response rate, 84%). Of the 1688 women with test results, 149 (8.8%) tested positive. At follow-up, chlamydia-positive women (n = 71) had a 75% increase in anxiety about sexual aspects of their life on the Multidimensional Sexual Self-Concept Questionnaire (P < 0.001), significantly greater than the 26% increase among 280 randomly selected chlamydia-negative women (P = 0.02). There were no differences for the other 8 scales/subscales, including general measures of anxiety, depression, and self-esteem. Chlamydia-positive women were more likely than chlamydia-negative women to be "concerned about chlamydia" (80% vs. 40%, P < 0.001) and to report breaking up with a main partner (33% vs. 11%, P < 0.001) at follow-up. Women testing positive reported a range of chlamydia-specific concerns. Chlamydia-positive women had significant increases in anxiety about sex and concern about chlamydia, but did not have marked changes in more general measures of psychosocial well-being about 1 month after diagnosis. Chlamydia diagnoses were associated with some disruption of relationships with main partners. Chlamydia-specific concerns may guide counseling messages to minimize psychosocial impact.

  1. Do psychosocial interventions improve rehabilitation outcomes after anterior cruciate ligament reconstruction? A systematic review.

    Science.gov (United States)

    Coronado, Rogelio A; Bird, Mackenzie L; Van Hoy, Erin E; Huston, Laura J; Spindler, Kurt P; Archer, Kristin R

    2018-03-01

    To examine the role of psychosocial interventions in improving patient-reported clinical outcomes, including return to sport/activity, and intermediary psychosocial factors after anterior cruciate ligament reconstruction. MEDLINE/PubMed, CINAHL, PsycINFO, and Web of Science were searched from each database's inception to March 2017 for published studies in patients after anterior cruciate ligament reconstruction. Studies were included if they reported on the effects of a postoperative psychosocial intervention on a patient-reported clinical measure of disability, function, pain, quality of life, return to sport/activity, or intermediary psychosocial factor. Data were extracted using a standardized form and summary effects from each article were compiled. The methodological quality of randomized trials was assessed using the Physiotherapy Evidence Database Scale and scores greater than 5/10 were considered high quality. A total of 893 articles were identified from the literature search. Of these, four randomized trials ( N = 210) met inclusion criteria. The four articles examined guided imagery and relaxation, coping modeling, and visual imagery as postoperative psychosocial interventions. Methodological quality scores of the studies ranged from 5 to 9. There were inconsistent findings for the additive benefit of psychosocial interventions for improving postoperative function, pain, or self-efficacy and limited evidence for improving postoperative quality of life, anxiety, or fear of reinjury. No study examined the effects of psychosocial interventions on return to sport/activity. Overall, there is limited evidence on the efficacy of postoperative psychosocial interventions for improving functional recovery after anterior cruciate ligament reconstruction.

  2. School Disorder, School Connectedness, and Psychosocial Outcomes: Moderation by a Supportive Figure in the School

    Science.gov (United States)

    Hurd, Noelle M.; Hussain, Saida; Bradshaw, Catherine P.

    2018-01-01

    The current study examined whether students' perceptions of school disorder influenced their psychosocial outcomes directly and indirectly via connectedness to school. The current study also explored moderation by the presence of a supportive figure in the school and investigated gender differences. Participants were 28,104 high school students.…

  3. Survivors of septic shock caused by Neisseria meningitidis in childhood: psychosocial outcomes in young adulthood

    NARCIS (Netherlands)

    Vermunt, Lindy C.; Buysse, Corinne M.; Joosten, Koen F.; Duivenvoorden, Hugo J.; Hazelzet, Jan A.; Verhulst, Frank C.; Utens, Elisabeth M.

    2011-01-01

    To investigate long-term psychosocial outcomes in young adults who survived septic shock caused by Neisseria meningitidis (meningococcal septic shock) during childhood. A cross-sectional study. The psychological investigation took place in the department of Child and Adolescent Psychiatry of the

  4. Survivors of septic shock caused by Neisseria meningitidis in childhood : Psychosocial outcomes in young adulthood

    NARCIS (Netherlands)

    Vermunt, Lindy C.; Buysse, Corinne M.; Joosten, Koen F.; Duivenvoorden, Hugo J.; Hazelzet, Jan A.; Verhulst, Frank C.; Utens, Elisabeth M.

    Objective: To investigate long-term psychosocial outcomes in young adults who survived septic shock caused by Neisseria meningitidis (meningococcal septic shock) during childhood. Design: A cross-sectional study. Setting: The psychological investigation took place in the department of Child and

  5. Nonorganic Failure to Thrive: Developmental Outcomes and Psychosocial Assessment and Intervention Issues.

    Science.gov (United States)

    Heffer, Robert W.; Kelley, Mary L.

    1994-01-01

    This review describes Nonorganic Failure to Thrive, presents developmental outcomes, and discusses psychosocial assessment and intervention issues relevant to this developmental disability of early childhood, focusing on child-specific variables, situational and family variables, parent-child interaction variables, and biopsychosocial formulation…

  6. Parent Perceptions of Psychosocial Outcomes of Equine-Assisted Interventions for Children with Autism Spectrum Disorder

    Science.gov (United States)

    Tan, Vanessa Xue-Ling; Simmonds, Janette Graetz

    2018-01-01

    This research explored parents' perceptions of the psychosocial outcomes of their children's experience of receiving equine-assisted interventions (EAI). Participants were the parents of six children (aged 3-14) diagnosed with autism spectrum disorder. Five semi-structured interviews were conducted and the transcript data was analysed using…

  7. Psychosocial Outcomes of Adult Children of Mothers with Depression and Bipolar Disorder

    Science.gov (United States)

    Mowbray, Carol T.; Mowbray, Orion P.

    2006-01-01

    Research has established that children of parents with mental illness, compared with normative samples, are more likely to have emotional/behavioral problems or psychiatric diagnoses themselves. Few studies have examined these children at adulthood, however, to document their diverse psychosocial outcomes and the parenting and contextual variables…

  8. Psychosocial outcomes in adult men born with hypospadias: A register-based study.

    Directory of Open Access Journals (Sweden)

    Anna Skarin Nordenvall

    Full Text Available In this nationwide matched cohort study, we have investigated whether being born with hypospadias affect subsequent psychosocial outcomes in adulthood. We analyzed prospectively collected data from national Swedish registers. Data on the diagnoses were collected from the National Patient Register and the Medical Birth Register. Data on psychosocial outcomes such as educational and income level, marital status and disability pension were collected from Statistics Sweden. The effects of covariates, such as age, county of birth, presence of other malformations and psychiatric illness, were taken into account. The associations between hypospadias and psychosocial outcomes were calculated using conditional logistic regression and expressed as odds ratios (OR and 95% confidence intervals (CI. We included 4378 men diagnosed with hypospadias, born between 1969 and 1993 in Sweden. Patients with hypospadias were matched with unaffected men by year of birth and birth county. We did not detect any differences in educational or income level. The probability of entering marriage (OR 1.02, 95% CI 0.90-1.14 did not differ, regardless of phenotype. We did, however, detect a 40% increased probability of receiving a disability pension, (OR 1.39, 95% CI 1.20-1.61. In conclusion, men born with hypospadias in Sweden do not differ from unaffected men with respect to the majority of psychosocial outcomes studied. They are, however, at increased risk of receiving a disability pension, which motivates further investigations.

  9. Conduct Disorder and Psychosocial Outcomes at Age 30: Early Adult Psychopathology as a Potential Mediator

    Science.gov (United States)

    Olino, Thomas M.; Seeley, John R.; Lewinsohn, Peter M.

    2010-01-01

    Conduct disorder (CD) is associated with a number of adverse psychosocial outcomes in adulthood. There is consistent evidence that CD is predictive of antisocial behavior, but mixed evidence that CD is predictive of other externalizing and internalizing disorders. Further, externalizing and internalizing disorders are often associated with similar…

  10. Psychosocial predictors of treatment outcome for trauma-affected refugees

    DEFF Research Database (Denmark)

    Sonne, Charlotte; Carlsson, Jessica; Bech, Per

    2016-01-01

    situation. The primary outcome measure was PTSD symptoms measured on the Harvard Trauma Questionnaire (HTQ). Other outcome measures included the Hopkins Symptom Check List-25, the WHO-5 Well-being Index, Sheehan Disability Scale, Hamilton Depression and Anxiety Scales, the somatisation scale of the Symptoms...... Checklist-90, Global Assessment of Functioning scales, and pain rated on visual analogue scales. The relations between treatment outcomes and the total score as well as subscores of the CTP Predictor Index were analysed. Results Overall, the total score of the CTP Predictor Index was significantly...

  11. Psychosocial predictors of treatment outcome for trauma-affected refugees

    DEFF Research Database (Denmark)

    Sonne, Charlotte; Carlsson, Jessica; Bech, Per

    2016-01-01

    at the Competence Centre for Transcultural Psychiatry (CTP), Denmark. The CTP Predictor Index used in the study included 15 different possible outcome predictors concerning the patients' past, chronicity of mental health problems, pain, treatment motivation, prerequisites for engaging in psychotherapy, and social...... situation. The primary outcome measure was PTSD symptoms measured on the Harvard Trauma Questionnaire (HTQ). Other outcome measures included the Hopkins Symptom Check List-25, the WHO-5 Well-being Index, Sheehan Disability Scale, Hamilton Depression and Anxiety Scales, the somatisation scale of the Symptoms...

  12. Adult psychosocial outcome of prepubertal major depressive disorder.

    Science.gov (United States)

    Geller, B; Zimerman, B; Williams, M; Bolhofner, K; Craney, J L

    2001-06-01

    To compare adult psychosocial functioning (PSF) of subjects with prepubertal major depressive disorder (PMDD) to a normal comparison (NC) group. PSF of subjects with PMDD (n = 72) and of NC subjects (n = 28) was compared after prospective follow-up to adulthood. These 100 subjects were 90.9% of the baseline 110 subjects who participated in the "Nortriptyline in Childhood Depression: Follow-up Study." Research nurses who were blind to group status conducted telephone interviews using the Longitudinal Interval Follow-up Evaluation (LIFE) to obtain PSF data. At follow-up, the PMDD group was 20.7+/-2.0 and the NC subjects were 20.9+/-2.2 years old. The PMDD subjects were 10.3+/-1.5 years old at baseline. Time between baseline and follow-up was 9.9+/-1.5 years. In the PMDD group, subjects with MDD, bipolar disorder, or substance use disorders during the previous 5 years had significantly worse PSF than NC subjects. These PSF impairments included significantly worse relationships with parents, siblings, and friends; significantly worse functioning in household, school, and work settings; and worse overall quality of life and global social adjustment. Although combined treatments for PMDD have little scientific basis, multimodality regimens seem prudent until definitive treatment data become available.

  13. Relative relationships of general shame and body shame with body dysmorphic phenomenology and psychosocial outcomes.

    Science.gov (United States)

    Weingarden, Hilary; Renshaw, Keith D; Davidson, Eliza; Wilhelm, Sabine

    2017-07-01

    Body Dysmorphic Disorder (BDD) is characterized by a preoccupation with a perceived flaw in appearance and repetitive avoidance behaviors. BDD involves severe psychosocial outcomes (e.g., depression, suicidality, functional impairment). Identifying correlates of BDD symptoms and outcomes can inform treatment. Shame, a painful emotion felt in response to critical self-judgment, may be one key correlate. However, research on shame in BDD is scarce and previous studies have not distinguished general shame from body shame. This study examines the relative relationships between body shame and general shame with body dysmorphic phenomenology and psychosocial outcomes. Participants ( N = 184) were recruited online via BDD organizations and completed a survey. Path analysis was used to examine associations between body and general shame with 1) body dysmorphic phenomenology and 2) depression severity, suicide risk, and functional impairment. Both types of shame were differentially related to outcomes. Body shame was more strongly related to phenomenology, whereas general shame was more strongly related to psychosocial outcomes. Thus, it may be important for BDD treatment to focus on reducing both general and body shame. Further research should evaluate whether current treatments adequately address and reduce general and body shame, and whether addressing shame promotes better treatment outcomes.

  14. Long-term psychosocial consequences of false-positive screening mammography

    DEFF Research Database (Denmark)

    Brodersen, John; Siersma, Volkert Dirk

    2013-01-01

    Cancer screening programs have the potential of intended beneficial effects, but they also inevitably have unintended harmful effects. In the case of screening mammography, the most frequent harm is a false-positive result. Prior efforts to measure their psychosocial consequences have been limite...... by short-term follow-up, the use of generic survey instruments, and the lack of a relevant benchmark-women with breast cancer....

  15. Psychosocial and Health Behavior Outcomes of Young Adults with Asthma or Diabetes.

    Science.gov (United States)

    Berge, Jerica M; Bauer, Katherine W; Eisenberg, Marla E; Denny, Kara; Neumark-Sztainer, Dianne

    2012-04-30

    Previous research has shown a relationship between childhood/adolescent chronic conditions and negative health behaviors, psychological outcomes, and social outcomes. Less is known about whether these negative outcomes are experienced by young adults with chronic health conditions. The purpose of this paper is to investigate how young adults' BMI, health behaviors, and psychological and social outcomes differ depending on whether they have diabetes, asthma, or neither of these chronic conditions. Data were drawn from the third wave of Project EAT-III: Eating and Activity in Young Adults, a population-based study of 2287 young adults (mean age = 25.3; range 19.8 - 31.2). General linear models were used to test differences in BMI, health behaviors (e.g., fast food intake) and psychosocial outcomes (e.g. depressive symptoms) by young adults' chronic disease status. Young adults with diabetes had higher BMIs, engaged in less physical activity and more unhealthy weight control behaviors and binge eating, had lower self-esteem and lower body satisfaction, and experienced more depressive symptoms and appearance-based teasing compared to young adults with asthma or no chronic conditions, after adjusting for age, race/ethnicity, socio-economic status (SES) and, when relevant, for BMI. There were no significant differences between young adults with asthma and young adults with no chronic condition on all of the psychosocial and health behavior outcomes. Young adults with diabetes reported higher prevalence of negative health behaviors and psychosocial outcomes. Providers may find it useful to assess for negative health behaviors and psychosocial variables with young adults with diabetes in order to improve treatment and quality of life for these individuals.

  16. Sexual quality of life, body image distress, and psychosocial outcomes in colorectal cancer: a longitudinal study.

    Science.gov (United States)

    Reese, Jennifer Barsky; Handorf, Elizabeth; Haythornthwaite, Jennifer A

    2018-04-20

    The objectives were to assess changes in sexual QOL and body image distress over time and to examine longitudinal associations between sexual QOL and body image variables with psychosocial outcomes in a sample of colorectal cancer patients. Participants (N = 141) completed a mail-based survey assessing sexual QOL [sexual distress (ISS), treatment impact on sexual function (SFQ), sexual function (FSFI; IIEF)], body image distress (BIS), and psychosocial outcomes [relationship quality (DAS-4), depressive symptoms (CESD-SF), and health-related QOL (HRQOL; FACT-C)]; 88 patients completed 6-month follow-up surveys (62%). Gender and cancer subgroups (male vs. female; rectal vs. colon cancer) were compared and longitudinal models examined associations between sexual QOL and body image variables with psychosocial outcomes over time and by subgroup. Impairments in sexual QOL and body image distress were common. Women and patients with rectal cancer reported worse body image distress compared to men (p = .005) and those with colon cancer (p = .03), respectively; compared to patients with colon cancer, those with rectal cancer reported worse treatment impact (p image distress decreased (p = .02), while sexual QOL was stable (e.g., 58% classified as dysfunctional at both time points, p = .13). For most sexual and body image predictors, worse impairment was associated with worse psychosocial outcomes over time. Several significant gender and cancer subgroup effects were found. Sexual QOL and body image are compromised after colorectal cancer and tend to remain impaired if unaddressed. Sexual concerns should be addressed early to limit broader-reaching psychosocial effects.

  17. Racial and ethnic disparities in functional, psychosocial, and neurobehavioral outcomes after brain injury.

    Science.gov (United States)

    Arango-Lasprilla, Juan Carlos; Kreutzer, Jeffrey S

    2010-01-01

    Because of the growing minority population in the past 3 decades in the United States and the increasing numbers of individuals who sustain a traumatic brain injury (TBI), researchers and clinicians have started to pay more attention to the role of race and ethnicity in outcomes after TBI, with the goal of better serving this population. The aim of this article is to review the literature on the influence of race/ethnicity on functional, psychosocial, and neurobehavioral outcomes after TBI. Specifically, the following 8 areas of outcomes will be examined: (1) treatment outcomes, (2) neuropsychological outcomes, (3) employment/productivity, (4) functional outcomes, (5) community integration, (6) marital status, (7) quality of life/life satisfaction, and (8) emotional/neurobehavioral outcomes. To conclude this review, suggestions for improvements in professional competency, research, systems of care, and training are proposed.

  18. Cross-Cultural Differences in the Experience of Grandparent-Grandchild Relationships and Related Psychosocial Outcomes.

    Science.gov (United States)

    Hayslip, Bert; Toledo, Ray M; Henderson, Craig E; Rodriguez, R Mishelle; Caballero Vela, Daniela M

    2018-01-01

    This study examined grandchildren's perceptions of the quality of their relationship with their grandmothers and how these perceptions relate to psychosocial outcomes. Eighty-two youth from Mexico and 99 youth from the United States aged between 13 and 16 participated. Results suggested that both cultures benefit in unique ways from positive relationship with their grandmothers. Yet, there were also differences in the relational experience of grandmother-grandchild relationships across cultures. Specifically, grandchildren in the U.S. sample reported higher relationship quality, relational competency, and self-efficacy than the grandchildren in the Mexico sample. Within the U.S. sample, relationship quality was associated with grandchildren's relational competence, while in the Mexico sample, relationship quality was associated with self-efficacy. Limitations of the present study include restricted generalizability to other age groups and to grandfathers and that only one element of the grandparent-grandchild dyad was sampled. Longitudinal research will improve our understanding of the causal dynamics of grandparent-grandchild relationships.

  19. Effects of a Workplace Intervention Targeting Psychosocial Risk Factors on Safety and Health Outcomes

    Directory of Open Access Journals (Sweden)

    Leslie B. Hammer

    2015-01-01

    Full Text Available The goal of this study was to test the effectiveness of a workplace intervention targeting work-life stress and safety-related psychosocial risk factors on health and safety outcomes. Data were collected over time using a randomized control trial design with 264 construction workers employed in an urban municipal department. The intervention involved family- and safety-supportive supervisor behavior training (computer-based, followed by two weeks of behavior tracking and a four-hour, facilitated team effectiveness session including supervisors and employees. A significant positive intervention effect was found for an objective measure of blood pressure at the 12-month follow-up. However, no significant intervention results were found for self-reported general health, safety participation, or safety compliance. These findings suggest that an intervention focused on supervisor support training and a team effectiveness process for planning and problem solving should be further refined and utilized in order to improve employee health with additional research on the beneficial effects on worker safety.

  20. Effects of a Workplace Intervention Targeting Psychosocial Risk Factors on Safety and Health Outcomes

    Science.gov (United States)

    Hammer, Leslie B.; Truxillo, Donald M.; Bodner, Todd; Rineer, Jennifer; Pytlovany, Amy C.; Richman, Amy

    2015-01-01

    The goal of this study was to test the effectiveness of a workplace intervention targeting work-life stress and safety-related psychosocial risk factors on health and safety outcomes. Data were collected over time using a randomized control trial design with 264 construction workers employed in an urban municipal department. The intervention involved family- and safety-supportive supervisor behavior training (computer-based), followed by two weeks of behavior tracking and a four-hour, facilitated team effectiveness session including supervisors and employees. A significant positive intervention effect was found for an objective measure of blood pressure at the 12-month follow-up. However, no significant intervention results were found for self-reported general health, safety participation, or safety compliance. These findings suggest that an intervention focused on supervisor support training and a team effectiveness process for planning and problem solving should be further refined and utilized in order to improve employee health with additional research on the beneficial effects on worker safety. PMID:26557703

  1. Psychosocial job strain and risk of adverse birth outcomes

    DEFF Research Database (Denmark)

    Larsen, Ann Dyreborg; Hannerz, Harald; Juhl, Mette

    2013-01-01

    OBJECTIVE: A number of studies examined the effects of prenatal stress on birth outcomes with diverging and inconclusive results. We aimed to examine if working with high job strain during pregnancy measured in week 16 was associated with risk of giving birth to a child born preterm or small....../large for gestational age (SGA/LGA), and second, if social support affected any associations. DESIGN: Study population was 48 890 pregnancies from the Danish National Birth Cohort. Multinomial logistic regression estimated ORs. Covariates included: maternal age, BMI, parity, exercise, smoking, alcohol and coffee...... consumption, manual work, serious maternal disease, parental height and gestational age at interview. In accordance with Good Epidemiological Practice, a protocol outlined the study design before analyses were initiated. RESULTS: High job strain was associated with significantly lower odds of being born LGA...

  2. Cognitive rehabilitation therapy after acquired brain injury in Argentina: psychosocial outcomes in connection with the time elapsed before treatment initiation.

    Science.gov (United States)

    Saux, Gastón; Demey, Ignacio; Rojas, Galeno; Feldberg, Carolina

    2014-01-01

    To examine the effect of cognitive rehabilitation therapy (CRT) on psychosocial outcomes in Argentinean patients with acquired brain injury (ABI), in connection with the time elapsed between injury and treatment initiation. Self-reported data from patients in a naturalistic setting was collected before and after CRT. An outpatient sample of 75 Spanish-speaking patients with cognitive disturbances secondary to ABI (49 male/26 female, age: 50.2 ± 20.1 years; education 14.3 ± 3.2 years) completed a set of scales on their daily living activities, memory self-perception, quality-of-life and mood. Single and multi-group analyses were conducted, considering pre- and post- responses and the time elapsed between injury and treatment initiation. The influence of socio-demographic moderators was controlled during comparisons. Results suggest an improvement in several psychosocial indicators after treatment. Additionally, correlations and group comparisons showed greater improvement in subjective memory and quality-of-life self-reports in patients who began treatment earlier than those who began treatment after a longer time period. Overall, results suggest that CRT is associated with positive results in different areas of the psychosocial domain and that post-injury time can mediate this effect.

  3. Neighborhood Conditions and Psychosocial Outcomes Among Middle-Aged African Americans.

    Science.gov (United States)

    Tabet, Maya; Sanders, Erin A; Schootman, Mario; Chang, Jen Jen; Wolinsky, Fredric D; Malmstrom, Theodore K; Miller, Douglas K

    2017-04-01

    We examined associations between observed neighborhood conditions (good/adverse) and psychosocial outcomes (stress, depressive symptoms, resilience, and sense of control) among middle-aged and older African Americans. The sample included 455 middle-aged and older African Americans examined in Wave 10 of the African American Health (AAH) study. Linear regression was adjusted for attrition, self-selection into neighborhoods, and potential confounders, and stratified by the duration at current address (stress (standardized β = -0.18; P = .002) and depressive symptoms (standardized β = -0.12; P = .048). Among those who lived at their current address for stress (standardized β = 0.18; P = .305) or depressive symptoms (standardized β = 0.36; P = .080). Neighborhood conditions appear to have significant, complex associations with psychosocial factors among middle-aged and older African Americans. This holds important policy implications, especially since adverse neighborhood conditions may still result in adverse physical health outcomes in individuals with >5 years at current residence despite being associated with better psychosocial outcomes.

  4. The Family Environment as a Moderator of Psychosocial Outcomes Following Traumatic Brain Injury in Young Children

    Science.gov (United States)

    Yeates, Keith Owen; Taylor, H. Gerry; Walz, Nicolay Chertkoff; Stancin, Terry; Wade, Shari L.

    2010-01-01

    Objective This study sought to determine whether the family environment moderates psychosocial outcomes after traumatic brain injury (TBI) in young children. Method Participants were recruited prospectively from consecutive hospital admissions of 3-6 year old children, and included 19 with severe TBI, 56 with complicated mild/moderate TBI, and 99 with orthopedic injuries (OI). They completed four assessments across the first 18 months post-injury. The initial assessment included measures of parenting style, family functioning, and the quality of the home. Children’s behavioral adjustment, adaptive functioning, and social competence were assessed at each occasion. Mixed model analyses examined the relationship of the family environment to psychosocial outcomes across time. Results The OI and TBI groups differed significantly in social competence, but the family environment did not moderate the group difference, which was of medium magnitude. In contrast, group differences in behavioral adjustment became more pronounced across time at high levels of authoritarian and permissive parenting; among children with severe TBI, however, even those with low levels of permissive parenting showed increases in behavioral problems. For adaptive functioning, better home environments provided some protection following TBI, but not over time for the severe TBI group. These three-way interactions of group, family environment, and time post injury were all of medium magnitude. Conclusions The findings indicate that the family environment moderates the psychosocial outcomes of TBI in young children, but the moderating influence may wane with time among children with severe TBI. PMID:20438212

  5. Insight, self-stigma and psychosocial outcomes in Schizophrenia: a structural equation modelling approach.

    Science.gov (United States)

    Lien, Y-J; Chang, H-A; Kao, Y-C; Tzeng, N-S; Lu, C-W; Loh, C-H

    2018-04-01

    Poor insight is prevalent in patients with schizophrenia and has been associated with acute illness severity, medication non-adherence and poor treatment outcomes. Paradoxically, high insight has been associated with various undesirable outcomes, including low self-esteem, depression and low subjective quality of life (QoL) in patients with schizophrenia. Despite the growing body of studies conducted in Western countries supporting the pernicious effects of improved insight in psychosis, which bases on the level of self-stigma, the effects are unclear in non-Western societies. The current study examined the role of self-stigma in the relationship between insight and psychosocial outcomes in a Chinese population. A total of 170 outpatients with schizophrenia spectrum disorders were recruited from two general university hospitals. Sociodemographic data and clinical variables were recorded and self-report scales were employed to measure self-stigma, depression, insight, self-esteem and subjective QoL. Structural equation modelling (SEM) was used to analyse the cross-sectional data. High levels of self-stigma were reported by 39% of the participants (n = 67). The influences of insight, self-stigma, self-esteem and depression on subjective QoL were confirmed by the SEM results. Our model with the closest fit to the data (χ 2 = 33.28; df = 20; p = 0.03; χ 2/df = 1.66; CFI = 0.98; TLI = 0.97; RMSEA = 0.06) demonstrated that self-stigma might fully mediate the association of insight with low self-esteem, depression and poor subjective QoL. High insight into illness contributed to self-stigma, which caused low self-esteem and depression and, consequently, low QoL. Notably, insight did not directly affect self-esteem, depression or QoL. Furthermore, the association of insight with poor psychosocial outcomes was not moderated by self-stigma. Our findings support the mediating model of insight relevant to the poor psychosocial outcomes of individuals diagnosed with

  6. Differences on psychosocial outcomes between male and female caregivers of children with life-limiting illnesses.

    Science.gov (United States)

    Schneider, Monica; Steele, Rose; Cadell, Susan; Hemsworth, David

    2011-06-01

    This secondary analysis of data examined the psychosocial outcomes of meaning in caregiving, self-esteem, optimism, burden, depression, spirituality, and posttraumatic growth in 273 parents caring for children with life-limiting illnesses to (a) determine if there were gender differences and (b) identify gender-specific correlations among these outcomes. Findings suggest that significant gender differences exist. Women reported higher average scores compared with men for meaning in caregiving, depression, burden, and posttraumatic growth and lower average scores for optimism. Correlations also revealed some significant differences. Health care professionals need to be aware of gender differences and tailor their interventions appropriately. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Adolescents with congenital heart disease: the importance of perceived parenting for psychosocial and health outcomes.

    Science.gov (United States)

    Luyckx, Koen; Goossens, Eva; Missotten, Lies; Moons, Philip

    2011-11-01

    : Little is known about how parenting relates to psychosocial functioning and health behavior in adolescents with congenital heart disease (CHD). Different parenting styles were identified through relying on adolescent perceptions of multiple dimensions (regulation, responsiveness, and psychological control). The degree to which parents were perceived as consistent in their rearing style was assessed. : Adolescents with CHD were selected from the database of pediatric and congenital cardiology of the University Hospitals Leuven; control individuals were recruited at secondary schools. A total of 429 adolescents (14-18 years) with CHD participated; 403 were matched on gender and age with control individuals. Adolescents completed questionnaires on maternal and paternal regulation, psychological control, and responsiveness. Main outcome measures were depressive symptoms, loneliness, quality of life, health status, alcohol, cigarette, and drug use. : No significant differences emerged between adolescents with CHD and controls in perceived parenting styles. Democratic parenting was accompanied by the most optimal pattern of outcomes in adolescents with CHD, whereas psychologically controlling parenting by the least optimal pattern. Overprotective parenting was related to high patient substance use. Perceiving both parents as democratic turned out most favorably for psychosocial functioning and quality of life, whereas parental consistency was unrelated to substance use in adolescents with CHD. : By building bridges between the fields of adolescent medicine and family studies, the present study generated important information on the role of parents in psychosocial and behavioral functioning of adolescents with CHD. Future longitudinal studies could inform family-based interventions for this population.

  8. Community-Based Psychosocial Treatment Has an Impact on Social Processing and Functional Outcome in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Eszter Varga

    2018-06-01

    Full Text Available Schizophrenic patients have serious impairments in social cognition, which often persists after significant reduction in clinical symptoms. Community-based psychosocial treatments aim to recover social functioning for mentally ill individuals. Our aim was to examine prospective changes in social cognition and functional outcomes in two groups of schizophrenic patients involved in two forms of community-based psychosocial treatments namely case management (CM and community-based club (CC compared to a matched, treatment as usual (TAU group of patients. We hypothesized that CC and CM groups would exhibit better functional and social cognitive outcomes after a 6-month long psychosocial treatment period. Seventy-five patients participated either in CC, CM or TAU. Both CC and CM took part in community-based psychosocial treatment programs including trainings, such as communication and assertiveness trainings. In addition, CC provided group therapeutic treatments and a continuously available day care where patients had the possibility to participate in various social interactions. All participants were in remission, and on maintenance antipsychotic treatment. Participants were assessed on all study variables at two time points: baseline and after 6 months with a battery of questionnaires that examined affective face perception, affective prosody perception, pragmatic language comprehension and ToM. Our results showed that functional outcomes improved significantly in the CC as well as in the CM groups, in contrast to the TAU group. While analyzing summary scores of social cognition, it was found that only the CC group increased its performance in social cognition. In addition, a significant between-group difference in social cognitive function was found after 6 months between the three groups, with the CC group performing best. When investigating associations between changes in social cognition and changes in functional outcomes during a 6-month long

  9. Cluster subgroups based on overall pressure pain sensitivity and psychosocial factors in chronic musculoskeletal pain: Differences in clinical outcomes.

    Science.gov (United States)

    Almeida, Suzana C; George, Steven Z; Leite, Raquel D V; Oliveira, Anamaria S; Chaves, Thais C

    2018-05-17

    We aimed to empirically derive psychosocial and pain sensitivity subgroups using cluster analysis within a sample of individuals with chronic musculoskeletal pain (CMP) and to investigate derived subgroups for differences in pain and disability outcomes. Eighty female participants with CMP answered psychosocial and disability scales and were assessed for pressure pain sensitivity. A cluster analysis was used to derive subgroups, and analysis of variance (ANOVA) was used to investigate differences between subgroups. Psychosocial factors (kinesiophobia, pain catastrophizing, anxiety, and depression) and overall pressure pain threshold (PPT) were entered into the cluster analysis. Three subgroups were empirically derived: cluster 1 (high pain sensitivity and high psychosocial distress; n = 12) characterized by low overall PPT and high psychosocial scores; cluster 2 (high pain sensitivity and intermediate psychosocial distress; n = 39) characterized by low overall PPT and intermediate psychosocial scores; and cluster 3 (low pain sensitivity and low psychosocial distress; n = 29) characterized by high overall PPT and low psychosocial scores compared to the other subgroups. Cluster 1 showed higher values for mean pain intensity (F (2,77)  = 10.58, p cluster 3, and cluster 1 showed higher values for disability (F (2,77)  = 3.81, p = 0.03) compared with both clusters 2 and 3. Only cluster 1 was distinct from cluster 3 according to both pain and disability outcomes. Pain catastrophizing, depression, and anxiety were the psychosocial variables that best differentiated the subgroups. Overall, these results call attention to the importance of considering pain sensitivity and psychosocial variables to obtain a more comprehensive characterization of CMP patients' subtypes.

  10. Psychosocial safety climate buffers effects of job demands on depression and positive organizational behaviors.

    Science.gov (United States)

    Hall, Garry B; Dollard, Maureen F; Winefield, Anthony H; Dormann, Christian; Bakker, Arnold B

    2013-01-01

    In a general population sample of 2343 Australian workers from a wide ranging employment demographic, we extended research testing the buffering role of psychosocial safety climate (PSC) as a macro-level resource within the health impairment process of the Job Demands-Resources (JD-R) model. Moderated structural equation modeling was used to test PSC as a moderator between emotional and psychological job demands and worker depression compared with control and social support as alternative moderators. We also tested PSC as a moderator between depression and positive organizational behaviors (POB; engagement and job satisfaction) compared with control and social support as moderators. As expected we found PSC moderated the effects of job demands on depression and further moderated the effects of depression on POB with fit to the data that was as good as control and social support as moderators. This study has shown that PSC is a macro-level resource and safety signal for workers acting to reduce demand-induced depression. We conclude that organizations need to focus on the development of a robust PSC that will operate to buffer the effects of workplace psychosocial hazards and to build environments conducive to worker psychological health and positive organizational behaviors.

  11. Quality of life and psychosocial outcomes after fixed orthodontic treatment: a 17-year observational cohort study.

    Science.gov (United States)

    Arrow, Peter; Brennan, David; Spencer, A John

    2011-12-01

    There is little evidence to suggest that orthodontic treatment can prevent or reduce the likelihood of dental caries or of periodontal disease or dental trauma and temporomandibular disorders, but there is a modest association between the presence of malocclusion/orthodontic treatment need and quality of life. However, little is known of the long-term outcomes of orthodontic treatment. This study reports on the longitudinal follow-up of quality of life and psychosocial outcomes of orthodontic treatment among a cohort of adults who were examined as adolescents in 1988/1989. Children who were examined in 1988/1989 were invited to a follow-up in 2005/2006. Respondents completed a questionnaire, which collected information on quality of life, receipt of orthodontic treatment and psychosocial factors, and were invited for a clinical examination. Oral health conditions including occlusal status using the Dental Aesthetic Index were recorded. Analysis of variance and multiple linear regression were used to examine the relationship between the measured factors. There was no statistically significant association between occlusal status at adolescence and quality of life at adulthood. Those individuals who had orthodontic treatment but did not need orthodontic treatment had higher self-esteem (23.1, SD 5.2) and were more satisfied with life (18.5, SD 3.7) than other treatment groups (self-esteem range, 20.0-22.7; life satisfaction range, 16.4-18.1), anovaP life, P life. Orthodontic treatment was negatively associated with psychosocial factors (life satisfaction; fixed orthodontic treatment (FOT) β = -0.91, P = 0.02 and self-esteem; FOT β = -1.39, P life and psychosocial factors. Receipt of fixed orthodontic treatment does not appear to be associated with oral health-related quality of life but appears to be negatively associated with self-esteem and satisfaction with life. © 2011 John Wiley & Sons A/S.

  12. A systematic review of exercise and psychosocial rehabilitation interventions to improve health-related outcomes in patients with bladder cancer undergoing radical cystectomy.

    Science.gov (United States)

    Rammant, Elke; Decaestecker, Karel; Bultijnck, Renée; Sundahl, Nora; Ost, Piet; Pauwels, Nele S; Deforche, Benedicte; Pieters, Ronny; Fonteyne, Valérie

    2018-05-01

    Summarizing the evidence on the effects of pre- and postoperative exercise and psychosocial rehabilitation interventions on patient-reported outcomes (PROs) and physical fitness in bladder cancer patients undergoing radical cystectomy. The Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Web of Science and the Physiotherapy Evidence Database were searched independently by two authors from inception until 10 November 2017. Cited references of the studies and citing references retrieved via Web of Science were also checked. Randomized controlled trials (RCTs) and non-randomized studies assessing effects of exercise and psychosocial interventions in bladder cancer patients undergoing radical cystectomy were eligible. Primary outcome measures were PROs and physical fitness. Risk of bias was assessed using the Cochrane Collaboration tool and the Newcastle-Ottawa Scale. Five RCTs (three exercise and two psychosocial studies) and one non-randomized psychosocial study comprising 317 bladder cancer patients were included. Timing of the intervention was preoperative ( n = 2), postoperative ( n = 2) or both pre- and postoperative ( n = 2). Positive effects of exercise were found for physical fitness ( n = 3), some health-related quality-of-life (HRQoL) domains ( n = 2), personal activities in daily living ( n = 1) and muscle strength ( n = 1). Psychosocial interventions showed positive effects on anxiety ( n = 1), fatigue ( n = 1), depression ( n = 1), HRQoL ( n = 1) and posttraumatic growth ( n = 1). Quality assessment showed most shortcomings with sample sizes and strong heterogeneity was observed between studies. The evidence relating to the effects of exercise in bladder cancer is very limited and is even less for psychosocial interventions.

  13. Dyadic interdependence of psychosocial outcomes among haematological cancer survivors and their support persons.

    Science.gov (United States)

    Paul, Christine; Hall, Alix; Oldmeadow, Christopher; Lynagh, Marita; Campbell, Sharon; Bradstock, Ken; Williamson, Anna; Carey, Mariko; Sanson-Fisher, Rob

    2017-11-01

    This study aimed to explore the dyadic relationships between unmet need, depression, and anxiety in people diagnosed with haematological cancer and their support persons. Adult survivors (18 years+) who had been diagnosed with a haematological cancer were recruited to a cross-sectional mailed survey via five state cancer registries in Australia. Participating survivors invited a support person to also complete a survey. Structural equation modelling was used to explore the relationships among survivor and support person self-reported depression, anxiety, and unmet needs. Of the 4299 eligible haematological cancer survivors contacted by the registries, 1511 (35%) returned a completed survey as did 1004 support persons. There were 787 dyads with complete data. After adjusting for age, gender, rurality, cancer type, and whether the support person was a relative, positive correlations were found between survivor and support person scores for depression (p = 0.0029) and unmet needs (p < 0.001), but not anxiety scores (p = 0.075). Survivor unmet needs were significantly related to support person depression (p = 0.0036). Support person unmet needs were significantly related to a higher depression score for survivors (p = 0.0067). Greater support person unmet needs were significantly related to a higher anxiety score for survivors (p = 0.0083). Survivor unmet needs did not have a significant relationship to support person anxiety (p = 0.78). Unmet needs may mediate the interdependence of psychosocial experiences for survivors and support persons, although a longitudinal study is required to confirm causality. Addressing unmet needs may be a potential target for improving outcomes for both groups.

  14. Standardized assessment of psychosocial factors and their influence on medically confirmed health outcomes in workers: a systematic review.

    Science.gov (United States)

    Rosário, Susel; Fonseca, João A; Nienhaus, Albert; da Costa, José Torres

    2016-01-01

    Previous studies of psychosocial work factors have indicated their importance for workers' health. However, to what extent health problems can be attributed to the nature of the work environment or other psychosocial factors is not clear. No previous systematic review has used inclusion criteria based on specific medical evaluation of work-related health outcomes and the use of validated instruments for the assessment of the psychosocial (work) environment. The aim of this systematic review is to summarize the evidence assessing the relationship between the psychosocial work environment and workers' health based on studies that used standardized and validated instruments to assess the psychosocial work environment and that focused on medically confirmed health outcomes. A systematic review of the literature was carried out by searching the databases PubMed, B-ON, Science Direct, Psycarticles, Psychology and Behavioral Sciences Collection and the search engine (Google Scholar) using appropriate words for studies published from 2004 to 2014. This review follows the recommendations of the Statement for Reporting Systematic Reviews (PRISMA). Studies were included in the review if data on psychosocial validated assessment method(s) for the study population and specific medical evaluation of health-related work outcome(s) were presented. In total, the search strategy yielded 10,623 references, of which 10 studies (seven prospective cohort and three cross-sectional) met the inclusion criteria. Most studies (7/10) observed an adverse effect of poor psychosocial work factors on workers' health: 3 on sickness absence, 4 on cardiovascular diseases. The other 3 studies reported detrimental effects on sleep and on disease-associated biomarkers. A more consistent effect was observed in studies of higher methodological quality that used a prospective design jointly with the use of validated instruments for the assessment of the psychosocial (work) environment and clinical

  15. Directional preference and functional outcomes among subjects classified at high psychosocial risk using STarT.

    Science.gov (United States)

    Werneke, Mark W; Edmond, Susan; Young, Michelle; Grigsby, David; McClenahan, Brian; McGill, Troy

    2018-03-14

    Physiotherapy has an important role in managing patients with non-specific low back pain who experience elevated psychosocial distress or risk for chronic disability. In terms of evidence-based physiotherapy practice, cognitive-behavioural approaches for patients at high psychosocial risk are the recommended management to improve patient treatment outcomes. Evidence also suggests that directional preference (DP) is an important treatment effect modifier for prescribing specific exercises for patients to improve outcomes. Little is known about the influence of treatment techniques based on DP on outcomes for patients classified as high psychosocial risk using the Subgroups for Targeted Treatment (STarT) Back Screening Tool. This study aimed to examine the association between functional status (FS) at rehabilitation discharge for patients experiencing low back pain classified at high STarT psychosocial risk and whose symptoms showed a DP versus No-DP. High STarT risk patients (n = 138) completed intake surveys, that is, the lumbar FS of Focus On Therapeutic Outcomes, Inc., and STarT, and were evaluated for DP by physiotherapists credentialed in McKenzie methods. The FS measure of Focus On Therapeutic Outcomes, Inc., was repeated at discharge. DP and No-DP prevalence rates were calculated. Associations between first-visit DP and No-DP and change in FS were assessed using univariate and multivariate regression models controlling for 11 risk-adjusted variables. One hundred nine patients classified as high STarT risk had complete intake and discharge FS and DP data. Prevalence rate for DP was 65.1%. A significant and clinically important difference (7.98 FS points; p = .03) in change in function at discharge between DP and No-DP was observed after controlling for all confounding variables in the final model. Findings suggest that interventions matched to DP are effective for managing high psychological risk patients and may provide physiotherapists with an

  16. The use of a patient-reported outcome questionnaire to assess cancer survivorship concerns and psychosocial outcomes among recent survivors.

    Science.gov (United States)

    Palmer, Steven C; Stricker, Carrie T; DeMichele, Angela M; Schapira, Marilyn; Glanz, Karen; Griggs, Jennifer J; Jacobs, Linda A

    2017-08-01

    Survivor distress is well represented in the literature, but less is known about survivors' concerns and how these relate to adaptation. Using a newly designed Survivorship Concern Scale, we examined concerns and their relationship to psychosocial adaptation among recent breast cancer (BC) survivors. One hundred forty-three stage 0-III BC survivors completed an online assessment including the Survivorship Concern Scale (0-3 scale; alpha = 0.91), unmet needs, quality of life (QoL), and anxiety and depressive symptoms within 1 year of end of treatment. Participants were predominately white (76%), middle-aged (51 years), married (70%), and college educated (79%). Eighty-two percent were stage I or II at diagnosis. Mean degree of survivorship concern was moderate (M = 1.75, SD = 0.70) though variable (range = 0.12-3.00). Survivorship concerns were not significantly related to disease, treatment, or demographic variables except income (p = 0.02). Degree of survivorship concern was significantly associated with all indices of psychosocial adaptation: unmet need (r = 0.50), physical and mental QoL (r = -0.32 and r = -0.32, respectively), depressive symptoms (r = 0.21), and anxiety symptoms (r = 0.51; all p psychosocial adaptation. Adequately addressing concerns may be a way to improve psychosocial outcomes early in the survivorship trajectory.

  17. Studying psychosocial adaptation to end-stage renal disease: the proximal-distal model of health-related outcomes as a base model.

    Science.gov (United States)

    Chan, Ramony; Brooks, Robert; Erlich, Jonathan; Gallagher, Martin; Snelling, Paul; Chow, Josephine; Suranyi, Michael

    2011-05-01

    Studying psychosocial adaptation in end-stage renal disease (ESRD) is increasingly important, as it may explain the variability in health outcomes unaccounted for by clinical factors. The Brenner et al. proximal-distal model of health-related outcomes provides a theoretical foundation for understanding psychosocial adaptation and integrating health outcomes, clinical, and psychosocial factors (Brenner MH, Curbow B, Legro MW. The proximal-distal continuum of multiple health outcome measures: the case of cataract surgery. Med Care. 1995;33(4 Suppl):AS236-44). This study aims to empirically validate the proximal-distal model in the dialysis population and examine the impact of psychosocial factors on the model. A cross-sectional observational study was conducted with a sample of long-term dialysis patients (n=201). Eleven factors: quality of life (QoL), depression, positive affect, comorbidity, symptoms, physical functioning, disease accommodation, loss, self-efficacy, illness acceptance, and social support were measured by standardized psychometric scales. A three-month average of hemoglobin was used. Latent composite structural equation modeling was used to examine the models. The proximal-distal model with slight modification was supported by fit statistics [χ(2)=16.04, df=13, P=.25, root mean square error of approximation (RMSEA)=0.024], indicating that the impact of clinical factors on QoL is mediated through a range of functional and psychological factors, except for hemoglobin which impacts directly on QoL. The model with additional psychosocial factors was also supported by fit statistics (χ(2)=43.59, df=41, P=.36, RMSEA=0.018). These additional factors mainly impact on symptom status, psychological states, and QoL components of the model. The present study supported the proximal-distal model in the dialysis population and demonstrated the considerable impact of psychosocial factors on the model. The proximal-distal model plus psychosocial factors as a

  18. Spiritual transcendence as a predictor of psychosocial outcome from an outpatient substance abuse program.

    Science.gov (United States)

    Piedmont, Ralph L

    2004-09-01

    Does the Spiritual Transcendence Scale (STS; R. L. Piedmont, 1999) predict psychosocial outcomes from an outpatient substance abuse program? Self-report data on symptoms, personality, and coping resources were obtained for 73 consecutive admissions (57 men and 16 women; ages 19-66 years) at intake and again from the 56 (47 men and 9 women) who completed treatment. Controlling for relevant demographic variables, pretreatment STS scores were significantly related to self-ratings at posttreatment. The STS predicted treatment outcomes over and above the contribution of the five-factor model of personality. Significant partial correlations between pretreatment STS scores and therapist ratings of treatment outcome were also obtained. Spiritual Transcendence, especially the facets of Universality and Connectedness, appears to play a significant role in substance abuse recovery. (c) 2004 APA

  19. Psychosocial Stress During First Pregnancy Predicts Infant Health Outcomes in the First Postnatal Year.

    Science.gov (United States)

    Phelan, A L; DiBenedetto, M R; Paul, I M; Zhu, J; Kjerulff, K H

    2015-12-01

    To evaluate the impact of psychosocial stress during pregnancy on infant health outcomes in the first postnatal year. A sample of 3000 women completed a stress inventory (the Psychosocial Hassles Scale) during their third trimester before first childbirth. Infant health outcomes were measured via maternal report at 1, 6 and 12 months postpartum. Poisson regression was used to model the effect of maternal stress during pregnancy on infant health outcomes in the first year, controlling for age, race/ethnicity, education, insurance coverage, marital status, and cigarette smoking during pregnancy. Women who were younger, minority, unmarried, publicly insured and without a college degree were more likely to report high levels of prenatal stress. High prenatal stress was a significant predictor of maternal reporting of gastrointestinal illness (p stress was also a significant predictor of urgent care visits (p stress is associated with increased maternal reporting of infant illness, as well as increased frequency of both urgent care visits and emergency department visits.

  20. Facial Identity and Self-Perception: An Examination of Psychosocial Outcomes in Cosmetic Surgery Patients.

    Science.gov (United States)

    Slavin, Benjamin; Beer, Jacob

    2017-06-01

    The psychosocial health of patients undergoing cosmetic procedures has often been linked to a host of pre-existing conditions, including the type of procedure being performed. Age, gender, and the psychological state of the patients also contribute to the perceived outcome. Specifically, the presence or absence of Body Dysmorphic Disorder (BDD) has been identified as an independent marker for unhappiness following cosmetic procedures.1 However, no study has, to our knowledge, identified a more precise indicator that is associated with higher rates of patient dissatisfaction from cosmetic procedure. This review identifies facial identity and self-perception as potential identifiers of future patient dissatisfaction with cosmetic procedures. Specifically, we believe that patients with a realistic facial identity and self-perception are more likely to be satisfied than those whose self-perceptions are distorted. Patients undergoing restorative procedures, including blepharoplasty, rhytidectomy, and liposuction, are more likely to have an increased outcome favorability rating than those undergoing type change procedures, such as rhinoplasty and breast augmentation. Age, which typically is an independent variable for satisfaction, tends to be associated with increased favorability ratings following cosmetic procedures. Female gender is a second variable associated with higher satisfaction. The authors believe that negative facial identity and self-perception are risk factors for patient dissatisfaction with cosmetic procedural outcomes. Based on this assumption, clinicians may want to focus on the face as a particular area of psychosocial concern. J Drugs Dermatol. 2017;16(6):617-620..

  1. Psychosocial Adaptation to Disability Within the Context of Positive Psychology: Findings from the Literature.

    Science.gov (United States)

    Martz, Erin; Livneh, Hanoch

    2016-03-01

    This purpose of this article is to review of the trends of research that examined positive psychology constructs in the context of adapting to chronic illness and disability (CID). This article examines the empirical findings on the relationships between six selected positive psychology-associated constructs (optimism, hope, resilience, benefit-finding, meaning-making, and post-traumatic growth) and adaptation to disability. Six positive psychology constructs were selected to represent the trends found in recent literature published on CID. The process of choosing these six variables included reviewing chapters on positive psychology and CID, reviewing the top rehabilitation journals that typically publish articles on psychosocial adaptation to CID, using search engines to find relevant journal articles published since the year 2000, and selecting the most important constructs based on the authors’ professional judgment. The available evidence supports the unique benefits of these six positive psychology constructs in predicting successful adaptation to a range of disabling conditions. Based on the available findings, the authors offer four suggestions for occupational rehabilitation researchers.

  2. Early post-operative psychosocial and weight predictors of later outcome in bariatric surgery: a systematic literature review.

    Science.gov (United States)

    Hindle, A; de la Piedad Garcia, X; Brennan, L

    2017-03-01

    This is the first systematic review to synthesize the evidence concerning early post-operative variables predictive of later weight and psychosocial outcomes in bariatric surgery. Eight electronic databases for empirical studies were searched (1954 to 2016). Most of the 39 included studies reported solely on weight outcomes; eating and psychosocial outcomes were less common. A better early weight loss trajectory was the most consistent predictor of more successful medium-term weight outcome (≤24 months); however, its relationship to longer term weight loss maintenance is less certain. Early eating adaptation may be associated with later weight loss, but further research is needed. Evidence is lacking for associations between early adherence or early psychosocial variables and later outcome. In particular, the relationship between early post-operative depression and later weight remains unclear. Little research has considered early prediction of later eating or psychosocial outcomes. Consideration of mediating or moderating relationships is lacking. The body of evidence is limited, and synthesis is hampered by heterogeneity in the type and time at which predictors and outcomes are measured and quality of statistical reporting. Further research on prospective prediction of bariatric surgery outcome is needed to guide early post-operative intervention for those at greatest risk of poor outcomes. © 2017 World Obesity Federation.

  3. Do factors in the psychosocial work environment mediate the effect of socioeconomic position on the risk of myocardial infarction? Study from the Copenhagen Centre for Prospective Population Studies

    DEFF Research Database (Denmark)

    Andersen, I; Burr, H; Kristensen, T S

    2004-01-01

    To investigate whether the effect of socioeconomic position on risk of myocardial infarction (MI) is mediated by differential exposure or differential susceptibility to psychosocial work environment....

  4. Long-term psychosocial outcomes among bereaved siblings of children with cancer.

    Science.gov (United States)

    Rosenberg, Abby R; Postier, Andrea; Osenga, Kaci; Kreicbergs, Ulrika; Neville, Bridget; Dussel, Veronica; Wolfe, Joanne

    2015-01-01

    The death of a child from cancer affects the entire family. Little is known about the long-term psychosocial outcomes of bereaved siblings. To describe 1) the prevalence of risky health behaviors, psychological distress, and social support among bereaved siblings and 2) potentially modifiable factors associated with poor outcomes. Bereaved siblings were eligible for this dual-center, cross-sectional, survey-based study if they were 16 years or older and their parents had enrolled in one of three prior studies about caring for children with cancer at the end of life. Linear regression models identified associations between personal perspectives before, during, and after the family's cancer experience and outcomes (health behaviors, psychological distress, and social support). Fifty-eight siblings completed surveys (62% response rate). They were approximately 12 years bereaved, with a mean age of 26 years at the time of the survey (SD 7.8). Anxiety, depression, and illicit substance use increased during the year after their brother/sister's death but then returned to baseline. Siblings who reported dissatisfaction with communication, poor preparation for death, missed opportunities to say goodbye, and/or a perceived negative impact of the cancer experience on relationships tended to have higher distress and lower social support scores (P siblings reported that their loss still affected them; half stated that the experience impacted current educational and career goals. How siblings experience the death of a child with cancer may impact their long-term psychosocial well-being. Sibling-directed communication and concurrent supportive care during the cancer experience and the year after the sibling death may mitigate poor long-term outcomes. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  5. Psychosocial outcomes and counselee satisfaction following genetic counseling for hereditary breast and ovarian cancer: A patient-reported outcome study.

    Science.gov (United States)

    Oberguggenberger, Anne; Sztankay, Monika; Morscher, Raphael Johannes; Sperner-Unterweger, Barbara; Weber, Ingrid; Hubalek, Michael; Kemmler, Georg; Zschocke, Johannes; Martini, Caroline; Egle, Daniel; Dünser, Martina; Gamper, Eva; Meraner, Verena

    2016-10-01

    We investigated the psychosocial consequences of genetic counseling and testing (GCT) for hereditary breast and ovarian cancer (HBOC) at follow-up in a "real-life" sample of counselees at an Austrian tertiary care center. The study cohort included counselees who had undergone genetic counseling for HBOC and completed a follow-up self-report questionnaire battery on psychosocial outcomes (quality of life, psychological distress, satisfaction with counseling and decisions). For comparison of distress, we recruited a reference sample of breast cancer survivors (BCS; n=665) who had not requested GCT in the same setting. Overall, counselees did not exhibit increased levels of anxiety and depression when compared to BCS. No specific follow-up deleterious psychosocial consequences were detected among the former group. Of the 137 counselees, 22.6% and 9.8% experienced clinically relevant levels of anxiety and depression, respectively, at an average follow-up time of 1.8years. However, both anxiety and depression significantly decreased with time and were alike between counselees with and without cancer diagnosis. Follow-up cancer worry seems to be significantly higher among counselees who had not undergone genetic testing or were undecided about it than among counselees who had been tested. Our results strongly support GCT as part of routine care for patients with HBOC. The risk factors of increased distress in specific subgroups of counselees, such as recent cancer diagnosis or uncertainty about testing, warrant further exploration and specific attention in clinical routines. Particularly, the psychological needs of undecided counselees warrant ongoing attention and potential follow-ups. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Fight for Your Right to Fruit: Psychosocial Outcomes of a Manga Comic Promoting Fruit Consumption in Middle-School Youth.

    Science.gov (United States)

    Leung, May May; Green, Melanie C; Tate, Deborah F; Cai, Jianwen; Wyka, Katarzyna; Ammerman, Alice S

    2017-05-01

    The purpose of this study was to determine whether exposure to a manga comic (Japanese comic art) with messages promoting fruit consumption influenced psychosocial variables associated with increased fruit intake in middle-school youth. A three-group, randomized, single-session study was conducted in two public middle schools in central North Carolina. Participants were randomly assigned to one of three groups: (a) comic (manga comic promoting fruit consumption, (b) newsletter (newsletter about fruit), or (c) attention-control (newsletter about ancient Greece). Participants included N = 263 youth, with a mean age of 13.18 years (SD = 1.12). Outcome expectations, self-efficacy, and knowledge related to fruit intake were measured at baseline and immediately after reading. Secondary outcomes included transportation (degree to which participants are immersed in their media) and enjoyment, measured at posttest. Data were analyzed using regression analyses. Comic group participants tended to have greater change in outcome expectations related to fruit intake compared to the attention-control group and greater transportation and enjoyment than the newsletter and attention-control groups. Study results are promising and suggest that manga comics may be a useful format to promote positive health beliefs in youth.

  7. A Qualitative Exploration of the Mental Health and Psychosocial Contexts of HIV-Positive Adolescents in Tanzania.

    Directory of Open Access Journals (Sweden)

    Megan K Ramaiya

    Full Text Available Although 85% of HIV-positive adolescents reside in sub-Saharan Africa, little is known about the psychosocial and mental health factors affecting their daily well-being. Identifying these contextual variables is key to development of culturally appropriate and effective interventions for this understudied and high-risk population. The purpose of this study was to identify salient psychosocial and mental health challenges confronted by HIV-positive youth in a resource-poor Tanzanian setting. A total of 24 qualitative interviews were conducted with a convenience sample of adolescents aged 12-24 receiving outpatient HIV care at a medical center in Moshi, Tanzania. All interviews were audio-recorded, transcribed, and coded using thematic analysis. Psychosocial challenges identified included loss of one or more parents, chronic domestic abuse, financial stressors restricting access to medical care and education, and high levels of internalized and community stigma among peers and other social contacts. Over half of youth (56% reported difficulties coming to terms with their HIV diagnosis and espoused related feelings of self-blame. These findings highlight the urgent need to develop culturally proficient programs aimed at helping adolescents cope with these manifold challenges. Results from this study guided the development of Sauti ya Vijana (The Voice of Youth, a 10-session group mental health intervention designed to address the psychosocial and mental health needs of HIV-positive Tanzanian youth.

  8. Personally tailored activities for improving psychosocial outcomes for people with dementia in long-term care.

    Science.gov (United States)

    Möhler, Ralph; Renom, Anna; Renom, Helena; Meyer, Gabriele

    2018-02-13

    People with dementia who are being cared for in long-term care settings are often not engaged in meaningful activities. Offering them activities which are tailored to their individual interests and preferences might improve their quality of life and reduce challenging behaviour. ∙ To assess the effects of personally tailored activities on psychosocial outcomes for people with dementia living in long-term care facilities.∙ To describe the components of the interventions.∙ To describe conditions which enhance the effectiveness of personally tailored activities in this setting. We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group's Specialized Register, on 16 June 2017 using the terms: personally tailored OR individualized OR individualised OR individual OR person-centred OR meaningful OR personhood OR involvement OR engagement OR engaging OR identity. We also performed additional searches in MEDLINE (Ovid SP), Embase (Ovid SP), PsycINFO (Ovid SP), CINAHL (EBSCOhost), Web of Science (ISI Web of Science), ClinicalTrials.gov, and the World Health Organization (WHO) ICTRP, to ensure that the search for the review was as up to date and as comprehensive as possible. We included randomised controlled trials and controlled clinical trials offering personally tailored activities. All interventions included an assessment of the participants' present or past preferences for, or interests in, particular activities as a basis for an individual activity plan. Control groups received either usual care or an active control intervention. Two authors independently checked the articles for inclusion, extracted data and assessed the methodological quality of included studies. For all studies, we assessed the risk of selection bias, performance bias, attrition bias and detection bias. In case of missing information, we contacted the study authors. We included eight studies with 957 participants. The mean age of participants in the studies ranged from 78 to 88

  9. Testing predictive models of positive and negative affect with psychosocial, acculturation, and coping variables in a multiethnic undergraduate sample

    OpenAIRE

    Kuo, Ben CH; Kwantes, Catherine T

    2014-01-01

    Despite the prevalence and popularity of research on positive and negative affect within the field of psychology, there is currently little research on affect involving the examination of cultural variables and with participants of diverse cultural and ethnic backgrounds. To the authors’ knowledge, currently no empirical studies have comprehensively examined predictive models of positive and negative affect based specifically on multiple psychosocial, acculturation, and coping variables as pr...

  10. Childhood Obesity: Psychosocial Outcomes and the Role of Weight Bias and Stigma

    Science.gov (United States)

    Bromfield, Pauline V.

    2009-01-01

    Research, policy and media discourses highlight negative physical and non-physical outcomes for overweight/obese children and adolescents compared with their non-overweight/obese peers. The research findings that have positioned this "vulnerable" group are reviewed with particular reference to the desired outcomes of the "Every Child Matters"…

  11. Influence of CHDs on psycho-social and neurodevelopmental outcomes in children with Down syndrome.

    Science.gov (United States)

    Visootsak, Jeannie; Huddleston, Lillie; Buterbaugh, Allison; Perkins, Adrienne; Sherman, Stephanie; Hunter, Jessica

    2016-02-01

    To evaluate the family psycho-social outcomes of children with Down syndrome and atrioventricular septal defect, and examine the impact of these variables on the child's neurodevelopmental outcome. This was a cross-sectional study that consisted of 57 children with Down syndrome - 20 cases and 37 controls - of ~12-14 months of age. In both groups, we assessed the development of the child, the quality of the child's home environment, and parenting stress. Compared with the Down syndrome without CHD group, the atrioventricular septal defect group revealed lower scores in all developmental domains, less optimal home environments, and higher parental stress. Significant differences in development were seen in the areas of cognition (p=0.04), expressive language (p=0.05), and gross motor (pneurodevelopmental deficits. Finding that parental stress and home environment may play a role in the neurodevelopmental outcomes may prompt new family-directed interventions and anticipatory guidance for the families of children with Down syndrome who have a CHD.

  12. Psychosocial constructs and postintervention changes in physical activity and dietary outcomes in a lifestyle intervention, HUB City Steps, 2010

    Science.gov (United States)

    Purpose: To examine relationships among psychosocial constructs (PSC) of behavior change and post-intervention changes in physical activity (PA) and dietary outcomes. Design: Non-controlled, pre- post-experimental intervention. Setting: Midsized, southern United States city. Subjects: 269 prima...

  13. Effectiveness of storytelling interventions on psychosocial outcomes in adult patients with a life-threatening illness: a systematic review protocol.

    Science.gov (United States)

    Schoenau, Mai Nanna; Jackson, Inger Marie

    2016-06-01

    The objective of this review is to identify the effectiveness of storytelling interventions on psychosocial outcomes. In this review, storytelling is where adult patients with a life-threatening illness tell their illness story, facilitated by a healthcare professional.Specifically the review questions are.

  14. Enhancing Collegiate Women’s Soccer Psychosocial and Performance Outcomes by Promoting Intrinsic Sources of Sport Enjoyment

    Directory of Open Access Journals (Sweden)

    Scott P. Barnicle, Damon Burton

    2016-12-01

    Full Text Available This study examined the effectiveness of an applied mental skills training (MST intervention utilizing mental skills to enhance intrinsic sources of enjoyment (ISOEs as a means of promoting self-confidence, motivational style, and athletic performance, while also decreasing trait anxiety. The intervention project was designed to increase intrinsic SOE using a systematic and individualized mental training protocol, and then examine its relationships to mental skills and soccer performance. A Division 1 collegiate women’s soccer team was randomly assigned to treatment (n = 8 and control (n = 11 groups, equally distributed by academic year, position, and pre-season coach-evaluated starters and non-starts. Results revealed that the MST intervention significantly increased intrinsic enjoyment targeted psychological and competitive outcomes, both in practice and competition within the treatment group as compared to the control group. This study’s support for the impact mental skills training may have had on ISOEs, as well as other psychosocial outcomes and athletic performance can serve to highlight a mental skill often overlooked by consultants and coaches.

  15. Effect of psychosocial distress on outcome for head and neck cancer patients undergoing radiation.

    Science.gov (United States)

    Chen, Allen M; Hsu, Sophia; Felix, Care; Garst, Jordan; Yoshizaki, Taeko

    2018-03-01

    To determine the impact of pretreatment psychosocial distress on compliance to radiation therapy (RT) and clinical outcomes for patients with head and neck cancer STUDY DESIGN: Self-reported responses to the mood and anxiety domains of the University of Washington Quality of Life instrument were reviewed among 133 patients with newly diagnosed head and neck cancer prior to initiating RT. Varying definitions were used (total number of unexpectedly missed RT days, >5 days continuous interruption of RT outside of weekends, >10 days continuous interruption of RT, and failure to complete prescribed course of RT) to analyze the effect of psychosocial disruption on compliance. Survival was determined using the Kaplan-Meier method. The prevalence of pretreatment depression and anxiety was 23% and 47%, respectively. Continuous RT breaks >5 days occurred in 46%, 33%, 10%, 9%, and 0% of patients whose mood was rated as "extremely depressed," "somewhat depressed," "neither in a good mood or depressed," "generally good," and "excellent," respectively (P = .0016). The corresponding proportion of patients who did not complete their planned RT was 23%, 11%, 5%, and 3%, and 0%, respectively (P = .043). The 2-year overall survival of patients who were "extremely depressed" or "somewhat depressed" at baseline was 71% versus 86% for all others (P = .026). Depression was independently associated with decreased overall survival on logistical regression analysis. Pretreatment depression predicted for decreased RT compliance and inferior survival for head and neck cancer. Additional research to overcome potential barriers to treatment in this setting may be warranted. 4. Laryngoscope, 128:641-645, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  16. Rejection Sensitivity as a Moderator of Psychosocial Outcomes Following Pediatric Traumatic Brain Injury.

    Science.gov (United States)

    Meadows, Emily A; Owen Yeates, Keith; Rubin, Kenneth H; Taylor, H Gerry; Bigler, Erin D; Dennis, Maureen; Gerhardt, Cynthia A; Vannatta, Kathryn; Stancin, Terry; Hoskinson, Kristen R

    2017-07-01

    The current study examines whether psychosocial outcomes following pediatric traumatic brain injury (TBI) vary as a function of children's rejection sensitivity (RS), defined as their disposition to be hypersensitive to cues of rejection from peers. Children ages 8-13 with a history of severe TBI (STBI, n=16), complicated mild/moderate TBI (n=35), or orthopedic injury (OI, n=49) completed measures assessing self-esteem and RS on average 3.28 years post-injury (SD=1.33, range=1.25-6.34). Parents reported on their child's emotional and behavioral functioning and social participation. Regression analyses found moderation of group differences by RS for three outcomes: social participation, self-perceptions of social acceptance, and externalizing behavior problems. Conditional effects at varying levels of RS indicated that externalizing problems and social participation were significantly worse for children with STBI at high levels of RS, compared to children with OI. Social participation for the STBI group remained significantly lower than the OI group at mean levels of RS, but not at low levels of RS. At high levels of RS, self-perceptions of social acceptance were lower for children with moderate TBI compared to OI, but group differences were not significant at mean or low levels of RS. No evidence of moderation was found for global self-worth, self-perceptions of physical appearance or athletic ability, or internalizing problems. The findings highlight the salient nature of social outcomes in the context of varying levels of RS. These findings may have implications for the design of interventions to improve social outcomes following TBI. (JINS, 2017, 23, 451-459).

  17. Initiation and Maintenance of Weight Loss after Laparoscopic Adjustable Gastric Banding. The role of Outcome Expectation and Satisfaction with the Psychosocial Outcome

    NARCIS (Netherlands)

    Zijlstra, H.; Larsen, J.K.; Ridder, D.T.D. de; Ramshorst, B. van; Geenen, R.

    2009-01-01

    A premise of this study was that different psychological processes would predict the initiation and maintenance of weight loss after surgery for morbid obesity. Our aim was to examine whether more favorable preoperative expectations of psychosocial outcomes predict weight loss in the first year

  18. A prospective study of musculoskeletal outcomes among manufacturing workers: II. Effects of psychosocial stress and work organization factors.

    Science.gov (United States)

    Gerr, Fredric; Fethke, Nathan B; Anton, Dan; Merlino, Linda; Rosecrance, John; Marcus, Michele; Jones, Michael P

    2014-02-01

    The aim of this study was to characterize associations between psychosocial and work organizational risk factors and upper-extremity musculoskeletal symptoms and disorders. Methodological limitations of previous studies of psychosocial and work organizational risk factors and musculoskeletal outcomes have produced inconsistent associations. In this prospective epidemiologic study of 386 workers, questionnaires to assess decision latitude ("control") and psychological job demands ("demand") were administered to study participants and were used to classify them into job strain "quadrants". Measures of job stress and job change were collected during each week of follow-up. Incident hand/arm and neck/shoulder symptoms and disorders were ascertained weekly. Associations between exposure measures and musculoskeletal outcomes were estimated with proportional hazard methods. When compared to the low-demand/high-control job strain referent category, large increases in risk of hand/arm disorders were observed for both high-demand/high-control (hazard ratio [HR] = 4.49, 95% confidence interval [CI] = [1.23, 16.4]) and high-demand/low-control job strain categories (HR = 5.18,95% CI = [1.39, 19.4]). Similar associations were observed for hand/arm symptoms. A strong association was also observed between the low-demand/low-control job strain category and neck/shoulder disorders (HR = 6.46, 95% CI = [1.46, 28.6]). Statistically significant associations were also observed between weekly stress level and weekly job change and several musculoskeletal outcomes. Associations between psychosocial risk factors and work organizational factors and musculoskeletal outcomes were large and in the hypothesized direction. Prevention of occupational musculoskeletal disorders may require attention to psychosocial and work organizational factors in addition to physical factors. Methods to control adverse effects of psychosocial and work organizational risk factors should be explored.

  19. Genetic Testing and Post-Testing Decision Making among BRCA-Positive Mutation Women: A Psychosocial Approach.

    Science.gov (United States)

    Hesse-Biber, Sharlene; An, Chen

    2016-10-01

    Through an analysis of an online survey of women who tested positive for the BRCA genetic mutation for breast cancer, this research uses a social constructionist and feminist standpoint lens to understand the decision-making process that leads BRCA-positive women to choose genetic testing. Additionally, this research examines how they socially construct and understand their risk for developing breast cancer, as well as which treatment options they undergo post-testing. BRCA-positive women re-frame their statistical medical risk for developing cancer and their post-testing treatment choices through a broad psychosocial context of engagement that also includes their social networks. Important psychosocial factors drive women's medical decisions, such as individual feelings of guilt and vulnerability, and the degree of perceived social support. Women who felt guilty and fearful that they might pass the BRCA gene to their children were more likely to undergo risk reducing surgery. Women with at least one daughter and women without children were more inclined toward the risk reducing surgery compared to those with only sons. These psychosocial factors and social network engagements serve as a "nexus of decision making" that does not, for the most part, mirror the medical assessments of statistical odds for hereditary cancer development, nor the specific treatment protocols outlined by the medical establishment.

  20. Individual and group based parenting programmes for improving psychosocial outcomes for teenage parents and their children

    Science.gov (United States)

    Barlow, Jane; Smailagic, Nadja; Bennett, Cathy; Huband, Nick; Jones, Hannah; Coren, Esther

    2014-01-01

    Background Parenting programmes are a potentially important means of supporting teenage parents and improving outcomes for their children, and parenting support is a priority across most Western countries. This review updates the previous version published in 2001. Objectives To examine the effectiveness of parenting programmes in improving psychosocial outcomes for teenage parents and developmental outcomes in their children. Search methods We searched to find new studies for this updated review in January 2008 and May 2010 in CENTRAL, MEDLINE, EMBASE, ASSIA, CINAHL, DARE, ERIC, PsycINFO, Sociological Abstracts and Social Science Citation Index. The National Research Register (NRR) was last searched in May 2005 and UK Clinical Research Network Portfolio Database in May 2010. Selection criteria Randomised controlled trials assessing short-term parenting interventions aimed specifically at teenage parents and a control group (no-treatment, waiting list or treatment-as-usual). Data collection and analysis We assessed the risk of bias in each study. We standardised the treatment effect for each outcome in each study by dividing the mean difference in post-intervention scores between the intervention and control groups by the pooled standard deviation. Main results We included eight studies with 513 participants, providing a total of 47 comparisons of outcome between intervention and control conditions. Nineteen comparisons were statistically significant, all favouring the intervention group. We conducted nine meta-analyses using data from four studies in total (each meta-analysis included data from two studies). Four meta-analyses showed statistically significant findings favouring the intervention group for the following outcomes: parent responsiveness to the child post-intervention (SMD −0.91, 95% CI −1.52 to −0.30, P = 0.04); infant responsiveness to mother at follow-up (SMD −0.65, 95% CI −1.25 to −0.06, P = 0.03); and an overall measure of parent

  1. Predictors of Psychosocial Outcomes in Hard-of-Hearing Preschool Children

    Science.gov (United States)

    Laugen, Nina J.; Jacobsen, Karl H.; Rieffe, Carolien; Wichstrøm, Lars

    2016-01-01

    Children with hearing loss are at risk for developing psychosocial problems. Children with mild to severe hearing loss are less frequently subject to research, in particular in preschool, and we therefore know less about the risk in this particular group. To address this, we compared psychosocial functioning in thirty-five 4-5-year olds with…

  2. Psychosocial outcomes for preschool children and families after surgery for complex congenital heart disease.

    Science.gov (United States)

    Brosig, C L; Mussatto, K A; Kuhn, E M; Tweddell, J S

    2007-01-01

    The purpose of the current study was to assess the psychosocial outcomes of preschool-aged survivors (ages 3-6 years) of hypoplastic left heart syndrome (HLHS; n=13) and transposition of the great arteries (TGA; n=13). Parents completed the following measures: Pediatric Quality of Life Inventory, Impact on the Family Scale, Parenting Stress Index, Parent Behavior Checklist, and Child Behavior Checklist. Quality of life scores did not differ from those of healthy controls. Parents of children with HLHS reported more negative impact of the child's illness on the family and more parenting stress than parents of children with TGA. Parents of both groups of children were more permissive in their parenting style than parents of healthy controls. Children with HLHS had higher rates of attention and externalizing behavior problems than children with TGA. The results highlight the need for practitioners working with these children and families to ask about parental stress, family functioning, and behavioral expectations for the child in the context of routine medical/cardiac follow-up.

  3. Pregnancy, Obstetric and Neonatal Outcomes in HIV Positive ...

    African Journals Online (AJOL)

    While the effect of HIV infection on some maternal outcomes is well established, for some others there is conflicting information on possible association with HIV. In this study we investigated pregnancy and neonatal outcome of HIV positive women in large HIV treatment centre over a period of 84 months. They were ...

  4. Testing the association between psychosocial job strain and adverse birth outcomes - design and methods

    Directory of Open Access Journals (Sweden)

    Thulstrup Ane M

    2011-04-01

    Full Text Available Abstract Background A number of studies have examined the effects of prenatal exposure to stress on birth outcomes but few have specifically focused on psychosocial job strain. In the present protocol, we aim to examine if work characterised by high demands and low control, during pregnancy, is associated with the risk of giving birth to a child born preterm or small for gestational age. Methods and design We will use the Danish National Birth Cohort where 100.000 children are included at baseline. In the present study 49,340 pregnancies will be included. Multinomial logistic regression will be applied to estimate odds ratios for the outcomes: preterm; full term but small for gestational age; full term but large for gestational age, as a function of job-strain (high strain, active and passive versus low strain. In the analysis we control for maternal age, Body Mass Index, parity, exercise, smoking, alcohol use, coffee consumption, type of work (manual versus non-manual, maternal serious disease and parents' heights as well as gestational age at interview. Discussion The prospective nature of the design and the high number of participants strengthen the study. The large statistical power allows for interpretable results regardless of whether or not the hypotheses are confirmed. This is, however, not a controlled study since all kinds of 'natural' interventions takes place throughout pregnancy (e.g. work absence, medical treatment and job-redesign. The analysis will be performed from a public health perspective. From this perspective, we are not primarily interested in the effect of job strain per se but if there is residual effect of job strain after naturally occurring preventive measures have been taken.

  5. A randomised trial of a psychosocial intervention for cancer patients integrated into routine care: the PROMPT study (promoting optimal outcomes in mood through tailored psychosocial therapies

    Directory of Open Access Journals (Sweden)

    Jolley Damien

    2011-02-01

    Full Text Available Abstract Background Despite evidence that up to 35% of patients with cancer experience significant distress, access to effective psychosocial care is limited by lack of systematic approaches to assessment, a paucity of psychosocial services, and patient reluctance to accept treatment either because of perceived stigma or difficulties with access to specialist psycho-oncology services due to isolation or disease burden. This paper presents an overview of a randomised study to evaluate the effectiveness of a brief tailored psychosocial Intervention delivered by health professionals in cancer care who undergo focused training and participate in clinical supervision. Methods/design Health professionals from the disciplines of nursing, occupational therapy, speech pathology, dietetics, physiotherapy or radiation therapy will participate in training to deliver the psychosocial Intervention focusing on core concepts of supportive-expressive, cognitive and dignity-conserving care. Health professional training will consist of completion of a self-directed manual and participation in a skills development session. Participating health professionals will be supported through structured clinical supervision whilst delivering the Intervention. In the stepped wedge design each of the 5 participating clinical sites will be allocated in random order from Control condition to Training then delivery of the Intervention. A total of 600 patients will be recruited across all sites. Based on level of distress or risk factors eligible patients will receive up to 4 sessions, each of up to 30 minutes in length, delivered face-to-face or by telephone. Participants will be assessed at baseline and 10-week follow-up. Patient outcome measures include anxiety and depression, quality of life, unmet psychological and supportive care needs. Health professional measures include psychological morbidity, stress and burnout. Process evaluation will be conducted to assess perceptions

  6. Psychosocial outcomes and interventions among cancer survivors diagnosed during adolescence and young adulthood (AYA): a systematic review

    Science.gov (United States)

    Barnett, Marie; McDonnell, Glynnis; DeRosa, Antonio; Schuler, Tammy; Philip, Errol; Peterson, Lisa; Touza, Kaitlin; Jhanwar, Sabrina; Atkinson, Thomas M.; Ford, Jennifer S.

    2016-01-01

    Purpose A cancer diagnosis during adolescence or young adulthood (AYA; defined as ages 15–39) generates unique medical and psychosocial needs as developmental milestones are simultaneously impacted. Past research highlights that AYAs’ experiences and psychosocial outcomes are different, and more research and attention is needed. We aimed to identify and synthesize literature regarding psychosocial outcomes, unique needs, and existing psychosocial interventions pertaining to individuals diagnosed with cancer exclusively during AYA, and to highlight areas for future research. Methods A systematic literature search was conducted using MEDLINE (via PubMed), EMBASE, Cochrane, Web of Science, and PsycINFO (via OVID). Grey literature was searched using key term variations and combinations. Overall, 15,301 records were assessed by two independent reviewers, with 38 studies meeting inclusion criteria. Results Data synthesis of the 38 articles was organized by four main themes based on quality of life and survivorship: physical well-being (7 studies), psychological well-being (8 studies), social well-being (9 studies), and survivorship care (14 studies). The paucity of studies for such broad inclusion criteria highlights that this population is often combined or subsumed under other age groups, missing needs unique to these AYAs. Conclusions AYA cancer survivors’ experiences are nuanced, with interacting variables contributing to post-treatment outcomes. AYAs require age-appropriate and flexible care, informational needs and treatment-related education that foster autonomy for long-term survivorship, as well as improved follow-up care and psychological outcomes. Implications for Cancer Survivors By incorporating these findings into practice, the informational and unmet needs of AYAs can be addressed effectively. Education and programming is lacking specific and general subject matter specific to AYAs, incorporating ranging needs at different treatment stages. PMID

  7. The effect of antenatal education in small classes on obstetric and psycho-social outcomes - a systematic review.

    Science.gov (United States)

    Brixval, Carina Sjöberg; Axelsen, Solveig Forberg; Lauemøller, Stine Glenstrup; Andersen, Stig Krøger; Due, Pernille; Koushede, Vibeke

    2015-02-28

    The aims of antenatal education are broad and encompass outcomes related to pregnancy, birth, and parenthood. Both form and content of antenatal education have changed over time without evidence of effects on relevant outcomes. The effect of antenatal education in groups, with participation of a small number of participants, may differ from the effect of other forms of antenatal education due to, for example, group dynamic. The objective of this systematic review is to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes. Bibliographic databases (Medline, EMBASE, CENTRAL, CINAHL, Web of Science, and PsycINFO) were searched. We included randomized and quasi-randomized trials irrespective of language, publication year, publication type, and publication status. Only trials carried out in the Western world were considered in this review. Studies were assessed for bias using the Cochrane risk of bias tool. Results are presented as structured summaries of the included trials and as forest plots. We identified 5,708 records. Of these, 17 studies met inclusion criteria. Studies varied greatly in content of the experimental and control condition. All outcomes were only reported in a single or a few trials, leading to limited or uncertain confidence in effect estimates. Given the heterogeneity in interventions and outcomes and also the high risk of bias of studies, we are unable to draw definitive conclusions as to the impact of small group antenatal education on obstetric and psycho-social outcomes. Insufficient evidence exists as to whether antenatal education in small classes is effective in regard to obstetric and psycho-social outcomes. We recommend updating this review following the emergence of well-conducted randomized controlled trials with a low risk of bias. PROSPERO CRD42013004319.

  8. The Anticipated Positive Psychosocial Impact of Present Web-Based E-Health Services and Future Mobile Health Applications: An Investigation among Older Swedes.

    Science.gov (United States)

    Wiklund Axelsson, S; Nyberg, L; Näslund, A; Melander Wikman, A

    2013-01-01

    This study investigates the anticipated psychosocial impact of present web-based e-health services and future mobile health applications among older Swedes. Random sample's of Swedish citizens aged 55 years old and older were given a survey containing two different e-health scenarios which respondents rated according to their anticipated psychosocial impact by means of the PIADS instrument. Results consistently demonstrated the positive anticipation of psychosocial impacts for both scenarios. The future mobile health applications scored more positively than the present web-based e-health services. An increase in age correlated positively to lower impact scores. These findings indicate that from a psychosocial perspective, web-based e-health services and mobile health applications are likely to positively impact quality of life. This knowledge can be helpful when tailoring and implementing e-health services that are directed to older people.

  9. Patient's perceptions of chronic kidney disease and their association with psychosocial and clinical outcomes: a narrative review.

    Science.gov (United States)

    Clarke, Amy L; Yates, Thomas; Smith, Alice C; Chilcot, Joseph

    2016-06-01

    Patients with chronic kidney disease (CKD) form organized beliefs regarding their illness and treatment. These perceptions influence the coping strategies employed by an individual to manage his/her illness and may act as a predictor for his/her willingness to engage in self-management behaviours. While illness perceptions have been identified as predictors of non-adherence, depression and mortality in dialysis patients, there is a paucity of research in CKD patients not requiring renal replacement therapy. This narrative review synthesizes the existing literature regarding the role of illness perceptions and associated clinical and psychosocial outcomes in non-dialysis CKD patients. Studies were identified following database searches of AMED, BNI, CINAHL, EMBASE, Health Business Elite, HMIC, Medline, PsycINFO and Google Scholar in January 2016. Despite the small evidence base, existing studies indicate that negative illness perceptions are associated with disease progression and a number of psychosocial outcomes in non-dialysis CKD patients. Evidence from other clinical populations suggests that illness perceptions are modifiable through psychological intervention, which may be most effective if delivered early before beliefs have the chance to become more established. Therefore, targeting illness perceptions in the earlier stages of CKD may be optimal. Further studies are now required to ascertain the mechanisms through which illness perceptions predict psychosocial and clinical outcomes in CKD patients and to ultimately test the efficacy of illness perception-based interventions.

  10. A Qualitative Study of Migrant-related Stressors, Psychosocial Outcomes and HIV Risk Behavior among Truck Drivers in Zambia

    Science.gov (United States)

    Ncube, Nomagugu; Simona, Simona J.; Kansankala, Brian; Sinkala, Emmanuel; Raidoo, Jasmin

    2017-01-01

    Truck drivers are part of mobile populations which have been noted as a key population at risk of HIV in Zambia. This study was aimed at 1) determining Potentially Traumatic Events (PTEs), labor migrant-related stressors, psychosocial problems and HIV risk behaviors among truck drivers in Zambia and 2) examining the relationship between PTEs, migrant-related stressors, psychosocial outcomes and HIV sexual risk behavior among truck drivers in Zambia. We conducted fifteen semi-structured interviews with purposively sampled male truck drivers at trucking companies in Lusaka, Zambia. Findings indicate that truck drivers experience multiple stressors and potentially traumatic incidences, including delays and long waiting hours at borders, exposure to crime and violence, poverty, stress related to resisting temptation of sexual interactions with sex workers or migrant women, and job-related safety concerns. Multiple psychosocial problems such as intimate partner violence, loneliness, anxiety and depression-like symptoms were noted. Transactional sex, coupled with inconsistent condom use were identified as HIV sexual risk behaviors. Findings suggest the critical need to develop HIV prevention interventions which account for mobility, potentially traumatic events, psychosocial problems, and the extreme fear of HIV testing among this key population. PMID:27681145

  11. The psychopathological and psychosocial outcome of early-onset schizophrenia: Preliminary data of a 13-year follow-up

    Directory of Open Access Journals (Sweden)

    Mehler-Wex Claudia

    2008-02-01

    Full Text Available Abstract Background Relatively little is known about the long-term psychopathological and psychosocial outcome of early-onset schizophrenia. The existing literature describes more severe courses of illness in these patients compared with adult-onset schizophrenia. This article reports preliminary data of a study exploring the outcome of early-onset schizophrenia 13.4 years (mean after first admission. Predictors for interindividual outcomes were investigated. Methods We retrospectively assessed 27 former patients (mean age at first admission 15.5 years, SD = 2.0 that were consecutively admitted to the Department of Child and Adolescent Psychiatry at the University of Wuerzburg between 1990 and 2000. A multidimensional approach was chosen to assess the outcome consisting of a mail survey including different questions about psychopathological symptoms, psychosocial parameters, and standardized self-reports (ESI and ADS. Results Concerning the psychopathological outcome, 22.2% reported having acute schizophrenic symptoms. Almost one third (30.8% described symptoms of depression and 37.0% reported having tried to commit suicide or seriously thought about it. 77.8% of the former patients were still in outpatient treatment. Compared to the general population, the number of patients without a school graduation was relatively high (18.5%. Almost half of participants still live with their parents (48.1% or in assisted or semi-assisted living conditions (33.3%. Only 18.5% were working in the open market. Conclusion Schizophrenia with an early onset has an unfavourable prognosis. Our retrospective study of the psychopathological and psychosocial outcome concludes with a generally poor rating.

  12. Comparative effects of meditation and exercise on physical and psychosocial health outcomes: a review of randomized controlled trials.

    Science.gov (United States)

    Edwards, Meghan K; Loprinzi, Paul D

    2018-03-01

    No review papers have examined studies that have directly compared non-active forms of meditation with exercise to evaluate effects on physical or psychosocial outcomes, which was the purpose of this paper. Studies were included if they had a randomized controlled trial (RCT) design, included a non-active form of meditation and exercise as intervention arms, and evaluated physical or psychosocial outcomes. The quality of included RCTs was rated using the Cochrane Collaboration's tool for assessing risk of bias in randomized trials. Five RCTs met the inclusion criteria. The total sample size across all studies was N = 325. Of the main outcomes assessed across the five studies, meditation was shown to be more effective than the exercise comparison arm when evaluating the psychosocial outcomes of anxiety, altruism, and life changes. Additionally, meditation was more effective at reducing chronic neck pain at rest and pain-related bothersomeness. Exercise, however, was more effective in improving physical health-related quality of life, HDL and LDL cholesterol, and fasting blood glucose levels. The interventions were found to be comparable when evaluating the outcomes of well-being, ethanol consumption, and perceived stress levels. Four of the evaluated studies were determined to have an overall 'unclear' risk of bias and one study was found to have a 'high' risk of bias. Exercise and non-active meditation may uniquely influence various health-related outcomes. A continued exploration of the effects of exercise and non-active meditation in controlled trials may yield a better understanding of their benefits.

  13. Psychosocial factors associated with change in pain and disability outcomes in chronic low back pain patients treated by physiotherapist: A systematic review.

    Science.gov (United States)

    Alhowimel, Ahmed; AlOtaibi, Mazyad; Radford, Kathryn; Coulson, Neil

    2018-01-01

    Almost 80% of people have low back pain at least once in their life. Clinical guidelines emphasize the use of conservative physiotherapy and the importance of staying active. While the psychological factors predicting poor recovery following surgical intervention are understood, the psychosocial factors associated with poor outcomes following physiotherapy have yet to be identified. Electronic searches of PubMed, Medline, CINAHL, PsycINFO and EBSCO were conducted using terms relating to psychosocial factors, chronic low back pain, disability and physiotherapy. Papers examining the relationship between psychosocial factors and pain and disability outcomes following physiotherapy were included. Two reviewers selected, appraised and extracted studies independently. In total, 10 observational studies were identified that suggested an association between fear of movement, depression, self-efficacy and catastrophizing in modifying pain and disability outcomes following physiotherapy. Although limited by methodological shortcomings of included studies, and heterogeneity of physiotherapy interventions and measures of disability and psychosocial outcomes, the findings are consistent with other research in the context of back pain and physiotherapy, which suggest an association between psychosocial factors, including fear of movement, catastrophizing and self-efficacy and pain and disability outcomes in chronic low back pain patients treated by physiotherapist. However, a direct relationship cannot be concluded from this study. Findings suggest an association between psychosocial factors, including fear of movement, catastrophizing and self-efficacy and pain and disability outcomes in chronic low back pain patients treated by physiotherapist, which warrants further study.

  14. Promoting positive outcomes through strengths interventions : A literature review

    NARCIS (Netherlands)

    Ghielen, S.T.S.; van Woerkom, M.; Meyers, M.C.

    2018-01-01

    This paper reviews studies of strengths interventions published between 2011 and 2016. Strengths interventions aim to promote well-being or other positive outcomes by facilitating strengths identification, and sometimes also strengths use and/or development. The present review provides an overview

  15. Positive parenting in ethnic minority families : challenges and outcomes

    NARCIS (Netherlands)

    Emmen, Rosalia Antonia Grada (Rosanneke)

    2014-01-01

    The overall goal of the current dissertation is to uncover predictors and outcomes of positive parenting in ethnic minority families. Chapter 2 provides an overview of commonly used observational instruments to measure sensitivity, showing the versatility and scientific importance of the construct.

  16. The Effectiveness of CASAs in Achieving Positive Outcomes for Children.

    Science.gov (United States)

    Litzelfelner, Pat

    2000-01-01

    Evaluated effectiveness of court-appointed special advocates (CASAs) in achieving positive outcomes for children in the child welfare system, using data from court and CASA program files on 200 children. Found that CASAs may have reduced the number of placements and court continuances children experienced. More services were provided to children…

  17. Do Menstrual Hygiene Management Interventions Improve Education and Psychosocial Outcomes for Women and Girls in Low and Middle Income Countries? A Systematic Review

    Science.gov (United States)

    Hennegan, Julie; Montgomery, Paul

    2016-01-01

    Background Unhygienic and ineffective menstrual hygiene management has been documented across low resource contexts and linked to negative consequences for women and girls. Objectives To summarise and critically appraise evidence for the effectiveness of menstruation management interventions in improving women and girls’ education, work and psychosocial wellbeing in low and middle income countries. Methods Structured systematic searches were conducted in peer-reviewed and grey literature to identify studies evaluating education and resource provision interventions for menstruation management. Individual and cluster randomised controlled trials were eligible for inclusion, as were non-randomised controlled trials. Study characteristics, outcomes and risk of bias were extracted using a piloted form. Risk of bias was independently assessed by two researchers. Results Eight studies described in ten citations were eligible for inclusion. Studies were highly heterogeneous in design and context. Six included assessment of education-only interventions, and three provided assessment of the provision of different types of sanitary products (menstrual cups, disposable sanitary pads, and reusable sanitary pads). A moderate but non-significant standardised mean difference was found for the two studies assessing the impact of sanitary pad provision on school attendance: 0.49 (95%CI -0.13, 1.11). Included studies were heterogeneous with considerable risk of bias. Trials of education interventions reported positive impacts on menstrual knowledge and practices, however, many studies failed to assess other relevant outcomes. No trials assessed or reported harms. Conclusions There is insufficient evidence to establish the effectiveness of menstruation management interventions, although current results are promising. Eight trials have been conducted, but a high risk of bias was found and clinical heterogeneity precluded synthesis of most results. Whilst trials provided some

  18. Do Menstrual Hygiene Management Interventions Improve Education and Psychosocial Outcomes for Women and Girls in Low and Middle Income Countries? A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Julie Hennegan

    Full Text Available Unhygienic and ineffective menstrual hygiene management has been documented across low resource contexts and linked to negative consequences for women and girls.To summarise and critically appraise evidence for the effectiveness of menstruation management interventions in improving women and girls' education, work and psychosocial wellbeing in low and middle income countries.Structured systematic searches were conducted in peer-reviewed and grey literature to identify studies evaluating education and resource provision interventions for menstruation management. Individual and cluster randomised controlled trials were eligible for inclusion, as were non-randomised controlled trials. Study characteristics, outcomes and risk of bias were extracted using a piloted form. Risk of bias was independently assessed by two researchers.Eight studies described in ten citations were eligible for inclusion. Studies were highly heterogeneous in design and context. Six included assessment of education-only interventions, and three provided assessment of the provision of different types of sanitary products (menstrual cups, disposable sanitary pads, and reusable sanitary pads. A moderate but non-significant standardised mean difference was found for the two studies assessing the impact of sanitary pad provision on school attendance: 0.49 (95%CI -0.13, 1.11. Included studies were heterogeneous with considerable risk of bias. Trials of education interventions reported positive impacts on menstrual knowledge and practices, however, many studies failed to assess other relevant outcomes. No trials assessed or reported harms.There is insufficient evidence to establish the effectiveness of menstruation management interventions, although current results are promising. Eight trials have been conducted, but a high risk of bias was found and clinical heterogeneity precluded synthesis of most results. Whilst trials provided some indication of positive results, further

  19. Do Menstrual Hygiene Management Interventions Improve Education and Psychosocial Outcomes for Women and Girls in Low and Middle Income Countries? A Systematic Review.

    Science.gov (United States)

    Hennegan, Julie; Montgomery, Paul

    2016-01-01

    Unhygienic and ineffective menstrual hygiene management has been documented across low resource contexts and linked to negative consequences for women and girls. To summarise and critically appraise evidence for the effectiveness of menstruation management interventions in improving women and girls' education, work and psychosocial wellbeing in low and middle income countries. Structured systematic searches were conducted in peer-reviewed and grey literature to identify studies evaluating education and resource provision interventions for menstruation management. Individual and cluster randomised controlled trials were eligible for inclusion, as were non-randomised controlled trials. Study characteristics, outcomes and risk of bias were extracted using a piloted form. Risk of bias was independently assessed by two researchers. Eight studies described in ten citations were eligible for inclusion. Studies were highly heterogeneous in design and context. Six included assessment of education-only interventions, and three provided assessment of the provision of different types of sanitary products (menstrual cups, disposable sanitary pads, and reusable sanitary pads). A moderate but non-significant standardised mean difference was found for the two studies assessing the impact of sanitary pad provision on school attendance: 0.49 (95%CI -0.13, 1.11). Included studies were heterogeneous with considerable risk of bias. Trials of education interventions reported positive impacts on menstrual knowledge and practices, however, many studies failed to assess other relevant outcomes. No trials assessed or reported harms. There is insufficient evidence to establish the effectiveness of menstruation management interventions, although current results are promising. Eight trials have been conducted, but a high risk of bias was found and clinical heterogeneity precluded synthesis of most results. Whilst trials provided some indication of positive results, further research is needed

  20. The relationship of undernutrition/psychosocial factors and developmental outcomes of children in extreme poverty in Ethiopia.

    Science.gov (United States)

    Worku, Berhanu Nigussie; Abessa, Teklu Gemechu; Wondafrash, Mekitie; Vanvuchelen, Marleen; Bruckers, Liesbeth; Kolsteren, Patrick; Granitzer, Marita

    2018-02-09

    Extreme poverty is severe deprivation of basic needs and services. Children living in extreme poverty may lack adequate parental care and face increased developmental and health risks. However, there is a paucity of literature on the combined influences of undernutrition and psychosocial factors (such as limited play materials, playground, playtime, interactions of children with their peers and mother-child interaction) on children's developmental outcomes. The main objective of this study was, therefore, to ascertain the association of developmental outcomes and psychosocial factors after controlling nutritional indices. A community-based cross-sectional study design was used to compare the developmental outcomes of extremely poor children (N = 819: 420 girls and 399 boys) younger than 5 years versus age-matched reference children (N = 819: 414 girls and 405 boys) in South-West Ethiopia. Using Denver II-Jimma, development in personal-social, language, fine and gross motor skills were assessed, and social-emotional skills were evaluated using the Ages and Stages Questionnaires: Social-Emotional (ASQ: SE). Nutritional status was derived from the anthropometric method. Independent samples t-test was used to detect mean differences in developmental outcomes between extremely poor and reference children. Multiple linear regression analysis was employed to identify nutritional and psychosocial factors associated with the developmental scores of children in extreme poverty. Children in extreme poverty performed worse in all the developmental domains than the reference children. Among the 819 extremely poor children, 325 (39.7%) were stunted, 135 (16.5%) were underweight and 27 (3.3%) were wasted. The results also disclosed that stunting and underweightness were negatively associated with all the developmental skills. After taking into account the effects of stunting and being underweight on the developmental scores, it was observed that limited play activities

  1. Multigenerational Challenges: Team-Building for Positive Clinical Workforce Outcomes

    Science.gov (United States)

    Moore, Jill M; Everly, Marcee; Bauer, Renee

    2016-05-31

    Patient acuity in hospital settings continues to increase, and there is greater emphasis on patient outcomes. The current nursing workforce is comprised of four distinct generational cohorts that include veterans, baby boomers, millennials, and generation Xers. Each group has unique characteristics that add complexity to the workforce and this can add challenges to providing optimal patient care. Team building is one strategy to increase mutual understanding, communication, and respect, and thus potentially improve patient outcomes. In this article, we first briefly define generational cohorts by characteristics, and discuss differing expectations for work/life balance and potential negative outcomes. Our discussion offers team building strategies for positive outcomes, a case scenario, and concludes with resources for team building and organizational opportunities.

  2. Positive interaction of social comparison and personal responsibility for outcomes.

    Science.gov (United States)

    Grygolec, Jaroslaw; Coricelli, Giorgio; Rustichini, Aldo

    2012-01-01

    We formulate and test a model that allows sharp separation between two different ways in which environment affects evaluation of outcomes, by comparing social vs. private and personal responsibility vs. chance. In the experiment, subjects chose between two lotteries, one low-risk and one high-risk. They could then observe the outcomes. By varying the environment between private (they could observe the outcome of the chosen lottery and the outcome of the lottery they had not chosen) and social (they could observe the outcome of the lottery chosen by another subject) we can differentiate the response and brain activity following the feedback in social and private settings. The evidence suggests that envy and pride are significant motives driving decisions and outcomes evaluation, stronger than private emotions like regret and rejoice, with ventral striatum playing a key role. When we focus on the outcome evaluation stage we demonstrate that BOLD signal in ventral striatum is increasing in the difference between obtained and counterfactual payoffs. For a given difference in payoffs, striatal responses are more pronounced in social than in private environment. Moreover, a positive interaction (complementarity) between social comparison and personal responsibility is reflected in the pattern of activity in the ventral striatum. At decision stage we observe getting ahead of the Joneses effect in ventral striatum with subjective value of risk larger in social than in private environment.

  3. Do psychopathic traits assessed in mid-adolescence predict mental health, psychosocial, and antisocial, including criminal outcomes, over the subsequent 5 years?

    Science.gov (United States)

    Hemphälä, Malin; Hodgins, Sheilagh

    2014-01-01

    To determine whether psychopathic traits assessed in mid-adolescence predicted mental health, psychosocial, and antisocial (including criminal) outcomes 5 years later and would thereby provide advantages over diagnosing conduct disorder (CD). Eighty-six women and 61 men were assessed in mid-adolescence when they first contacted a clinic for substance misuse and were reassessed 5 years later. Assessments in adolescence include the Psychopathy Checklist-Youth Version (PCL-YV), and depending on their age, either the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Aged Children or the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). Assessments in early adulthood included the SCID, self-reports of psychosocial functioning, aggressive behaviour, and criminality and official criminal records. The antisocial facet score positively predicted the number of anxiety symptoms and likelihood of receiving treatment for substance use disorders (SUDs). Lifestyle and antisocial facet scores negatively predicted Global Assessment of Functioning scores. By contrast, the interpersonal score and male sex independently and positively predicted the number of months worked or studied, as did the interaction of Lifestyle × Sex indicating that among men, but not women, an increase in lifestyle facet score was associated with less time worked or studied. Interpersonal and antisocial scores positively predicted school drop-out. Antisocial facet scores predicted the number of symptoms of antisocial personality disorder, alcohol and SUDs, and violent and nonviolent criminality but much more strongly among males than females. Predictions from numbers of CD symptoms were similar. Psychopathic traits among adolescents who misuse substances predict an array of outcomes over the subsequent 5 years. Information on the levels of these traits may be useful for planning treatment.

  4. Psychosocial outcome and psychiatric comorbidity in older adolescents with Tourette syndrome: controlled study

    DEFF Research Database (Denmark)

    Gorman, Daniel A; Thompson, Nancy; Plessen, Kerstin J

    2010-01-01

    assessed around 18 years of age regarding psychosocial functioning and lifetime psychiatric disorders. RESULTS: Compared with controls, individuals with Tourette syndrome had substantially lower CGAS scores (P = 10(-8)) and higher rates of attention-deficit hyperactivity disorder (ADHD), major depression...

  5. Adolescent Obesity and Young Adult Psychosocial Outcomes: Gender and Racial Differences

    Science.gov (United States)

    Merten, Michael J.; Wickrama, K. A. S.; Williams, Amanda L.

    2008-01-01

    Using a sample of 7,881 African American (915 males and 1,073 females) and White (2,864 males and 3,029 females) adolescents from Waves 1 and 3 of the National Longitudinal Study of Adolescent Health, this study examined the psychosocial consequences that obese adolescents encounter as they reach young adulthood. Results indicate that obesity…

  6. Intergenerational Transmission of Familial Boundary Dissolution: Observations and Psychosocial Outcomes in Adolescence

    Science.gov (United States)

    Shaffer, Anne; Egeland, Byron

    2011-01-01

    This study investigated the transmission of boundary dissolution (BD) in parent-child relationships from parental behaviors observed in early childhood to adolescent behaviors observed at age 13 and relations to adolescent psychosocial adaptation. The goals of the study are (a) to examine the developmental relation of early childhood BD to several…

  7. Relationship between positive self-recognition of maternal role and psychosocial factors in Japanese mothers with severe mental illness.

    Science.gov (United States)

    Ueno, Rie; Kamibeppu, Kiyoko

    2011-10-01

    Mothers with mental illness have positive self-recognition of maternal role (PM), and it is important for parenting. The purpose of this study was to determine the psychosocial factors related to the PM. We recruited a total of 74 women diagnosed as having schizophrenia or mood disorders according to the DSM-IV-TR and who had minor children. Participant completed devaluation-discrimination measure, The social support questionnaire, self-efficacy for community life scale (SECL), parenting stress-short form scale (PS-SF), and Acceptance of maternal role scale. To identify factors predicting the PM, we utilized hierarchical regression analysis. The variables in all blocks explained 53% of the variance in the PM. In the final model, 'hard' living conditions (β = -0.31, P < 0.05), SECL (β = 0.34, P < 0.01) and PS-SF (β = -0.45, P < 0.01) were significant predictors of the PM. Our result indicates that psychosocial approach could enhance the PM.

  8. High risk pregnancy in the workplace. Influencing positive outcomes.

    Science.gov (United States)

    Cannon, R B; Schmidt, J V; Cambardella, B; Browne, S E

    2000-09-01

    Childbearing employees are well served by the occupational health nurse who promotes optimal preconceptual and pregnancy health practices, uses community resources, and maintains current knowledge about high risk pregnancy prevention and care. These broad goals of care can lead to decreased absenteeism, healthier and happier employees, and more positive outcomes of pregnancy. For employees with high risk pregnancies, the role of the occupational health nurse includes, but is not limited to, facilitating awareness with the employer, making suggestions for adjusting working conditions, making frequent assessments of the employee's needs, and communicating with prenatal health care providers. Occupational health nurses should never underestimate their role and potential influence on the mother, and on her significant other, for a positive outcome of her pregnancy.

  9. Short-Term Psychiatric Rehabilitation in Major Depressive and Bipolar Disorders: Neuropsychological-Psychosocial Outcomes.

    Science.gov (United States)

    Perna, Giampaolo; Daccò, Silvia; Sacco, Ferdinando; Micieli, Wilma; Cavedini, Paolo; Caldirola, Daniela

    2017-01-01

    Our pilot study aims to investigate the efficacy of a Short-Term (4 weeks) Psychiatric Rehabilitation Program (S-T PsyRP), without specific cognitive remediation trainings, on the neuropsychological performance and psychosocial functioning of inpatients with Major Depressive Disorder (MDD) or Bipolar Disorder (BD). Published studies with similar aims are lacking. Fifty-three inpatients with MDD and 27 with BD (type I/II) were included. The S-T PsyRP was usually performed as clinical practice at Villa San Benedetto Menni Hospital and included a variety of activities aimed at promoting personal autonomies, interpersonal/social skills, and self-care. At the beginning and the end of the hospitalization we evaluated: neuropsychological performance (cognitive tests on verbal/visual working memory, attention, visual-constructive ability, language fluency, and comprehension); psychosocial functioning by the Rehabilitation Areas Form (RAF, handbook VADO); illness severity by the Brief Psychiatric Rating Scale (BPRS). Repeated-measure ANOVA and Pearson's linear correlation were used. We found significant improvement (pneuropsychological tests except for one, in 4 out of 6 RAF psychosocial areas ("involvement in ward activities", "autonomies", "self-care", and "self-management of health") and in clinical symptoms severity. No associations were found between the amelioration of clinical symptoms and neuropsychological or psychosocial improvement. A S-T PsyRP without specific cognitive remediation trainings may improve several cognitive/functional domains in MDD or BD inpatients, probably by offering opportunities to engage in demanding problem-solving conditions and cognitively stimulating activities.

  10. Motivation, treatment engagement and psychosocial outcomes in outpatients with severe mental illness: a test of Self-Determination Theory.

    Science.gov (United States)

    Jochems, Eline C; Duivenvoorden, Hugo J; van Dam, Arno; van der Feltz-Cornelis, Christina M; Mulder, Cornelis L

    2017-09-01

    Currently, it is unclear whether Self-Determination Theory (SDT) applies to the mental health care of patients with severe mental illness (SMI). Therefore, the current study tested the process model of SDT in a sample of outpatients with SMI. Participants were 294 adult outpatients with a primary diagnosis of a psychotic disorder or a personality disorder and their clinicians (n = 57). Structural equation modelling was used to test the hypothesized relationships between autonomy support, perceived competence, types of motivation, treatment engagement, psychosocial functioning and quality of life at two time points and across the two diagnostic groups. The expected relations among the SDT variables were found, but additional direct paths between perceived competence and clinical outcomes were needed to obtain good model fit. The obtained process model was found to be stable across time and different diagnostic patient groups, and was able to explain 18% to 36% of variance in treatment engagement, psychosocial functioning and quality of life. It is concluded that SDT can be a useful basis for interventions in the mental health care for outpatients with SMI. Additional experimental research is needed to confirm the causality of the relations between the SDT constructs and their ability to influence treatment outcomes. Copyright © 2016 John Wiley & Sons, Ltd.

  11. A qualitative analysis of psychosocial outcomes among women with sexual violence-related pregnancies in eastern Democratic Republic of Congo.

    Science.gov (United States)

    Scott, Jennifer; Mullen, Colleen; Rouhani, Shada; Kuwert, Philipp; Greiner, Ashley; Albutt, Katherine; Burkhardt, Gillian; Onyango, Monica; VanRooyen, Michael; Bartels, Susan

    2017-01-01

    Sexual violence is prevalent in eastern Democratic Republic of Congo (DRC) and has potentially devastating psychosocial consequences. Previous studies have reported on sexual violence and its impact on the mental health of survivors, but there are few studies conducted among women with sexual violence-related pregnancies (SVRPs). Women with SVRPs may be at greater risk of complex psychosocial outcomes, including social stigmatization. This study aimed to describe psychosocial outcomes among this subgroup of sexual violence survivors in order to inform future interventions. A mixed methods study was conducted in Bukavu, DRC in 2012 among adult women who self-reported an SVRP and either (1) were currently raising a child from an SVRP (parenting group) or (2) had terminated an SVRP (termination group). This manuscript presents qualitative findings from the mixed methods study. Participants were recruited using respondent-driven sampling and a proportion engaged in semi-structured qualitative interviews conducted by trained female interviewers. Thematic content analysis was conducted and key themes were identified. In total, 55 women were interviewed, of whom 38 were in the parenting group and 17 in the termination group. Women with SVRPs experienced a myriad of emotional responses as they navigated their social environments following the SVRPs. Negative reactions, including social stigmatization and/or social rejection, toward women with SVRPs and toward children born from SVRPs were important influences on psychological well-being. Women expressed both internalized emotionality intertwined with externalized experiences in the social environment. Many women demonstrated resilience, or what could be termed post-traumatic growth, identifying avenues of agency to advance the social conditions for women. The findings from the qualitative study, and in particular, the respondents' needs and suggested strategies, may be useful to inform future research, programs, and

  12. Assessment of psychosocial outcomes in adolescents and young adults with cancer: a systematic review of available instruments

    Directory of Open Access Journals (Sweden)

    Wakefield CE

    2013-02-01

    Full Text Available Claire E Wakefield,1,2 Pandora Patterson,3 Fiona E J McDonald,3 Helen L Wilson,1,2 Esther Davis,3 Ursula M Sansom-Daly2,41School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia; 2Centre for Children's Cancer and Blood Disorders, Sydney Children's Hospital, Sydney, NSW, Australia; 3CanTeen, Sydney, NSW, Australia; 4School of Psychology, University of New South Wales, Sydney, NSW, AustraliaPurpose: Given the burgeoning body of research relating to the psychosocial needs of adolescents and young adults (AYAs with cancer, this review aimed to evaluate the psychometric properties and appropriateness of the instruments available for use in this unique population. Specifically, we reviewed published instruments developed to assess psychological distress (depression, anxiety, stress, and fear of recurrence, psychological growth (resilience, posttraumatic growth, and benefit finding, unmet needs, coping, quality of life, identity, and mindfulness-based practices and skills in AYAs with cancer. Given the dearth of validated instruments targeting AYAs with cancer, this review also provides a summary of promising measures yet to be formally validated in this population.Methods: Five electronic databases were searched by a team of six researchers, and studies involving AYAs (who have or have had cancer aged 15–30 years, and published between 1982 and 2012 were reviewed. Of 410 abstracts, 7 instruments were identified as validated in this population, with a further 19 identified as promising.Results: While there are numerous scales to assess psychosocial outcomes in cancer, few have been specifically validated for AYAs affected by cancer, particularly in the domains of psychological distress, psychological growth, coping, unmet needs, and identity. There are relatively more instruments validated, or promising, for assessment of quality of life than scales for other domains.Conclusion: In the AYA context

  13. Fluid intelligence and psychosocial outcome: from logical problem solving to social adaptation.

    Science.gov (United States)

    Huepe, David; Roca, María; Salas, Natalia; Canales-Johnson, Andrés; Rivera-Rei, Álvaro A; Zamorano, Leandro; Concepción, Aimée; Manes, Facundo; Ibañez, Agustín

    2011-01-01

    While fluid intelligence has proved to be central to executive functioning, logical reasoning and other frontal functions, the role of this ability in psychosocial adaptation has not been well characterized. A random-probabilistic sample of 2370 secondary school students completed measures of fluid intelligence (Raven's Progressive Matrices, RPM) and several measures of psychological adaptation: bullying (Delaware Bullying Questionnaire), domestic abuse of adolescents (Conflict Tactic Scale), drug intake (ONUDD), self-esteem (Rosenberg's Self Esteem Scale) and the Perceived Mental Health Scale (Spanish adaptation). Lower fluid intelligence scores were associated with physical violence, both in the role of victim and victimizer. Drug intake, especially cannabis, cocaine and inhalants and lower self-esteem were also associated with lower fluid intelligence. Finally, scores on the perceived mental health assessment were better when fluid intelligence scores were higher. Our results show evidence of a strong association between psychosocial adaptation and fluid intelligence, suggesting that the latter is not only central to executive functioning but also forms part of a more general capacity for adaptation to social contexts.

  14. Fluid Intelligence and Psychosocial Outcome: From Logical Problem Solving to Social Adaptation

    Science.gov (United States)

    Huepe, David; Roca, María; Salas, Natalia; Canales-Johnson, Andrés; Rivera-Rei, Álvaro A.; Zamorano, Leandro; Concepción, Aimée; Manes, Facundo; Ibañez, Agustín

    2011-01-01

    Background While fluid intelligence has proved to be central to executive functioning, logical reasoning and other frontal functions, the role of this ability in psychosocial adaptation has not been well characterized. Methodology/Principal Findings A random-probabilistic sample of 2370 secondary school students completed measures of fluid intelligence (Raven's Progressive Matrices, RPM) and several measures of psychological adaptation: bullying (Delaware Bullying Questionnaire), domestic abuse of adolescents (Conflict Tactic Scale), drug intake (ONUDD), self-esteem (Rosenberg's Self Esteem Scale) and the Perceived Mental Health Scale (Spanish adaptation). Lower fluid intelligence scores were associated with physical violence, both in the role of victim and victimizer. Drug intake, especially cannabis, cocaine and inhalants and lower self-esteem were also associated with lower fluid intelligence. Finally, scores on the perceived mental health assessment were better when fluid intelligence scores were higher. Conclusions/Significance Our results show evidence of a strong association between psychosocial adaptation and fluid intelligence, suggesting that the latter is not only central to executive functioning but also forms part of a more general capacity for adaptation to social contexts. PMID:21957464

  15. Fluid intelligence and psychosocial outcome: from logical problem solving to social adaptation.

    Directory of Open Access Journals (Sweden)

    David Huepe

    Full Text Available While fluid intelligence has proved to be central to executive functioning, logical reasoning and other frontal functions, the role of this ability in psychosocial adaptation has not been well characterized.A random-probabilistic sample of 2370 secondary school students completed measures of fluid intelligence (Raven's Progressive Matrices, RPM and several measures of psychological adaptation: bullying (Delaware Bullying Questionnaire, domestic abuse of adolescents (Conflict Tactic Scale, drug intake (ONUDD, self-esteem (Rosenberg's Self Esteem Scale and the Perceived Mental Health Scale (Spanish adaptation. Lower fluid intelligence scores were associated with physical violence, both in the role of victim and victimizer. Drug intake, especially cannabis, cocaine and inhalants and lower self-esteem were also associated with lower fluid intelligence. Finally, scores on the perceived mental health assessment were better when fluid intelligence scores were higher.Our results show evidence of a strong association between psychosocial adaptation and fluid intelligence, suggesting that the latter is not only central to executive functioning but also forms part of a more general capacity for adaptation to social contexts.

  16. Questions never asked. Positive family outcomes of extremely premature childbirth

    DEFF Research Database (Denmark)

    Lou, Hanne; Pedersen, Birthe D; Hedegaard, Morten

    2009-01-01

    OBJECTIVE: To explore positive aspects of family life after extremely premature childbirth, thereby supplementing current literature on long-term family outcome. DESIGN: Semi-structured, qualitative research interviews were analysed according to the editing strategy described by Miller and Crabtree....... SETTING: Denmark, Europe. PARTICIPANTS: Nine fathers and 11 mothers of 14 children born before 28 completed weeks of gestation at a tertiary centre were interviewed when their children were 7-10 years old. RESULTS: Whereas developmental delay, functional limitations, family burden, and parental distress...

  17. The effect of maternal exposure to psychosocial job strain on pregnancy outcomes and child development.

    Science.gov (United States)

    Larsen, Ann Dyreborg

    2015-02-01

    Psychological stress at work is a rising problem in Denmark. Nearly one third of the women reported in 2005 that they had difficulties completing their work tasks, and 17 % found that they had only limited or no influence on their work tasks. The corresponding numbers for 1987 were 18.3 % and 16 %, respectively. Work-related stress shortens the life expectancy and reduces the number of years without prolonged disease. For the society work-related stress amounts to more than 30,000 hospital admissions each year, half a million extra days on sick-leave for women, 500,000 contacts to general practitioners, 1600 early retirements for women, and an overuse of the health-care system. With the second highest employment rate in Europe for women - and many of them in the childbearing age - effects of psychological stress at work may extend beyond the exposed individual and affect pregnancy, birth and health of the child. Few studies on job stress relative to pregnancy have been carried out, but both animal and epidemiological studies have shown effect of exposure to stressful conditions during pregnancy and adverse effects on the offspring. The specific aims for the three studies included in this thesis were to investigate the association between maternal psychosocial job strain during pregnancy, measured as high demands and low control and the risk of: - Having a child born preterm or with low or high birth weight relative to gestational week (paper I + II) - Congenital malformations in offspring (paper III) - Asthma and atopic dermatitis in the children (paper IV). Furthermore, it was also the ambition to maximize and secure the quality of research and integrity of the data used by documenting the methods in a protocol that described the analyses before they were done and to keep transparency in the methods used following good epidemiological practices (GEP) for occupational and environmental epidemiological research. All analyses in this thesis are based on information

  18. Testing predictive models of positive and negative affect with psychosocial, acculturation, and coping variables in a multiethnic undergraduate sample.

    Science.gov (United States)

    Kuo, Ben Ch; Kwantes, Catherine T

    2014-01-01

    Despite the prevalence and popularity of research on positive and negative affect within the field of psychology, there is currently little research on affect involving the examination of cultural variables and with participants of diverse cultural and ethnic backgrounds. To the authors' knowledge, currently no empirical studies have comprehensively examined predictive models of positive and negative affect based specifically on multiple psychosocial, acculturation, and coping variables as predictors with any sample populations. Therefore, the purpose of the present study was to test the predictive power of perceived stress, social support, bidirectional acculturation (i.e., Canadian acculturation and heritage acculturation), religious coping and cultural coping (i.e., collective, avoidance, and engagement coping) in explaining positive and negative affect in a multiethnic sample of 301 undergraduate students in Canada. Two hierarchal multiple regressions were conducted, one for each affect as the dependent variable, with the above described predictors. The results supported the hypotheses and showed the two overall models to be significant in predicting affect of both kinds. Specifically, a higher level of positive affect was predicted by a lower level of perceived stress, less use of religious coping, and more use of engagement coping in dealing with stress by the participants. Higher level of negative affect, however, was predicted by a higher level of perceived stress and more use of avoidance coping in responding to stress. The current findings highlight the value and relevance of empirically examining the stress-coping-adaptation experiences of diverse populations from an affective conceptual framework, particularly with the inclusion of positive affect. Implications and recommendations for advancing future research and theoretical works in this area are considered and presented.

  19. Erectile dysfunction, masculinity, and psychosocial outcomes: a review of the experiences of men after prostate cancer treatment.

    Science.gov (United States)

    Chambers, Suzanne K; Chung, Eric; Wittert, Gary; Hyde, Melissa K

    2017-02-01

    Prostate cancer (PC) treatment side-effects such as erectile dysfunction (ED) can impact men's quality of life (QoL), psychosocial and psycho-sexual adjustment. Masculinity (i.e., men's identity or sense of themselves as being a man) may also be linked to how men respond to PC treatment and ED however the exact nature of this link is unclear. This review aims to provide a snapshot of the current state of evidence regarding ED, masculinity and psychosocial impacts after PC treatment. Three databases (Medline/PsycINFO, CINHAL, and EMBASE) were searched January 1st 1980 to January 31st 2016. Study inclusion criteria were: patients treated for PC; ED or sexual function measured; masculinity measured in quantitative studies or emerged as a theme in qualitative studies; included psychosocial or QoL outcome(s); published in English language, peer-reviewed journal articles. Fifty two articles (14 quantitative, 38 qualitative) met review criteria. Studies were predominantly cross-sectional, North American, samples of heterosexual men, with localised PC, and treated with radical prostatectomy. Results show that masculinity framed men's responses to, and was harmed by their experience with, ED after PC treatment. In qualitative studies, men with ED consistently reported lost (no longer a man) or diminished (less of a man) masculinity, and this was linked to depression, embarrassment, decreased self-worth, and fear of being stigmatised. The correlation between ED and masculinity was similarly supported in quantitative studies. In two studies, masculinity was also a moderator of poorer QoL and mental health outcomes for PC patients with ED. In qualitative studies, masculinity underpinned how men interpreted and adjusted to their experience. Men used traditional (hegemonic) coping responses including emotional restraint, stoicism, acceptance, optimism, and humour or rationalised their experience relative to their age (ED inevitable), prolonged life (ED small price to pay

  20. Morgellons disease: experiences of an integrated multidisciplinary dermatology team to achieve positive outcomes.

    Science.gov (United States)

    Mohandas, Padma; Bewley, Anthony; Taylor, Ruth

    2018-03-01

    In recent years, there has been a reported increase in affliction of the skin with small fibres or other particles. The condition has been referred to as Morgellons disease. Patients present with stinging, burning or crawling sensations of the skin, with perceived extrusion of inanimate material alongside fatigue and other systemic symptoms. Sufferers often experience significant morbidity and reduction in quality of life. We aimed to explore the various clinical presentations, management strategies and outcomes employed to treat this condition in our patients. We conducted a retrospective case notes review of 35 patients referred to our multidisciplinary psycho-dermatology clinic at the Royal London Hospital between January 2004 and January 2017. The majority of patients were women (25) 71.4%, with a mean age of 54.6 years (26-80 years). Most (26) 74.2% were living alone. The average duration of illness prior to presentation was 3.8 years (4 months-20 years). Many patients had perceived precipitating factors (54.2%) and often self-diagnosed (28.5%). Psychiatric co-morbidities included 42.8% with depressive symptoms and 25.7% with anxiety. Substance misuse was elicited in five patients (14%). Management of patients included both the treatment of skin disease and psychosocial co-morbidities. Out of the 35 patients who attended (14) 40% cleared or showed significant improvement. Sixteen (45.7%) patients were stable and under review. One patient declined treatment and three did not attend review. One patient died from disease unrelated to her skin condition. Morgellons disease is a condition, which is widely discussed on the internet and patients often self-diagnose. The course of the disease can be chronic and debilitating. For a positive outcome, it is important that a strong physican-patient relationship is cultivated. As demonstrated in this case series, managing patients holistically in an integrated multidisciplinary dermatology setting helps achieve

  1. Gender-associated differences in the psychosocial and developmental outcome in patients affected with the bladder exstrophy-epispadias complex.

    Science.gov (United States)

    Lee, Celine; Reutter, Heiko M; Grässer, Melanie F; Fisch, Margit; Noeker, Meinolf

    2006-02-01

    To identify problems in the long-term psychosocial and developmental outcome specific to patients with the bladder exstrophy-epispadias complex (BEEC), using a self-developed semi-structured questionnaire, as there are various techniques of reconstruction to repair BEEC but to date neither patients nor surgeons have a clear answer about which type gives the most acceptable long-term results. Increasingly many patients with BEEC reach adulthood and wish to have sexual relationships and families. To date, no studies have used disease-specific psychological instruments to measure the psychosocial status of patients with BEEC. Thus we contacted 208 patients with BEEC, and 122 were enrolled, covering the complete spectrum of the BEEC. The data assessed included the surgical reconstruction, subjective assessment of continence, developmental milestones, school performance and career, overall satisfaction in life, disease-specific fears and partnership experiences in patients aged >18 years. We compared affected females and males to assess gender-associated differences in quality of life. Affected females had more close friendships, fewer disadvantages in relation to healthy female peers and more partnerships than the males. Family planning seemed to be less of a problem in affected females. There were no gender differences in the adjustments within school and professional career, which was very good in general. Future studies are needed to assess the disease-specific anxieties, considering gender-specific differences.

  2. Positive Feedback From Male Authority Figures Boosts Women's Math Outcomes.

    Science.gov (United States)

    Park, Lora E; Kondrak, Cheryl L; Ward, Deborah E; Streamer, Lindsey

    2018-03-01

    People often search for cues in the environment to determine whether or not they will be judged or treated negatively based on their social identities. Accordingly, feedback from gatekeepers-members of majority groups who hold authority and power in a field-may be an especially important cue for those at risk of experiencing social identity threat, such as women in math settings. Across a series of studies, women who received positive ("Good job!") versus objective (score only) feedback from a male (vs. female) authority figure in math reported greater confidence; belonging; self-efficacy; more favorable Science, Technology, Engineering, and Mathematics (STEM) attitudes/identification/interest; and greater implicit identification with math. Men were affected only by the type of math feedback they received, not by the source of feedback. A meta-analysis across studies confirmed results. Together, these findings suggest that positive feedback from gatekeepers is an important situational cue that can improve the outcomes of negatively stereotyped groups.

  3. Beyond emotional benefits: physical activity and sedentary behaviour affect psychosocial resources through emotions.

    Science.gov (United States)

    Hogan, Candice L; Catalino, Lahnna I; Mata, Jutta; Fredrickson, Barbara L

    2015-01-01

    Physical activity is known to improve emotional experiences, and positive emotions have been shown to lead to important life outcomes, including the development of psychosocial resources. In contrast, time spent sedentary may negatively impact emotional experiences and, consequently, erode psychosocial resources. Two studies tested whether activity independently influenced emotions and psychosocial resources, and whether activity indirectly influenced psychosocial resources through emotional experiences. Using cross-sectional (Study 1a) and longitudinal (Study 1b) methods, we found that time spent physically active independently predicted emotions and psychosocial resources. Mediation analyses suggested that emotions may account for the relation between activity and psychosocial resources. The improved emotional experiences associated with physical activity may help individuals build psychosocial resources known to improve mental health. Study 1a provided first indicators to suggest that, in contrast, sedentary behaviour may reduce positive emotions, which could in turn lead to decrements in psychosocial resources.

  4. Parental expectations, physical punishment, and violence among adolescents who score positive on a psychosocial screening test in primary care.

    Science.gov (United States)

    Ohene, Sally-Ann; Ireland, Marjorie; McNeely, Clea; Borowsky, Iris Wagman

    2006-02-01

    We sought to examine the relationship between perceived and stated parental expectations regarding adolescents' use of violence, parental use of physical punishment as discipline, and young adolescents' violence-related attitudes and involvement. Surveys were completed by 134 youth and their parents attending 8 pediatric practices. All youth were 10 to 15 years of age and had scored positive on a psychosocial screening test. Multivariate analyses revealed that perceived parental disapproval of the use of violence was associated with a more prosocial attitude toward interpersonal peer violence and a decreased likelihood of physical fighting by the youth. Parental report of whether they would advise their child to use violence in a conflict situation (stated parental expectations) was not associated with the adolescents' attitudes toward interpersonal peer violence, intentions to fight, physical fighting, bullying, or violence victimization. Parental use of corporal punishment as a disciplining method was inversely associated with a prosocial attitude toward interpersonal peer violence among the youth and positively correlated with youths' intentions to fight and fighting, bullying, and violence victimization. Perceived parental disapproval of the use of violence may be an important protective factor against youth involvement in violence, and parental use of physical punishment is associated with both violence perpetration and victimization among youth. Parents should be encouraged to clearly communicate to their children how to resolve conflicts without resorting to violence and to model these skills themselves by avoiding the use of physical punishment.

  5. An urban food store intervention positively affects food-related psychosocial variables and food behaviors.

    Science.gov (United States)

    Gittelsohn, Joel; Song, Hee-Jung; Suratkar, Sonali; Kumar, Mohan B; Henry, Elizabeth G; Sharma, Sangita; Mattingly, Megan; Anliker, Jean A

    2010-06-01

    Obesity and other diet-related chronic diseases are more prevalent in low-income urban areas, which commonly have limited access to healthy foods. The authors implemented an intervention trial in nine food stores, including two supermarkets and seven corner stores, in a low-income, predominantly African American area of Baltimore City, with a comparison group of eight stores in another low-income area of the city. The intervention (Baltimore Healthy Stores; BHS) included an environmental component to increase stocks of more nutritious foods and provided point-of-purchase promotions including signage for healthy choices and interactive nutrition education sessions. Using pre- and postassessments, the authors evaluated the impact of the program on 84 respondents sampled from the intervention and comparison areas. Exposure to intervention materials was modest in the intervention area, and overall healthy food purchasing scores, food knowledge, and self-efficacy did not show significant improvements associated with intervention status. However, based on adjusted multivariate regression results, the BHS program had a positive impact on healthfulness of food preparation methods and showed a trend toward improved intentions to make healthy food choices. Respondents in the intervention areas were significantly more likely to report purchasing promoted foods because of the presence of a BHS shelf label. This is the first food store intervention trial in low-income urban communities to show positive impacts at the consumer level.

  6. Psychosocial outcomes of Hong Kong Chinese diagnosed with acute coronary syndromes: a prospective repeated measures study.

    Science.gov (United States)

    Chan, Dominic S K; Chau, Janita P C; Chang, Anne M

    2007-08-01

    Western studies have suggested that emotional stress and distress impacted on the morbidity and mortality in people following acute coronary events. Symptoms of anxiety and depression have been associated with re-infarction and death, prolonged recovery and disability and depression may precipitate the client's low self-esteem. This study examined perceived anxiety, depression and self-esteem of Hong Kong Chinese clients diagnosed with acute coronary syndrome (ACS) over a 6-month period following hospital admission. To examine: A prospective, repeated measures design with measures taken on two occasions over a 6-month period; (1) within the 1st week of hospital admission following the onset of ACS and (2) at 6 months follow up. Convenient sample of 182 voluntary consented clients admitted with ACS to a major public hospital in Hong Kong who could communicate in Chinese, complete questionnaires, cognitive intact, and were haemodynamically stable and free from acute chest pain at the time of interview. Baseline data were obtained within 1 week after hospital admission. The follow-up data was collected 6 months after hospital discharge. The Chinese version of the Hospital Anxiety and Depression Scale (HADS), State Self-esteem Scale (SSES), and Rosenberg's Self-Esteem Scale (RSES) were used to assess anxiety and depression, state self-esteem, and trait self-esteem, respectively. Findings suggested gender differences in clients' perception in anxiety, depression and self-esteem. Improvements in clients' perception of these variables were evident over the 6-month period following their acute coronary events. The study confirmed the western notion that psychosocial problems are common among coronary clients and this also applies to Hong Kong Chinese diagnosed with ACS. Further studies to explore effective interventions to address these psychosocial issues are recommended.

  7. The Impact of Childhood Bullying among HIV-Positive Men: Psychosocial Correlates and Risk Factors

    Science.gov (United States)

    Kamen, Charles; Bergstrom, Jessica; Vorasarun, Chaniga; Mardini, Mona; Patrick, Rudy; Lee, Susanne; Lazar, Rachael; Koopman, Cheryl; Gore-Felton, Cheryl

    2012-01-01

    Objectives While some studies have examined the deleterious effects of childhood bullying on adults, no studies to date have focused on the effects of bullying on Persons Living with HIV (PLH), a particularly at-risk population. PLH experience higher rates of childhood and adulthood physical and sexual abuse than the population at large, and experience of childhood abuse appears to be predictive of sexual and other risk behaviors in this population. Thus it remains critical to examine rates of childhood bullying and correlates of bullying in adult PLH. Methods A sample of 171 HIV-positive men over 18 years of age were recruited from the San Francisco Bay Area. All participants reported experiencing symptoms of traumatic stress. The participants were recruited as part of a larger study assessing a group intervention for individuals with HIV and symptoms of trauma. Self-report questionnaires were administered to assess participants’ exposure to bullying in childhood and trauma symptoms in adulthood. Results Bullying was commonly reported by men in the current sample, with 91% of the sample endorsing having experienced some level of bullying before age 18. Having been bullied in childhood was significantly (p bullying in childhood predicted additional, unique variance in trauma symptoms in adulthood above and beyond the effect of exposure to other forms of trauma, resulting in a better-fitting model. Conclusions The current study highlights the association between rate of childhood bullying and symptoms of trauma in adulthood, accounting for the effect of exposure to other forms of trauma. Given the impact of trauma symptoms on disease progression in PLH, exposure to bullying must be considered in any intervention aiming to reduce trauma symptoms or improve mental or physical health among HIV-positive populations. PMID:23294606

  8. A Multicenter, Randomized, Open-Labeled, Parallel Group Trial of Sildenafil in Alcohol-Associated Erectile Dysfunction: The Impact on Psychosocial Outcomes

    Directory of Open Access Journals (Sweden)

    Alexander Grinshpoon

    2009-09-01

    Full Text Available To examine the effect of sildenafil on erectile dysfunction (ED and psychosocial outcomes in alcohol-dependent (AD men, 108 men with these diagnoses were randomly assigned to either take sildenafil (50 mg as add-on to standard treatment for AD, or the same treatment without sildenafil, for 12 weeks. Only 50 patients in sildenafil group and 51 in control group twice completed the International Index of Erectile Function (IIEF and a battery of self-report questionnaires. IIEF scores and psychosocial functioning, self-esteem and support from friends improved only for sildenafil-treated patients (P < 0.001. The high effect sizes suggest that the observed benefits are unlikely to be a placebo effect, although their unspecific nature could not be ruled out. In men with ED associated with AD, sildenafil improves both ED and psychosocial outcomes. Further placebo-controlled clinical trial is warranted.

  9. The effect of acupuncture on psychosocial outcomes for women experiencing infertility: a pilot randomized controlled trial.

    Science.gov (United States)

    Smith, Caroline A; Ussher, Jane M; Perz, Janette; Carmady, Bridget; de Lacey, Sheryl

    2011-10-01

    The study objectives were to examine the effectiveness of acupuncture for reducing infertility-related stress. The study design was a randomized controlled trial of acupuncture compared with a wait-list control. The study was conducted at The University of Western Sydney. Thirty-two (32) women aged 20-45 years, with a diagnosis of infertility, or a history of unsuccessfully trying to conceive for 12 months or more, were the subjects of the study. Women received six sessions of acupuncture over 8 weeks. The primary outcomes were infertility self-efficacy, anxiety, and infertility-related stress. The women's experience of infertility and acupuncture is also reported. At the end of the 8-week intervention, women in the acupuncture group reported significant changes on two domains on the Fertility Problem Inventory with less social concern (mean difference [MD] -3.75, 95% confidence interval [CI] -7.58 to 0.84, p=0.05), and less relationship concern (MD -3.66, 95% CI -6.80 to -0.052, p=0.02). There were also trends toward a reduction of infertility stress on other domains, and a trend toward improved self-efficacy (MD 11.9, 95% CI -2.20 to 26.0, p=0.09) and less anxiety (MD -2.54, 95% CI -5.95 to 0.86, p=0.08) in the acupuncture group compared with the wait-list control. Women described the experience and impact of acupuncture as positive relating to a sense of relaxation and time out, the engagement with the practitioner, and an intervention that had very few negative side-effects. Changes were also perceived after treatment with women describing a physical and psychologic sense of relaxation and calmness, and a changed perspective in relation to coping. Acupuncture may be a useful intervention to assist with the reduction of infertility-related stress. Further research is justified.

  10. Feasibility and outcomes of paid undergraduate student nurse positions.

    Science.gov (United States)

    Gamroth, Lucia; Budgen, Claire; Lougheed, Mary

    2006-09-01

    An Undergraduate Nurse Employment Demonstration Project (UNDP) was implemented in four Health Service Areas in British Columbia with a concurrent evaluation study. This demonstration project comprised the development and implementation of a new position in the BC healthcare system. The position enabled third- and fourth-year nursing students to be employed at their level of education. The purposes of the evaluation were to explore the feasibility and outcomes of this type of paid undergraduate student nurse employment. The three-year project and evaluation included both implementation and outcome analysis. The implementation evaluation design was descriptive and prospective, involving multiple data sources. The outcome evaluation design was quasi-experimental, with intervention and comparison groups. Learning outcomes for undergraduate nurses were increased confidence, organizational ability, competency and ability to work with a team. Workplace outcomes were increased unit morale, help with workload and improved patient care. New graduates with undergraduate nurse experience reported less time required for orientation and transition than other graduates who did not have this experience, and workplace nurses viewed these new graduates as more job-ready than other new graduates. After 21 months, new graduates with undergraduate nurse experience were less likely to move to other employment than other new graduates. Results from the four Health Service Areas indicated that the paid undergraduate nurse position was feasible and that outcomes benefited students, new graduates and workplaces. The undergraduate nurse position is now being implemented throughout all Health Service Areas in British Columbia.By 2000, concerns in British Columbia about the nursing workforce, workplace and patient safety had escalated to the point where diverse stakeholder groups were prepared to work together in new ways to prepare nursing graduates to be more job-ready, to recruit and retain

  11. Smart Device Use and Perceived Physical and Psychosocial Outcomes among Hong Kong Adolescents

    Directory of Open Access Journals (Sweden)

    Stephen Wai Hang Kwok

    2017-02-01

    Full Text Available Excessive electronic screen-based activities have been found to be associated with negative outcomes. The aim of this study was to investigate the prevalences and patterns of smart device activities and the purposes and perceived outcomes related to smart device use, and the differences in patterns of smart device activities between adolescents who did and did not perceive these outcomes. The study was a cross-sectional survey of Hong Kong primary and secondary school students. Demographic characteristics, purpose and pattern of the activities, and frequencies of the outcomes were measured. Data from 960 adolescents aged 10–19 were analyzed. Nearly 86% of the sample use smart device daily. The one-week prevalence of perceived sleep deprivation, eye discomfort, musculoskeletal discomfort, family conflict and cyberbullying victimization related to smart device use were nearly 50%, 45%, 40%, 20% and 5% respectively. More than 25% of the respondents were at risk of negative outcomes related to smart device activities for more than 1 h per day, browsing and gaming on at least 4 days per week and watching TV/movies and posting on more than 2 days per week. Their patterns of smart device activities may put a significant number of them at risk of negative outcomes.

  12. The effects of formalized and trained non-reciprocal peer teaching on psychosocial, behavioral, pedagogical, and motor learning outcomes in physical education

    Directory of Open Access Journals (Sweden)

    Peter R Whipp

    2015-02-01

    Full Text Available Peer teaching is recognized as a powerful instructional method; however, there is a paucity of studies that have evaluated the outcomes experienced by peer-teachers and their student recipients in the context of trained, non-reciprocal, high school physical education. Accordingly, the effectiveness of a formalized and trained non-reciprocal peer teaching (T-PT program upon psychosocial, behavioral, pedagogical and student learning outcomes within high school physical education classes was investigated. Students from eight intact classes (106 males, 94 females, Mage = 12.46, SD = 0.59 were randomly assigned to either a T-PT intervention group (taught by a volunteer peer-teacher who was trained in line with a tactical games approach or untrained group (U-PT; where volunteer peer-teachers received no formal training, but did receive guidance on the game concepts to teach. Data were collected over 10 lessons in a 5-week soccer unit. Mixed-model ANOVAs/MANOVAs revealed that, in comparison to U-PT, the T-PT program significantly enhanced in-game performance actions and academic learning time among student recipients. Those in the T-PT also provided greater levels of feedback and structured learning time, as well as reporting more positive feelings about peer teaching and fewer perceived barriers to accessing learning outcomes. These findings show that non-reciprocal peer-teachers who receive formalized support through training and tactical games approach-based teaching resources can enhance behavioral, pedagogical, and motor performance outcomes in physical education.

  13. The effects of formalized and trained non-reciprocal peer teaching on psychosocial, behavioral, pedagogical, and motor learning outcomes in physical education.

    Science.gov (United States)

    Whipp, Peter R; Jackson, Ben; Dimmock, James A; Soh, Jenny

    2015-01-01

    Peer teaching is recognized as a powerful instructional method; however, there is a paucity of studies that have evaluated the outcomes experienced by peer-teachers and their student recipients in the context of trained, non-reciprocal, high school physical education (PE). Accordingly, the effectiveness of a formalized and trained non-reciprocal peer teaching (T-PT) program upon psychosocial, behavioral, pedagogical, and student learning outcomes within high school PE classes was investigated. Students from eight intact classes (106 males, 94 females, Mage = 12.46, SD = 0.59) were randomly assigned to either a T-PT intervention group (taught by a volunteer peer-teacher who was trained in line with a tactical games approach) or untrained group (U-PT; where volunteer peer-teachers received no formal training, but did receive guidance on the game concepts to teach). Data were collected over 10 lessons in a 5-week soccer unit. Mixed-model ANOVAs/MANOVAs revealed that, in comparison to U-PT, the T-PT program significantly enhanced in-game performance actions and academic learning time among student recipients. Those in the T-PT also provided greater levels of feedback and structured learning time, as well as reporting more positive feelings about peer teaching and fewer perceived barriers to accessing learning outcomes. These findings show that non-reciprocal peer-teachers who receive formalized support through training and tactical games approach-based teaching resources can enhance behavioral, pedagogical, and motor performance outcomes in PE.

  14. Survival, hypothalamic obesity, and neuropsychological/psychosocial status after childhood-onset craniopharyngioma: newly reported long-term outcomes.

    Science.gov (United States)

    Sterkenburg, Anthe S; Hoffmann, Anika; Gebhardt, Ursel; Warmuth-Metz, Monika; Daubenbüchel, Anna M M; Müller, Hermann L

    2015-07-01

    Quality of life (QoL) and long-term prognosis are frequently, and often severely, impaired in craniopharyngioma (CP) patients. Knowledge of risk factors for long-term outcome is important for optimization of treatment. Overall survival (OS) and progression-free survival (PFS), body mass index (BMI), neuropsychological status (EORTCQLQ-C30, MFI-20), and psychosocial status were analyzed in 261 patients with childhood-onset CP diagnosed before 2000 and longitudinally observed in HIT-Endo. Twenty-year OS was lower (P = .006) in CP with hypothalamic involvement (HI) (n = 132; 0.84 ± 0.04) when compared with CP without HI (n = 82; 0.95 ± 0.04). OS was not related to degree of resection, sex, age at diagnosis, or year of diagnosis (before/after 1990). PFS (n = 168; 0.58 ± 0.05) was lower in younger patients (12 years of follow-up, patients with HI presented no further increase in BMI. QoL in CP patients with HI was impaired by obesity, physical fatigue, reduced motivation, dyspnea, diarrhea, and nonoptimal psychosocial development. OS and QoL are impaired by HI in long-term survivors of CP. HI is associated with severe obesity, which plateaus after 12 years. OS/PFS are not related to degree of resection, but gross-total resection should be avoided in cases of HI to prevent further hypothalamic damage, which exacerbates sequelae. © The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Psychosocial and career outcomes of peer mentorship in medical resident education: a systematic review protocol.

    Science.gov (United States)

    Pethrick, Helen; Nowell, Lorelli; Oddone Paolucci, Elizabeth; Lorenzetti, Liza; Jacobsen, Michele; Clancy, Tracey; Lorenzetti, Diane L

    2017-08-31

    Many medical residents lack ready access to social and emotional supports that enable them to successfully cope with the challenges associated with medical residency. This absence of support has been shown to lead to high levels of burnout, decreased mental wellbeing, and difficulty mastering professional competencies in this population. While there is emerging evidence that peer mentoring can be an important source of psychosocial and career-related support for many individuals, the extent of the evidence regarding the benefits of peer mentorship in medical residency education has not yet been established. We describe a protocol for a systematic review to assess the effects of peer mentoring on medical residents' mental wellbeing, social connectedness, and professional competencies. Studies included in this review will be those that report on peer-mentoring relationships among medical residents. Quantitative, qualitative, and mixed-methods studies will be eligible for inclusion. No date or language limits will be applied. We will search EMBASE, MEDLINE, PsychINFO, Web of Science, Scopus, ERIC, Education Research Complete, and Academic Research Complete databases to identify relevant studies. Two authors will independently assess all abstracts and full-text studies for inclusion and study quality and extract study data in duplicate. This is the first systematic review to explicitly explore the role of peer mentoring in the context of medical residency education. We anticipate that the findings from this review will raise awareness of the benefits and challenges associated with peer-mentoring relationships, further the development and implementation of formal peer-mentoring programs for medical residents, and, through identifying gaps in the existing literature, inform future research efforts. This protocol has not been registered in PROSPERO or any other publicly accessible registry.

  16. Psychosocial predictors of health outcomes in colorectal cancer: a comprehensive review.

    Science.gov (United States)

    Sales, Paulo M G; Carvalho, André F; McIntyre, Roger S; Pavlidis, Nicholas; Hyphantis, Thomas N

    2014-07-01

    A diagnosis of colorectal cancer (CRC) and its long-term treatment may lead to significant psychological distress and impaired health-related quality of life (HRQoL) for a significant proportion of patients. We searched the PubMed/MEDLINE electronic database for available literature on the associations between personality characteristics, depression, psychological distress and HRQoL in CRC. Additional references were identified through the citation tracking of the included articles. Recent evidence indicates that Type-D (distressed) personality may predict distress among CRC patients. Additionally, other personality traits, such as specific ego defense mechanisms, influence the coping responses and HRQoL. Although the presence of a stoma has been linked to the development of depressive symptoms and impairment in HRQoL in CRC patients, more prospective studies are necessary to confirm these associations. Sense of coherence (SOC) has both a moderating and mediating effect on health (especially mental health and HRQoL), and preliminary data indicate that SOC may be an independent predictor of CRC survival. The interplay between personality variables during the elaboration of "the impaired role" is complex, and the assessment of personality traits may be incorporated into a comprehensive psychosomatic evaluation of CRC patients. More well-designed prospective investigations are necessary to establish the contributory role of personality dimensions for the development of and protection from distress and impairment in the HRQoL of CRC patients, which could eventually lead to the development of psychosocial interventions that are personalized to this patient population (for example, manual-based psychotherapies). Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Associations Between Pre-Implant Psychosocial Factors and Spinal Cord Stimulation Outcome: Evaluation Using the MMPI-2-RF.

    Science.gov (United States)

    Block, Andrew R; Marek, Ryan J; Ben-Porath, Yossef S; Kukal, Deborah

    2017-01-01

    Spinal cord stimulation (SCS) has variable effectiveness in controlling chronic pain. Previous research has demonstrated that psychosocial factors are associated with diminished results of SCS. The objective of this investigation is to examine associations between pre-implant psychological functioning as measured by the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and SCS outcomes. SCS candidates at two sites (total N = 319) completed the MMPI-2-RF and measures of pain, emotional distress, and functional ability as part of a pre-implant psychological evaluation. At an average of 5 months post-implant, patients completed the measures of pain and emotional distress a second time. Poorer SCS outcomes and poorer patient satisfaction were associated with higher pre-implant MMPI-2-RF scores on scales used to assess emotional dysfunction, somatic/cognitive complaints, and interpersonal problems. Ways through which pre-implant psychological evaluations of spinal cord stimulator candidates can be informed by MMPI-2-RF findings are discussed. © The Author(s) 2015.

  18. A randomized controlled trial examining the effectiveness of a STOMA psychosocial intervention programme on the outcomes of colorectal patients with a stoma: study protocol.

    Science.gov (United States)

    Lim, Siew Hoon; Chan, Sally Wai-Chi; Lai, Jiunn Herng; He, Hong-Gu

    2015-06-01

    To report a study protocol that evaluates the effects of a psychosocial intervention on patients with a newly formed stoma. With the loss of a significant body function and distorted body image, stoma patients experience physical, psychological and social challenges. Nurses have an important role in helping patients' make a smooth transition to living with their stoma. Limited studies have examined the effects of psychosocial interventions on improving stoma-related health outcomes. A randomized controlled trial is planned. Eighty-four patients with newly formed stoma in a tertiary hospital in Singapore (Research Ethics Committee approval obtained in January 2013) will be recruited. Participants will be randomly assigned to either a control group who receive routine care or an intervention group who receive STOMA psychosocial intervention besides routine care. Outcome variables include stoma care self-efficacy, days to stoma proficiency, length of hospital stay, acceptance of stoma, anxiety and depression and quality of life. Data will be collected at four time points: before randomization and intervention (baseline), on the day of discharge (mid-intervention), at 4 weeks after discharge (postintervention 1) and at 4 months after discharge (postintervention 2). This study will develop a psychosocial intervention programme, which may improve patients' stoma-related outcomes. The findings will provide direction to health professionals about education and the type of support that could be offered to patients concerning stoma care in the hospital setting, which will eventually improve their quality of life. © 2014 John Wiley & Sons Ltd.

  19. Biomedical Risk, Psychosocial Influences, and Developmental Outcomes: Lessons from the Pediatric HIV Population in Africa

    Science.gov (United States)

    Serpell, Robert; Marfo, Kofi; Abubakar, Amina

    2014-01-01

    Sub-Saharan Africa is home to millions of HIV-affected children. These children are likely to experience multiple developmental delays. In this chapter, I present data highlighting compromised neurobehavioral, mental health, and scholastic outcomes for children affected by HIV. Furthermore, I discuss biomedical factors (e.g., disease severity and…

  20. Biomedical risk, psychosocial influences, and developmental outcomes : Lessons from the pediatric HIV population in Africa

    NARCIS (Netherlands)

    Ali, A.A.

    2014-01-01

    Sub-Saharan Africa is home to millions of HIV-affected children. These children are likely to experience multiple developmental delays. In this chapter, I present data highlighting compromised neurobehavioral, mental health, and scholastic outcomes for children affected by HIV. Furthermore, I

  1. A systematic review of inequalities in psychosocial outcomes for women with breast cancer according to residential location and Indigenous status in Australia.

    Science.gov (United States)

    Youl, P H; Dasgupta, P; Youlden, D; Aitken, J F; Garvey, G; Zorbas, H; Chynoweth, J; Wallington, I; Baade, P D

    2016-10-01

    The aim of this systematic review was to examine variations in psychosocial outcomes by residential location and Indigenous status in women diagnosed with breast cancer (BC) in Australia. Systematic searches were undertaken using multiple databases covering articles between 1 January 1990 and 1 March 2015 focusing on adult women with BC in an Australian setting and measuring quality of life (QOL), psychological distress or psychosocial support. Thirteen quantitative and three qualitative articles were included. Two quantitative and one qualitative article were rated high quality, seven moderate and the remaining were low quality. No studies examining inequalities by Indigenous status were identified. Non-metropolitan women were more likely to record lower QOL relating to breast cancer-specific concerns and reported a lack of information and resources specific to their needs. Continuity of support, ongoing care and access to specialist and allied health professionals were major concerns for non-metropolitan women. Non-metropolitan women identified unmet needs in relation to travel, fear of cancer recurrence and lack of psychosocial support. Overall, there was a lack of evidence relating to variations in psychosocial outcomes for women with BC according to residential status or Indigenous status. While the review identified some specific concerns for non-metropolitan women with BC, it was limited by the lack of good quality studies using standardised measures. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel

    DEFF Research Database (Denmark)

    Hansen, Claus D.; Rasmussen, Kurt; Kyed, Morten

    2012-01-01

    with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal problems and the presence of positive organizational support mechanisms that can prevent negative effects from the high levels of emotional demands....

  3. Association of Dietary Habits with Psychosocial Outcomes in Women with Fibromyalgia : The al-Ándalus Project

    NARCIS (Netherlands)

    Ruiz-Cabello, Pilar; Soriano-Maldonado, Alberto; Delgado-Fernandez, M; Alvarez-Gallardo, I C; Segura-Jimenez, V; Estevez-Lopez, F; Camiletti-Moirón, Daniel; Aparicio, Virgina A

    2017-01-01

    BACKGROUND: Fibromyalgia (FM) is a complex multidimensional disorder with pain as its main symptom. Fibromyalgia imposes a psychosocial burden on individuals that negatively impacts quality of life. The relationship of dietary habits with these psychosocial aspects is still unclear. OBJECTIVE: The

  4. Do problem-solving interventions improve psychosocial outcomes in vision impaired adults: a systematic review and meta-analysis.

    Science.gov (United States)

    Holloway, Edith E; Xie, Jing; Sturrock, Bonnie A; Lamoureux, Ecosse L; Rees, Gwyneth

    2015-05-01

    To evaluate the effectiveness of problem-solving interventions on psychosocial outcomes in vision impaired adults. A systematic search of randomised controlled trials (RCTs), published between 1990 and 2013, that investigated the impact of problem-solving interventions on depressive symptoms, emotional distress, quality of life (QoL) and functioning was conducted. Two reviewers independently selected and appraised study quality. Data permitting, intervention effects were statistically pooled and meta-analyses were performed, otherwise summarised descriptively. Eleven studies (reporting on eight trials) met inclusion criteria. Pooled analysis showed problem-solving interventions improved vision-related functioning (standardised mean change [SMC]: 0.15; 95% CI: 0.04-0.27) and emotional distress (SMC: -0.36; 95% CI: -0.54 to -0.19). There was no evidence to support improvements in depressive symptoms (SMC: -0.27, 95% CI: -0.66 to 0.12) and insufficient evidence to determine the effectiveness of problem-solving interventions on QoL. The small number of well-designed studies and narrow inclusion criteria limit the conclusions drawn from this review. However, problem-solving skills may be important for nurturing daily functioning and reducing emotional distress for adults with vision impairment. Given the empirical support for the importance of effective problem-solving skills in managing chronic illness, more well-designed RCTs are needed with diverse vision impaired samples. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Outcome evaluation of a community center-based program for mothers at high psychosocial risk.

    Science.gov (United States)

    Rodrigo, María José; Máiquez, María Luisa; Correa, Ana Delia; Martín, Juan Carlos; Rodríguez, Guacimara

    2006-09-01

    This study reported the outcome evaluation of the "Apoyo Personal y Familiar" (APF) program for poorly-educated mothers from multi-problem families, showing inadequate behavior with their children. APF is a community-based multi-site program delivered through weekly group meetings in municipal resource centers. A total of 340 mothers referred by the municipal social services of Tenerife, Spain were assessed; 185 mothers participated in the APF program that lasted 8 months, and 155 mothers were in the control group. Pre-post test comparisons for the intervention group and post-test comparisons with the control group on self-rating measures of maternal beliefs, personal agency and child-rearing practices were performed. Multivariate tests, t tests and effect sizes (ES) were calculated to determine the program effectiveness on the outcome measures. Mothers' support of nurturist and nativist beliefs and the reported use of Neglect-permissive and Coercive practices significantly decreased after program completion whereas the reported use of Inductive practices significantly increased. Increases in self-efficacy, internal control and role difficulty were also significant in relation to those of the control group. The program was especially effective for older mothers, with fewer children, living in a two-parent family, in urban areas and with either low or medium educational levels. The program was very effective in changing the mothers' perceived competences and modestly effective in changing their beliefs about child development and education and reported child-rearing practices. Changes in personal agency are very important for at-risk parents who feel helpless and with no control over their lives.

  6. Tailored and integrated Web-based tools for improving psychosocial outcomes of cancer patients: the DoTTI development framework.

    Science.gov (United States)

    Smits, Rochelle; Bryant, Jamie; Sanson-Fisher, Rob; Tzelepis, Flora; Henskens, Frans; Paul, Christine; Stevenson, William

    2014-03-14

    Effective communication with cancer patients and their families about their disease, treatment options, and possible outcomes may improve psychosocial outcomes. However, traditional approaches to providing information to patients, including verbal information and written booklets, have a number of shortcomings centered on their limited ability to meet patient preferences and literacy levels. New-generation Web-based technologies offer an innovative and pragmatic solution for overcoming these limitations by providing a platform for interactive information seeking, information sharing, and user-centered tailoring. The primary goal of this paper is to discuss the advantages of comprehensive and iterative Web-based technologies for health information provision and propose a four-phase framework for the development of Web-based information tools. The proposed framework draws on our experience of constructing a Web-based information tool for hematological cancer patients and their families. The framework is based on principles for the development and evaluation of complex interventions and draws on the Agile methodology of software programming that emphasizes collaboration and iteration throughout the development process. The DoTTI framework provides a model for a comprehensive and iterative approach to the development of Web-based informational tools for patients. The process involves 4 phases of development: (1) Design and development, (2) Testing early iterations, (3) Testing for effectiveness, and (4) Integration and implementation. At each step, stakeholders (including researchers, clinicians, consumers, and programmers) are engaged in consultations to review progress, provide feedback on versions of the Web-based tool, and based on feedback, determine the appropriate next steps in development. This 4-phase framework is evidence-informed and consumer-centered and could be applied widely to develop Web-based programs for a diverse range of diseases.

  7. Positive pregnancy outcomes in Mexican immigrants: what can we learn?

    Science.gov (United States)

    Page, Robin L

    2004-01-01

    To provide an integrated review of the literature of potential explanations for better than expected pregnancy outcomes in Mexican immigrants, focusing on socioeconomics, social support, desirability of pregnancy, nutrition, substance use, religion, acculturation, and prenatal care. Computerized searches of MEDLINE and CINAHL databases, as well as reference lists from published articles on low birth weight and prematurity in immigrants and acculturation in immigrants from January 1989 to December 2002. Search terms were Mexican immigrant women, childbearing, and pregnancy outcome, and only English-language articles were reviewed. Literature was selected from refereed publications in the areas of nursing, medicine, public health, family, and sociology. Data were extracted using keywords pertinent to pregnancy outcome in Mexican immigrants. Despite having many of the risk factors for poor pregnancy outcomes, Mexican immigrants have superior birth outcomes when compared to U.S.-born women. Social support, familism, healthy diet, limited use of cigarettes and alcohol, and religion may play a role in improved outcomes. The superior outcomes diminish with the process of acculturation as the individual adapts to her new culture. Low birth weight and prematurity are public health concerns in the United States. Through further study of the factors that lead to superior birth outcomes among Mexican immigrant women, rates of low birth weight and prematurity in the United States may be reduced.

  8. Medical-Legal Partnerships At Veterans Affairs Medical Centers Improved Housing And Psychosocial Outcomes For Vets.

    Science.gov (United States)

    Tsai, Jack; Middleton, Margaret; Villegas, Jennifer; Johnson, Cindy; Retkin, Randye; Seidman, Alison; Sherman, Scott; Rosenheck, Robert A

    2017-12-01

    Medical-legal partnerships-collaborations between legal professionals and health care providers that help patients address civil legal problems that can affect health and well-being-have been implemented at several Veterans Affairs (VA) medical centers to serve homeless and low-income veterans with mental illness. We describe the outcomes of veterans who accessed legal services at four partnership sites in Connecticut and New York in the period 2014-16. The partnerships served 950 veterans, who collectively had 1,384 legal issues; on average, the issues took 5.4 hours' worth of legal services to resolve. The most common problems were related to VA benefits, housing, family issues, and consumer issues. Among a subsample of 148 veterans who were followed for one year, we observed significant improvements in housing, income, and mental health. Veterans who received more partnership services showed greater improvements in housing and mental health than those who received fewer services, and those who achieved their predefined legal goals showed greater improvements in housing status and community integration than those who did not. Medical-legal partnerships represent an opportunity to expand cross-sector, community-based partnerships in the VA health care system to address social determinants of mental health.

  9. Obstetric and psychosocial risk factors for Australian-born and non-Australian born women and associated pregnancy and birth outcomes: a population based cohort study.

    Science.gov (United States)

    Dahlen, Hannah Grace; Barnett, Bryanne; Kohlhoff, Jane; Drum, Maya Elizabeth; Munoz, Ana Maria; Thornton, Charlene

    2015-11-09

    One in four Australians is born overseas and 47% are either born overseas or have a parent who was. Obstetric and psychosocial risk factors for these women may differ. Data from one Sydney hospital (2012-2013) of all births recorded in the ObstetriX database were analysed (n = 3,092). Demographics, obstetric and psychosocial risk profile, obstetric interventions and complications and selected maternal and neonatal outcomes were examined for women born in Australia and overseas. Women born in Australia were younger, more likely to be primiparous (28.6 v 27.5%), be obese (32.0% v 21.4%), smoke (19.7 % v 3.0%), have an epidural (26.2% v 20.2%) and were less likely to have gestational diabetes mellitus (GDM) (6.8% v 13.7% when compared to non-Australian born women. The highest rates of GDM, Gestational Hypertension (GH) and maternal anaemia were seen in women born in China, the Philippines and Pakistan respectively. Differences were also seen in psychosocial screening between Australian and non-Australian women with Australian-born women more likely to smoke and report a mental health disorder. There was an association between having an Edinburgh Postnatal Depression Scale (EPDS) ≥ 13 and other psychosocial issues, such as thoughts of self-harm, domestic violence, childhood abuse etc. These women were also less likely to breastfeed. Women with an EPDS ≥ 13 at booking compared to women with EPDS ≤12 had a higher chance of being diagnosed with GDM (AOR 1.85 95% CI 1.14-3.0). There are significant differences in obstetric and psychosocial risk profiles and maternal and neonatal outcomes between Australian-born and non-Australian born women. In particular there appears to be an association between an EPDS of ≥13 and developing GDM, which warrants further investigation.

  10. Mediating effects of self-stigma on the relationship between perceived stigma and psychosocial outcomes among psychiatric outpatients: findings from a cross-sectional survey in Singapore

    Science.gov (United States)

    Picco, Louisa; Lau, Ying Wen; Pang, Shirlene; Abdin, Edimansyah; Vaingankar, Janhavi Ajit; Chong, Siow Ann; Subramaniam, Mythily

    2017-01-01

    Objectives To examine whether self-stigma mediates the relationship between perceived stigma and quality of life, self-esteem and general functioning among outpatients with depression, schizophrenia, anxiety and obsessive-compulsive disorder (OCD). Design Cross-sectional survey. Setting Outpatient clinics at a tertiary psychiatric hospital in Singapore. Participants 280 outpatients with a primary clinical diagnosis of either schizophrenia, depression, anxiety or OCD. Methods Data were collected in relation to self-stigma, perceived stigma, self-esteem, functioning and quality of life. In order to examine the mediating role of self-stigma on the relationship between perceived stigma and psychosocial outcomes, bootstrapping mediation analyses were used. Results Mediation analyses revealed that the relationship between perceived stigma and psychosocial outcomes was subject to the effects of self-stigma among the overall sample. Separate mediation analyses were conducted by diagnoses and showed differences in the mediating effects of self-stigma. Among the whole sample and the subsample with OCD, self-stigma mediated the relationship between perceived stigma and all psychosocial outcomes. For those with anxiety, depression and schizophrenia, the mediating effects of self-stigma were present in all relationships except (1) perceived stigma with physical health in the anxiety sample, (2) perceived stigma with social relationships in the depression sample and (3) perceived stigma with physical health in the schizophrenia sample. Conclusions The mediating effects of self-stigma on the relationship between perceived stigma and various psychosocial outcomes are evident and differ across diagnoses. Interventions to address and reduce the effects of self-stigma along with targeted treatments and psychoeducation to assist people with mental illness overcome or better manage self-stigma while providing them the skills to counteract public stigma are needed. PMID:28851803

  11. An Empirical Study of the Relationship between Mentoring program and Mentees’ psychosocial Development

    Directory of Open Access Journals (Sweden)

    Azman Ismail

    2013-07-01

    Full Text Available The study was undertaken to investigate the correlation between mentoring program and mentees’ psychosocial development using self-report questionnaires collected from undergraduate students in teaching based higher learning institutions in Sarawak, Malaysia. The outcomes of SmartPLS path model analysis showed two important findings: firstly, communication positively and significantly correlated with psychosocial. Secondly, support positively and significantly correlated with psychosocial. In sum, the result demonstrates that mentoring program does act as an important determinant of mentees’ psychosocial development in the organizational sample. In addition, this study provides discussion, implications and conclusion.

  12. Returning to paid employment after stroke: the Psychosocial Outcomes In StrokE (POISE cohort study.

    Directory of Open Access Journals (Sweden)

    Maree L Hackett

    Full Text Available OBJECTIVES: To determine which early modifiable factors are associated with younger stroke survivors' ability to return to paid work in a cohort study with 12-months of follow-up conducted in 20 stroke units in the Stroke Services NSW clinical network. PARTICIPANTS: Were aged >17 and <65 years, recent (within 28 days stroke, able to speak English sufficiently to respond to study questions, and able to provide written informed consent. Participants with language or cognitive impairment were eligible to participate if their proxy provided consent and completed assessments on the participants' behalf. The main outcome measure was return to paid work during the 12 months following stroke. RESULTS: Of 441 consented participants (average age 52 years, 68% male, 83% with ischemic stroke, 218 were in paid full-time and 53 in paid part-time work immediately before their stroke, of whom 202 (75% returned to paid part- or full-time work within 12 months. Being male, female without a prior activity restricting illness, younger, independent in activities of daily living (ADL at 28 days after stroke, and having private health insurance was associated with return to paid work, following adjustment for other illnesses and a history of depression before stroke (C statistic 0·81. Work stress and post stroke depression showed no such independent association. CONCLUSIONS: Given that independence in ADL is the strongest predictor of return to paid work within 12 months of stroke, these data reinforce the importance of reducing stroke-related disability and increasing independence for younger stroke survivors. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ANZCTRN 12608000459325.

  13. Pregnancy Outcomes in Booked HIV Positive Women Initiating ...

    African Journals Online (AJOL)

    Saharan Africa which bears the highest burden of the disease. To evaluate pregnancy outcomes in booked preg-nant women on Highly Active Antiretroviral Therapy (HAART) at the University of Ilorin Teach-ing Hospital (UITH), Ilorin, Nigeria; ...

  14. How positioning strategies affect co-branding outcomes

    OpenAIRE

    Wason, Hilary; Charlton, Nathalie

    2015-01-01

    Co-branding is a widely applied strategy, with research indicating differential benefits to the parent brands. Past studies suggest the source of these differences may be due to the partners’ relative market position, and characteristics such as brand familiarity, brand equity and proximity to the consumer have been explored. However, the role of brand positioning has received little attention in the context of co-branding. The current study attempts to address this gap, considering the posit...

  15. A systematic review of the psychosocial outcomes associated with erectile dysfunction: does the impact of erectile dysfunction extend beyond a man's inability to have sex?

    Science.gov (United States)

    McCabe, Marita P; Althof, Stanley E

    2014-02-01

    The aim of this study was to report and analyze the published data from randomized controlled trials (RCTs) for (i) the psychosocial outcomes associated with erectile dysfunction (ED) before treatment with a phosphodiesterase type 5 (PDE5) inhibitor; and (ii) the change in psychosocial outcomes after the use of a PDE5 inhibitor in men with ED. The method used was a prospectively designed systematic literature review of publications reported in MEDLINE via PubMed, EMBASE, the Cochrane Library, Science Citation Index Expanded, and PsychINFO from January 1, 1995 to May 14, 2012. The main outcome measures were scores on psychosocial measures in men who were treated for ED with a PDE5 inhibitor before and after treatment. A total of 1,714 publications were retrieved; 1,674 publications were excluded because they did not meet the design requirements of the review, and 40 publications (32 RCTs) were retained. Before treatment, men who participated in clinical trials reported relatively good quality of life and overall relationships, but poor sexual relationships and sexual satisfaction, diminished confidence, low self-esteem, and symptoms of depression. After treatment, there were significant improvements from baseline in most of these measures, except for overall life satisfaction and overall relationship satisfaction. ED and the treatment of ED are associated with substantially broader aspects of a man's life than just erectile functioning. This review demonstrates the importance of evaluating the psychosocial factors associated with ED and its treatment, and the importance of using standardized scales to conduct this evaluation. Further research is needed to better understand the mechanisms underlying the reciprocal relationships among physical and psychological functioning in men with ED. © 2013 International Society for Sexual Medicine.

  16. Pregnancy, Obstetric and Neonatal Outcomes in HIV Positive ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Keywords: Pregnancy, delivery, HIV, neonate, adverse outcome. Introduction. HIV-1 infection has remained a major public health challenge in sub-Saharan Africa, accounting ... practice have greatly reduced both maternal deaths .... 2010 we reverted back to triple ARV .... between the two groups in the rates of obstetric.

  17. How related multiscreening could positively affect advertising outcomes

    NARCIS (Netherlands)

    Segijn, C.M.; Voorveld, H.A.M.; Smit, E.G.

    2017-01-01

    The use of multiple screens, also known as multiscreening, is assumed to have detrimental consequences for advertising outcomes. However, many people are engaging in this form of media multitasking on a daily basis. Therefore, it is important to focus on how to improve the effectiveness of

  18. How positioning strategies affect co-branding outcomes

    Directory of Open Access Journals (Sweden)

    Hilary Wason

    2015-12-01

    Full Text Available Co-branding is a widely applied strategy, with research indicating differential benefits to the parent brands. Past studies suggest the source of these differences may be due to the partners’ relative market position, and characteristics such as brand familiarity, brand equity and proximity to the consumer have been explored. However, the role of brand positioning has received little attention in the context of co-branding. The current study attempts to address this gap, considering the positioning of a brand and the impact of a co-branding strategy on customer perceptions. Using the Blankson and Kalafatis positioning typology, we explore the impact of co-branding on the parent brand perceptions from a hedonic vs. functional (utilitarian focus. The results suggest that for hedonically oriented positioning strategies, fit between the brands is more important than fit between the product categories in driving positive brand perceptions. For a functionally oriented positioning strategy, the reverse holds, with product fit a more important factor than brand fit in driving post-alliance perceptions.

  19. Combining biological and psychosocial baseline variables did not improve prediction of outcome of a very-low-energy diet in a clinic referral population.

    Science.gov (United States)

    Sumithran, P; Purcell, K; Kuyruk, S; Proietto, J; Prendergast, L A

    2018-02-01

    Consistent, strong predictors of obesity treatment outcomes have not been identified. It has been suggested that broadening the range of predictor variables examined may be valuable. We explored methods to predict outcomes of a very-low-energy diet (VLED)-based programme in a clinically comparable setting, using a wide array of pre-intervention biological and psychosocial participant data. A total of 61 women and 39 men (mean ± standard deviation [SD] body mass index: 39.8 ± 7.3 kg/m 2 ) underwent an 8-week VLED and 12-month follow-up. At baseline, participants underwent a blood test and assessment of psychological, social and behavioural factors previously associated with treatment outcomes. Logistic regression, linear discriminant analysis, decision trees and random forests were used to model outcomes from baseline variables. Of the 100 participants, 88 completed the VLED and 42 attended the Week 60 visit. Overall prediction rates for weight loss of ≥10% at weeks 8 and 60, and attrition at Week 60, using combined data were between 77.8 and 87.6% for logistic regression, and lower for other methods. When logistic regression analyses included only baseline demographic and anthropometric variables, prediction rates were 76.2-86.1%. In this population, considering a wide range of biological and psychosocial data did not improve outcome prediction compared to simply-obtained baseline characteristics. © 2017 World Obesity Federation.

  20. Psychosocial and socio-demographic factors associated with outcomes for patients undergoing rehabilitation for chronic whiplash associated disorders: a pilot study.

    Science.gov (United States)

    Baltov, Petko; Côte, Julie; Truchon, Manon; Feldman, Debbie Ehrmann

    2008-01-01

    Identify psychosocial and socio-demographic factors (measured prior to treatment) that were associated with post-treatment self-perceived pain and disability and two secondary outcomes: psychological distress, and return to work in patients undergoing multidisciplinary rehabilitation for chronic whiplash associated disorders (WAD). Interviews were conducted with 28 patients with chronic WAD at entry to and completion of an intensive rehabilitation program, and a telephone interview was carried out three months later. Participants completed pain and disability, and psychological distress questionnaires, at baseline and at both follow-ups. They also completed psychosocial questionnaires and provided socio-demographic information. The effect of each of the independent variables on the outcomes was first evaluated by simple regressions, and then subsequently by multiple regression analysis. Higher baseline pain and disability predicted higher pain and disability at both follow-ups (p factor that affected pain and disability post-rehabilitation. Psychosocial factors played a role in the prognosis of psychological distress and return to work.

  1. Effect of socioeconomic position on patient outcome after hysterectomy

    DEFF Research Database (Denmark)

    Daugbjerg, Signe B; Cesaroni, Giulia; Ottesen, Bent

    2014-01-01

    OBJECTIVE: To investigate the association between socioeconomic position (assessed by education, employment and income) and complications following hysterectomy and assess the role of lifestyle, co-morbidity and clinical conditions on the relationship. DESIGN: Register-based cohort study. SETTING...... significantly higher odds of complications following hysterectomy compared with women with a high socioeconomic position. Unhealthy lifestyle and presence of co-morbidity in women with low socioeconomic position partially explains the differences in complications.......OBJECTIVE: To investigate the association between socioeconomic position (assessed by education, employment and income) and complications following hysterectomy and assess the role of lifestyle, co-morbidity and clinical conditions on the relationship. DESIGN: Register-based cohort study. SETTING...... and employed women. Furthermore, unemployed women had higher odds of hospitalization >4 days than women in employment. Lifestyle factors (smoking and body mass index) and co-morbidity status seemed to explain most of the social differences. However, an association between women with less than high school...

  2. Nomogram for predicting the probability of the positive outcome of ...

    African Journals Online (AJOL)

    F.A. Yeboah

    distribution, the median and inter quartile (IQR) values were used. ... Crude or adjusted odds ratios and ... model, the estimated probability of a positive biopsy was calcu- ..... Gratitude goes to workers at Department of Surgery (Urology Unit).

  3. Frequency and Therapeutic Outcomes of Culture Positive Invasive ...

    African Journals Online (AJOL)

    From May 2012 to July 2013, all cases from consults sent to the clinical microbiologists for review and patients with positive samples were identified from the mycology laboratory registers. Hospital based frequency of Invasive Fungal Infections was 42.5%. Patients' ages ranged from 5 days to 71 years with a median of 29 ...

  4. Nomogram for predicting the probability of the positive outcome of ...

    African Journals Online (AJOL)

    F.A. Yeboah

    Abstract. Introduction and objectives: Several existing models have been developed to predict positive prostate biopsy among men undergoing evaluation for prostate cancer (PCa). However, most of these models have come from industrialized countries. We therefore, developed a prostate disease nomogram model to ...

  5. Patient satisfaction and positive patient outcomes in ambulatory anesthesia

    Directory of Open Access Journals (Sweden)

    Shah U

    2015-04-01

    Full Text Available Ushma Shah, David T Wong, Jean Wong Department of Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada Abstract: Most surgeries in North America are performed on an ambulatory basis, reducing health care costs and increasing patient comfort. Patient satisfaction is an important outcome indicator of the quality of health care services incorporated by the American Society of Anesthesiologists (ASA. Patient satisfaction is a complex concept that is influenced by multiple factors. A patient's viewpoint and knowledge plays an influential role in patient satisfaction with ambulatory surgery. Medical optimization and psychological preparation of the patient plays a pivotal role in the success of ambulatory surgery. Postoperative pain, nausea, and vomiting are the most important symptoms for the patient and can be addressed by multimodal drug regimens. Shared decision making, patient–provider relationship, communication, and continuity of care form the main pillars of patient satisfaction. Various psychometrically developed instruments are available to measure patient satisfaction, such as the Iowa Satisfaction with Anesthesia Scale and Evaluation du Vecu de I'Anesthesie Generale, but none have been developed specifically for ambulatory surgery. The ASA has made recommendations for data collection for patient satisfaction surveys and emphasized the importance of reporting the data to the Anesthesia Quality Institute. Future research is warranted to develop a validated tool to measure patient satisfaction in ambulatory surgery. Keywords: patient, satisfaction, anesthesia, outcomes, questionnaire, perspectives

  6. Does an advantageous occupational position make women happier in contemporary Japan? Findings from the Japanese Study of Health, Occupation, and Psychosocial Factors Related Equity (J-HOPE

    Directory of Open Access Journals (Sweden)

    Maki Umeda

    2015-12-01

    Full Text Available Occupational position is one of the determinants of psychological health, but this association may differ for men and women depending on the social context. In contemporary Japanese society, occupational gender segregation persists despite increased numbers of women participating in the labour market, which may contribute to gender specific patterns in the prevalence of poor psychological health. The present study examined gender specific associations between occupational position and psychological health in Japan, and the potential mediating effects of job control and effort–reward imbalance in these associations. We used data obtained from 7123 men and 2222 women, aged between 18 and 65 years, who participated in an occupational cohort study, the Japanese Study of Health, Occupation, and Psychosocial Factors Related Equity (J-HOPE, between 2011 and 2012. We used logistic regression to examine the association between occupational position and poor psychological health, adjusted for age, working hours, household income and education, as well as psychosocial work characteristics (job control and effort–reward imbalance. The prevalence of poor psychological health increased from manual/service occupations (23% to professionals/managers (38% among women, while it did not vary by occupational position among men. In women, the significant association between occupational position and psychological health was not explained by job control, but was attenuated by effort–reward imbalance. Our findings suggest that Japanese women in more advantaged occupational positions are likely to be at a greater risk for poor psychological health due to higher levels of effort–reward imbalance at work.

  7. Positive Outcomes Following Bereavement: Paths to Posttraumatic Growth

    Directory of Open Access Journals (Sweden)

    Lawrence G Calhoun

    2010-09-01

    Full Text Available Recent theory and research have drawn attention to the need to better understand the positive changes, termed posttraumatic growth, that often occur in bereaved individuals; even as negative emotions related to grief persist. We describe five dimensions of posttraumatic growth and present a model for understanding how the loss of a close other can eventually lead to a recognition of important positive personal changes. Loss, especially unexpected loss, disrupts an individual's beliefs about the world and initiates a process of rebuilding an understanding. During this process, many people come to realise their own strengths, appreciate the impact of their relationships, and have new spiritual insights. A strategy for facilitating growth during clinical work also is described.

  8. High-performance HR practices, positive affect and employee outcomes

    OpenAIRE

    Mostafa, Ahmed

    2017-01-01

    Purpose – The purpose of this paper is to provide insight into the affective or emotional mechanisms that underlie the relationship between high-performance HR practices (HPHRP) and employee attitudes and behaviours. Drawing on affective events theory (AET), this paper examines a mediation model in which HPHRP influence positive affect which in turn affects job satisfaction and organizational citizenship behaviours (OCBs). Design/methodology/approach – Two-wave data was collected from a sampl...

  9. Gender-based Outcomes and Acceptability of a Computer-assisted Psychosocial Intervention for Substance Use Disorders.

    Science.gov (United States)

    Campbell, Aimee N C; Nunes, Edward V; Pavlicova, Martina; Hatch-Maillette, Mary; Hu, Mei-Chen; Bailey, Genie L; Sugarman, Dawn E; Miele, Gloria M; Rieckmann, Traci; Shores-Wilson, Kathy; Turrigiano, Eva; Greenfield, Shelly F

    2015-06-01

    Digital technologies show promise for increasing treatment accessibility and improving quality of care, but little is known about gender differences. This secondary analysis uses data from a multi-site effectiveness trial of a computer-assisted behavioral intervention, conducted within NIDA's National Drug Abuse Clinical Trials Network, to explore gender differences in intervention acceptability and treatment outcomes. Men (n=314) and women (n=192) were randomly assigned to 12-weeks of treatment-as-usual (TAU) or modified TAU+Therapeutic Education System (TES), whereby TES substituted for 2hours of TAU per week. TES is composed of 62 Web-delivered, multimedia modules, covering skills for achieving and maintaining abstinence plus prize-based incentives contingent on abstinence and treatment adherence. Outcomes were: (1) abstinence from drugs and heavy drinking in the last 4weeks of treatment, (2) retention, (3) social functioning, and (4) drug and alcohol craving. Acceptability was the mean score across five indicators (i.e., interesting, useful, novel, easy to understand, and satisfaction). Gender did not moderate the effect of treatment on any outcome. Women reported higher acceptability scores at week 4 (p=.02), but no gender differences were detected at weeks 8 or 12. Acceptability was positively associated with abstinence, but only among women (p=.01). Findings suggest that men and women derive similar benefits from participating in a computer-assisted intervention, a promising outcome as technology-based treatments expand. Acceptability was associated with abstinence outcomes among women. Future research should explore characteristics of women who report less satisfaction with this modality of treatment and ways to improve overall acceptability. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Positive outcomes of office ergonomics in terms of higher productivity

    Directory of Open Access Journals (Sweden)

    Terek Edit

    2014-01-01

    Full Text Available One of the sciences which considers to human health, human performance and body activities is Ergonomics. Ergonomics is one of the modern sciences, drawing as much from the field as from the laboratory, and including elements of art and craft as well. Before designing the workplace it is necessary to determine its requirements, i.e., which it is intended for, what are the characteristics of the existing work equipment and the additional tools needed. However, there are some standards and with their application people will prevent the occurrence of modern office diseases. This paper is focused on the positive aspects of ergonomics in improvement of the working environment.

  11. Being Nontraditional and Learning Online: Assessing the Psychosocial Learning Environments, Self-Efficacy, and Affective Outcomes among College Student Groups

    Science.gov (United States)

    Ashford, Roslyn La'Toya

    2014-01-01

    The study compared traditional and nontraditional students' attitudes about the psychosocial learning environment and their influence on self-efficacy, enjoyment of online learning, and student satisfaction by using Moos' (1979) Model of Environmental and Personal Variables and the three dimensions of social climate as its theoretical framework.…

  12. Evaluating Questionnaires Used to Assess Self-Reported Physical Activity and Psychosocial Outcomes Among Survivors of Adolescent and Young Adult Cancer: A Cognitive Interview Study.

    Science.gov (United States)

    Wurz, Amanda; Brunet, Jennifer

    2017-09-01

    Physical activity is increasingly being studied as a way to improve psychosocial outcomes (e.g., quality of life, self-efficacy, physical self-perceptions, self-esteem, body image, posttraumatic growth) among survivors of adolescent and young adult (AYA) cancer. Assessing levels of and associations between self-reported physical activity and psychosocial outcomes requires clear, appropriate, and relevant questionnaires. To explore how survivors of AYA cancer interpreted and responded to the following eight published questionnaires: Leisure Time Exercise Questionnaire, Exercise Self-Efficacy Scale, Physical Self-Description Questionnaire, Rosenberg Global Self-Esteem Scale, Multidimensional Body-Self Relations Questionnaire, Posttraumatic Growth Inventory, Functional Assessment of Cancer Therapy-General (FACT-G), RAND 36-Item Health Survey 1.0 (RAND-36), cognitive interviews were conducted with three men and four women age 18-36 years who were diagnosed with cancer at age 16-35 years. Initially, the first seven questionnaires listed above were assessed. Summaries of the interviews were prepared and compared across participants. Potential concerns were identified with the FACT-G; thus, a second interview was conducted with participants to explore the clarity, appropriateness, and relevance of the RAND-36. Concerns identified for the FACT-G related mostly to the lack of relevance of items pertaining to cancer-specific aspects of quality of life given that participants were posttreatment. No or few concerns related to comprehension and/or structure/logic were identified for the other questionnaires. In general, the questionnaires assessed were clear, appropriate, and relevant. Participants' feedback suggested they could be used to assess self-reported physical activity and varied psychosocial outcomes in studies with survivors of AYA cancer, either with or without slight modifications.

  13. An investigation of the impact of regular use of the Wii Fit to improve motor and psychosocial outcomes in children with movement difficulties: a pilot study.

    Science.gov (United States)

    Hammond, J; Jones, V; Hill, E L; Green, D; Male, I

    2014-03-01

    Children with Developmental Co-ordination Disorder (DCD) experience poor motor and psychosocial outcomes. Interventions are often limited within the healthcare system, and little is known about how technology might be used within schools or homes to promote the motor skills and/or psychosocial development of these children. This study aimed to evaluate whether short, regular school-based sessions of movement experience using a commercially available home video game console (Nintendo's Wii Fit) would lead to benefits in both motor and psychosocial domains in children with DCD. A randomized crossover controlled trial of children with movement difficulties/DCD was conducted. Children were randomly assigned to an intervention (n = 10) or comparison (n = 8) group. The intervention group spent 10 min thrice weekly for 1 month using Wii Fit during the lunch break, while the comparison group took part in their regular Jump Ahead programme. Pre- and post-intervention assessments considered motor proficiency, self-perceived ability and satisfaction and parental assessment of emotional and behavioural problems. Significant gains were seen in motor proficiency, the child's perception of his/her motor ability and reported emotional well-being for many, but not all children. This study provides preliminary evidence to support the use of the Wii Fit within therapeutic programmes for children with movement difficulties. This simple, popular intervention represents a plausible method to support children's motor and psychosocial development. It is not possible from our data to say which children are most likely to benefit from such a programme and particularly what the dose and duration should be. Further research is required to inform across these and other questions regarding the implementation of virtual reality technologies in therapeutic services for children with movement difficulties. © 2013 John Wiley & Sons Ltd.

  14. Continuity, psychosocial correlates, and outcome of problematic substance use from adolescence to young adulthood in a community sample

    OpenAIRE

    Steinhausen, H C; Eschmann, S; Winkler Metzke, C

    2007-01-01

    Abstract Background The study of the continuity, psychosocial correlates, and prediction of problematic substance use (PSU) across time from adolescence to young adulthood. Methods Substance use was studied in a cohort of N = 593 subjects who had been assessed at three times between adolescence and young adulthood within the Zurich Psychology and Psychopathology Study (ZAPPS). Based on the frequency of tobacco, alcohol, and cannabis consumption, groups with PSU were defined at each of the thr...

  15. Network position and related power : how they affect and are affected by network management and outcomes

    NARCIS (Netherlands)

    Oukes, Tamara

    2018-01-01

    In network position and related power you learn more about how network position and related power affect and are affected by network management and outcomes. First, I expand our present understanding of how startups with a fragile network position manage business relationships by taking an

  16. The Gutenberg Health Study: measuring psychosocial factors at work and predicting health and work-related outcomes with the ERI and the COPSOQ questionnaire.

    Science.gov (United States)

    Nuebling, Matthias; Seidler, Andreas; Garthus-Niegel, Susan; Latza, Ute; Wagner, Mandy; Hegewald, Janice; Liebers, Falk; Jankowiak, Sylvia; Zwiener, Isabella; Wild, Philipp S; Letzel, Stephan

    2013-06-04

    Several instruments have been developed to assess psychosocial workload. We compared two of these instruments, the Effort-Reward Imbalance (ERI) model and the Copenhagen Psychosocial Questionnaire (COPSOQ) with regard to congruent validity and internal validity. This analysis is based on a population-based sample of the baseline examination of 2,783 employees from the Gutenberg Health Study (GHS). About half of the participants completed the ERI questionnaire (n = 1,342), the other half completed the COPSOQ (n = 1,441). First, the two samples were compared and descriptive analyses were carried out calculating mean values for both instruments in general, then separately for age, gender and main occupational groups. Second, we analyzed the relationship between ERI and COPSOQ scales on the workplace situation and on the workplace outcomes: job satisfaction, general health, burnout, satisfaction with life, by applying stepwise logistic regression analysis. For the majority of occupations, high effort as reflected by the ERI corresponded with high demands as reflected by the COPSOQ. Comparably, high reward (according to ERI) yielded a good agreement with high "influence and development" (according to COPSOQ). However, we could also find differences between ERI and COPSOQ concerning the intensity of psychosocial workload in some occupations (e.g., physicians/pharmacists or warehouse managers/warehousemen/transport workers). These differences point to differing theoretical concepts of ERI and COPSOQ. When the ability of ERI and COPSOQ was examined to determine the associations with health and work outcomes, burnout could be better predicted by the COPSOQ; this might be due to the fact that COPSOQ comprises the constructs "work-privacy conflict" and "emotional demand", which are closely related to burnout. However, methodological differences between these instruments limit their direct comparability. The ERI and COPSOQ instrument yielded similar results for most

  17. Socioeconomic position, psychosocial work environment and disability in an ageing workforce: a longitudinal analysis of SHARE data from 11 European countries.

    Science.gov (United States)

    Reinhardt, Jan D; Wahrendorf, Morten; Siegrist, Johannes

    2013-03-01

    Prevention of disability in the ageing workforce is essential for sustaining economic growth in Europe. In order to provide information on entry points for preventive measures, it is important to better understand sociodemographic, socioeconomic and work-related determinants of disability in older employees. We aimed to test the hypothesis that low socioeconomic position and exposure to a stressful psychosocial work environment at baseline contribute to later disability. We further assumed that the association of socioeconomic position with disability is partly mediated by exposure to adverse working conditions. We studied longitudinal data from the first two waves of the Survey on Health, Ageing and Retirement in Europe comprising 11 European countries. Sociodemographic, socioeconomic and work-related factors (low control, effort-reward imbalance) and baseline disability of 2665 male and 2209 female employees aged between 50 and 64 years were used to predict disability 2 years later. Following the International Classification of Functioning (ICF), disability was subdivided into the components 'impairment' and 'restriction in activities and participation'. Two multilevel Poisson regressions were fitted to the data. After adjusting for baseline disability and relevant confounding variables, low socioeconomic position and chronic stress at work exerted significant effects on disability scores 2 years later. We found some support for the hypothesis that the association of socioeconomic position with disability is partly mediated by work stress. Investing in reduction of work stress and reducing social inequalities in health functioning are relevant entry points of policies that aim at maintaining work ability in early old age.

  18. Long-term outcome after whiplash injury. A 2-year follow-up considering features of injury mechanism and somatic, radiologic, and psychosocial findings.

    Science.gov (United States)

    Radanov, B P; Sturzenegger, M; Di Stefano, G

    1995-09-01

    With the increased incidence of whiplash injury following the introduction of compulsory car seat belts, a large number of reports have dealt with the aftermath of this condition. Previous studies, however, focused on somatic symptoms on the one hand or considered only psychological or neuropsychological variables on the other hand, often in loosely defined or selected groups of patients. No study so far has analyzed the long-term outcome in a nonselected group of patients using a clear injury definition considering patient history; somatic, radiologic, and neuropsychological findings; and features of the injury mechanisms assessed soon after trauma and during follow-up. the present investigation was designed to assess these combined factors. According to a strict definition of whiplash injury, we assessed a consecutive nonselected sample of 117 patients with recent injury who had similar sociocultural and educational backgrounds. The patients had been in automobile crashes and were all equally covered by accident insurance according to the country-wide scheme. Initial examination was performed 7.2 +/- 4.2 days after trauma, and follow-up examinations 3, 6, 12, and 24 months later. At baseline, features of injury mechanism, subjective complaints, and different aspects of patient history were documented and cervical spine X rays performed. At all examinations patients underwent neurologic examination and cognitive and psychosocial factor assessment. At 2 years, patients were divided into symptomatic and asymptomatic groups and then compared with regard to the initial findings. In addition, symptomatic patients who were disabled at the 2-year follow-up examination and symptomatic patients not disabled (that is, they were able to work at the pretraumatic level) were compared regarding initial and 2-year findings. At 2 years, 18% of patients still had injury-related symptoms. With regard to baseline findings the following significant differences were found: Symptomatic

  19. Positive psychology outcome measures for family caregivers of people living with dementia: a systematic review.

    Science.gov (United States)

    Stansfeld, Jacki; Stoner, Charlotte R; Wenborn, Jennifer; Vernooij-Dassen, Myrra; Moniz-Cook, Esme; Orrell, Martin

    2017-08-01

    Family caregivers of people living with dementia can have both positive and negative experiences of caregiving. Despite this, existing outcome measures predominately focus on negative aspects of caregiving such as burden and depression. This review aimed to evaluate the development and psychometric properties of existing positive psychology measures for family caregivers of people living with dementia to determine their potential utility in research and practice. A systematic review of positive psychology outcome measures for family caregivers of people with dementia was conducted. The databases searched were as follows: PsychINFO, CINAHL, MEDLINE, EMBASE, and PubMed. Scale development papers were subject to a quality assessment to appraise psychometric properties. Twelve positive outcome measures and six validation papers of these scales were identified. The emerging constructs of self-efficacy, spirituality, resilience, rewards, gain, and meaning are in line with positive psychology theory. There are some robust positive measures in existence for family caregivers of people living with dementia. However, lack of reporting of the psychometric properties hindered the quality assessment of some outcome measures identified in this review. Future research should aim to include positive outcome measures in interventional research to facilitate a greater understanding of the positive aspects of caregiving and how these contribute to well-being.

  20. Branding MBA Programs: The Use of Target Market Desired Outcomes for Effective Brand Positioning

    Science.gov (United States)

    Heslop, Louise A.; Nadeau, John

    2010-01-01

    Branding is about delivering on desired outcomes. The importance of positioning program offerings on the basis of outcomes sought in the education market is illustrated in this study of choice of an MBA program by prospective students. MBA fair attendees were surveyed and multiple methods were employed to determine the importance of desired…

  1. Do psychosocial work conditions predict risk of disability pensioning? An analysis of register-based outcomes using pooled data on 40,554 observations.

    Science.gov (United States)

    Clausen, Thomas; Burr, Hermann; Borg, Vilhelm

    2014-06-01

    To investigate whether high psychosocial job demands (quantitative demands and work pace) and low psychosocial job resources (influence at work and quality of leadership) predicted risk of disability pensioning among employees in four occupational groups--employees working with customers, employees working with clients, office workers and manual workers--in line with the propositions of the Job Demands-Resources (JD-R) model. Survey data from 40,554 individuals were fitted to the DREAM register containing information on payments of disability pension. Using multi-adjusted Cox regression, observations were followed in the DREAM-register to assess risk of disability pensioning. Average follow-up time was 5.9 years (SD=3.0). Low levels of influence at work predicted an increased risk of disability pensioning and medium levels of quantitative demands predicted a decreased risk of disability pensioning in the study population. We found significant interaction effects between job demands and job resources as combinations low quality of leadership and high job demands predicted the highest rate of disability pensioning. Further analyses showed some, but no statistically significant, differences between the four occupational groups in the associations between job demands, job resources and risk of disability pensioning. The study showed that psychosocial job demands and job resources predicted risk of disability pensioning. The direction of some of the observed associations countered the expectations of the JD-R model and the findings of the present study therefore imply that associations between job demands, job resources and adverse labour market outcomes are more complex than conceptualised in the JD-R model. © 2014 the Nordic Societies of Public Health.

  2. Social participation and psychosocial outcomes of young adults with chronic physical conditions: Comparing recipients and non-recipients of disability benefits.

    Science.gov (United States)

    Bal, Marjolijn I; Sattoe, Jane N T; Miedema, Harald S; van Staa, AnneLoes

    2018-03-01

    Little is known about any differences between young people with chronic physical conditions who do and do not apply for disability benefits in young adulthood for providing insights for future policy and rehabilitation care. We aimed to identify predictors during adolescence of receiving disability benefits in young adulthood and to compare recipients and non-recipients of benefits in social participation and psychosocial outcomes in young adulthood. Follow-up study of 18 to 25 year olds with various chronic conditions who at adolescent age completed a web-based survey (n=518; T0). The outcome was receiving disability benefits (yes or no). Associations with background characteristics, social participation, and impact of the chronic condition were explored with stepwise multivariate modelling, using T0 variables. Differences between recipients and non-recipients were explored using chi-square tests and t-tests. Receiving disability benefits in young adulthood was associated with greater extent of physical disability, receiving less special education, absenteeism at school/work, and low health-related quality of life during adolescence. In young adulthood, recipients of benefits reported higher perceived impact of the chronic condition on their school/work career and lower quality of life than non-recipients. Social participation varied across domains. This study provides important insights into the characteristics of a vulnerable subgroup of young people with chronic physical conditions. Disability benefit recipients experienced more impact of their chronic condition and reported a lower health-related quality of life over time than non-recipients. Rehabilitation professionals are encouraged to use patient-reported outcomes to address the lived experiences and screen the need for psychosocial support of this vulnerable subgroup of young people with chronic physical conditions. Copyright © 2018. Published by Elsevier Masson SAS.

  3. Comorbidity, Pain, Utilization, and Psychosocial Outcomes in Older versus Younger Sickle Cell Adults: The PiSCES Project

    Directory of Open Access Journals (Sweden)

    Donna K. McClish

    2017-01-01

    Full Text Available Background. Patients with SCD now usually live well into adulthood. Whereas transitions into adulthood are now often studied, little is published about aging beyond the transition period. We therefore studied age-associated SCD differences in utilization, pain, and psychosocial variables. Methods. Subjects were 232 adults in the Pain in Sickle Cell Epidemiology Study (PiSCES. Data included demographics, comorbidity, and psychosocial measures. SCD-related pain and health care utilization were recorded in diaries. We compared 3 age groups: 16–25 (transition, 26–36 (younger adults, and 37–64 (older adults years. Results. Compared to the 2 adult groups, the transition group reported fewer physical challenges via comorbidities, somatic complaints, and pain frequency, though pain intensity did not differ on crisis or noncrisis pain days. The transition group utilized opioids less often, made fewer ambulatory visits, and had better quality of life, but these differences disappeared after adjusting for pain and comorbidities. However, the transition group reported more use of behavioral coping strategies. Conclusion. We found fewer biological challenges, visits, and better quality of life, in transition-aged versus older adults with SCD, but more behavioral coping. Further study is required to determine whether age-appropriate health care, behavioral, or other interventions could improve age-specific life challenges of patients with SCD.

  4. Continuity, psychosocial correlates, and outcome of problematic substance use from adolescence to young adulthood in a community sample

    Directory of Open Access Journals (Sweden)

    Metzke Christa

    2007-10-01

    Full Text Available Abstract Background The study of the continuity, psychosocial correlates, and prediction of problematic substance use (PSU across time from adolescence to young adulthood. Methods Substance use was studied in a cohort of N = 593 subjects who had been assessed at three times between adolescence and young adulthood within the Zurich Psychology and Psychopathology Study (ZAPPS. Based on the frequency of tobacco, alcohol, and cannabis consumption, groups with PSU were defined at each of the three measurement points in time and compared to the rest of the sample. Comparisons included questionnaire data regarding emotional and behavioural problems, life events, coping style, self-related cognitions, perceived parenting style, perceived school environment, and size and efficiency of the social network. Results The size of the groups with PSU increased continuously across time. The cross-sectional correlates of PSU were characterized by a similar pattern that included higher scores for externalizing behaviour, and both number and negative impact of life events across all three times. At time 1 and 2 subjects with PSU also experienced less favourable parenting styles and school environments. Longitudinally, PSU in young adulthood was predicted most strongly and persistently by previous risk status, externalizing problems and male gender. Conclusion Problematic substance use is a major problem in youth. Its contributing pattern of associated and predictive psychosocial variables can be identified in the community.

  5. The mediating effects of family functioning on psychosocial outcomes in healthy siblings of children with sickle cell disease.

    Science.gov (United States)

    Gold, Jeffrey I; Treadwell, Marsha; Weissman, Lina; Vichinsky, Elliott

    2011-12-01

    Children with siblings coping with chronic illness experience stresses and disruptions in daily life as families work together to care for the affected child. Research suggests that children and adolescents with sickle cell disease (SCD) may be at risk for adjustment problems, impaired psychosocial functioning, and reduced quality of life. These potential stressors affect the child with SCD as well as their caregivers and other family members. This study examined the role of family functioning on the psychosocial functioning of healthy siblings of children with SCD. Participants were 65 healthy African-American siblings of children with SCD with a mean age of 11.19 years (range: 7-16) and their primary caregiver. Caregivers completed questionnaires assessing family functioning and child adjustment including demographic surveys, the Family Relations Scale (FRS), and the Child Behavior Checklist (CBCL). Increased number of emergency room visits (β = -0.28, P Family functioning mediated this effect (β = 0.27; P family expressiveness (total score, r = -0.34; P family conflict (total score, r = 0.41; P family expressiveness, support, and conflict are indicated for this population. Copyright © 2011 Wiley-Liss, Inc.

  6. Continuity, psychosocial correlates, and outcome of problematic substance use from adolescence to young adulthood in a community sample.

    Science.gov (United States)

    Steinhausen, Hans-Christoph; Eschmann, Susanne; Metzke, Christa Winkler

    2007-10-11

    The study of the continuity, psychosocial correlates, and prediction of problematic substance use (PSU) across time from adolescence to young adulthood. Substance use was studied in a cohort of N = 593 subjects who had been assessed at three times between adolescence and young adulthood within the Zurich Psychology and Psychopathology Study (ZAPPS). Based on the frequency of tobacco, alcohol, and cannabis consumption, groups with PSU were defined at each of the three measurement points in time and compared to the rest of the sample. Comparisons included questionnaire data regarding emotional and behavioural problems, life events, coping style, self-related cognitions, perceived parenting style, perceived school environment, and size and efficiency of the social network. The size of the groups with PSU increased continuously across time. The cross-sectional correlates of PSU were characterized by a similar pattern that included higher scores for externalizing behaviour, and both number and negative impact of life events across all three times. At time 1 and 2 subjects with PSU also experienced less favourable parenting styles and school environments. Longitudinally, PSU in young adulthood was predicted most strongly and persistently by previous risk status, externalizing problems and male gender. Problematic substance use is a major problem in youth. Its contributing pattern of associated and predictive psychosocial variables can be identified in the community.

  7. IMPACT OF MEDICAL AND SOCIAL FACTORS ON SURGICAL OUTCOMES OF PULMONARY TUBERCULOSIS IN HIV POSITIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    D. V. Аlkаz

    2018-01-01

    Full Text Available The article presents the study of the impact of social and medical factors and bad habits on the outcomes of planned surgery in 95 patients with concurrent respiratory tuberculosis and HIV infection The correlation analysis was performed which discovered the factors providing a positive impact on treatment outcomes The following factors have the strongest association with treatment outcome: patient's regular job, family, no alcohol or nicotine addiction, a form of tuberculosis, and administration of antiretroviral therapy It was noted that surgery outcome could be predicted and potential complications prevented 

  8. Does a positive pretransplant crossmatch affect long-term outcome in liver transplantation?

    LENUS (Irish Health Repository)

    Al-Sibae, Mohamad R

    2012-02-01

    Despite the historical success of liver transplantation in the face of a positive lymphocytic crossmatch, increased incidence of acute cellular rejection and graft loss have been reported in this setting. Given the potential adverse effects of antirejection treatment, especially in hepatitis C virus-positive recipients, identification of predisposing factors could allow for better surveillance, avoidance of rejection, and potentially better graft outcomes.

  9. Neonatal outcomes of deliveries in occiput posterior position when delayed pushing is practiced: a cohort study.

    Science.gov (United States)

    Dahlqvist, Kristina; Jonsson, Maria

    2017-11-14

    To examine the impact of occiput posterior position, compared to occiput anterior position, on neonatal outcomes in a setting where delayed pushing is practiced. The specific aim was to estimate the risk of acidaemia. Cohort study from a university hospital in Sweden between 2004 and 2012. Information was collected from a local database of 35,546 births. Umbilical artery sampling was routine. Outcomes were: umbilical artery pH pushing, birth in occiput posterior compared with anterior position is not associated with acidaemia. The higher risk of neonatal morbidity is of concern and any long-term consequences need to be investigated in future studies.

  10. Wealth and happiness across the world: material prosperity predicts life evaluation, whereas psychosocial prosperity predicts positive feeling.

    Science.gov (United States)

    Diener, Ed; Ng, Weiting; Harter, James; Arora, Raksha

    2010-07-01

    The Gallup World Poll, the first representative sample of planet Earth, was used to explore the reasons why happiness is associated with higher income, including the meeting of basic needs, fulfillment of psychological needs, increasing satisfaction with one's standard of living, and public goods. Across the globe, the association of log income with subjective well-being was linear but convex with raw income, indicating the declining marginal effects of income on subjective well-being. Income was a moderately strong predictor of life evaluation but a much weaker predictor of positive and negative feelings. Possessing luxury conveniences and satisfaction with standard of living were also strong predictors of life evaluation. Although the meeting of basic and psychological needs mediated the effects of income on life evaluation to some degree, the strongest mediation was provided by standard of living and ownership of conveniences. In contrast, feelings were most associated with the fulfillment of psychological needs: learning, autonomy, using one's skills, respect, and the ability to count on others in an emergency. Thus, two separate types of prosperity-economic and social psychological-best predict different types of well-being.

  11. Predicting Positive Education Outcomes for Emerging Adults in Mental Health Systems of Care.

    Science.gov (United States)

    Brennan, Eileen M; Nygren, Peggy; Stephens, Robert L; Croskey, Adrienne

    2016-10-01

    Emerging adults who receive services based on positive youth development models have shown an ability to shape their own life course to achieve positive goals. This paper reports secondary data analysis from the Longitudinal Child and Family Outcome Study including 248 culturally diverse youth ages 17 through 22 receiving mental health services in systems of care. After 12 months of services, school performance was positively related to youth ratings of school functioning and service participation and satisfaction. Regression analysis revealed ratings of young peoples' perceptions of school functioning, and their experience in services added to the significant prediction of satisfactory school performance, even controlling for sex and attendance. Finally, in addition to expected predictors, participation in planning their own services significantly predicted enrollment in higher education for those who finished high school. Findings suggest that programs and practices based on positive youth development approaches can improve educational outcomes for emerging adults.

  12. Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review.

    Science.gov (United States)

    Kruse, Clemens Scott; Beane, Amanda

    2018-02-05

    Health information technology (HIT) has been introduced into the health care industry since the 1960s when mainframes assisted with financial transactions, but questions remained about HIT's contribution to medical outcomes. Several systematic reviews since the 1990s have focused on this relationship. This review updates the literature. The purpose of this review was to analyze the current literature for the impact of HIT on medical outcomes. We hypothesized that there is a positive association between the adoption of HIT and medical outcomes. We queried the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDLINE) by PubMed databases for peer-reviewed publications in the last 5 years that defined an HIT intervention and an effect on medical outcomes in terms of efficiency or effectiveness. We structured the review from the Primary Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and we conducted the review in accordance with the Assessment for Multiple Systematic Reviews (AMSTAR). We narrowed our search from 3636 papers to 37 for final analysis. At least one improved medical outcome as a result of HIT adoption was identified in 81% (25/37) of research studies that met inclusion criteria, thus strongly supporting our hypothesis. No statistical difference in outcomes was identified as a result of HIT in 19% of included studies. Twelve categories of HIT and three categories of outcomes occurred 38 and 65 times, respectively. A strong majority of the literature shows positive effects of HIT on the effectiveness of medical outcomes, which positively supports efforts that prepare for stage 3 of meaningful use. This aligns with previous reviews in other time frames. ©Clemens Scott Kruse, Amanda Beane. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 05.02.2018.

  13. Positive Outcome Expectancy Mediates the Relationship Between Peer Influence and Internet Gaming Addiction Among Adolescents in Taiwan.

    Science.gov (United States)

    Wu, Jo Yung Wei; Ko, Huei-Chen; Wong, Tsui-Yin; Wu, Li-An; Oei, Tian Po

    2016-01-01

    The present study examined the role of positive outcome expectancy in the relationship between peer/parental influence and Internet gaming addiction (IGA) among adolescents in Taiwan. Two thousand, one hundred and four junior high students completed the Chen Internet Addiction Scale for IGA, Parental Influence for IGA, peer influence for IGA, and Positive Outcome Expectancy of Internet Gaming Questionnaire. Results showed that the three types of peer influences (positive attitudes toward Internet gaming, frequency of Internet game use, and invitation to play) and positive outcome expectancy were significantly and positively correlated with IGA. Moreover, peer influence was also positively correlated with positive outcome expectancy. On the other hand, positive outcome expectancy and parental influences had a low correlation. Structural equation modeling analysis revealed that positive outcome expectancy did not mediate the relationship between either type of parental influences and IGA, and only the parent's invitation to play Internet games directly predicted IGA severity. However, peers' positive attitude or the frequency of peers' Internet game use positively predicted IGA and was fully mediated through positive outcome expectancy of Internet gaming. In addition, the frequency of peers' invitation to play Internet games directly and indirectly predicted IGA severity through a partial mediation of positive outcome expectancy of Internet gaming. The overall fit of the model was adequate and was able to explain 25.0 percent of the variance. The findings provide evidence in illuminating the role of peer influences and positive outcome expectancy of Internet gaming in the process of why adolescents may develop IGA.

  14. Position of the American Dietetic Association and American Society for Nutrition: obesity, reproduction, and pregnancy outcomes.

    Science.gov (United States)

    Siega-Riz, Anna Maria; King, Janet C

    2009-05-01

    Given the detrimental influence of maternal overweight and obesity on reproductive and pregnancy outcomes for the mother and child, it is the position of the American Dietetic Association and the American Society for Nutrition that all overweight and obese women of reproductive age should receive counseling on the roles of diet and physical activity in reproductive health prior to pregnancy,during pregnancy, and in the inter conceptional period, in order to ameliorate these adverse outcomes. The effect of maternal nutritional status prior to pregnancy on reproduction and pregnancy outcomes is of great public health importance. Obesity in the United States and worldwide has grown to epidemic proportions, with an estimated 33% of US women classified as obese. This position paper has two objectives: (a) to help nutrition professionals become aware of the risks and possible complications of overweight and obesity for fertility,the course of pregnancy, birth outcomes, and short- and long-term maternal and child health outcomes;and (b) related to the commitment to research by the American Dietetic Association and the American Society for Nutrition, to identify the gaps in research to improve our knowledge of the risks and complications associated with being overweight and obese before and during pregnancy.Only with an increased knowledge of these risks and complications can health care professionals develop effective strategies that can be implemented before and during pregnancy as well as during the inter conceptional period to ameliorate adverse outcomes.

  15. Resolution of psychosocial crises associated with flying in space

    Science.gov (United States)

    Suedfeld, Peter; Brcic, Jelena

    2011-07-01

    Erikson (1959) proposed a theoretical basis for healthy psychosocial development. His theory posits eight critical conflict situations throughout one's lifetime, each of which can result in a favorable or unfavorable resolution. Autobiographies, memoirs, interviews, personal diaries, and oral histories of 97 international astronauts were content analyzed to assess reported resolutions of Erikson's psychosocial crises, regardless of chronological sequence. We made comparisons across flight phases (before, during, and after), gender, nationality of home space agency, and flight duration. Astronauts reported more favorable than unfavorable outcomes across flight phases and demographic variables. Differences across demographic variables and flight phases, as well as the changes as a result of the flight are discussed.

  16. Testing links between childhood positive peer relations and externalizing outcomes through a randomized controlled intervention study

    NARCIS (Netherlands)

    Witvliet, M.; van Lier, P.A.C.; Cuijpers, P.; Koot, H.M.

    2009-01-01

    In this study, the authors used a randomized controlled trial to explore the link between having positive peer relations and externalizing outcomes in 758 children followed from kindergarten to the end of 2nd grade. Children were randomly assigned to the Good Behavior Game (GBG), a universal

  17. Outcome in clients with positive pregnancy test following IVF/ICSI ...

    African Journals Online (AJOL)

    Background: A retrospective analysis of the outcome of all patients who have recorded a positive pregnancy test following IVF/ICSI treatment from June 1999 to December 2002 was done. Materials and Methods: A total of 1256 treatment cycles were carried out using the long day 1 (early follicular phase) or day 21 ...

  18. Predictors and Health-Related Outcomes of Positive Body Image in Adolescent Girls: A Prospective Study

    Science.gov (United States)

    Andrew, Rachel; Tiggemann, Marika; Clark, Levina

    2016-01-01

    This study aimed to investigate prospective predictors and health-related outcomes of positive body image in adolescent girls. In so doing, the modified acceptance model of intuitive eating was also examined longitudinally. A sample of 298 girls aged 12 to 16 years completed a questionnaire containing measures of body appreciation, potential…

  19. Positive psychology outcome measures for family caregivers of people living with dementia: a systematic review

    NARCIS (Netherlands)

    Stansfeld, J.; Stoner, C.R.; Wenborn, J.; Vernooij-Dassen, M.J.F.J.; Moniz-Cook, E.; Orrell, M.

    2017-01-01

    BACKGROUND: Family caregivers of people living with dementia can have both positive and negative experiences of caregiving. Despite this, existing outcome measures predominately focus on negative aspects of caregiving such as burden and depression. This review aimed to evaluate the development and

  20. Impact of a goal setting and decision support telephone coaching intervention on diet, psychosocial, and decision outcomes among people with type 2 diabetes.

    Science.gov (United States)

    Swoboda, Christine M; Miller, Carla K; Wills, Celia E

    2017-07-01

    Evaluate a 16-week decision support and goal-setting intervention to compare diet quality, decision, and diabetes-related outcomes to a control group. Adults with type 2 diabetes (n=54) were randomly assigned to an intervention or control group. Intervention group participants completed one in-person motivational interviewing and decision support session followed by seven biweekly telephone coaching calls. Participants reported previous goal attempts and set diet- and/or physical activity-related goals during coaching calls. Control group participants received information about local health care resources on the same contact schedule. There was a significant difference between groups for diabetes empowerment (p=0.045). A significant increase in diet quality, diabetes self-efficacy, and diabetes empowerment, and a significant decrease in diabetes distress and depressive symptoms (all p≤0.05) occurred in the intervention group. Decision confidence to achieve diet-related goals significantly improved from baseline to week 8 but then declined at study end (both p≤0.05). Setting specific diet-related goals may promote dietary change, and telephone coaching can improve psychosocial outcomes related to diabetes self-management. Informed shared decision making can facilitate progressively challenging yet attainable goals tailored to individuals' lifestyle. Decision coaching may empower patients to improve self-management practices and reduce distress. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Problem coping skills, psychosocial adversities and mental health problems in children and adolescents as predictors of criminal outcomes in young adulthood.

    Science.gov (United States)

    Aebi, Marcel; Giger, Joël; Plattner, Belinda; Metzke, Christa Winkler; Steinhausen, Hans-Christoph

    2014-05-01

    The purpose of this study was to test child and adolescent psychosocial and psychopathological risk factors as predictors of adult criminal outcomes in a Swiss community sample. In particular, the role of active and avoidant problem coping in youths was analysed. Prevalence rates of young adult crime convictions based on register data were calculated. Univariate and multivariate logistic regressions were used to analyse the prediction of adult criminal convictions 15 years after assessment in a large Swiss community sample of children and adolescents (n = 1,086). Risk factors assessed in childhood and adolescence included socio-economic status (SES), migration background, perceived parental behaviour, familial and other social stressors, coping styles, externalizing and internalizing problems and drug abuse including problematic alcohol consumption. The rate of any young adult conviction was 10.1 %. Besides externalizing problems and problematic alcohol consumption, the presence of any criminal conviction in young adulthood was predicted by low SES and avoidant coping even after controlling for the effects of externalizing problems and problematic alcohol use. The other predictors were significant only when externalizing behaviours and problematic alcohol use were not controlled. In addition to child and adolescent externalizing behaviour problems and substance use, low SES and inadequate problem-solving skills, in terms of avoidant coping, are major risk factors of young adult criminal outcomes and need to be considered in forensic research and criminal prevention programs.

  2. Psychosocial and Clinical Outcomes of a Cognitive Behavioral Therapy for Asians and Pacific Islanders with Type 2 Diabetes: A Randomized Clinical Trial.

    Science.gov (United States)

    Inouye, Jillian; Li, Dongmei; Davis, James; Arakaki, Richard

    2015-11-01

    Asian Americans and Pacific Islanders are twice as likely to be diagnosed with type 2 diabetes compared to Caucasians. The objective was to determine the effect of cognitive behavioral therapy on quality of life, general health perceptions, depressive symptoms, and glycemia in Asians and Pacific Islanders with type 2 diabetes. The design was a randomized controlled clinical trial comparing cognitive behavioral therapy to diabetes education and support for six weekly sessions. Participants were recruited from two endocrinology practices; 207 were enrolled. The cognitive behavioral therapy group was provided self-management tools which included biofeedback, breathing exercises, and stress relievers, while the diabetes education and support group included diabetes education and group discussions. Assessments of psychosocial and clinical outcomes were obtained before and after sessions and 12 months PostSession. Differences between the two groups were examined using linear mixed-effects models with linear contrasts. The cognitive behavioral therapy group had improved depressive symptom scores from PreSession to EndSession compared to the diabetes education and support group (P < .03), but the improvement did not extend to 12 months PostSession. Similar results were observed with misguided support scores in the Multidimensional Diabetes Questionnaire (P < .03) and susceptibility in health beliefs (P < .01), but no significant differences in HbA1c improvement were found between the two groups. Both interventions improved outcomes from baseline but were not sustained for 1 year.

  3. The Swiss Transplant Cohort Study's framework for assessing lifelong psychosocial factors in solid-organ transplants.

    Science.gov (United States)

    De Geest, Sabina; Burkhalter, Hanna; Berben, Lut; Bogert, Laura Jane; Denhaerynck, Kris; Glass, Tracy R; Goetzmann, Lutz; Kirsch, Monika; Kiss, Alexander; Koller, Michael T; Piot-Ziegler, Chantal; Schmidt-Trucksäss, Arno

    2013-09-01

    Understanding outcomes after transplant requires a biopsychosocial model that includes biomedical and psychosocial factors. The latter, to date, are assessed only in a limited way as part of transplant registries or cohort studies. The Swiss Transplant Cohort Study (STCS) is a nationwide open cohort study (starting May 2008) to systematically and prospectively assess psychosocial factors. This article describes the framework underpinning STCS's psychosocial assessment. The STCS framework was adapted from the multidimensional conceptual perspective of Dew et al to describe transplant psychosocial domains and specific outcomes by adding a time perspective, a system perspective, and interaction among domains. We propose a multidimensional, multilevel biopsychosocial framework representing mutually influencing domains from before to after transplant, and exemplify each domain by factors included in STCS and their measurement. The transplant patient, centrally positioned, is described by clinical and sociodemographic characteristics (eg, socioeconomic status, educational, professional, and relationship status). The following psychosocial domains further describe the patient: (1) physical/functional (eg, perceived health status, sleep quality, daytime sleepiness), (2) psychological (eg, depression, stress), (3) behavioral (eg, medication adherence, smoking, drug use, physical activity, sun protection), (4) social (eg, work capacity/return to work), and (5) global quality of life. Factors associated with health care system level (eg, trust in transplant team) are also included in the model. The STCS's psychosocial framework provides a basis for studying the interplay of biomedical, sociodemographic, psychosocial, behavioral, and health care system factors in view of transplant outcomes and therefore has the potential to guide biopsychosocial transplant research.

  4. [Serological and nutritional outcome of infants born to HIV positive mothers undergoing option B + therapy in Guédiawaye].

    Science.gov (United States)

    Baptiste, Diouf Jean; Djibril, Diallo; Assane, Sylla; Ngagne, Mbaye; Baly, Ouattara; Ousmane, Ndiaye

    2016-01-01

    As part of its Plan to eliminate mother-to-child transmission of HIV, Senegal has adopted, since 2012, WHO's B + option, which consists of systematic triple therapy for HIV-positive pregnant women associated with breastfeeding and antiretroviral (ARV) prophylaxis for their infants. Our study aims to analyze the risks of mother-to-child transmission of HIV and the nutritional outcome of infants undergoing B + option. We conducted a descriptive, retrospective study at the King Baudouin health center in Guédiaway from 1 September 2012 to 30 April 2015. All infants whose mothers were on triple therapy, undergoing protected breastfeeding, ARV prophylaxis and serological test at 14th months were included in the study. The parameters studied were mother's age and serological profile, father's serological status, the sharing of the status within the couple, infant nourishing, infant ARV prophylaxis, nutritional status at 6 and 12 months and serological status of the infant at 14 months. Out of the 126 infants undergoing PMTCT program, 42 or 33.33% of infants following the B + guidelines were included in the study. The age of mothers ranged from 15 to 42 years, with an average age of 31 years. The majority of mothers (88.1%) carried type 1 virus and 11.9% carried type 2 virus; 20 couples (47.62%) were sero-concordant, 14 were serodifferent, while the serological status was unknown or not investigated in 8 fathers (19.05%). A significant difference between fathers' serological profile and the sharing status (p option is an effective strategy to reduce the MTCT rate. However, early malnutrition in children requires nutritional support for breastfeeding mothers as well as a good psychosocial support.

  5. Linear and nonlinear relations between psychosocial job characteristics, subjective outcomes, and sickness absence : baseline results from SMASH

    NARCIS (Netherlands)

    Jonge, J. de; Houtman, I.L.D.; Bongers, P.M.; Reuvers, M.M.E.N.; Kompier, M.A.J.

    2000-01-01

    This study investigates the demand-control-support (DCS) model by (a) using a more focused measure of job control, (b) testing for interactive and nonlinear relationships, and (c) further extending the model to the prediction of an objective outcome measure (i.e., company-administrated sickness

  6. Linear and non-linear relations between psychosocial job characteristics, subjective outcomes, and sickness absence: baseline results from SMASH

    NARCIS (Netherlands)

    Jonge, J. de; Reuvers, M.M.E.N.; Houtman, I.L.D.; Bongers, P.M.; Kompier, M.A.J.

    2000-01-01

    This study investigates the demand-control-support (DCS) model by (a) using a more focused measure of job control, (b) testing for interactive and nonlinear relationships, and (c) further extending the model to the prediction of an objective outcome measure (i.e., company-administrated sickness

  7. Developmental Language Disorders--A Follow-Up in Later Adult Life. Cognitive, Language and Psychosocial Outcomes

    Science.gov (United States)

    Clegg, J.; Hollis, C.; Mawhood, L.; Rutter, M.

    2005-01-01

    Background: Little is known on the adult outcome and longitudinal trajectory of childhood developmental language disorders (DLD) and on the prognostic predictors. Method: Seventeen men with a severe receptive DLD in childhood, reassessed in middle childhood and early adult life, were studied again in their mid-thirties with tests of intelligence…

  8. The outcome of infected total knee arthroplasty: culture-positive versus culture-negative.

    Science.gov (United States)

    Kim, Young-Hoo; Park, Jang-Won; Kim, Jun-Shik; Kim, Dong-Jin

    2015-10-01

    We studied the outcome in culture-positive and culture-negative infected total knee arthroplasty (TKA). We retrospectively reviewed 140 patients with culture-positive and 102 patients with culture-negative infected TKAs. We determined the infection control rate and clinical outcome after repeated debridement, and repeated 2-stage TKA in the culture-positive and culture-negative groups. The mean follow-up was 9.3 years (range 5-14 years) in the culture-positive group and 10.6 years (5-22) in the culture-negative group. The overall infection control rate was 56 % in both groups after the first treatment. The overall infection control rate was 90 % in the culture-positive group and 95 % in the culture-negative group. A functional knee was obtained in 90 % in the culture-positive group and 95 % in the culture-negative group. The data suggest that treatment according to the types of infection in both culture-positive and culture-negative groups after TKA controlled infection and maintained functional TKA with a firm level of fixation for most patients. Repeated debridement and repeated two-stage exchange TKA further improved infection control rates after the initial treatment and increased the likelihood of maintaining a functional TKA.

  9. Frequency of head-impact-related outcomes by position in NCAA division I collegiate football players.

    Science.gov (United States)

    Baugh, Christine M; Kiernan, Patrick T; Kroshus, Emily; Daneshvar, Daniel H; Montenigro, Philip H; McKee, Ann C; Stern, Robert A

    2015-03-01

    Concussions and subconcussive impacts sustained in American football have been associated with short- and long-term neurological impairment, but differences in head impact outcomes across playing positions are not well understood. The American Medical Society for Sports Medicine has identified playing position as a key risk factor for concussion in football and one for which additional research is needed. This study examined variation in head impact outcomes across primary football playing positions in a group of 730 National Collegiate Athletic Association Division I Football Championship Series athletes, using a self-report questionnaire. Although there were no significant differences between position groups in the number of diagnosed concussions during the 2012 football season, there were significant differences between groups in undiagnosed concussions (p=0.008) and "dings" (pfootball season, with offensive linemen reporting significantly more symptoms compared to most other groups. There were also positional differences in frequency of returning to play while symptomatic (p<0.001) and frequency of participating in full-contact practice (p<0.001). Offensive linemen reported having returned to play while experiencing symptoms more frequently and participating in more full-contact practices than other groups. These findings suggest that offensive linemen, a position group that experiences frequent, but low-magnitude, head impacts, develop more postimpact symptoms than other playing positions, but do not report these symptoms as a concussion.

  10. Frequency of Head-Impact–Related Outcomes by Position in NCAA Division I Collegiate Football Players

    Science.gov (United States)

    Kiernan, Patrick T.; Kroshus, Emily; Daneshvar, Daniel H.; Montenigro, Philip H.; McKee, Ann C.; Stern, Robert A.

    2015-01-01

    Abstract Concussions and subconcussive impacts sustained in American football have been associated with short- and long-term neurological impairment, but differences in head impact outcomes across playing positions are not well understood. The American Medical Society for Sports Medicine has identified playing position as a key risk factor for concussion in football and one for which additional research is needed. This study examined variation in head impact outcomes across primary football playing positions in a group of 730 National Collegiate Athletic Association Division I Football Championship Series athletes, using a self-report questionnaire. Although there were no significant differences between position groups in the number of diagnosed concussions during the 2012 football season, there were significant differences between groups in undiagnosed concussions (p=0.008) and “dings” (pfootball season, with offensive linemen reporting significantly more symptoms compared to most other groups. There were also positional differences in frequency of returning to play while symptomatic (p<0.001) and frequency of participating in full-contact practice (p<0.001). Offensive linemen reported having returned to play while experiencing symptoms more frequently and participating in more full-contact practices than other groups. These findings suggest that offensive linemen, a position group that experiences frequent, but low-magnitude, head impacts, develop more postimpact symptoms than other playing positions, but do not report these symptoms as a concussion. PMID:25155288

  11. Right ventricular pacemaker lead position is associated with differences in long-term outcomes and complications.

    Science.gov (United States)

    Witt, Chance M; Lenz, Charles J; Shih, Henry H; Ebrille, Elisa; Rosenbaum, Andrew N; van Zyl, Martin; Aung, Htin; Manocha, Kevin K; Deshmukh, Abhishek J; Hodge, David O; Mulpuru, Siva K; Cha, Yong-Mei; Espinosa, Raul E; Asirvatham, Samuel J; Mcleod, Christopher J

    2017-08-01

    Cardiac pacing from the right ventricular apex is associated with detrimental long-term effects and nonapical pacing locations may be associated with improved outcomes. There is little data regarding complications with nonapical lead positions. The aim of this study was to assess long-term outcomes and lead-related complications associated with differing ventricular lead tip position. All adult patients who underwent dual-chamber pacemaker implantation from 2004 to 2014 were included if they had postprocedure chest radiographs amenable to lead position determination. Long-term outcomes and lead-related complication rates were recorded. These were compared at 5 years between: (1) apical and septal leads, (2) apical and nonseptal nonapical (NSNA), and (3) apical and septal with >40% ventricular pacing. We retrospectively evaluated 3,450 patients, which included 238 with a septal position and 733 with NSNA lead positions. Septal lead position was associated with a lower mortality compared to apical leads (24% vs. 31%, P = 0.02). In patients with greater than 40% pacing, septal leads were associated with significantly higher rates of incident atrial fibrillation compared to apical leads (49% vs. 34%, P = 0.04). NSNA positions were associated with a significantly higher rate of lead dislodgement (4% vs. 2%, P = 0.005) and need for revision (8% vs. 5%, P = 0.005). Septal pacemaker lead position is associated with a lower mortality compared to apically placed leads, but a higher incidence of atrial fibrillation with higher percentage ventricular pacing. NSNA lead locations are associated with more complications and should be avoided. © 2017 Wiley Periodicals, Inc.

  12. How psychosocial factors affect well-being of practice assistants at work in general medical care?--a questionnaire survey.

    Science.gov (United States)

    Goetz, Katja; Berger, Sarah; Gavartina, Amina; Zaroti, Stavria; Szecsenyi, Joachim

    2015-11-11

    Well-being at work is an important aspect of a workforce strategy. The aim of the study was to explore and evaluate psychosocial factors and health and work-related outcomes of practices assistants depending on their employment status in general medical practices. This observational study was based on a questionnaire survey to evaluate psychosocial aspects at work in general medical practices. A standardized questionnaire was used, the Copenhagen Psychosocial Questionnaire (COPSOQ). Beside descriptive analyses linear regression analyses were performed for each health and work-related outcome scale of the COPSOQ. 586 practice assistants out of 794 respondents (73.8 %) from 234 general medical practices completed the questionnaire. Practice assistants reported the highest scores for the psychosocial factor 'sense of community' (mean = 85.9) and the lower score for 'influence at work' (mean = 41.2). Moreover, practice assistants who worked part-time rated their psychosocial factors at work and health-related outcomes more positively than full-time employees. Furthermore, the two scales of health related outcomes 'burnout' and 'job satisfaction' showed strong associations between different psychosocial factors and socio-demographic variables. Psychosocial factors at work influence well-being at work and could be strong risk factors for poor health and work-related outcomes. Effective management of these issues could have an impact on the retention and recruitment of health care staff.

  13. Communication, Psychosocial, and Educational Outcomes of Children with Cochlear Implants and Challenges Remaining for Professionals and Parents

    Directory of Open Access Journals (Sweden)

    Renée Punch

    2011-01-01

    Full Text Available This paper provides an overview and a synthesis of the findings of a large, multifaceted study investigating outcomes from paediatric cochlear implantation. The study included children implanted at several Australian implant clinics and attending a variety of early intervention and educational settings across a range of locations in eastern Australia. It investigated three major aspects of childhood cochlear implantation: (1 parental expectations of their children's implantation, (2 families' decision-making processes, and (3 the communication, social, and educational outcomes of cochlear implantation for deaf children. It employed a mixed-methods approach in which quantitative survey data were gathered from 247 parents and 151 teachers, and qualitative data from semistructured interviews with 27 parents, 15 teachers, and 11 children and adolescents with cochlear implants. The summarised findings highlight several areas where challenges remain for implant clinics, parents, and educators if children with cochlear implants are to reach their full potential personally, educationally, and socially.

  14. The key role of psychosocial risk on therapeutic outcome in obese children and adolescents. Results from a longitudinal multicenter study.

    OpenAIRE

    Röbl, Markus; de Souza, Martin; Schiel, Ralf; Gellhaus, Ines; Zwiauer, Karl; Holl, Reinhard W.; Wiegand, Susanna

    2013-01-01

    Objective: Childhood obesity is high on the global public health agenda. Although risk factors are well known, the influence of social risk on the therapeutic outcome of lifestyle intervention is poorly examined. This study aims to investigate the influence of migration background, low education, and parental unemployment. Methods: 62,147 patients participated in multidimensional lifestyle intervention programs in 179 pediatric obesity centers. Data were collected using standardized software ...

  15. The effect of antenatal education in small classes on obstetric and psycho-social outcomes: a systematic review and meta-analysis protocol.

    Science.gov (United States)

    Brixval, Carina Sjöberg; Axelsen, Solveig Forberg; Andersen, Stig Krøger; Due, Pernille; Koushede, Vibeke

    2014-02-13

    The aims of antenatal education contain both outcomes related to pregnancy, birth and parenthood. Both content and methods of antenatal education have changed over time without evidence of effects on relevant outcomes. The effect of antenatal education in groups, with participation of a small number of participants, may differ from the effect of other forms of antenatal education. The latest Cochrane review, assessed as up-to-date in 2007, concluded that the effect of antenatal education for childbirth or parenthood or both remains largely unknown. This systematic review and meta-analysis aims to assess the effects of antenatal education in small groups on obstetric as well as psycho-social outcomes. Eligible studies include individually randomized as well as cluster-randomized trials irrespective of language, publication year, publication type, and publication status. Only interventions carried out in the Western world will be considered in this review. We will search the databases Medline, EMBASE, CENTRAL, CINAHL, Web of Science, and PsycINFO using relevant search terms. Two independent review authors will extract data and assess risk of bias. Results will be presented as structured summaries of the included trials. A meta-analysis will be conducted. We will assess heterogeneity by using both the Chi-squared test and the I-squared statistic, and conduct subgroup analysis separately for various intervention types. In healthcare systems with limited resources evidence of the effectiveness of services provided is important for decision making, and there is a need for policy makers to implement changes in healthcare systems based on scientific evidence. The effectiveness of antenatal education in small classes is still questioned. Therefore an up-to-date systematic review is needed.This systematic review protocol was registered within the International Prospective Register of Systematic Reviews (PROSPERO) as number CRD42013004319.

  16. The key role of psychosocial risk on therapeutic outcome in obese children and adolescents. Results from a longitudinal multicenter study.

    Science.gov (United States)

    Röbl, Markus; de Souza, Martin; Schiel, Ralf; Gellhaus, Ines; Zwiauer, Karl; Holl, Reinhard W; Wiegand, Susanna

    2013-01-01

    Childhood obesity is high on the global public health agenda. Although risk factors are well known, the influence of social risk on the therapeutic outcome of lifestyle intervention is poorly examined. This study aims to investigate the influence of migration background, low education, and parental unemployment. 62,147 patients participated in multidimensional lifestyle intervention programs in 179 pediatric obesity centers. Data were collected using standardized software for longitudinal multicenter documentation. 12,305 (19.8%) attended care for 6-24 months, undergoing an intensive therapy period and subsequent follow-ups for up to 3 years. A cumulative social risk score was calculated based on different risk indicators. Migration background, low education, and parental employment significantly influenced the outcome of lifestyle intervention. The observed BMI-SDS reduction was significantly higher in the subgroup with low social risks factors (Δ BMI-SDS -0.19) compared to those presenting moderate (Δ BMI-SDS -0.14) and high social risk (Δ BMI-SDS -0.11). Our data underline the effect of children's social setting on the outcome of multidimensional lifestyle intervention. The presence of a high social risk burden is a negative predictor for successful weight loss. Specific therapeutic programs need to be developed for disadvantaged children and adolescents. Copyright © 2013 S. Karger GmbH, Freiburg

  17. The Key Role of Psychosocial Risk on Therapeutic Outcome in Obese Children and Adolescents. Results from a Longitudinal Multicenter Study

    Directory of Open Access Journals (Sweden)

    Markus Röbl

    2013-06-01

    Full Text Available Objective: Childhood obesity is high on the global public health agenda. Although risk factors are well known, the influence of social risk on the therapeutic outcome of lifestyle intervention is poorly examined. This study aims to investigate the influence of migration background, low education, and parental unemployment. Methods: 62,147 patients participated in multidimensional lifestyle intervention programs in 179 pediatric obesity centers. Data were collected using standardized software for longitudinal multicenter documentation. 12,305 (19.8% attended care for 6-24 months, undergoing an intensive therapy period and subsequent follow-ups for up to 3 years. A cumulative social risk score was calculated based on different risk indicators. Results: Migration background, low education, and parental employment significantly influenced the outcome of lifestyle intervention. The observed BMI-SDS reduction was significantly higher in the subgroup with low social risks factors (Δ BMI-SDS -0.19 compared to those presenting moderate (Δ BMI-SDS -0.14 and high social risk (Δ BMI-SDS -0.11. Conclusion: Our data underline the effect of children's social setting on the outcome of multidimensional lifestyle intervention. The presence of a high social risk burden is a negative predictor for successful weight loss. Specific therapeutic programs need to be developed for disadvantaged children and adolescents.

  18. Negative relationship behavior is more important than positive: Correlates of outcomes during stressful life events.

    Science.gov (United States)

    Rivers, Alannah Shelby; Sanford, Keith

    2018-04-01

    When people who are married or cohabiting face stressful life situations, their ability to cope may be associated with two separate dimensions of interpersonal behavior: positive and negative. These behaviors can be assessed with the Couple Resilience Inventory (CRI). It was expected that scales on this instrument would correlate with outcome variables regarding life well-being, stress, and relationship satisfaction. It was also expected that effects for negative behavior would be larger than effects for positive and that the effects might be curvilinear. Study 1 included 325 married or cohabiting people currently experiencing nonmedical major life stressors and Study 2 included 154 married or cohabiting people with current, serious medical conditions. All participants completed an online questionnaire including the CRI along with an alternate measure of couple behavior (to confirm scale validity), a measure of general coping style (to serve as a covariate), and measures of outcome variables regarding well-being, quality of life, perceived stress, and relationship satisfaction. The effects for negative behavior were larger than effects for positive in predicting most outcomes, and many effects were curvilinear. Notably, results remained significant after controlling for general coping style, and scales measuring positive and negative behavior demonstrated comparable levels of validity. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  19. Enhancing Psychosocial Outcomes for Young Adult Childhood CNS Cancer Survivors: Importance of Addressing Vocational Identity and Community Integration

    Science.gov (United States)

    Strauser, David R.; Wagner, Stacia; Wong, Alex W. K.

    2012-01-01

    The purpose of this study was to examine the relationship between vocational identity, community integration, positive and negative affect, and satisfaction with life in a group of young adult central nervous system (CNS) cancer survivors. Participants in this study included 45 young adult CNS cancer survivors who ranged in age from 18 to 30 years…

  20. Society of Behavioral Medicine (SBM) position statement: improving access to psychosocial care for individuals with persistent pain: supporting the National Pain Strategy's call for interdisciplinary pain care.

    Science.gov (United States)

    Janke, E Amy; Cheatle, Martin; Keefe, Francis J; Dhingra, Lara

    2018-03-01

    Policy makers have articulated a need for clear, evidence-based guidance to help inform pain policy. Persistent pain is common, expensive, and debilitating, and requires comprehensive assessment and treatment planning. Recently released opioid prescribing guidelines by the CDC (2016) emphasize the importance of using nonopioid therapies before considering opioid treatment for those without a malignant illness. The National Pain Strategy (2016) underscores the importance of comprehensive, interdisciplinary pain care. Unfortunately, despite persuasive evidence supporting the efficacy of psychosocial approaches, these interventions are inaccessible to the majority of Americans. Psychosocial approaches to pain management should be available for all individuals with persistent pain and in all health care settings and contexts as part of the comprehensive, interdisciplinary approach to pain care as outlined in the National Pain Strategy. To achieve this, we must prioritize reimbursement of evidence-based psychosocial approaches for pain assessment and management and improve provider training and competencies to implement these approaches.

  1. Perinatal Outcomes in HIV Positive Pregnant Women with Concomitant Sexually Transmitted Infections

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    Erin Burnett

    2015-01-01

    Full Text Available Objective. To evaluate whether HIV infected pregnant women with concomitant sexually transmitted infection (STIs are at increased risk of adverse perinatal and neonatal outcomes. Methods. We conducted a cohort study of HIV positive women who delivered at an inner-city hospital in Atlanta, Georgia, from 2003 to 2013. Demographics, presence of concomitant STIs, prenatal care information, and maternal and neonatal outcomes were collected. The outcomes examined were the association of the presence of concomitant STIs on the risk of preterm birth (PTB, postpartum hemorrhage, chorioamnionitis, preeclampsia, intrauterine growth restriction, small for gestational age, low Apgar scores, and neonatal intensive care admission. Multiple logistic regression was performed to adjust for potential confounders. Results. HIV positive pregnant women with concomitant STIs had an increased risk of spontaneous PTB (odds ratio (OR 2.11, 95% confidence interval [CI] 1.12–3.97. After adjusting for a history of preterm birth, maternal age, and low CD4+ count at prenatal care entry the association between concomitant STIs and spontaneous PTB persisted (adjusted OR 1.96, 95% CI 1.01–3.78. Conclusions. HIV infected pregnant women with concomitant STIs relative to HIV positive pregnant women without a concomitant STI are at increased risk of spontaneous PTB.

  2. Long-Term Functional and Psychosocial Outcomes After Hypoxic-Ischemic Brain Injury: A Case-Controlled Comparison to Traumatic Brain Injury.

    Science.gov (United States)

    Harbinson, Meredith; Zarshenas, Sareh; Cullen, Nora K

    2017-12-01

    Despite the increasing rate of survival from hypoxic-ischemic brain injury (HIBI), there is a paucity of evidence on the long-term functional outcomes after inpatient rehabilitation among these nontrauma patients compared to patients with traumatic brain injury (TBI). To compare functional and psychosocial outcomes of patients with HIBI to those of case-matched patients with TBI 4-11 years after brain insult. Retrospective, matched case-controlled study. Data at the time of rehabilitation admission and discharge were collected as part of a larger acquired brain injury (ABI) database at Toronto Rehabilitation Institute (TRI) between 1999 and 2009. This study consisted of 11 patients with HIBI and 11 patients with TBI that attended the neuro-rehabilitation day program at TRI during a similar time frame and were matched on age, admission Functional Independence Measure (FIM) scores, and acute care length of stay (ALOS). At 4-11 years following brain insult, patients were reassessed using the FIM, Disability Rating Scale (DRS), Personal Health Questionnaire Depression Scale (PHQ-9), and the Mayo-Portland Adaptability Inventory 4 (MPAI-4). At follow-up, patients with HIBI had significantly lower FIM motor and cognitive scores than patients with TBI (75.3 ± 20.6 versus 88.1 ± 4.78, P MPAI-4 at follow-up (P < .05). The study results suggest that patients with HIBI achieve less long-term functional improvements compared to patients with TBI. Further research is warranted to compare the components of inpatient rehabilitation while adjusting for demographics and clinical characteristics between these 2 groups of patients. III. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  3. The PiGeOn project: protocol for a longitudinal study examining psychosocial, behavioural and ethical issues and outcomes in cancer tumour genomic profiling.

    Science.gov (United States)

    Best, Megan; Newson, Ainsley J; Meiser, Bettina; Juraskova, Ilona; Goldstein, David; Tucker, Kathy; Ballinger, Mandy L; Hess, Dominique; Schlub, Timothy E; Biesecker, Barbara; Vines, Richard; Vines, Kate; Thomas, David; Young, Mary-Anne; Savard, Jacqueline; Jacobs, Chris; Butow, Phyllis

    2018-04-05

    Genomic sequencing in cancer (both tumour and germline), and development of therapies targeted to tumour genetic status, hold great promise for improvement of patient outcomes. However, the imminent introduction of genomics into clinical practice calls for better understanding of how patients value, experience, and cope with this novel technology and its often complex results. Here we describe a protocol for a novel mixed-methods, prospective study (PiGeOn) that aims to examine patients' psychosocial, cognitive, affective and behavioural responses to tumour genomic profiling and to integrate a parallel critical ethical analysis of returning results. This is a cohort sub-study of a parent tumour genomic profiling programme enrolling patients with advanced cancer. One thousand patients will be recruited for the parent study in Sydney, Australia from 2016 to 2019. They will be asked to complete surveys at baseline, three, and five months. Primary outcomes are: knowledge, preferences, attitudes and values. A purposively sampled subset of patients will be asked to participate in three semi-structured interviews (at each time point) to provide deeper data interpretation. Relevant ethical themes will be critically analysed to iteratively develop or refine normative ethical concepts or frameworks currently used in the return of genetic information. This will be the first Australian study to collect longitudinal data on cancer patients' experience of tumour genomic profiling. Findings will be used to inform ongoing ethical debates on issues such as how to effectively obtain informed consent for genomic profiling return results, distinguish between research and clinical practice and manage patient expectations. The combination of quantitative and qualitative methods will provide comprehensive and critical data on how patients cope with 'actionable' and 'non-actionable' results. This information is needed to ensure that when tumour genomic profiling becomes part of routine

  4. Psychosocial and psychosexual aspects of disorders of sex development

    NARCIS (Netherlands)

    Cohen-Kettenis, P.T.

    2010-01-01

    Psychosocial aspects of the treatment of disorders of sex development (DSDs) concern gender assignment, information management and communication, timing of medical interventions, consequences of surgery, and sexuality. Although outcome is often satisfactory, a variety of medical and psychosocial

  5. Predictors and health-related outcomes of positive body image in adolescent girls: A prospective study.

    Science.gov (United States)

    Andrew, Rachel; Tiggemann, Marika; Clark, Levina

    2016-03-01

    This study aimed to investigate prospective predictors and health-related outcomes of positive body image in adolescent girls. In so doing, the modified acceptance model of intuitive eating was also examined longitudinally. A sample of 298 girls aged 12 to 16 years completed a questionnaire containing measures of body appreciation, potential predictors, and a range of health outcomes, at 2 time points separated by 1 year. Longitudinal change regression models showed that perceived body acceptance by others (positively), self-objectification and social comparison (negatively), and body appreciation (positively) prospectively predicted intuitive eating 1 year later, consistent with the acceptance model of intuitive eating. Perceived body acceptance by others was the only proposed predictor to prospectively predict an increase in body appreciation over time. Time 1 body appreciation prospectively predicted a decrease in dieting, alcohol, and cigarette use, and an increase in physical activity 1 year later. In particular, girls with low body appreciation were more likely than girls with high body appreciation to take up alcohol and cigarette use between time points. The results highlight body appreciation as an important target for interventions designed to prevent or delay the uptake of alcohol and cigarette consumption among girls. More broadly, they suggest that a positive body image can confer considerable benefit for adolescent girls. (c) 2016 APA, all rights reserved).

  6. What interventions can improve quality of life or psychosocial factors of individuals with knee osteoarthritis? A systematic review with meta-analysis of primary outcomes from randomised controlled trials.

    Science.gov (United States)

    Briani, Ronaldo Valdir; Ferreira, Amanda Schenatto; Pazzinatto, Marcella Ferraz; Pappas, Evangelos; De Oliveira Silva, Danilo; Azevedo, Fábio Mícolis de

    2018-03-16

    To systematically review evidence of primary outcomes from randomised controlled trials (RCTs) examining the effect of treatment strategies on quality of life (QoL) or psychosocial factors in individuals with knee osteoarthritis (OA). Systematic review with meta-analysis. Medline, Embase, SPORTDiscus, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science were searched from inception to November 2017. We included RCTs investigating the effect of conservative interventions on QoL or psychosocial factors in individuals with knee OA. Only RCTs considering these outcomes as primary were included. Pooled data supported the use of exercise therapy compared with controls for improving health-related and knee-related QoL. There was limited evidence that a combined treatment of yoga, transcutaneous electrical stimulation and ultrasound may be effective in improving QoL. Limited evidence supported the use of cognitive behavioural therapies (with or without being combined with exercise therapy) for improving psychosocial factors such as self-efficacy, depression and psychological distress. Exercise therapy (with or without being combined with other interventions) seems to be effective in improving health-related and knee-related QoL or psychosocial factors of individuals with knee OA. In addition, evidence supports the use of cognitive behavioural therapies (with or without exercise therapy) for improving psychosocial factors such as self-efficacy, depression and psychological distress in individuals with knee OA. CRD42016047602. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Functional and Psychosocial Outcomes of Hand Transplantation Compared with Prosthetic Fitting in Below-Elbow Amputees: A Multicenter Cohort Study.

    Directory of Open Access Journals (Sweden)

    Stefan Salminger

    Full Text Available Hand-transplantation and improvements in the field of prostheses opened new frontiers in restoring hand function in below-elbow amputees. Both concepts aim at restoring reliable hand function, however, the indications, advantages and limitations for each treatment must be carefully considered depending on level and extent of amputation. Here we report our findings of a multi-center cohort study comparing hand function and quality-of-life of people with transplanted versus prosthetic hands.Hand function in amputees with either transplant or prostheses was tested with Action Research Arm Test (ARAT, Southampton Hand Assessment Procedure (SHAP and the Disabilities of the Arm, Shoulder and Hand measure (DASH. Quality-of-life was compared with the Short-Form 36 (SF-36.Transplanted patients (n = 5 achieved a mean ARAT score of 40.86 ± 8.07 and an average SHAP score of 75.00 ± 11.06. Prosthetic patients (n = 7 achieved a mean ARAT score of 39.00 ± 3.61 and an average SHAP score of 75.43 ± 10.81. There was no significant difference between transplanted and prosthetic hands in ARAT, SHAP or DASH. While quality-of-life metrics were equivocal for four scales of the SF-36, transplanted patients reported significantly higher scores in "role-physical" (p = 0.006, "vitality" (p = 0.008, "role-emotional" (p = 0.035 and "mental-health" (p = 0.003.The indications for hand transplantation or prosthetic fitting in below-elbow amputees require careful consideration. As functional outcomes were not significantly different between groups, patient's best interests and the route of least harm should guide treatment. Due to the immunosuppressive side-effects, the indication for allotransplantation must still be restrictive, the best being bilateral amputees.

  8. Green Schoolyards in Low-Income Urban Neighborhoods: Natural Spaces for Positive Youth Development Outcomes

    Directory of Open Access Journals (Sweden)

    Carolyn R. Bates

    2018-05-01

    Full Text Available Children from low-income families are increasingly growing up in urban areas with limited access to nature. In these environments, strategies that promote access to natural outdoor spaces, such as green schoolyards, may enhance positive youth development outcomes by promoting physical activity (PA and prosocial behavior, as well as increasing perceptions of safety. The current study examines children’s PA and social interactions, as well as caregiver and teacher perceptions of safety, injuries, teasing/bullying, and gang activity on three newly renovated green schoolyards in low-income urban neighborhoods. A multi-method strategy, including behavioral mapping and caregiver- and teacher-reported surveys, was utilized at three time points to examine positive youth development outcomes and maintenance of effects over time. Analyses revealed that children evidenced a range of PA on the green schoolyards and demonstrated significant decreases in sedentary activity over time. The majority of children were engaged in social interactions with peers on the green schoolyards when observed. Less than 3% of interactions were negative and follow-up analyses found significant increases in positive interactions on the green schoolyards up to 24 months post-renovation. Caregivers and teachers reported increased perceptions of safety, fewer injuries, less teasing/bullying, and less gang-related activity on the renovated green schoolyards in comparison to the pre-renovation schoolyards, and these effects were maintained up to 32 months post-renovation. Overall, the study suggests that green schoolyards may promote positive development outcomes among youth living in urban, low-income neighborhoods by providing natural and safe spaces for PA and prosocial behavior.

  9. Perioperative Desensitization Improves Outcomes Among Crossmatch Positive Recipients of Deceased Donor Renal Transplants.

    Science.gov (United States)

    Sharma, Amit; King, Anne; Kumar, Dhiren; Behnke, Martha; McDougan, Felecia; Kimball, Pamela M

    2016-06-01

    Graft failure due to chronic rejection is greater among renal transplant patients with donor-specific antibody (DSA) than among DSA-free patients. For patients dependent on deceased donor transplantation, preoperative desensitization to eliminate DSAs may be impractical. We speculated that perioperative desensitization might eliminate preexisting DSAs and prevent de novo DSAs and improve graft outcomes. We report that brief perioperative desensitization using either intravenous immunoglobulin (IVIG) or plasmapheresis/IVIG (PP/IVIG) treatment improves clinical outcomes among patients with positive crossmatches. Immediately following deceased donor transplantation, 235 renal recipients were assigned points for PRA and flow crossmatches (FCXM): delayed graft function (DGF) ≤ 1 point received standard therapy; 2 points received high-dose IVIG; and ≥3 points received PP/IVIG. The DSAs were serially monitored by single antigen bead luminex for 1 year. Five-year clinical outcomes were determined from the chart review. All desensitized patients had preoperatively positive FCXM with DSA. Rejection was more common (P desensitized than nonsensitized groups. However, overall graft survivals were similar between the groups (P = not significant) and superior to historic untreated patients (P 90% in all desensitizated patients with DSA elimination as well as PP/IVIG patients with residual DSA. In contrast, IVIG patients with persistent DSA had poorer graft survival (45%, P desensitization improved overall graft survival of sensitized patients compared to historic untreated patients. Plasmapheresis/IVIG had greater impact on DSA eradication and graft survival than IVIG alone. © 2016, NATCO.

  10. Change for the better: an innovative model of care delivering positive patient and workforce outcomes.

    Science.gov (United States)

    Cann, Tina; Gardner, Anne

    2012-01-01

    To evaluate patient and workforce outcomes following the implementation of the Practice Partnership Model of Care. Pre-test-post-test design. A 29-bed surgical ward at a tertiary-level regional hospital. Summary de-identified data from all patients and ward nursing staff in the study period. The Practice Partnership Model of Care has four main components: working in partnership; clinical handover at the bedside; comfort rounds; and environmental modifications. These reflect patient-centered and quality focused initiatives and use a total quality improvement framework that aims to transform care at the bedside. Patient outcomes: changes in patient safety (measured by numbers of medication errors and patient falls); satisfaction with care (use of the call bell system, number of complaints and compliments). Workforce outcomes: changes in staff satisfaction (measured through staff sick leave). A statistically significant reduction in use of nurse call bells (p=<0.001) post-implementation. Medication errors and patient falls reduced, with an overall reduction of 4% in staff sick leave. The Practice Partnership Model of Care positively affected patient and workforce outcomes, suggesting further exploration of this model in other hospital contexts is warranted.

  11. Moderating effect of gender on the prospective relation of physical activity with psychosocial outcomes and asthma control in adolescents: a longitudinal study

    NARCIS (Netherlands)

    Tiggelman, D.; Ven, M.O.M. van de; Schayck, C.P. van; Engels, R.C.M.E.

    2014-01-01

    Objective: Adolescents with asthma experience more psychosocial and physiological problems compared to their healthy peers. Physical activity (PA) might decrease these problems. This study was the first observational longitudinal study to examine whether habitual PA could predict changes in

  12. Pregnancy outcomes in HIV-positive women: a retrospective cohort study.

    Science.gov (United States)

    Arab, Kholoud; Spence, Andrea R; Czuzoj-Shulman, Nicholas; Abenhaim, Haim A

    2017-03-01

    In the United States, an estimated 8500 HIV (human immunodeficiency virus) positive women gave birth in 2014. This rate appears to be increasing annually. Our objective is to examine obstetrical outcomes of pregnancy among HIV-positive women. A population-based cohort study was conducted using the Nationwide Inpatient Sample database (2003-2011) from the United States. Pregnant HIV-positive women were identified and compared to pregnant women without HIV. Multivariate logistic regression was used to estimate the adjusted effect of HIV status on obstetrical and neonatal outcomes. Among 7,772,999 births over the study period, 1997 were in HIV-positive women (an incidence of 25.7/100,000 births). HIV-infected patients had greater frequency of pre-existing diabetes and chronic hypertension, and use of cigarettes, drugs, and alcohol during pregnancy (p HIV-infected women had greater likelihood of antenatal complications: preterm premature rupture of membranes (OR 1.35, 95% CI 1.14-1.60) and urinary tract infections (OR 3.02, 95% CI 2.40-3.81). Delivery and postpartum complications were also increased among HIV-infected women: cesarean delivery (OR 3.06, 95% CI 2.79-3.36), postpartum sepsis (OR 8.05, 95% CI 5.44-11.90), venous thromboembolism (OR 2.21, 95% CI 1.46-3.33), blood transfusions (OR 3.67, 95% CI 3.01-4.49), postpartum infection (OR 3.00, 95% CI 2.37-3.80), and maternal mortality (OR 21.52, 95% CI 12.96-35.72). Neonates born to these mothers were at higher risk of prematurity and intrauterine growth restriction. Pregnancy in HIV-infected women is associated with adverse maternal and newborn complications. Pregnant HIV-positive women should be followed in high-risk healthcare centers.

  13. The acute effects of exercise on cortical excitation and psychosocial outcomes in men treated for prostate cancer: a randomized controlled trial

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    Daniel eSanta Mina

    2014-11-01

    Full Text Available Purpose: Regular exercise improves psychological wellbeing in men treated for prostate cancer. For this population and among cancer survivors in general, the effect of a single bout of exercise on self-report or objective measures of psychological wellbeing has not been examined. We examined the acute effect of a single bout of exercise on the cortical silent period (CSP and on self-reported mood in men that have received treatment for prostate cancer. Methods: Thirty-six prostate cancer survivors were randomly assigned to 60 minutes of low to moderate intensity exercise or to a control condition. Outcomes were assessed immediately before and after either the exercise or the control condition. Results: No significant differences in baseline CSP or mood were observed following the exercise session or control conditions. Participants with higher scores of trait anxiety had significantly shorter CSP at baseline, as well as those receiving androgen deprivation therapy. Age and baseline CSP had a low-moderate, but significant negative correlation. Changes in CSP following the exercise condition were strongly negatively correlated with changes in self-reported vigor. Conclusions: While we did not observe any acute effect of exercise on the CSP in this population, the associations between CSP and trait anxiety, age, and vigor are novel findings requiring further examination.Implications for Cancer Survivors: Exercise did not acutely affect our participants in measures of psychological wellbeing. Additional mechanisms to explain the chronic psychosocial benefits of exercise previously observed in men with prostate cancer require further exploration.Clinicaltrials.gov Identifier: NCT01715064 (http://clinicaltrials.gov/show/NCT01715064

  14. Cognitive appraisals of alcohol use in early adolescence: Psychosocial predictors and reciprocal associations with alcohol use.

    Science.gov (United States)

    Colder, Craig R; Read, Jennifer P; Wieczorek, William F; Eiden, Rina D; Lengua, Liliana J; Hawk, Larry W; Trucco, Elisa M; Lopez-Vergara, Hector I

    2017-04-01

    Early adolescence is a dynamic period for the development of alcohol appraisals (expected outcomes of drinking and subjective evaluations of expected outcomes), yet the literature provides a limited understanding of psychosocial factors that shape these appraisals during this period. This study took a comprehensive view of alcohol appraisals and considered positive and negative alcohol outcome expectancies, as well as subjective evaluations of expected outcomes. Developmental-ecological theory guided examination of individual, peer, family, and neighborhood predictors of cognitive appraisals of alcohol and use. A community sample of 378 adolescents (mean age 11.5 years at Wave 1, 52% female) was assessed annually for 4 years. Longitudinal path analysis suggested that the most robust predictors of alcohol appraisals were peer norms. Furthermore, perceived likelihood of positive and negative alcohol outcomes prospectively predicted increases in drinking. There was limited support for appraisals operating as mediators of psychosocial risk and protective factors.

  15. ALK Positive Lung Cancer: Clinical Profile, Practice and Outcomes in a Developing Country.

    Directory of Open Access Journals (Sweden)

    Vanita Noronha

    Full Text Available To evaluate the performance and treatment profile of advanced EML4-ALK positive Non-small cell lung cancer (NSCLC patients in a developing country with potentially restricted access to Crizotinib.A retrospective analysis of advanced ALK positive NSCLC patients who were treated from June 2012 to September 2015 was conducted. The primary goal was to evaluate outcomes of advanced ALK positive NSCLC in our practice and examine the logistic constraints in procuring Crizotinib.94 patients were available for analysis. 21 (22.3% patients were started on Crizotinib upfront, 60 (63.8% on chemotherapy, 10 (10.6% on Tyrosine kinase inhibitors (in view of poor PS and 3 (3.2% patients were offered best supportive care. Reasons for not starting Crizotinib upfront included symptomatic patients needing early initiation of therapy (23.3%, ALK not tested upfront (23.3% and financial constraints (21.9%. 69 patients (73.4% received Crizotinib at some stage during treatment. Dose interruptions (> 1 week with Crizotinib were seen in 20 patients (29%, with drug toxicity being the commonest reason (85%. Median Progression free survival (PFS on first line therapy for the entire cohort was 10 months, with a significant difference between patients receiving Crizotinib and those who did not ever receive Crizotinib (10 months vs. 2 months, p = 0.028. Median Overall Survival (OS was not reached for the entire cohort, with 1 year survival being 81.2%. Patients with an ECOG Performance Status (PS of >2 had a significantly reduced PFS compared to patients with PS < = 2 (1.5 months vs. 11 months, p< 0.001. 47 patients with financial constraints (68.1% received Crizotinib completely free via various extramural support schemes.A majority of our ALK positive NSCLC patients were exposed to Crizotinib through the help of various support mechanisms and these patients had similar outcomes to that reported from previously published literature.

  16. Tape functionality: position, change in shape, and outcome after TVT procedure--mid-term results.

    Science.gov (United States)

    Kociszewski, Jacek; Rautenberg, Oliver; Kolben, Sebastian; Eberhard, Jakob; Hilgers, Reinhard; Viereck, Volker

    2010-07-01

    This study evaluates the relevance of the tape position and change in shape (tape functionality) under in vivo conditions for mid-term outcome. Changes in the sonographic tension-free vaginal tape (TVT) position relative to the percentage urethral length and the tape-urethra distance were determined after 6 and 48 months in 41 women with stress urinary incontinence. At 48 months, 76% (31/41) of women were cured, 17% (7/41) were improved, and 7% (3/41) were failures. Disturbed bladder voiding was present in 12% (5/41), de novo urge incontinence in 7% (3/41). The median TVT position was at 63% of urethral length. Median tape-urethra distance was 2.7 mm, ranging from 2.9 mm in continent patients without complications to 1.1 mm in those with obstructive complications. Patients with postoperative urine loss had a median distance of 3.9 mm. The tape was stretched at rest and C-shaped during straining in 15 of 41 women (37%) at 48 months (all continent). Patients with this tape functionality at 6 months were also cured at 48 months in 86% of cases (19/22), and only 14% (3/22) showed recurrent incontinence. Mid-term data suggest an optimal outcome if the tape is positioned at least 2 mm from the urethra at the junction of the middle and distal thirds. Patients with optimal tape functionality at 6 months are likely to show mid-term therapeutic success.

  17. Reducing turnover is not enough: The need for proficient organizational cultures to support positive youth outcomes in child welfare.

    Science.gov (United States)

    Williams, Nathaniel J; Glisson, Charles

    2013-11-01

    High caseworker turnover has been identified as a factor in the poor outcomes of child welfare services. However, almost no empirical research has examined the relationship between caseworker turnover and youth outcomes in child welfare systems and there is an important knowledge gap regarding whether, and how, caseworker turnover relates to outcomes for youth. We hypothesized that the effects of caseworker turnover are moderated by organizational culture such that reduced caseworker turnover is only associated with improved youth outcomes in organizations with proficient cultures. The study applied hierarchical linear models (HLM) analysis to the second National Survey of Child and Adolescent Well-being (NSCAW II) with a U.S. nationwide sample of 2,346 youth aged 1.5- to 18-years-old and 1,544 caseworkers in 73 child welfare agencies. Proficient organizational culture was measured by caseworkers' responses to the Organizational Social Context (OSC) measure; staff turnover was reported by the agencies' directors; and youth outcomes were measured as total problems in psychosocial functioning with the Child Behavior Checklist (CBCL) completed by the youths' caregivers at intake and at 18 month follow-up. The association between caseworker turnover and youth outcomes was moderated by organizational culture. Youth outcomes were improved with lower staff turnover in proficient organizational cultures and the best outcomes occurred in organizations with low turnover and high proficiency. To be successful, efforts to improve child welfare services by lowering staff turnover must also create proficient cultures that expect caseworkers to be competent and responsive to the needs of the youth and families they serve.

  18. Alloimmunization due to red cell antibodies in Rhesus positive Omani Pregnant Women: Maternal and Perinatal outcome

    Directory of Open Access Journals (Sweden)

    Tamima Al-Dughaishi

    2015-01-01

    Full Text Available Objective: This study is aimed to determine the prevalence of alloimmunization due to antibodies to red blood cell (RBC antigens (other than rhesus [Rh] antigen and report the maternal, perinatal, and neonatal outcomes. Materials and Methods: A retrospective review of medical records of all patients with minor RBCs antibodies alloimmunization who were followed and delivered at Sultan Qaboos University Hospital, Oman from June 2011 to June 2013. Maternal characteristics, antibody type, antibody titer in addition to perinatal and neonatal outcomes were reviewed. Results: There were 1160 patients with Rh positive status in the study. The most common ABO blood group was O, followed by A, B, and AB. We found 33 out of 1160 Rh positive women alloimmunized with minor RBCs antibodies that gave a prevalence of minor RBCs alloimmunization of 2.7%. The most frequent antibody was anti-E 38%, followed by anti-c 17% and anti-kell 17%. 6 of these 33 patients were identified to have significant antibody titer, and two cases showed evidence of fetal anemia. Only one case required an intrauterine blood transfusion. The most common neonatal complication was jaundice in 53%, followed by respiratory distress syndrome in 28%. Two cases complicated by neonatal anemia required a postnatal blood transfusion. Conclusion: Alloimmunization with anti-E, anti-c, and anti-kell were the most common antibodies among the study group. Minor RBCs alloimmunization was an important cause of neonatal morbidity.

  19. Tibial Sesamoid Position Influence on Functional Outcome and Satisfaction After Hallux Valgus Surgery.

    Science.gov (United States)

    Chen, Jerry Yongqiang; Rikhraj, Kiran; Gatot, Cheryl; Lee, Justine Yun Yu; Singh Rikhraj, Inderjeet

    2016-11-01

    During hallux valgus surgery, the abnormal position of the first metatarsal bone relative to the sesamoids is addressed. Our study aimed to investigate the influence of postoperative tibial sesamoid position (TSP) on functional outcome and patient satisfaction after hallux valgus surgery. Between February 2007 and November 2011, 250 patients who underwent hallux valgus surgery at our tertiary hospital were followed for 2 years after surgery. They were categorized into 2 groups based on Hardy and Clapham's TSP classification, recorded on postoperative weight-bearing anteroposterior (AP) radiographs: (1) normal (grades I-IV) and (2) outliers (grades V-VII). The mode TSP improved from grade VII preoperatively to grade IV postoperatively (P Hallux Metatarsophalangeal-Interphalangeal Scale was 6 (95% CI 2, 11) points higher in the normal group (P = .009). Patients in the outlier group were also more likely to be dissatisfied with the surgery performed when compared to the normal group (OR 3.881, 95% CI 1.689, 8.920, P = .001). We recommend correcting the TSP to grade of IV or less to improve functional outcome and satisfaction after hallux valgus surgery. Level III, retrospective comparative series. © The Author(s) 2016.

  20. [Psychosocial disintegration].

    Science.gov (United States)

    Köhler, S

    1994-08-01

    Among the patients referred for rehabilitation in the latter half of their working life, many are notable due to considerable discrepancies between their objectively ascertainable performance and its subjectively perceived decline. In these cases, the "substantial threat to earning capacity" cannot be explained by measurable organ deficiencies. Similarly, treatment efforts focussed solely at improved somatic functioning remain inefficient in terms of stabilization of earning capacity, because they do not bring about changes in the cause of subjective performance deterioration. The author in these circumstances assumes the presence of an independent syndrome, called "psychosocial disintegration". He describes the full picture of this disease entity, and suggests causal mechanisms as well as potential for remedial intervention. On account of the considerable social dimension of the disorder outlined, early identification of these gradually developing changes as well as qualified care of the insurants are indispensable. All those involved in treatment and care of the patients or working in some branch of the social security system should be familiar with this psychosocial disintegration syndrome in order to avoid the guidance and counselling mistakes that are frequently the case. As rehabilitation is impossible in case of inhibiting personal attitudes of an insurant, it is advisable to verify the individual's readiness for rehabilitation and/or to strengthen it by appropriate measures before engaging in costly in-patient service provision. If the needed motivation is to be achieved during participation in a rehabilitation measure, extended service provision will invariably be required.

  1. Gestational surrogacy: Psychosocial aspects

    Directory of Open Access Journals (Sweden)

    Nicolás Ruiz-Robledillo

    2016-12-01

    Full Text Available Innovation in assisted reproductive technologies together with increased infertility and new family structures are increasing the use of gestational surrogacy as a means to have children. Before, during and after the process, it is necessary to study the psychosocial characteristics of triad members: the gestational surrogate, intended parents, and offspring. Research has indicated positive adaptation to the process and benefits for all members of the triad. Altruism is the main motivation of surrogates. Notably, psychological well-being has been found to be higher in individuals who have become parents through surrogacy than in those who have used egg donation or have followed a natural process of conception. Moreover, no differences in psychosocial characteristics have been observed in the offspring, compared with children born through natural conception or egg donation. Results highlight the positive aspects of surrogacy. Future research should investigate psychosocial factors that modulate the process, acting as risk and protective factors for well-being of the triad members, and identify the optimal profiles of surrogates for the process to be a success.

  2. Using Prenatal Advocates to Implement a Psychosocial Education Intervention for Posttraumatic Stress Disorder during Pregnancy: Feasibility, Care Engagement, and Predelivery Behavioral Outcomes.

    Science.gov (United States)

    Upshur, Carole C; Wenz-Gross, Melodie; Weinreb, Linda; Moffitt, Jennifer Jo Averill

    2016-01-01

    Pregnant women with posttraumatic stress disorder (PTSD) engage in more high-risk behavior and use less prenatal care. Although treating depression in pregnancy is becoming widespread, options for addressing PTSD are few. This study was designed to test the feasibility of implementing a manualized psychosocial PTSD intervention, Seeking Safety, delivered by prenatal advocates. All women entering prenatal care at two federally qualified health centers were screened for current symptoms of PTSD. One site was selected randomly to have prenatal care advocates deliver eight Seeking Safety topics for women that indicated clinical or subclinical PTSD symptoms. Baseline and pre-delivery interviews were conducted, which collected background characteristics and assessed PTSD severity and coping skills. Medical records were collected to document care visits. Documentation of participation rates, fidelity to the treatment, and qualitative feedback from advocates and participants was collected. More than one-half (57.3%) of the intervention women received all Seeking Safety sessions and fidelity ratings of the session showed acceptable quality. Using an intent-to-treat analysis, intervention women participated in significantly more prenatal care visits (M = 11.7 versus 8.9; p accounting for baseline differences, intervention women also reduced negative coping skills but not PTSD symptoms. Using prenatal care advocates to deliver Seeking Safety sessions to women screening positive for PTSD symptoms at entry to prenatal care is a promising intervention that seems to increase prenatal care participation and may reduce negative coping strategies. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  3. Psychosocial Clusters and their Associations with Well-Being and Health: An Empirical Strategy for Identifying Psychosocial Predictors Most Relevant to Racially/Ethnically Diverse Women’s Health

    Science.gov (United States)

    Jabson, Jennifer M.; Bowen, Deborah; Weinberg, Janice; Kroenke, Candyce; Luo, Juhua; Messina, Catherine; Shumaker, Sally; Tindle, Hilary A.

    2016-01-01

    BACKGROUND Strategies for identifying the most relevant psychosocial predictors in studies of racial/ethnic minority women’s health are limited because they largely exclude cultural influences and they assume that psychosocial predictors are independent. This paper proposes and tests an empirical solution. METHODS Hierarchical cluster analysis, conducted with data from 140,652 Women’s Health Initiative participants, identified clusters among individual psychosocial predictors. Multivariable analyses tested associations between clusters and health outcomes. RESULTS A Social Cluster and a Stress Cluster were identified. The Social Cluster was positively associated with well-being and inversely associated with chronic disease index, and the Stress Cluster was inversely associated with well-being and positively associated with chronic disease index. As hypothesized, the magnitude of association between clusters and outcomes differed by race/ethnicity. CONCLUSIONS By identifying psychosocial clusters and their associations with health, we have taken an important step toward understanding how individual psychosocial predictors interrelate and how empirically formed Stress and Social clusters relate to health outcomes. This study has also demonstrated important insight about differences in associations between these psychosocial clusters and health among racial/ethnic minorities. These differences could signal the best pathways for intervention modification and tailoring. PMID:27279761

  4. Electronic gaming and psychosocial adjustment.

    Science.gov (United States)

    Przybylski, Andrew K

    2014-09-01

    The rise of electronic games has driven both concerns and hopes regarding their potential to influence young people. Existing research identifies a series of isolated positive and negative effects, yet no research to date has examined the balance of these potential effects in a representative sample of children and adolescents. The objective of this study was to explore how time spent playing electronic games accounts for significant variation in positive and negative psychosocial adjustment using a representative cohort of children aged 10 to 15 years. A large sample of children and adolescents aged 10 to 15 years completed assessments of psychosocial adjustment and reported typical daily hours spent playing electronic games. Relations between different levels of engagement and indicators of positive and negative psychosocial adjustment were examined, controlling for participant age and gender and weighted for population representativeness. Low levels (3 hours daily) of game engagement was linked to key indicators of psychosocial adjustment. Low engagement was associated with higher life satisfaction and prosocial behavior and lower externalizing and internalizing problems, whereas the opposite was found for high levels of play. No effects were observed for moderate play levels when compared with non-players. The links between different levels of electronic game engagement and psychosocial adjustment were small (Games consistently but not robustly associated with children's adjustment in both positive and negative ways, findings that inform policy-making as well as future avenues for research in the area. Copyright © 2014 by the American Academy of Pediatrics.

  5. Outcome of Blunt Abdominal Traumas with Stable Hemodynamic and Positive FAST Findings

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    Firooz Behboodi

    2016-04-01

    Full Text Available Introduction: Focused assessment with sonography for trauma (FAST is a highly effective first screening tool for initial classification of abdominal trauma patients. The present study was designed to evaluate the outcome of patients with blunt abdominal trauma and positive FAST findings. Methods: The present prospective cross-sectional study was done on patients over 7 years old with normal abdominal examination, positive FAST findings, and available abdominopelvic computed tomography (CT scan findings. The frequency of need for laparotomy as well as its probable risk factors were calculated. Results: 180 patients were enrolled (mean age: 28.0 ± 11.5 years; 76.7% male. FAST findings were confirmed by abdominopelvic CT scan in only 124 (68.9% cases. Finally, 12 (6.6% patients needed laparotomy. Mean age of those in need of laparotomy was significantly higher than others (36.75 ± 11.37 versus 27.34 ± 11.37, p = 0.006. Higher grading of spleen (p = 0.001 and hepatic (p = 0.038 ruptures increased the probability of need for laparotomy. Conclusion: 68.9% of the positive FAST findings in patients with blunt abdominal trauma and stable hemodynamics was confirmed by abdominopelvic CT scan and only 6.6% needed laparotomy. Simultaneous presence of free fluid and air in the abdominal area, old age, and higher grading o solid organ injuries were factors that had a significant correlation with need for laparotomy.

  6. Outcome of Blunt Abdominal Traumas with Stable Hemodynamic and Positive FAST Findings.

    Science.gov (United States)

    Behboodi, Firooz; Mohtasham-Amiri, Zahra; Masjedi, Navid; Shojaie, Reza; Sadri, Peyman

    2016-01-01

    Focused assessment with sonography for trauma (FAST) is a highly effective first screening tool for initial classification of abdominal trauma patients. The present study was designed to evaluate the outcome of patients with blunt abdominal trauma and positive FAST findings. The present prospective cross-sectional study was done on patients over 7 years old with normal abdominal examination, positive FAST findings, and available abdominopelvic computed tomography (CT) scan findings. The frequency of need for laparotomy as well as its probable risk factors were calculated. 180 patients were enrolled (mean age: 28.0 ± 11.5 years; 76.7% male). FAST findings were confirmed by abdominopelvic CT scan in only 124 (68.9%) cases. Finally, 12 (6.6%) patients needed laparotomy. Mean age of those in need of laparotomy was significantly higher than others (36.75 ± 11.37 versus 27.34 ± 11.37, p = 0.006). Higher grading of spleen (p = 0.001) and hepatic (p = 0.038) ruptures increased the probability of need for laparotomy. 68.9% of the positive FAST findings in patients with blunt abdominal trauma and stable hemodynamics was confirmed by abdominopelvic CT scan and only 6.6% needed laparotomy. Simultaneous presence of free fluid and air in the abdominal area, old age, and higher grading o solid organ injuries were factors that had a significant correlation with need for laparotomy.

  7. Testing links between childhood positive peer relations and externalizing outcomes through a randomized controlled intervention study.

    Science.gov (United States)

    Witvliet, Miranda; van Lier, Pol A C; Cuijpers, Pim; Koot, Hans M

    2009-10-01

    In this study, the authors used a randomized controlled trial to explore the link between having positive peer relations and externalizing outcomes in 758 children followed from kindergarten to the end of 2nd grade. Children were randomly assigned to the Good Behavior Game (GBG), a universal classroom-based preventive intervention, or a control condition. Children's acceptance by peers, their number of mutual friends, and their proximity to others were assessed annually through peer ratings. Externalizing behavior was annually rated by teachers. Reductions in children's externalizing behavior and improvements in positive peer relations were found among GBG children, as compared with control-group children. Reductions in externalizing behavior appeared to be partly mediated by the improvements in peer acceptance. This mediating role of peer acceptance was found for boys only. The results suggest that positive peer relations are not just markers, but they are environmental mediators of boys' externalizing behavior development. Implications for research and prevention are discussed. (c) 2009 APA, all rights reserved.

  8. [Congenital lens subluxation: visual acuity outcomes and intraocular lens postoperative position].

    Science.gov (United States)

    Arraes, Caroline; Endriss, Daniela; Lobato, Francisco; Arraes, João; Ventura, Marcelo

    2010-01-01

    To evaluate the visual acuity outcomes and to investigate the intraocular lens (IOL) and endocapsular ring positions with ultrasound biomicroscopy in 17 eyes of 10 patients with congenital lens subluxation who underwent the same surgical technique, by the same surgeon. The study was performed in the ''Hospital de Olhos de Pernambuco'' and ''Fundação Altino Ventura''. The surgical technique consisted of phacoaspiration with implant of endocapsular ring and intraocular lens with one loop haptic amputated. The age varied from 7 to 22 years. Data on visual acuity (VA) before and after surgery, surgery follow-up period, and complications were analyzed. All patients underwent ultrasound biomicroscopy. The mean follow-up period was 2.8 years. There was a VA improvement in 17 (100%) eyes: in 12 eyes (70.6%) the visual acuity was better than 20/40; 4 (23.5%) ranged from 20/40 to 20/100, and 1 (5.9%) had visual acuity worse than 20/100, however better than the preoperative visual acuity. The posterior capsular opacification occurred in 10 eyes (58.9%). Ultrasound biomicroscopy showed that all IOL were partially decentralized, however without surpassing the pupil border limit. Endocapsular ring position was correct and there was a good capsular support in all cases. The evaluated surgical treatment provided good intraocular lens and endocapsular ring position, with VA improvement Thus, this technique is a viable, effective and safe option for the visual rehabilitation of patients with congenital lens subluxation.

  9. Treatment Adherence and Outcomes of Antiretroviral Agents in HIV Positive Patients

    International Nuclear Information System (INIS)

    Tahir, N. B.; Uddin, Q. T.

    2014-01-01

    Objective: To describe the treatment outcomes in terms of adherence, outcomes and side effects of antiretroviral (ARV) agents. Study Design: An observational study. Place and Duration of Study: Teaching Hospital of Khyber Medical University, Institute of Medical Sciences, Kohat, from February 2007 to December 2012. Methodology: Human Immunodeficiency Virus (HIV) positive patients, taking 1st line ARV agents for at least 6 months were included. Adherence was calculated by self report on asking the number of doses missed in last 30 days. ARVs were provided on monthly basis. Adherence data was noted over a period of 6 months. ARVs outcomes were recorded in the form of adherence, CD4 count, functional status of the patient, change in weight, further transmission of the disease, number of hospital admissions and deaths. Adverse Drug Reactions (ARDs) to ARVs were assessed clinically and by laboratory markers. Mean and standard deviation were calculated for numerical variables while frequencies and percentages were calculated for categorical variables. Results: Total number of patients included in this study were 107. Out of them, 66.4% were males and 33.6% were females. The mean age was 39.9 +- 13.80 years. Patients taking AZT/3TC/NVP, AZT/3TC/EFZ, D4T/3TC/NVP, D4T/3TC/EFZ, TNF/3TC/NVP or EFZ were 49.5%, 22.4%, 10.3%, 4.7% and 13% respectively. Most adverse affects were observed in 10 days to 90 days of initiation of therapy. Rash was observed in 71 (66.4%) patients, anaemia in 4 (3.7%) patients while only one patient (0.93%) had nausea / vomiting. Thirty (28%) patients reported no side effects. Out of 107 patients, 98 (91.5%) were alive whereas 9 (8.4%) died at the end of the study period. Twelve patients had one hospital admission (11.21%) whereas 9 (8.4%) patients had two admissions during the study period. The first mean CD4 was 325.27 cells /mcL whereas mean last CD4 count was 389.86 cells/mcL. Conclusion: ARVs have very satisfactory outcomes in HIV/AIDS patients

  10. Direct and Indirect Psychosocial Outcomes for Children with Autism Spectrum Disorder and their Parents Following a Parent-involved Social Skills Group Intervention.

    Science.gov (United States)

    Weiss, Jonathan A; Viecili, Michelle A; Sloman, Leon; Lunsky, Yona

    2013-11-01

    This study examined the direct and indirect outcomes of a social skills group intervention for children with high functioning autism spectrum disorders and their parents. Thirty-five children and their parents participated in the program evaluation. Children and parents completed measures of child social skills and problem behaviors. Children reported on their self-concept, and parents reported on their psychological acceptance and empowerment. Results indicate significant increases in overall child social skills according to parent and child report, in child general self-worth, and in parent service empowerment and psychological acceptance. While past program evaluations of social skills groups highlight changes in social competence, taking a broader perspective on the types of positive outcomes suggests potential benefits for both child and parent.

  11. Parenting, socioeconomic status and psychosocial functioning in Peruvian families and their children

    Directory of Open Access Journals (Sweden)

    Denisse L. Manrique Millones

    2014-10-01

    Full Text Available The purpose of this study was to analyze the relation between two dimensions of parenting (Positive Parenting and Negative Behavioral Control and child psychosocial functioning, such as self-worth and problem behavior. We investigated (a whether socioeconomic status moderates the relationship between parenting and child psychosocial outcomes, (b whether parenting mediates the relation between socioeconomic status and psychosocial functioning in a Peruvian context and finally, (c whether there are interaction effects between positive parenting and negative behavioral control. Information was gathered on 591 Peruvian children and their families from the normal population in urban zones of Metropolitan Lima. Hierarchical multiple regression analyses were conducted to investigate direct and indirect effects (mediation and moderation. Results revealed a significant mediation effect of positive parenting and negative behavioral control in the relationship between socioeconomic status and self-worth. Implications about the role played by context are discussed.

  12. The PiGeOn project: protocol of a longitudinal study examining psychosocial and ethical issues and outcomes in germline genomic sequencing for cancer.

    Science.gov (United States)

    Best, Megan; Newson, Ainsley J; Meiser, Bettina; Juraskova, Ilona; Goldstein, David; Tucker, Kathy; Ballinger, Mandy L; Hess, Dominique; Schlub, Timothy E; Biesecker, Barbara; Vines, Richard; Vines, Kate; Thomas, David; Young, Mary-Anne; Savard, Jacqueline; Jacobs, Chris; Butow, Phyllis

    2018-04-23

    Advances in genomics offer promise for earlier detection or prevention of cancer, by personalisation of medical care tailored to an individual's genomic risk status. However genome sequencing can generate an unprecedented volume of results for the patient to process with potential implications for their families and reproductive choices. This paper describes a protocol for a study (PiGeOn) that aims to explore how patients and their blood relatives experience germline genomic sequencing, to help guide the appropriate future implementation of genome sequencing into routine clinical practice. We have designed a mixed-methods, prospective, cohort sub-study of a germline genomic sequencing study that targets adults with cancer suggestive of a genetic aetiology. One thousand probands and 2000 of their blood relatives will undergo germline genomic sequencing as part of the parent study in Sydney, Australia between 2016 and 2020. Test results are expected within12-15 months of recruitment. For the PiGeOn sub-study, participants will be invited to complete surveys at baseline, three months and twelve months after baseline using self-administered questionnaires, to assess the experience of long waits for results (despite being informed that results may not be returned) and expectations of receiving them. Subsets of both probands and blood relatives will be purposively sampled and invited to participate in three semi-structured qualitative interviews (at baseline and each follow-up) to triangulate the data. Ethical themes identified in the data will be used to inform critical revisions of normative ethical concepts or frameworks. This will be one of the first studies internationally to follow the psychosocial impact on probands and their blood relatives who undergo germline genome sequencing, over time. Study results will inform ongoing ethical debates on issues such as informed consent for genomic sequencing, and informing participants and their relatives of specific

  13. Circle Solutions, a philosophy and pedagogy for learning positive relationships: What promotes and inhibits sustainable outcomes?

    Directory of Open Access Journals (Sweden)

    Florence McCarthy

    2013-04-01

    Full Text Available Educators are increasingly aware that the efficacy of social and emotional learning (SEL is dependent on implementation factors, not just program content. These include the philosophy underpinning an intervention, the beliefs as well as the skills of facilitators, and the classroom/whole school context in which the intervention takes place. This article outlines the philosophy and pedagogy of Circle Solutions and presents findings from research where 18 undergraduate students supported and developed ‘Circle Time’ in 8 Greater Western Sydney primary schools for a university module on community service. The study indicates that when there is full teacher participation within the principles of the Circle philosophy, together with activeschool support that promotes relational values, the learning outcomes for positive relationship building are more sustainable.

  14. Nutrition Prescription to Achieve Positive Outcomes in Chronic Kidney Disease: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Susan Ash

    2014-01-01

    Full Text Available In Chronic Kidney Disease (CKD, management of diet is important in prevention of disease progression and symptom management, however evidence on nutrition prescription is limited. Recent international CKD guidelines and literature was reviewed to address the following question “What is the appropriate nutrition prescription to achieve positive outcomes in adult patients with chronic kidney disease?” Databases included in the search were Medline and CINAHL using EBSCOhost search engine, Embase and the Cochrane Database of Systematic Reviews published from 2000 to 2009. International guidelines pertaining to nutrition prescription in CKD were also reviewed from 2000 to 2013. Three hundred and eleven papers and eight guidelines were reviewed by three reviewers. Evidence was graded as per the National Health and Medical Research Council of Australia criteria. The evidence from thirty six papers was tabulated under the following headings: protein, weight loss, enteral support, vitamin D, sodium, fat, fibre, oral nutrition supplements, nutrition counselling, including protein and phosphate, nutrients in peritoneal dialysis solution and intradialytic parenteral nutrition, and was compared to international guidelines. While more evidence based studies are warranted, the customary nutrition prescription remains satisfactory with the exception of Vitamin D and phosphate. In these two areas, additional research is urgently needed given the potential of adverse outcomes for the CKD patient.

  15. Using a retention in care protocol to promote positive health and systems related outcomes.

    Science.gov (United States)

    Larbi, Alfred A; Spielberg, Freya; Kamanu Elias, Nnemdi; Athey, Erin; Ogbuawa, Ngozi; Murphy, Nancy

    2018-04-18

    People living with HIV can experience the full benefits of retention when they are continuously engaged in care. Continuous engagement in care promotes improved adherence to ART and positive health outcomes. An infectious disease clinic has implemented a protocol to primarily improve patient retention. The retrospective, facility-based, costing study took place in an infectious disease clinic in Washington DC. Retention was defined in two ways and over a 12-month period. Micro-costing direct measurement methods were used to collect unit costs in time series. Return on investment accounted for the cost of treatment based on CD4 strata. ROI was expressed in 2016USD. The difference in CD4 and viral load levels between the two periods of analysis were determined for active patients, infected with HIV. The year before the intervention was compared to the year of the intervention. Total treatment expenditure decreased from $2,435,653.00 to $2,283,296.23, resulting in a $152,356.77 gain from investment for the healthcare system over a 12-month investment period. The viral load suppression rate increased from 81 to 95 (p = 0.04) over the investment period. The number of patients in need of HIV related opportunistic infection prophylaxis decreased from 21 to 13 (p = 0.06). Improved immunologic, virologic and healthcare expenditure outcomes can be linked to the quality of retention practice.

  16. Both preparing to teach and teaching positively impact learning outcomes for peer teachers.

    Science.gov (United States)

    Gregory, Alexander; Walker, Ian; McLaughlin, Kevin; Peets, Adam D

    2011-01-01

    We sought to evaluate the independent effects of preparing to teach and teaching on peer teacher learning outcomes. To evaluate the independent contributions of both preparing to teach and teaching to the learning of peer teachers in medical education. In total, 17 third-year medical students prepared to teach second-year students Advanced Cardiac Life Support algorithms and electrocardiogram (ECG) interpretation. Immediately prior to teaching they were randomly allocated to not teach, to teach algorithms, or to teach ECG. Peer teachers were tested on both topics prior to preparation, immediately after teaching and 60 days later. Compared to baseline, peer teachers' mean examination scores (±SD) demonstrated the greatest gains for content areas they prepared for and then taught (43.0% (13.9) vs. 66.3% (8.8), p teach but did not teach, less dramatic gains were evident (43.6% (8.3) vs. 54.7% (9.4), p teaching were greater than those for preparation (23.3% (10.9) vs. 8% (9.6), p teach and actively teaching may have independent positive effects on peer teacher learning outcomes.

  17. Positive effects of tertiary centres for amyotrophic lateral sclerosis on outcome and use of hospital facilities.

    Science.gov (United States)

    Chiò, A; Bottacchi, E; Buffa, C; Mutani, R; Mora, G

    2006-08-01

    To evaluate the effects of tertiary centres for amyotrophic lateral sclerosis (ALS) on ALS outcome and the use of hospital facilities. The study was based on the data of an epidemiological, prospective, population-based register on ALS (Piemonte and Valle d'Aosta Register for amyotrophic lateral sclerosis, PARALS). The 221 patients recruited between 1995 and 1996 were prospectively followed up for outcome and use of hospital-based services. In all, 97 patients were followed up by tertiary ALS centres and 124 by general neurological clinics. Patients followed up by tertiary ALS centres were found to be 4 years younger and underwent percutaneous endoscopic gastronomy and non-invasive positive-pressure ventilation more often. Patients followed up by tertiary ALS centres were found to have a considerably longer median survival time (1080 v 775 days), even when stratifying by age, site of onset and respiratory function at diagnosis. In Cox multivariate analysis, attending a tertiary ALS centre was observed to be an independent positive prognostic factor. Moreover, patients attending a tertiary ALS centre were admitted to hospital less often (1.2 v 3.3) and were more frequently admitted for planned interventions. Conversely, patients followed up by general neurological clinics were more frequently admitted for acute events. Also, the hospital stay was considerably shorter for patients attending tertiary ALS centres (5.8 v 12.4 days). Improved survival was seen in patients with ALS attending tertiary ALS centres, independently from all other known prognostic factors, possibly through a better implementation of supportive treatments. Moreover, because of these centres, the hospitalisation rate was markedly reduced, thus offering a cost-effective service to patients with ALS and to the community as a whole.

  18. Long-term outcomes of kidney transplantation across a positive complement-dependent cytotoxicity crossmatch.

    Science.gov (United States)

    Riella, Leonardo V; Safa, Kassem; Yagan, Jude; Lee, Belinda; Azzi, Jamil; Najafian, Nader; Abdi, Reza; Milford, Edgar; Mah, Helen; Gabardi, Steven; Malek, Sayeed; Tullius, Stefan G; Magee, Colm; Chandraker, Anil

    2014-06-27

    More than 30% of potential kidney transplant recipients have pre-existing anti-human leukocyte antigen antibodies. This subgroup has significantly lower transplant rates and increased mortality. Desensitization has become an important tool to overcome this immunological barrier. However, limited data is available regarding long-term outcomes, in particular for the highest risk group with a positive complement-dependent cytotoxicity crossmatch (CDC XM) before desensitization. Between 2002 and 2010, 39 patients underwent living-kidney transplantation across a positive CDC XM against their donors at our center. The desensitization protocol involved pretransplant immunosuppression, plasmapheresis, and low-dose intravenous immunoglobulin±rituximab. Measured outcomes included patient survival, graft survival, renal function, rates of rejection, infection, and malignancy. The mean and median follow-up was 5.2 years. Patient survival was 95% at 1 year, 95% at 3 years, and 86% at 5 years. Death-censored graft survival was 94% at 1 year, 88% at 3 years, and 84% at 5 years. Uncensored graft survival was 87% at 1 year, 79% at 3 years, and 72% at 5 years. Twenty-four subjects (61%) developed acute antibody-mediated rejection of the allograft and one patient lost her graft because of hyperacute rejection. Infectious complications included pneumonia (17%), BK nephropathy (10%), and CMV disease (5%). Skin cancer was the most prevalent malignancy in 10% of patients. There were no cases of lymphoproliferative disorder. Mean serum creatinine was 1.7±1 mg/dL in functioning grafts at 5 years after transplantation. Despite high rates of early rejection, desensitization in living-kidney transplantation results in acceptable 5-year patient and graft survival rates.

  19. Using Surgeon-Specific Outcome Reports and Positive Deviance for Continuous Quality Improvement.

    Science.gov (United States)

    Ivanovic, Jelena; Anstee, Caitlin; Ramsay, Tim; Gilbert, Sebastien; Maziak, Donna E; Shamji, Farid M; Sundaresan, R Sudhir; Villeneuve, P James; Seely, Andrew J E

    2015-10-01

    Using the thoracic morbidity and mortality classification to document all postoperative adverse events between October 2012 and February 2014, we created surgeon-specific outcome reports (SSORs) to promote self-assessment and to implement a divisional continuous quality improvement (CQI) program, on the construct of positive deviance, to improve individual surgeon's clinical performance. Mixed-methods study within a division of six thoracic surgeons, involving (1) development of real-time, Web-based, risk-adjusted SSORs; (2) implementation of CQI seminars (n = 6; September 2013 to June 2014) for evaluation of results, collegial discussion on quality improvement based on identification of positive outliers, and selection of quality indicators for future discussion; and (3) in-person interviews to identify facilitators and barriers to using SSORs and CQI. Interview transcripts were analyzed using thematic analysis. Interviews revealed enthusiastic support for SSORs as a means to improve patient care through awareness of personal outcomes with blinded divisional comparison for similar operations and diseases, and apply the learning objectives to continuous professional development and maintenance of certification. Perceived limitations of SSORs included difficulty measuring surgeon expertise, limited understanding of risk adjustment, resistance to change, and belief that knowledge of sensitive data could lead to punitive actions. All surgeons believed CQI seminars led to collegial discussions, whereas perceived limitations included quorum participation and failing to circle back on actionable items. Real-time performance feedback using SSORs can motivate surgeons to improve their practice, and CQI seminars offer the opportunity to review and interpret results and address issues in a supportive environment. Whether SSORs and CQI can lead to improvements in rates of postoperative adverse events is a matter of ongoing research. Copyright © 2015 The Society of Thoracic

  20. Barriers against psychosocial communication: oncologists' perceptions.

    Science.gov (United States)

    Fagerlind, Hanna; Kettis, Åsa; Glimelius, Bengt; Ring, Lena

    2013-10-20

    To explore oncologists' psychosocial attitudes and beliefs and their perceptions regarding barriers against psychosocial communication. A questionnaire was distributed to oncologists in Sweden (n = 537). Questions covered demography, the Physician Psychosocial Beliefs Scale (PPBS), and barriers against psychosocial communication. Stepwise multiple regression was used to determine what factors contribute the most to the PPBS score and the total number of barriers and barriers affecting clinical practice, respectively. Spearman rank-order correlation was used to determine correlation between PPBS score and number of barriers. Questionnaire response rate was 64%. Mean PPBS value was 85.5 (range, 49 to 123; SD, 13.0). Most oncologists (93%) perceived one or more barriers in communicating psychosocial aspects with patients. On average, five different communication barriers were perceived, of which most were perceived to affect clinical practice. These barriers included insufficient consultation time, lack of resources for taking care of problems discovered, and lack of methods to evaluate patients' psychosocial health in clinical practice. There was a positive correlation (rs = 0.490; P barriers (ie, less psychosocially oriented oncologists perceived more barriers). Oncologists with supplementary education with a psychosocial focus perceived fewer barriers/barriers affecting clinical practice (P barriers affecting psychosocial communication in clinical practice. Interventions aiming to improve psychosocial communication must therefore be multifaceted and individualized to clinics and individual oncologists. It is important to minimize barriers to facilitate optimal care and treatment of patients with cancer.

  1. Percutaneous left atrial appendage occlusion: Effect of device positioning on outcome.

    Science.gov (United States)

    Wolfrum, Mathias; Attinger-Toller, Adrian; Shakir, Samera; Gloekler, Steffen; Seifert, Burkhardt; Moschovitis, Aris; Khattab, Ahmed; Maisano, Francesco; Meier, Bernhard; Nietlispach, Fabian

    2016-10-01

    The study in patients with percutaneous left atrial appendage (LAA) occlusion investigates clinical outcomes according to the position of the Amplatzer Cardiac Plug (ACP) disc. The ACP consists of a disc and an anchoring lobe. The disc is meant to cover the ostium of the LAA, but frequently retracts partially or completely into the neck of the LAA. It is not known whether a retracted disc affects outcome. Outcomes of 169 consecutive patients (age 73.1 ± 10.4 years; 76% male) with successful LAA closure were analyzed according to the position of the ACP disc: group A had complete coverage of the LAA ostium; in group B the disc prolapsed partially or completely into the LAA-neck. Transesophageal echocardiography was performed 1-6 months after ACP implantation. The safety endpoint was the composite of clinically significant pericardial effusion, device embolization, procedure-related stroke/transient ischemic attack (TIA), major bleeding, or device thrombus. The efficacy endpoint was the composite of death, neurological events (ischemic and hemorrhagic stroke, TIA), or systemic embolism during follow-up. Group A comprised 76 patients (age 73.0 ± 9.9 years; 74% male) and group B 93 patients (age 73.3 ± 10.9 years; 79% male). Mean CHA 2 DS 2 -Vasc score and HASBLED score were 4.2 ± 1.7 (group A 4.3 ± 1.6; group B 4.2 ± 1.8) and 2.9 ± 1.1 (group A 2.9 ± 1.0; group B 3.0 ± 1.2), respectively. Mean follow-up of the study population was 13.0 ± 10.4 months. Overall, the composite safety and efficacy endpoints occurred in 20 (12%) and 6 patients (4%), respectively. There was no significant difference between groups A and B in the occurrence of the safety endpoint (13% vs. 11%, P = 0.64), or the efficacy endpoint (4% vs. 3%, P = 1.0). No evidence for a difference in the occurrence of the safety and efficacy endpoint was found between patients with complete vs. incomplete ACP disc coverage of the LAA ostium. The risk of

  2. Positive smoking outcome expectancies mediate the association between negative affect and smoking urge among women during a quit attempt.

    Science.gov (United States)

    Cano, Miguel Ángel; Lam, Cho Y; Chen, Minxing; Adams, Claire E; Correa-Fernández, Virmarie; Stewart, Diana W; McClure, Jennifer B; Cinciripini, Paul M; Wetter, David W

    2014-08-01

    Ecological momentary assessment was used to examine associations between negative affect, positive smoking outcome expectancies, and smoking urge during the first 7 days of a smoking quit attempt. Participants were 302 female smokers who enrolled in an individually tailored smoking cessation treatment study. Multilevel mediation analysis was used to examine the temporal relationship among the following: (a) the effects of negative affect and positive smoking outcome expectancies at 1 assessment point (e.g., time j) on smoking urge at the subsequent time point (e.g., time j + 1) in Model 1; and, (b) the effects of negative affect and smoking urge at time j on positive smoking outcome expectancies at time j + 1 in Model 2. The results from Model 1 showed a statistically significant effect of negative affect at time j on smoking urge at time j + 1, and this effect was mediated by positive smoking outcome expectancies at time j, both within- and between-participants. In Model 2, the within-participant indirect effect of negative affect at time j on positive smoking outcome expectancies at time j + 1 through smoking urge at time j was nonsignificant. However, a statistically significant indirect between-participants effect was found in Model 2. The findings support the hypothesis that urge and positive smoking outcome expectancies increase as a function of negative affect, and suggest a stronger effect of expectancies on urge as opposed to the effect of urge on expectancies.

  3. Predicting Outcome in Patients With Work-Related Upper Extremity Disorders: A Prospective Study of Medical, Physical, Ergonomic, and Psychosocial Risk Factors

    National Research Council Canada - National Science Library

    Huang, Grant D

    1999-01-01

    .... Over the past few decades, empirical investigations have found that medical, physical, ergonomic, and psychosocial factors are correlated with and/or predictive of these disorders (e.g., Armstrong et al., 1993; Bongers et al., 1993; Hales AND Bernard, 1996).

  4. How Interdisciplinary Teamwork Contributes to Psychosocial Cancer Support.

    Science.gov (United States)

    Daem, Michiel; Verbrugghe, Mathieu; Schrauwen, Wim; Leroux, Silvian; Van Hecke, Ann; Grypdonck, Maria

    2018-03-30

    The organization of psychosocial care is rather complex, and its provision diverse. Access is affected by the acceptance and attitude of patients and professional caregivers toward psychosocial care. The aims of this study were to examine when patients with cancer experience quality psychosocial care and to identify circumstances in collaboration that contribute to patient-perceived positive psychosocial care. This study used a qualitative design in which semistructured interviews were conducted with patients, hospital workers, and primary health professionals. Psychosocial care is often requested but also refused by patients with cancer. Based on this discrepancy, a distinction is made between psychosocial support and psychosocial interventions. Psychosocial support aims to reduce the chaos in patients' lives caused by cancer and is not shunned by patients. Psychosocial interventions comprise the formal care offered in response to psychosocial problems. Numerous patients are reluctant to use psychosocial interventions, which are often provided by psychologists. Psychosocial care aims to assist patients in bearing the difficulties of cancer and its treatment. Patients prefer informal support, given often in conjunction with physical care. This study confirms the important role of nurses in promoting psychosocial care. Patients perceive much support from nurses, although nurses are not considered to be professional psychosocial caregivers. Being perceived as approachable and trustworthy offers nurses a significant opportunity to bring more intense psychosocial interventions within reach of cancer patients.

  5. Toxicity and outcome of pelvic IMRT for node-positive prostate cancer

    International Nuclear Information System (INIS)

    Mueller, A.C.; Luetjens, J.; Eckert, F.; Bamberg, M.; Alber, M.; Schilling, D.; Belka, C.; Gaswindt, U.

    2012-01-01

    Background and purpose: This study reports on the treatment techniques, toxicity, and outcome of pelvic intensity-modulated radiotherapy (IMRT) for lymph node-positive prostate cancer (LNPPC, T1-4, c/pN1 cM0). Patients and methods: Pelvic IMRT to 45-50.4 Gy was applied in 39 cases either after previous surgery of involved lymph nodes (n = 18) or with a radiation boost to suspicious nodes (n = 21) with doses of 60-70 Gy, usually combined with androgen deprivation (n = 37). The prostate and seminal vesicles received 70-74 Gy. In cases of previous prostatectomy, prostatic fossa and remnants of seminal vesicles were given 66-70 Gy. Treatment-related acute and late toxicity was graded according to the RTOG criteria. Results: Acute radiation-related toxicity higher than grade 2 occurred in 2 patients (with the need for urinary catheter/subileus related to adhesions after surgery). Late toxicity was mild (grade 1-2) after a median follow-up of 70 months. Over 50% of the patients reported no late morbidity (grade 0). PSA control and cancer-specific survival reached 67% and 97% at over 5 years. Conclusion: Pelvic IMRT after the removal of affected nodes or with a radiation boost to clinically positive nodes led to an acceptable late toxicity (no grade 3/4 events), thus justifying further evaluation of this approach in a larger cohort. (orig.)

  6. Impact of positive and negative lesion site remodeling on clinical outcomes: insights from PROSPECT.

    Science.gov (United States)

    Inaba, Shinji; Mintz, Gary S; Farhat, Naim Z; Fajadet, Jean; Dudek, Dariusz; Marzocchi, Antonio; Templin, Barry; Weisz, Giora; Xu, Ke; de Bruyne, Bernard; Serruys, Patrick W; Stone, Gregg W; Maehara, Akiko

    2014-01-01

    This study investigated coronary artery remodeling patterns associated with clinical outcomes. In the prospective, multicenter PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree: An Imaging Study in Patients With Unstable Atherosclerotic Lesions) study, reported predictors of nonculprit lesion (NCL) major adverse cardiac events (MACE) were an intravascular ultrasound (IVUS) minimal lumen area (MLA) ≤4 mm(2), a plaque burden ≥70%, and a IVUS-virtual histology (VH) thin-cap fibroatheroma (TCFA), but not lesion site remodeling. Overall, 697 consecutive patients with an acute coronary syndrome were enrolled and underwent 3-vessel gray-scale and IVUS-VH; 3,223 NCLs were identified by IVUS. The remodeling index (RI) was calculated as the external elastic membrane area at the MLA site divided by the average of the proximal and distal reference external elastic membrane areas. First, one third of the patients were randomly selected to determine RI cutoffs related to NCL MACE (development cohort). Receiver-operating characteristic analysis showed that there were 2 separate cut points that predicted NCL MACE: RI = 0.8789 and RI = 1.0046 (area under the curve = 0.663). These cut points were used to define negative remodeling as an RI 1.00. Second, we used the remaining two-thirds of patients to validate these cut points with respect to lesion morphology and clinical outcomes (validation cohort). Kaplan-Meier curve analysis in the validation cohort showed that NCL MACE occurred more frequent (and equally) in negative and positive remodeling lesions compared with intermediate remodeling lesions. In this cohort, negative remodeling lesions had the smallest MLA, positive remodeling lesions had the largest plaque burden, and VH TCFA, especially VH TCFA with multiple necrotic cores, was most common in negatively remodeling lesions. The present study showed the novel concept that positive and negative lesion site remodeling was

  7. Expressions of positive emotion in women's college yearbook pictures and their relationship to personality and life outcomes across adulthood.

    Science.gov (United States)

    Harker, L; Keltner, D

    2001-01-01

    To test hypotheses about positive emotion, the authors examined the relationship of positive emotional expression in women's college pictures to personality, observer ratings, and life outcomes. Consistent with the notion that positive emotions help build personal resources, positive emotional expression correlated with the self-reported personality traits of affiliation, competence, and low negative emotionality across adulthood and predicted changes in competence and negative emotionality. Observers rated women displaying more positive emotion more favorably on several personality dimensions and expected interactions with them to be more rewarding; thus, demonstrating the beneficial social consequences of positive emotions. Finally, positive emotional expression predicted favorable outcomes in marriage and personal well-being up to 30 years later. Controlling for physical attractiveness and social desirability had little impact on these findings.

  8. Predictors of Positive Outcomes in Offspring of Depressed Parents and Non-depressed Parents Across 20 Years

    Science.gov (United States)

    Verdeli, Helen; Wickramaratne, Priya; Warner, Virginia; Mancini, Anthony; Weissman, Myrna

    2014-01-01

    Understanding differences in factors leading to positive outcomes in high-risk and low-risk offspring has important implications for preventive interventions. We identified variables predicting positive outcomes in a cohort of 235 offspring from 76 families in which one, both, or neither parent had major depressive disorder. Positive outcomes were termed resilient in offspring of depressed parents, and competent in offspring of non-depressed parents, and defined by two separate criteria: absence of psychiatric diagnosis and consistently high functioning at 2, 10, and 20 years follow-up. In offspring of depressed parents, easier temperament and higher self-esteem were associated with greater odds of resilient outcome defined by absence of diagnosis. Lower maternal overprotection, greater offspring self-esteem, and higher IQ were associated with greater odds of resilient outcome defined by consistently high functioning. Multivariate analysis indicated that resilient outcome defined by absence of diagnosis was best predicted by offspring self-esteem; resilient outcome defined by functioning was best predicted by maternal overprotection and self-esteem. Among offspring of non-depressed parents, greater family cohesion, easier temperament and higher self-esteem were associated with greater odds of offspring competent outcome defined by absence of diagnosis. Higher maternal affection and greater offspring self-esteem were associated with greater odds of competent outcome, defined by consistently high functioning. Multivariate analysis for each criterion indicated that competent outcome was best predicted by offspring self-esteem. As the most robust predictor of positive outcomes in offspring of depressed and non-depressed parents, self-esteem is an important target for youth preventive interventions. PMID:25374449

  9. Sibling relationship quality and psychosocial outcomes among adult siblings of individuals with autism spectrum disorder and individuals with intellectual disability without autism.

    Science.gov (United States)

    Tomeny, Theodore S; Ellis, Brandi M; Rankin, James A; Barry, Tammy D

    2017-03-01

    Research on adult typically-developing (TD) siblings of individuals with developmental disabilities remains limited, and outcomes for TD siblings appear to vary widely. For the current study, 82 adult TD siblings of individuals with autism spectrum disorder (ASD) or intellectual disability (ID) completed questionnaires about themselves and their affected sibling. Results of this study suggest that the attitudes possessed by adult TD siblings are important to consider when understanding adult TD sibling outcomes. Specifically, data indicate that higher levels of positive sibling relationship attitudes are related to TD siblings providing more aid/support to their sibling with a disability, along with having higher levels of general life satisfaction, and negatively related to levels of stress and depressive symptoms among TD siblings. Consistent with previous child research, siblings of individuals with ASD reported fewer positive sibling relationship attitudes compared to siblings of individuals with ID. Finally, group membership related to aid provided, depressive symptoms, and stress of TD siblings indirectly through sibling relationship attitudes. Overall, results indicate that sibling relationship attitudes may be particularly important to consider when conceptualizing sibling relationships when one sibling has an intellectual or developmental disability. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Psychosocial Resolution and Counsellor Trainee Empathy.

    Science.gov (United States)

    Gold, Joshua M.

    1992-01-01

    Entry-level counseling students (n=74) were surveyed to investigate the relationship between resolution of Erikson's psychosocial stage of intimacy/isolation and counselor trainee empathy. Results revealed a significant positive relationship between measures of psychosocial stage resolution and counselor empathy and a significant main effect for…

  11. Cardiac rehabilitation with a nurse case manager (GoHeart) across local and regional health authorities improves risk factors, self-care and psychosocial outcomes. A one-year follow-up study

    DEFF Research Database (Denmark)

    Hansen, Vibeke Brogaard; Maindal, Helle Terkildsen

    2014-01-01

    %). MAIN OUTCOME MEASURES: Cardiac risk factors, stratified self-care and self-reported psychosocial factors (SF12 and Hospital Anxiety and Depression Scale (HADS)) were assessed at admission (phase IIa), at three months at discharge (phase IIb) and at one-year follow-up (phase III). Intention.......01), self-care management (p depression symptoms (p ...OBJECTIVES: In Denmark, the local and regional health authorities share responsibility for cardiac rehabilitation (CR). The objective was to assess effectiveness of CR across sectors coordinated by a nurse case manager (NCM). DESIGN: A one-year follow-up study. SETTING: A CR programme (Go...

  12. A randomised controlled trial in comparing maternal and neonatal outcomes between hands-and-knees delivery position and supine position in China.

    Science.gov (United States)

    Zhang, Hongyu; Huang, Shurong; Guo, Xiaolan; Zhao, Ningning; Lu, Yujing; Chen, Min; Li, Yingxia; Wu, Junqin; Huang, Lihua; Ma, Fenglan; Yang, Yuhong; Zhang, Xiaoli; Zhou, Xiaoyu; Guo, Renfei; Cai, Wenzhi

    2017-07-01

    the supine position is the most frequently offered for birth delivery in China and many other countries, but the hands-and-knees position is now gaining prominence with doctors in China. This study aims to examine the differences in maternal and neonatal outcomes among low-risk women who gave birth either in the hands-and-knees position or the supine position. a randomised controlled trial was conducted in 11 hospitals in China from May to December in 2012. In total, 1400 women were recruited and randomly allocated to either the experimental group (n=700, 446 completed the protocol) who delivered in hands-and-knees position and the control group (n=700, 440 completed the protocol) who delivered in supine position. Women who could not maintain the randomised position during the second stage of labour were allowed to withdraw from the study. The primary maternal outcome measured was rate of episiotomy. Secondary outcomes included degree of perineum laceration, rate of emergency caesarean section, rate of shoulder dystocia, and duration of labour, postpartum bleeding, neonatal Apgar score, and the rate of neonatal asphyxia. Because outcome data were only collected for women who gave birth in the randomised position, per-protocol analyses were used to compare groups. The primary outcome, episiotomy, was also compared between groups using logistic regression adjusting for maternal age,gestational age at birth, whether the woman was primiparous, the process of second stage of labour and birthweight. as compared with the control group, the experimental group had lower rates of episiotomy and second-degree perineum laceration (including episiotomy), and higher rates of intact perineum and first-degree perineum laceration, with a longer duration of second stage of labour. No significant differences were found in the amount of postpartum bleeding, shoulder dystocia, neonatal asphyxia and neonatal Apgar scores at 1minute and 5minutes. Adjusted for maternal age, gestational

  13. Can achievement goal theory provide a useful motivational perspective for explaining psychosocial attributes of medical students?

    Directory of Open Access Journals (Sweden)

    Madjar Nir

    2012-01-01

    Full Text Available Abstract Background Psychosocial competence and frustration tolerance are important characteristics of skilled medical professionals. In the present study we explored the usefulness of applying a comprehensive motivational theory (Goal orientations, for this purpose. According to goal orientation theory, learning motivation is defined as the general goals students pursue during learning (either mastery goals - gaining new knowledge; or performance goals - gaining a positive evaluation of competence or avoiding negative evaluation. Perceived psychosocial abilities are a desirable outcome, and low frustration tolerance (LFT, is a negative feature of student behavior. The hypothesis was that the mastery goal would be positively associated with psychosocial abilities while performance goals would be positively associated with LFT. Methods 143 first-year medical students completed at the end of an annual doctor-patient communication course a structured questionnaire that included measures of learning goal orientations (assessed by Pattern of Adaptive Learning Scale - PALS, psychosocial abilities (assessed by Psychological Medicine Inventory- student version -PMI-S and Low Frustration Tolerance (LFT. Results All study variables were found reliable (Cronbach's α ranged from .66 to .90 and normally distributed. Hierarchical multiple regression analysis revealed significant associations supporting the hypotheses. The mastery goal orientation was positively associated with perceived psychosocial abilities (PMI-S (β = .16, p Conclusions The results suggest that the goal orientations theory may be a useful theoretical framework for understanding and facilitating learning motivation among medical students. Limitations and suggestions for practice within medical education context are discussed.

  14. Can achievement goal theory provide a useful motivational perspective for explaining psychosocial attributes of medical students?

    Science.gov (United States)

    Madjar, Nir; Bachner, Yaacov G; Kushnir, Talma

    2012-01-12

    Psychosocial competence and frustration tolerance are important characteristics of skilled medical professionals. In the present study we explored the usefulness of applying a comprehensive motivational theory (Goal orientations), for this purpose. According to goal orientation theory, learning motivation is defined as the general goals students pursue during learning (either mastery goals - gaining new knowledge; or performance goals - gaining a positive evaluation of competence or avoiding negative evaluation). Perceived psychosocial abilities are a desirable outcome, and low frustration tolerance (LFT), is a negative feature of student behavior. The hypothesis was that the mastery goal would be positively associated with psychosocial abilities while performance goals would be positively associated with LFT. 143 first-year medical students completed at the end of an annual doctor-patient communication course a structured questionnaire that included measures of learning goal orientations (assessed by Pattern of Adaptive Learning Scale - PALS), psychosocial abilities (assessed by Psychological Medicine Inventory- student version -PMI-S) and Low Frustration Tolerance (LFT). All study variables were found reliable (Cronbach's α ranged from .66 to .90) and normally distributed. Hierarchical multiple regression analysis revealed significant associations supporting the hypotheses. The mastery goal orientation was positively associated with perceived psychosocial abilities (PMI-S) (β = .16, p frustration tolerance (β = -.22, p frustration tolerance (β = .36, p < .001). The results suggest that the goal orientations theory may be a useful theoretical framework for understanding and facilitating learning motivation among medical students. Limitations and suggestions for practice within medical education context are discussed.

  15. Relationships between psychosocial outcomes in adolescents who are obese and their parents during a multi-disciplinary family-based healthy lifestyle intervention: One-year follow-up of a waitlist controlled trial (Curtin University's Activity, Food and Attitudes Program).

    Science.gov (United States)

    Fenner, Ashley A; Howie, Erin K; Davis, Melissa C; Straker, Leon M

    2016-07-07

    Limited studies have investigated relationships in psychosocial outcomes between adolescents who are obese and their parents and how psychosocial outcomes change during participation in a physical activity and healthy eating intervention. This study examined both adolescent and parent psychosocial outcomes while participating in a one - year multi-disciplinary family-based intervention: Curtin University's Activity, Food, and Attitudes Program (CAFAP). Following a waitlist control period, the intervention was delivered to adolescent (n = 56, ages 11-16) and parent participants over 8 weeks, with one-year maintenance follow-up. Adolescent depression and quality of life, family functioning, and parent depression, anxiety, and stress were assessed at six time points: baseline and prior to intervention (e.g., waitlist control period), immediately following intervention, and at 3, 6, and 12 months post-intervention. Relationships between adolescent and parent psychosocial outcomes were assessed using Spearman correlations and changes in both adolescent and parent outcomes were assessed using linear mixed models. Changes in adolescent psychosocial outcomes were compared to changes in behavioural (physical activity and healthy eating) and physical (weight) outcomes using independent samples t-tests. The majority of psychosocial outcomes were significantly correlated between adolescents and parents across the one-year follow-up. Adolescent depression, psychosocial and physical quality of life outcomes significantly improved before or following intervention and were maintained at 6-months or one-year follow-up. Parent symptoms of depression, anxiety, and stress were reduced during waitlist and primarily remained improved. Changes in adolescent psychosocial outcomes were shown to be partially associated with behavioural changes and independent of physical changes. Adolescents in CAFAP improved psychosocial and physical quality of life and reversed the typical

  16. Not all developmental assets are related to positive health outcomes in college students

    Directory of Open Access Journals (Sweden)

    Teoli Daniel A

    2011-07-01

    Full Text Available Abstract Background The purpose of this investigation was to model the relationships between developmental assets, life satisfaction, and health-related quality of life (HRQOL among a stratified, random sample (n = 765, 56% response rate of college students. Methods Structural equation modeling techniques were employed to test the relationships using Mplus v4.21; Model evaluations were based on 1 theoretical salience, 2 global fit indices (chi-square goodness of fit, comparative fit index: CFI and Tucker-Lewis Index: TLI, 3 microfit indices (parameter estimates, root mean squared error of approximation: RMSEA and residuals and 4 parsimony. Results The model fit the data well: χ2(n = 581, 515 = 1252.23, CFI = .94, TLI = .93 and RMSEA = .05. First, participants who reported increased Family Communication also reported higher levels of life satisfaction. Second, as participants reported having more Non-Parental Role Models, life satisfaction decreased and poor mental HRQOL days increased. Finally increased Future Aspirations was related to increased poor mental HRQOL days. Results were variant across gender. Conclusions Preliminary results suggest not all developmental assets are related to positive health outcomes among college students, particularly mental health outcomes. While the findings for Family Communication were expected, the findings for Non-Parental Role Models suggest interactions with potential role models in college settings may be naturally less supportive. Future Aspirations findings suggest college students may harbor a greater temporal urgency for the rigors of an increasingly competitive work world. In both cases, these assets appear associated with increased poor mental HRQOL days.

  17. Radical prostatectomy and positive surgical margins: relationship with prostate cancer outcome

    Directory of Open Access Journals (Sweden)

    Ricardo L. R. Felts de La Roca

    2014-06-01

    Full Text Available Introduction Positive surgical margins (PSMs are an adverse factor that may predict a worse outcome in patients submitted to radical prostatectomy (RP. However, not all of these cases will evolve to biochemical (BCR or clinical (CR recurrence, therefore relationship between PSMs and these recurrent events has to be correlated with other clinical and pathologic findings to indicate complementary treatment for selected patients. Materials and Methods Of 1250 patients submitted to open retropubic radical prostatectomy (RRP, between March 1991 and June 2008, the outcome of 161 patients with PSMs and of 67 without PSMs as a control group, comprising a total of 228 cases were retrospectively reviewed. A minimum follow-up time of 2 years after surgery was considered. BCR was determined when PSA ≥ 0.2ng/mL. CR was determined whenever there was clinical evidence of tumor. Chi-square test was used to correlate clinical and pathologic variables with PSMs. Time interval to biochemical recurrence was analyzed by the Kaplan-Meier product limit analysis using the log-rank test for comparison between groups. Univariate and multivariate Cox stepwise logistic regression models were used to identify significant predictors of risk of shorter intervals to BCR. Results Prostate circumference margin was the most common site with 78 cases (48.44%. Regarding the outcome of 228 cases from both groups, BCR occurred in 68 patients (29.82%, and CR in 10 (4.38%. Univariate analysis showed statistically significant associations (p < 0.001 between presence of PSMs with BCR, but not with CR (p = 0.05. At follow-up of the 161 patients with PSMs, only 61(37.8% presented BCR, while 100 (62.8% did not. BCR correlated with pathologic stage; Gleason score; preoperative PSA; tumor volume in the specimen; capsular and perineural invasion; presence and number of PSMs. CR correlated only with angiolymphatic invasion and Gleason score. Considering univariate analysis of clinical and

  18. Psychosocial Factors Versus Single Predictors: A Factor Analytic Approach to Cardiovascular Outcomes in The Women’s Ischemia Syndrome Evaluation (WISE) Study

    Science.gov (United States)

    2010-02-18

    later than men (Bello & Mosca, 2004). Also, for women 6 taking oral contraceptives , smoking significantly increases their risk of developing CVD...to include both the physiological processes involved in stress and the stress response as well as the emotional and psychological aspects of stress...and stressors (Mason, 1975). The emotional and psychological aspects of stress are critical components in the link between psychosocial factors and

  19. Asthma outcomes improve with continuous positive airway pressure for obstructive sleep apnea.

    Science.gov (United States)

    Serrano-Pariente, J; Plaza, V; Soriano, J B; Mayos, M; López-Viña, A; Picado, C; Vigil, L

    2017-05-01

    Continuous positive airway pressure (CPAP) in asthma patients with concomitant obstructive sleep apnea syndrome (OSAS) seems to have a favorable impact on asthma, but data are inconsistent due to methodological limitations of previous studies. Prospective, multicenter study. We examined asthma outcomes after 6 months of CPAP in 99 adult asthma patients (mean age 57 years) with OSAS (respiratory disturbance index ≥20). Asthma control and quality of life were assessed with the Asthma Control Questionnaire (ACQ) and the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), respectively. Data were analyzed by intention-to-treat basis. The mean ± SD score of the ACQ decreased from 1.39 ± 0.91 at baseline to 1.0 ± 0.78 at 6 months (P = 0.003), the percentage of patients with uncontrolled asthma from 41.4% to 17.2% (P = 0.006), and the percentage of patients with asthma attacks in the 6 months before and after treatment from 35.4% to 17.2% (P = 0.015). The score of the mAQLQ increased from 5.12 ± 1.38 to 5.63 ± 1.17 (P = 0.009). There were also significant improvements in symptoms of gastroesophageal reflux and rhinitis, bronchial reversibility, and exhaled nitric oxide values (all P obstructive sleep apnea syndrome. © 2016 The Authors. Allergy published by John Wiley & Sons Ltd.

  20. Clinical characteristics and treatment outcomes for benign paroxysmal positional vertigo comorbid with hypertension.

    Science.gov (United States)

    Tan, Jun; Deng, Yuxiao; Zhang, Tianyu; Wang, Menghong

    2017-05-01

    Patients with BPPV comorbid with hypertension (h-BPPV) tend to receive a delayed diagnosis of BPPV. Comorbidity with hypertension did not influence the efficacy of the repositioning maneuver; however, comorbidity with hypertension was associated with an increased recurrence rate of BPPV. To determine the clinical characteristics and outcomes of h-BPPV, as well as the clinical differences between h-BPPV and idiopathic BPPV (i-BPPV). The authors reviewed the medical records of 41 consecutive patients with h-BPPV (the h-BPPV group) from March to December 2014 and 47 patients with i-BPPV (the i-BPPV group) during the same period. There were no significant differences in age, sex ratio, or the affected side between the h-BPPV and i-BPPV groups. The proportion of patients reporting an initial episode of positional vertigo was significantly lower in the h-BPPV group (51.22% vs 74.47%; p = .024). Patients in the h-BPPV group reported a longer median episode duration than did those in the i-BPPV group (60 days vs 15 days; p = .017). The results of treatment using repositioning maneuvers were similar between the two groups. At follow-up, 13 patients in the h-BPPV group were diagnosed with recurrent BPPV compared with six in the i-BPPV group (p = .031).

  1. The processing of unexpected positive response outcomes in the mediofrontal cortex.

    Science.gov (United States)

    Ferdinand, Nicola K; Mecklinger, Axel; Kray, Jutta; Gehring, William J

    2012-08-29

    The human mediofrontal cortex, especially the anterior cingulate cortex, is commonly assumed to contribute to higher cognitive functions like performance monitoring. How exactly this is achieved is currently the subject of lively debate but there is evidence that an event's valence and its expectancy play important roles. One prominent theory, the reinforcement learning theory by Holroyd and colleagues (2002, 2008), assigns a special role to feedback valence, while the prediction of response-outcome (PRO) model by Alexander and Brown (2010, 2011) claims that the mediofrontal cortex is sensitive to unexpected events regardless of their valence. However, paradigms examining this issue have included confounds that fail to separate valence and expectancy. In the present study, we tested the two competing theories of performance monitoring by using an experimental task that separates valence and unexpectedness of performance feedback. The feedback-related negativity of the event-related potential, which is commonly assumed to be a reflection of mediofrontal cortex activity, was elicited not only by unexpected negative feedback, but also by unexpected positive feedback. This implies that the mediofrontal cortex is sensitive to the unexpectedness of events in general rather than their valence and by this supports the PRO model.

  2. Relationship between early somatic, radiological, cognitive and psychosocial findings and outcome during a one-year follow-up in 117 patients suffering from common whiplash.

    Science.gov (United States)

    Radanov, B P; Sturzenegger, M; De Stefano, G; Schnidrig, A

    1994-05-01

    To analyse the significance of the interplay between somatic and psychosocial factors in influencing the course of recovery a non-selected well defined group of 117 whiplash patients was investigated. Initial examination was performed, on average, 7.2 +/- 4.2 days after trauma and follow-ups were carried out at 3, 6 and 12 months. At the initial investigation all patients were given a neurological examination, cognitive and psychosocial factor assessment and cervical spine X-rays. At each follow-up stepwise regression was performed to evaluate the relationship between initial findings and the course of recovery. Fifty-one (44%), 36 (31%) and 28 (24%) patients were symptomatic at 3, 6 and 12 months respectively. Poor improvement at all examinations was significantly correlated with factors associated with severity of injury such as initial symptoms of radicular irritation and intensity of neck pain. Moreover, results indicate that poor recovery is related to severity of injury in addition to some pre-traumatic factors (previous history of head trauma and headache) and initial injury-related reaction (i.e. sleep disturbances, reduced speed of information processing and nervousness). However, psychosocial factors did not prove predictive at any follow-up examination. These results indicate that symptoms suggesting a more severe neck injury appear to be particularly related to delayed recovery from common whiplash. Moreover these results may be of value in the objective evaluation of potentially difficult claims for compensation, which may in some cases be falsely based.

  3. Positive stereotypes, negative outcomes: Reminders of the positive components of complementary gender stereotypes impair performance in counter-stereotypical tasks.

    Science.gov (United States)

    Kahalon, Rotem; Shnabel, Nurit; Becker, Julia C

    2018-04-01

    Gender stereotypes are complementary: Women are perceived to be communal but not agentic, whereas men are perceived to be agentic but not communal. The present research tested whether exposure to reminders of the positive components of these gender stereotypes can lead to stereotype threat and subsequent performance deficits on the complementary dimension. Study 1 (N = 116 female participants) revealed that compared to a control/no-stereotype condition, exposure to reminders of the stereotype about women's communality (but not to reminders of the stereotype about women's beauty) impaired women's math performance. In Study 2 (N = 86 male participants), reminders of the stereotype about men's agency (vs. a control/no-stereotype condition) impaired men's performance in a test of socio-emotional abilities. Consistent with previous research on stereotype threat, in both studies the effect was evident among participants with high domain identification. These findings extend our understanding of the potentially adverse implications of seemingly positive gender stereotypes. © 2018 The British Psychological Society.

  4. Whole pelvis radiotherapy for pathological node-positive prostate cancer. Oncological outcome and prognostic factors

    Energy Technology Data Exchange (ETDEWEB)

    Poelaert, Filip; Decaestecker, Karel; Claeys, Tom; Dhondt, Bert; Lumen, Nicolaas [Ghent University Hospital, Department of Urology, Ghent (Belgium); Fonteyne, Valerie; Ost, Piet [Ghent University Hospital, Department of Radiation Oncology, Ghent (Belgium); Troyer, Bart de [AZ Nikolaas, Department of Urology, Sint-Niklaas (Belgium); Meerleer, Gert de [University Hospitals Leuven, Department of Radiation Oncology, Leuven (Belgium); Visschere, Pieter de [Ghent University Hospital, Department of Radiology, Ghent (Belgium)

    2017-06-15

    The goal of this work was to investigate the oncological outcome of whole pelvis radiotherapy (wpRT) in pathologic pelvic lymph node-positive (pN1) prostate cancer (PCa), evaluate the location of relapse, and identify potential prognostic factors. All patients undergoing pelvic lymph node dissection (PLND) since the year 2000 at a single tertiary care center were evaluated. A total of 154 patients with pN1 PCa were treated with wpRT (39 in an adjuvant setting) and 2-3 years of androgen deprivation therapy (ADT). Kaplan-Meier analysis was performed to estimate biochemical recurrence-free survival (bRFS), clinical progression-free survival (cPFS), and prostate cancer-specific survival (CSS). Uni- and multivariate regression analyses were performed to identify prognostic factors. Estimated bRFS was 67%, cPFS was 71%, and CSS was 96% at 5 years. Median follow-up was 55 months (interquartile range 25-87). Multivariate analysis identified having only 1 positive lymph node, a shorter time between diagnosis and PLND, and older age as independent favorable prognostic factors for biochemical and clinical recurrence. The number of positive lymph nodes was prognostic for CSS (hazard ratio [HR] 1.34, 95% confidence interval 1.17-1.54) and OS (HR 1.22, 95% confidence interval 1.10-1.36). Bone metastases were the most frequent location of PCa relapse (n = 32, 64%). Patients with pN1 PCa treated with wpRT and 2-3 years ADT have an encouraging 5-year CSS. Understaging of the disease extent may be the most important enemy in definitive pN1 PCa treatment. (orig.) [German] Das Ziel dieser Studie war es, das onkologische Outcome der Bestrahlung des gesamten Beckens (wpRT) beim histologisch gesicherten nodal metastasierten Prostatakarzinom zu untersuchen, die Lokalisation eines eventuellen Rezidivs zu charakterisieren und moegliche prognostische Faktoren zu identifizieren. Alle Patienten, bei denen seit dem Jahr 2000 eine pelvine Lymphknotendissektion (PLND) durchgefuehrt worden war

  5. Nursing leadership style and psychosocial work environment.

    Science.gov (United States)

    Malloy, Terry; Penprase, Barbara

    2010-09-01

    This study examines the relationship between leadership style and the psychosocial work environment of registered nurses. Research consistently supports the positive relationship between transformational leadership style and job satisfaction. There is less evidence, which identifies the relationship between leadership style and psychosocial work environment. The Multifactor Leadership Questionnaire 5× was used to identify the leadership style. The Copenhagen Psychosocial Questionnaire was used to measure psychosocial work environment dimensions. Statistical analysis included Pearson's r correlation between leadership style and psychosocial work environment and anova to analyse group means. There is a significant correlation between leadership style and 22 out of the 37 dimensions of the psychosocial work environment. This correlation was significant ranging from r = 0.88, P leadership scores of the immediate supervisor report significant differences in their psychosocial work environment. This study supports the significant correlation between leadership style and psychosocial work environment for registered nurses. The results of this study suggest that there would be an improvement in the nursing psychosocial work environment by implementation of transformational and contingent reward leadership behaviours. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  6. Radical prostatectomy and positive surgical margins: tumor volume and Gleason score predicts cancer outcome

    International Nuclear Information System (INIS)

    La Roca, Ricardo L.R. Felts de; Fonseca, Francisco Paula da; Cunha, Isabela Werneck da; Bezerra, Stephania Martins

    2013-01-01

    Introduction: positive surgical margins (PSMs) are common adverse factors to predict the outcome of a patient submitted to radical prostatectomy (PR). However, not all of these men will follow with biochemical (BCR) or clinical (CR) recurrence. Relationship between PSMs with these recurrent events has to be correlated with other clinicopathological findings in order to recognize more aggressive tumors in order to recommend complementary treatment to these selected patients. Materials and methods: we retrospectively reviewed the outcome of 228 patients submitted to open retropubic RP between March 1991 and June 2008, where 161 had and 67 did not have PSMs. Minimum follow-up time was considered 2 years after surgery. BCR was considered when PSA ≥ 0.2 ng/ml. CR was determined when clinical evidence of tumor appeared. Chi-square test was used to correlate clinical and pathologic variables with PSMs. The estimated 5-year risk of BCR and CR in presence of PSMs was determined using the Kaplan-Meier method and compared to log-rank tests. Results: from the total of 228 patients, 161 (71%) had PSMs, while 67 (29%) had negative surgical margins (NSMs). Prostatic circumferential margin was the most common (43.4%) site. Univariate analysis showed statistically significant (p < 0.001) associations between the presence of PSMs and BCR, but not with CR (p = 0.06). Among 161 patients with PSMs, 61 (37.8%) presented BCR, while 100 (62.8%) did not. Predicting progression-free survival for 5 years, BCR was correlated with pathological stage; Gleason score; pre-treatment PSA; tumor volume in specimen; capsular and perineural invasion; presence and number of PSMs. RC correlated only with angiolymphatic invasion and Gleason score. Considering univariate analyses the clinicopathological factors predicting BCR for 5 years, results statistically significant links with prostate weight; pre-treatment PSA; Gleason score; pathological stage; tumor volume; PSMs; capsular and perineural

  7. Radical prostatectomy and positive surgical margins: tumor volume and Gleason score predicts cancer outcome

    Energy Technology Data Exchange (ETDEWEB)

    La Roca, Ricardo L.R. Felts de, E-mail: Ricardo@delarocaurologia.com.br [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil); Fonseca, Francisco Paula da, E-mail: fpf@uol.com.br [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Divisao de Urologia. Dept. de Cirurgia Pelvica; Cunha, Isabela Werneck da; Bezerra, Stephania Martins, E-mail: iwerneck@gmail.com, E-mail: stephaniab@gmail.com [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Patologia

    2013-07-01

    Introduction: positive surgical margins (PSMs) are common adverse factors to predict the outcome of a patient submitted to radical prostatectomy (PR). However, not all of these men will follow with biochemical (BCR) or clinical (CR) recurrence. Relationship between PSMs with these recurrent events has to be correlated with other clinicopathological findings in order to recognize more aggressive tumors in order to recommend complementary treatment to these selected patients. Materials and methods: we retrospectively reviewed the outcome of 228 patients submitted to open retropubic RP between March 1991 and June 2008, where 161 had and 67 did not have PSMs. Minimum follow-up time was considered 2 years after surgery. BCR was considered when PSA {>=} 0.2 ng/ml. CR was determined when clinical evidence of tumor appeared. Chi-square test was used to correlate clinical and pathologic variables with PSMs. The estimated 5-year risk of BCR and CR in presence of PSMs was determined using the Kaplan-Meier method and compared to log-rank tests. Results: from the total of 228 patients, 161 (71%) had PSMs, while 67 (29%) had negative surgical margins (NSMs). Prostatic circumferential margin was the most common (43.4%) site. Univariate analysis showed statistically significant (p < 0.001) associations between the presence of PSMs and BCR, but not with CR (p = 0.06). Among 161 patients with PSMs, 61 (37.8%) presented BCR, while 100 (62.8%) did not. Predicting progression-free survival for 5 years, BCR was correlated with pathological stage; Gleason score; pre-treatment PSA; tumor volume in specimen; capsular and perineural invasion; presence and number of PSMs. RC correlated only with angiolymphatic invasion and Gleason score. Considering univariate analyses the clinicopathological factors predicting BCR for 5 years, results statistically significant links with prostate weight; pre-treatment PSA; Gleason score; pathological stage; tumor volume; PSMs; capsular and perineural

  8. Computer intervention impact on psychosocial adaptation of rural women with chronic conditions.

    Science.gov (United States)

    Weinert, Clarann; Cudney, Shirley; Comstock, Bryan; Bansal, Aasthaa

    2011-01-01

    Adapting to living with chronic conditions is a life-long psychosocial challenge. The purpose of this study was to report the effect of a computer intervention on the psychosocial adaptation of rural women with chronic conditions. A two-group study design was used with 309 middle-aged, rural women who had chronic conditions, randomized into either a computer-based intervention or a control group. Data were collected at baseline, at the end of the intervention, and 6 months later on the psychosocial indicators of social support, self-esteem, acceptance of illness, stress, depression, and loneliness. The impact of the computer-based intervention was statistically significant for five of six of the psychosocial outcomes measured, with a modest impact on social support. The largest benefits were seen in depression, stress, and acceptance. The women-to-women intervention resulted in positive psychosocial responses that have the potential to contribute to successful management of illness and adaptation. Other components of adaptation to be examined are the impact of the intervention on illness management and quality of life and the interrelationships among environmental stimuli, psychosocial response, and illness management.

  9. Investigation of the Impact of Sports, Exercise, and Recreation Participation on Psychosocial Outcomes in a Population of Veterans with Disabilities: A Cross-sectional Study.

    Science.gov (United States)

    Laferrier, Justin Z; Teodorski, Emily; Cooper, Rory A

    2015-12-01

    The aim of this study was to investigate possible effects that participation in sports, exercise, and recreation may have on self-esteem and quality-of-life in service members/veterans with disabilities. Two hundred twenty service members/veterans with disabilities who were participants in one of three annual adaptive sporting events took part in this cross-sectional study. Variables of interest were years of sport, exercise, and recreation participation since the onset of disability as well as the type of activity they engaged in. Main outcome measures were self-esteem and quality-of-life. A positive relationship was found between participant quality-of-life and the number of years spent participating in sports, exercise, and recreation since the onset of their disability. A significant difference was found between pre-event and postevent self-esteem scores. A significant difference was also found in self-esteem scores between the levels of years of participation in sports, exercise, and recreation when averaged across activity type. Finally, there were significant differences found on self-esteem scores between the levels of type of activity averaged across years of participation. Our results indicate that participation in sports, exercise, and recreation has a positive influence on self-esteem and quality-of-life in individuals with disabilities.

  10. Treatment deintensification in human papillomavirus-positive oropharynx cancer: Outcomes from the National Cancer Data Base.

    Science.gov (United States)

    Cheraghlou, Shayan; Yu, Phoebe K; Otremba, Michael D; Park, Henry S; Bhatia, Aarti; Zogg, Cheryl K; Mehra, Saral; Yarbrough, Wendell G; Judson, Benjamin L

    2018-02-15

    The growing epidemic of human papillomavirus-positive (HPV+) oropharyngeal cancer and the favorable prognosis of this disease etiology have led to a call for deintensified treatment for some patients with HPV+ cancers. One of the proposed methods of treatment deintensification is the avoidance of chemotherapy concurrent with definitive/adjuvant radiotherapy. To the authors' knowledge, the safety of this form of treatment de-escalation is unknown and the current literature in this area is sparse. The authors investigated outcomes after various treatment combinations stratified by American Joint Committee on Cancer (AJCC) eighth edition disease stage using patients from the National Cancer Data Base. A retrospective study of 4443 patients with HPV+ oropharyngeal cancer in the National Cancer Data Base was conducted. Patients were stratified into AJCC eighth edition disease stage groups. Multivariate Cox regressions as well as univariate Kaplan-Meier analyses were conducted. For patients with stage I disease, treatment with definitive radiotherapy was associated with diminished survival compared with chemoradiotherapy (hazard ratio [HR], 1.798; P = .029), surgery with adjuvant radiotherapy (HR, 2.563; P = .002), or surgery with adjuvant chemoradiotherapy (HR, 2.427; P = .001). For patients with stage II disease, compared with treatment with chemoradiotherapy, patients treated with a single-modality (either surgery [HR, 2.539; P = .009] or radiotherapy [HR, 2.200; P = .030]) were found to have poorer survival. Among patients with stage III disease, triple-modality therapy was associated with improved survival (HR, 0.518; P = .024) compared with treatment with chemoradiotherapy. Deintensification of treatment from chemoradiotherapy to radiotherapy or surgery alone in cases of HPV+ AJCC eighth edition stage I or stage II disease may compromise patient safety. Treatment intensification to triple-modality therapy for patients with stage III disease may improve survival in

  11. Psychosocial Benefits of Cooking Interventions: A Systematic Review

    Science.gov (United States)

    Farmer, Nicole; Touchton-Leonard, Katherine; Ross, Alyson

    2018-01-01

    Objectives: Cooking interventions are used in therapeutic and rehabilitative settings; however, little is known about the influence of these interventions on psychosocial outcomes. This systematic review examines the research evidence regarding the influence of cooking interventions on psychosocial outcomes. Methods: A systematic review of the…

  12. Social support and negative and positive outcomes of experienced traumatic events in a group of male emergency service workers.

    Science.gov (United States)

    Ogińska-Bulik, Nina

    2015-01-01

    The paper investigates the relationship between perceived social support in the workplace and both negative (post-traumatic stress disorder (PTSD) symptoms) and positive outcomes (post-traumatic growth) of experienced traumatic events in a group of male emergency service workers. Data of 116 workers representing emergency services (37.1% firefighters, 37.1%, police officers and 30% medical rescue workers) who have experienced a traumatic event in their worksite were analyzed. The range of age of the participants was 21-57 years (M=35.27; SD=8.13). Polish versions of the Impact of Event Scale--Revised and the Post-traumatic Growth Inventory were used to assess the negative and positive outcomes of the experienced event. A perceived social support scale was measured by the scale What support you can count on. The data obtained from the study revealed the negative dependence of social support from supervisors with PTSD symptoms and positive--social support from co-workers with post-traumatic growth. Moreover the results of the study indicate the positive relationship between negative and positive outcomes of experienced traumatic events in the workplace. Perceived social support plays a more important role in gaining benefits from trauma than preventing negative outcomes of the experienced traumatic event. Support from co-workers, compared to support from supervisors, has greater importance.

  13. Long-term psychosocial behavioral outcomes in children following anesthesia: A comparison of the effects of general versus regional anesthesia on term infants delivered by elective cesarean section

    Directory of Open Access Journals (Sweden)

    Aouni Alameddine

    2013-01-01

    Full Text Available Background: Data on the effects of general anesthesia on the fetal and neonatal brain are limited. Animal studies demonstrated that anesthetic agents leave their consequences in the form of learning and memory deficits. The effects of propofol on the fetal neurodevelopment are not clear yet. Materials and Methods: This is a telephone-based questionnaire survey that addressed the effect of general anesthesia by propofol during cesarean section at term with no perinatal complications on the psychosocial behavior of children at 8-10 years of age compared with children having same characteristics except for delivery under neuraxial anesthesia using the Pediatric Symptom Checklist as a score. Results: A total of 187 children were born at term between January 1, 2002 and December 31, 2004 with no perinatal distress under induction of general anesthesia by propofol. 66 children (35.3% were lost to follow-up and parents of two children (1.1% refused to participate. A total of 189 children were included in the study: 119 were born by cesarean section under general anesthesia and 70 were born by cesarean section under neuraxial block. The incidence of psychosocial behavior impairment at 8-10 years of age was not found to be affected by the mode of anesthesia during delivery by cesarean section nor by neonatal nor parental characteristics. Conclusion: Exposure to propofol as an induction agent for general anesthesia or cesarean section does not seem to increase the psychosocial behavior disorder development risk at 8-10 years of age.

  14. Socioeconomic and psychosocial correlates of oral health.

    Science.gov (United States)

    Armfield, Jason M; Mejía, Gloria C; Jamieson, Lisa M

    2013-08-01

    It has been proposed that psychosocial variables are important determinants of oral health outcomes. In addition, the effect of socioeconomic factors in oral health has been argued to work through the shaping of psychosocial stressors and resources. This study therefore aimed to examine the role of psychosocial factors in oral health after controlling for selected socioeconomic and behavioural factors. Logistic and generalised linear regression analyses were conducted on self-rated oral health, untreated decayed teeth and number of decayed, missing and filled teeth (DMFT) from dentate participants in a national survey of adult oral health (n = 5364) conducted in 2004-2006 in Australia. After controlling for all other variables, more frequent dental visiting and toothbrushing were associated with poorer self-rated oral health, more untreated decay and higher DMFT. Pervasive socioeconomic inequalities were demonstrated, with higher income, having a tertiary degree, higher self-perceived social standing and not being employed all significantly associated with oral health after controlling for the other variables. The only psychosocial variables related to self-rated oral health were the stressors perceived stress and perceived constraints. Psychosocial resources were not statistically associated with self-rated oral health and no psychosocial variables were significantly associated with either untreated decayed teeth or DMFT after controlling for the other variables. Although the role of behavioural and socioeconomic variables as determinants of oral health was supported, the role of psychosocial variables in oral health outcomes received mixed support. © 2013 FDI World Dental Federation.

  15. How Does Stigma Affect People Living with HIV? The Mediating Roles of Internalized and Anticipated HIV Stigma in the Effects of Perceived Community Stigma on Health and Psychosocial Outcomes.

    Science.gov (United States)

    Turan, Bulent; Budhwani, Henna; Fazeli, Pariya L; Browning, Wesley R; Raper, James L; Mugavero, Michael J; Turan, Janet M

    2017-01-01

    Few researchers have attempted to examine the mechanisms through which HIV-related stigma in the community is processed and experienced at an individual level by people living with HIV. We examined how the effects of perceived HIV stigma in the community on health outcomes for people living with HIV are mediated by internalized stigma and anticipated stigma. Participants (N = 203) from an HIV clinic completed self-report measures and their clinical data were obtained from medical records. Results suggested that the association between perceived community stigma and affective, cognitive, and mental health outcomes (self-esteem, depressive symptoms, avoidance coping, self-blame) are mediated by internalized stigma. Furthermore, a serial mediation model suggested that perceived community stigma leads to internalized stigma, which leads to anticipated community stigma, which in turn leads to lower medication adherence. The associations between perceived community stigma and interpersonal outcomes (social support, trust in physicians) were mediated by internalized stigma and anticipated stigma, again in a serial fashion (perceived community stigma leads to internalized stigma, which leads to anticipated stigma, which in turn leads to interpersonal outcomes). These results suggest that perceived HIV-related stigma in the community may cause people living with HIV to internalize stigma and anticipate stigmatizing experiences, resulting in adverse health and psychosocial outcomes-information that can be used to shape interventions.

  16. Exploring factors influencing HbA1c and psychosocial outcomes in people with type 1 diabetes after training in advanced carbohydrate counting

    DEFF Research Database (Denmark)

    Schmidt, Signe; Vistisen, Dorte; Almdal, Thomas

    2017-01-01

    was tested (using a non-validated test developed specifically for this study) and behavioral measures (number of daily blood glucose measurements and self-reported use of ACC) were obtained. Associations between change in HbA1c and these measures plus sex, age, diabetes duration and BMI were tested. RESULTS......AIMS: The purpose of this secondary analysis of the StenoABC Study was to identify determinants of the changes in HbA1c observed after training of people with type 1 diabetes in advanced carbohydrate counting (ACC) and automated bolus calculator (ABC) use, and further to investigate psychosocial...

  17. The CORE study protocol: a stepped wedge cluster randomised controlled trial to test a co-design technique to optimise psychosocial recovery outcomes for people affected by mental illness in the community mental health setting

    Science.gov (United States)

    Palmer, Victoria J; Chondros, Patty; Piper, Donella; Callander, Rosemary; Weavell, Wayne; Godbee, Kali; Potiriadis, Maria; Richard, Lauralie; Densely, Konstancja; Herrman, Helen; Furler, John; Pierce, David; Schuster, Tibor; Iedema, Rick; Gunn, Jane

    2015-01-01

    Introduction User engagement in mental health service design is heralded as integral to health systems quality and performance, but does engagement improve health outcomes? This article describes the CORE study protocol, a novel stepped wedge cluster randomised controlled trial (SWCRCT) to improve psychosocial recovery outcomes for people with severe mental illness. Methods An SWCRCT with a nested process evaluation will be conducted over nearly 4 years in Victoria, Australia. 11 teams from four mental health service providers will be randomly allocated to one of three dates 9 months apart to start the intervention. The intervention, a modified version of Mental Health Experience Co-Design (MH ECO), will be delivered to 30 service users, 30 carers and 10 staff in each cluster. Outcome data will be collected at baseline (6 months) and at completion of each intervention wave. The primary outcome is improvement in recovery score using the 24-item Revised Recovery Assessment Scale for service users. Secondary outcomes are improvements to user and carer mental health and well-being using the shortened 8-item version of the WHOQOL Quality of Life scale (EUROHIS), changes to staff attitudes using the 19-item Staff Attitudes to Recovery Scale and recovery orientation of services using the 36-item Recovery Self Assessment Scale (provider version). Intervention and usual care periods will be compared using a linear mixed effects model for continuous outcomes and a generalised linear mixed effects model for binary outcomes. Participants will be analysed in the group that the cluster was assigned to at each time point. Ethics and dissemination The University of Melbourne, Human Research Ethics Committee (1340299.3) and the Federal and State Departments of Health Committees (Project 20/2014) granted ethics approval. Baseline data results will be reported in 2015 and outcomes data in 2017. Trial registration number Australian and New Zealand Clinical Trials Registry ACTRN

  18. The tense the hostile and the distressed : Multidimensional psychosocial risk profiles based on the ESC interview in coronary artery disease patients. The THORESCI study

    NARCIS (Netherlands)

    van Montfort, E.M.J.; Denollet, J.; Vermunt, J.K.; Widdershoven, J.W.M.G.; Kupper, N.

    2017-01-01

    Background While single psychosocial factors have been associated with cardiovascular outcomes, it is still unclear how they cluster. Therefore, we examined whether latent multidimensional psychosocial risk profiles could be identified in the European Society of Cardiology (ESC) psychosocial

  19. The influence of different maternal pushing positions on birth outcomes at the second stage of labor in nulliparous women.

    Science.gov (United States)

    Moraloglu, Ozlem; Kansu-Celik, Hatice; Tasci, Yasemin; Karakaya, Burcu Kısa; Yilmaz, Yasar; Cakir, Ebru; Yakut, Halil Ibrahim

    2017-01-01

    To assess the effects on neonatal and maternal outcomes of different pushing positions during the second stage of labor in nulliparous women. This prospective study included 102 healthy, pregnant, nulliparous women who were randomly allocated to either of two positions: a squatting using bars (n = 51), or a supine position modified to 45 degree of semi-fowler (n = 51) during the second stage of labor. Duration of the second stage of labor, maternal pain, postpartum blood loss, abnormal fetal heart rate patterns that required intervention, and newborn outcomes were compared between the two groups. The trial showed that women who adopted the squatting position using bars experienced a significant reduction in the duration of the second stage of labor; they were less likely to be induced, and their Visual Analog Scale score was lower than those who were allocated the supine position modified to 45 degree of semi-fowler during second stage of labor (p < 0.05). There were no significant differences with regard to postpartum blood loss, neonatal birth weight, Apgar score at one and five minutes, or admission to the Neonatal Intensive Care Unit. In healthy nulliparous women, adopting a squatting position using bars was associated with a shorter second stage of labor, lower Visual Analog Scale score, more satisfaction, and a reduction in oxytocin requirements compared with adopting the supine position. For Turkish women, the squatting position is easy to adopt as it is more appropriate in terms of Turkish social habits and traditions.

  20. Returnees, Student-Migrants and Second Chance Learners: Case Studies of Positional and Transformative Outcomes of Australian International Education

    Science.gov (United States)

    Robertson, Shanthi; Hoare, Lynnel; Harwood, Aramiha

    2011-01-01

    There is a clear need for new research into the work and life outcomes for graduates of Australian international education. Drawing upon divergent post-study transitions, this article aims to present a multi-faceted, qualitative foundation for the consideration of both positional and transformative impacts of international education on graduates'…

  1. It gets better: resolution of internalized homophobia over time and associations with positive health outcomes among MSM.

    Science.gov (United States)

    Herrick, Amy L; Stall, Ron; Chmiel, Joan S; Guadamuz, Thomas E; Penniman, Typhanye; Shoptaw, Steven; Ostrow, David; Plankey, Michael W

    2013-05-01

    Health disparities research among gay and bisexual men has focused primarily on risk and deficits. However, a focus on resiliencies within this population may greatly benefit health promotion. We describe a pattern of resilience (internalized homophobia (IHP) resolution) over the life-course and its associations with current health outcomes. 1,541 gay and bisexual men from the Multi-Center AIDS Cohort study, an ongoing prospective study of the natural and treated histories of HIV, completed a survey about life-course events thought to be related to health. The majority of men resolved IHP over time independent of demographics. Men who resolved IHP had significantly higher odds of positive health outcomes compared to those who did not. These results provide evidence of resilience among participants that is associated with positive health outcomes. Understanding resiliencies and incorporating them into interventions may help to promote health and well-being among gay and bisexual men.

  2. Heterogeneity in outcomes of treated HIV-positive patients in Europe and North America

    DEFF Research Database (Denmark)

    May, Margaret T; Hogg, Robert S; Justice, Amy C

    2012-01-01

    HIV cohort collaborations, which pool data from diverse patient cohorts, have provided key insights into outcomes of antiretroviral therapy (ART). However, the extent of, and reasons for, between-cohort heterogeneity in rates of AIDS and mortality are unclear....

  3. Health Information Technology Continues to Show Positive Effect on Medical Outcomes: Systematic Review

    OpenAIRE

    Kruse, Clemens Scott; Beane, Amanda

    2018-01-01

    Background Health information technology (HIT) has been introduced into the health care industry since the 1960s when mainframes assisted with financial transactions, but questions remained about HIT’s contribution to medical outcomes. Several systematic reviews since the 1990s have focused on this relationship. This review updates the literature. Objective The purpose of this review was to analyze the current literature for the impact of HIT on medical outcomes. We hypothesized that there is...

  4. How Does Stigma Affect People Living with HIV? The Mediating Roles of Internalized and Anticipated HIV Stigma in the Effects of Perceived Community Stigma on Health and Psychosocial Outcomes

    Science.gov (United States)

    Budhwani, Henna; Fazeli, Pariya L.; Browning, Wesley R.; Raper, James L.; Mugavero, Michael J.; Turan, Janet M.

    2016-01-01

    Few researchers have attempted to examine the mechanisms through which HIV-related stigma in the community is processed and experienced at an individual level by people living with HIV. We examined how the effects of perceived HIV stigma in the community on health outcomes for people living with HIV are mediated by internalized stigma and anticipated stigma. Participants (N = 203) from an HIV clinic completed self-report measures and their clinical data were obtained from medical records. Results suggested that the association between perceived community stigma and affective, cognitive, and mental health outcomes (self-esteem, depressive symptoms, avoidance coping, self-blame) are mediated by internalized stigma. Furthermore, a serial mediation model suggested that perceived community stigma leads to internalized stigma, which leads to anticipated community stigma, which in turn leads to lower medication adherence. The associations between perceived community stigma and interpersonal outcomes (social support, trust in physicians) were mediated by internalized stigma and anticipated stigma, again in a serial fashion (perceived community stigma leads to internalized stigma, which leads to anticipated stigma, which in turn leads to interpersonal outcomes). These results suggest that perceived HIV-related stigma in the community may cause people living with HIV to internalize stigma and anticipate stigmatizing experiences, resulting in adverse health and psychosocial outcomes—information that can be used to shape interventions. PMID:27272742

  5. Psychosocial aspects of head and neck cancer--a review of the literature.

    Science.gov (United States)

    Pruyn, J F; de Jong, P C; Bosman, L J; van Poppel, J W; van Den Borne, H W; Ryckman, R M; de Meij, K

    1986-12-01

    This study is a systematic analysis of the literature on psychosocial aspects in head and neck cancer patients. Patients with head and neck cancer experience a variety of physical as well as psychosocial problems. Physical problems include swallowing or chewing, speech and physical appearance. Psychosocial problems include anxiety, depression, loss of self-esteem and uncertainty about the future. Because of these problems, isolation from friends typically occurs, re-employment is difficult, and there are social and sexual tensions within families. Information and support by professionals, partners and/or fellow patients are related to positive rehabilitation outcomes such as the acquisition of speech, increases in constructive social functioning and decreases in depression.

  6. The Positive Effect of Resilience on Stress and Business Outcomes in Difficult Work Environments.

    Science.gov (United States)

    Shatté, Andrew; Perlman, Adam; Smith, Brad; Lynch, Wendy D

    2017-02-01

    To examine whether resilience has a protective effect in difficult work environments. A survey of 2063 individuals measured individual resilience, stress, burnout, sleep problems, likelihood of depression, job satisfaction, intent to quit, absences, and productivity. It also measured work characteristics: job demands, job influence, and social support. Multivariate and logistic regression models examined the main effects and interactions of resilience and job characteristics. High strain work environments (high demand, low influence, and low support) have an unfavorable effect on all outcomes. Resilience has a protective effect on all outcomes. For stress, burnout, and sleep, higher resilience has a more protective effect under low-strain conditions. For depression, absence and productivity, resilience has a more protective effect when job strain is high. Workers with high resilience have better outcomes in difficult work environments.

  7. Sample size calculations based on a difference in medians for positively skewed outcomes in health care studies

    Directory of Open Access Journals (Sweden)

    Aidan G. O’Keeffe

    2017-12-01

    Full Text Available Abstract Background In healthcare research, outcomes with skewed probability distributions are common. Sample size calculations for such outcomes are typically based on estimates on a transformed scale (e.g. log which may sometimes be difficult to obtain. In contrast, estimates of median and variance on the untransformed scale are generally easier to pre-specify. The aim of this paper is to describe how to calculate a sample size for a two group comparison of interest based on median and untransformed variance estimates for log-normal outcome data. Methods A log-normal distribution for outcome data is assumed and a sample size calculation approach for a two-sample t-test that compares log-transformed outcome data is demonstrated where the change of interest is specified as difference in median values on the untransformed scale. A simulation study is used to compare the method with a non-parametric alternative (Mann-Whitney U test in a variety of scenarios and the method is applied to a real example in neurosurgery. Results The method attained a nominal power value in simulation studies and was favourable in comparison to a Mann-Whitney U test and a two-sample t-test of untransformed outcomes. In addition, the method can be adjusted and used in some situations where the outcome distribution is not strictly log-normal. Conclusions We recommend the use of this sample size calculation approach for outcome data that are expected to be positively skewed and where a two group comparison on a log-transformed scale is planned. An advantage of this method over usual calculations based on estimates on the log-transformed scale is that it allows clinical efficacy to be specified as a difference in medians and requires a variance estimate on the untransformed scale. Such estimates are often easier to obtain and more interpretable than those for log-transformed outcomes.

  8. Positive and negative volume-outcome relationships in the geriatric trauma population.

    Science.gov (United States)

    Matsushima, Kazuhide; Schaefer, Eric W; Won, Eugene J; Armen, Scott B; Indeck, Matthew C; Soybel, David I

    2014-04-01

    In trauma populations, improvements in outcome are documented in institutions with higher case volumes. However, it is not known whether improved outcomes are attributable to the case volume within specific higher-risk groups, such as the elderly, or to the case volume among all trauma patients treated by an institution. To test the hypothesis that outcomes of trauma care for geriatric patients are affected differently by the volume of geriatric cases and nongeriatric cases of an institution. This retrospective cohort study using a statewide trauma registry was set in state-designated levels 1 and 2 trauma centers in Pennsylvania. It included 39 431 eligible geriatric trauma patients (aged >65 years) in the Pennsylvania Trauma Outcomes Study. In-hospital mortality, major complications, and mortality after major complications (failure to rescue). Between 2001 and 2010, 39 431 geriatric trauma patients and 105 046 nongeriatric patients were captured in a review of outcomes in 20 state-designated levels 1 and 2 trauma centers. Larger volumes of geriatric trauma patients were significantly associated with lower odds of in-hospital mortality, major complications, and failure to rescue. In contrast, larger nongeriatric trauma volumes were significantly associated with higher odds of major complications in geriatric patients. Higher rates of in-hospital mortality, major complications, and failure to rescue were associated with lower volumes of geriatric trauma care and paradoxically with higher volumes of trauma care for younger patients. These findings offer the possibility that outcomes might be improved with differentiated pathways of care for geriatric trauma patients.

  9. Normative evaluations and frequency expectations regarding positive versus negative outcome allocations between groups

    NARCIS (Netherlands)

    Blanz, M; Mummendey, A; Otten, S

    1997-01-01

    Data from several recent studies consistently show a positive-negative asymmetry in social discrimination: within a minimal social situation tendencies cowards ingroup favouritism which usually appear in allocations of positively valenced resources are absent in the domain of negatively valenced

  10. Outcomes of single organism peritonitis in peritoneal dialysis: gram negatives versus gram positives in the Network 9 Peritonitis Study.

    Science.gov (United States)

    Bunke, C M; Brier, M E; Golper, T A

    1997-08-01

    The use of the "peritonitis rate" in the management of patients undergoing peritoneal dialysis is assuming importance in comparing the prowess of facilities, care givers and new innovations. For this to be a meaningful outcome measure, the type of infection (causative pathogen) must have less clinical significance than the number of infections during a time interval. The natural history of Staphylococcus aureus, pseudomonas, and fungal peritonitis would not support that the outcome of an episode of peritonitis is independent of the causative pathogen. Could this concern be extended to other more frequently occurring pathogens? To address this, the Network 9 Peritonitis Study identified 530 episodes of single organism peritonitis caused by a gram positive organism and 136 episodes caused by a single non-pseudomonal gram negative (NPGN) pathogen. Coincidental soft tissue infections (exit site or tunnel) occurred equally in both groups. Outcomes of peritonitis were analyzed by organism classification and by presence or absence of a soft tissue infection. NPGN peritonitis was associated with significantly more frequent catheter loss, hospitalization, and technique failure and was less likely to resolve regardless of the presence or absence of a soft tissue infection. Hospitalization and death tended to occur more frequently with enterococcal peritonitis than with other gram positive peritonitis. The outcomes in the NPGN peritonitis group were significantly worse (resolution, catheter loss, hospitalization, technique failure) compared to coagulase negative staphylococcal or S. aureus peritonitis, regardless of the presence or absence of a coincidental soft tissue infection. Furthermore, for the first time, the poor outcomes of gram negative peritonitis are shown to be independent of pseudomonas or polymicrobial involvement or soft tissue infections. The gram negative organism appears to be the important factor. In addition, the outcome of peritonitis caused by S. aureus

  11. Hurdles overcome in technology transfer for AIET and Positive outcome in Indian patients

    Directory of Open Access Journals (Sweden)

    Dedeepiya V

    2012-01-01

    Full Text Available Introduction Cell based immunotherapies have been in practice in Japan for the past two decades with established clinical trials on its efficacy in both solid tumours and hematological malignancies including gastric cancer, ovarian cancer , lung cancer and liver cancer. [1,2,3,4] In India, NCRM has been providing Autologous Immune Enhancement Therapy (AIET using autologous Natural Killer (NK cells and activated T Lymphocytes for Cancer since 2005 following the established protocols practiced by the Biotherapy Institute of Japan. Significant outcome achieved after AIET in advanced pancreatic cancer, Acute Myeloid leukemia (AML in Indian patients have already been reported. [5, 6] Here we report our experience in few more patients and present the hurdles overcome and lessons learned in translating the technology from Japan to India Case Details: Case 1: A 54 year-old female presented with Stage IV recurrent ovarian malignancy in 2010 with a history of previous surgery and chemotherapy for ovarian malignancy in June 2009. The CA-125 level of 243 U/ml. CT scan revealed lesions in the liver, spleen, along the greater curvature of body of stomach and in the perisplenic region, between the medial aspect of liver and stomach and in the right inguinal region. She was suggested six cycles of chemotherapy with Doxorubicin (50 mg and Carboplatin (450 mg along with AIET. After proper informed consent, the peripheral blood was withdrawn and the in vitro expansion of the NK cells, activated T Lymphocytes from the peripheral blood was performed using the protocol reported earlier. [7] Average cell count after the in vitro expansion was 1.2 X 108 cells. Six transfusions of the in vitro expanded NK cells and activated T lymphocytes were administered following which the CA-125 decreased to 4.7 U/mL. CT scan taken in December 2010 showed a regression of the lesions in the spleen and perisplenic peritoneal deposits, stable hepatic lesions and resolution of

  12. Respiratory Outcomes of the Surfactant Positive Pressure and Oximetry Randomized Trial

    Science.gov (United States)

    Stevens, Timothy P.; Finer, Neil N.; Carlo, Waldemar A.; Szilagyi, Peter G.; Phelps, Dale L.; Walsh, Michele C.; Gantz, Marie G.; Laptook, Abbot R.; Yoder, Bradley A.; Faix, Roger G.; Newman, Jamie E.; Das, Abhik; Do, Barbara T.; Schibler, Kurt; Rich, Wade; Newman, Nancy S.; Ehrenkranz, Richard A.; Peralta-Carcelen, Myriam; Vohr, Betty R.; Wilson-Costello, Deanne E.; Yolton, Kimberly; Heyne, Roy J.; Evans, Patricia W.; Vaucher, Yvonne E.; Adams-Chapman, Ira; McGowan, Elisabeth C.; Bodnar, Anna; Pappas, Athina; Hintz, Susan R.; Acarregui, Michael J.; Fuller, Janell; Goldstein, Ricki F.; Bauer, Charles R.; O’Shea, T. Michael; Myers, Gary J.; Higgins, Rosemary D.

    2014-01-01

    Objective To explore the early childhood pulmonary outcomes of infants who participated in the NICHD SUPPORT Trial, using a factorial design that randomized extremely preterm infants to lower vs. higher oxygen saturation targets and delivery room CPAP vs. intubation/surfactant, found no significant difference in the primary composite outcome of death or BPD. Study design The Breathing Outcomes Study, a prospective secondary to SUPPORT, assessed respiratory morbidity at 6 month intervals from hospital discharge to 18–22 months corrected age (CA). Two pre-specified primary outcomes, wheezing more than twice per week during the worst 2 week period and cough longer than 3 days without a cold were compared between each randomized intervention. Results One or more interviews were completed for 918 of 922 eligible infants. The incidence of wheezing and cough were 47.9% and 31.0%, respectively, and did not differ between study arms of either randomized intervention. Infants randomized to lower vs. higher oxygen saturation targets had similar risks of death or respiratory morbidities (except for croup, treatment with oxygen or diuretics at home). Infants randomized to CPAP vs. intubation/surfactant had fewer episodes of wheezing without a cold (28.9% vs. 36.5%, pCPAP rather than intubation/surfactant is associated with less respiratory morbidity by 18–22 months CA. Longitudinal assessment of pulmonary morbidity is necessary to fully evaluate the potential benefits of respiratory interventions for neonates. PMID:24725582

  13. Positive Youth Development and Nutrition: Interdisciplinary Strategies to Enhance Student Outcomes

    Science.gov (United States)

    Edwards, Oliver W.; Cheeley, Taylor

    2016-01-01

    Educational policies require the use of data and progress monitoring frameworks to guide instruction and intervention in schools. As a result, different problem-solving models such as multitiered systems of supports (MTSS) have emerged that use these frameworks to improve student outcomes. However, problem-focused models emphasize negative…

  14. Influence of continuous positive airway pressure on outcomes of rehabilitation in stroke patients with obstructive sleep apnea.

    Science.gov (United States)

    Ryan, Clodagh M; Bayley, Mark; Green, Robin; Murray, Brian J; Bradley, T Douglas

    2011-04-01

    In stroke patients, obstructive sleep apnea (OSA) is associated with poorer functional outcomes than in those without OSA. We hypothesized that treatment of OSA by continuous positive airway pressure (CPAP) in stroke patients would enhance motor, functional, and neurocognitive recovery. This was a randomized, open label, parallel group trial with blind assessment of outcomes performed in stroke patients with OSA in a stroke rehabilitation unit. Patients were assigned to standard rehabilitation alone (control group) or to CPAP (CPAP group). The primary outcomes were the Canadian Neurological scale, the 6-minute walk test distance, sustained attention response test, and the digit or spatial span-backward. Secondary outcomes included Epworth Sleepiness scale, Stanford Sleepiness scale, Functional Independence measure, Chedoke McMaster Stroke assessment, neurocognitive function, and Beck depression inventory. Tests were performed at baseline and 1 month later. Patients assigned to CPAP (n=22) experienced no adverse events. Regarding primary outcomes, compared to the control group (n=22), the CPAP group experienced improvement in stroke-related impairment (Canadian Neurological scale score, PStroke assessment of upper and lower limb motor recovery test of the leg (P=0.001), and the affective component of depression (P=0.006), but not neurocognitive function. Treatment of OSA by CPAP in stroke patients undergoing rehabilitation improved functional and motor, but not neurocognitive outcomes. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00221065.

  15. Avoiding negative vs. achieving positive outcomes in hard and prosperous economic times

    NARCIS (Netherlands)

    Millet, K.; Lamey, L.; Van den Bergh, B.

    2012-01-01

    Three studies suggest that business cycle fluctuations trigger distinct motivational orientations that selectively affect economic judgment and decision making. Economic contractions induce avoidance motivation and affect negative economic sentiment, but leave approach motivation and positive

  16. A systematic review of psychosocial factors associated with emotional adjustment in in vitro fertilization patients.

    Science.gov (United States)

    Rockliff, Helen E; Lightman, Stafford L; Rhidian, Emily; Buchanan, Heather; Gordon, Uma; Vedhara, Kavita

    2014-01-01

    IVF treatment is usually stressful for patients, but individual differences in emotional response do exist. Differences in the stress response may be related to reproductive outcomes as well as to the development of psychiatric problems. This review collates research exploring which psychosocial factors (e.g. personality traits and coping strategies) are associated with the emotional adjustment of IVF patients. The aim is to reveal what is currently known about risk and protective factors for coping with the stress of IVF treatment and where further enquiry would be most beneficial. The databases, MEDLINE/PUBMED (US National Library of Medicine), PsycINFO (American Psychological Association), Web of Science (Social Sciences Citation Index) and EMbase, were searched from 1978 to September 2012 using relevant key words. All published peer-reviewed studies exploring associations between psychosocial factors and emotional adjustment outcomes were considered for inclusion. There were 23 studies identified for review. One-third of the psychosocial factors explored were found to be significantly related to emotional adjustment outcome measures. Neuroticism and the use of escapist coping strategies were positively associated with distress by multiple studies. Social support was negatively associated with distress by several studies. A number of other psychosocial variables appear to be associated with distress, including self-criticism, dependency, situation appraisals and attachment style, but these have only been explored by one or two studies at most. There is a paucity of research using positive emotional outcome measures (e.g. well-being, positive affect, happiness or life satisfaction) to quantify emotional adjustment. Whilst some psychosocial variables appear to be consistently associated with distress for IVF patients, two-thirds of the variables tested to date do not appear to be associated with emotional adjustment. This review highlights key psychosocial factors

  17. Psychosocial factors at work, long work hours, and obesity: a systematic review.

    Science.gov (United States)

    Solovieva, Svetlana; Lallukka, Tea; Virtanen, Marianna; Viikari-Juntura, Eira

    2013-05-01

    Associations between psychosocial work environment and excess weight have not been systematically addressed. The aim of this systematic review was to summarize the published evidence for the associations of psychosocial factors at work and long work hours with weight-related outcomes . Methods We conducted a search of Medline and Embase for all original articles published up to September 2012 using predefined keywords. After excluding studies with a definite selection bias, we included 39 articles. About 60% of the studies reported at least one positive association between psychosocial factors at work and a weight-related outcome. However, 76% of the tested associations were found to be non-significant. Furthermore, the associations were rather weak. Studies of higher quality tended to observe associations more often than those of lower quality. Positive associations were found more frequently (i) among women versus men, (ii) in cross-sectional versus longitudinal studies, and (iii) for overweight or obesity versus other outcomes. About 70% of the studies reported positive associations between long work hours and weight-related outcomes. All four studies that evaluated the association between working overtime and weight gain (three longitudinal and one cross-sectional), showed a positive association among men and two of them also observed associations among women. We found evidence for weak associations between psychosocial factors at work and excess weight. Associations were observed between long work hours, working overtime, and weight gain, especially among men. More cohort studies among non-obese baseline participants using appropriate analytical methods based on an elaborated hypothetical model are needed.

  18. Do Job Demands of Chinese Manufacturing Employees Predict Positive or Negative Outcomes? A Test of Competing Hypotheses.

    Science.gov (United States)

    Cheung, Janelle H; Sinclair, Robert R; Shi, Junqi; Wang, Mo

    2015-12-01

    Karasek's job demands-control (JDC) model posits that job control can buffer against the harmful effects of demands experienced by employees. A large volume of JDC research has obtained support for the main effects of demands and control, but not the interactive effects. Recent research on the challenge-hindrance stressors framework, however, found that work stressors may not always be deleterious, suggesting alternative hypotheses about the effects of demands and control. The present study therefore examined competing hypotheses concerning the effects of job demands on occupational health outcomes. Using a sample of 316 employees in a Chinese manufacturing company, we found that, consistent with the challenge-hindrance framework, production demands were challenge stressors associated with favourable outcomes (i.e. job satisfaction and psychological well-being). In addition, results showed that the interactive role of job control depended on the nature of outcome variables. Future recommendations and implications of findings are discussed. Copyright © 2014 John Wiley & Sons, Ltd.

  19. Occupational wellbeing--management of injured workers with psychosocial barriers.

    Science.gov (United States)

    Cotton, Peter

    2006-12-01

    Although most injured workers return to work with minimal intervention, approximately 20% show levels of distress and disability beyond that expected for the injury. The level of morale in a workplace seems to play a major role in this. Workers who experience positive emotions leading to increased morale are more likely to be resilient following injury. It is important for general practitioners to recognise the nonclinical factors that exert a significant influence over employee wellbeing and return to work outcomes. Some management strategies are presented. General practitioners who work collaboratively with all major stakeholders, who identify and manage psychosocial barriers early, who take an active role in promoting positive expectations, and who focus on the immediate problem rather than its industrial associations will achieve better outcomes for their injured patients.

  20. The impact of socioeconomic position on severe maternal morbidity outcomes among women in Australia: a national case-control study.

    Science.gov (United States)

    Lindquist, A; Noor, N; Sullivan, E; Knight, M

    2015-11-01

    Studies in other developed countries have suggested that socioeconomic position may be a risk factor for poorer pregnancy outcomes. This analysis aimed to explore the independent impact of socioeconomic position on selected severe maternal morbidities among women in Australia. A case-control study using data on severe maternal morbidities associated with direct maternal death collected through the Australasian Maternity Outcomes Surveillance System. Australia. 623 cases, 820 controls. Logistic regression analysis to investigate differences in outcomes among different socioeconomic groups, classified by Socio-Economic Indexes for Areas (SEIFA) quintile. Severe maternal morbidity (amniotic fluid embolism, placenta accreta, peripartum hysterectomy, eclampsia or pulmonary embolism). SEIFA quintile was statistically significantly associated with maternal morbidity, with cases being twice as likely as controls to reside in the most disadvantaged areas (adjusted OR 2.00, 95%CI 1.29-3.10). Maternal age [adjusted odds ratio (aOR) 2.20 for women aged 35 or over compared with women aged 25-29, 95%CI 1.64-3.15] and previous pregnancy complications (aOR 1.30, 95%CI 1.21-1.87) were significantly associated with morbidity. A parity of 1 or 2 was protective (aOR 0.58, 95%CI 0.43-0.79), whereas previous caesarean delivery was associated with maternal morbidity (aOR 2.20 for women with one caesarean delivery, 95%CI 1.44-2.85, compared with women with no caesareans). The risk of severe maternal morbidity among women in Australia is significantly increased by social disadvantage. This study suggests that future efforts in improving maternity care provision and maternal outcomes in Australia should include socioeconomic position as an independent risk factor for adverse outcome. © 2014 Royal College of Obstetricians and Gynaecologists.

  1. Workaholism, work engagement and work-home outcomes: exploring the mediating role of positive and negative emotions.

    Science.gov (United States)

    Clark, Malissa A; Michel, Jesse S; Stevens, Gregory W; Howell, Julia W; Scruggs, Ross S

    2014-10-01

    This study examines the mechanisms through which workaholism and work engagement impact work-home conflict and enrichment, respectively. Specifically, we examine the mediating role of positive and negative emotions (e.g. joviality and guilt) in the relationship between workaholism, work engagement and work-home outcomes. Results, based on a sample of 340 working adults participating in a two-wave study, indicate that negative emotions-particularly anxiety, anger and disappointment-mediate the relationship between workaholism and work-home conflict and positive emotions-particularly joviality and self-assurance-mediate the relationship between work engagement and work-home enrichment. These results provide further evidence that workaholism and work engagement are related to distinct sets of emotional variables and disparate work and home outcomes. Copyright © 2013 John Wiley & Sons, Ltd.

  2. Risk associated with traumatic intracranial bleed and outcome in patients following a fall from a standing position.

    Science.gov (United States)

    Ahmed, N; Soroush, A; Kuo, Y-H; Davis, J M

    2015-06-01

    A fall from a standing position (FFS) is a low impact injury; however, in certain patient populations it can result in serious, complex injuries associated with significant morbidity and mortality. The purpose of the study was to identify the patient population, risk factors and outcomes of intracranial bleed (ICB) after a fall from a standing position. Data of all patients from the trauma database at State designated Trauma Center were analyzed who FFS. Patient's demography, clinical information was obtained. An ICB seen on computed tomography (CT) scan was considered positive. From January 2001 through December 2008, 163 patients admitted to the trauma center after FFS. Ninety-one out of 163 patients (56 %) had positive CT scan. There was no significant difference between the groups with a positive or negative CT regarding age (P = 0.07), gender (P = 0.58), race (P = 0.15), Glasgow Coma Scale (P = 0.27), aspirin use (P = 0.06), Plavix (P = 0.92), combination of aspirin and Plavix (P = 0.86) or use of Coumadin (P = 0.82). Patients with ICB had significantly higher injury severity score (ISS) than patients without ICB (P patient characteristic on the outcome of the disease, level III.

  3. Engaging children in the development of obesity interventions: exploring outcomes that matter most among obesity positive outliers

    OpenAIRE

    Sharifi, Mona; Marshall, Gareth; Goldman, Roberta E.; Cunningham, Courtney; Marshall, Richard; Taveras, Elsie M

    2015-01-01

    Objective To explore outcomes and measures of success that matter most to 'positive outlier' children who improved their body mass index (BMI) despite living in obesogenic neighborhoods. Methods We collected residential address and longitudinal height/weight data from electronic health records of 22,657 children ages 6–12 years in Massachusetts. We defined obesity “hotspots” as zip codes where >15% of children had a BMI ≥95th percentile. Using linear mixed effects models, we gener...

  4. Psychosocial functioning in pediatric heart transplant recipients and their families.

    Science.gov (United States)

    Cousino, Melissa K; Schumacher, Kurt R; Rea, Kelly E; Eder, Sally; Zamberlan, Mary; Jordan, Jessica; Fredericks, Emily M

    2018-03-01

    Across pediatric organ transplant populations, patient and family psychosocial functioning is associated with important health-related outcomes. Research has suggested that pediatric heart transplant recipients and their families are at increased risk for adverse psychosocial outcomes; however, recent investigation of psychosocial functioning in this population is lacking. This study aimed to provide a contemporary characterization of psychosocial functioning in pediatric heart transplant recipients and their families. Associations between psychosocial function, demographic variables, and transplant-related variables were investigated. Fifty-six parents/guardians of pediatric heart transplant recipients completed a comprehensive psychosocial screening measure during transplant follow-up clinic visits. Descriptive statistics, correlational analyses, and independent samples t tests were performed. Forty percent of pediatric heart transplant recipients and their families endorsed clinically meaningful levels of total psychosocial risk. One-third of patients presented with clinically significant psychological problems per parent report. Psychosocial risk was unassociated with demographic or transplant-related factors. Despite notable improvements in the survival of pediatric heart transplant recipients over the past decade, patients and families present with sustained psychosocial risks well beyond the immediate post-transplant period, necessitating mental health intervention to mitigate adverse impact on health-related outcomes. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. A conceptual model of psychosocial risk and protective factors for excessive gestational weight gain.

    Science.gov (United States)

    Hill, Briony; Skouteris, Helen; McCabe, Marita; Milgrom, Jeannette; Kent, Bridie; Herring, Sharon J; Hartley-Clark, Linda; Gale, Janette

    2013-02-01

    nearly half of all women exceed the guideline recommended pregnancy weight gain for their Body Mass Index (BMI) category. Excessive gestational weight gain (GWG) is correlated positively with postpartum weight retention and is a predictor of long-term, higher BMI in mothers and their children. Psychosocial factors are generally not targeted in GWG behaviour change interventions, however, multifactorial, conceptual models that include these factors, may be useful in determining the pathways that contribute to excessive GWG. We propose a conceptual model, underpinned by health behaviour change theory, which outlines the psychosocial determinants of GWG, including the role of motivation and self-efficacy towards healthy behaviours. This model is based on a review of the existing literature in this area. there is increasing evidence to show that psychosocial factors, such as increased depressive symptoms, anxiety, lower self-esteem and body image dissatisfaction, are associated with excessive GWG. What is less known is how these factors might lead to excessive GWG. Our conceptual model proposes a pathway of factors that affect GWG, and may be useful for understanding the mechanisms by which interventions impact on weight management during pregnancy. This involves tracking the relationships among maternal psychosocial factors, including body image concerns, motivation to adopt healthy lifestyle behaviours, confidence in adopting healthy lifestyle behaviours for the purposes of weight management, and actual behaviour changes. health-care providers may improve weight gain outcomes in pregnancy if they assess and address psychosocial factors in pregnancy. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Socioeconomic position and ten-year survival and virologic outcomes in a Ugandan HIV cohort receiving antiretroviral therapy.

    Directory of Open Access Journals (Sweden)

    Andrew G Flynn

    Full Text Available Lifelong ART is essential to reducing HIV mortality and ending the epidemic, however the interplay between socioeconomic position and long-term outcomes of HIV-infected persons receiving antiretroviral therapy (ART in sub-Saharan Africa is unknown. Furthering the understanding of factors related to long-term ART outcomes in this important region will aid the successful scale-up of ART programs. We enrolled 559 HIV-infected Ugandan adults starting ART in 2004-2005 at the Infectious Diseases Institute in Kampala, Uganda and followed them for 10 years. We documented baseline employment status, regular household income, education level, housing description, physical ability, and CD4 count. Viral load was measured every six months. Proportional hazard regression tested for associations between baseline characteristics and 1 mortality, 2 virologic failure, and 3 mortality or virologic failure as a composite outcome. Over ten years 23% (n = 127 of participants died, 6% (n = 31 were lost-to-follow-up and 23% (107/472 experienced virologic treatment failure. In Kaplan-Meier analysis we observed an association between employment and mortality, with the highest cumulative probability of death occurring in unemployed individuals. In univariate analysis unemployment and disease severity were associated with mortality, but in multivariable analysis the only association with mortality was disease severity. We observed an association between higher household income and an increased incidence of both virologic failure and the combined outcome, and an association between self-employment and lower incidence of virologic failure and the combined outcome when compared to unemployment. Formal education level and housing status were unrelated to outcomes. It is feasible to achieve good ten-year survival, retention-in-care, and viral suppression in a socioeconomically diverse population in a resource-limited setting. Unemployment appears to be related to adverse 10

  7. Positive outcomes following gait therapy intervention for hip osteoarthritis: A longitudinal study.

    Science.gov (United States)

    Solomonow-Avnon, Deborah; Herman, Amir; Levin, Daniel; Rozen, Nimrod; Peled, Eli; Wolf, Alon

    2017-10-01

    Footwear-generated biomechanical manipulation of lower-limb joints was shown to beneficially impact gait and quality of life in knee osteoarthritis patients, but has not been tested in hip osteoarthritis patients. We examined a customized gait treatment program using a biomechanical device shown in previous investigations to be capable of manipulating hip biomechanics via foot center of pressure (COP) modulation. The objective of this study was to assess the treatment program for hip osteoarthritis patients, enrolled in a 1-year prospective investigation, by means of objective gait and spatiotemporal parameters, and subjective quality of life measures. Gait analysis and completion of questionnaires were performed at the start of the treatment (baseline), and after 3, 6, and 12 months. Outcome parameters were evaluated over time using linear mixed effects models, and association between improvement in quality of life measures and change in objective outcomes was tested using mixed effect linear regression models. Quality of life measures improved compared to baseline, accompanied by increased gait speed and cadence. Sagittal-plane hip joint kinetics, kinematics, and spatiotemporal parameters changed throughout the study compared to baseline, in a manner suggesting improvement of gait. The most substantial improvement occurred within 3 months after treatment initiation, after which improvement approximately plateaued, but was sustained at 12 months. Speed and cadence, as well as several sagittal-plane gait parameters, were significant predictors of improvement in quality of life. Evidence suggests that a biomechanical gait therapy program improves subjective and objective outcomes measures and is a valid treatment option for hip osteoarthritis. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2222-2232, 2017. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  8. Religious and Spiritual Salience, Well-Being, and Psychosocial Functioning Among Psychotherapy Clients: Moderator Effects for Humility.

    Science.gov (United States)

    Paine, David R; Sandage, Steven J; Ruffing, Elizabeth G; Hill, Peter C

    2018-04-21

    A number of studies have examined the mediating factors in the relationship between religion and spirituality (R/S) and psychological health. Humility is a virtue that has been positively correlated with R/S variables, measures of well-being, and indicators of psychosocial functioning. In this study, we investigate dispositional humility as a potential moderator in the relationship between religious and spiritual salience and (1) well-being and (2) psychosocial functioning outcomes in a clinical sample. Results indicated that dispositional humility significantly moderated the relationships tested. Implications for future research and clinical practice are discussed.

  9. Positive outcomes of participatory ergonomics in terms of greater comfort and higher productivity

    NARCIS (Netherlands)

    Vink, P.; Koningsveld, E.A.P.; Molenbroek, J.F.

    2006-01-01

    Ergonomics sometimes has a negative connotation, as it is seen to be connected to illness or guidelines that limit innovations. This paper is focused on the positive aspects of ergonomics in improvement of the working environment. It consists of a part that studies the literature on success factors

  10. Positive Discrimination in Education: A Comparative Investigation of Its Bases, Forms, and Outcomes.

    Science.gov (United States)

    Wang, Bee-Lan Chan

    1983-01-01

    Explores some basic theoretical questions pertaining to positive discrimination in education, drawing from empirical experiences of several countries that have practiced it in one form or another--the United States, India, Malaysia, and Sri Lanka. Encompasses policies and practices that have variously been called reverse discrimination,…

  11. Positive Behavior Support in Delaware Schools: Developing Perspectives on Implementation and Outcomes. Executive Summary

    Science.gov (United States)

    Ackerman, Cheryl M.; Cooksy, Leslie J.; Murphy, Aideen; Rubright, Jonathan; Bear, George; Fifield, Steve

    2010-01-01

    In Spring 2010, the Delaware Education Research and Development Center conducted an evaluation of Delaware's PBS project, an initiative focused on developing a school-wide system of strategies to reduce behavior problems and foster a positive school climate. The study focused on facilitators and barriers to PBS implementation, and also included…

  12. Positive Youth Development within a Family Leisure Context: Youth Perspectives of Family Outcomes

    Science.gov (United States)

    Ward, Peter J.; Zabriskie, Ramon B.

    2011-01-01

    Family leisure involvement may provide the first and most essential context for positive youth development in today's society. Similar to the broader ecological perspective used in the youth development literature, family systems theory suggests that each individual in the family influences the whole, while the whole family also influences each…

  13. Hepatitis C virus reinfection incidence and treatment outcome among HIV-positive MSM.

    Science.gov (United States)

    Martin, Thomas C S; Martin, Natasha K; Hickman, Matthew; Vickerman, Peter; Page, Emma E; Everett, Rhiannon; Gazzard, Brian G; Nelson, Mark

    2013-10-23

    Liver disease secondary to hepatitis C virus (HCV) infection in the context of HIV infection is one of the leading non-AIDS causes of death. Sexual transmission of HCV infection among HIV-positive MSM appears to be leading to increased reports of acute HCV infection. Reinfection after successful treatment or spontaneous clearance is reported among HIV-positive MSM but the scale of reinfection is unknown. We calculate and compare HCV reinfection rates among HIV-positive MSM after spontaneous clearance and successful medical treatment of infection. Retrospective analysis of HIV-positive MSM with sexually acquired HCV who subsequently spontaneously cleared or underwent successful HCV treatment between 2004 and 2012. Among 191 individuals infected with HCV, 44 were reinfected over 562 person-years (py) of follow-up with an overall reinfection rate of 7.8/100 py [95% confidence interval (CI) 5.8-10.5]. Eight individuals were subsequently reinfected a second time at a rate of 15.5/100 py (95% CI 7.7-31.0). Combining all reinfections, 20% resulted in spontaneous clearance and treatment sustained viral response rates were 73% (16/22) for genotypes one and four and 100% (2/2) for genotypes two and three. Among 145 individuals with a documented primary infection, the reinfection rate was 8.0 per 100 py (95% CI 5.7-11.3) overall, 9.6/100 py (95% CI 6.6-14.1) among those successfully treated and 4.2/100 py (95% CI 1.7-10.0) among those who spontaneously cleared. The secondary reinfection rate was 23.2/100 py (95% CI 11.6-46.4). Despite efforts at reducing risk behaviour, HIV-positive MSM who clear HCV infection remain at high risk of reinfection. This emphasizes the need for increased sexual education, surveillance and preventive intervention work.

  14. Effect of Supine vs Prone Position on Outcomes of Percutaneous Nephrolithotomy in Staghorn Calculi: Results From the Clinical Research Office of the Endourology Society Study

    DEFF Research Database (Denmark)

    Astroza, Gaston; Lipkin, Michael; Neisius, Andreas

    2013-01-01

    To analyze the effect of patient positioning on outcomes of percutaneous nephrolithotomy (PNL) among patients with staghorn stones. The choice of optimal position for these patients undergoing PNL remains challenging. No previous studies exclusively addressing this point have been performed....

  15. The CORE study protocol: a stepped wedge cluster randomised controlled trial to test a co-design technique to optimise psychosocial recovery outcomes for people affected by mental illness in the community mental health setting.

    Science.gov (United States)

    Palmer, Victoria J; Chondros, Patty; Piper, Donella; Callander, Rosemary; Weavell, Wayne; Godbee, Kali; Potiriadis, Maria; Richard, Lauralie; Densely, Konstancja; Herrman, Helen; Furler, John; Pierce, David; Schuster, Tibor; Iedema, Rick; Gunn, Jane

    2015-03-24

    User engagement in mental health service design is heralded as integral to health systems quality and performance, but does engagement improve health outcomes? This article describes the CORE study protocol, a novel stepped wedge cluster randomised controlled trial (SWCRCT) to improve psychosocial recovery outcomes for people with severe mental illness. An SWCRCT with a nested process evaluation will be conducted over nearly 4 years in Victoria, Australia. 11 teams from four mental health service providers will be randomly allocated to one of three dates 9 months apart to start the intervention. The intervention, a modified version of Mental Health Experience Co-Design (MH ECO), will be delivered to 30 service users, 30 carers and 10 staff in each cluster. Outcome data will be collected at baseline (6 months) and at completion of each intervention wave. The primary outcome is improvement in recovery score using the 24-item Revised Recovery Assessment Scale for service users. Secondary outcomes are improvements to user and carer mental health and well-being using the shortened 8-item version of the WHOQOL Quality of Life scale (EUROHIS), changes to staff attitudes using the 19-item Staff Attitudes to Recovery Scale and recovery orientation of services using the 36-item Recovery Self Assessment Scale (provider version). Intervention and usual care periods will be compared using a linear mixed effects model for continuous outcomes and a generalised linear mixed effects model for binary outcomes. Participants will be analysed in the group that the cluster was assigned to at each time point. The University of Melbourne, Human Research Ethics Committee (1340299.3) and the Federal and State Departments of Health Committees (Project 20/2014) granted ethics approval. Baseline data results will be reported in 2015 and outcomes data in 2017. Australian and New Zealand Clinical Trials Registry ACTRN12614000457640. Published by the BMJ Publishing Group Limited. For

  16. Psychosocial interventions in opiate substitution treatment services: does the evidence provide a case for optimism or nihilism?

    Science.gov (United States)

    Day, Ed; Mitcheson, Luke

    2017-08-01

    Clinical guidelines from around the world recommend the delivery of psychosocial interventions as part of routine care in opiate substitution treatment (OST) programmes. However, although individual studies demonstrate benefit for structured psychosocial interventions, meta-analytical reviews find no benefit for manual-based treatments beyond 'routine counselling'. We consider the question of whether OST medication alone is sufficient to produce the required outcomes, or whether greater efforts should be made to provide high-quality psychosocial treatment alongside medication. In so doing, we consider the nuances and limitations of the evidence and the organizational barriers to transferring it into routine practice. The evidence base for psychosocial interventions in opiate substitution treatment (OST) services can be interpreted both positively and negatively. Steering a path between overly optimistic or nihilistic interpretations of the value of psychosocial treatment in OST programmes is the most pragmatic approach. Greater attention should be paid to elements common to all psychological treatments (such as therapeutic alliance), but also to the sequencing and packaging of psychosocial elements and their linkage to peer-led interventions. © 2017 Society for the Study of Addiction.

  17. Cardiac rehabilitation with a nurse case manager (GoHeart) across local and regional health authorities improves risk factors, self-care and psychosocial outcomes. A one-year follow-up study.

    Science.gov (United States)

    Hansen, Vibeke Brogaard; Maindal, Helle Terkildsen

    2014-01-01

    In Denmark, the local and regional health authorities share responsibility for cardiac rehabilitation (CR). The objective was to assess effectiveness of CR across sectors coordinated by a nurse case manager (NCM). A one-year follow-up study. A CR programme (GoHeart) was evaluated in a cohort at Lillebaelt Hospital Vejle, DK from 2010 to 2011. Consecutive patients admitted to CR were included. The inclusion criteria were the event of acute myocardial infarction or stable angina and invasive revascularization (left ventricular ejection fraction (LVEF) ≥45%). Cardiac risk factors, stratified self-care and self-reported psychosocial factors (SF12 and Hospital Anxiety and Depression Scale (HADS)) were assessed at admission (phase IIa), at three months at discharge (phase IIb) and at one-year follow-up (phase III). Intention-to-treat and predefined subgroup analysis on sex was performed. Of 241 patients, 183 (75.9%) were included (mean age 63.8 years). At discharge improvements were found in total-cholesterol (p management (p < 0.001), Health status Short Form 12 version (SF12; physical; p < 0.001 and mental; p < 0.01) and in depression symptoms (p < 0.01). At one-year follow-up these outcomes were maintained; additionally there was improvement in body mass index (BMI; p < 0.05), and high density lipoprotein (HDL; p < 0.05). There were no sex differences. CR shared between local and regional health authorities led by a NCM (GoHeart) improves risk factors, self-care and psychosocial factors. Further improvements in most variables were at one-year follow-up.

  18. Psychosocial Adaptation to Chronic Illness and Disability: A Conceptual Framework.

    Science.gov (United States)

    Livneh, Hanoch

    2001-01-01

    Reviews the fundamental components inherent in the process of psychosocial adaptation to chronic illness and disability. It is proposed that psychosocial outcomes correspond to specific or global indicators of quality of life and may be categorized according to their functional domains, content areas, technologies or methods of assessment, and…

  19. Promoting a combination approach to paediatric HIV psychosocial support.

    Science.gov (United States)

    Amzel, Anouk; Toska, Elona; Lovich, Ronnie; Widyono, Monique; Patel, Tejal; Foti, Carrie; Dziuban, Eric J; Phelps, B Ryan; Sugandhi, Nandita; Mark, Daniella; Altschuler, Jenny

    2013-11-01

    is still limited evidence demonstrating which interventions have positive effects on the well being of HIV-infected children. Interventions that improve the psychosocial well being of children living with HIV must be replicable in resource-limited settings, avoiding dependence on specialized staff for implementation.This paper advocates for combination approaches that strengthen the capacity of service providers, expand the availability of age appropriate and family-centred support and equip schools to be more protective and supportive of children living with HIV. The coordination of care with other community-based interventions is also needed to foster more supportive and less stigmatizing environments. To ensure effective, feasible, and scalable interventions, improving the evidence base to document improved outcomes and longer term impact as well as implementation of operational studies to document delivery approaches are needed.

  20. Reality television predicts both positive and negative outcomes for adolescent girls.

    Science.gov (United States)

    Ferguson, Christopher J; Salmond, Kimberlee; Modi, Kamla

    2013-06-01

    To assess the influence of media, specifically reality television, on adolescent behavior. A total of 1141 preteen and adolescent girls (age range 11-17) answered questions related to their reality television viewing, personality, self-esteem, relational aggression, appearance focus, and desire for fame. Our results indicated that the influence of reality television on adolescent behavior is complex and potentially related to the adolescents' intended uses and gratifications for using reality television. Reality television viewing was positively related to increased self-esteem and expectations of respect in dating relationships. However, watching reality television also was related to an increased focus on appearance and willingness to compromise other values for fame. Reality television viewing did not predict relational aggression. The potential influences of reality television use on adolescent girls are both positive and negative, defying easy categorization. Copyright © 2013 Mosby, Inc. All rights reserved.

  1. Scalar position in cochlear implant surgery and outcome in residual hearing and the vestibular system.

    Science.gov (United States)

    Nordfalk, Karl Fredrik; Rasmussen, Kjell; Hopp, Einar; Greisiger, Ralf; Jablonski, Greg Eigner

    2014-02-01

    To evaluate the effect of the intracochlear electrode position on the residual hearing and VNG- and cVEMP responses. Prospective pilot study. Thirteen adult patients who underwent unilateral cochlear implant surgery were examined with high-resolution rotational tomography after cochlear implantation. All subjects were also tested with VNG, and 12 of the subjects were tested with cVEMP and audiometry before and after surgery. We found that although the electrode was originally planned to be positioned inside the scala tympani, only 8 of 13 had full insertion into the scala tympani. Loss of cVEMP response occurred to the same extent in the group with full scala tympani positioning and the group with scala vestibuli involvement. There was a non-significant difference in the loss of caloric response and residual hearing between the two groups. Interscalar dislocation of the electrode inside the cochlea was observed in two patients. A higher loss of residual hearing could be seen in the group with electrode dislocation between the scalae. Our findings indicate that intracochlear electrode dislocation is a possible cause to loss of residual hearing during cochlear implantation but cannot be the sole cause of postoperative vestibular loss.

  2. Exploring factors influencing HbA1c and psychosocial outcomes in people with type 1 diabetes after training in advanced carbohydrate counting.

    Science.gov (United States)

    Schmidt, Signe; Vistisen, Dorte; Almdal, Thomas; Hommel, Eva; Nørgaard, Kirsten

    2017-08-01

    The purpose of this secondary analysis of the StenoABC Study was to identify determinants of the changes in HbA1c observed after training of people with type 1 diabetes in advanced carbohydrate counting (ACC) and automated bolus calculator (ABC) use, and further to investigate psychosocial effects of these insulin dosing approaches. Validated diabetes-specific questionnaires were used to assess diabetes treatment satisfaction, problem areas in diabetes, fear of hypoglycemia and diabetes dependent quality of life before and one year after the training. In addition, numeracy was tested (using a non-validated test developed specifically for this study) and behavioral measures (number of daily blood glucose measurements and self-reported use of ACC) were obtained. Associations between change in HbA1c and these measures plus sex, age, diabetes duration and BMI were tested. Numeracy was the only baseline predictor of yearly change in HbA1c identified. Higher levels of numeracy were associated with greater reductions in HbA1c (P=0.031). No associations between change in HbA1c and the behavioral measures investigated were found, nor were any clinically relevant associations between changes in HbA1c and questionnaire scores. Treatment satisfaction increased in all users of ACC (PHbA1c after training in ACC were inversely related to numeracy. Use of an ABC did not compensate for poor numeracy skills. However, device use reduced fear of hypoglycemia compared with ACC without ABC use. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Expression level of novel tumor suppressor gene FATS is associated with the outcome of node positive breast cancer

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jun; GU Lin; ZHAO Lu-jun; ZHANG Xi-feng; QIU Li; LI Zheng

    2011-01-01

    Background Recently, we reported the identification of a previously uncharacterized and evolutionarily conserved gene, fragile-site associated tumor suppressor (FATS), at a frequently deleted region in irradiation (IR)-induced tumors.However, the role of FATS in breast cancer development and its clinical significance has not been defined. The aim of this study was to determine the role of FA7S in breast cancer development and to evaluate its clinical significance in breast cancer.Methods The expression level of FATS mRNA was determined in 106 breast carcinomas and 23 paired normal breast tissues using quantitative real time reverse transcription-polymerase chain reaction (RT-PCR). The relationship between FATS expression and clinicopathological parameters were also analyzed.Results The mRNA level of FATS was down-regulated in breast cancer compared with paired normal tissues. Low expression of FATS was correlated with high nuclear grade. There was a tendency to a favorable outcome for patients with high expression of FATS (P=0.346). However, low expression of FATS was associated with poor outcome of breast cancer patients with node positive (P=0.011). Furthermore, the mRNA level of FATS showed an independent value in predicting the outcome of breast cancer patients with positive lymph nodes.Conclusion FATS is involved in the carcinogenesis and development of breast cancer and could be a potential biomarker and prognostic factor for breast cancer therapy.

  4. Circumcision policy: A psychosocial perspective.

    Science.gov (United States)

    Goldman, Ronald

    2004-11-01

    The debate about the advisability of circumcision in English-speaking countries has typically focused on the potential health factors. The position statements of committees from national medical organizations are expected to be evidence-based; however, the contentiousness of the ongoing debate suggests that other factors are involved. Various potential factors related to psychology, sociology, religion and culture may also underlie policy decisions. These factors could affect the values and attitudes of medical committee members, the process of evaluating the medical literature and the medical literature itself. Although medical professionals highly value rationality, it can be difficult to conduct a rational and objective evaluation of an emotional and controversial topic such as circumcision. A negotiated compromise between polarized committee factions could introduce additional psychosocial factors. These possibilities are speculative, not conclusive. It is recommended that an open discussion of psychosocial factors take place and that the potential biases of committee members be recognized.

  5. Maternal Prenatal Positive Affect, Depressive and Anxiety Symptoms and Birth Outcomes: The PREDO Study.

    Directory of Open Access Journals (Sweden)

    Anu-Katriina Pesonen

    Full Text Available We investigated whether maternal prenatal emotions are associated with gestational length and birth weight in the large PREDO Study with multiple measurement points of emotions during gestation.Altogether 3376 pregnant women self-assessed their positive affect (PA, Positive and Negative Affect Schedule and depressive (Center for Epidemiologic Studies Depression Scale, CES-D and anxiety (Spielberger State Anxiety Scale, STAI symptoms up to 14 times during gestation. Birth characteristics were derived from the National Birth Register and from medical records.One standard deviation (SD unit higher PA during the third pregnancy trimester was associated with a 0.05 SD unit longer gestational length, whereas one SD unit higher CES-D and STAI scores during the third trimester were associated with 0.04-0.05 SD unit shorter gestational lengths (P-values ≤ 0.02, corresponding to only 0.1-0.2% of the variation in gestational length. Higher PA during the third trimester was associated with a significantly decreased risk for preterm (< 37 weeks delivery (for each SD unit higher positive affect, odds ratio was 0.8-fold (P = 0.02. Mothers with preterm delivery showed a decline in PA and an increase in CES-D and STAI during eight weeks prior to delivery. Post-term birth (≥ 42 weeks, birth weight and fetal growth were not associated with maternal prenatal emotions.This study with 14 measurements of maternal emotions during pregnancy show modest effects of prenatal emotions during the third pregnancy trimester, particularly in the weeks close to delivery, on gestational length. From the clinical perspective, the effects were negligible. No associations were detected between prenatal emotions and birth weight.

  6. Long-term Clinical Outcomes of Whole-Breast Irradiation Delivered in the Prone Position

    International Nuclear Information System (INIS)

    Stegman, Lauren D.; Beal, Katherine P.; Hunt, Margie A.; Fornier, Monica N.; McCormick, Beryl

    2007-01-01

    Purpose: The aim of this study was to evaluate retrospectively the effectiveness and toxicity of post-lumpectomy whole-breast radiation therapy delivered with prone positioning. Methods and Materials: Between September 1992 and August 2004, 245 women with 248 early-stage invasive or in situ breast cancers were treated using a prone breast board. Photon fields treated the whole breast to 46 to 50.4 Gy with standard fractionation. The target volume was clinically palpable breast tissue; no attempt was made to irradiate chest wall lymphatics. Tumor bed boosts were delivered in 85% of cases. Adjuvant chemotherapy and hormonal therapy were administered to 42% and 62% of patients, respectively. Results: After a median follow-up of 4.9 years, the 5 year actuarial true local and elsewhere ipsilateral breast tumor recurrence rates were 4.8% and 1.3%, respectively. The 5-year actuarial rates of regional nodal recurrence and distant metastases were 1.6% and 7.4%. Actuarial disease-free, disease-specific, and overall survival rates at 5 years were 89.4%, 97.3%, and 93%, respectively. Treatment breaks were required by 2.4% of patients. Grade 3 acute dermatitis and edema were each limited to 2% of patients. Only 4.9% of patients complained of acute chest wall discomfort. Chronic Grade 2 to 3 skin and subcutaneous tissue toxicities were reported in 4.4% and 13.7% of patients, respectively. Conclusions: Prone position breast radiation results in similar long-term disease control with a favorable toxicity profile compared with standard supine tangents. The anatomic advantages of prone positioning may contribute to improving the therapeutic ratio of post-lumpectomy radiation by improving dose homogeneity and minimizing incidental cardiac and lung dose

  7. Internal Impingement of the Shoulder: A Risk of False Positive Test Outcomes in External Impingement Tests?

    Directory of Open Access Journals (Sweden)

    Tim Leschinger

    2017-01-01

    Full Text Available Background. External impingement tests are considered as being particularly reliable for identifying subacromial and coracoid shoulder impingement mechanisms. The purpose of the present study was to evaluate if these tests are likely to provoke an internal shoulder impingement mechanism which, in cases of a pathologic condition, can lead to a positive test result. Method. In 37 subjects, the mechanical contact between the glenoid rim and the rotator cuff (RC was measured quantitatively and qualitatively in external impingement test positions using an open MRI system. Results. Mechanical contact of the supraspinatus with the posterosuperior glenoid was present in 30 subjects in the Neer test. In the Hawkins test, the subscapularis was in contact with the anterosuperior glenoid in 33 subjects and the supraspinatus in 18. In the horizontal impingement test, anterosuperior contact of the supraspinatus with the glenoid was identified in 35 subjects. Conclusion. The Neer, Hawkins, and horizontal impingement tests are likely to provoke the mechanism of an internal shoulder impingement. A posterosuperior internal impingement mechanism is being provoked predominately in the Neer test. The Hawkins test narrows the distance between the insertions of the subscapularis and supraspinatus and the anterosuperior labrum, which leads to an anterosuperior impingement mechanism.

  8. Sleep dysfunction and psychosocial adaptation among women undergoing treatment for non-metastatic breast cancer.

    Science.gov (United States)

    Vargas, Sara; Wohlgemuth, William K; Antoni, Michael H; Lechner, Suzanne C; Holley, Heather A; Carver, Charles S

    2010-06-01

    The current study aimed to determine the frequency of sleep disturbances in women prior to adjuvant therapy for breast cancer (BCa), and whether greater sleep dysfunction uniquely predicts poorer functional outcomes. We assessed subjective sleep reports and associated them with multiple indicators of psychosocial adaptation in 240 women with Stage I-III BCa before they had begun adjuvant treatment. The average global score on the Pittsburgh Sleep Quality Index (PSQI) was 8.49 (SD=4.16); 54% scoring above the suggested adjusted cutoff for cancer populations of 8.0. Controlling for various medical, sociodemographic, and psychosocial covariates, multiple regression analyses revealed that higher global PSQI score was significantly associated with poorer functional well-being, greater fatigue intensity, greater disruptions in social interactions, and lower positive states of mind. Specifically, a poorer 'sleep efficiency' PSQI component was associated with poorer functional quality of life and the SIP-Social Interactions subscale, while a poorer 'sleep quality' (SQ) PSQI component was associated with all of the outcomes except for the SIP-Recreations and Pastimes subscale. Results indicate consistent associations between a clinical indicator of sleep dysfunction, particularly those subscales of the PSQI comprising the 'SQ' component, and multiple indicators of psychosocial adaptation among women treated for BCa, independent of anxiety and depression, and suggest the value of comprehensive psychosocial interventions that consider sleep problems. (c) 2009 John Wiley & Sons, Ltd.

  9. Distant metastasis in p16-positive oropharyngeal squamous cell carcinoma: a critical analysis of patterns and outcomes.

    Science.gov (United States)

    Sinha, P; Thorstad, W T; Nussenbaum, B; Haughey, B H; Adkins, D R; Kallogjeri, D; Lewis, J S

    2014-01-01

    With good loco-regional control, disease failure in p16-positive oropharyngeal squamous cell carcinoma (OPSCC) mainly results from distant metastasis (DM). Our objective was to characterize the patterns and clinical outcomes of DM in p16-positive OPSCC and compare these to patients with p16-negative disease. Primary OPSCC patients who developed DM after completing surgical or non-surgical treatment were identified and p16 status was evaluated. Patterns of DM and post-DM progression-free (PFS) and disease-specific survival (DSS) were assessed. Forty-one of the 66 (62%) patients with DM were p16-positive. DM patterns were not statistically different by p16 status. However, p16-positive patients developed DM later in their course and had longer survival. All p16-negative patients either had progression or died within 24 months of DM detection whereas the 2-year post-DM PFS in the p16-positive group was 20% (95% CI: 8-32.5%, p=0.003). The 3-year post-DM disease-specific survival (DSS) estimate in the p16-positive patients was 16% (95% CI: 7-18%) while all p16-negative patients died within 34 months (p<0.001). p16-negativity, loco-regional disease, and no/palliative versus curative intent treatment were all associated with reduced post-DM DSS in multivariate analysis. The DM pattern did not differ remarkably between p16-positive and negative OPSCC patients in our practice. In p16-positive OPSCC with pulmonary oligometastatic disease, curative intent treatment and optimized locoregional control for the index primary prolonged survival. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Interdisciplinary care in disorders/differences of sex development (DSD): The psychosocial component of the DSD-Translational research network.

    Science.gov (United States)

    Sandberg, David E; Gardner, Melissa; Callens, Nina; Mazur, Tom

    2017-06-01

    Scientific discovery and clinical management strategies for Disorders/Differences of Sex Development (DSD) have advanced in recent years. The 2006 Consensus Statement on Management of Intersex Disorders stated that a mental health component to care is integral to promote positive adaptation, yet the parameters of this element have not been described. The objective of this paper is threefold: to describe the psychosocial screening protocol adopted by the clinical centers of the DSD-Translational Research Network; to summarize psychosocial data collected at 1 of the 10 network sites; and to suggest how systematic behavioral health screenings can be employed to tailor care in DSD that results in better health and quality of life outcomes. Steps taken in developing the largely "noncategorical" screening protocol are described. These preliminary findings suggest that DSD, as one category of pediatric chronic conditions, is not associated with marked disturbances of psychosocial adaptation, either for the family or the child; however, screening frequently uncovered "risk factors" for individual families or patients that can potentially be addressed in the context of ongoing clinical care. Administration of the DSD-TRN psychosocial screening protocol was demonstrated to be feasible in the context of interdisciplinary team care and was acceptable to families on a longitudinal basis. The ultimate value of systematic screening will be demonstrated through a tailoring of psychosocial, medical and surgical services, based on this information that enhances the quality of patient and family-centered care and subsequent outcomes. © 2017 Wiley Periodicals, Inc.

  11. Self-regulation as a mediator between sibling relationship quality and early adolescents' positive and negative outcomes.

    Science.gov (United States)

    Padilla-Walker, Laura M; Harper, James M; Jensen, Alexander C

    2010-08-01

    The current study examined the role of adolescents' self-regulation as a mediator between sibling relationship quality and adolescent outcomes, after controlling for the quality of the parent-child relationship. Participants were 395 families (282 two parent; 113 single parent) with an adolescent child (M age of child at Time 1 = 11.15, SD = .96, 49% female) who took part in [project name masked for blind review] at both Time 1 and Time 2. Path analysis via structural equation modeling suggested that sibling affection was longitudinally and positively related to self-regulation and prosocial behaviors, and negatively related to externalizing behaviors; while sibling hostility was positively, and having a sister was negatively related to internalizing behaviors (in general, paths were stronger for adolescents from two- vs. single-parent families). There was also evidence that adolescents' self-regulation partially mediated the relation between sibling affection and positive and negative adolescent outcomes. The discussion focuses on the importance of continued research examining the mechanisms through which the sibling relationship influences development during adolescence.

  12. A Ten-Year Review of Antenatal Complications and Pregnancy Outcomes Among HIV-Positive Pregnant Women.

    Science.gov (United States)

    Yudin, Mark H; Caprara, Daniela; MacGillivray, S Jay; Urquia, Marcelo; Shah, Rajiv R

    2016-01-01

    To review the incidence of antenatal complications among a cohort of HIV-positive pregnant women over a 10-year period. A retrospective review was performed of all HIV-positive pregnant women receiving multidisciplinary prenatal care at an urban tertiary care centre from March 2000 to March 2010. Collected data included the presence of additional infectious or medical conditions, genetic screening information, and the presence or absence of antenatal complications. One hundred and forty-two singleton pregnancies during the study period were identified. Almost 95% of women were taking combination antiretroviral therapy during pregnancy, and greater than 90% had viral loads less than 1000 copies/ml at delivery. The presence of co-infections was low. Forty-one women (29%) had other medical comorbidities. Genetic screening occurred in 104 pregnancies (73%); 4% were abnormal screens. Rates of any hypertension, gestational diabetes, and fetal growth restriction were all low. Thirty-two percent of women were colonized with group B streptococcus. This study adds strength to the argument that good outcomes can be achieved for HIV-positive pregnant women with good access to both prenatal and HIV care, and appropriate management. Women with HIV should be optimally cared for in advance of and during pregnancy in order to maximize the likelihood of good pregnancy outcomes. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  13. From Parent-Child Mutuality to Security to Socialization Outcomes: Developmental Cascade toward Positive Adaptation in Preadolescence

    Science.gov (United States)

    Kim, Sanghag; Boldt, Lea J.; Kochanska, Grazyna

    2016-01-01

    A developmental cascade from positive early parent-child relationship to child security with the parent to adaptive socialization outcomes, proposed in attachment theory and often implicitly accepted but rarely formally tested, was examined in 100 mothers, fathers, and children followed from toddler age to preadolescence. Parent-child Mutually Responsive Orientation (MRO) was observed in lengthy interactions at 38, 52, 67, and 80 months; children reported their security with parents at age 8. Socialization outcomes (parent- and child-reported cooperation with parental monitoring and teacher-reported school competence) were assessed at age 10. Mediation was tested with PROCESS (Hayes, 2013). The parent-child history of MRO significantly predicted both mother-child and father-child security. For mother-child dyads, security mediated links between history of MRO and cooperation with maternal monitoring and school competence, controlling for developmental continuity of the studied constructs. For father-child dyads, the mediation effect was not evident. PMID:26258443

  14. Adverse psychosocial factors predict poorer prognosis in HIV disease: a meta-analytic review of prospective investigations.

    Science.gov (United States)

    Chida, Yoichi; Vedhara, Kavita

    2009-05-01

    There is a growing epidemiological literature focusing on the association between psychosocial stress and human immunodeficiency virus (HIV) disease progression or acquired immunodeficiency syndrome (AIDS), but inconsistent findings have been published. We aimed to quantify the association between adverse psychosocial factors and HIV disease progression. We searched Medline; PsycINFO; Web of Science; PubMed up to 19 January 2009, and included population studies with a prospective design that investigated associations between adverse psychosocial factors and HIV disease progression or AIDS. Two reviewers independently extracted data on study characteristics, quality, and estimates of associations. The overall meta-analysis examined 36 articles including 100 psychosocial and disease related relationships. It exhibited a small, but robust positive association between adverse psychosocial factors and HIV progression (correlation coefficient as combined size effect 0.059, 95% confidence interval 0.043-0.074, p<0.001). Notably, sensitivity analyses showed that personality types or coping styles and psychological distress were more strongly associated with greater HIV disease progression than stress stimuli per se, and that all of the immunological and clinical outcome indicators (acquired immunodeficiency syndrome stage, CD4+ T-cell decline, acquired immunodeficiency syndrome diagnosis, acquired immunodeficiency syndrome mortality, and human immunodeficiency virus disease or acquired immunodeficiency syndrome symptoms) except for viral load exhibited detrimental effects by adverse psychosocial factors. In conclusion, the current review reveals a robust relationship between adverse psychosocial factors and HIV disease progression. Furthermore, there would appear to be some evidence for particular psychosocial factors to be most strongly associated with HIV disease progression.

  15. Cardiac rehabilitation with a nurse case manager (GoHeart across local and regional health authorities improves risk factors, self-care and psychosocial outcomes. A one-year follow-up study

    Directory of Open Access Journals (Sweden)

    Vibeke Brogaard Hansen

    2014-10-01

    Full Text Available Objectives In Denmark, the local and regional health authorities share responsibility for cardiac rehabilitation (CR. The objective was to assess effectiveness of CR across sectors coordinated by a nurse case manager (NCM. Design A one-year follow-up study. Setting A CR programme (GoHeart was evaluated in a cohort at Lillebaelt Hospital Vejle, DK from 2010 to 2011. Participants Consecutive patients admitted to CR were included. The inclusion criteria were the event of acute myocardial infarction or stable angina and invasive revascularization (left ventricular ejection fraction (LVEF ≥45%. Main outcome measures Cardiac risk factors, stratified self-care and self-reported psychosocial factors (SF12 and Hospital Anxiety and Depression Scale (HADS were assessed at admission (phase IIa, at three months at discharge (phase IIb and at one-year follow-up (phase III. Intention-to-treat and predefined subgroup analysis on sex was performed. Results Of 241 patients, 183 (75.9% were included (mean age 63.8 years. At discharge improvements were found in total-cholesterol ( p  < 0.001, low density lipoprotein (LDL; p  < 0.001, functional capacities (metabolic equivalent of tasks (METS, p  < 0.01, self-care management ( p  < 0.001, Health status Short Form 12 version (SF12; physical; p  < 0.001 and mental; p  < 0.01 and in depression symptoms ( p  < 0.01. At one-year follow-up these outcomes were maintained; additionally there was improvement in body mass index (BMI; p  < 0.05, and high density lipoprotein (HDL; p  < 0.05. There were no sex differences. Conclusion CR shared between local and regional health authorities led by a NCM (GoHeart improves risk factors, self-care and psychosocial factors. Further improvements in most variables were at one-year follow-up.

  16. The impact of mindfulness-based interventions on symptom burden, positive psychological outcomes, and biomarkers in cancer patients

    Directory of Open Access Journals (Sweden)

    Rouleau CR

    2015-06-01

    Full Text Available Codie R Rouleau,1 Sheila N Garland,2 Linda E Carlson3 1Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB, Canada; 2Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 3Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada Abstract: Research on the use of mindfulness-based stress reduction and related mindfulness-based interventions (MBIs in cancer care has proliferated over the past decade. MBIs have aimed to facilitate physical and emotional adjustment to life with cancer through the cultivation and practice of mindfulness (ie, purposeful, nonjudgmental, moment-to-moment awareness. This descriptive review highlights three categories of outcomes that have been evaluated in MBI research with cancer patients – namely, symptom reduction, positive psychological growth, and biological outcomes. We also examine the clinical relevance of each targeted outcome, while describing recently published original studies to highlight novel applications of MBIs tailored to individuals with cancer. Accumulating evidence suggests that participation in a MBI contributes to reductions in psychological distress, sleep disturbance, and fatigue, and promotes personal growth in areas such as quality of life and spirituality. MBIs may also influence markers of immune function, hypothalamic–pituitary–adrenal axis regulation, and autonomic nervous system activity, though it remains unclear whether these biological changes translate to clinically important health benefits. We conclude by discussing methodological limitations of the extant literature, and implications of matching MBIs to the needs and preferences of cancer patients. Overall, the growing popularity of MBIs in cancer care must be balanced against scientific evidence for their impact on specific clinical outcomes. Keywords: mindfulness-based intervention

  17. Establishing a pragmatic framework to optimise health outcomes in heart failure and multimorbidity (ARISE-HF): A multidisciplinary position statement.

    Science.gov (United States)

    Stewart, Simon; Riegel, Barbara; Boyd, Cynthia; Ahamed, Yasmin; Thompson, David R; Burrell, Louise M; Carrington, Melinda J; Coats, Andrew; Granger, Bradi B; Hides, Julie; Weintraub, William S; Moser, Debra K; Dickson, Victoria Vaughan; McDermott, Cressida J; Keates, Ashley K; Rich, Michael W

    2016-06-01

    Multimorbidity in heart failure (HF), defined as HF of any aetiology and multiple concurrent conditions that require active management, represents an emerging problem within the ageing HF patient population worldwide. To inform this position paper, we performed: 1) an initial review of the literature identifying the ten most common conditions, other than hypertension and ischaemic heart disease, complicating the management of HF (anaemia, arrhythmias, cognitive dysfunction, depression, diabetes, musculoskeletal disorders, renal dysfunction, respiratory disease, sleep disorders and thyroid disease) and then 2) a review of the published literature describing the association between HF with each of the ten conditions. From these data we describe a clinical framework, comprising five key steps, to potentially improve historically poor health outcomes in this patient population. We identified five key steps (ARISE-HF) that could potentially improve clinical outcomes if applied in a systematic manner: 1) Acknowledge multimorbidity as a clinical syndrome that is associated with poor health outcomes, 2) Routinely profile (using a standardised protocol - adapted to the local health care system) all patients hospitalised with HF to determine the extent of concurrent multimorbidity, 3) Identify individualised priorities and person-centred goals based on the extent and nature of multimorbidity, 4) Support individualised, home-based, multidisciplinary, case management to supplement standard HF management, and 5) Evaluate health outcomes well beyond acute hospitalisation and encompass all-cause events and a person-centred perspective in affected individuals. We propose ARISE-HF as a framework for improving typically poor health outcomes in those affected by multimorbidity in HF. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  18. Outcome of hypovascular hepatic nodules with positive uptake of gadoxetic acid in patients with cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Sano, Katsuhiro; Ichikawa, Tomoaki; Morisaka, Hiroyuki [University of Yamanashi, Department of Radiology, Chuo-City, Yamanashi (Japan); Saitama Medical University International Medical Center, Department of Diagnostic Radiology, Hidaka-City, Saitama (Japan); Motosugi, Utaroh; Ichikawa, Shintaro [University of Yamanashi, Department of Radiology, Chuo-City, Yamanashi (Japan); Enomoto, Nobuyuki [University of Yamanashi, First Department of Internal Medicine, Yamanashi (Japan); Matsuda, Masanori; Fujii, Hideki [University of Yamanashi, First Department of Surgery, Yamanashi (Japan)

    2017-02-15

    To evaluate the longitudinal risk to patients with cirrhosis of hypervascular hepatocellular carcinoma (HCC) developing from hypovascular hepatic nodules that show positive uptake of gadoxetic acid (hyperintensity) on hepatocyte phase images. In 69 patients, we evaluated findings from serial follow-up examinations of 633 hepatic nodules that appeared hypovascular and hyperintense on initial gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) until the nodules demonstrated hypervascularity and were diagnosed as hypervascular HCC. Cox analyses were performed to identify risk factors for the development of hypervascular HCCs from the nodules. The median follow-up was 663 days (range, 110 to 1215 days). Hypervascular HCCs developed in six of the 633 nodules (0.9 %) in five of the 69 patients. The only independent risk factor, the nodule's initial maximum diameter of 10 mm or larger, demonstrated a hazard ratio of 1.25. The one-year risk of hypervascular HCC developing from a nodule was 0.44 %. The risk was significantly higher for nodules of larger diameter (1.31 %) than those smaller than 10 mm (0.10 %, p < 0.01). Hypervascular HCC rarely develops from hypovascular, hyperintense hepatic nodules. We observed low risk even for nodules of 10 mm and larger diameter at initial examination. (orig.)

  19. Two Cases of Endogenous Endophthalmitis Caused by Gram-Positive Bacteria with Good Visual Outcome

    Directory of Open Access Journals (Sweden)

    Machiko Itoh

    2010-09-01

    Full Text Available Background: Endogenous endophthalmitis is a rare disease and its visual prognosis is poor. Case Reports: We present two patients, a 60-year-old man and a 53-year-old man, who developed endogenous endophthalmitis caused byGram-positive organismsbut recovered good vision after antibiotics and vitrectomy. Results: The first patient complained of ocular pain and visual decrease in his right eye. Ophthalmoscopy showed inflammation in the anterior chamber and vitreous opacities. Antibiotic was administrated systemically, and blood culture detected Streptococcus anginosus. He underwent successful heart surgery for endocarditis and total dental extraction for severe gingivitis. Vitrectomy was performed 36 days after the onset and vision improved from 0.02 to 0.7. The second patient was referred for acute visual decrease in his left eye. Severe iritis and vitreous opacities were observed, and systemic examination showed acute pyelitis and prostatic abscesses. Blood cultures detected Staphylococcus sp., and systemic antibiotics were given. Vitrectomy was performed 12 days after the onset, and vision improved from 0.06 to 1.2. Conclusions: We conclude that the rapid treatment with systemic antibiotics for the organisms at the primary site, and the vitrectomy, even though delayed, can lead to a good recovery of vision.

  20. The role of emergency neurology in Italy: outcome of a consensus meeting for a Intersociety position.

    Science.gov (United States)

    Micieli, Giuseppe; De Falco, Fabrizio A; Consoli, Domenico; Inzitari, Domenico; Sterzi, Roberto; Tedeschi, Gioacchino; Toni, Danilo

    2012-04-01

    A possible definition of clinical, educational and organizing aspects of emergency neurology in Italy is reported in this position paper of Emergency Neurology Intersociety Group, created in 2008 among the two neurological Societies in Italy: Società Italiana di Neurologia and Società di Neuroscienze Ospedaliere. The aim of this Group has been the evaluation of the role of neurologist in the emergency setting of Italian hospitals, as well as of the description of different scenarios in which a ward dedicated to a semi-intensive care of neurological emergencies could have a role in the actual organization of academic or general hospitals in our Country. The actual great relevance of neurologist activity in the inpatients treatment, in fact, is actually misleaded as it is the considerable significance of neurological expertise, techniques and support in hospital care pathways also involving neurological manifestations throughout the course of other diseases. Finally, the possible contents of educational programs orienting neurological specialty towards a better comprehension and management of emergency neurological problems either in terms of specific formation or of techniques to be learned by emergency neurologist, are reported as a results of the Consensus Workshop hold in Castiglioncello (LI) in September 12th, 2009.

  1. Positive outcomes influence the rate and time to publication, but not the impact factor of publications of clinical trial results.

    Directory of Open Access Journals (Sweden)

    Pilar Suñé

    Full Text Available OBJECTIVES: Publication bias may affect the validity of evidence based medical decisions. The aim of this study is to assess whether research outcomes affect the dissemination of clinical trial findings, in terms of rate, time to publication, and impact factor of journal publications. METHODS AND FINDINGS: All drug-evaluating clinical trials submitted to and approved by a general hospital ethics committee between 1997 and 2004 were prospectively followed to analyze their fate and publication. Published articles were identified by searching Pubmed and other electronic databases. Clinical study final reports submitted to the ethics committee, final reports synopses available online and meeting abstracts were also considered as sources of study results. Study outcomes were classified as positive (when statistical significance favoring experimental drug was achieved, negative (when no statistical significance was achieved or it favored control drug and descriptive (for non-controlled studies. Time to publication was defined as time from study closure to publication. A survival analysis was performed using a Cox regression model to analyze time to publication. Journal impact factors of identified publications were recorded. Publication rate was 48·4% (380/785. Study results were identified for 68·9% of all completed clinical trials (541/785. Publication rate was 84·9% (180/212 for studies with results classified as positive and 68·9% (128/186 for studies with results classified as negative (p<0·001. Median time to publication was 2·09 years (IC95 1·61-2·56 for studies with results classified as positive and 3·21 years (IC95 2·69-3·70 for studies with results classified as negative (hazard ratio 1·99 (IC95 1·55-2·55. No differences were found in publication impact factor between positive (median 6·308, interquartile range: 3·141-28·409 and negative result studies (median 8·266, interquartile range: 4·135-17·157. CONCLUSIONS

  2. Matched Cohort Analysis of Outcomes of Definitive Radiotherapy for Prostate Cancer in Human Immunodeficiency Virus-Positive Patients

    Energy Technology Data Exchange (ETDEWEB)

    Kahn, Shannon, E-mail: shannonkahn@yahoo.com [Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA (United States); Jani, Ashesh; Edelman, Scott; Rossi, Peter; Godette, Karen; Landry, Jerome; Anderson, Cynthia [Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA (United States); Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA (United States)

    2012-05-01

    Purpose: To compare the biochemical outcome and toxicity scores of men with human immunodeficiency virus (HIV) and prostate cancer with a matched control population with negative or unknown HIV status when treated with external-beam radiotherapy (EBRT). Methods and Materials: A single-institution database of men with prostate cancer treated with EBRT from 1999 to 2009 was reviewed. Thirteen men with HIV were identified and matched to 2 control patients according to age, race, T stage, prostate-specific antigen level, Gleason score, RT dose, intensity-modulated RT vs. three-dimensional conformal RT, and whole-pelvis vs. prostate-only RT, for a total of 39 cases. The median follow-up time was 39 months (range, 3-110 months). Results: The 4-year biochemical failure (BF)-free survival rate was 87% in the HIV-positive group vs. 89% in the controls (p = 0.94). Pre- and post-RT viral loads were found to be predictive of BF (p = 0.04 and p = 0.04, respectively). No men with HIV died, whereas 2 in the control group died of causes unrelated to prostate cancer. Acute and chronic genitourinary and gastrointestinal toxicity were less in the HIV-positive patients than in controls (p < 0.001, p < 0.001, p = 0.003, and p < 0.001, respectively). The HIV-positive men experienced an average decline in CD4 count of 193 cells/mm{sup 3}. Conclusions: Our findings suggest that men with HIV treated with EBRT have a similar risk of BF; however, high viral loads may contribute to an increased risk. This analysis supports that HIV-positive men with prostate cancer can be treated with definitive EBRT with similar disease control and toxicity outcomes as in the general population.

  3. Assessment of psychosocial impact of dental aesthetics.

    Science.gov (United States)

    Khan, Munizeh; Fida, Mubassar

    2008-09-01

    To assess the psychosocial impact of dental aesthetics using the 'Psychosocial Impact of Dental Aesthetics Questionnaire' (PIDAQ) and self-rated Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). Cross-sectional study. Dental Section, the Aga Khan University Hospital, Karachi, from August to September 2006. Adults with no prior orthodontic treatment were asked to complete a modified version of the 'Psychosocial Impact of Dental Aesthetics Questionnaire' (PIDAQ). A total of four variables including 'Dental Self-confidence', 'Social impact', 'Psychological impact' and 'Perceived orthodontic treatment need' were assessed by a series of statements, whereas dental aesthetics were assessed by the respondents using the IOTN Aesthetic Component (self-rated IOTN-AC). Kruskal-Walli's test was applied to determine significance. The respondents were 120 adults (70 females and 50 males; mean age 25.8 years), all four of the above-mentioned variables measuring psychosocial impact showed positive and significant correlations with the perceived severity of malocclusion as depicted by the Aesthetic Component (AC) of Index of Orthodontic Treatment Need (IOTN), with p-value of less than 0.01 for all variables. The results indicate the strong psychosocial impact of altered dental aesthetics on the emotional state of an individual. The association between self-rated IOTN-AC grading with psychosocial well-being stands established, indicating that the perceived aesthetics of malocclusion may be as significant a factor in determining treatment need as the degree of malocclusion.

  4. Age but not Philadelphia positivity impairs outcome in older/elderly patients with acute lymphoblastic leukemia in Sweden.

    Science.gov (United States)

    Kozlowski, Piotr; Lennmyr, Emma; Ahlberg, Lucia; Bernell, Per; Hulegårdh, Erik; Karbach, Holger; Karlsson, Karin; Tomaszewska-Toporska, Beata; Åström, Maria; Hallböök, Heléne

    2017-08-01

    Older/elderly patients with acute lymphoblastic leukemia (ALL) are poorly represented in clinical trials. Using Swedish national leukemia registries, we investigated disease/patient characteristics, treatment choices, outcome, and the impact of an age-adapted protocol (introduced in 2009) in this population-based study of patients aged 55-85 years, diagnosed with ALL 2005-2012. Of 174 patients, 82% had B-phenotype, 11% Burkitt leukemia (excluded), and 7% T-phenotype. Philadelphia chromosome positivity (Ph+) occurred in 35%. Of the 155 B- and T-ALL patients, 80% were treated with intensive protocols, and 20% with a palliative approach. Higher age and WHO performance status ≥2 influenced the choice of palliation. Intensive, palliative, and both approaches resulted in complete remission rate 83/16/70% and 3-year overall survival (OS) 32/3/26%. The age-adapted protocol did not improve outcome. With intensive treatment, platelet count ≤35×10 9 /L and age ≥75 years were adverse prognostic factors for OS, Ph+ was not. Male sex was an adverse prognostic factor in the 55-64 year age-group. We report a high frequency of Ph+ in older/elderly patients, with no evidence of poorer outcome compared to Ph-negative disease. Overall prognosis for elderly patients with ALL remains dismal, despite the use of age-adapted treatment. © 2017 The Authors. European Journal of Haematology Published by John Wiley & Sons Ltd.

  5. The effects of positive and negative parenting practices on adolescent mental health outcomes in a multicultural sample of rural youth.

    Science.gov (United States)

    Smokowski, Paul R; Bacallao, Martica L; Cotter, Katie L; Evans, Caroline B R

    2015-06-01

    The quality of parent-child relationships has a significant impact on adolescent developmental outcomes, especially mental health. Given the lack of research on rural adolescent mental health in general and rural parent-child relationships in particular, the current longitudinal study explores how rural adolescents' (N = 2,617) perceptions of parenting practices effect their mental health (i.e., anxiety, depression, aggression, self-esteem, future optimism, and school satisfaction) over a 1 year period. Regression models showed that current parenting practices (i.e., in Year 2) were strongly associated with current adolescent mental health outcomes. Negative current parenting, manifesting in parent-adolescent conflict, was related to higher adolescent anxiety, depression, and aggression and lower self-esteem, and school satisfaction. Past parent-adolescent conflict (i.e., in Year 1) also positively predicted adolescent aggression in the present. Current positive parenting (i.e., parent support, parent-child future orientation, and parent education support) was significantly associated with less depression and higher self-esteem, future optimism, and school satisfaction. Past parent education support was also related to current adolescent future optimism. Implications for practice and limitations were discussed.

  6. Openness to Experience as a Predictor and Outcome of Upward Job Changes into Managerial and Professional Positions

    Science.gov (United States)

    Nieß, Christiane; Zacher, Hannes

    2015-01-01

    In industrial and organizational psychology, there is a long tradition of studying personality as an antecedent of work outcomes. Recently, however, scholars have suggested that personality characteristics may not only predict, but also change due to certain work experiences, a notion that is depicted in the dynamic developmental model (DDM) of personality and work. Upward job changes are an important part of employees’ careers and career success in particular, and we argue that these career transitions can shape personality over time. In this study, we investigate the Big Five personality characteristics as both predictors and outcomes of upward job changes into managerial and professional positions. We tested our hypotheses by applying event history analyses and propensity score matching to a longitudinal dataset collected over five years from employees in Australia. Results indicated that participants’ openness to experience not only predicted, but that changes in openness to experience also followed from upward job changes into managerial and professional positions. Our findings thus provide support for a dynamic perspective on personality characteristics in the context of work and careers. PMID:26110527

  7. More than Resisting Temptation: Beneficial Habits Mediate the Relationship between Self-Control and Positive Life Outcomes

    Science.gov (United States)

    Galla, Brian M.; Duckworth, Angela L.

    2015-01-01

    Why does self-control predict such a wide array of positive life outcomes? Conventional wisdom holds that self-control is used to effortfully inhibit maladaptive impulses, yet this view conflicts with emerging evidence that self-control is associated with less inhibition in daily life. We propose that one of the reasons individuals with better self-control use less effortful inhibition, yet make better progress on their goals is that they rely on beneficial habits. Across six studies (total N = 2,274), we found support for this hypothesis. In Study 1, habits for eating healthy snacks, exercising, and getting consistent sleep mediated the effect of self-control on both increased automaticity and lower reported effortful inhibition in enacting those behaviors. In Studies 2 and 3, study habits mediated the effect of self-control on reduced motivational interference during a work-leisure conflict and on greater ability to study even under difficult circumstances. In Study 4, homework habits mediated the effect of self-control on classroom engagement and homework completion. Study 5 was a prospective longitudinal study of teenage youth who participated in a five-day meditation retreat. Better self-control before the retreat predicted stronger meditation habits three months after the retreat, and habits mediated the effect of self-control on successfully accomplishing meditation practice goals. Finally, in Study 6, study habits mediated the effect of self-control on homework completion and two objectively measured long-term academic outcomes: grade point average and first-year college persistence. Collectively, these results suggest that beneficial habits--perhaps more so than effortful inhibition--are an important factor linking self-control with positive life outcomes. PMID:25643222

  8. More than resisting temptation: Beneficial habits mediate the relationship between self-control and positive life outcomes.

    Science.gov (United States)

    Galla, Brian M; Duckworth, Angela L

    2015-09-01

    Why does self-control predict such a wide array of positive life outcomes? Conventional wisdom holds that self-control is used to effortfully inhibit maladaptive impulses, yet this view conflicts with emerging evidence that self-control is associated with less inhibition in daily life. We propose that one of the reasons individuals with better self-control use less effortful inhibition, yet make better progress on their goals is that they rely on beneficial habits. Across 6 studies (total N = 2,274), we found support for this hypothesis. In Study 1, habits for eating healthy snacks, exercising, and getting consistent sleep mediated the effect of self-control on both increased automaticity and lower reported effortful inhibition in enacting those behaviors. In Studies 2 and 3, study habits mediated the effect of self-control on reduced motivational interference during a work-leisure conflict and on greater ability to study even under difficult circumstances. In Study 4, homework habits mediated the effect of self-control on classroom engagement and homework completion. Study 5 was a prospective longitudinal study of teenage youth who participated in a 5-day meditation retreat. Better self-control before the retreat predicted stronger meditation habits 3 months after the retreat, and habits mediated the effect of self-control on successfully accomplishing meditation practice goals. Finally, in Study 6, study habits mediated the effect of self-control on homework completion and 2 objectively measured long-term academic outcomes: grade point average and first-year college persistence. Collectively, these results suggest that beneficial habits-perhaps more so than effortful inhibition-are an important factor linking self-control with positive life outcomes. (c) 2015 APA, all rights reserved).

  9. Psychosocial Issues in Pediatric Oncology

    Science.gov (United States)

    Marcus, Joel

    2012-01-01

    Psychosocial oncology, a relatively new discipline, is a multidisciplinary application of the behavioral and social sciences, and pediatric psychosocial oncology is an emerging subspecialty within the domain of psychosocial oncology. This review presents a brief overview of some of the major clinical issues surrounding pediatric psychosocial oncology. PMID:23049457

  10. Matched Cohort Analysis of Outcomes of Definitive Radiotherapy for Prostate Cancer in Human Immunodeficiency Virus-Positive Patients

    International Nuclear Information System (INIS)

    Kahn, Shannon; Jani, Ashesh; Edelman, Scott; Rossi, Peter; Godette, Karen; Landry, Jerome; Anderson, Cynthia

    2012-01-01

    Purpose: To compare the biochemical outcome and toxicity scores of men with human immunodeficiency virus (HIV) and prostate cancer with a matched control population with negative or unknown HIV status when treated with external-beam radiotherapy (EBRT). Methods and Materials: A single-institution database of men with prostate cancer treated with EBRT from 1999 to 2009 was reviewed. Thirteen men with HIV were identified and matched to 2 control patients according to age, race, T stage, prostate-specific antigen level, Gleason score, RT dose, intensity-modulated RT vs. three-dimensional conformal RT, and whole-pelvis vs. prostate-only RT, for a total of 39 cases. The median follow-up time was 39 months (range, 3–110 months). Results: The 4-year biochemical failure (BF)-free survival rate was 87% in the HIV-positive group vs. 89% in the controls (p = 0.94). Pre- and post-RT viral loads were found to be predictive of BF (p = 0.04 and p = 0.04, respectively). No men with HIV died, whereas 2 in the control group died of causes unrelated to prostate cancer. Acute and chronic genitourinary and gastrointestinal toxicity were less in the HIV-positive patients than in controls (p 3 . Conclusions: Our findings suggest that men with HIV treated with EBRT have a similar risk of BF; however, high viral loads may contribute to an increased risk. This analysis supports that HIV-positive men with prostate cancer can be treated with definitive EBRT with similar disease control and toxicity outcomes as in the general population.

  11. Epilepsy and its Impact on psychosocial outcomes in Canadian children: Data from the National Longitudinal Study of Children and Youth (NLSCY).

    Science.gov (United States)

    Prasad, A N; Corbett, B

    2016-12-01

    The purpose of this study was to use data from a population-based survey to evaluate the association between childhood epilepsy and social outcomes through tests of mathematics skills, and sense of general self-esteem (GSS). Using data from Cycles 1 to 8 of the National Longitudinal Survey of Children and Youth (NLSCY), Hierarchical linear modeling (HLM) was used to compare baseline math scores and changes in math scores and sense of general self esteem (GSS) over time in children with and without epilepsy. Scores of Health Utility Index (HUI) were factored into the analysis. Children with epilepsy do not significantly differ in their scaled math scores in comparison to their peers without epilepsy, at age 12; however, in the two level HLM model the children with epilepsy lagged behind the healthy comparison group in terms of their growth in acquiring knowledge in mathematics. Additionally, when children with epilepsy carry an added health impairment as measured by an imperfect health utility (HUI) score the group shows a slower rate of growth in their math scores over time. Self-esteem measures show variable effects in children with epilepsy alone, and those with added health impairments. The interaction with HUI scores shows a significant negative effect on self-esteem, when epilepsy is associated with added health impairment. The findings suggest that the population of Canadian children surveyed with epilepsy are vulnerable to poorer academic outcomes in mathematics in later years, and this problem is compounded further with the presence of other additional health impairments. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Social support and moment-to-moment changes in treatment self-efficacy in men living with HIV: Psychosocial moderators and clinical outcomes

    Science.gov (United States)

    Turan, Bulent; Fazeli, Pariya; Raper, James L.; Mugavero, Michael J.; Johnson, Mallory O.

    2016-01-01

    Objective For people living with HIV, treatment adherence self-efficacy is an important predictor of treatment adherence and therefore of clinical outcomes. Using experience sampling method (ESM), this study aimed to examine: (1) the within-person association between moment-to-moment changes in social support and HIV treatment self-efficacy; (2) the moderators of this within-person association, (3) the concordance between questionnaire and ESM measurement of treatment self-efficacy; and (4) the utility of each approach (ESM and questionnaire) in predicting adherence to medication, adherence to clinic visits, CD4 counts, and viral load. Methods 109 men living with HIV responded to the same set of ESM questions 3 times a day for 7 days via a smart phone given to them for the study. They also completed cross-sectional questionnaires and their clinic data was extracted from medical records in order to examine predictors and consequences of state and trait treatment self-efficacy. Results In within-person hierarchical linear modeling (HLM) analyses, receipt of recent social support predicted higher current ESM treatment self-efficacy. This association was stronger for individuals reporting higher avoidance coping with HIV. The correlation between ESM and questionnaire measures of treatment self-efficacy was r = .37. ESM measure of average treatment self-efficacy predicted medication adherence, visit adherence, CD4 counts, and viral load, while questionnaire-based self-efficacy did not predict these outcomes. Conclusion Interventions aimed at improving treatment adherence may target social support processes, which may improve treatment self-efficacy and adherence. PMID:27089459

  13. Psychosocial cancer care

    African Journals Online (AJOL)

    family members to cancer is an increasing interest in education, ... all stages of the cancer journey and is passionate about enabling more professionals in South Africa to provide psychosocial cancer .... therapeutic support together with more.

  14. Outcome of wide local excision in dermatofibrosarcoma protuberans and use of radiotherapy for margin-positive disease

    Directory of Open Access Journals (Sweden)

    Raashid Hamid

    2013-01-01

    Full Text Available Purpose: Wide local excision (WLE is the preferred treatment of dermatofibrosarcoma protuberans (DFSP. The aim is to achieve negtive margins. We followed the impact of radiotherapy used postoperatively for both margin-negative and margin-positive DFSP tumors. Materials and Methods: Outcome of treatment of 36 patients of DFSP treated at our hospital was assessed. Thirty patients received radiotherapy postoperatively and six patients received radiotherapy alone. The maximum dimension of the lesion was 15 cm 2 . Patients were followed up for varying periods of time for any recurrence. Results: 10-year actuarial local control rate was determined. Local control was realized in six patients who were treated with radiotherapy alone. 30 patients were treated by radiotherapy and surgery. Out of these 30 patients, there were 6 local failures (failure rate 10%. Actuarial control rate was 82%. The failures were among patients who had positive margins. Conclusion: Radiotherapy is effective, and it decreases the recurrence rate in the treatment of DFSP. It is especially helpful in margin-positive disease. This appears true for patients treated with radiotherapy alone or radiotherapy used postoperatively.

  15. Engaging children in the development of obesity interventions: Exploring outcomes that matter most among obesity positive outliers.

    Science.gov (United States)

    Sharifi, Mona; Marshall, Gareth; Goldman, Roberta E; Cunningham, Courtney; Marshall, Richard; Taveras, Elsie M

    2015-11-01

    To explore outcomes and measures of success that matter most to 'positive outlier' children who improved their body mass index (BMI) despite living in obesogenic neighborhoods. We collected residential address and longitudinal height/weight data from electronic health records of 22,657 children ages 6-12 years in Massachusetts. We defined obesity "hotspots" as zip codes where >15% of children had a BMI ≥95th percentile. Using linear mixed effects models, we generated a BMI z-score slope for each child with a history of obesity. We recruited 10-12 year-olds with negative slopes living in hotspots for focus groups. We analyzed group transcripts and discussed emerging themes in iterative meetings using an immersion/crystallization approach. We reached thematic saturation after 4 focus groups with 21 children. Children identified bullying and negative peer comparisons related to physical appearance, clothing size, and athletic ability as motivating them to achieve a healthier weight, and they measured success as improvement in these domains. Positive relationships with friends and family facilitated both behavior change initiation and maintenance. The perspectives of positive outlier children can provide insight into children's motivations leading to successful obesity management. Child/family engagement should guide the development of patient-centered obesity interventions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Strong subjective recovery as a protective factor against the effects of positive symptoms on quality of life outcomes in schizophrenia.

    Science.gov (United States)

    Kukla, Marina; Lysaker, Paul H; Roe, David

    2014-08-01

    Interest in recovery from schizophrenia has been growing steadily, with much of the focus on remission from psychotic symptoms and a return to functioning. Less is known about the experience of subjective recovery and its relationships with other important outcomes, such as quality of life and the formation and sustenance of social connections. This study sought to address this gap in knowledge by examining the links between self perceived recovery, symptoms, and the social components of quality of life. Sixty eight veterans with schizophrenia-spectrum disorders who were participating in a study of cognitive remediation and work were concurrently administered the Recovery Assessment Scale, Positive and Negative Syndrome Scale, and the Heinrichs-Carpenter Quality of Life Scale (QLS). Linear regression analyses demonstrated that subjective recovery moderated the relationship between positive symptoms and both QLS intrapsychic foundations scores and QLS instrumental role functioning after controlling for negative symptoms. Further examination of this interaction revealed that for individuals with substantial positive symptoms, higher levels of subjective recovery were associated with better instrumental role functioning and intrapsychic foundational abilities. Greater self perceived recovery is linked with stronger quality of life, both in regards to the cognitive and affective bases for socialization and active community involvement, even in the presence of substantial psychotic symptoms. Clinical implications of these findings are discussed. Published by Elsevier Inc.

  17. Reflections on Researcher Identity and Power: The Impact of Positionality on Community Based Participatory Research (CBPR) Processes and Outcomes.

    Science.gov (United States)

    Muhammad, Michael; Wallerstein, Nina; Sussman, Andrew L; Avila, Magdalena; Belone, Lorenda; Duran, Bonnie

    2015-11-01

    The practice of community based participatory research (CBPR) has evolved over the past 20 years with the recognition that health equity is best achieved when academic researchers form collaborative partnerships with communities. This article theorizes the possibility that core principles of CBPR cannot be realistically applied unless unequal power relations are identified and addressed. It provides theoretical and empirical perspectives for understanding power, privilege, researcher identity and academic research team composition, and their effects on partnering processes and health disparity outcomes. The team's processes of conducting seven case studies of diverse partnerships in a national cross-site CBPR study are analyzed; the multi-disciplinary research team's self-reflections on identity and positionality are analyzed, privileging its combined racial, ethnic, and gendered life experiences, and integrating feminist and post-colonial theory into these reflections. Findings from the inquiry are shared, and incorporating academic researcher team identity is recommended as a core component of equalizing power distribution within CBPR.

  18. The potential impact of recruitment method on sample characteristics and treatment outcomes in a psychosocial trial for women with co-occurring substance use disorder and PTSD.

    Science.gov (United States)

    Winhusen, Theresa; Winstanley, Erin L; Somoza, Eugene; Brigham, Gregory

    2012-01-01

    Recruitment method can impact the sample composition of a clinical trial and, thus, the generalizability of the results, but the importance of recruitment method in substance use disorder trials has received little attention. The present paper sought to address this research gap by evaluating the association between recruitment method and sample characteristics and treatment outcomes in a substance use disorder trial. In a multi-site trial evaluating Seeking Safety (SS), relative to Women's Health Education (WHE), for women with co-occurring PTSD (either sub-threshold or full PTSD) and substance use disorders, one site assessed the method by which each participant was recruited. Data from this site (n=106), which recruited participants from newspaper advertising and clinic intakes, were analyzed. Participants recruited through advertising, relative to those from the clinic, had significantly higher levels of baseline drug use and higher rates of meeting DSM-IV-TR criteria for full PTSD. Results suggest that the effectiveness of SS in decreasing PTSD symptoms was greater for participants recruited through advertising relative to those recruited from the clinic. Conversely, the results revealed a significant treatment effect in the clinic-recruited participants, not seen in the advertising-recruited participants, with SS, relative to WHE, participants being more likely to report past week drug use during the follow-up phase. Recruitment method may impact sample composition and treatment effects. Replication of this finding would have important implications for substance use disorder efficacy trials which often utilize advertising to recruit participants. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  19. Inadequate vitamin D levels are associated with culture positive sepsis and poor outcomes in paediatric intensive care.

    Science.gov (United States)

    Onwuneme, Chike; Carroll, Aoife; Doherty, Dermot; Bruell, Heike; Segurado, Ricardo; Kilbane, Mark; Murphy, Nuala; McKenna, Malachi J; Molloy, Eleanor J

    2015-10-01

    This study aimed to assess vitamin D status, and its determinants, in paediatric patients with suspected sepsis who were admitted to a paediatric intensive care unit (PICU). We also investigated the association between vitamin D status and clinical outcomes. Serum 25-hydroxy vitamin D (25OHD) and clinical determinants were prospectively assessed in children with suspected sepsis (<12 years old) admitted to the PICU. The relationship between 25OHD and clinical outcomes was evaluated. Vitamin D status was also assessed in control children of a similar age. We enrolled 120 children with suspected sepsis admitted to the PICU and 30 paediatric controls. 25OHD was <50 nmol/L in 59% of the children admitted to the PICU and 25OHD was lower than in the controls (47 ± 29 vs 66 ± 26 nmol/L, p < 0.001). After adjusting for potential confounders, 25OHD was strongly associated with culture positive sepsis (p < 0.001), the paediatric index of mortality (p = 0.026) and the duration of mechanical ventilation (p = 0.008). There was a negative correlation between 25OHD and C-reactive protein (CRP): each 0.1% decrease in 25OHD increased CRP (p = 0.04). Children admitted to the PICU with suspected sepsis had lower 25OHD than controls and inadequate 25OHD status was associated with confirmed sepsis and poor outcomes. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  20. Psychosocial impact of involvement in the Special Olympics.

    Science.gov (United States)

    Crawford, Clare; Burns, Jan; Fernie, Bruce A

    2015-01-01

    Existing evidence suggests that people with intellectual disabilities are vulnerable to low self-esteem leading to additional psychosocial issues such as social exclusion and stress. Previous research into the involvement of Special Olympics (SO) of people with intellectual disabilities has indicted positive psychosocial outcomes. Involvement in sport is known generally to have psychological and social benefits. This study aimed to compare the psychosocial impact of involvement in sport through the SO to no or limited sports involvement, for a sample of people with intellectual disabilities. A cross sectional design was employed comparing three groups, SO, Mencap Sports, and Mencap No Sports on the variables: Self-esteem, quality of life, stress levels and social networks. One hundred and one participants were recruited either through the SO or Mencap. Data were collected through the completion of validated questionnaires by one to one interviews with the participants. Analysis revealed that self-esteem, quality of life, and stress were all significantly associated with SO involvement. Logistic regression analysis was used to explore whether scores on these variables were able to predict group membership. Self-esteem was found to be a significant predictor of group membership, those in the SO having the highest self-esteem. The findings provide further evidence of a positive association between sport involvement and increased psychological wellbeing, especially for those involved in the SO. The implications of these findings for practice and future research into the relationship between sport and psychological wellbeing within the learning disabled population are considered. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Excursions out-of-lane versus standard deviation of lateral position as outcome measure of the on-the-road driving test

    NARCIS (Netherlands)

    Verster, Joris C; Roth, Thomas

    BACKGROUND: The traditional outcome measure of the Dutch on-the-road driving test is the standard deviation of lateral position (SDLP), the weaving of the car. This paper explores whether excursions out-of-lane are a suitable additional outcome measure to index driving impairment. METHODS: A

  2. Psychosocial Risks: Is Risk Management Strategic Enough in Business and Policy Making?

    Science.gov (United States)

    Langenhan, Melissa K.; Leka, Stavroula; Jain, Aditya

    2013-01-01

    Background In times of continuous change and volatile markets, organizations are increasingly characterized by downsizing, work intensification, and resource rationalization. This has resulted in diversification, and the emergence of new risks within the field of occupational health and safety, with an important impact. This paper focuses on one such type of risk in the modern workplace—psychosocial risks. The current study aimed to explore stakeholder perspectives, regarding the extent to which psychosocial risks are incorporated into strategic risk management practices, at both the business and policy level. Methods Semi-structured interviews were conducted with 14 professionals, representing employer, expert, policy maker, and trade union stakeholder perspectives. Results It was found that the majority of organizations do not sufficiently, if at all, understand and incorporate psychosocial risks into strategic decision making, whereby the key barrier related to practical difficulties of not knowing how to manage psychosocial risks adequately. Conclusion The study found that there is a need to close the gap between policy and practice on a number of levels. Future recommendations comprise a policy framework and infrastructure underpinned by educational initiatives, partnerships, and networks to drive a shift in attitudes toward recognizing the duality of the concept of risk (including both potential negative and positive outcomes) and moving beyond simple regulatory compliance. PMID:23961331

  3. Psychosocial risks: is risk management strategic enough in business and policy making?

    Science.gov (United States)

    Langenhan, Melissa K; Leka, Stavroula; Jain, Aditya

    2013-06-01

    In times of continuous change and volatile markets, organizations are increasingly characterized by downsizing, work intensification, and resource rationalization. This has resulted in diversification, and the emergence of new risks within the field of occupational health and safety, with an important impact. This paper focuses on one such type of risk in the modern workplace-psychosocial risks. The current study aimed to explore stakeholder perspectives, regarding the extent to which psychosocial risks are incorporated into strategic risk management practices, at both the business and policy level. Semi-structured interviews were conducted with 14 professionals, representing employer, expert, policy maker, and trade union stakeholder perspectives. It was found that the majority of organizations do not sufficiently, if at all, understand and incorporate psychosocial risks into strategic decision making, whereby the key barrier related to practical difficulties of not knowing how to manage psychosocial risks adequately. The study found that there is a need to close the gap between policy and practice on a number of levels. Future recommendations comprise a policy framework and infrastructure underpinned by educational initiatives, partnerships, and networks to drive a shift in attitudes toward recognizing the duality of the concept of risk (including both potential negative and positive outcomes) and moving beyond simple regulatory compliance.

  4. The role of positive/negative outcome expectancy and refusal self-efficacy of Internet use on Internet addiction among college students in Taiwan.

    Science.gov (United States)

    Lin, Min-Pei; Ko, Huei-Chen; Wu, Jo Yung-Wei

    2008-08-01

    Based on Bandura's social cognitive theory, this study was designed to examine positive and negative outcome expectancy and refusal self-efficacy of Internet use and their contribution to Internet addiction among college students by using hierarchical multiple regression analyses in a cross-sectional study design. Schools were first stratified into technical or nontechnical colleges and then into seven majors. A cluster random sampling by department was further applied to randomly choose participants from each major. A representative sample of 4,456 college students participated in this study. The Outcome Expectancy and Refusal Self-Efficacy of Internet Use Questionnaire and the Chen Internet Addiction Scale were used to assess the cognitive factors and the levels of Internet addiction. Results showed that both positive outcome expectancy and negative outcome expectancy were significantly and positively correlated with Internet addiction, and refusal self-efficacy of Internet use was significantly and negatively related to Internet addiction. Further analyses revealed that refusal self-efficacy of Internet use directly and negatively predicted Internet addiction. Moreover, we discovered that positive outcome expectancy positively predicted Internet addiction via refusal self-efficacy of Internet use; however, surprisingly, negative outcome expectancy had both a direct and indirect positive relationship in predicting Internet addiction via the refusal self-efficacy of Internet use. These results give empirical evidence to verify the theoretical effectiveness of the three cognitive factors to Internet addiction and should be incorporated when designing prevention programs and strategies for Internet addicted college students.

  5. Implant-supported mandibular removable partial dentures; patient-based outcome measures in relation to implant position.

    Science.gov (United States)

    Jensen, Charlotte; Raghoebar, Gerry M; Kerdijk, Wouter; Meijer, Henny J A; Cune, Marco S

    2016-12-01

    To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region. Thirty subjects with a bilateral unbounded posterior saddle received 2 PM and 2M implants. A new RPD was placed. Implant support was provided 3 months later. Two PM implants supported the RPD. After 3 months the 2M implants were used or vice versa. Outcome measures included oral health related quality of life (OHIP-NL49), general health status (SF-36), contentment assessed on a Visual Analogue Scale (VAS) and the number of hours that the RPD was worn. Data were collected prior to treatment, 3 months after having functioned with a new RPD and after 3 and 6 months with implant support. Finally, patients expressed their preferred implant position. The general health status (SF-36) was not influenced. OHIP-NL49 values and mean wearing-time were statistical significantly more favorable for ISRPD's, regardless of the implant position. Per day, the ISRPD's were worn 2-3h more than the unsupported new RPD. Patients' expectations were met as the VAS-scores of anticipated and realized contentment did not reach a statistical significant level (p>0.05). VAS scores for ISRPD's with M implant support were higher than for PM implant support. Finally, 56.7% of subjects preferred the M implant support, 13.3% expressed no preference and 30% opted for PM implant support. Mandibular implant support favorably influences oral health related patient-based outcome measures in patients with a bilateral free-ending situation. The majority of patients prefer the implant support to be in the molar region. Patients with a bilateral free-ending situation in the mandible opposed by a maxillary denture benefit from implant support to their mandibular removable partial denture. Most patients prefer this support to be in the molar region. Copyright © 2016

  6. Primary Endoscopic Transnasal Transsphenoidal Surgery for Magnetic Resonance Image-Positive Cushing Disease: Outcomes of a Series over 14 Years.

    Science.gov (United States)

    Kuo, Chao-Hung; Yen, Yu-Shu; Wu, Jau-Ching; Chen, Yu-Chun; Huang, Wen-Cheng; Cheng, Henrich

    2015-09-01

    There are scant data of endoscopic transsphenoidal surgery (ETS) with adjuvant therapies of Cushing disease (CD). To report the remission rate, secondary management, and outcomes of a series of CD patients. Patients with CD with magnetic resonance imaging (MRI)-positive adenoma who underwent ETS as the first and primary treatment were included. The diagnostic criteria were a combination of 24-hour urine-free cortisol, elevated serum cortisol levels, or other tests (e.g., inferior petrosal sinus sampling). All clinical and laboratory evaluations and radiological examinations were reviewed. Forty consecutive CD patients, with an average age of 41.0 years, were analyzed with a mean follow-up of 40.2 ± 29.6 months. These included 22 patients with microadenoma and 18 with macroadenoma, including 9 cavernous invasions. The overall remission rate of CD after ETS was 72.5% throughout the entire follow-up. Patients with microadenoma or noninvasive macroadenoma had a higher remission rate than those who had macroadenoma with cavernous sinus invasion (81.8% or 77.8% vs. 44.4%, P = 0.02). After ETS, the patients who had adrenocorticotropic hormone-positive adenoma had a higher remission rate than those who had not (76.5% vs. 50%, P = 0.03). In the 11 patients who had persistent/recurrent CD after the first ETS, 1 underwent secondary ETS, 8 received gamma-knife radiosurgery (GKRS), and 2 underwent both. At the study end point, two (5%) of these CD patients had persistent CD and were under the medication of ketoconazole. For MRI-positive CD patients, primary (i.e., the first) ETS yielded an overall remission rate of 72.5%. Adjuvant therapies, including secondary ETS, GKRS, or both, yielded an ultimate remission rate of 95%. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Positive psychiatry: its time has come.

    Science.gov (United States)

    Jeste, Dilip V; Palmer, Barton W; Rettew, David C; Boardman, Samantha

    2015-06-01

    Traditionally, psychiatry has been defined and practiced as a branch of medicine focused on the diagnosis and treatment of mental illnesses. Based on growing empirical evidence, we believe that this definition warrants expansion to include the concept of positive psychiatry. In the present article, we provide a critical overview of this emerging field and a select review of relevant scientific literature. Positive psychiatry may be defined as the science and practice of psychiatry that seeks to understand and promote well-being through assessment and interventions involving positive psychosocial characteristics (PPCs) in people who suffer from or are at high risk of developing mental or physical illnesses. It can also benefit nonclinical populations. Positive psychiatry has 4 main components: (1) positive mental health outcomes (eg, well-being), (2) PPCs that comprise psychological traits (resilience, optimism, personal mastery and coping self-efficacy, social engagement, spirituality and religiosity, and wisdom-including compassion) and environmental factors (family dynamics, social support, and other environmental determinants of overall health), (3) biology of positive psychiatry constructs, and (4) positive psychiatry interventions including preventive ones. There are promising empirical data to suggest that positive traits may be improved through psychosocial and biological interventions. As a branch of medicine rooted in biology, psychiatry, especially with the proposed conceptualization of positive psychiatry, is well poised to provide major contributions to the positive mental health movement, thereby impacting the overall health care of the population. © Copyright 2015 Physicians Postgraduate Press, Inc.

  8. Positive Psychiatry: Its Time Has Come

    Science.gov (United States)

    Jeste, Dilip V.; Palmer, Barton W.; Rettew, David C.; Boardman, Samantha

    2017-01-01

    Traditionally, psychiatry has been defined and practiced as a branch of medicine focused on the diagnosis and treatment of mental illnesses. Based on growing empirical evidence, we believe that this definition warrants expansion to include the concept of positive psychiatry. In the present article we provide a critical overview of this emerging field and a select review of relevant scientific literature. Positive psychiatry may be defined as the science and practice of psychiatry that seeks to understand and promote well-being through assessment and interventions involving positive psychosocial characteristics (PPCs) in people who suffer from or are at high risk of developing mental or physical illnesses. It can also benefit non-clinical populations. Positive psychiatry has 4 main components: (1) positive mental health outcomes (e.g., well-being), (2) PPCs that comprise psychological traits (resilience, optimism, personal mastery and coping self-efficacy, social engagement, spirituality and religiosity, and wisdom - including compassion) and environmental factors (family dynamics, social support, and other environmental determinants of overall health), (3) biology of positive psychiatry constructs, and (4) positive psychiatry Interventions including preventive ones. There are promising empirical data to suggest that positive traits may be improved through psychosocial and biological interventions. As a branch of medicine, rooted in biology, psychiatry, especially with the proposed conceptualization of positive psychiatry, is well poised to provide major contributions to the positive mental health movement, thereby impacting the overall healthcare of the population. PMID:26132670

  9. Longitudinal Psychosocial Adjustment of Women to Human Papillomavirus Infection.

    Science.gov (United States)

    Hsu, Yu-Yun; Wang, Wei-Ming; Fetzer, Susan Jane; Cheng, Ya-Min; Hsu, Keng-Fu

    2018-05-29

    The aim of this study was to examine the psychosocial adjustment trajectory, focusing on psychological distress, sexual relationships and health care information, as well as factors which have an impact on adjustment on receiving a positive diagnosis of human papillomavirus infection. Human papillomavirus is a common sexually transmitted infection in females. To date, knowledge of the longitudinal psychosocial response to the diagnosis of human papillomavirus is limited. A prospective longitudinal design was conducted with a convenience sample. Women aged 20-65 years old were followed at one, 6 and 12 months after a diagnosis of HPV. Participants completed measures of initial emotional distress and followed-up psychosocial adjustment. A mixed-effects model was applied to analyze the longitudinal changes in psychosocial adjustment. Seventy human papillomavirus positive women participated in the study with nearly 20% of the women reporting emotional distress during their first visit. Mixed-effects model analyses showed that a trajectory of psychosocial adjustment in health care orientation, sexual relationship and psychosocial distress occur from one to 6 months after HPV diagnosis. However, a declining trend from 6-12 months was significant in health care orientation. Initial emotional distress was associated with changes in psychological adjustment. Psychosocial adjustment to human papillomavirus was worse at one month compared with 6 and 12 months after diagnosis. Healthcare providers should offer health information and psychosocial support to women according to their disease progression. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. Long-Term Outcomes of Homografts in the Aortic Valve and Root Position: A 20-Year Experience

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    Joo Yeon Kim

    2016-08-01

    Full Text Available Background: The advantages of using a homograft in valve replacement surgery are the excellent hemodynamic profile, low risk of thromboembolism, and low risk of prosthetic valve infection. The aim of this study was to evaluate the long-term outcomes of homograft implantation in the aortic valve position. Methods: This is a retrospective study of 33 patients (>20 years old who underwent aortic valve replacement or root replacement with homografts between April 1995 and May 2015. Valves were collected within 24 hours from explanted hearts of heart transplant recipients (<60 years and organ donors who were not suitable for heart transplantation. The median follow-up duration was 35.6 months (range, 0 to 168 months. Results: Aortic homografts were used in all patients. The 30-day mortality rate was 9.1%. The 1- and 5-year survival rates were 80.0%±7.3% and 60.8%±10.1%, respectively. The 1-, 5-, and 10-year freedom from reoperation rates were 92.3%±5.2%, 68.9%±10.2%, and 50.3%±13.6%, respectively. The 1-, 5-, and 10-year freedom from significant aortic dysfunction rates were 91.7%±8.0%, 41.7%±14.2%, and 25.0%±12.5%, respectively. Conclusion: Homografts had the advantages of a good hemodynamic profile and low risk of thromboembolic events, and with good outcomes in cases of aortitis.

  11. Family Violence and Aggression and Their Associations with Psychosocial Functioning in Jamaican Adolescents

    Science.gov (United States)

    Smith, Delores E.; Moore, Todd M.

    2013-01-01

    The purpose of the current study was to examine the relationships among selected family interaction variables and psychosocial outcomes in a sample of Jamaican adolescents. The authors hypothesized that adolescent psychosocial outcomes would be negatively associated with physical violence, verbal aggression would be more potent than physical…

  12. The Ontario Psychosocial Oncology Framework: a quality improvement tool.

    Science.gov (United States)

    Li, Madeline; Green, Esther

    2013-05-01

    To overview the newly developed Psychosocial Health Care for Cancer Patients and Their Families: A Framework to Guide Practice in Ontario and Guideline Recommendations in the context of Canadian psychosocial oncology care and propose strategies for guideline uptake and implementation. Recommendations from the 2008 Institute of Medicine standard Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs were adapted into the Ontario Psychosocial Oncology (PSO) Framework. Existing practice guidelines developed by the Canadian Partnership against Cancer and Cancer Care Ontario and standards developed by the Canadian Association of Psychosocial Oncology are supporting resources for adopting a quality improvement (QI) approach to the implementation of the framework in Ontario. The developed PSO Framework, including 31 specific actionable recommendations, is intended to improve the quality of comprehensive cancer care at both the provider and system levels. Important QI change management processes are described as Educate - raising awareness among medical teams of the significance of psychosocial needs of patients, Evidence - developing a research evidence base for patient care benefits from psychosocial interventions, and Electronics - using technology to collect patient reported outcomes of both physical and emotional symptoms. The Ontario PSO Framework is unique and valuable in providing actionable recommendations that can be implemented through QI processes. Overall, the result will be improved psychosocial health care for the cancer population. Copyright © 2012 John Wiley & Sons, Ltd.

  13. Outcomes in culture positive and culture negative ascitic fluid infection in patients with viral cirrhosis: cohort study

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    Ali Ailia W

    2008-12-01

    Full Text Available Abstract Background Ascitic fluid infection (AFI in cirrhotic patients has a high morbidity and mortality. It has two variants namely, spontaneous bacterial peritonitis (SBP and culture negative neutrocytic ascites (CNNA. The aim of this study was to determine the outcome in cirrhotic patients with culture positive (SBP and culture negative neutrocytic ascites. Methods We analyzed 675 consecutive hepatitis B and/or C related cirrhosis patients with ascites admitted in our hospital from November 2005 to December 2007. Of these, 187 patients had AFI; clinical and laboratory parameters of these patients including causes of cirrhosis, Child Turcotte Pugh (CTP score were recorded. Results Out of 187 patients with AFI, 44 (23.5% had SBP while 143 (76.4% had CNNA. Hepatitis C virus (HCV infection was the most common cause of cirrhosis in 139 (74.3% patients. Patients with SBP had high CTP score as compared to CNNA (12.52 ± 1.45 vs. 11.44 ± 1.66; p 9/L as compared to CNNA (132 ± 91 × 109/L, p = 0.005. We found a high creatinine (mg/dl (1.95 ± 1.0 vs. 1.44 ± 0.85, (p = 0.003 and high prothrombin time (PT in seconds (24.8 ± 6.6 vs. 22.4 ± 7.2 (p = 0.04 in SBP as compared to CNNA. More patients with SBP (14/44; 31.8% had blood culture positivity as compare to CNNA (14/143; 9.8%, p = 0.002. Escherichia. Coli was the commonest organism in blood culture in 15/28 (53.5% patients. SBP group had a higher mortality (11/44; 25% as compared to CNNA (12/143; 8.4%, p = 0.003. On multiple logistic regression analysis, creatinine >1.1 mg/dl and positive blood culture were the independent predictors of mortality in patients with SBP. Conclusion Patients with SBP have a higher mortality than CNNA. Independent predictors of mortality in SBP are raised serum creatinine and a positive blood culture.

  14. Endophthalmitis caused by gram-positive bacteria resistant to vancomycin: Clinical settings, causative organisms, antimicrobial susceptibilities, and treatment outcomes

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    Hegde Sharat Shivaramaiah

    2018-06-01

    Full Text Available Purpose: To report the clinical settings, causative organisms, antimicrobial susceptibilities, and treatment outcomes of patients with endophthalmitis caused by gram-positive bacteria resistant to vancomycin. Methods: Retrospective case series of all patients with culture-proven endophthalmitis caused by gram-positive bacteria resistant to vancomycin between January 2010 and December 2016 in LV Prasad Eye Institute, Visakhapatnam, India. Results: The current study included 14 patients. The clinical settings were post-cataract surgery in 8/14 (57.1% and open globe injury in 6/14 (42.8%. Primary intervention for all patients included tap and intravitreal antibiotic injection. During subsequent follow-up, pars plana vitrectomy was performed in 6 patients and one patient underwent penetrating keratoplasty. Mean number of intravitreal antibiotic injections performed were 3.4 per patient. The most common organisms isolated were coagulase-negative Staphylococci in 6/14 (42.8%, Staphylococcus aureus in 5/14 (35.7%, Streptococcus sp in 2/14 (14.2% and Bacillus sp in 1/14 (7.14%. In addition to vancomycin, resistance to multiple drugs (three or more groups of antibiotics was found in all 14 cases. Antimicrobial susceptibility results showed susceptibility to amikacin in 7/14 (50.0%, gatifloxacin in 6/14 (42.8%, moxifloxacin in 3/13 (23.0%, cefazoline in 5/14 (35.7%, cefuroxime in 3/14 (21.4%, ciprofloxacin in 2/14 (14.2% and linezolid in 5/5 (100%. The mean duration of follow-up was 30.7 weeks (6 weeks–90 weeks. At last follow-up, visual acuity (VA of 20/200 or better was recorded in 7/14 (50% and VA < 5/200 occurred in 7/14 (50%. Conclusion and importance: Antimicrobial susceptibility testing may help in selection of suitable antimicrobial agents for repeat intravitreal injection. Inspite of retreatment with intravitreal antibiotics, these patients generally had poor VA outcomes. Keywords: Coagulase-negative Staphylococci, Endophthalmitis

  15. Impact of helminth diagnostic test performance on estimation of risk factors and outcomes in HIV-positive adults.

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    Michael B Arndt

    Full Text Available BACKGROUND: Traditional methods using microscopy for the detection of helminth infections have limited sensitivity. Polymerase chain reaction (PCR assays enhance detection of helminths, particularly low burden infections. However, differences in test performance may modify the ability to detect associations between helminth infection, risk factors, and sequelae. We compared these associations using microscopy and PCR. METHODS: This cross-sectional study was nested within a randomized clinical trial conducted at 3 sites in Kenya. We performed microscopy and real-time multiplex PCR for the stool detection and quantification of Ascaris lumbricoides, Necator americanus, Ancylostoma duodenale, Strongyloides stercoralis, and Schistosoma species. We utilized regression to evaluate associations between potential risk factors or outcomes and infection as detected by either method. RESULTS: Of 153 HIV-positive adults surveyed, 55(36.0% and 20(13.1% were positive for one or more helminth species by PCR and microscopy, respectively (p<0.001. PCR-detected infections were associated with farming (Prevalence Ratio 1.57, 95% CI: 1.02, 2.40, communal water source (PR 3.80, 95% CI: 1.01, 14.27, and no primary education (PR 1.54, 95% CI: 1.14, 2.33, whereas microscopy-detected infections were not associated with any risk factors under investigation. Microscopy-detected infections were associated with significantly lower hematocrit and hemoglobin (means of -3.56% and -0.77 g/dl and a 48% higher risk of anemia (PR 1.48, 95% CI: 1.17, 1.88 compared to uninfected. Such associations were absent for PCR-detected infections unless infection intensity was considered, Infections diagnosed with either method were associated with increased risk of eosinophilia (PCR PR 2.42, 95% CI: 1.02, 5.76; microscopy PR 2.92, 95% CI: 1.29, 6.60. CONCLUSION: Newer diagnostic methods, including PCR, improve the detection of helminth infections. This heightened sensitivity may improve the

  16. Empirically Based Psychosocial Therapies for Schizophrenia: The Disconnection between Science and Practice

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    Glenn D. Shean

    2013-01-01

    Full Text Available Empirically validated psychosocial therapies for individuals diagnosed with schizophrenia were described in the report of the Schizophrenia Patient Outcomes Research Team (PORT, 2009. The PORT team identified eight psychosocial treatments: assertive community treatment, supported employment, cognitive behavioral therapy, family-based services, token economy, skills training, psychosocial interventions for alcohol and substance use disorders, and psychosocial interventions for weight management. PORT listings of empirically validated psychosocial therapies provide a useful template for the design of effective recovery-oriented mental health care systems. Unfortunately, surveys indicate that PORT listings have not been implemented in clinical settings. Obstacles to the implementation of PORT psychosocial therapy listings and suggestions for changes needed to foster implementation are discussed. Limitations of PORT therapy listings that are based on therapy outcome efficacy studies are discussed, and cross-cultural and course and outcome studies of correlates of recovery are summarized.

  17. Psychosocial interventions for premature ejaculation

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    Tamara Melnik

    Full Text Available BACKGROUND: Premature ejaculation (PE is a very common sexual dysfunction among patients, and with varying prevalence estimates ranging from 3% to 20%. Although psychological issues are present in most patients with premature PE, as a cause or as a consequence, research on the effects of psychological approaches for PE has in general not been controlled or randomised and is lacking in long-term follow up. OBJECTIVE: To assess the efficacy of psychosocial interventions for PE. CRITERIA FOR CONSIDERING STUDIES FOR THIS REVIEW: Trials were searched in computerized general and specialized databases, such as: MEDLINE by PubMed (1966 to 2010; PsycINFO (1974 to 2010; EMBASE (1980 to 2010; LILACS (1982 to 2010; the Cochrane Central Register of Controlled Trials (Cochrane Library, 2010; and by checking bibliographies, and contacting manufacturers and researchers. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials evaluating psychosocial interventions compared with different psychosocial interventions, pharmacological interventions, waiting list, or no treatment for PE. DATA COLLECTION AND ANALYSIS: Information on patients, interventions, and outcomes was extracted by at least two independent reviewers using a standard form. The primary outcome measure for comparing the effects of psychosocial interventions to waiting list and standard medications was improvement in IELT (i.e., time from vaginal penetration to ejaculation. The secondary outcome was change in validated PE questionnaires. MAIN RESULTS: In one study behavioral therapy (BT was significantly better than waiting list for duration of intercourse (MD (mean difference 407.90 seconds, 95% CI 302.42 to 513.38, and couples' sexual satisfaction (MD -26.10, CI -50.48 to -1.72. BT was also significantly better for a new functional-sexological treatment (FS (MD 412.00 seconds, 95% CI 305.88 to 518.12, change over time in subjective perception of duration of intercourse (Women: MD 2

  18. Bilateral Moyamoya Disease in a 2-Year-Old Pakistani Male Treated with Bilateral Encephaloduroarteriosynangiosis: A Positive Outcome

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    Shahvaiz Magsi

    2016-01-01

    Full Text Available Background. We present a rare case of bilateral moyamoya disease presenting as multiple strokes and neurological deficits, treated with the neurosurgical procedure, encephaloduroarteriosynangiosis (EDAS, in a 2-year-old male Pakistani minor. A positive outcome was achieved and the patient recovered fully. Case Summary. Our patient presented with a history of seizures and multiple episodes of hemiparesis (on and off weakness at the age of 2 years. He had a delayed speech development and could not speak more than a few words. He had a slight slurring of speech too. He was diagnosed with bilateral moyamoya disease on Computed Tomography Angiography (CTA. Bilateral EDAS was done in the same year, after which his symptoms improved and patient had moderate functional recovery. Conclusion. A rare disease, moyamoya has been left unexplored in Pakistan; physicians and surgeons when dealing with cases in the pediatric population presenting with symptoms of stroke, signs of generalized weakness, and seizures should consider moyamoya disease as a possibility. Furthermore, this case demonstrates the effectiveness of EDAS procedure for the treatment of moyamoya disease.

  19. Examining the relationships between posttraumatic stress disorder symptoms, positive smoking outcome expectancies, and cigarette smoking in people with substance use disorders: a multiple mediator model.

    Science.gov (United States)

    Hruska, Bryce; Bernier, Jennifer; Kenner, Frank; Kenne, Deric R; Boros, Alec P; Richardson, Christopher J; Delahanty, Douglas L

    2014-01-01

    Cigarette smoking is highly prevalent in people with substance use disorders (SUDs) and is associated with significant physical health problems. Posttraumatic stress disorder (PTSD) is also highly associated with both SUDs and cigarette smoking and may serve as a barrier to smoking cessation efforts. In addition, people with PTSD are more likely to hold positive smoking outcome expectancies (i.e., beliefs that smoking cigarettes results in positive outcomes); these beliefs may contribute to cigarette smoking in people with SUDs experiencing PTSD symptoms. The present study examined the relationship between PTSD symptoms and typical daily cigarette smoking/cigarette dependence symptoms in a sample of 227 trauma-exposed current smokers with SUDs (59.9% male, 89.4% Caucasian) seeking detoxification treatment services. Additionally, the indirect effects of multiple types of positive smoking outcome expectancies on these relationships were examined. Participants completed questionnaires assessing PTSD symptoms, positive smoking outcome expectancies, cigarette consumption, and cigarette dependence symptoms. Results indicated that PTSD symptoms were not directly related to cigarette consumption or cigarette dependence symptoms. However, negative affect reduction outcome expectancies were shown to have a significant indirect effect between PTSD symptoms and cigarette consumption, while negative affect reduction, boredom reduction, and taste-sensorimotor manipulation outcome expectancies were all found to have significant indirect effects between PTSD symptoms and cigarette dependence symptoms. The indirect effect involving negative affect reduction outcome expectancies was statistically larger than that of taste sensorimotor manipulation outcome expectancies, while negative affect reduction and boredom reduction outcome expectancies were comparable in magnitude. These results suggest that expectancies that smoking can manage negative affective experiences are related to

  20. [Prevention of psychosocial risks].

    Science.gov (United States)

    Dalle, Édouard; Trichard-Salembier, Alexandra; Sobaszek, Annie

    2018-02-01

    The theme of psychosocial risks remains in the workplace. It is therefore essential that all members of a company are made aware of the terminology and specific prevention actions in this field. Distinguishing between the manifestations of these risks and their causes and consequences helps to improve prevention. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  1. Psychosocial functioning in adults with congenital craniofacial conditions.

    Science.gov (United States)

    Roberts, R M; Mathias, J L

    2012-05-01

    To examine the psychosocial functioning of adults with congenital craniofacial conditions relative to normative data. Single sample cross-sectional design. The Australian Craniofacial Unit, Women's and Children's Hospital, Adelaide, which is one of the main craniofacial treatment centers in Australia. Adults (N  =  93) with congenital craniofacial conditions (excluding cleft lip/palate) who were treated in the Australian Craniofacial Unit. All participants completed self-report scales assessing health-related quality of life (SF-36); life satisfaction, anxiety, and depression (HADS); self-esteem (Rosenberg); appearance-related concerns; perceived social support; and social anxiety. Overall, participants were very similar in psychosocial function to the general population. However, adults with craniofacial conditions were less likely to be married and have children (females), were more likely to be receiving a disability pension, and reported more appearance-related concerns and less social support from friends. They also reported more limitations in both their social activities, due to physical or emotional problems, and usual role activities, because of emotional problems, as well as poorer mental health. These results give cause to be very positive about the long-term outcomes of children who are undergoing treatment for craniofacial conditions, while also identifying specific areas that interventions could target.

  2. The fading affect bias shows positive outcomes at the general but not the individual level of analysis in the context of social media.

    Science.gov (United States)

    Gibbons, Jeffrey A; Horowitz, Kyle A; Dunlap, Spencer M

    2017-08-01

    Unpleasant affect fades faster than pleasant affect (e.g., Walker, Vogl, & Thompson, 1997); this effect is referred to as the Fading Affect Bias (FAB; Walker, Skowronski, Gibbons, Vogl, & Thompson, 2003a). Research shows that the FAB is consistently related to positive/healthy outcomes at a general but not at a specific level of analysis based on event types and individual differences (e.g., Gibbons et al., 2013). Based on the positive outcomes for FAB and negative outcomes for social media (Bolton et al., 2013; Huang, 2010), the current study examined FAB in the context of social media events along with related individual differences. General positive outcomes were shown in the form of robust FAB effects across social media and non-social media events, a larger FAB for non-social media events than for social media events, negative correlations of FAB with depression, anxiety, and stress as well as a positive correlation of FAB with self-esteem. However, the lack of a negative correlation between FAB and anxiety for social media events in a 3-way interaction did not show positive outcomes at a specific level of analysis. Rehearsal ratings mediated the 3-way interaction. Implications are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Nutrition Habits and Health Outcomes of Breastfeeding HIV-positive mothers in the Dschang Health District, West Region Cameroon.

    Science.gov (United States)

    Sanou Sobze, Martin; Kien-Atsu, Tsi; Djeunang Dongho, Bruna; Fotso, Jimmy Roger; TiotsiaTsapi, Armand; Azeufack Ngueko, Yannick; Ben Bechir, Sali; Pana, Augusto; Ercoli, Lucia; Colizzi, Vittorio; Russo, Gianluca

    2016-01-01

    Amongst the different at-risk periods for mother-to-child HIV transmission that is, during pregnancy, labor and delivery and breastfeeding, much care and attention needs to be given, not only to the child as concerns its feeding options, but also to the mother. The aim of this study was to determine the nutritional habits and health outcomes of HIV-positive breastfeeding mothers in the Dschang Health District, in the context of prevention of mother-to-child transmission (PMTCT) activities. A cross-sectional study was carried out from September 2014 to February 2015, at the Dschang District Day Care Hospital. A standard questionnaire was administered by face-to-face interview to 56 breastfeeding HIV-positive mothers. Anthropometric parameters of the mothers were measured (weight and height), and a physical check-up performed, with examination of the mothers' conjunctiva and palms. Clinical status was determined by anemia test using the Tallquist hemoglobin test. Data collected were analyzed using Epi Info version 7.1.3.3 and Excel 2013. The mean age of participants was 33 years. Most women ate three meals per day (53.6%, n=30/56), while 26,8% (15/56) ate two. Staples (27.27%) and fruits (33.68%) were found to be the most consumed foods per week and green leafy and yellow vegetables the least consumed (13.74%). Body mass index was used to evaluate the nutritional status of participating women: 26.9% (n=14/52) were in the normal range of weight, slightly more than half were overweight (51.9%, n=27/52) and 21.2% (n=11/52) were obese. All mothers were on antiretroviral therapy (ART). Recent CD4 count results were available for about half of the women and the mean was 293 cells/mmc (range 97-798). Physical checkup showed that 64.3% (n=36/56) and 67.9% (n=38/56) of women respectively had moderately colored conjunctiva and palms, while 10.7% (n=6/56) and 12.5% (n=7/56) respectively had pale conjunctiva and palms, considered to be clinical signs of anemia. About 74.1% (n=40

  4. Self-declared stock ownership and association with positive trial outcome in randomized controlled trials with binary outcomes published in general medical journals: a cross-sectional study.

    Science.gov (United States)

    Falk Delgado, Alberto; Falk Delgado, Anna

    2017-07-26

    Describe the prevalence and types of conflicts of interest (COI) in published randomized controlled trials (RCTs) in general medical journals with a binary primary outcome and assess the association between conflicts of interest and favorable outcome. Parallel-group RCTs with a binary primary outcome published in three general medical journals during 2013-2015 were identified. COI type, funding source, and outcome were extracted. Binomial logistic regression model was performed to assess association between COI and funding source with outcome. A total of 509 consecutive parallel-group RCTs were included in the study. COI was reported in 74% in mixed funded RCTs and in 99% in for-profit funded RCTs. Stock ownership was reported in none of the non-profit RCTs, in 7% of mixed funded RCTs, and in 50% of for-profit funded RCTs. Mixed-funded RCTs had employees from the funding company in 11% and for-profit RCTs in 76%. Multivariable logistic regression revealed that stock ownership in the funding company among any of the authors was associated with a favorable outcome (odds ratio = 3.53; 95% confidence interval = 1.59-7.86; p < 0.01). COI in for-profit funded RCTs is extensive, because the factors related to COI are not fully independent, a multivariable analysis should be cautiously interpreted. However, after multivariable adjustment only stock ownership from the funding company among authors is associated with a favorable outcome.

  5. Match of psychosocial risk and psychosocial care in families of a child with cancer.

    Science.gov (United States)

    Sint Nicolaas, S M; Schepers, S A; van den Bergh, E M M; de Boer, Y; Streng, I; van Dijk-Lokkart, E M; Grootenhuis, M A; Verhaak, C M

    2017-12-01

    The Psychosocial Assessment Tool (PAT) was developed to screen for psychosocial risk, aimed to be supportive in directing psychosocial care to families of a child with cancer. This study aimed to determine (i) the match between PAT risk score and provided psychosocial care with healthcare professionals blind to outcome of PAT assessment, and (ii) the match between PAT risk score and team risk estimation. Eighty-three families of children with cancer from four pediatric oncology centers in the Netherlands participated (59% response rate). The PAT and team risk estimation was assessed at diagnosis (M = 40.2 days, SD = 14.1 days), and the content of provided psychosocial care in the 5-month period thereafter resulting in basic or specialized care. According to the PAT, 65% of families were defined as having low (universal), 30% medium (targeted), and 5% high (clinical) risk for developing psychosocial problems. Thirty percent of patients from universal group got basic psychosocial care, 63% got specialized care, and 7% did not get any care. Fourteen percent of the families at risk got basic care, 86% got specialized care. Team risk estimations and PAT risk scores matched with 58% of the families. This study showed that families at risk, based on standardized risk assessment with the PAT, received more specialized care than families without risk. However, still 14% of the families with high risks only received basic care, and 63% of the families with standard risk got specialized care. Standardized risk assessment can be used as part of comprehensive care delivery, complementing the team. © 2017 Wiley Periodicals, Inc.

  6. Favorable outcomes in locally advanced and node positive prostate cancer patients treated with combined pelvic IMRT and androgen deprivation therapy

    International Nuclear Information System (INIS)

    Lilleby, Wolfgang; Narrang, Amol; Tafjord, Gunnar; Vlatkovic, Ljiljana; Russnes, Kjell Magne; Stensvold, Andreas; Hole, Knut Håkon; Tran, Phuoc; Eilertsen, Karsten

    2015-01-01

    The most appropriate treatment for men with prostate cancer and positive pelvic nodes, N+, is an area of active controversy. We report our 5-years outcomes in men with locally advanced prostate cancer (T1-T4N0-N1M0) treated with definitive radiotherapy encompassing the prostate and pelvic lymph nodes (intensity modulated radiotherapy, IMRT) and long-term androgen deprivation therapy (ADT). Of the 138 consecutive eligible men all living patients have been followed up to almost 5 years. Survival endpoints for 5-year biochemical failure-free survival (BFFS), relapse-free survival (RFS), prostate cancer-specific survival (PCSS), and overall survival (OS) were assessed by Kaplan-Meier analysis. Univariate and multivariate Cox regression proportional hazards models were constructed for all survival endpoints. The RTOG morbidity grading system for physician rated toxicity was applied. Patients with locally advanced T3-T4 tumors (35 %) and N1 (51 %) have favorable outcome when long-term ADT is combined with definitive radiotherapy encompassing pelvic lymph nodes. The 5-year BFFS, RFS, PCSS and OS were 71.4, 76.2, 94.5 and 89.0 %, respectively. High Gleason sum (9–10) had a strong independent prognostic impact on BFFS, RFS and OS (p = 0.001, <0.001, and 0.005 respectively). The duration of ADT (= > 28 months) showed a significant independent association with improved PCSS (p = 0.02) and OS (p = 0.001). Lymph node involvement was not associated with survival endpoints in the multivariate analysis. The radiotherapy induced toxicity seen in our study population was moderate with rare Grade 3 GI side effects and up to 11 % for Grade 3 GU consisting mainly of urgency and frequency. Pelvic IMRT in combination with long-term ADT can achieve long-lasting disease control in men with N+ disease and unfavorable prognostic factors. The online version of this article (doi:10.1186/s13014-015-0540-3) contains supplementary material, which is available to authorized users

  7. Aged rats are hypo-responsive to acute restraint: implications for psychosocial stress in aging

    Directory of Open Access Journals (Sweden)

    Heather M Buechel

    2014-02-01

    Full Text Available Cognitive processes associated with prefrontal cortex and hippocampus decline with age and are vulnerable to disruption by stress. The stress/ stress hormone/ allostatic load hypotheses of brain aging posit that brain aging, at least in part, is the manifestation of life-long stress exposure. In addition, as humans age, there is a profound increase in the incidence of new onset stressors, many of which are psychosocial (e.g., loss of job, death of spouse, social isolation, and aged humans are well-understood to be more vulnerable to the negative consequences of such new-onset chronic psychosocial stress events. However, the mechanistic underpinnings of this age-related shift in chronic psychosocial stress response, or the initial acute phase of that chronic response, have been less well-studied. Here, we separated young (3 mo. and aged (21 mo. male F344 rats into control and acute restraint (an animal model of psychosocial stress groups (n = 9-12/ group. We then assessed hippocampus-associated behavioral, electrophysiological, and transcriptional outcomes, as well as blood glucocorticoid and sleep architecture changes. Aged rats showed characteristic water maze, deep sleep, transcriptome, and synaptic sensitivity changes compared to young. Young and aged rats showed similar levels of distress during the three hour restraint, as well as highly significant increases in blood glucocorticoid levels 21 hours after restraint. However, young, but not aged, animals responded to stress exposure with water maze deficits, loss of deep sleep and hyperthermia. These results demonstrate that aged subjects are hypo-responsive to new-onset acute psychosocial stress, which may have negative consequences for long-term stress adaptation and suggest that age itself may act as a stressor occluding the influence of new onset stressors.

  8. Aged rats are hypo-responsive to acute restraint: implications for psychosocial stress in aging

    Science.gov (United States)

    Buechel, Heather M.; Popovic, Jelena; Staggs, Kendra; Anderson, Katie L.; Thibault, Olivier; Blalock, Eric M.

    2013-01-01

    Cognitive processes associated with prefrontal cortex and hippocampus decline with age and are vulnerable to disruption by stress. The stress/stress hormone/allostatic load hypotheses of brain aging posit that brain aging, at least in part, is the manifestation of life-long stress exposure. In addition, as humans age, there is a profound increase in the incidence of new onset stressors, many of which are psychosocial (e.g., loss of job, death of spouse, social isolation), and aged humans are well-understood to be more vulnerable to the negative consequences of such new-onset chronic psychosocial stress events. However, the mechanistic underpinnings of this age-related shift in chronic psychosocial stress response, or the initial acute phase of that chronic response, have been less well-studied. Here, we separated young (3 month) and aged (21 month) male F344 rats into control and acute restraint (an animal model of psychosocial stress) groups (n = 9–12/group). We then assessed hippocampus-associated behavioral, electrophysiological, and transcriptional outcomes, as well as blood glucocorticoid and sleep architecture changes. Aged rats showed characteristic water maze, deep sleep, transcriptome, and synaptic sensitivity changes compared to young. Young and aged rats showed similar levels of distress during the 3 h restraint, as well as highly significant increases in blood glucocorticoid levels 21 h after restraint. However, young, but not aged, animals responded to stress exposure with water maze deficits, loss of deep sleep and hyperthermia. These results demonstrate that aged subjects are hypo-responsive to new-onset acute psychosocial stress, which may have negative consequences for long-term stress adaptation and suggest that age itself may act as a stressor occluding the influence of new onset stressors. PMID:24575039

  9. Health outcomes among HIV-positive Latinos initiating antiretroviral therapy in North America versus Central and South America

    Science.gov (United States)

    Cesar, Carina; Koethe, John R; Giganti, Mark J; Rebeiro, Peter; Althoff, Keri N; Napravnik, Sonia; Mayor, Angel; Grinsztejn, Beatriz; Wolff, Marcelo; Padgett, Denis; Sierra-Madero, Juan; Gotuzzo, Eduardo; Sterling, Timothy R; Willig, James; Levison, Julie; Kitahata, Mari; Rodriguez-Barradas, Maria C; Moore, Richard D; McGowan, Catherine; Shepherd, Bryan E; Cahn, Pedro

    2016-01-01

    Introduction Latinos living with HIV in the Americas share a common ethnic and cultural heritage. In North America, Latinos have a relatively high rate of new HIV infections but lower rates of engagement at all stages of the care continuum, whereas in Latin America antiretroviral therapy (ART) services continue to expand to meet treatment needs. In this analysis, we compare HIV treatment outcomes between Latinos receiving ART in North America versus Latin America. Methods HIV-positive adults initiating ART at Caribbean, Central and South America Network for HIV (CCASAnet) sites were compared to Latino patients (based on country of origin or ethnic identity) starting treatment at North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) sites in the United States and Canada between 2000 and 2011. Cox proportional hazards models compared mortality, treatment interruption, antiretroviral regimen change, virologic failure and loss to follow-up between cohorts. Results The study included 8400 CCASAnet and 2786 NA-ACCORD patients initiating ART. CCASAnet patients were younger (median 35 vs. 37 years), more likely to be female (27% vs. 20%) and had lower nadir CD4 count (median 148 vs. 195 cells/µL, p<0.001 for all). In multivariable analyses, CCASAnet patients had a higher risk of mortality after ART initiation (adjusted hazard ratio (AHR) 1.61; 95% confidence interval (CI): 1.32 to 1.96), particularly during the first year, but a lower hazard of treatment interruption (AHR: 0.46; 95% CI: 0.42 to 0.50), change to second-line ART (AHR: 0.56; 95% CI: 0.51 to 0.62) and virologic failure (AHR: 0.52; 95% CI: 0.48 to 0.57). Conclusions HIV-positive Latinos initiating ART in Latin America have greater continuity of treatment but are at higher risk of death than Latinos in North America. Factors underlying these differences, such as HIV testing, linkage and access to care, warrant further investigation. PMID:26996992

  10. Lassa hemorrhagic fever in a late term pregnancy from northern sierra leone with a positive maternal outcome: case report

    Directory of Open Access Journals (Sweden)

    Bangura James J

    2011-08-01

    Full Text Available Abstract Lassa fever (LF is a devastating viral disease prevalent in West Africa. Efforts to take on this public health crisis have been hindered by lack of infrastructure and rapid field deployable diagnosis in areas where the disease is prevalent. Recent capacity building at the Kenema Government Hospital Lassa Fever Ward (KGH LFW in Sierra Leone has lead to a major turning point in the diagnosis, treatment and study of LF. Herein we present the first comprehensive rapid diagnosis and real time characterization of an acute hemorrhagic LF case at KGH LFW. This case report focuses on a third trimester pregnant Sierra Leonean woman from the historically non-endemic Northern district of Tonkolili who survived the illness despite fetal demise. Employed in this study were newly developed recombinant LASV Antigen Rapid Test cassettes and dipstick lateral flow immunoassays (LFI that enabled the diagnosis of LF within twenty minutes of sample collection. Deregulation of overall homeostasis, significant hepatic and renal system involvement, and immunity profiles were extensively characterized during the course of hospitalization. Rapid diagnosis, prompt treatment with a full course of intravenous (IV ribavirin, IV fluids management, and real time monitoring of clinical parameters resulted in a positive maternal outcome despite admission to the LFW seven days post onset of symptoms, fetal demise, and a natural still birth delivery. These studies solidify the growing rapid diagnostic, treatment, and surveillance capabilities at the KGH LF Laboratory, and the potential to significantly improve the current high mortality rate caused by LF. As a result of the growing capacity, we were also able to isolate Lassa virus (LASV RNA from the patient and perform Sanger sequencing where we found significant genetic divergence from commonly circulating Sierra Leonean strains, showing potential for the discovery of a newly emerged LASV strain with expanded geographic

  11. Factors related to positive and negative outcomes in psychiatric inpatients in a General Hospital Psychiatric Unit: a proposal for an outcomes index

    Directory of Open Access Journals (Sweden)

    HUGO KARLING MORESCHI

    2015-02-01

    Full Text Available Background General Hospital Psychiatric Units have a fundamental importance in the mental health care systems. However, there is a lack of studies regarding the level of improvement of patients in this type of facility. Objective To assess factors related to good and poor outcomes in psychiatric inpatients using an index composed by clinical parameters easily measured. Methods Length of stay (LOS, Global Assessment of Functioning (variation and at discharge and Clinical Global Impression (severity and improvement were used to build a ten-point improvement index (I-Index. Records of psychiatric inpatients of a general hospital during an 18-month period were analyzed. Three groups (poor, intermediate and good outcomes were compared by univariate and multivariate models according to clinical and sociodemographic variables. Results Two hundred and fifty patients were included, with a percentage in the groups with poor, regular and good outcomes of 16.4%, 59,6% and 24.0% respectively. Poor outcome at the discharge was associated mainly with lower education, transient disability, antipsychotics use, chief complaint “behavioral change/aggressiveness” and psychotic features. Multivariate analysis found a higher OR for diagnoses of “psychotic disorders” and “personality disorders” and others variables in relation to protective categories in the poor outcome group compared to the good outcome group. Discussion Our I-Index proved to be an indicator of that allows an easy and more comprehensive evaluation to assess outcomes of inpatients than just LOS. Different interventions addressed to conditions such as psychotic disorders and disruptive chief complaints are necessary.

  12. A systematic review of studies on psychosocial late effects of childhood cancer: structures of society and methodological pitfalls may challenge the conclusions

    DEFF Research Database (Denmark)

    Lund, Lasse Wegener; Schmiegelow, Kjeld; Rechnitzer, Catherine

    2011-01-01

    High survival rates after childhood cancer raise attention to possible psychosocial late effects. We focus on predictors of psychosocial outcomes based on diagnosis, treatment, demography, somatic disease, and methodological problems. Overall, survivors evaluate their health-related quality of life...

  13. Finding benefits from acculturative stress among Asian Americans: Self-reflection moderating the mediating effects of ethnocultural empathy on positive outcomes.

    Science.gov (United States)

    Wei, Meifen; Li, Chun-I; Wang, Cixin; Ko, Stacy Y

    2016-11-01

    This study examined a moderated mediation model to see whether self-reflection moderated (a) the association between acculturative stress and ethnocultural empathy and (b) the indirect effects of acculturative stress on 2 positive outcomes (i.e., bicultural competence and making positive sense of adversity) through ethnocultural empathy. A total of 330 Asian American college students from a West coast university participated in an online survey. Results from PROCESS supported hypotheses. First, self-reflection significantly moderated the effects of acculturative stress on ethnocultural empathy. Specifically, the effect of acculturative stress on ethnocultural empathy was significantly positive for those with lower self-reflection. Conversely, this effect was not significant for those with higher self-reflection, but ethnocultural empathy was consistently high across all levels of acculturative stress for those with higher self-reflection. Post hoc exploratory analyses examined the moderated mediation model using each of the 5 domains of acculturative stress as predictors; results supported the moderated mediation hypotheses for 2 domains, discrimination and cultural isolation. Second, self-reflection significantly moderated the indirect effects of acculturative stress on 2 positive outcomes through ethnocultural empathy. Results from conditional indirect effects suggested that the indirect effects of acculturative stress on 2 positive outcomes through ethnocultural empathy were significantly positive for those with lower self-reflection. Conversely, the indirect effects were not significant for those with higher self-reflection, but the 2 positive outcomes stayed high at all levels of acculturative stress. Post hoc analyses found that 5 of 6 components of bicultural competence used as outcome variables supported the moderation mediation hypotheses. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  14. Psychosocial interventions for disruptive behavioural problems in children living in low- and middle-income countries: study protocol of a systematic review.

    Science.gov (United States)

    Burkey, Matthew D; Hosein, Megan; Purgato, Marianna; Adi, Ahmad; Morton, Isabella; Kohrt, Brandon A; Tol, Wietse A

    2015-05-20

    Disruptive behaviour disorders (DBDs) are among the most common forms of child psychopathology and have serious long-term academic, social, and mental health consequences worldwide. Psychosocial treatments are the first line of evidence-based treatments for DBDs, yet their effectiveness often varies according to patient sociodemographic characteristics, practice setting, and implementation procedures. While a large majority of the world's children live in low- and middle-income countries (LMIC), most studies have evaluated psychosocial treatments for DBDs in high-income Anglo countries. The primary objective of this systematic review is to assess the effects of psychosocial treatments for DBDs in children and adolescents (under age 18) diagnosed with oppositional defiant disorder, conduct disorder, or other disruptive behavioural problems living in LMIC. The secondary objectives are to: (1) describe the range and types of psychosocial treatments used to address DBDs in LMIC and (2) identify key dissemination and implementation factors (adaptation processes, training/supervision processes, and financial costs). All controlled trials comparing psychosocial treatments versus waiting list, no treatment, or treatment as usual in children living in LMIC will be included. Studies will be identified using the methods outlined in the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines without restrictions on language, publication type, status, or date of publication. The primary outcome measures will be disruptive behavioural problems (eg, oppositionality, defiance, aggression or deceit). Secondary outcomes will be positive mental health outcomes (eg, prosocial behaviour), function impairment, institutionalisation (or hospitalisation), academic outcomes and caregiver outcomes. This study uses data from published studies; therefore ethical review is not required. Findings will be presented in a published manuscript. PROSPERO CRD42014015334

  15. Clients' psychosocial communication and midwives' verbal and nonverbal communication during prenatal counseling for anomaly screening.

    Science.gov (United States)

    Martin, Linda; Gitsels-van der Wal, Janneke T; Pereboom, Monique T R; Spelten, Evelien R; Hutton, Eileen K; van Dulmen, Sandra

    2016-01-01

    This study focuses on facilitation of clients' psychosocial communication during prenatal counseling for fetal anomaly screening. We assessed how psychosocial communication by clients is related to midwives' psychosocial and affective communication, client-directed gaze and counseling duration. During 184 videotaped prenatal counseling consultations with 20 Dutch midwives, verbal psychosocial and affective behavior was measured by the Roter Interaction Analysis System (RIAS). We rated the duration of client-directed gaze. We performed multilevel analyses to assess the relation between clients' psychosocial communication and midwives' psychosocial and affective communication, client-directed gaze and counseling duration. Clients' psychosocial communication was higher if midwives' asked more psychosocial questions and showed more affective behavior (β=0.90; CI: 0.45-1.35; pcommunication was not related to midwives" client-directed gaze. Additionally, psychosocial communication by clients was directly, positively related to the counseling duration (β=0.59; CI: 0.20-099; p=0.004). In contrast with our expectations, midwives' client-directed gaze was not related with psychosocial communication of clients. In addition to asking psychosocial questions, our study shows that midwives' affective behavior and counseling duration is likely to encourage client's psychosocial communication, known to be especially important for facilitating decision-making. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  16. [Adolescent psychosocial development].

    Science.gov (United States)

    Gaete, Verónica

    2015-01-01

    It is increasingly necessary that pediatricians have greater knowledge of adolescent health. To begin with they should be familiar with the psychosocial development of this period, an issue which is imperative for the health care of the age group. With that purpose, this article reviews the normal adolescent psychosocial development. Adolescence is a stage that has been progressively prolonged, during which fast and big changes occur, that lead human beings to become biologically, psychologically and socially mature, and potentially able to live independently. Developmental tasks of this period are the establishment of identity and the achievement of autonomy. Although it is a process of high individual variability in terms of its beginning and end, the progression through stages, the synchrony of development between the various areas, and in other aspects, the psychosocial development of this period usually have common characteristics and a progressive pattern of 3 phases: early, middle and late adolescence. Psychological, cognitive, social, sexual and moral development of young people in each of them are described in this article. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Material, behavioural, cultural and psychosocial factors in the explanation of socioeconomic inequalities in oral health.

    Science.gov (United States)

    Duijster, Denise; Oude Groeniger, Joost; van der Heijden, Geert J M G; van Lenthe, Frank J

    2017-12-19

    This study aimed to assess the contribution of material, behavioural, cultural and psychosocial factors in the explanation of socioeconomic inequalities (education and income) in oral health of Dutch adults. Cross-sectional data from participants (25-75 years of age) of the fifth wave of the GLOBE cohort were used (n = 2812). Questionnaires were used to obtain data on material factors (e.g. financial difficulties), behavioural factors (e.g. smoking), cultural factors (e.g. cultural activities) and psychosocial factors (e.g. psychological distress). Oral health outcomes were self-reported number of teeth and self-rated oral health (SROH). Mediation analysis, using multivariable negative binomial regression and logistic regression, was performed. Education level and income showed a graded positive relationship with both oral health outcomes. Adding material, behavioural, cultural and psychosocial factors substantially reduced the rate ratio for the number of teeth of the lowest education group from 0.79 (95% confidence interval (CI): 0.75-0.83) to 0.92 (95% CI: 0.87-0.97) and of the lowest income group from 0.80 (95% CI: 0.73-0.88) to 1.04 (95% CI: 0.96-1.14). Inclusion of all factors also substantially reduced the odds ratio for poor SROH of the lowest education group from 1.61 (95% CI: 1.28-2.03) to 1.12 (95% CI: 0.85-1.48) and of the lowest income groups from 3.18 (95% CI: 2.13-4.74) to 1.48 (95% CI: 0.90-2.45). In general, behavioural factors contributed most to the explanation of socioeconomic inequalities in adult oral health, followed by material factors. The contribution of cultural and psychosocial factors was relatively moderate. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association.

  18. Intrinsic motivation, neurocognition and psychosocial functioning in schizophrenia: testing mediator and moderator effects.

    Science.gov (United States)

    Nakagami, Eri; Xie, Bin; Hoe, Maanse; Brekke, John S

    2008-10-01

    This study examined the nature of the relationships among neurocognition, intrinsic motivation, and psychosocial functioning for persons with schizophrenia. Hypotheses concerning both mediator and moderator mechanisms were tested. 120 individuals diagnosed with schizophrenia were recruited as they entered outpatient psychosocial rehabilitation programs. Measures of psychosocial functioning and intrinsic motivation were administered at baseline. Measures of neurocognition were administered at baseline by testers blind to scores on other study variables. Data were analyzed using latent construct modeling to test for mediator and moderator effects. There were strong bivariate relationships between neurocognition, intrinsic motivation, and psychosocial functioning. The results demonstrated that intrinsic motivation strongly mediated the relationship between neurocognition and psychosocial functioning. This mediation was evidenced by: (i) the direct path from neurocognition to functional outcome no longer being statistically significant after the introduction of motivation into the model, (ii) the statistical significance of the indirect path from neurocognition through motivation to functional outcome. There was no support for the two moderation hypotheses: the level of neurocognition did not influence the relationship between intrinsic motivation and psychosocial functioning, nor did the level of intrinsic motivation influence the relationship between neurocognition and psychosocial functioning. Neurocognition influences psychosocial functioning through its relationship with intrinsic motivation. Intrinsic motivation is a critical mechanism for explaining the relationship between neurocognition and psychosocial functioning. Implications for the theoretical understanding and psychosocial treatment of intrinsic motivation in schizophrenia are discussed.

  19. Transplantation with positive complement-dependent microcytotoxicity crossmatch in contemporary kidney transplantation: Practice patterns and associated outcomes

    Directory of Open Access Journals (Sweden)

    Ralph J Graff

    2012-01-01

    Full Text Available We analyzed clinical factors and graft survival associated with complement-dependent microcytotoxicity (CDC crossmatch (XM positive (+ kidney transplants in 1995 to 2009 United Network of Sharing (UNOS registry data. CDCXM negative (- transplants were selected from centers and years in which at least one CDCXM+ transplant was performed at a given center in a given year. CDCXM+ and CDCXM- results were compared with bivariate and multivariate survival analysis. Our observations are as follows: (1 The risk of graft loss with CDCXM+ vs. CDCXM- results was markedly lower than the risk observed historically, e.g., living donor (LD-CDCXM+ absolute all-cause graft survival reductions were 0.7% at 24 hours (P=0.007, 2.9% at one year (P <0.0001, 3.7% at five years (P<0.0001; deceased donor (DD-CDCXM+ absolute graft survival reductions were 0.7% at 24 hours (P=0.02, 3.5% at one year (P <0.0001, 2.7% at five years (P=0.0009. On covariate adjustment, the only significant association of CDCXM+ vs. CDCXM- results was with one-year graft loss risk: LD aHR 1.44 (95% CI 1.05-1.96, DD aHR 1.33 (CI 1.10-1.61. (2 CDCXM+ transplantation was more commonly performed among groups disadvantaged with respect to transplant access, including sensitized, previously transplanted women and black recipients. (3 In CDCXM+ recipients, there was a high percentage of flow cytometry (FC XM- and autoXM+ results. After removing these groups, outcomes with CDCXM+ results were relatively good. (4 CDCXM+/FCXM+ vs. CDCXM-/FCXM- graft loss risk was observed only in LD recipients transplanted at centers performing fewer than 10 such transplants during the study period: 11.0% reduction (P<0.0001 and aHR of 2.86 (CI 1.18-6.94 at one year; 14.7% reduction (P<0.0001 and aHR of 1.77 (CI 0.88-3.58 at five years. Although using CDCXM+ as a contraindication to transplantation has been associated with virtual elimination of hyperacute rejection, the negative effect of a CDCXM+ in contemporary

  20. Distinct clinical outcomes of two CIMP-positive colorectal cancer subtypes based on a revised CIMP classification system.

    Science.gov (United States)

    Bae, Jeong Mo; Kim, Jung Ho; Kwak, Yoonjin; Lee, Dae-Won; Cha, Yongjun; Wen, Xianyu; Lee, Tae Hun; Cho, Nam-Yun; Jeong, Seung-Yong; Park, Kyu Joo; Han, Sae Won; Lee, Hye Seung; Kim, Tae-You; Kang, Gyeong Hoon

    2017-04-11

    Colorectal cancer (CRC) is a heterogeneous disease in terms of molecular carcinogenic pathways. Based on recent findings regarding the multiple serrated neoplasia pathway, we revised an eight-marker panel for a new CIMP classification system. 1370 patients who received surgical resection for CRCs were classified into three CIMP subtypes (CIMP-N: 0-4 methylated markers, CIMP-P1: 5-6 methylated markers and CIMP-P2: 7-8 methylated markers). Our findings were validated in a separate set of high-risk stage II or stage III CRCs receiving adjuvant fluoropyrimidine plus oxaliplatin (n=950). A total of 1287/62/21 CRCs cases were classified as CIMP-N/CIMP-P1/CIMP-P2, respectively. CIMP-N showed male predominance, distal location, lower T, N category and devoid of BRAF mutation, microsatellite instability (MSI) and MLH1 methylation. CIMP-P1 showed female predominance, proximal location, advanced TNM stage, mild decrease of CK20 and CDX2 expression, mild increase of CK7 expression, BRAF mutation, MSI and MLH1 methylation. CIMP-P2 showed older age, female predominance, proximal location, advanced T category, markedly reduced CK20 and CDX2 expression, rare KRAS mutation, high frequency of CK7 expression, BRAF mutation, MSI and MLH1 methylation. CIMP-N showed better 5-year cancer-specific survival (CSS; HR=0.47; 95% CI: 0.28-0.78) in discovery set and better 5-year relapse-free survival (RFS; HR=0.50; 95% CI: 0.29-0.88) in validation set compared with CIMP-P1. CIMP-P2 showed marginally better 5-year CSS (HR=0.28, 95% CI: 0.07-1.22) in discovery set and marginally better 5-year RFS (HR=0.21, 95% CI: 0.05-0.92) in validation set compared with CIMP-P1. CIMP subtypes classified using our revised system showed different clinical outcomes, demonstrating the heterogeneity of multiple serrated precursors of CIMP-positive CRCs.

  1. Faculty Perceptions of Conflict with Administrators: An Analysis of the Associations between the Nature of Conflict and Positive and Negative Outcomes

    Science.gov (United States)

    Hancks, Meredith L.

    2013-01-01

    This study examines the perceptions of faculty members regarding conflict experiences with administrators. It is driven by the question, "To what extent are faculty perceptions of positive and negative outcomes of faculty-administrator conflict associated with domain, nature and disciplinary context of the conflict," where domain refers…

  2. Effects of Continuous Positive Airway Pressure on Cognitive and Functional Outcome of Stroke Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial

    NARCIS (Netherlands)

    Aaronson, Justine A.; Hofman, Winni F.; van Bennekom, Coen A. M.; van Bezeij, Tijs; van den Aardweg, Joost G.; Groet, Erny; Kylstra, Wytske A.; Schmand, Ben

    2016-01-01

    Obstructive sleep apnea (OSA) in stroke patients is associated with worse functional and cognitive status during inpatient rehabilitation. We hypothesized that a four-week period of continuous positive airway pressure (CPAP) treatment would improve cognitive and functional outcomes. We performed a

  3. Impact of positive chest X-ray findings and blood cultures on adverse outcomes following hospitalized pneumococcal lower respiratory tract infection

    DEFF Research Database (Denmark)

    Skovgaard, Marlene; Schønheyder, Henrik Carl; Benfield, Thomas

    2013-01-01

    Little is known about the clinical presentation and outcome of pneumococcal lower respiratory tract infection (LRTI) without positive chest X-ray findings and blood cultures. We investigated the prognostic impact of a pulmonary infiltrate and bacteraemia on the clinical course of hospitalized...

  4. Associations between positive end-expiratory pressure and outcome of patients without ARDS at onset of ventilation: a systematic review and meta-analysis of randomized controlled trials

    NARCIS (Netherlands)

    Serpa Neto, Ary; Filho, Roberto Rabello; Cherpanath, Thomas; Determann, Rogier; Dongelmans, Dave A.; Paulus, Frederique; Tuinman, Pieter Roel; Pelosi, Paolo; de Abreu, Marcelo Gama; Schultz, Marcus J.

    2016-01-01

    The aim of this investigation was to compare ventilation at different levels of positive end-expiratory pressure (PEEP) with regard to clinical important outcomes of intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) at onset of ventilation. Meta-analysis of

  5. Spontaneous Pushing in Lateral Position versus Valsalva Maneuver During Second Stage of Labor on Maternal and Fetal Outcomes: A Randomized Clinical Trial.

    Science.gov (United States)

    Vaziri, Farideh; Arzhe, Amene; Asadi, Nasrin; Pourahmad, Saeedeh; Moshfeghy, Zeinab

    2016-10-01

    There are concerns about the harmful effects of the Valsalva maneuver during the second stage of labor. Comparing the effects of spontaneous pushing in the lateral position with the Valsalva maneuver during the second stage of labor on maternal and fetal outcomes. Inclusion criteria in this randomized clinical trial conducted in Iran were as follows: nulliparous mothers, live fetus with vertex presentation, gestational age of 37 - 40 weeks, spontaneous labor, and no complications. The intervention group pushed spontaneously while they were in the lateral position, whereas the control group pushed using Valsalva method while in the supine position at the onset of the second stage of labor. Maternal outcomes such as pain and fatigue severity and fetal outcomes such as pH and pO2 of the umbilical cord blood were measured. Data pertaining to 69 patients, divided into the intervention group (35 subjects) and control group (34 subjects), were analyzed statistically. The mean pain (7.80 ± 1.21 versus 9.05 ± 1.11) and fatigue scores (46.59 ± 21 versus 123.36 ± 43.20) of the two groups showed a statistically significant difference (P pushing in the lateral position reduced fatigue and pain severity of the mothers. Also, it did not worsen fetal outcomes. Thus, it can be used as an alternative method for the Valsalva maneuver.

  6. Psychosocial issues during an expedition to Mars

    Science.gov (United States)

    Kanas, Nick

    2014-10-01

    Much is known about psychological and interpersonal issues affecting astronauts participating in manned space missions near the Earth. But in a future long-distance, long-duration expedition to Mars, additional stressors will occur that will result in psychological, psychiatric, and interpersonal effects on the crew, both negative and positive. This paper will review what is known about important psychosocial issues in space and will extrapolate them to the scenario of a future manned space mission to Mars.

  7. Illness beliefs and psychological outcome in people with Parkinson's disease.

    Science.gov (United States)

    Simpson, Jane; Lekwuwa, Godwin; Crawford, Trevor

    2013-06-01

    Illness beliefs are important predictors of psychological outcome in people with chronic illness and evidence suggests these could also be significant in furthering our understanding of psychological functioning in people with Parkinson's disease. Illness beliefs are specific, dynamic representations of an illness and cover dimensions such as cause, identity, consequences and controllability. Eighty-one people with Parkinson's disease completed a series of questionnaires to provide demographic, clinical and psychosocial data, which were then used to assess the relative impact of illness beliefs on their psychological functioning. Psychological functioning was assessed by measuring levels of depression, anxiety, stress, positive affect and emotional well-being. Hierarchical block regression indicated that illness beliefs were important independent predictors across some but not all outcomes and the results emphasised the importance of testing new predictors against more established predictors of outcome such as physical functioning and self-esteem. The illness beliefs most important in psychological outcome in people with PD were causal beliefs (particularly in psychosocial causes) and illness coherence (the level of understanding of the illness). The therapeutic potential of psychosocial variables was discussed given that these can be modified during therapy and this change can positively influence psychological outcome.

  8. Psychosocial considerations about children and radiological events

    International Nuclear Information System (INIS)

    Lemyre, L.; Corneil, W.; Johnson, C.; Boutette, P.

    2010-01-01

    Children are identified as a vulnerable population in the case of radiological events because of their increased physical sensitivity to radiation and its impact on critical development stages. Using a comprehensive integrated risk framework, psychosocial risk protective factors are discussed in a social ecology paradigm. Children have been shown to be both vulnerable and resilient; they are both easily impressionable and also quick to adapt and learn. Psychosocial interventions during, after and most efficiently before an event can improve outcome, especially if they involve parents and schools, media and work organisations. Public education through children should be encouraged to increase knowledge of radiation and strategies to minimise exposure and irradiation. Children can become vectors of prevention, preparedness and mitigation through information and behavioural rehearsal. Special consideration must therefore be given to education, school programmes, practice rehearsal and media exposure. (authors)

  9. Psychosocial work environment factors and weight change

    DEFF Research Database (Denmark)

    Gram Quist, Helle; Christensen, Ulla; Christensen, Karl Bang

    2013-01-01

    BACKGROUND: Lifestyle variables may serve as important intermediate factors between psychosocial work environment and health outcomes. Previous studies, focussing on work stress models have shown mixed and weak results in relation to weight change. This study aims to investigate psychosocial...... factors outside the classical work stress models as potential predictors of change in body mass index (BMI) in a population of health care workers. METHODS: A cohort study, with three years follow-up, was conducted among Danish health care workers (3982 women and 152 men). Logistic regression analyses...... predicted weight loss among men. Associations were generally weak, with the exception of quality of leadership, age, and cohabitation. CONCLUSION: This study of a single occupational group suggested a few new risk factors for weight change outside the traditional work stress models....

  10. Definition and classification of chronic kidney disease : A position statement from Kidney Disease: Improving Global Outcomes (KDIGO)

    NARCIS (Netherlands)

    Levey, Andrew S.; Eckardt, Kai Uwe; Tsukamoto, Yusuke; Levin, Adeera; Coresh, Josef; Rossert, Jerome; de Zeeuw, Dick; Hostetter, Thomas H.; Lameire, Norbert; Eknoyan, Garabed

    Chronic kidney disease (CKD) is a worldwide public health problem, with adverse outcomes of kidney failure, cardiovascular disease (CVD), and premature death. A simple definition and classification of kidney disease is necessary for international development and implementation of clinical practice

  11. Effectiveness of an SMS-based maternal mHealth intervention to improve clinical outcomes of HIV-positive pregnant women.

    Science.gov (United States)

    Coleman, Jesse; Bohlin, Kate C; Thorson, Anna; Black, Vivian; Mechael, Patricia; Mangxaba, Josie; Eriksen, Jaran

    2017-07-01

    We conducted a retrospective study to investigate the effectiveness of an mHealth messaging intervention aiming to improve maternal health and HIV outcomes. Maternal health SMSs were sent to 235 HIV-infected pregnant women twice per week in pregnancy and continued until the infant's first birthday. The messages were timed to the stage of the pregnancy/infant age and covered maternal health and HIV-support information. Outcomes, measured as antenatal care (ANC) visits, birth outcomes and infant HIV testing, were compared to a control group of 586 HIV-infected pregnant women who received no SMS intervention. Results showed that intervention participants attended more ANC visits (5.16 vs. 3.95, p mHealth interventions can have a positive impact on health outcomes and should be scaled nationally following comprehensive evaluation.

  12. Do Savings Mediate Changes in Adolescents' Future Orientation and Health-Related Outcomes? Findings From Randomized Experiment in Uganda.

    Science.gov (United States)

    Karimli, Leyla; Ssewamala, Fred M

    2015-10-01

    This present study tests the proposition that an economic strengthening intervention for families caring for AIDS-orphaned adolescents would positively affect adolescent future orientation and psychosocial outcomes through increased asset accumulation (in this case, by increasing family savings). Using longitudinal data from the cluster-randomized experiment, we ran generalized estimating equation models with robust standard errors clustering on individual observations. To examine whether family savings mediate the effect of the intervention on adolescents' future orientation and psychosocial outcomes, analyses were conducted in three steps: (1) testing the effect of intervention on mediator; (2) testing the effect of mediator on outcomes, controlling for the intervention; and (3) testing the significance of mediating effect using Sobel-Goodman method. Asymmetric confidence intervals for mediated effect were obtained through bootstrapping-to address the assumption of normal distribution. Results indicate that participation in a matched Child Savings Account (CSA) program improved adolescents' future orientation and psychosocial outcomes by reducing hopelessness, enhancing self-concept, and improving adolescents' confidence about their educational plans. However, the positive intervention effect on adolescent future orientation and psychosocial outcomes was not transmitted through saving. In other words, participation in the matched CSA program improved adolescent future orientation and psychosocial outcomes regardless of its impact on reported savings. Further research is necessary to understand exactly how participation in economic strengthening interventions, for example, those that employ matched CSAs, shape adolescent future orientation and psychosocial outcomes: what, if not savings, transmits the treatment effect and how? Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  13. PSYCHOSOCIAL MORBIDITY IN PATIENTS UNDERGOING MASTECTOMY FOR BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Kavitha Konnakkaparambil Ramakrishnan

    2018-02-01

    Full Text Available BACKGROUND Breast Cancer is the most common female cancer worldwide and carries significant psychosocial morbidity. The diagnosis of the disease and the treatment modalities like surgery and chemotherapy contribute to the morbidity. The recognition of the psychosocial morbidity associated with mastectomy can help us formulate effective counselling strategies. The objectives of this study were- to assess the psychosocial morbidity in patients undergoing mastectomy for carcinoma breast, to identify the preoperative variables that predict the morbidity and to find out the correlation between degree of neuroticism of the individual and morbidity. MATERIALS AND METHODS 35 female patients who had mastectomy for breast cancer were evaluated at three time-points, preoperatively, immediately after surgery and 2 months after surgery. Anxiety and depression was assessed using Hospital Anxiety and Depression Scale (HADS, psychological distress was measured using General Health Questionnaire (GHQ-12 and neuroticism was assessed by Eysenck Personality Inventory Neuroticism subscale (EPI-N. RESULTS There was a high level of anxiety, depression and GHQ scores preoperatively with a further worsening of these over the three interviews. Age, marital status and menopausal status were factors which had an influence on psychosocial morbidity. Preoperative EPI-N scores positively correlated with psychosocial morbidity. CONCLUSION There is a high level of psychosocial morbidity in patients undergoing mastectomy for breast cancer and mastectomy seems to worsen it in the first two months after surgery. Our study shows that psychosocial morbidity is affected by age, marital status, menopausal status and level of neuroticism.

  14. Psychosocial factors associated with paternal postnatal depression.

    Science.gov (United States)

    Demontigny, Francine; Girard, Marie-Eve; Lacharité, Carl; Dubeau, Diane; Devault, Annie

    2013-08-15

    While maternal postpartum depression is a well-known phenomenon, paternal postnatal depression has been less studied. It is known that paternal postnatal depression impacts on children's and families' development, affects marital satisfaction and affects the economic health of industrialized countries. The aim of this study was to identify the psychosocial factors associated with paternal postnatal depression. A descriptive-correlational study was conducted with a sample of fathers of infants (average age: 11 months) who were breastfed exclusively or predominantly for at least 6 months, comparing psychosocial factors in fathers with (n: 17, 8.2%) and without a positive score for depression on the EPDS scale (n: 188). Psychosocial factors were assessed through questionnaires. Depression in fathers of breastfed infants is associated with the experience of perinatal loss in a previous pregnancy, parenting distress, infant temperament (difficult child), dysfunctional interactions with the child, decreased marital adjustment and perceived low parenting efficacy. Multivariate analysis suggests an independent effect of psychosocial factors such as parenting distress, quality of the marital relationship and perceived parenting efficacy on paternal depression. The sample focused on fathers of breastfed infant, since breastfeeding has become the feeding norm, and this should be taken into account when considering the generalization of findings. These findings emphasize the need to consider a set of psychosocial factors when examining fathers' mental health in the first year of a child's birth. Health professionals can enhance parenting efficacy and alleviate parenting distress by supporting fathers' unique experiences and addressing their needs. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Knowledge, attitudes, and practice behaviors (KAPb) of nurses and the effectiveness of a training program in psychosocial cancer care.

    Science.gov (United States)

    Mahendran, Rathi; Chua, Joanne; Peh, Chao Xu; Lim, Haikel A; Ang, Emily N K; Lim, Siew Eng; Kua, Ee Heok

    2014-08-01

    Psychosocial distress in oncology patients may significantly interfere with their health outcomes and quality of life. Nurses work closely with their patients and are in the best position to screen for distress and provide timely intervention. It is thus important for nurses working in oncology settings to be equipped and prepared to address distressing psychosocial issues. The present study aims to investigate the impact of a training program in psychosocial care on nurses' knowledge, attitudes, and clinical practice behaviors. A total of 180 nurses working in medical oncology and radiation oncology departments at the National University Cancer Institute Singapore underwent a training program in psychosocial care as part of their continuing nursing education curriculum. One hundred fifty four of these nurses completed a self-designed questionnaire on nurses' knowledge, attitudes, and practice behaviors (KAPb) at all four time points: baseline, post-training, and at 6 and 12 weeks post-training, respectively. The self-designed KAPb questionnaire proved adequate for this study. Positive gains on applied knowledge and practice behaviors were sustained over a 12-week period. There were no changes in theoretical knowledge. A decreasing trend in attitudes was noted, although this was specific to the participants' attitudes toward the importance of emotional concerns as compared to physical concerns in cancer treatment. Enrolled nurses seemed to have higher starting levels of theoretical knowledge than their registered counterparts were. There were no other differences on demographic variables in relation to the efficacy of the training program. The training program was successful in improving the applied knowledge and practice behaviors of nurses in providing psychosocial care for cancer patients. However, further refinement to the program, with particular attention to nurses' existing training and years of clinical nursing experience, would enhance staff empowerment

  16. Excursions out-of-lane versus standard deviation of lateral position as outcome measure of the on-the-road driving test.

    Science.gov (United States)

    Verster, Joris C; Roth, Thomas

    2014-07-01

    The traditional outcome measure of the Dutch on-the-road driving test is the standard deviation of lateral position (SDLP), the weaving of the car. This paper explores whether excursions out-of-lane are a suitable additional outcome measure to index driving impairment. A literature search was conducted to search for driving tests that used both SDLP and excursions out-of-lane as outcome measures. The analyses were limited to studies examining hypnotic drugs because several of these drugs have been shown to produce next-morning sedation. Standard deviation of lateral position was more sensitive in demonstrating driving impairment. In fact, solely relying on excursions out-of-lane as outcome measure incorrectly classifies approximately half of impaired drives as unimpaired. The frequency of excursions out-of-lane is determined by the mean lateral position within the right traffic lane. Defining driving impairment as having a ΔSDLP > 2.4 cm, half of the impaired driving tests (51.2%, 43/84) failed to produce excursions out-of-lane. Alternatively, 20.9% of driving tests with ΔSDLP < 2.4 cm (27/129) had at least one excursion out-of-lane. Excursions out-of-lane are neither a suitable measure to demonstrate driving impairment nor is this measure sufficiently sensitive to differentiate adequately between differences in magnitude of driving impairment. Copyright © 2014 John Wiley & Sons, Ltd.

  17. The effectiveness of traditional Chinese medicine-based lifestyle interventions on biomedical, psychosocial, and behavioral outcomes in individuals with type 2 diabetes: A systematic review with meta-analysis.

    Science.gov (United States)

    Yu, Xingfeng; Chau, Janita P C; Huo, Lanting

    2018-04-01

    .77%; 95%CI, -0.97% to -0.56%; p < 0.001), fasting blood glucose (mean difference, -0.82 mmol/L; 95%CI, -1.05 to -0.59 mmol/L; p < 0.001), body mass index (mean difference, -2.77; 95%CI, -4.11 to -1.43; p < 0.001), and depression (mean difference, -4.53; 95%CI, -7.12 to -1.94; p < 0.001). Conclusions on the effects of ba duan jin on quality of life cannot be drawn because only two studies measured the outcome. Evidence regarding the effectiveness of other TCM-based lifestyle interventions is limited. Tai chi and ba duan jin are potentially effective options for individuals with T2DM to improve biomedical and psychosocial well-being. Further well-designed studies are needed to explore the optimal intervention dose and to investigate the effectiveness of other TCM-based lifestyle interventions. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Psychosocial Intervention Model

    DEFF Research Database (Denmark)

    Singla, Rashmi

    2007-01-01

    The article is based on a research project drawing upon survey data (N=628) and qualitative interviews (N=60) of youth and their parents belonging to the five largest ethnic minority groups in Denmark i.e. Turkey, former Yugoslavia, Pakistan, Lebanon and Somalia, along with the experiences of psy.......K.