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Sample records for acute health symptoms

  1. Self-reported acute health symptoms and exposure to companion animals

    EPA Science Inventory

    Background: In order to understand the etiological burden of disease associated with acute health symptoms (e.g. gastrointestinal [GI], respiratory, dermatological), it is important to understand how common exposures influence these symptoms. Exposures to familiar and unfamiliar ...

  2. Self-reported acute health symptoms and exposure to companion animals#

    EPA Science Inventory

    Self-reported acute health symptoms and exposure to companion animalsWhitney S. Krueger1,2, Elizabeth D. Hilborn2, Timothy J. Wade21Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA2Environmental Public Health Division, Office of Research and Development, U...

  3. Study relating residential formaldehyde concentrations and acute health symptoms in adult women

    SciTech Connect

    Zollinger, T.; Godish, T.

    1986-09-01

    This study consisted of a survey of 180 families who requested formaldehyde sampling of their homes through the local health or state health departments in Indiana in 1980-1985. At the time that the air sample was collected, the residents of the house were interviewed regarding the presence and severity of 22 acute health symptoms suspected to be associated with formaldehyde exposure. Surveyed individuals did not know the concentration of formaldehyde in their home at the time of the interview. For the purpose of this report, analysis was limited to the oldest (typically the only) adult woman in the household who was interviewed on the day that the air sample was taken (n = 163). The level of formaldehyde in the samples ranged from less than 0.010 ppm to 0.750 ppm. Comparisons of the formaldehyde concentrations with the health symptoms indicate that formaldehyde levels above 0.050 ppm did not increase the likelihood of the women to report the presence of any of the acute health symptoms studied. However, formaldehyde levels above 0.100 ppm significantly increased the likelihood of the women to report eye and sinus irritation, difficulty in breathing and sleeping, runny nose, and chest pain.

  4. Psychiatric nurse practitioners' experiences of working with mental health care users presenting with acute symptoms.

    PubMed

    Ngako, Kgalabi J; Van Rensburg, Elsie S J; Mataboge, Sanah M L

    2012-05-30

    Psychiatric nurse practitioners (PNPs) working with mental health care users presenting with acute symptoms work in a complex environment. This environment is characterised by mental health care users who may present with a history of violence, sexual assault and substance misuse. The objectives of this study were twofold: firstly, to explore and describe the experiences of PNPs working with mental health care users (MHCUs) presenting with acute symptoms; and secondly, to make recommendations for the advanced PNPs to facilitate promotion of the mental health of PNPs with reference to nursing practice, research and education. A qualitative, explorative, descriptive and contextual design was used. The target population was PNPs working with MHCUs presenting with acute symptoms in a public mental health care institution in Gauteng. Data were collected by means of four focus group interviews involving 21 PNPs. The researcher made use of drawings, naïve sketches and field notes for the purpose of data triangulation. Data were analysed in accordance with Tesch's method of open coding. The three themes that emerged were: PNPs experienced working with these MHCUs as entering an unsafe world where care became a burden; they experienced negative emotional reactions and attitudes towards these MHCUs that compromised quality nursing care; and they made a plea for a nurturing environment that would enhance quality nursing care. The PNPs suggest skills and competency development, organisational support, and a need for external resources. Creation of a positive environment and mobilisation of resources as well as the identification and bridging of obstacles are essential in the promotion of the overall wellbeing and mental health of PNPs.

  5. Symptoms, functioning and quality of life after treatment in a residential sub-acute mental health service in Australia.

    PubMed

    Thomas, Kerry A; Rickwood, Debra J; Brown, Patricia M

    2017-01-01

    The aim of this study was to assess clients' and service providers' perspectives on changes in mental health after an admission to a residential recovery-focused, sub-acute service, in Australia. Clients were either step-up clients, entering the service directly from the community, or step-down clients who were transitioning from an inpatient unit to home. During the 30-month period of data collection (August 2011 to January 2014) all clients (N = 102) were invited to participate in the longitudinal study and 41 clients consented to be involved (38% response rate). At admission and exit, participants completed the Behaviour and Symptom Identification Scale (Basis-32) and service providers completed the Life Skills Profile-16 and Health of the Nations Outcome Scales. Follow-up data 3 months after exit were available for 12 clients, including the Basis-32 and a self-report measure of quality of life (Assessment of Quality of Life 8-dimension). Both client groups reported positive improvements between admission and exit in the areas of relation to self and others, psychosis, daily living and presence of depression or anxiety symptoms. Service providers reported gains for clients in the areas of self-care, level of symptoms and presence of social problems. At 3 months, clients generally reported positive quality of life, although there was no significant change in symptoms and functioning. This study demonstrates that after an admission to a sub-acute service, step-up clients experience an improvement in their symptoms and functioning, have avoided a hospital admission and are well enough to return home. Step-down clients also experience further improvements in their symptoms and functioning, indicating that the service has assisted them in their transition to independent living after a hospital admission. Sub-acute residential units provide a continuation of care for inpatients preparing to return home, and people with a mental health problem living in the

  6. [Enterobius vermicularis causing symptoms of acute appendicitis].

    PubMed

    Antal, András; Kocsis, Béla

    2008-08-01

    The authors present a case of enterobiasis of the appendix. Enterobius infection is an uncommon cause of acute appendicitis. Preoperative diagnosis of pinworm infestation is almost impossible unless there is a strong clinical suspicion. Parasites may produce symptoms which resemble acute appendicitis. Careful observation of the appendix stump may lead to intraoperative diagnosis of enterobiasis. A quick diagnosis and appropriate treatment may prevent future complications.

  7. Effectiveness of alcohol-based hand disinfectants in a public administration: Impact on health and work performance related to acute respiratory symptoms and diarrhoea

    PubMed Central

    2010-01-01

    Background The economical impact of absenteeism and reduced productivity due to acute infectious respiratory and gastrointestinal disease is normally not in the focus of surveillance systems and may therefore be underestimated. However, large community studies in Europe and USA have shown that communicable diseases have a great impact on morbidity and lead to millions of lost days at work, school and university each year. Hand disinfection is acknowledged as key element for infection control, but its effect in open, work place settings is unclear. Methods Our study involved a prospective, controlled, intervention-control group design to assess the epidemiological and economical impact of alcohol-based hand disinfectants use at work place. Volunteers in public administrations in the municipality of the city of Greifswald were randomized in two groups. Participants in the intervention group were provided with alcoholic hand disinfection, the control group was unchanged. Respiratory and gastrointestinal symptoms and days of work were recorded based on a monthly questionnaire over one year. On the whole, 1230 person months were evaluated. Results Hand disinfection reduced the number of episodes of illness for the majority of the registered symptoms. This effect became statistically significant for common cold (OR = 0.35 [0.17 - 0.71], p = 0.003), fever (OR = 0.38 [0.14-0.99], p = 0.035) and coughing (OR = 0.45 [0.22 - 0.91], p = 0.02). Participants in the intervention group reported less days ill for most symptoms assessed, e.g. colds (2.07 vs. 2.78%, p = 0.008), fever (0.25 vs. 0.31%, p = 0.037) and cough (1.85 vs. 2.00%, p = 0.024). For diarrhoea, the odds ratio for being absent became statistically significant too (0.11 (CI 0.01 - 0.93). Conclusion Hand disinfection can easily be introduced and maintained outside clinical settings as part of the daily hand hygiene. Therefore it appears as an interesting, cost-efficient method within the scope of company health

  8. Lay Public's Knowledge and Decisions in Response to Symptoms of Acute Myocardial Infarction

    ERIC Educational Resources Information Center

    Cytryn, Kayla N.; Yoskowitz, Nicole A.; Cimino, James J.; Patel, Vimla L.

    2009-01-01

    Despite public health initiatives targeting rapid action in response to symptoms of myocardial infarction (MI), people continue to delay in going to a hospital when experiencing these symptoms due to lack of recognition as cardiac-related. The objective of this research was to characterize lay individuals' knowledge of symptoms of acute myocardial…

  9. ru2hot?: A public health education campaign for men who have sex with men to increase awareness of symptoms of acute HIV infection

    PubMed Central

    Stekler, Joanne D; Baldwin, Heather D; Louella, Michael W; Katz, David A; Golden, Matthew R

    2014-01-01

    Objectives Teach HIV-negative men who have sex with men (MSM) symptoms of acute HIV infection (AHI) and direct them to nucleic acid amplification testing (NAAT) though Public Health—Seattle & King County (PHSKC). Design Cross-sectional surveys, retrospective database analysis and chart review. Methods Beginning in June 2009, the ru2hot? campaign described AHI symptoms and NAAT. Two preintervention and two postintervention surveys assessed campaign visibility, symptom knowledge, and healthcare-seeking behaviour. Regression analyses evaluated secular trends in case-finding. Results 366 MSM completed surveys. In survey 4, 23% of 100 men reported seeing the campaign, and 25% knew ‘ru2hot?’ referred to AHI. From survey 1 to survey 4, the proportion of subjects who knew ≥2 symptoms or that AHI was a ‘flu-like’ illness was unchanged (61% vs 57%, p=0.6). However, in survey 4, 13 (72%) of 18 subjects who saw the campaign named fever as a symptom of AHI compared with 19 (35%) of 55 subjects who had not seen the campaign (p=0.005). From 9/2003 to 12/2010, 622 (2.2%) of 27 661 MSM tested HIV-positive, and 111 (18%) were identified by the Public Health—Seattle & King County NAAT programme. In terms of the impact of the campaign on case-finding, diagnosis of EIA-negative/NAAT-positive and OraQuick-negative/EIA-positive cases increased from six in 2004 to 20 in 2010 (p=0.01), but postcampaign numbers were unchanged. 23 (51%) of 45 cases identified before and 8 (44%) of 18 cases identified after the campaign reported symptoms at initial testing (p=0.6). Conclusions Although a quarter of MSM surveyed saw the campaign and knowledge of fever (the symptom of emphasis) was high, case-finding was unchanged. Increasing campaign visibility could have had greater impact. PMID:23349338

  10. Acute effects of particulate matter on respiratory diseases, symptoms and functions:. epidemiological results of the Austrian Project on Health Effects of Particulate Matter (AUPHEP)

    NASA Astrophysics Data System (ADS)

    Neuberger, Manfred; Schimek, Michael G.; Horak, Friedrich; Moshammer, Hanns; Kundi, Michael; Frischer, Thomas; Gomiscek, Bostjan; Puxbaum, Hans; Hauck, Helger; Auphep-Team

    To examine hypotheses regarding health effects of particulate matter, we conducted time series studies in Austrian urban and rural areas. Of the pollutants measured, ambient PM 2.5 was most consistently associated with parameters of respiratory health. Time series studies applying semiparametric generalized additive models showed significant increases of respiratory hospital admissions (ICD 490-496) at age 65 and older. The early increase of 5.5% in Vienna at a lag of 2 days in males and of 5.6% per 10 μg/m 3 at a lag of 3 days in females was not observed in a nearby rural area. Another increase of respiratory admissions (mainly COPD) was observed after a lag of 10-11 days. A time series on a panel of 56 healthy preschool children showed a significant impact of the carbonaceous fraction of PM 2.5 on tidal breathing pattern assessed by inductive plethysmography. In repeated oscillometric measurements of respiratory resistance in 164 healthy elementary school children not only immediate responses to fine particulates were found but also latent ones, possibly indicating inflammatory changes in airways. It may be speculated that the improvements of urban air quality prevented measurable effects on respiratory mortality. More sensitive indicators, however, still show acute impairments of respiratory function and health in elderly and children which are associated with fine particulates and subfractions related to motor traffic.

  11. Acute Stress Symptoms in Young Children with Burns

    ERIC Educational Resources Information Center

    Stoddard, Frederick J.; Saxe, Glenn; Ronfeldt, Heidi; Drake, Jennifer E.; Burns, Jennifer; Edgren, Christy; Sheridan, Robert

    2006-01-01

    Objective: Posttraumatic stress disorder symptoms are a focus of much research with older children, but little research has been conducted with young children, who account for about 50% of all pediatric burn injuries. This is a 3-year study of 12- to 48-month-old acutely burned children to assess acute traumatic stress outcomes. The aims were to…

  12. Estimating the spatial distribution of acute undifferentiated fever (AUF) and associated risk factors using emergency call data in India. A symptom-based approach for public health surveillance.

    PubMed

    Kauhl, Boris; Pilot, Eva; Rao, Ramana; Gruebner, Oliver; Schweikart, Jürgen; Krafft, Thomas

    2015-01-01

    The System for Early-warning based on Emergency Data (SEED) is a pilot project to evaluate the use of emergency call data with the main complaint acute undifferentiated fever (AUF) for syndromic surveillance in India. While spatio-temporal methods provide signals to detect potential disease outbreaks, additional information about socio-ecological exposure factors and the main population at risk is necessary for evidence-based public health interventions and future preparedness strategies. The goal of this study is to investigate whether a spatial epidemiological analysis at the ecological level provides information on urban-rural inequalities, socio-ecological exposure factors and the main population at risk for AUF. Our results displayed higher risks in rural areas with strong local variation. Household industries and proximity to forests were the main socio-ecological exposure factors and scheduled tribes were the main population at risk for AUF. These results provide additional information for syndromic surveillance and could be used for evidence-based public health interventions and future preparedness strategies.

  13. Acute Symptoms after a Community Hydrogen Fluoride Spill

    PubMed Central

    2013-01-01

    hospitalized due to chemical hazard release of hydrogen fluoride had acute respiratory, gastrointestinal, and neurologic health problems. Non-hospitalized patients have acute symptoms mainly related to upper respiratory irritation. PMID:24472561

  14. Heart Health - Heart Disease: Symptoms, Diagnosis, Treatment

    MedlinePlus

    ... Bar Home Current Issue Past Issues Cover Story Heart Health Heart Disease: Symptoms, Diagnosis, Treatment Past Issues / Winter 2009 ... of this page please turn Javascript on. Most heart attacks happen when a clot in the coronary ...

  15. Symptom Recognition and Healthcare Experiences of Young Women with Acute Myocardial Infarction

    PubMed Central

    Lichtman, Judith H.; Leifheit-Limson, Erica C.; Watanabe, Emi; Allen, Norrina B.; Garavalia, Brian; Garavalia, Linda S.; Spertus, John A.; Krumholz, Harlan M.; Curry, Leslie A.

    2016-01-01

    Background Prompt recognition of acute myocardial infarction (AMI) symptoms and timely care-seeking behavior are critical to optimize acute medical therapies. Relatively little is known about the symptom presentation and care-seeking experiences of women aged ≤55 years with AMI, a group shown to have increased mortality risk as compared with similarly aged men. Understanding symptom recognition and experiences engaging the healthcare system may provide opportunities to reduce delays and improve acute care for this population. Methods and Results We conducted a qualitative study using in-depth interviews with 30 women (aged 30-55 years) hospitalized with AMI to explore their experiences with prodromal symptoms and their decision-making process to seek medical care. Five themes characterized their experiences: 1) prodromal symptoms varied substantially in both nature and duration; 2) they inaccurately assessed personal risk of heart disease and commonly attributed symptoms to non-cardiac causes; 3) competing and conflicting priorities influenced decisions about seeking acute care; 4) the healthcare system was not consistently responsive to them, resulting in delays in workup and diagnosis; and 5) they did not routinely access primary care, including preventive care for heart disease. Conclusions Participants did not accurately assess their cardiovascular risk, reported poor preventive health behaviors, and delayed seeking care for symptoms, suggesting that differences in both prevention and acute care may be contributing to young women's elevated AMI mortality relative to men. Identifying factors that promote better cardiovascular knowledge, improved preventive health care, and prompt care-seeking behaviors represent important targets for this population. PMID:25714826

  16. Acute stress, depression, and anxiety symptoms among English and Spanish speaking children with recent trauma exposure.

    PubMed

    Barber, Beth A; Kohl, Krista L; Kassam-Adams, Nancy; Gold, Jeffrey I

    2014-03-01

    A growing literature suggests the clinical importance of acute stress disorder symptoms in youth following potentially traumatic events. A multisite sample of English and Spanish speaking children and adolescents (N = 479) between the ages of 8-17, along with their caregivers completed interviews and self-report questionnaires between 2 days and 1 month following the event. The results indicate that children with greater total acute stress symptoms reported greater depressive (r = .41, p < .01) and anxiety symptoms (r = .53, p < .01). Examining specific acute stress subscales, reexperiencing was correlated with anxiety (r = .47, p < .01) and arousal was correlated with depression (r = .50, p < .01) and anxiety (r = .55, p < .01). Age was inversely associated with total acute stress symptoms (r = -.24, p < .01), reexperiencing (r = -.17, p < .01), avoidance (r = -.27, p < .01), and arousal (r = -.19, p < .01) and gender was related to total anxiety symptoms (Spearman's ρ = .17, p < .01). The current study supports the importance of screening acute stress symptoms and other mental health outcomes following a potentially traumatic event in children and adolescents. Early screening may enable clinicians to identify and acutely intervene to support children's psychological and physical recovery.

  17. Geographical distribution of acute symptoms after a train collision involving epichlorohydrin exposure.

    PubMed

    Radon, Katja; Rosenberger, Armin; Ehrenstein, Vera; Hoopmann, Michael; Basting, Imke; Tödt, Helga; Reichert, Jörg; Dressel, Holger; Schmid, Martina; Suchenwirth, Roland; Nowak, Dennis

    2006-09-01

    In September 2002, two freight trains collided in a northern German town. The inhabitants were potentially exposed to the probable human carcinogen epichlorohydrin. As no objective data on the level of exposure were available, we aimed to assess the geographical distribution of acute symptoms among local residents and subjects occupationally involved in the accident (e.g., firemen). A random sample of 932 adult local residents and 342 occupationally involved subjects were invited to answer a mail-in questionnaire. The main outcome measures were self-reported acute symptoms potentially associated with combustion products (e.g., irritation of the eyes, nose, or throat) and stress-related nonspecific symptoms. The main location during the first 26 h after the accident served as exposure proxy. For occupationally involved subjects, the time spent at the accident site was also used. The overall prevalence of symptoms potentially associated with combustion products was 9.8% for residents and 25.4% for occupationally involved subjects. After adjustment, subjects whose main location was close to the accident site had an increased risk for such symptoms. Among occupationally involved subjects the risk increased with duration at the accident site. Neither main location nor time at the accident site was significantly associated with non-specific symptoms. We could provide an example for designing and carrying out an epidemiologic study shortly after a local accident with potential public health impact. We could define parts of the population at increased risk for symptoms potentially specific for the exposure under study.

  18. Acute Pain and Depressive Symptoms: Independent Predictors of Insomnia Symptoms among Adults with Sickle Cell Disease

    PubMed Central

    Moscou-Jackson, Gyasi; Allen, Jerilyn; Kozachik, Sharon; Smith, Michael T.; Budhathoki, Chakra; Haywood, Carlton

    2015-01-01

    Background No studies to-date have systematically investigated insomnia symptoms among adults with sickle cell disease (SCD). The purpose of this study was to 1) describe the prevalence of insomnia symptoms and 2) identify bio-psychosocial predictors in community-dwelling adults with Sickle Cell Disease. Methods Cross-sectional analysis of baseline data from 263 African-American adults with SCD (aged 18 years or older). Measures included the Insomnia Severity Index (ISI), Center for Epidemiologic Studies in Depression scale, Urban Life Stress Scale, Brief Pain Inventory, and a chronic pain item. SCD genotype was extracted from the medical record. Results A slight majority (55%) of the sample reported clinically significant insomnia symptomatology (ISI ≥10), which suggests that insomnia symptoms are prevalent among community-dwelling African-American adults with SCD. While insomnia symptoms were associated with a number of bio-psychosocial characteristics, depressive symptoms and acute pain were the only independent predictors. Conclusion Given the high number of participants reporting clinically significant insomnia symptoms, nurses should screen for insomnia symptoms and to explore interventions to promote better sleep among adults with SCD with an emphasis on recommending treatment for pain and depression. In addition, current pain and depression interventions in this population could add insomnia measures and assess the effect of the intervention on insomnia symptomatology as a secondary outcome. PMID:26673730

  19. Depressive Symptoms and Impaired Physical Function after Acute Lung Injury

    PubMed Central

    Colantuoni, Elizabeth; Mendez-Tellez, Pedro A.; Dinglas, Victor D.; Shanholtz, Carl; Husain, Nadia; Dennison, Cheryl R.; Herridge, Margaret S.; Pronovost, Peter J.; Needham, Dale M.

    2012-01-01

    Rationale: Survivors of acute lung injury (ALI) frequently have substantial depressive symptoms and physical impairment, but the longitudinal epidemiology of these conditions remains unclear. Objectives: To evaluate the 2-year incidence and duration of depressive symptoms and physical impairment after ALI, as well as risk factors for these conditions. Methods: This prospective, longitudinal cohort study recruited patients from 13 intensive care units (ICUs) in four hospitals, with follow-up 3, 6, 12, and 24 months after ALI. The outcomes were Hospital Anxiety and Depression Scale depression score greater than or equal to 8 (“depressive symptoms”) in patients without a history of depression before ALI, and two or more dependencies in instrumental activities of daily living (“impaired physical function”) in patients without baseline impairment. Measurements and Main Results: During 2-year follow-up of 186 ALI survivors, the cumulative incidences of depressive symptoms and impaired physical function were 40 and 66%, respectively, with greatest incidence by 3-month follow-up; modal durations were greater than 21 months for each outcome. Risk factors for incident depressive symptoms were education 12 years or less, baseline disability or unemployment, higher baseline medical comorbidity, and lower blood glucose in the ICU. Risk factors for incident impaired physical function were longer ICU stay and prior depressive symptoms. Conclusions: Incident depressive symptoms and impaired physical function are common and long-lasting during the first 2 years after ALI. Interventions targeting potentially modifiable risk factors (e.g., substantial depressive symptoms in early recovery) should be evaluated to improve ALI survivors’ long-term outcomes. PMID:22161158

  20. Acute symptoms of drug hypersensitivity (urticaria, angioedema, anaphylaxis, anaphylactic shock).

    PubMed

    Limsuwan, Ticha; Demoly, Pascal

    2010-07-01

    Drug hypersensitivity reactions (HSRs) are the adverse effects of drugs which, when taken at doses generally tolerated by normal subjects, clinically resemble allergy. Immediate-reaction of drug HSRs are those that occur less than 1 hour after the last drug intake, usually in the form of urticaria, angioedema, rhinitis, conjunctivitis, bronchospasm, and anaphylaxis or anaphylactic shock. Acute urticarial and angioedema reactions are common clinical problems frequently encountered by internists and general practitioners. They are not specific to drug allergic reaction, and can be caused by various pathogenic mechanisms. Despite the benign course of urticaria and angioedema, a mucocutaneous swelling of the upper respiratory tract could be life-threatening by itself or a feature of anaphylaxis. This article reviews acute symptoms of drug HSR-related urticaria, angioedema, anaphylaxis, and anaphylactic shock, and how clinicians should approach these problems.

  1. Psychological symptoms and intermittent hypertension following acute microwave exposure

    SciTech Connect

    Forman, S.A.; Holmes, C.K.; McManamon, T.V.; Wedding, W.R.

    1982-11-01

    Two men who were accidently, acutely irradiated with X-band microwave radiation have been followed up clinically for 12 months. Both men developed similar psychological symptoms, which included emotional lability, irritability, headaches, and insomnia. Several months after the incidents, hypertension was diagnosed in both patients. No organic basis for the psychological problems could be found nor could any secondary cause for the hypertension. A similar syndrome following microwave exposure has been described by the East Europeans. The two cases we report, with comparable subjective symptoms and hypertension following a common exposure, provide further strong, circumstantial evidence of cause and effect. A greater knowledge of the mechanisms involved in bioeffects which may be induced by radiofrequency and microwave radiation is definitely needed.

  2. Resilience as a correlate of acute stress disorder symptoms in patients with acute myocardial infarction

    PubMed Central

    Meister, Rebecca E; Weber, Tania; Princip, Mary; Schnyder, Ulrich; Barth, Jürgen; Znoj, Hansjörg; Schmid, Jean-Paul; von Känel, Roland

    2015-01-01

    Objectives Myocardial infarction (MI) may be experienced as a traumatic event causing acute stress disorder (ASD). This mental disorder has an impact on the daily life of patients and is associated with the development of post-traumatic stress disorder. Trait resilience has been shown to be a protective factor for post-traumatic stress disorder, but its association with ASD in patients with MI is elusive and was examined in this study. Methods We investigated 71 consecutive patients with acute MI within 48 h of having stable haemodynamic conditions established and for 3 months thereafter. All patients completed the Acute Stress Disorder Scale and the Resilience Scale to self-rate the severity of ASD symptoms and trait resilience, respectively. Results Hierarchical regression analysis showed that greater resilience was associated with lower symptoms of ASD independent of covariates (b=−0.22, p<0.05). Post hoc analysis revealed resilience level to be inversely associated with the ASD symptom clusters of re-experiencing (b=−0.05, p<0.05) and arousal (b=−0.09, p<0.05), but not with dissociation and avoidance. Conclusions The findings suggest that patients with acute MI with higher trait resilience experience relatively fewer symptoms of ASD during MI. Resilience was particularly associated with re-experiencing and arousal symptoms. Our findings contribute to a better understanding of resilience as a potentially important correlate of ASD in the context of traumatic situations such as acute MI. These results emphasise the importance of identifying patients with low resilience in medical settings and to offer them adequate support. PMID:26568834

  3. Neurosensory Symptom Complexes after Acute Mild Traumatic Brain Injury

    PubMed Central

    Szczupak, Mikhaylo; Kiderman, Alexander; Crawford, James; Murphy, Sara; Marshall, Kathryn; Pelusso, Constanza

    2016-01-01

    Mild Traumatic Brain Injury (mTBI) is a prominent public health issue. To date, subjective symptom complaints primarily dictate diagnostic and treatment approaches. As such, the description and qualification of these symptoms in the mTBI patient population is of great value. This manuscript describes the symptoms of mTBI patients as compared to controls in a larger study designed to examine the use of vestibular testing to diagnose mTBI. Five symptom clusters were identified: Post-Traumatic Headache/Migraine, Nausea, Emotional/Affective, Fatigue/Malaise, and Dizziness/Mild Cognitive Impairment. Our analysis indicates that individuals with mTBI have headache, dizziness, and cognitive dysfunction far out of proportion to those without mTBI. In addition, sleep disorders and emotional issues were significantly more common amongst mTBI patients than non-injured individuals. A simple set of questions inquiring about dizziness, headache, and cognitive issues may provide diagnostic accuracy. The consideration of other symptoms may be critical for providing prognostic value and treatment for best short-term outcomes or prevention of long-term complications. PMID:26727256

  4. Acute Mountain Sickness Symptoms Depend on Normobaric versus Hypobaric Hypoxia

    PubMed Central

    Strangman, Gary E.; Harris, N. Stuart; Muza, Stephen R.

    2016-01-01

    Acute mountain sickness (AMS), characterized by headache, nausea, fatigue, and dizziness when unacclimatized individuals rapidly ascend to high altitude, is exacerbated by exercise and can be disabling. Although AMS is observed in both normobaric (NH) and hypobaric hypoxia (HH), recent evidence suggests that NH and HH produce different physiological responses. We evaluated whether AMS symptoms were different in NH and HH during the initial stages of exposure and if the assessment tool mattered. Seventy-two 8 h exposures to normobaric normoxia (NN), NH, or HH were experienced by 36 subjects. The Environmental Symptoms Questionnaire (ESQ) and Lake Louise Self-report (LLS) were administered, resulting in a total of 360 assessments, with each subject answering the questionnaire 5 times during each of their 2 exposure days. Classification tree analysis indicated that symptoms contributing most to AMS were different in NH (namely, feeling sick and shortness of breath) compared to HH (characterized most by feeling faint, appetite loss, light headedness, and dim vision). However, the differences were not detected using the LLS. These results suggest that during the initial hours of exposure (1) AMS in HH may be a qualitatively different experience than in NH and (2) NH and HH may not be interchangeable environments. PMID:27847819

  5. Acute mental health nurses: comprehensive practitioners or specialist therapists?

    PubMed

    Mathers, B

    2012-02-01

    This paper examines the aids and barriers to implementing the psychosocial interventions (PSI) which trainees learned on two teaching modules. The main purpose of the modules is to teach trainees PSI to help them be more effective in their care of patients with severe mental illness. The trainees were qualified nurses working in acute mental health wards in various London hospitals. PSI has been found to be helpful for patients with psychotic symptoms in community contexts. In this study, the implementation of PSI specific to acute inpatient mental health settings is explored. This was achieved by conducting semi-structured audiotaped interviews with all 20 trainees from a single cohort. The data were analysed by categories and themes to elicit not only the problems but also helpful strategies which can be used when working with PSI in acute inpatient mental health settings. The paper concludes by offering recommendations for future good practice for this area of mental health service.

  6. Indoor air quality, ventilation and health symptoms in schools: an analysis of existing information.

    PubMed

    Daisey, J M; Angell, W J; Apte, M G

    2003-03-01

    We reviewed the literature on Indoor Air Quality (IAQ), ventilation, and building-related health problems in schools and identified commonly reported building-related health symptoms involving schools until 1999. We collected existing data on ventilation rates, carbon dioxide (CO2) concentrations and symptom-relevant indoor air contaminants, and evaluated information on causal relationships between pollutant exposures and health symptoms. Reported ventilation and CO2 data strongly indicate that ventilation is inadequate in many classrooms, possibly leading to health symptoms. Adequate ventilation should be a major focus of design or remediation efforts. Total volatile organic compounds, formaldehyde (HCHO) and microbiological contaminants are reported. Low HCHO concentrations were unlikely to cause acute irritant symptoms (<0.05 ppm), but possibly increased risks for allergen sensitivities, chronic irritation, and cancer. Reported microbiological contaminants included allergens in deposited dust, fungi, and bacteria. Levels of specific allergens were sufficient to cause symptoms in allergic occupants. Measurements of airborne bacteria and airborne and surface fungal spores were reported in schoolrooms. Asthma and 'sick building syndrome' symptoms are commonly reported. The few studies investigating causal relationships between health symptoms and exposures to specific pollutants suggest that such symptoms in schools are related to exposures to volatile organic compounds (VOCs), molds and microbial VOCs, and allergens.

  7. Surveillance of Acute Respiratory Infections Using Community-Submitted Symptoms and Specimens for Molecular Diagnostic Testing

    PubMed Central

    Goff, Jennifer; Rowe, Aaron; Brownstein, John S.; Chunara, Rumi

    2015-01-01

    Participatory systems for surveillance of acute respiratory infection give real-time information about infections circulating in the community, yet to-date are limited to self-reported syndromic information only and lacking methods of linking symptom reports to infection types. We developed the GoViral platform to evaluate whether a cohort of lay volunteers could, and would find it useful to, contribute self-reported symptoms online and to compare specimen types for self-collected diagnostic information of sufficient quality for respiratory infection surveillance. Volunteers were recruited, given a kit (collection materials and customized instructions), instructed to report their symptoms weekly, and when sick with cold or flu-like symptoms, requested to collect specimens (saliva and nasal swab). We compared specimen types for respiratory virus detection sensitivity (via polymerase-chain-reaction) and ease of collection. Participants were surveyed to determine receptivity to participating when sick, to receiving information on the type of pathogen causing their infection and types circulating near them. Between December 1 2013 and March 1 2014, 295 participants enrolled in the study and received a kit. Of those who reported symptoms, half (71) collected and sent specimens for analysis. Participants submitted kits on average 2.30 days (95 CI: 1.65 to 2.96) after symptoms began. We found good concordance between nasal and saliva specimens for multiple pathogens, with few discrepancies. Individuals report that saliva collection is easiest and report that receiving information about what pathogen they, and those near them, have is valued and can shape public health behaviors. Community-submitted specimens can be used for the detection of acute respiratory infection with individuals showing receptivity for participating and interest in a real-time picture of respiratory pathogens near them. PMID:26075141

  8. Surveillance of Acute Respiratory Infections Using Community-Submitted Symptoms and Specimens for Molecular Diagnostic Testing.

    PubMed

    Goff, Jennifer; Rowe, Aaron; Brownstein, John S; Chunara, Rumi

    2015-05-27

    Participatory systems for surveillance of acute respiratory infection give real-time information about infections circulating in the community, yet to-date are limited to self-reported syndromic information only and lacking methods of linking symptom reports to infection types. We developed the GoViral platform to evaluate whether a cohort of lay volunteers could, and would find it useful to, contribute self-reported symptoms online and to compare specimen types for self-collected diagnostic information of sufficient quality for respiratory infection surveillance. Volunteers were recruited, given a kit (collection materials and customized instructions), instructed to report their symptoms weekly, and when sick with cold or flu-like symptoms, requested to collect specimens (saliva and nasal swab). We compared specimen types for respiratory virus detection sensitivity (via polymerase-chain-reaction) and ease of collection. Participants were surveyed to determine receptivity to participating when sick, to receiving information on the type of pathogen causing their infection and types circulating near them. Between December 1 2013 and March 1 2014, 295 participants enrolled in the study and received a kit. Of those who reported symptoms, half (71) collected and sent specimens for analysis. Participants submitted kits on average 2.30 days (95 CI: 1.65 to 2.96) after symptoms began. We found good concordance between nasal and saliva specimens for multiple pathogens, with few discrepancies. Individuals report that saliva collection is easiest and report that receiving information about what pathogen they, and those near them, have is valued and can shape public health behaviors. Community-submitted specimens can be used for the detection of acute respiratory infection with individuals showing receptivity for participating and interest in a real-time picture of respiratory pathogens near them.

  9. Acute Stress Symptoms in Children: Results From an International Data Archive

    ERIC Educational Resources Information Center

    Kassam-Adams, Nancy; Palmieri, Patrick A.; Rork, Kristine; Delahanty, Douglas L.; Kenardy, Justin; Kohser, Kristen L.; Landolt, Markus A.; Le Brocque, Robyne; Marsac, Meghan L.; Meiser-Stedman, Richard; Nixon, Reginald D.V.; Bui, Eric; McGrath, Caitlin

    2012-01-01

    Objective: To describe the prevalence of acute stress disorder (ASD) symptoms and to examine proposed "DSM-5" symptom criteria in relation to concurrent functional impairment in children and adolescents. Method: From an international archive, datasets were identified that included assessment of acute traumatic stress reactions and…

  10. Acute post-traumatic stress symptoms and age predict outcome in military blast concussion.

    PubMed

    Mac Donald, Christine L; Adam, Octavian R; Johnson, Ann M; Nelson, Elliot C; Werner, Nicole J; Rivet, Dennis J; Brody, David L

    2015-05-01

    High rates of adverse outcomes have been reported following blast-related concussive traumatic brain injury in US military personnel, but the extent to which such adverse outcomes can be predicted acutely after injury is unknown. We performed a prospective, observational study of US military personnel with blast-related concussive traumatic brain injury (n = 38) and controls (n = 34) enrolled between March and September 2012. Importantly all subjects returned to duty and did not require evacuation. Subjects were evaluated acutely 0-7 days after injury at two sites in Afghanistan and again 6-12 months later in the United States. Acute assessments revealed heightened post-concussive, post-traumatic stress, and depressive symptoms along with worse cognitive performance in subjects with traumatic brain injury. At 6-12 months follow-up, 63% of subjects with traumatic brain injury and 20% of controls had moderate overall disability. Subjects with traumatic brain injury showed more severe neurobehavioural, post-traumatic stress and depression symptoms along with more frequent cognitive performance deficits and more substantial headache impairment than control subjects. Logistic regression modelling using only acute measures identified that a diagnosis of traumatic brain injury, older age, and more severe post-traumatic stress symptoms provided a good prediction of later adverse global outcomes (area under the receiver-operating characteristic curve = 0.84). Thus, US military personnel with concussive blast-related traumatic brain injury in Afghanistan who returned to duty still fared quite poorly on many clinical outcome measures 6-12 months after injury. Poor global outcome seems to be largely driven by psychological health measures, age, and traumatic brain injury status. The effects of early interventions and longer term implications of these findings are unknown.

  11. Health Impacts from Acute Radiation Exposure

    SciTech Connect

    Strom, Daniel J.

    2003-09-30

    Absorbed doses above1-2 Gy (100-200 rads) received over a period of a day or less lead to one or another of the acute radiation syndromes. These are the hematopoietic syndrome, the gastrointestinal (GI) syndrome, the cerebrovascular (CV) syndrome, the pulmonary syndrome, or the cutaneous syndrome. The dose that will kill about 50% of the exposed people within 60 days with minimal medical care, LD50-60, is around 4.5 Gy (450 rads) of low-LET radiation measured free in air. The GI syndrome may not be fatal with supportive medical care and growth factors below about 10 Gy (1000 rads), but above this is likely to be fatal. Pulmonary and cutaneous syndromes may or may not be fatal, depending on many factors. The CV syndrome is invariably fatal. Lower acute doses, or protracted doses delivered over days or weeks, may lead to many other health outcomes than death. These include loss of pregnancy, cataract, impaired fertility or temporary or permanent sterility, hair loss, skin ulceration, local tissue necrosis, developmental abnormalities including mental and growth retardation in persons irradiated as children or fetuses, radiation dermatitis, and other symptoms listed in Table 2 on page 12. Children of parents irradiated prior to conception may experience heritable ill-health, that is, genetic changes from their parents. These effects are less strongly expressed than previously thought. Populations irradiated to high doses at high dose rates have increased risk of cancer incidence and mortality, taken as about 10-20% incidence and perhaps 5-10% mortality per sievert of effective dose of any radiation or per gray of whole-body absorbed dose low-LET radiation. Cancer risks for non-uniform irradiation will be less.

  12. Behavioral Predictors of Acute Stress Symptoms During Intense Military Training

    DTIC Science & Technology

    2009-06-01

    peritraumatic dissociative symptoms (PDS; i.e., per- ceptual disconnectedness) and that general troops who endorsed symptoms of dissociation at baseline were...also more likely to dissociate under stress. Furthermore, self-reported peritraumatic symptoms were significantly lower in elite Special Forces per... peritraumatic dissociative states (PDS) and quantified the link between PDS and the subsequent psychological impact of stressful events during

  13. Maternal Depressive Symptoms in Pediatric Major Depressive Disorder: Relationship to Acute Treatment Outcome

    ERIC Educational Resources Information Center

    Kennard, Betsy D.; Hughes, Jennifer L.; Stewart, Sunita M.; Mayes, Taryn; Nightingale-Teresi, Jeanne; Tao, Rongrong; Carmody, Thomas; Emslie, Graham J.

    2008-01-01

    A study examined maternal depressive symptoms at the beginning and end of acute pediatric treatment of children with major depressive disorder (MDD). Results suggested a direct and possible reciprocal association between maternal and child depression severity.

  14. Oral health and the symptoms of schizophrenia.

    PubMed

    Arnaiz, Ainara; Zumárraga, Mercedes; Díez-Altuna, Izaskun; Uriarte, Jose J; Moro, Juan; Pérez-Ansorena, Maria A

    2011-06-30

    The objectives of this study were to evaluate the oral health of a group of schizophrenic outpatients and a control group without psychiatric illness. The study also aimed to assess the influence of positive and negative symptomatology on oral health among outpatients with schizophrenia. The DMF-T Index (sum of decayed, missing and filled teeth) and the Community Periodontal Index of Treatment Needs (CPITN) were assessed in both groups. We evaluated the psychopathological state of the patient group using the Positive and Negative Syndrome Scale (PANSS). The schizophrenic patients had higher scores than the control group with respect to decayed teeth (4.39 vs. 0.72), missing teeth (5.66 vs. 1.50), the DMF-T index (13.51 vs. 7.8) and CPITN (2.32 vs. 1.04); and lower scores for filled teeth (3.53 vs. 5.54). The PANSS negative subscale score correlated positively with the oral health variables studied, whereas the PANSS positive subscale score correlated negatively and exclusively with the number of missing teeth. Age and smoking status affected oral health in both groups, but even when the influence of these factors was considered, the oral health of the patients was poorer than that of the control group.

  15. Acute Bronchitis

    MedlinePlus

    ... can also cause acute bronchitis. To diagnose acute bronchitis, your health care provider will ask about your symptoms and listen to your breathing. You may also have other tests. Treatments include rest, fluids, and aspirin (for adults) or ...

  16. Occurrence and correlates of symptom persistence following acute dengue fever in Peru.

    PubMed

    Halsey, Eric S; Williams, Maya; Laguna-Torres, V Alberto; Vilcarromero, Stalin; Ocaña, Victor; Kochel, Tadeusz J; Marks, Morgan A

    2014-03-01

    Dengue virus (DENV) infection causes an acute febrile illness generally considered to result in either complete recovery or death. Some reviews describe persistent symptoms after the febrile phase, although empirical data supporting this phenomenon is scarce. We evaluated symptom persistence in acute febrile DENV-infected and DENV-negative (controls) individuals from Peru. Self-reported solicited symptoms were evaluated at an acute and a follow-up visit, occurring 10-60 days after symptom onset. Rate of persistence of at least one symptom was 7.7% and 10.5% for DENV infected and control subjects, respectively (P < 0.01). The DENV-infected individuals had lower rates of persistent respiratory symptoms, gastrointestinal symptoms, headache, and fatigue, but higher rates of persistent rash compared with controls. Older age and female gender were positively associated with symptom persistence. As dengue cases continue to increase annually, even a relatively low frequency of persistent symptoms may represent a considerable worldwide morbidity burden.

  17. Racial Differences in Women’s Prodromal and Acute Myocardial Infarction Symptoms

    PubMed Central

    McSweeney, Jean C.; O’Sullivan, Patricia; Cleves, Mario A.; Lefler, Leanne L.; Cody, Marisue; Moser, Debra K.; Dunn, Kelly; Kovacs, Margaret; Crane, Patricia B.; Ramer, Lois; Messmer, Patricia R.; Garvin, Bonnie J.; Zhao, Weizhi

    2010-01-01

    Background Minority women, especially Black and Hispanic, have higher rates of coronary heart disease (CHD) and resulting disability and death than Whites. Because most studies have included insufficient numbers of Blacks and Hispanics for meaningful analyses, lack of knowledge of minority women’s CHD symptoms may contribute to these disparities. Objective To compare Black, Hispanic and White women’s prodromal CHD and acute myocardial infarction (AMI) symptoms. Methods Retrospective telephone surveys were conducted with 1270 (545 Black; 539 White, 186 Hispanic) cognitively intact women post AMI at 15 sites. Using general linear models, symptom severity and frequency were compared among racial groups, controlling for cardiovascular risk factors. Using logistic regression models, we examined individual prodromal or AMI symptoms by race, adjusting for cardiovascular risk factors. Results Ninety-six percent of all women reported prodromal symptoms. Unusual fatigue (73%) and sleep disturbance (50%) were the most frequent prodromal symptoms. Eighteen symptoms differed significantly by race (p<0.01); Blacks reported higher frequencies of 10 symptoms than Hispanics or Whites. Less than 37% reported prodromal chest discomfort; Hispanics reported more pain/discomfort symptoms than Black or White women. Minority women reported more acute symptoms (p<0.01). The most frequent symptom, regardless of race, was shortness of breath (62.8%); 22 symptoms differed by race (p<0.01). Twenty-eight percent of Hispanics, 38% Blacks, and 42% Whites reported no chest pain/discomfort. Conclusions Significant racial differences existed in prodromal and AMI symptoms reported by women in this study. Racial descriptions of women’s CHD and AMI symptoms should assist providers in interpreting women’s symptoms. PMID:20045850

  18. MDMA, cannabis, and cocaine produce acute dissociative symptoms.

    PubMed

    van Heugten-Van der Kloet, Dalena; Giesbrecht, Timo; van Wel, Janelle; Bosker, Wendy M; Kuypers, Kim P C; Theunissen, Eef L; Spronk, Desirée B; Jan Verkes, Robbert; Merckelbach, Harald; Ramaekers, Johannes G

    2015-08-30

    Some drugs of abuse may produce dissociative symptoms, but this aspect has been understudied. We explored the dissociative potential of three recreational drugs (3,4-methylenedioxymethamphetamine (MDMA), cannabis, and cocaine) during intoxication and compared their effects to literature reports of dissociative states in various samples. Two placebo-controlled studies were conducted. In Study 1 (N=16), participants received single doses of 25, 50, and 100 mg of MDMA, and placebo. In Study 2 (N=21), cannabis (THC 300 µg/kg), cocaine (HCl 300 mg), and placebo were administered. Dissociative symptoms as measured with the Clinician-Administered Dissociative States Scale (CADSS) significantly increased under the influence of MDMA and cannabis. To a lesser extent, this was also true for cocaine. Dissociative symptoms following MDMA and cannabis largely exceeded those observed in schizophrenia patients, were comparable with those observed in Special Forces soldiers undergoing survival training, but were lower compared with ketamine-induced dissociation. Cocaine produced dissociative symptoms that were comparable with those observed in schizophrenia patients, but markedly less than those in Special Forces soldiers and ketamine users. Thus, MDMA and cannabis can produce dissociative symptoms that resemble dissociative pathology. The study of drug induced dissociation is important, because it may shed light on the mechanisms involved in dissociative psychopathology.

  19. [Acute Paranoid Symptoms Following Intramuscular Injection of Nandrolone

    PubMed

    Teuber, Isabel; Freiwald, Daniel; Volz, Hans-Peter

    2003-05-01

    Affective disorders and impulsivity are quite common when using anabolic substances, in this case-study one of the rather rare cases of a psychotic disorder following the abuse of androgenic steroids is described. A 30-year old formerly healthy white male was admitted as inpatient to psychiatric hospital showing symptoms of anxiety and paranoid ideation. In the last 1,5 years he had consumed androgenic steroids, directly before the onset of the first psychotic symptoms 8 weeks before admission he had received an i. m.-injection of nandrolone. Under therapy with neuroleptics the patient recovered completely within 2 months.

  20. Basic symptoms and their contribution to the differential typology of acute schizophrenic and schizoaffective disorders.

    PubMed

    Fabisch, K; Fabisch, H; Langs, G; Macheiner, H; Fitz, W; Hönigl, D

    2001-01-01

    One hundred and fifty male inpatients - 128 patients with DSM-IV schizophrenia and 22 patients with DSM-IV schizoaffective disorder - were investigated, over the course of their acute psychosis, on whether there were differences in the extent of basic symptoms (measured by the Bonn Scale for the Assessment of Basic Symptoms) according to their diagnostic subtype. Another aim was to find out if the diagnostic subtypes could be discriminated by means of basic symptoms and if clusters gained from basic symptoms were in accordance with the diagnostic subtypes. Differences in basic symptoms were found between the subtypes, but a clear discrimination of diagnostic subtypes by means of basic symptoms could not be achieved. There was indication that patients with prominent delusions or auditory hallucinations reported more basic symptoms than patients with exclusively prominent disorganization.

  1. Signs and Symptoms that Differentiate Acute Sinusitis from Viral Upper Respiratory Tract Infection

    PubMed Central

    Shaikh, Nader; Hoberman, Alejandro; Kearney, Diana H.; Colborn, D. Kathleen; Kurs-Lasky, Marcia; Jeong, Jong H.; Haralam, Mary Ann; Bowen, A’Delbert; Flom, Lynda L.; Wald, Ellen R.

    2013-01-01

    Objective Differentiating acute bacterial sinusitis from viral upper respiratory tract infection (URI) is challenging; 20% to 40% of children diagnosed with acute sinusitis based on clinical criteria likely have an uncomplicated URI. The objective of this study was to determine which signs and symptoms could be used to identify the subgroup of children who meet current clinical criteria for sinusitis but who nevertheless have a viral URI. Methods We obtained sinus radiographs in consecutive children meeting a priori clinical criteria for acute sinusitis. We considered the subgroup of children with completely normal sinus radiographs to have an uncomplicated URI despite meeting the clinical diagnostic criteria for sinusitis. We examined the utility of signs and symptoms in identifying children with URI. Results Of 258 children enrolled, 54 (20.9%) children had completely normal radiographs. The absence of green nasal discharge, the absence of disturbed sleep, and mild symptoms were associated with a diagnosis of URI. No physical exam findings were particularly helpful in distinguishing between children with normal vs. abnormal radiographs. Conclusions Among children meeting current criteria for the diagnosis of acute sinusitis, those with mild symptoms are significantly more likely to have a URI than those with severe symptoms. In addition to assessing overall severity of symptoms, practitioners should ask about sleep disturbance and green nasal discharge when assessing children with suspected sinusitis; their absence favors a diagnosis of URI. PMID:23694838

  2. Time to standardize and broaden the criteria of acute coronary syndrome symptom presentations in women.

    PubMed

    Canto, John G; Canto, Elizabeth A; Goldberg, Robert J

    2014-07-01

    Early recognition of the signs and symptoms of acute coronary syndromes (ACS) is essential to improving patient management and associated outcomes. It is widely reported that women might have a different ACS symptom presentation than men. Multiple review articles have examined sex differences in symptom presentation of ACS and these studies have yielded inconclusive results and/or inconsistent recommendations. This is largely because these studies have included diverse study populations, different methods of assessing the chief complaint and associated coronary symptoms, relatively small sample sizes of women and men, and lack of adequate adjustment for age or other potentially confounding differences between the sexes. There is a substantial overlap of ACS symptoms that are not mutually exclusive according to sex, and are generally found in women and men. However, there are apparent differences in the frequency and distribution of ACS symptoms among women and men. Women, on average, are also more likely to have a greater number of ACS-related symptoms contributing to the perception that women have more atypical symptoms than men. In this review, we address issues surrounding whether women should have a different ACS symptom presentation message than men, and provide general recommendations from a public policy perspective. In the future, our goal should be to standardize ACS symptom presentation and to elucidate the full range of ACS and myocardial infarction symptoms considering the substantial overlap of symptoms among women and men rather than use conventional terms such as "typical" and "atypical" angina.

  3. Acute health effects of accidental chlorine gas exposure

    PubMed Central

    2014-01-01

    Objectives This study was conducted to report the course of an accidental release of chlorine gas that occurred in a factory in Gumi-si, South Korea, on March 5, 2013. We describe the analysis results of 2 patients hospitalized because of chlorine-induced acute health problems, as well as the clinical features of 209 non-hospitalized patients. Methods We analyzed the medical records of the 2 hospitalized patients admitted to the hospital, as well as the medical records and self-report questionnaires of 209 non-hospitalized patients completed during outpatient treatment. Results Immediately after the exposure, the 2 hospitalized patients developed acute asthma-like symptoms such as cough and dyspnea, and showed restrictive and combined pattern ventilatory defects on the pulmonary function test. The case 1 showed asthma-like symptoms over six months and diurnal variability in peak expiratory flow rate was 56.7%. In case 2, his FEV1 after treatment (93%) increased by 25% compared to initial FEV1 (68%). Both cases were diagnosed as chlorine-induced reactive airways dysfunction syndrome (RADS) on the basis of these clinical features. The most frequent chief complaints of the 209 non-hospitalized patients were headache (22.7%), followed by eye irritation (18.2%), nausea (11.2%), and sore throat (10.8%), with asymptomatic patients accounting for 36.5%. The multiple-response analysis of individual symptom revealed headache (42.4%) to be the most frequent symptom, followed by eye irritation (30.5%), sore throat (30.0%), cough (29.6%), nausea (27.6%), and dizziness (27.3%). Conclusions The 2 patients hospitalized after exposure to chlorine gas at the leakage site showed a clinical course corresponding to RADS. All of the 209 non-hospitalized patients only complained of symptoms of the upper airways and mucous membrane irritation. PMID:25852940

  4. Medical and Nonstroke Neurologic Causes of Acute, Continuous Vestibular Symptoms.

    PubMed

    Edlow, Jonathan A; Newman-Toker, David E

    2015-08-01

    Most patients with the acute vestibular syndrome (AVS) have vestibular neuritis or stroke or, in the setting of trauma, a posttraumatic vestibular cause. Some medical and nonstroke causes of the AVS must also be considered. Multiple sclerosis is the most common diagnosis in this group. Other less common causes include cerebellar masses, inflammation and infection, mal de debarquement, various toxins, Wernicke disease, celiac-related dizziness, and bilateral vestibulopathy. Finally, there may be unmasking of prior posterior circulation events by various physiologic alterations such as alterations of temperature, blood pressure, electrolytes, or various medications, especially sedating agents.

  5. Acute headache as a presenting symptom of tacrolimus encephalopathy.

    PubMed

    Kiemeneij, I M; de Leeuw, F-E; Ramos, L M P; van Gijn, J

    2003-08-01

    A 24 year old woman presented with a sudden excruciating headache mimicking an acute vascular event. She had undergone a lung transplantation because of cystic fibrosis and was receiving maintenance treatment with tacrolimus and prednisone. Ancillary investigation excluded vascular causes. Magnetic resonance imaging demonstrated hyperintense lesions in the infratentorial and parieto-occipital regions consistent with posterior leucencephalopathy syndrome. Both her clinical condition improved and the lesions disappeared completely after withdrawal of tacrolimus, suggesting that her condition could be explained by a tacrolimus encephalopathy.

  6. [Acute psychiatric symptoms during methylphenidate intravenous injections: A case report].

    PubMed

    Vérité, Fabrice; Micallef, Joëlle

    2016-11-24

    We report the case of a 32-year-old man who developed acute psychiatric disorders after repeated intravenous injections of methylphenidate. The behavioural disorders with extreme psychomotor restlessness and delirious syndrome have resolved within 24hours. The available data highlight the fact that the prescriptions of methylphenidate, an amphetamine-like substance, are constantly increasing in Europe and Northern America. The potential of abuse and addiction to this drug, which is growingly misused, is now clearly established. The medical professionals should be cautious and attentive to the risk of misuse of this drug.

  7. Increased QT interval dispersion in diagnosis of acute coronary syndrome with atypical symptoms and EKG.

    PubMed

    Rodríguez, Fernando; Chávez, Elibet; Machín, Wilfredo J; Alonso, Alain; González, Vielka

    2014-01-01

    INTRODUCTION EKG remains a highly valuable tool for heart disease management. Corrected QT interval dispersion is a useful EKG parameter to assess prognosis in ischemic heart disease and specifically acute coronary syndrome. Understanding QT interval physiopathology helps assess importance of QT measurement in this context. Although increased QT dispersion is an ominous prognostic marker, its utility has not been evaluated for all types of acute coronary syndrome, even though in many circumstances it is the only tool available for diagnosing patients with equivocal EKG signs and/or atypical symptoms. OBJECTIVE Describe corrected QT interval dispersion in acute coronary syndrome in three groups of patients-with ST elevation, without ST elevation, and without ST elevation with equivocal EKG signs-admitted to the intensive care unit of Celestino Hernández Robau University Hospital in Santa Clara, Cuba, from January 2010 through June 2011. METHODS A descriptive retrospective study was conducted in 194 patients admitted with diagnosis of acute coronary syndrome. QT interval was measured and its dispersion calculated for the first EKG after symptom onset. Patterns were assessed for typical and atypical clinical presentations, and unequivocal and equivocal EKG signs. RESULTS Nonclassifiable acute coronary syndrome was found in 6.7% of patients (13/194), the majority of whom had increased QT dispersion (76.9%, 10/13). There were significant differences in QT dispersion patterns between patients with typical and atypical presentations and between patients with equivocal and unequivocal EKG findings. In non-ST elevation acute coronary syndrome and nonclassifiable acute coronary syndrome with increased dispersion, atypical presentation was the most common (65.5%, 19/29; and 90%, 9/10, respectively). CONCLUSION Corrected QT interval dispersion is a useful diagnostic tool for acute coronary syndrome, especially when patients present with atypical symptoms and equivocal EKG

  8. Nutritional status, symptoms experienced and general state of health in HIV-infected patients.

    PubMed

    Karlsson, A; Nordström, G

    2001-09-01

    The aim of the study was to describe HIV-infected patients with respect to nutritional status, symptoms experienced, general state of health, and relevant medical and laboratory data. An additional aim was to study the relationships between some of these variables. On admission to an acute care hospital in Sweden, 25 HIV-positive men were consecutively included in the study. Medical data, anthropometric variables such as weight, height, body mass index (BMI) and percentage weight loss were studied. The following instruments were used: the subjective global assessment (SGA) was used to determine nutritional status; the oral assessment guide (OAG) was used for subjective assessment of the oral cavity; and the numeric rating scale (NRS) was used to assess the symptoms experienced. The Health Index (HI) was used to evaluate general state of health. The results showed that more than half of the patients had suspected/severe malnutrition; between 48% and 72% complained of moderate to severe symptoms of various kinds. Two thirds felt their general state of health was rather poor or very poor. Correlations showed that the lower the BMI, the worse the nutritional status (SGA); the greater the weight loss in percent, the worse the nutritional status (SGA); and the worse the general state of health (HI), the worse the nutritional status (SGA). In conclusion, it is important that nurses have good knowledge concerning nutritional problems in order to be able to detect these conditions at an early stage and/or to endeavour to prevent them.

  9. Health anxiety symptoms in children and adolescents diagnosed with OCD.

    PubMed

    Villadsen, Anna; Thorgaard, Mette V; Hybel, Katja A; Jensen, Jens Søndergaard; Thomsen, Per H; Rask, Charlotte U

    2017-02-01

    Health anxiety (HA) is an overlooked area in paediatric research. Little is known about the occurrence of HA symptoms in a child and adolescent psychiatric setting, and there are no age-appropriate diagnostic criteria and only limited number of assessment tools. It is therefore likely that HA is seen as part of obsessive-compulsive disorder (OCD) due to construct overlap and the diagnostic uncertainty of HA in this age group. In the present study, the extent of HA symptoms was investigated in 94 children and adolescents with a primary ICD-10 diagnosis of OCD. Self-reported HA symptoms were assessed using the Childhood Illness Attitude Scales. Clinician-rated OCD symptoms and severity were measured using the Children's Yale Brown Obsessive Compulsive Scale. Information on socio-demographics was obtained from the child's/adolescent's medical record. The distribution of HA symptoms resembled a normal curve shifted to the right compared with a normal population of Danish children, and 30 % presented with high HA symptoms. Chi-squared tests were used to examine the proportion of children and adolescents with high HA symptoms in relation to various clinical characteristics. Clinician-rated illness worries and comorbid anxiety disorder were associated with high self-reported HA symptoms. The results contribute to the understanding of how HA and OCD overlap conceptually in young patients and bring attention to the need for improved recognition of OCD patients dominated by illness worries. Further research in the description of childhood HA is important in order to understand whether HA is a distinct disorder early in life.

  10. Association of Interleukin-8 and Neutrophils with Nasal Symptom Severity During Acute Respiratory Infection

    PubMed Central

    Henriquez, Kelsey M.; Hayney, Mary S.; Xie, Yaoguo; Zhang, Zhengjun; Barrett, Bruce

    2015-01-01

    Using a large data set (n = 811), the relationship between acute respiratory infection illness severity and inflammatory biomarkers was investigated to determine whether certain symptoms are correlated more closely than others with the inflammatory biomarkers, interleukin-8 (IL-8) and nasal neutrophils. Participants with community acquired acute respiratory infection underwent nasal lavage for IL-8 and neutrophil testing, in addition to multiplex polymerase chain reaction (PCR) methods for the detection and identification of respiratory viruses. Information about symptoms was obtained throughout the duration of the illness episode using the well-validated Wisconsin Upper Respiratory Symptom Survey (WURSS-21). Global symptom severity was calculated by the area under the curve (AUC) plotting duration versus WURSS total. Of the specimens tested, 56% were positively identified for one or more of nine different respiratory viruses. During acute respiratory infection illness, both IL-8 and neutrophils positively correlate with AUC (rs = 0.082, P = 0.022; rs = 0.080, P = 0.030). IL-8 and neutrophils correlate with nasal symptom severity: runny nose (r = 0.13, P = <0.00001; r = 0.18, P = <0.003), plugged nose (r = 0.045, P = 0.003; r = 0.14, P = 0.058), and sneezing (r = −0.02, P = <0.0001; r = −0.0055, P = 0.31). Neutrophils correlate with some quality of life measures such as sleeping well (r = 0.15, P = 0.026). Thus, the study demonstrates that IL-8 and neutrophils are correlated with severity of nasal symptoms during acute respiratory infection. Further research is necessary to determine if the concentration of these or other biomarkers can predict the overall duration and severity of acute respiratory infection illness. PMID:25132248

  11. Predicting acute affective symptoms after deep brain stimulation surgery in Parkinson's disease.

    PubMed

    Schneider, Frank; Reske, Martina; Finkelmeyer, Andreas; Wojtecki, Lars; Timmermann, Lars; Brosig, Timo; Backes, Volker; Amir-Manavi, Atoosa; Sturm, Volker; Habel, Ute; Schnitzler, Alfons

    2010-01-01

    The current study aimed to investigate predictive markers for acute symptoms of depression and mania following deep brain stimulation (DBS) surgery of the subthalamic nucleus for the treatment of motor symptoms in Parkinson's disease (PD). Fourteen patients with PD (7 males) were included in a prospective longitudinal study. Neuropsychological tests, psychopathology scales and tests of motor functions were administered at several time points prior to and after neurosurgery. Pre-existing psychopathological and motor symptoms predicted postoperative affective side effects of DBS surgery. As these can easily be assessed, they should be considered along with other selection criteria for DBS surgery.

  12. Symptom Differences in Acute and Chronic Presentation of Childhood Post-Traumatic Stress Disorder.

    ERIC Educational Resources Information Center

    Famularo, Richard; And Others

    1990-01-01

    Twenty-four child abuse victims, age 5-13, were diagnosed with posttraumatic stress disorder (PTSD). Children with the acute form of PTSD exhibited such symptoms as difficulty falling asleep, hypervigilance, nightmares, and generalized anxiety. Children exhibiting chronic PTSD exhibited increased detachment, restricted range of affect,…

  13. Acute neurological symptoms during hypobaric exposure: consider cerebral air embolism.

    PubMed

    Weenink, Robert P; Hollmann, Markus W; van Hulst, Robert A

    2012-11-01

    Cerebral arterial gas embolism (CAGE) is well known as a complication of invasive medical procedures and as a risk in diving and submarine escape. In the underwater environment, CAGE is caused by trapped air, which expands and leads to lung vessel rupture when ambient pressure decreases during ascent. Pressure decrease also occurs during hypobaric activities such as flying and, therefore, CAGE may theoretically be a risk in hypobaric exposure. We reviewed the available literature on this subject. Identified were 12 cases of CAGE due to hypobaric exposure. Based on these cases, we discuss pathophysiology, diagnosis, and treatment of CAGE due to hypobaric exposure. The low and slow pressure decrease during most hypobaric activities (as opposed to diving) account for the low incidence of CAGE during these exposures and suggest that severe air trapping must be present to cause barotrauma. This is also suggested by the large prevalence of air filled cysts in the case reports reviewed. We recommend considering CAGE in all patients presenting with acute central neurological injury during or shortly after pressure decrease such as flying. A CT scan of head and chest should be performed in these patients. Treatment with hyperbaric oxygen therapy should be initiated as soon as possible in cases of proven or probable CAGE.

  14. Symptoms of peritraumatic and acute traumatic stress among victims of an industrial disaster.

    PubMed

    Birmes, Philippe J; Brunet, Alain; Coppin-Calmes, Dominique; Arbus, Christophe; Coppin, Dominique; Charlet, Jean-Paul; Vinnemann, Nathalie; Juchet, Henri; Lauque, Dominique; Schmitt, Laurent

    2005-01-01

    Previous studies have examined peritraumatic distress, peritraumatic dissociation, and acute stress disorder as predictors of posttraumatic stress disorder (PTSD). The authors examined whether these three predictors were associated with PTSD symptoms when considered simultaneously. Two-hundred victims of a factory explosion in Toulouse, France, were surveyed two and six months after the event with use of retrospective self-reports of peritraumatic distress, peritraumatic dissociation, and acute stress disorder. A hierarchical multiple regression predicting PTSD symptoms six months posttrauma indicated that all three constructs explained unique variance, accounting for up to 62 percent. Peritraumatic distress and dissociation and acute stress disorder appear conceptually different from one another and show promise in identifying who is at risk of PTSD.

  15. Prevalence of Musculoskeletal Symptoms among Dental Health Workers, Southern Thailand

    PubMed Central

    Phethuayluk, Piriyalux; Maneelok, Supandee

    2016-01-01

    Objectives. The objective of this study was to describe the socioeconomic situation of dental health work and work characteristics and to evaluate the prevalence of musculoskeletal symptoms among dental health workers. Material and Methods. A cross-sectional study was conducted with 124 dental health workers and 124 persons in the reference group, matched to dental health workers by gender, were recruited from the workers who worked at the same 17 community hospitals in Nakhon Si Thammarat province, Thailand. Information was collected by using questionnaire. Data analysis comprised descriptive and analytical components. Results and Discussion. 75.8% were female and 24.2% were male dental health workers. 91.9% of subjects had worked >5 years. Most subjects worked for >8 hours per day and worked >6 days per week, at 63.7% and 53.2%, respectively. 100% of subjects worked in public institutions, and 68% also worked in both public and private institutions. Most subjects (52.4%) did not exercise. Daily activity, gender, duration of work, hours worked per day, days worked per week, and physical activity were significantly associated with musculoskeletal symptoms at <0.001. Conclusion. The prevention and reduction of MSDs among dentists should include improving their education in dental ergonomics. PMID:27597901

  16. Prevalence of Musculoskeletal Symptoms among Dental Health Workers, Southern Thailand.

    PubMed

    Decharat, Somsiri; Phethuayluk, Piriyalux; Maneelok, Supandee

    2016-01-01

    Objectives. The objective of this study was to describe the socioeconomic situation of dental health work and work characteristics and to evaluate the prevalence of musculoskeletal symptoms among dental health workers. Material and Methods. A cross-sectional study was conducted with 124 dental health workers and 124 persons in the reference group, matched to dental health workers by gender, were recruited from the workers who worked at the same 17 community hospitals in Nakhon Si Thammarat province, Thailand. Information was collected by using questionnaire. Data analysis comprised descriptive and analytical components. Results and Discussion. 75.8% were female and 24.2% were male dental health workers. 91.9% of subjects had worked >5 years. Most subjects worked for >8 hours per day and worked >6 days per week, at 63.7% and 53.2%, respectively. 100% of subjects worked in public institutions, and 68% also worked in both public and private institutions. Most subjects (52.4%) did not exercise. Daily activity, gender, duration of work, hours worked per day, days worked per week, and physical activity were significantly associated with musculoskeletal symptoms at <0.001. Conclusion. The prevention and reduction of MSDs among dentists should include improving their education in dental ergonomics.

  17. Depressive Symptoms Are Associated with Mental Stress-Induced Myocardial Ischemia after Acute Myocardial Infarction

    PubMed Central

    Wei, Jingkai; Pimple, Pratik; Shah, Amit J.; Rooks, Cherie; Bremner, J. Douglas; Nye, Jonathon A.; Ibeanu, Ijeoma; Murrah, Nancy; Shallenberger, Lucy; Raggi, Paolo; Vaccarino, Viola

    2014-01-01

    Objectives Depression is an adverse prognostic factor after an acute myocardial infarction (MI), and an increased propensity toward emotionally-driven myocardial ischemia may play a role. We aimed to examine the association between depressive symptoms and mental stress-induced myocardial ischemia in young survivors of an MI. Methods We studied 98 patients (49 women and 49 men) age 38–60 years who were hospitalized for acute MI in the previous 6 months. Patients underwent myocardial perfusion imaging at rest, after mental stress (speech task), and after exercise or pharmacological stress. A summed difference score (SDS), obtained with observer-independent software, was used to quantify myocardial ischemia under both stress conditions. The Beck Depression Inventory-II (BDI-II) was used to measure depressive symptoms, which were analyzed as overall score, and as separate somatic and cognitive depressive symptom scores. Results There was a significant positive association between depressive symptoms and SDS with mental stress, denoting more ischemia. After adjustment for demographic and lifestyle factors, disease severity and medications, each incremental depressive symptom was associated with 0.14 points higher SDS. When somatic and cognitive depressive symptoms were examined separately, both somatic [β = 0.17, 95% CI: (0.04, 0.30), p = 0.01] and cognitive symptoms [β = 0.31, 95% CI: (0.07, 0.56), p = 0.01] were significantly associated with mental stress-induced ischemia. Depressive symptoms were not associated with ischemia induced by exercise or pharmacological stress. Conclusion Among young post-MI patients, higher levels of both cognitive and somatic depressive symptoms are associated with a higher propensity to develop myocardial ischemia with mental stress, but not with physical (exercise or pharmacological) stress. PMID:25061993

  18. Multimodal examination of distress tolerance and posttraumatic stress disorder symptoms in acute-care psychiatric inpatients.

    PubMed

    Vujanovic, Anka A; Dutcher, Christina D; Berenz, Erin C

    2016-09-01

    Distress tolerance (DT), the actual or perceived capacity to withstand negative internal states, has received increasing scholarly attention due to its theoretical and clinical relevance to posttraumatic stress disorder (PTSD). Past studies have indicated that lower self-reported - but not behaviorally observed - DT is associated with greater PTSD symptoms; however, studies in racially and socioeconomically diverse clinical samples are lacking. The current study evaluated associations between multiple measures of DT (self-report and behavioral) and PTSD symptoms in an urban, racially and socioeconomically diverse, acute-care psychiatric inpatient sample. It was hypothesized that lower self-reported DT (Distress Tolerance Scale [DTS]), but not behavioral DT (breath-holding task [BH]; mirror-tracing persistence task [MT]), would be associated with greater PTSD symptoms, above and beyond the variance contributed by trauma load, substance use, gender, race/ethnicity, and subjective social status. Participants were 103 (41.7% women, Mage=33.5) acute-care psychiatric inpatients who endorsed exposure to potentially traumatic events consistent with DSM-5 PTSD Criterion A. Results of hierarchical regression analyses indicated that DTS was negatively associated with PTSD symptom severity (PCL-5 Total) as well as with each of the four DSM-5 PTSD symptom clusters (p's<0.001), contributing between 5.0%-11.1% of unique variance in PTSD symptoms across models. BH duration was positively associated with PTSD arousal symptom severity (p<0.05). Covariates contributed between 21.3%-40.0% of significant variance to the models. Associations between DT and PTSD in this sample of acute-care psychiatric inpatients are largely consistent with those observed in community samples.

  19. Do acute psychological and psychobiological responses to trauma predict subsequent symptom severities of PTSD and depression?

    PubMed Central

    Ehring, Thomas; Ehlers, Anke; Cleare, Anthony J.; Glucksman, Edward

    2008-01-01

    The study investigated the relationship between the acute psychological and psychobiological trauma response and the subsequent development of posttraumatic stress disorder (PTSD) and depressive symptoms in 53 accident survivors attending an emergency department. Lower levels of salivary cortisol measured in the emergency room predicted greater symptom levels of PTSD and depression 6 months later, and lower diastolic blood pressure, past emotional problems, greater dissociation and data-driven processing predicted greater PTSD symptoms. Heart rate was not predictive. Low cortisol levels correlated with data-driven processing during the accident, and, in female participants only, with prior trauma and prior emotional problems. Higher evening cortisol 6 months after the accident correlated with PTSD and depressive symptoms at 6 months, but this relationship was no longer significant when levels of pain were controlled. The results support the role of the acute response to trauma in the development and maintenance of PTSD and provide promising preliminary evidence for a meaningful relationship between psychobiological and psychological factors in the acute trauma phase. PMID:18789538

  20. Wandering spleen in a child with symptoms of acute abdomen: ultrasonographic diagnosis. Case report.

    PubMed

    Ayaz, Umit Yasar; Dilli, Alper; Ayaz, Sevin; Api, Arman

    2012-03-01

    We report the initial and follow-up ultrasonography (US) findings in a pediatric case of wandering spleen with symptoms of acute abdomen, as a rare entity. A four-year-old boy was referred with complaints of blunt abdominal pain, vomiting and fatigue. US detected an oval- shaped, mildly enlarged spleen with inferomedial displacement. In right lateral decubitus, the spleen showed further medial displacement. Five months later, control US revealed further enlargement of the displaced spleen. Seven months later, due to acute torsion of the spleen, splenectomy was performed.

  1. Craniofacial pain can be the sole prodromal symptom of an acute myocardial infarction: an interdisciplinary study.

    PubMed

    Kreiner, Marcelo; Álvarez, Ramón; Michelis, Virginia; Waldenström, Anders; Isberg, Annika

    2016-04-01

    We recently found craniofacial pain to be the sole symptom of an acute myocardial infarction (AMI) in 4% of patients. We hypothesized that this scenario is also true for symptoms of prodromal (pre-infarction) angina. We studied 326 consecutive patients who experienced myocardial ischemia. Intra-individual variability analyses with respect to ECG findings and pain characteristics were performed for those 150 patients who experienced at least one recurrent ischemic episode. AMI patients (n=113) were categorized into two subgroups: "abrupt onset" (n=81) and "prodromal angina" (n=32). Age, gender and risk factor comparisons were performed between groups. Craniofacial pain constituted the sole prodromal symptom of an AMI in 5% of patients. In those who experienced two ischemic episodes, women were more likely than men to experience craniofacial pain in both episodes (p<0.01). There was no statistically significant difference between episodes regarding either ECG findings or the use of the two typical pain quality descriptors "pressure" and "burning". This study is to our knowledge the first to report that craniofacial pain can be the only symptom of a pre-infarction angina. Craniofacial pain constitutes the sole prodromal AMI symptom in one out of 20 AMI patients. Recognition of this atypical symptom presentation is low because research on prodromal AMI symptoms has to date studied only patients with chest pain. To avoid a potentially fatal misdiagnosis, awareness of this clinical presentation needs to be brought to the attention of clinicians, researchers and the general public.

  2. Overeducation and depressive symptoms: diminishing mental health returns to education.

    PubMed

    Bracke, Piet; Pattyn, Elise; von dem Knesebeck, Olaf

    2013-11-01

    In general, well-educated people enjoy better mental health than those with less education. As a result, some wonder whether there are limits to the mental health benefits of education. Inspired by the literature on the expansion of tertiary education, this article explores marginal mental health returns to education and studies the mental health status of overeducated people. To enhance the validity of the findings we use two indicators of educational attainment - years of education and ISCED97 categories - and two objective indicators of overeducation (the realised matches method and the job analyst method) in a sample of the working population of 25 European countries (unweighted sample N = 19,089). Depression is measured using an eight-item version of the CES-D scale. We find diminishing mental health returns to education. In addition, overeducated people report more depression symptoms. Both findings hold irrespective of the indicators used. The results must be interpreted in the light of the enduring expansion of education, as our findings show that the discussion of the relevance of the human capital perspective, and the diploma disease view on the relationship between education and modern society, is not obsolete.

  3. Subclinical depressive symptoms affect responses to acute psychosocial stress in healthy premenopausal women.

    PubMed

    Benson, S; Arck, P C; Blois, S; Schedlowski, M; Elsenbruch, S

    2011-01-01

    Subclinical depressive symptoms constitute a primary risk factor for major depression as well as for cardiovascular conditions, which may be mediated by endocrine or immune alterations. The aim of this study was to assess the association between the extent of subclinical depressive symptoms and neuroendocrine and immune cell responses to acute psychosocial stress in healthy females. In N = 33 healthy premenopausal women, state anxiety, plasma adrenocorticotropic hormone and serum cortisol, and interleukin-6 (IL-6) concentration responses to public speaking stress were assessed. Beck depression inventory (BDI) scores were entered as a covariate in the analyses. The IL-6 response was significantly associated with BDI scores (p < 0.05). Secondary analyses revealed that women with more subclinical depressive symptoms demonstrated a reduced stress-induced increase in circulating IL-6 level (p < 0.05). By contrast, stress-induced neuroendocrine activation was not associated with depressive symptoms. Hence, subclinical depressive symptoms were associated with IL-6 responses to stress in young, healthy women. Unexpectedly, there was a reduced increase of serum IL-6 level in response to stress. Effects of depressive symptoms on the IL-6 response to stress may differ between subclinical and major depression.

  4. Dimensional Structure and Correlates of Posttraumatic Stress Symptoms Following Suspected Acute Coronary Syndrome

    PubMed Central

    Sumner, Jennifer A.; Kronish, Ian M.; Pietrzak, Robert H.; Shimbo, Daichi; Shaffer, Jonathan A.; Parsons, Faith E.; Edmondson, Donald

    2015-01-01

    Background Posttraumatic stress disorder (PTSD) is a heterogeneous construct, and some have suggested that PTSD triggered by acute coronary syndrome (ACS) may differ from PTSD due to prototypical traumas. Methods We conducted the first examination of the latent structure of PTSD symptoms after suspected ACS in 399 adults in the REactions to Acute Care and Hospitalization (REACH) study, an observational cohort study of patients recruited from the emergency department during evaluation for ACS. Using confirmatory factor analysis, we compared the 4-factor dysphoria, 4-factor numbing, and 5-factor dysphoric arousal models of PTSD. Results Although all models fit well, the dysphoria model was selected as the best-fitting model. Further, there was measurement invariance of the dysphoria model by sex. PTSD dimensions evidenced differential associations with indicators of threat perception during ACS evaluation and adherence to cardioprotective medication. Limitations One limitation of this investigation is the use of self-report measures. In addition, only one-third of the sample was diagnosed with ACS at discharge; the remaining participants received diagnoses such as chest pain without a cardiac diagnosis, another symptom/disease process (e.g., hypertensive chronic kidney disease), or another cardiac disease. Conclusions Findings suggest that suspected ACS-related PTSD symptoms are best-represented by a 4-factor structure distinguishing between specific (e.g., re-experiencing) and non-specific (dysphoria) symptoms of PTSD that has received support in the broader PTSD literature. PMID:26241667

  5. Preliminary Study of Acute Changes in Emotion Processing in Trauma Survivors with PTSD Symptoms

    PubMed Central

    Wang, Xin; Xie, Hong; Cotton, Andrew S.; Duval, Elizabeth R.; Tamburrino, Marijo B.; Brickman, Kristopher R.; Elhai, Jon D.; Ho, S. Shaun; McLean, Samuel A.; Ferguson, Eric J.; Liberzon, Israel

    2016-01-01

    Accumulating evidence suggests traumatic experience can rapidly alter brain activation associated with emotion processing. However, little is known about acute changes in emotion neurocircuits that underlie PTSD symptom development. To examine acute alterations in emotion circuit activation and structure that may be linked to PTSD symptoms, thirty-eight subjects performed a task of appraisal of emotional faces as their brains were functionally and structurally studied with MRI at both two weeks and three months after motor vehicle collision (MVC). As determined by symptoms reported in the PTSD Checklist at three months, sixteen survivors developed probable PTSD, whereas the remaining 22 did not meet criteria for PTSD diagnosis (non-PTSD). The probable PTSD group had greater activation than the non-PTSD group in dorsal and ventral medial prefrontal cortex (dmPFC and vmPFC) while appraising fearful faces within two weeks after MVC and in left insular cortex (IC) three months after MVC. dmPFC activation at two weeks significantly positively correlated with PTSD symptom severity at two weeks (R = 0.462, P = 0.006) and three months (R = 0.418, p = 0.012). Changes over time in dmPFC activation and in PTSD symptom severity were also significantly positively correlated in the probable PTSD group (R = 0.641, P = 0.018). A significant time by group interaction was found for volume changes in left superior frontal gyrus (SFG, F = 6.048, p = 0.019) that partially overlapped dmPFC active region. Between two weeks and three months, left SFG volume decreased in probable PTSD survivors. These findings identify alterations in frontal cortical activity and structure during the early post-trauma period that appear to be associated with development of PTSD symptoms. PMID:27415431

  6. Bcl-2 associated with positive symptoms of schizophrenic patients in an acute phase.

    PubMed

    Tsai, Meng-Chang; Liou, Chia-Wei; Lin, Tsu-Kung; Lin, I-Mei; Huang, Tiao-Lai

    2013-12-30

    B cell lymphoma protein-2 (Bcl-2) may contribute to the pathophysiology of schizophrenia in the brain. The aim of this study was to investigate the serum levels of Bcl-2 in schizophrenic patients in an acute phase, and evaluate Bcl-2 level changes after antipsychotic treatment. We consecutively enrolled 41 schizophrenia patients in an acute phase; 28 were followed up with a 4-week antipsychotic treatment. Serum Bcl-2 levels were measured with assay kits. All patients were evaluated by examining the correlation between Bcl-2 levels and Positive and Negative Syndrome Scale (PANSS) scores, using Pearson correlation coefficients. In schizophrenic patients in an acute phase, positive PANSS subscores were significantly negatively correlated with Bcl-2 levels. In addition, we found Bcl-2 levels had a significantly negative correlation with PANSS total scores and positive subscores in male patients in an acute phase. Using the paired t-test, we found no significant changes in Bcl-2 levels in schizophrenia patients who had received the 4-week treatment with antipsychotic drugs (n=28). In conclusion, our results suggest that Bcl-2 might be an indicator of schizophrenia severity in the acute phase. In addition, Bcl-2 levels might be associated with positive symptoms in male patients with schizophrenia.

  7. Post-traumatic stress disorder symptoms may explain poor mental health in patients with fibromyalgia.

    PubMed

    Toussaint, Loren L; Whipple, Mary O; Vincent, Ann

    2015-10-20

    Symptoms of post-traumatic stress disorder are common in fibromyalgia patients. This study compared post-traumatic stress disorder symptoms in fibromyalgia patients and healthy controls and determined whether patient-control differences in post-traumatic stress disorder symptoms mediated differences in mental health. In all, 30 patients and 30 healthy controls completed questionnaires assessing symptoms of post-traumatic stress disorder and mental health. Fibromyalgia patients had greater symptoms of post-traumatic stress disorder and mental health than controls. Patient-control differences in mental health symptoms were fully or partially mediated by differences in post-traumatic stress disorder symptoms. Healthcare providers should understand the role of trauma as management of trauma symptoms may be one strategy for improving mental health.

  8. Use of Symptoms and Risk Factors to Predict Acute Otitis Media in Infants

    PubMed Central

    McCormick, David P.; Jennings, Kristofer; Ede, Linda C.; Alvarez-Fernandez, Pedro; Patel, Janak; Chonmaitree, Tasnee

    2016-01-01

    Objectives Infants and children with upper respiratory tract infection (URI) often have concurrent acute otitis media (AOM). Young infants have less specific symptoms than older children. The purpose of this study was to evaluate the usefulness of symptoms and other risk factors in predicting the presence of AOM in infants. Methods Healthy infants, age ≤ four weeks, were enrolled and followed prospectively for up to age one year. Infants were scheduled for a research visit when their parents noted the onset of symptoms. At each URI visit, parents first reported the severity of symptoms. An investigator then diagnosed the presence or absence of concurrent AOM. Risk factors and symptom scores for infants with and without AOM were studied. Results Infants (N=193, mean age at first URI 3.9 ± 2.5 months) experienced 360 URI episodes and 63 AOM events. Symptoms consisting of fever, earache, poor feeding, restless sleep, and irritability together (ETG-5) were statistically associated with the prediction of AOM (P=0.006). A multiple variable statistical model (J-Score) that included day care attendance, age, severity of cough and earache best predicted AOM (P < 0.001), with 95% specificity. Both ETG-5 and J-score yielded relatively low sensitivity for AOM prediction. Conclusions : In infants with URI in the first year of life, severity of symptoms was significantly associated with concurrent AOM. Daycare attendance, presence and severity of earache and cough added to better correlation. These observations may have clinical application in identification of infants at risk for AOM. PMID:26810291

  9. Guilt is associated with acute stress symptoms in children after road traffic accidents

    PubMed Central

    Haag, Ann-Christin; Zehnder, Daniel; Landolt, Markus A.

    2015-01-01

    Background Although previous research has consistently found considerable rates of acute stress disorder (ASD) in children with accidental injuries, knowledge about determinants of ASD remains incomplete. Guilt is a common reaction among children after a traumatic event and has been shown to contribute to posttraumatic stress disorder. However, its relationship to ASD has never been examined. Objective This study assessed the prevalence of ASD in children and adolescents following road traffic accidents (RTAs). Moreover, the association between peritraumatic guilt and ASD was investigated relying on current cognitive theories of posttraumatic stress and controlling for female sex, age, socioeconomic status (SES), injury severity, inpatient treatment, pretrauma psychopathology, and maternal posttraumatic stress symptoms (PTSS). Methods One hundred and one children and adolescents (aged 7–16 years) were assessed by means of a clinical interview approximately 10 days after an RTA. Mothers were assessed by questionnaires. Results Three participants (3.0%) met diagnostic criteria for full ASD according to DSM-IV, and 17 (16.8%) for subsyndromal ASD. In a multivariate regression model, guilt was found to be a significant predictor of ASD severity. Female sex, outpatient treatment, and maternal PTSS also predicted ASD severity. Child age, SES, injury severity, and pretraumatic child psychopathology were not related to ASD severity. Conclusions Future research should examine the association between peritraumatic guilt and acute stress symptoms in more detail. Moreover, guilt appraisals in the acute phase after an accident might be a relevant target for clinical attention. PMID:26514158

  10. No Significant Acute and Subacute Differences between Blast and Blunt Concussions across Multiple Neurocognitive Measures and Symptoms in Deployed Soldiers.

    PubMed

    Dretsch, Michael N; Kelly, Mark P; Coldren, Rodney L; Parish, Robert V; Russell, Michael L

    2015-08-15

    Seventy-one deployed U.S. Army soldiers who presented for concussion care due to either blast or blunt mechanisms within 72 h of injury were assessed using the Military Acute Concussion Evaluation, the Automated Neuropsychological Assessment Metrics (ANAM), traditional neuropsychological tests, and health status questionnaires. Follow-up ANAM testing was performed 10 d after initial testing (±5 d). Twenty-one soldiers were excluded: two for poor effort and 19 who had combined blast/blunt injuries. Of the remaining 50 male participants, 34 had blast injuries and 16 had blunt injuries. There were no statistically significant differences between blast injury and blunt injury participants in demographic, physical, or psychological health factors, concussive symptoms, or automated and traditional neurocognitive testing scores within 72 h post-injury. In addition, follow-up ANAM scores up to 15 d post-injury were not significantly different (available on 21 blast-injured and 13 blunt-injured subjects). Pre-injury baseline ANAM scores were compared where available, and revealed no statistically significant differences between 22 blast injury and eight blunt injury participants. These findings suggest there are no significant differences between mechanisms of injury during both the acute and subacute periods in neurobehavioral concussion sequelae while deployed in a combat environment. The current study supports the use of sports/mechanical concussion models for early concussion management in the deployed setting and exploration of variability in potential long-term outcomes.

  11. Acute child and mother psychophysiological responses and subsequent PTSD symptoms following a child's traumatic event.

    PubMed

    Ostrowski, Sarah A; Christopher, Norman C; van Dulmen, Manfred H M; Delahanty, Douglas L

    2007-10-01

    This study examined the relationship between acute cortisol responses to trauma and subsequent PTSD symptoms (PTSS) in children and their biological mothers. Urinary cortisol levels were assessed in 54 children aged 8-18 upon admission to a level-1 trauma center. Six weeks posttrauma, 15-hour urine samples were collected from children and their mothers. Depression and PTSS were assessed at 6 weeks (N = 44) and 7 months (N = 38) posttrauma. Higher child in-hospital cortisol significantly predicted 6-week child PTSS. This was true only for boys at 7 months. In mothers, lower 6-week cortisol levels significantly predicted 7-month PTSS. Results extend findings of differing directions of acute hormonal predictors of PTSS in adults versus children to a sample of genetically related individuals.

  12. Trauma-Related Context Increases Sleep Disturbances in People with Acute Stress Disorder Symptoms.

    PubMed

    Grossman, Ephraim S; Hoffman, Yaakov S G; Shrira, Amit

    2016-04-06

    In this study, we addressed how sleep is related to acute stress disorder (ASD) symptoms, and how the presence of a trauma related-context moderates this relationship. This study (N = 140) was carried out during the 2014 Israel-Gaza conflict, during which 70% of Israelis were exposed to missile attacks. Findings show that participants with clinical ASD symptom levels reported more sleep disturbances than participants without clinical ASD symptom levels. More critically, this effect was only evident among respondents who had a reinforced security room in their houses. While reinforced security rooms offer protection against indirect missile damage, their relevance is salient in negative traumatic situations, which individuals with a clinical level of ASD are more sensitive to. Conversely, in houses without a reinforced security room, there was no difference in subjective sleep reports between individuals with or without clinical levels of ASD symptoms. Results are discussed in reference to trauma being activated by context and the ensuing effects on sleep. Theoretical and clinical implications are discussed. Copyright © 2016 John Wiley & Sons, Ltd.

  13. Exploring psychotic symptoms: a comparison of motor related neuronal activation during and after acute psychosis

    PubMed Central

    2012-01-01

    Background Delusions and hallucinations are classic positive symptoms of schizophrenia. A contemporary cognitive theory called the ‘forward output model’ suggests that the misattribution of self-generated actions may underlie some of these types of symptoms, such as delusions of control – the experience of self-generated action being controlled by an external agency. In order to examine the validity of this suggestion, we performed a longitudinal functional magnetic resonance imaging (fMRI) study examining neuronal activation associated with motor movement during acute psychosis. Methods We studied brain activation using fMRI during a motor task in 11 patients with schizophrenia and 9 healthy controls. The patient group was tested at two time points separated by 6–8 weeks. Results At initial testing, the patient group had a mean Positive and Negative Syndrome Scale score of 56.3, and showed significantly increased activation within the left inferior parietal lobe (IPL) compared to controls. Patients reported significantly decreased positive symptoms at 6–8 week followup and IPL activation had returned to normal. Our results demonstrate that first-rank positive symptoms are associated with hyperactivation in the secondary somatosensory cortex (IPL). Conclusions These findings lend further credence to the theory that a dysfunction in the sensory feedback system located in the IPL, and which is thought to underlie our sense of agency, may contribute to the aetiology of delusions of control. PMID:22871335

  14. Symptom Interference Severity and Health-Related Quality of Life in Pulmonary Arterial Hypertension

    PubMed Central

    Matura, Lea Ann; McDonough, Annette; Carroll, Diane L.

    2015-01-01

    Context While assessing symptom severity is an important component of evaluating symptoms, understanding those symptoms that interfere with patients’ lives is also key. Pulmonary arterial hypertension (PAH) is a chronic disease resulting in right heart failure and increased mortality. Patients with PAH experience multiple symptoms but we do not know which symptoms and to what extent their symptoms interfere with daily life. Objectives To: 1) describe the prevalence of those symptoms that interfere with life; 2) describe the severity of symptom interference; and 3) determine those sociodemographic and clinical characteristics, and interfering symptoms associated with health-related quality of life (HRQOL) in patients with PAH. Methods A convenience sample of 191 patients with PAH completed a sociodemographic form; the Pulmonary Arterial Hypertension Symptom Interference Scale (PAHSIS) and the Medical Outcomes Survey Short Form-36 (SF-36) to measure HRQOL. Hierarchical multiple linear regression was used to analyze demographic and medical characteristics along with symptom interference from the PAHSIS as predictors of HRQOL from the composite mental and physical health summary scores of the SF-36. Results The most interfering symptoms reported were fatigue, shortness of breath with exertion and difficulty sleeping. Age, gender, functional class, oxygen use, fatigue, dizziness and Raynaud’s phenomenon were associated with the HRQOL physical health summary scores. The symptoms fatigue and SOB while lying down were associated with the HRQOL mental health summary scores. Conclusion Patients with PAH are experiencing multiple symptoms that are interfering with their HRQOL and ability to function. PMID:26300023

  15. Latex allergy symptoms among health care workers: results from a university health and safety surveillance system.

    PubMed

    Epling, Carol; Duncan, Jacqueline; Archibong, Emma; Østbye, Truls; Pompeii, Lisa A; Dement, John

    2011-01-01

    We sought to describe risk factors for latex glove allergy symptoms among health care workers by combining data from an active clinical surveillance program and a comprehensive occupational health surveillance system. A total of 4,584 employers completed a latex allergy questionnaire. Six percent (n = 276) of subjects reported symptoms consistent with latex allergy. Years of latex glove use was a significant risk factor for latex allergy symptoms even after controlling for the effects of atopy, gender, age, race, fruit, and other allergies. Nurses, medical or lab technicians, physician's assistants, other clinical professionals, and housekeepers had the highest prevalence of latex glove allergy symptoms. Forty subjects (0.87%) who were confirmed as having latex sensitization. Sensitizsation may have been underestimated due to use of specific IgE antibody, less sensitive than skin-prick testing, and tiered design leading to laboratory assessment on a subset of the cohort. This surveillance program identified risk factors for latex allergy symptoms. Our findings provide a basis for tailoring future prevention strategies.

  16. Nurses' attitudes towards the use of PRN psychotropic medications in acute and forensic mental health settings.

    PubMed

    Barr, Lesley; Wynaden, Dianne; Heslop, Karen

    2017-03-24

    Many countries now have national mental health policies and guidelines to decrease or eliminate the use of seclusion and restraint yet the use of Pro Re Nata (PRN) medications has received less practice evaluation. This research aimed to identify mental health nurses' attitudes towards the use of PRN medications with mental health consumers. Participants were working in forensic mental health and non-forensic acute mental health settings. The "Attitudes towards PRN medication use survey" was used and data were collected online. Data were analysed using the Statistical Package Social Sciences, Version 22.0. Practice differences between forensic and other acute mental health settings were identified related to the use of PRN medications to manage symptoms from nicotine, alcohol and other drug withdrawal. Differences related to the useage of comfort rooms and conducting comprehensive assessments of consumers' psychiatric symptoms were also detected. Qualitative findings highlighted the need for increased accountability for the prescribing and administration of PRN medications along with more nursing education/training to use alternative first line interventions. Nurses administering PRN medications should be vigilant regarding the indications for this practice to ensure they are facilitating the consumer's recovery by reducing the use of all forms of potentially restrictive practices in the hospital setting. The reasons for using PRN medications and PRN administration rates must be continually monitored to avoid practices such as high dose antipsychotics use and antipsychotic polypharmacy to ensure the efficacy of the consumers' management plans on their health care outcomes.

  17. Acute effects of moderate intensity aerobic exercise on affective withdrawal symptoms and cravings among women smokers.

    PubMed

    Williams, David M; Dunsiger, Shira; Whiteley, Jessica A; Ussher, Michael H; Ciccolo, Joseph T; Jennings, Ernestine G

    2011-08-01

    A growing number of laboratory studies have shown that acute bouts of aerobic exercise favorably impact affect and cravings among smokers. However, randomized trials have generally shown exercise to have no favorable effect on smoking cessation or withdrawal symptoms during quit attempts. The purpose of the present study was to explore this apparent contradiction by assessing acute changes in affect and cravings immediately prior to and following each exercise and contact control session during an eight-week smoking cessation trial. Sixty previously low-active, healthy, female smokers were randomized to an eight-week program consisting of brief baseline smoking cessation counseling and the nicotine patch plus either three sessions/week of moderate intensity aerobic exercise or contact control. Findings revealed a favorable impact of exercise on acute changes in positive activated affect (i.e., energy), negative deactivated affect (i.e., tiredness), and cigarette cravings relative to contact control. However, effects dissipated from session to session. Results suggest that aerobic exercise has potential as a smoking cessation treatment, but that it must be engaged in frequently and consistently over time in order to derive benefits. Thus, it is not surprising that previous randomized controlled trials-in which adherence to exercise programs has generally been poor-have been unsuccessful in showing effects of aerobic exercise on smoking cessation outcomes.

  18. Types, Risk Factors, Clinical symptoms and Diagnostic Tests of Acute Adult Meningitis in Northern Iran During 2006-2012

    PubMed Central

    Bagheri-Nesami, Masoumeh; Babamahmoodi, Farhang

    2015-01-01

    Background Acute bacterial meningitis is a medical emergency condition that requires prompt diagnosis and treatment and otherwise associated with serious morbidity and mortality. Aim The aim of this study was to assess types, risk factors, clinical symptoms and diagnostic tests of meningitis in hospitalized patients of Mazandaran University of medical sciences hospitals during 2006-2012. Matherials and Methods This is a retrospective descriptive study. Following approval of the ethics committee of Mazandaran University of Medical Sciences, records of adult patients diagnosed with acute meningitis from 2006 to 2012 were extracted from Mazandaran Provincial Health Center and patients attending hospitals affiliated to Mazandaran University of Medical Sciences. Statistical Analysis Data were analyzed with SPSS-16 using descriptive statistics (frequency, mean, standard deviation, and median). Results In this study, of the 137 patients with meningitis, 73 (53.9%) were viral, 61 (46%) bacterial, 1 (0.7%) fungal, and 2 (1.4%) unknown. The majority of risk factors in patients were head trauma, upper respiratory infection, and drug addiction. The most common clinical signs were headache, fever, nausea and vomiting, and stiff neck. Conclusion In this study, the incidence of meningitis was much lower than any other country. It could be due to geographic variation or incomplete recording of patient's data. It is recommended to perform a longitudinal study during the coming years on patients with meningitis. PMID:26155497

  19. Initial symptoms of acute radiation syndrome in the JCO criticality accident in Tokai-mura.

    PubMed

    Akashi, M; Hirama, T; Tanosaki, S; Kuroiwa, N; Nakagawa, K; Tsuji, H; Kato, H; Yamada, S; Kamata, T; Kinugasa, T; Ariga, H; Maekawa, K; Suzuki, G; Tsujii, H

    2001-09-01

    A criticality accident occurred on September 30, 1999, at the uranium conversion plant in Tokai-mura (Tokai-village), Ibaraki Prefecture, Japan. When the criticality occurred, three workers saw a "blue-white glow," and a radiation monitor alarm was sounded. They were severely exposed to neutron and gamma-ray irradiation, and subsequently developed acute radiation syndrome (ARS). One worker reported vomiting within minutes and loss of consciousness for 10-20 seconds. This worker also had diarrhea an hour after the exposure. The other worker started to vomit almost an hour after the exposure. The three workers, including their supervisor, who had no symptoms at the time, were brought to the National Mito Hospital by ambulance. Because of the detection of gamma-rays from their body surface by preliminary surveys and decreased numbers of lymphocytes in peripheral blood, they were transferred to the National Institute of Radiological Sciences (NIRS), which has been designated as a hospital responsible for radiation emergencies. Dose estimations for the three workers were performed by prodromal symptoms, serial changes of lymphocyte numbers, chromosomal analysis, and 24Na activity. The results obtained from these methods were fairly consistent. Most of the data, such as the dose rate of radiation, its distribution, and the quality needed to evaluate the average dose, were not available when the decision for hematopoitic stem cell transplantation had to be made. Therefore, prodromal symptoms may be important in making decisions for therapeutic strategies, such as stem-cell transplantation in heavily exposed victims.

  20. Depressive Symptoms and Health-Related Risk-Taking in Adolescence

    ERIC Educational Resources Information Center

    Testa, C. Rylann; Steinberg, Laurence

    2010-01-01

    This study investigated the relation between symptoms and a variety of health-related risk-taking behaviors during adolescence. A survey of 20,745 adolescents from the National Longitudinal Study of Adolescent Health provided data for analysis. Adolescents who reported more depressive symptoms were found to wear seatbelts less often, wear…

  1. Chronic Family Economic Hardship, Family Processes and Progression of Mental and Physical Health Symptoms in Adolescence

    ERIC Educational Resources Information Center

    Lee, Tae Kyoung; Wickrama, K. A. S.; Simons, Leslie Gordon

    2013-01-01

    Research has documented the relationship between family stressors such as family economic hardship and marital conflict and adolescents' mental health symptoms, especially depressive symptoms. Few studies, however, have examined the processes whereby supportive parenting lessens this effect and the progression of mental health and physical health…

  2. Effect of Tamoxifen and Lithium on Treatment of Acute Mania Symptoms in Children and Adolescents

    PubMed Central

    Fallah, Elham; Arman, Sorror; Najafi, Mostafa; Shayegh, Bahar

    2016-01-01

    Objective Many studies have supported the role of protein kinase C (PKC) inhibitors in the physiopathology and treatment of bipolar disorder in adults. Tamoxifen is one of the drugs with the effect of PKC inhibition. This study aimed to determine the effect of tamoxifen on the rate of improvement mania symptoms in the sample of children and adolescents with acute mania. Materials & Methods In this randomized, placebo-controlled clinical trial study, registered in www.irct.ir with the code of IRCT201410126418N3, overall 44 patients with bipolar disorder with acute manic episode were randomly assigned into treatment and control groups. The serum levels of lithium and tamoxifen among the participants in the treatment groups were 0.8 -1.1 mg and 20-40 mg per day respectively. Serum level of lithium among participants in the control group was similar. The main comparisons were made based on the Young Mania Rating Scale (YMRS) and Children Depression Inventory (CDI) scores of the participants at baseline and at the end of each study week. The pharmacological side effects of serum level of lithium were examined weekly. Analysis of Covariance(ANCOVA) test was used for the statistical analysis. Results There was no difference in the baseline score of YMRS and CDI in the treatment and control groups while a statistical significant difference (P < 0.05) in these scores was found between and within the groups. Conclusion The addition of tamoxifen to lithium causes a significant difference in reducing the symptoms of mania and depression in the treatment group compared to the control group. PMID:27247580

  3. [Development and clinical testing of the Russian version of the Acute Cystitis Symptom Score - ACSS].

    PubMed

    Alidjanov, J F; Abdufattaev, U A; Makhmudov, D Kh; Mirkhamidov, D Kh; Khadzhikhanov, F A; Azgamov, A V; Pilatz, A; Naber, K G; Wagenlehner, F M; Akilov, F A

    2014-01-01

    The Acute Cystitis Symptom Score - ACSS was originally developed in the Uzbek language and has demonstrated high reliability and validity. The study was aimed to develop a Russian version of the ACSS questionnaire and evaluate its psychometric properties. Translation and adaptation of the ACSS questionnaire containing 18 questions, 6 of them - for the typical symptoms of acute cystitis (AC), 4 - for the differential diagnosis; 3 - for the quality of life, and 5 - for the conditions that may affect the choice of treatment, were performed according to the recommendations developed by the Mapi Research Institute. Study involved 83 Russian-speaking women (mean age, 35.6 ±13.7 years); 38 (45.8%) patients were in the main group (patients with AC), and 45 (54.2%) - in the control group (without AC). Medical examination and appropriate treatment of the respondents were conducted in accordance with approved standards. After completing the course of therapy, 19 (50%) patients of the main group came for the control examination. There was statistically significant difference in the scores obtained in the two groups. Score profiles positively correlated with the results of laboratory tests (rho = 0.26-0.48). Cronbach's alpha for the Russian version of the questionnaire was 0.86 (95% CI, 0.81-0.91), area under the curve in the ROC analysis was 0.96. The results of testing the Russian version correspond to those of the original version. The Russian version of the ACSS questionnaire has high. reliability and validity, and can be recommended for clinical research and diagnosis of primary AC, and dynamic monitoring of the effectiveness of the treatment of the Russian-speaking population of patients.

  4. Improving Management of Behavioral and Psychological Symptoms of Dementia in Acute Care: Evidence and Lessons Learned From Across the Care Spectrum.

    PubMed

    McConnell, Eleanor S; Karel, Michele J

    2016-01-01

    As the prevalence of Alzheimer disease and related dementias increases, dementia-related behavioral symptoms present growing threats to care quality and safety of older adults across care settings. Behavioral and psychological symptoms of dementia (BPSD) such as agitation, aggression, and resistance to care occur in nearly all individuals over the course of their illness. In inpatient care settings, if not appropriately treated, BPSD can result in care complications, increased length of stay, dissatisfaction with care, and caregiver stress and injury. Although evidence-based, nonpharmacological approaches to treating BPSD exist, their implementation into acute care has been thwarted by limited nursing staff expertise in behavioral health, and a lack of consistent approaches to integrate behavioral health expertise into medically focused inpatient care settings. This article describes the core components of one evidence-based approach to integrating behavioral health expertise into dementia care. This approach, called STAR-VA, was implemented in Veterans' Health Administration community living centers (nursing homes). It has demonstrated effectiveness in reducing the severity and frequency of BPSD, while improving staff knowledge and skills in caring for people with dementia. The potential for adapting this approach in acute care settings is discussed, along with key lessons learned regarding opportunities for nursing leadership to ensure consistent implementation and sustainability.

  5. Effects of random dosimetry errors and the use of data on acute symptoms for dosimetry evaluation

    SciTech Connect

    Gilbert, E.S.

    1983-09-01

    Two approaches are used to address questions regarding dose measurement errors. The first is to describe and compare the effects of random error for several dose treatments including the use of grouped and ungrouped data, and analyses with and without truncation at 600 rad. It is found that the ways in which measurement error is most likely to mislead are through downward bias in the estimated regression coefficients and through distortion of the shape of the dose response curve. The second approach makes use of data on acute symptons to identify survivors in particular shielding situations or locations whose dose estimates may be especially biased or subject to unusual amounts of random error. It is found that the dose-response curves for acute symptoms differ considerably by many of the factors studied, but it is not possible to separate differences resulting from varying degrees of random error from systematic bias. The analyses also suggest that doses of Hiroshima survivors are in general better estimated than doses of Nagasaki survivors, a situation which could easily bias city comparisons. 17 references.

  6. Victoria Symptom Validity Test performance in acute severe traumatic brain injury: implications for test interpretation.

    PubMed

    Macciocchi, Stephen N; Seel, Ronald T; Alderson, Amy; Godsall, Robert

    2006-08-01

    Effort testing has become commonplace in clinical practice. Recent research has shown that performance on effort tests is highly correlated with performance on neuropsychological measures. Clinical application of effort testing is highly dependent on research derived interpretive guidelines. The Victoria Symptom Validity Test (VSVT) is one of many measures currently used in clinical practice. The VSVT has recommended interpretive guidelines published in the test manual, but the samples used in developing interpretive guidelines are small and heterogeneous and concern has been expressed regarding high false negative rates. In this study, a homogeneous sample of acute, severely brain injured persons were used to assess the sensitivity of the VSVT. Results confirmed that acute, severely brain injured persons (N=71) perform very well on the VSVT. The severe brain injury population is 99% likely to have between 44.1 and 46.8 correct VSVT Combined Score responses. While the VSVT was insensitive to memory dysfunction, the presence of severe visual perceptual (Benton Visual Form Discrimination Score<21) and verbal fluency (Controlled Oral Word Association Score<15) deficits predicted poor performance on the VSVT. These results provide further evidence that performance expectations currently incorporated in the VSVT manual interpretative criteria are too conservative. Empirically based alternative criteria for interpreting VSVT Combined Scores in the TBI population are presented.

  7. Brief Report: Health-Seeking Behavior and Symptoms Associated With Early HIV Infection: Results From a Population-Based Cohort in Southern Malawi.

    PubMed

    Yeatman, Sara E; Hoffman, Risa M; Chilungo, Abdallah; Lungu, Sydney R; Namadingo, Hazel C; Chimwaza, Angela F; Trinitapoli, Jenny A

    2015-05-01

    HIV transmission is most likely to occur during the first few months after infection, yet few cases are identified during this period. Using a population-based cohort of young Malawian women, we identify the distinct symptomology and health-seeking behavior marking early HIV infection by comparing it with periods of seronegativity and chronic infection. During early HIV infection, women are more likely to report malaria-like symptoms and visit clinics for malaria care. In malaria-endemic contexts, where acute HIV symptoms are commonly mistaken for malaria, early diagnostic HIV testing and counseling should be integrated into health care settings where people commonly seek treatment for malaria.

  8. Bordetella pertussis in infants hospitalized for acute respiratory symptoms remains a concern

    PubMed Central

    2013-01-01

    Background Preliminary results suggest that pertussis infection might be considered in infants during a seasonal respiratory syncytial virus (RSV) outbreak. Methods In order to analyze clinical features and laboratory findings in infants with pertussis hospitalized for acute respiratory symptoms during a seasonal RSV outbreak, we conducted a retrospective single-center study on 19 infants with pertussis (6 boys; median age 72 days) and 19 matched controls (RSV-bronchiolitis), hospitalized from October 2008 to April 2010. B. pertussis and RSV were detected from nasopharyngeal washes with Real Time-PCR. Results Infants with pertussis were less often breastfeed than infants with RSV bronchiolitis (63.2% vs 89.5%; p <0.06). Clinically, significantly fewer infants with pertussis than controls had more episodes of whooping cough (63.2% vs 0.0%; p < 0.001) and also less frequently fever at admission (15.8% vs 68.4%; p <0.01), apnea (52.6% vs 10.5%; p <0.006), and cyanosis (52.6% vs 10.5%; p < 0.006). Infants with pertussis had more often no abnormal chest sounds on auscultation than infants with RSV bronchiolitis (0% vs 42,1%; p < 0.005). The absolute blood lymphocyte and eosinophil counts were higher in infants with B. pertussis than in controls with bronchiolitis (23886 ± 16945 vs 10725 ± 4126 cells/mm3, p < 0.0001 and 13.653 ± 10.430 vs 4.730 ± 2.400 cells/mm3, p < 0.001). The molecular analysis of 2 B. pertussis isolates for ptxA1, ptxP3, and prn2 genes showed the presence of gene variants. Conclusions When infants are hospitalized for acute respiratory symptoms, physicians should suspect a pertussis infection, seek for specific clinical symptoms, investigate lymphocyte and eosinophil counts and thus diagnose infection early enough to allow treatment. PMID:24209790

  9. Concurrent and longitudinal associations of basal and diurnal cortisol with mental health symptoms in early adolescence.

    PubMed

    Shirtcliff, Elizabeth A; Essex, Marilyn J

    2008-11-01

    Recent biosocial theories postulate that both biological risk and the social context influence the development of mental health problems [Boyce and Ellis (2005) Development and Psychopathology, 17(2), 271-301]. Guided by this framework, we examined whether basal cortisol and its diurnal rhythm were associated with mental health symptoms in early adolescence. Because cross-sectional and longitudinal investigations sometimes reveal different cortisol-mental health associations, we examined the association both concurrently and longitudinally when children transition to middle school, a time which entails a major change in social context from single to multiple teachers, classrooms, and sets of classmates. Salivary cortisol was measured three times a day (waking, afternoon, and bedtime) across 3 days when adolescents were 5th graders. Mental health was measured when adolescents were in 5th and 7th grades, just before and after the transition to middle school. To deal with the substantial comorbidity of internalizing and externalizing symptoms at this developmental stage, mental health measures distinguished overall symptom severity from the preponderance of internalizing versus externalizing symptoms (i.e., directionality). A three-level Hierarchical Linear Model was used to extract basal cortisol and its diurnal rhythm separate from the day-to-day and within-the-day fluctuations in cortisol in response to daily experiences. Results were specific to symptom severity, suggesting that cortisol is a nonspecific risk factor for mental health symptoms in young adolescents. At 5th grade, low basal cortisol was associated with concurrent symptom severity. However, longitudinally, it was adolescents with high cortisol at 5th grade who were at risk for increasing mental health symptoms by 7th grade. Flat diurnal rhythms in 5th grade were related to levels of symptom severity at both 5th and 7th grades. Considering the change in social context, as defined by the transition to

  10. Chronic family economic hardship, family processes and progression of mental and physical health symptoms in adolescence.

    PubMed

    Lee, Tae Kyoung; Wickrama, K A S; Simons, Leslie Gordon

    2013-06-01

    Research has documented the relationship between family stressors such as family economic hardship and marital conflict and adolescents' mental health symptoms, especially depressive symptoms. Few studies, however, have examined the processes whereby supportive parenting lessens this effect and the progression of mental health and physical health symptoms in adolescence. The present study investigates the influences of chronic family economic hardship on adolescents' multiple health problem symptoms (i.e., symptoms of anxiety, and depression and physical complaints) through parents' marital conflict, and supportive parenting; it also examines how there adolescents' health problems mutually influence one another throughout adolescence. We used Structural Equation Modeling to analyze data from a longitudinal sample of European American mothers, fathers, and target adolescents (N = 451, 53% female) to examine direct and indirect effects. Findings generally supported the hypothesized model. Chronic family economic hardship contributed to mental and physical health problems of adolescents. This influence largely was mediated through supportive parenting. Moreover, supportive parenting buffered marital conflict on depressive symptoms of adolescents. Also, there was a tendency for females to show more stable depressive symptoms than males. The study demonstrates key mediating pathways and additional moderating influences based on the family stress model and also highlights the importance of improving health resources for adolescents.

  11. Patient- versus physician-reporting of symptoms and health status in chronic myeloid leukemia

    PubMed Central

    Efficace, Fabio; Rosti, Gianantonio; Aaronson, Neil; Cottone, Francesco; Angelucci, Emanuele; Molica, Stefano; Vignetti, Marco; Mandelli, Franco; Baccarani, Michele

    2014-01-01

    The main objective of this study was to compare the reporting of health status and symptom severity, for a set of core symptoms related to imatinib therapy, between chronic myeloid leukemia patients and their treating physicians. Patients were asked to complete a questionnaire including questions on symptom severity and health status. The symptoms assessed were: abdominal discomfort, diarrhea, edema, fatigue, headache, muscle cramps, musculoskeletal pain, nausea and skin problems. The physicians were asked to complete a questionnaire for each of their patients entering the study. Four hundred twenty-two patients were included in the study. All respective paired physicians (n=29) completed the questionnaire, and thus the analyses are based on 422 patient-physician dyads. Agreement on symptom ratings ranged from 34% (for muscle cramps) to 66% (for nausea). For all symptoms, patients reported higher severity more often than their physicians. The three symptoms whose severity was most frequently underestimated by physicians were fatigue (51%), muscle cramps (49%) and musculoskeletal pain (42%). Health status was overestimated by physicians in 67% of the cases. Physicians and their patients with chronic myeloid leukemia often disagree in their ratings of the patients’ symptom severity. Most typically, physicians tend to underestimate symptom severity and overestimate the overall health status of their patients. Current findings support the use of patient-reported outcome measures as a possible means to enhance the management of patients with chronic myeloid leukemia. PMID:24241488

  12. Symptoms and Health Complaints and Their Association with Perceived Stressors among Students at Nine Libyan Universities

    PubMed Central

    El Ansari, Walid; Khalil, Khalid; Stock, Christiane

    2014-01-01

    University students are exposed to many stressors. We assessed the associations between two stressors (educational related and general overall), socio-demographic characteristics (five variables), health behaviours/lifestyle factors (six variables), as well as religiosity and quality of life as independent variables, with self-reported symptoms/health complaints as dependent variables (eight health complaints). A sample of 2100 undergraduate students from nine institutions (six universities, three colleges) located in seven cities in Libya completed a general health questionnaire. The most prevalent symptoms were headaches, depressive mood, difficulties to concentrate and sleep disorder/insomnia that have been reported by 50%–60% of the students. The majority of students (62%) reported having had three or more symptoms sometimes or very often in the last 12 months. There was a positive association between perceived stressors and health symptoms, which remained significant after adjustment for gender and many other relevant factors for headache (OR 1.52; 95% CI 1.15–2.02), depressive mood (OR 2.20; 95% CI 1.64–2.94) and sleep disorder/ insomnia (OR 1.55, 95% CI 1.19–2.03). Other factors independently associated with most health symptoms were female gender and poor self-perceived health. Stress management programmes and a reduction of educational related stressors might help to prevent stress-related symptoms and health complaints in this student population. PMID:25429678

  13. Symptoms and health complaints and their association with perceived stressors among students at nine Libyan universities.

    PubMed

    El Ansari, Walid; Khalil, Khalid; Stock, Christiane

    2014-11-25

    University students are exposed to many stressors. We assessed the associations between two stressors (educational related and general overall), socio-demographic characteristics (five variables), health behaviours/lifestyle factors (six variables), as well as religiosity and quality of life as independent variables, with self-reported symptoms/health complaints as dependent variables (eight health complaints). A sample of 2100 undergraduate students from nine institutions (six universities, three colleges) located in seven cities in Libya completed a general health questionnaire. The most prevalent symptoms were headaches, depressive mood, difficulties to concentrate and sleep disorder/insomnia that have been reported by 50%-60% of the students. The majority of students (62%) reported having had three or more symptoms sometimes or very often in the last 12 months. There was a positive association between perceived stressors and health symptoms, which remained significant after adjustment for gender and many other relevant factors for headache (OR 1.52; 95% CI 1.15-2.02), depressive mood (OR 2.20; 95% CI 1.64-2.94) and sleep disorder/ insomnia (OR 1.55, 95% CI 1.19-2.03). Other factors independently associated with most health symptoms were female gender and poor self-perceived health. Stress management programmes and a reduction of educational related stressors might help to prevent stress-related symptoms and health complaints in this student population.

  14. Health Perception and Symptom Severity Bone Marrow Transplantation Patients

    DTIC Science & Technology

    2013-01-31

    ability to identify biodemographic, psychological and/or social factors which contribute to symptom development would be instrumental in the medical...anxiety), coping strategies and social support have been examined. Results have indicated that emotional distress is the most significant predictor of... social support received, prior coping ability, present ability to cope with disease and treatment, quality of affect, mental status, and proneness

  15. Mental health care use in relation to depressive symptoms among pregnant women in the USA.

    PubMed

    Byatt, Nancy; Xiao, Rui S; Dinh, Kate H; Waring, Molly E

    2016-02-01

    We examined mental health care use in relation to depressive symptoms (Patient Health Questionnaire (PHQ-9) ≥ 10) among a nationally representative sample of pregnant women using data from the National Health and Nutrition Examination Survey 2005-2012. Logistic regression models estimated crude and adjusted odds ratios for mental health care use in the past year in relation to depressive symptoms. While 8.2 % (95 % CI 4.6-11.8) of pregnant women were depressed, only 12 % (95 % CI 1.8-22.1) of these women reported mental health care use in the past year.

  16. Associations of Adenovirus Genotypes in Korean Acute Gastroenteritis Patients with Respiratory Symptoms and Intussusception

    PubMed Central

    Kim, Jae-Seok; Lee, Su Kyung; Ko, Dae-Hyun; Hyun, Jungwon; Song, Wonkeun

    2017-01-01

    Human adenoviruses (HAdVs) cause a wide range of diseases, including respiratory infections and gastroenteritis, and have more than 65 genotypes. To investigate the current genotypes of circulating HAdV strains, we performed molecular genotyping of HAdVs in the stool from patients with acute gastroenteritis and tried to determine their associations with clinical symptoms. From June 2014 to May 2016, 3,901 fecal samples were tested for an AdV antigen, and 254 samples (6.5%) yielded positive results. Genotyping using PCR and sequencing of the capsid hexon gene was performed for 236 AdV antigen-positive fecal specimens. HAdV-41, of species F, was the most prevalent genotype (60.6%), followed by HAdV-2 of species C (13.8%). Other genotypes, including HAdV-3, HAdV-1, HAdV-5, HAdV-6, HAdV-31, HAdV-40, HAdV-12, and HAdV-55, were also detected. Overall, 119 patients (50.4%) showed concomitant respiratory symptoms, and 32 patients (13.6%) were diagnosed with intussusception. HAdV-1 and HAdV-31 were significantly associated with intussusception (P < 0.05). Our results demonstrate the recent changes in trends of circulating AdV genotypes associated with gastroenteritis in Korea, which should be of value for improving the diagnosis and developing new detection, treatment, and prevention strategies for broad application in clinical laboratories. PMID:28255553

  17. Acute symptoms related to air pollution in urban areas: a study protocol

    PubMed Central

    Yunesian, Masud; Asghari, Fariba; Vash, Javad Homayoun; Forouzanfar, Mohammad Hossein; Farhud, Dariush

    2006-01-01

    Background The harmful effects of urban air pollution on general population in terms of annoying symptoms are not adequately evaluated. This is in contrast to the hospital admissions and short term mortality. The present study protocol is designed to assess the association between the level of exposure to certain ambient air pollutants and a wide range of relevant symptoms. Awareness of the impact of pollution on the population at large will make our estimates of the pertinent covert burden imposed on the society more accurate. Methods/design A cross sectional study with spatial analysis for the addresses of the participants was conducted. Data were collected via telephone interviews administered to a representative sample of civilians over age four in the city. Households were selected using random digit dialling procedures and randomization within each household was also performed to select the person to be interviewed. Levels of exposure are quantified by extrapolating the addresses of the study population over the air pollution matrix of the city at the time of the interview and also for different lag times. This information system uses the data from multiple air pollution monitoring stations in conjunction with meteorological data. General linear models are applied for statistical analysis. Discussion The important limitations of cross-sectional studies on acute effects of air pollution are personal confounders and measurement error for exposure. A wide range of confounders in this study are controlled for in the statistical analysis. Exposure error may be minimised by employing a validated geographical information system that provides accurate estimates and getting detailed information on locations of individual participants during the day. The widespread operation of open air conditioning systems in the target urban area which brings about excellent mixing of the outdoor and indoor air increases the validity of outdoor pollutants levels that are taken as

  18. Mental Health Symptoms among Student Service Members/Veterans and Civilian College Students

    ERIC Educational Resources Information Center

    Cleveland, Sandi D.; Branscum, Adam J.; Bovbjerg, Viktor E.; Thorburn, Sheryl

    2015-01-01

    Objective: The aim of this study was to investigate if and to what extent student service members/veterans differ from civilian college students in the prevalence of self-reported symptoms of poor mental health. Participants: The Fall 2011 implementation of the American College Health Association-National College Health Assessment included 27,774…

  19. ASTHMA AND MENTAL HEALTH SYMPTOMS AMONG ADULT ARAB AMERICANS IN THE DETROIT AREA

    EPA Science Inventory

    The burden of managing chronic health problems such as asthma is often compounded by psychological distress and debilitating mental health problems associated with these conditions. In this study we assessed the relationship between asthma and self-reported mental health symptom...

  20. Dose-Volume Effects on Patient-Reported Acute Gastrointestinal Symptoms During Chemoradiation Therapy for Rectal Cancer

    SciTech Connect

    Chen, Ronald C.; Mamon, Harvey J.; Ancukiewicz, Marek; Killoran, Joseph H.; Crowley, Elizabeth M.; Blaszkowsky, Lawrence S.; Wo, Jennifer Y.; Ryan, David P.; Hong, Theodore S.

    2012-07-15

    Purpose: Research on patient-reported outcomes (PROs) in rectal cancer is limited. We examined whether dose-volume parameters of the small bowel and large bowel were associated with patient-reported gastrointestinal (GI) symptoms during 5-fluorouracil (5-FU)-based chemoradiation treatment for rectal cancer. Methods and Materials: 66 patients treated at the Brigham and Women's Hospital or Massachusetts General Hospital between 2006 and 2008 were included. Weekly during treatment, patients completed a questionnaire assessing severity of diarrhea, urgency, pain, cramping, mucus, and tenesmus. The association between dosimetric parameters and changes in overall GI symptoms from baseline through treatment was examined by using Spearman's correlation. Potential associations between these parameters and individual GI symptoms were also explored. Results: The amount of small bowel receiving at least 15 Gy (V15) was significantly associated with acute symptoms (p = 0.01), and other dosimetric parameters ranging from V5 to V45 also trended toward association. For the large bowel, correlations between dosimetric parameters and overall GI symptoms at the higher dose levels from V25 to V45 did not reach statistical significance (p = 0.1), and a significant association was seen with rectal pain from V15 to V45 (p < 0.01). Other individual symptoms did not correlate with small bowel or large bowel dosimetric parameters. Conclusions: The results of this study using PROs are consistent with prior studies with physician-assessed acute toxicity, and they identify small bowel V15 as an important predictor of acute GI symptoms during 5-FU-based chemoradiation treatment. A better understanding of the relationship between radiation dosimetric parameters and PROs may allow physicians to improve radiation planning to optimize patient outcomes.

  1. The Role of Acculturative Stress on Mental Health Symptoms for Immigrant Adolescents: A Longitudinal Investigation

    ERIC Educational Resources Information Center

    Sirin, Selcuk R.; Ryce, Patrice; Gupta, Taveeshi; Rogers-Sirin, Lauren

    2013-01-01

    Immigrant-origin adolescents represent the fastest growing segment of youth population in the United States, and in many urban schools they represent the majority of students. In this 3-wave longitudinal study, we explored trajectories of internalizing mental health symptoms (depression, anxiety, and somatic symptoms). The participants included…

  2. An examination of prenatal and postpartum depressive symptoms among women served by urban community health centers.

    PubMed

    Sidebottom, Abbey C; Hellerstedt, Wendy L; Harrison, Patricia A; Hennrikus, Deborah

    2014-02-01

    We characterized depressive symptoms in the prenatal and/or postpartum periods and examined associated risk factors among 594 women who received care at community health care centers. Women were screened with comprehensive risk assessments, which included the Patient Health Questionnaire-9 depression screen, during pregnancy and at least 4 weeks after delivery. Fifteen percent had depressive symptoms in the prenatal period only; 6 % in the postpartum period only, and 8 % had depressive symptoms in both periods. Risk markers varied for women who reported depressive symptoms at one period only compared with those who reported persistent depressive symptoms. Age (25 years versus younger), having experienced abuse, not living with the infant's father, and cigarette smoking were associated with depressive symptoms at both periods; being US-born, lacking social support, and experiencing food insecurity were associated with reporting symptoms only in the prenatal period, and lack of phone access was associated with risk only in the postpartum period. Our findings confirm the importance of repeated screenings for depressive symptoms during the perinatal period. The variability in risk markers associated with periods of reported depressive symptoms may reflect their varying associations with persistence, new onset, or recovery from depressive symptoms.

  3. Acute kidney injury: global health alert.

    PubMed

    Li, Philip Kam Tao; Burdmann, Emmanuel A; Mehta, Ravindra L

    2013-05-01

    Acute kidney injury (AKI) is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality. Most etiologies of AKI can be prevented by interventions at the individual, community, regional and in-hospital levels. Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies, as well as early recognition and management. Efforts should be focused on minimizing causes of AKI, increasing awareness of the importance of serial measurements of serum creatinine in high-risk patients, and documenting urine volume in acutely ill people to achieve early diagnosis; there is as yet no definitive role for alternative biomarkers. Protocols need to be developed to systematically manage prerenal conditions and specific infections. More accurate data about the true incidence and clinical impact of AKI will help to raise the importance of the disease in the community, and increase awareness of AKI by governments, the public, general and family physicians and other healthcare professionals to help prevent the disease. Prevention is the key to avoid the heavy burden of mortality and morbidity associated with AKI.

  4. Perceived discrimination and mental health symptoms among Black men with HIV.

    PubMed

    Bogart, Laura M; Wagner, Glenn J; Galvan, Frank H; Landrine, Hope; Klein, David J; Sticklor, Laurel A

    2011-07-01

    People living with HIV (PLWH) exhibit more severe mental health symptoms, including depression and posttraumatic stress disorder (PTSD) symptoms, than do members of the general public. We examined whether perceived discrimination, which has been associated with poor mental health in prior research, contributes to greater depression and PTSD symptoms among HIV-positive Black men who have sex with men (MSM), who are at high risk for discrimination from multiple stigmatized characteristics (HIV-serostatus, race/ethnicity, sexual orientation). A total of 181 Black MSM living with HIV completed audio computer-assisted self-interviews (ACASI) that included measures of mental health symptoms (depression, PTSD) and scales assessing perceived discrimination due to HIV-serostatus, race/ethnicity, and sexual orientation. In bivariate tests, all three perceived discrimination scales were significantly associated with greater symptoms of depression and PTSD (i.e., reexperiencing, avoidance, and arousal subscales; all p values < .05). The multivariate model for depression yielded a three-way interaction among all three discrimination types (p < .01), indicating that perceived racial discrimination was negatively associated with depression symptoms when considered in isolation from other forms of discrimination, but positively associated when all three types of discrimination were present. In multivariate tests, only perceived HIV-related discrimination was associated with PTSD symptoms (p < .05). Findings suggest that some types of perceived discrimination contribute to poor mental health among PLWH. Researchers need to take into account intersecting stigmata when developing interventions to improve mental health among PLWH.

  5. Acute and long term health effects of radiation

    SciTech Connect

    Voelz, G.L.

    1986-11-19

    This paper covers selected aspects of the acute and long term health effects excluding acute radiation syndrome and carcinogenesis, resulting from exposure to ionizing radiation. The changes addressed in this paper are those witnessed within an organ or whole body rather than at the molecular or even cellular level. They include acute and late health effects. Some of these effects are threshold effects, meaning that the dose must exceed a certain threshold before one sees these effects. Less than the threshold dose results in no observable organ or whole body effect. The severity of the effects correlate directly with the amount of cell damage or cell death that has occurred. 15 refs., 4 figs., 8 tabs.

  6. The acute symptoms of sport-related concussion: diagnosis and on-field management.

    PubMed

    Putukian, Margot

    2011-01-01

    Sport-related concussion is a common injury that occurs in a variety of sports. In recent years, more attention has been focused on the importance of this injury as well as the long-term complications of unrecognized, repetitive, and/or severe injury. The acute presentation of concussion as well as the diagnosis of concussion is often straightforward and obvious, but it can also be subtle and difficult to discern. Most injuries are short lived with complete recovery within a couple of weeks, with a small minority taking several months to resolve. Unfortunately, it is difficult to predict which injuries will linger. This article discusses the on-field presentation, diagnosis, and management of sport-related concussion. It is important to have a concussion protocol for high-risk sports, including a preseason and postinjury assessment, and an individualized yet comprehensive approach that includes evaluating symptoms, and a neurologic examination that includes cognitive function and balance testing. A multifaceted approach to the evaluation and diagnosis of concussion is endorsed for the optimal management of this injury.

  7. Masked Symptoms: Mid-Life Women, Health, and Work

    ERIC Educational Resources Information Center

    Abramson, Zelda

    2007-01-01

    Data from the Canadian Labour Force Survey (1997) reveal that relatively few mid-life women offer ill health as a reason for leaving their job or downshifting to part-time employment, implying that the role of ill health may be inconsequential in effecting changing patterns in mid-life women's labour force activity. In contrast, interviews with 30…

  8. Grief, Depressive Symptoms, and Physical Health among Recently Bereaved Spouses

    ERIC Educational Resources Information Center

    Utz, Rebecca L.; Caserta, Michael; Lund, Dale

    2012-01-01

    Purpose: Widowhood is among the most distressing of all life events, resulting in both mental and physical health declines. This paper explores the dynamic relationship between physical health and psychological well-being among recently bereaved spouses. Design and Methods: Using a sample of 328 bereaved persons who participated in the "Living…

  9. Predictors of diagnostic neuroimaging delays among adults presenting with symptoms suggestive of acute stroke in Ontario: a prospective cohort study

    PubMed Central

    Burton, Kirsteen R.; Kapral, Moira K.; Li, Shudong; Fang, Jiming; Moody, Alan R.; Krahn, Murray; Laupacis, Andreas

    2016-01-01

    Background: Many studies have examined the timeliness of thrombolysis for acute ischemic stroke, but less is known about door-to-imaging time. We conducted a prospective cohort study to assess the timing of neuroimaging among patients with suspected acute stroke in the province of Ontario, Canada, and to examine factors associated with delays in neuroimaging. Methods: We included all patients 18 years and older with suspected acute stroke seen at hospitals with neuroimaging capacity within the Ontario Stroke Registry between Apr. 1, 2010, and Mar. 31, 2011. We used a hierarchical, multivariable Cox proportional hazards model to evaluate the association between patient and hospital factors and the likelihood of receiving timely neuroimaging (≤ 25 min) after arrival in the emergency department. Results: A total of 13 250 patients presented to an emergency department with stroke-like symptoms during the study period. Of the 3984 who arrived within 4 hours after symptom onset, 1087 (27.3%) had timely neuroimaging. The factors independently associated with an increased likelihood of timely neuroimaging were less time from symptom onset to presentation, more severe stroke, male sex, no history of stroke or transient ischemic attack, arrival to hospital from a setting other than home and presentation to a designated stroke centre or an urban hospital. Interpretation: A minority of patients with stroke-like symptoms who presented within the 4-hour thrombolytic treatment window received timely neuroimaging. Neuroimaging delays were influenced by various patient and hospital factors, some of which are modifiable. PMID:27398382

  10. Acute Health Delivery, Energy Impact, and Rural Texas.

    ERIC Educational Resources Information Center

    Milburn, Lonna; And Others

    To examine what changes occurred in the acute health care delivery systems of rural Texas energy impact communities from 1978 to 1983, a retrospective survey was used to acquire data from which a database could be generated that could provide information for community and state policy decisions. From a pool of communities chosen by a panel of…

  11. Use of Electronic Health Records by Nurses for Symptom Management in Inpatient Settings: A Systematic Review.

    PubMed

    Ozkaynak, Mustafa; Reeder, Blaine; Hoffecker, Lilian; Makic, Mary Beth; Sousa, Karen

    2017-02-25

    Symptom management is one of the essential functions of nurses in inpatient settings; yet, little is understood about the manner in which nurses use electronic health records for symptom documentation. Therefore, the purpose of this systematic review is to characterize nurses' use of electronic health records for documentation of symptom assessment and management in inpatient settings, to inform design studies that better support electronic health records for patient symptom management by nurses. We searched the Ovid Medline (1946-current), Cumulative Index to Nursing and Allied Health Literature (EBSCO, 1981-current), and Excerpta Medica Database (Embase.com, 1974-current) databases from inception through May 2015 using multiple subject headings and "free text" key words, representing the concepts of electronic medical records, symptom documentation, and inpatient setting. One thousand nine hundred eighty-two articles were returned from the search. Eighteen publications from the years 2003 to 2014 were included after abstract and full text review. Studies heavily focused on a pain as symptom. Nurses face challenges when using electronic health records that can threaten quality and safety of care. Clinical, design, and administrative recommendations were identified to overcome the challenges of nurses' electronic health record use. A call for interdisciplinary, comprehensive, systematic interventions and user-centered design of information systems is needed.

  12. Nighttime Insomnia Symptoms and Perceived Health in the America Insomnia Survey (AIS)

    PubMed Central

    Walsh, James K.; Coulouvrat, Catherine; Hajak, Goeran; Lakoma, Matthew D.; Petukhova, Maria; Roth, Thomas; Sampson, Nancy A.; Shahly, Victoria; Shillington, Alicia; Stephenson, Judith J.; Kessler, Ronald C.

    2011-01-01

    Study Objectives: To explore the distribution of the 4 cardinal nighttime symptoms of insomnia—difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), and nonrestorative sleep (NRS)—in a national sample of health plan members and the associations of these nighttime symptoms with sociodemographics, comorbidity, and perceived health. Design/Setting/Participants: Cross-sectional telephone survey of 6,791 adult respondents. Intervention: None. Measurements/Results: Current insomnia was assessed using the Brief Insomnia Questionnaire (BIQ)—a fully structured validated scale generating diagnoses of insomnia using DSM-IV-TR, ICD-10, and RDC/ICSD-2 inclusion criteria. DMS (61.0%) and EMA (52.2%) were more prevalent than DIS (37.7%) and NRS (25.2%) among respondents with insomnia. Sociodemographic correlates varied significantly across the 4 symptoms. All 4 nighttime symptoms were significantly related to a wide range of comorbid physical and mental conditions. All 4 also significantly predicted decrements in perceived health both in the total sample and among respondents with insomnia after adjusting for comorbid physical and mental conditions. Joint associations of the 4 symptoms predicting perceived health were additive and related to daytime distress/impairment. Individual-level associations were strongest for NRS. At the societal level, though, where both prevalence and strength of individual-level associations were taken into consideration, DMS had the strongest associations. Conclusions: The extent to which nighttime insomnia symptoms are stable over time requires future long-term longitudinal study. Within the context of this limitation, the results suggest that core nighttime symptoms are associated with different patterns of risk and perceived health and that symptom-based subtyping might have value. Citation: Walsh JK; Coulouvrat C; Hajak G; Lakoma MD; Petukhova M; Roth T; Sampson NA; Shahly V; Shillington A

  13. Acute Health Effects Among Military Personnel Participating in the Cleanup of the Hebei Spirit Oil Spill, 2007, in Taean County, Korea

    PubMed Central

    Gwack, Jin; Lee, Ju Hyung; Kang, Young Ah; Chang, Kyu-jin; Lee, Moo Sik; Hong, Jee Young

    2012-01-01

    Objectives This study was conducted to investigate acute health effects and its related factors among military personnel participating in the cleanup of the 2007 Hebei Spirit oil spill accident in Taean county, Korea. Methods We collected data on acute symptoms during the cleanup and their predictors using a self-administered questionnaire to 2624 military personnel. Selfreported symptoms included six neurologic symptoms, five respiratory symptoms, two dermatologic symptoms, three ophthalmic symptoms, and three general symptoms. Independent variables were demographic factors (gender, age, education level, and rank), health behavioral factors (smoking history and usage of the personal protective equipment such as masks and gloves), and occupational history such as where and for how long individuals participated in cleanup. Results The duration of work days was significantly associated with 17 acute symptoms except for itchiness and red skin.Working in Taean county also increased the risk of most acute symptoms except headache and back pain. In regard to personal protective equipment, wearing masks was mainly related to the development of respiratory symptoms such as sore throat and wearing other protective equipment was related to the development of sore throat, back pain, headache, and cough. Military personnel younger than 25 years reported 4.66 times more hot flushing and 5.39 times more itchiness than those older than 25 years. Conclusion It should be emphasized that for early-stage cleanup the number of workers should be minimized, sufficient personal protective equipment with approved quality for blocking noxious gas should be supplied, and systematic health care for the workers should be provided. Health effects could be diminished by providing adequate education regarding the appropriate use of protective equipment, especially to nonprofessionals such as residents and volunteers. To make disaster response expeditious, a national and regional preparedness

  14. Internalizing Symptoms and Safe Sex Intentions among Adolescents in Mental Health Treatment: Personal Factors as Mediators

    PubMed Central

    Joppa, Meredith C.; Rizzo, Christie J.; Brown, Larry K.; Hadley, Wendy; Dattadeen, Jodi-Ann; Donenberg, Geri; DiClemente, Ralph

    2014-01-01

    Little is known about why some adolescents with internalizing symptoms engage in sexual behaviors that increase their risk for HIV. This study tested a mediation model of internalizing symptoms and safe sex intentions among adolescents receiving mental health treatment. Self-efficacy for HIV prevention, HIV knowledge, and worry about HIV were hypothesized to mediate associations between internalizing symptoms and safe sex intentions among sexually active and non-active adolescents receiving mental health treatment (N = 893, M age = 14.9). Significant indirect effects from internalizing symptoms to safe sex intentions varied according sexual experience: for sexually non-active adolescents, HIV worry and knowledge mediated this link, whereas for sexually active adolescents, HIV self-efficacy was the significant mediator. Increasing both HIV knowledge and self-efficacy for HIV prevention are important targets for HIV prevention with adolescents with internalizing symptoms, and careful attention should be paid towards targeting these interventions to sexually experienced and inexperienced youth. PMID:25284921

  15. Mental health of Chinese primary care patients with lower urinary tract symptoms.

    PubMed

    Choi, Edmond P H; Lam, Cindy L K; Chin, Weng Yee

    2016-01-01

    The aim of this study was to evaluate the mental health of Chinese primary care patients with lower urinary tract symptoms (LUTS). This was a cross-sectional observational study. Five hundred and nineteen subjects with LUTS completed a structured questionnaire containing the Depression, Anxiety, and Stress Scale-Short Form, the International Prostate Symptom Score, the adapted International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and questions about socio-demographics. Overall, 17.7% of subjects reported depressive symptoms, 24.3% anxiety symptoms and 9.6% stress symptoms. In males, demographic factors associated with poorer mental health included being not married; clinical factors included higher LUTS severity, weak stream, straining and mixed urinary incontinence. In females, demographic factors associated with poorer mental health included being younger, not married and lower household income; clinical factors included higher LUTS severity, incomplete bladder emptying, urgency and weak stream. Chinese primary care patients with LUTS appear to be an at-risk group for poorer mental health with increased prevalence of anxiety and depressive symptoms and may require routine screening to identify those who may require more tailored interventions to address both their urinary symptoms and psychological distress.

  16. Tele-Interpersonal Psychotherapy Acutely Reduces Depressive Symptoms in Depressed HIV-Infected Rural Persons: A Randomized Clinical Trial.

    PubMed

    Heckman, Timothy G; Heckman, Bernadette D; Anderson, Timothy; Lovejoy, Travis I; Markowitz, John C; Shen, Ye; Sutton, Mark

    2016-04-26

    Human immunodeficiency virus (HIV)-positive rural individuals carry a 1.3-times greater risk of a depressive diagnosis than their urban counterparts. This randomized clinical trial tested whether telephone-administered interpersonal psychotherapy (tele-IPT) acutely relieved depressive symptoms in 132 HIV-infected rural persons from 28 states diagnosed with Diagnostic and Statistical Manual of Mental Disorders-IV major depressive disorder (MDD), partially remitted MDD, or dysthymic disorder. Patients were randomized to either 9 sessions of one-on-one tele-IPT (n = 70) or standard care (SC; n = 62). A series of intent-to-treat (ITT), therapy completer, and sensitivity analyses assessed changes in depressive symptoms, interpersonal problems, and social support from pre- to postintervention. Across all analyses, tele-IPT patients reported significantly lower depressive symptoms and interpersonal problems than SC controls; 22% of tele-IPT patients were categorized as a priori "responders" who reported 50% or higher reductions in depressive symptoms compared to only 4% of SC controls in ITT analyses. Brief tele-IPT acutely decreased depressive symptoms and interpersonal problems in depressed rural people living with HIV.

  17. Differences in psychiatric symptoms and barriers to mental health care between volunteer and career firefighters.

    PubMed

    Stanley, Ian H; Boffa, Joseph W; Hom, Melanie A; Kimbrel, Nathan A; Joiner, Thomas E

    2017-01-01

    Firefighters are at increased risk for mental health problems. However, little is known about differences in psychiatric symptoms between volunteer and career firefighters. This study aimed to (1) describe differences in psychiatric symptoms and barriers to mental health care between U.S. firefighters in volunteer-only and career-only departments; and (2) determine if greater self-reported structural barriers to mental health care (e.g., cost, availability of resources) explain the differences in psychiatric symptom levels. Overall, 525 current U.S. firefighters participated. Analyses of covariance and logistic regression analyses were used to evaluate group differences between volunteer (n=204) and career (n=321) firefighters, adjusting for demographic and occupational characteristics. Volunteer firefighters reported significantly elevated levels of depression, posttraumatic stress, and suicidal symptoms compared to career firefighters. Career firefighters reported relatively elevated levels of problematic alcohol use. Volunteer firefighters additionally reported greater structural barriers to mental health care (e.g., cost, availability of resources), and these barriers accounted for the differences in mental health variables between volunteer and career firefighters. Findings suggest that volunteer firefighters report elevated psychiatric symptoms compared to career firefighters and greater structural barriers to mental health treatment may explain this link. Increased efforts are needed to develop firefighter-specific interventions and bolster mental health service utilization.

  18. Changes in health behaviors and their associations with depressive symptoms among Israelis aged 50 +

    PubMed Central

    Khalaila, Rabia; Litwin, Howard

    2014-01-01

    Objective To examine the longitudinal association between changes in health behaviors and depression, and to determine the mediating effect of health characteristics on this association. Method Based on the first and second waves of the Survey of Health, Aging and Retirement in Europe (SHARE)-Israel, depressive symptoms of 1,524 Israelis aged 50 or older were analyzed using logistic regression. Results Changes in physical activity and body weight are associated with depressive symptoms after adjusting for confounders. However, after adding measures of health, the respective correlations of weight gain and commenced physical activity with depression disappear, and the correlation between continued activity and depression is reduced. Discussion Changes in health behaviors are related to mental health in late life, but their effect is mediated by physical and functional health. Future interventions should nevertheless target older individuals who stop physical activity and those who remain inactive to lessen the risk of depression. PMID:24401321

  19. The impact of loneliness on self-rated health symptoms among victimized school children

    PubMed Central

    2012-01-01

    Background Loneliness is associated with peer victimization, and the two adverse experiences are both related to ill health in childhood and adolescence. There is, however, a lack of knowledge on the importance of loneliness among victimized children. Therefore, possible modifying effects of loneliness on victimized school children’s self-rated health were assessed. Methods A population based cross-section study included 419 children in grades 1–10 from five schools. The prevalence of loneliness and victimization across grades was analyzed by linear test for trend, and associations of the adverse experiences with four health symptoms (sadness, anxiety, stomach ache, and headache) were estimated by logistic regression. Results In crude regression analysis, both victimization and loneliness showed positive associations with all the four health symptoms. However, in multivariable analysis, the associations of victimization with health symptoms were fully attenuated except for headache. In contrast, loneliness retained about the same strength of associations in the multivariable analysis as in the crude analysis. More detailed analyses demonstrated that children who reported both victimization and loneliness had three to seven times higher prevalence of health symptoms compared to children who reported neither victimization nor loneliness (the reference group). Rather surprisingly, victimized children who reported no loneliness did not have any higher prevalence of health symptoms than the reference group, whereas lonely children without experiences of victimization had almost the same prevalence of health symptoms (except for stomach ache) as children who were both victimized and lonely. Conclusions Adverse effects of loneliness need to be highlighted, and for victimized children, experiences of loneliness may be an especially harsh risk factor related to ill health. PMID:22643050

  20. Perfusion-CT - Can We Predict Acute Pancreatitis Outcome within the First 24 Hours from the Onset of Symptoms?

    PubMed Central

    Pieńkowska, Joanna; Gwoździewicz, Katarzyna; Skrobisz-Balandowska, Katarzyna; Marek, Iwona; Kostro, Justyna; Szurowska, Edyta; Studniarek, Michał

    2016-01-01

    Purpose Severe acute pancreatitis (AP) is still a significant clinical problem which is associated with a highly mortality. The aim of this study was the evaluation of prognostic value of CT regional perfusion measurement performed on the first day of onset of symptoms of AP, in assessing the risk of developing severe form of acute pancreatitis. Material and Methods 79 patients with clinical symptoms and biochemical criteria indicative of acute pancreatitis (acute upper abdominal pain, elevated levels of serum amylase and lipase) underwent perfusion CT within 24 hours after onset of symptoms. The follow-up examinations were performed after 4–6 days to detect progression of the disease. Perfusion parameters were compared in 41 people who developed severe form of AP (pancreatic and/or peripancreatic tissue necrosis) with parameters in 38 consecutive patients in whom course of AP was mild. Blood flow, blood volume, mean transit time and permeability surface area product were calculated in the three anatomic pancreatic subdivisions (head, body and tail). At the same time the patient's clinical status was assessed by APACHE II score and laboratory parameters such as CRP, serum lipase and amylase, AST, ALT, GGT, ALP and bilirubin were compared. Results Statistical differences in the perfusion parameters between the group of patients with mild and severe AP were shown. Blood flow, blood volume and mean transit time were significantly lower and permeability surface area product was significantly higher in patients who develop severe acute pancreatitis and presence of pancreatic and/or peripancreatic necrosis due to pancreatic ischemia. There were no statistically significant differences between the two groups in terms of evaluated on admission severity of pancreatitis assessed using APACHE II score and laboratory tests. Conclusions CT perfusion is a very useful indicator for prediction and selection patients in early stages of acute pancreatitis who are at risk of

  1. Passive smoking, air pollution, and acute respiratory symptoms in a diary study of student nurses

    SciTech Connect

    Schwartz, J.; Zeger, S. )

    1990-01-01

    A cohort of approximately 100 student nurses in Los Angeles was recruited for a diary study of the acute effects of air pollution. Smoking histories and presence of asthma and other allergies were determined by questionnaire. Diaries were completed daily and collected weekly for as long as 3 yr. Air pollution was measured at a monitoring location within 2.5 miles of the school. Incidence and duration of a symptom were modeled separately. Pack-years of cigarettes were predictive of the number of episodes of coughing (p less than 0.0001) and of bringing up phlegm (p less than 0.0001). Current smoking, rather than cumulative smoking, was a better predictor of the duration of a phlegm episode (p less than 0.0001). Controlling for personal smoking, a smoking roommate increased the risk of an episode of phlegm (odds ratio (OR) = 1.41, p less than 0.001), but not of cough. Excluding asthmatics (who may be medicated), increased the odds ratio for passive smoking to 1.76 (p less than 0.0001). In logistic regression models controlling for temperature and serial correlation between days, an increase of 1 SD in carbon monoxide exposure (6.5 ppm) was associated with increased risk of headache (OR = 1.09, p less than 0.001), photochemical oxidants (7.4 pphm) were associated with increased risk of chest discomfort (OR = 1.17, p less than 0.001) and eye irritation (OR = 1.20 p less than 0.001), and nitrogen dioxide (9.1 pphm) was associated with increased risk of phlegm (OR = 1.08 p less than 0.01), sore throats (OR = 1.26, p less than 0.001), and eye irritation (OR = 1.16, p less than 0.001).

  2. A content validity study of signs, symptoms and diseases/health problems expressed in LIBRAS1

    PubMed Central

    Aragão, Jamilly da Silva; de França, Inacia Sátiro Xavier; Coura, Alexsandro Silva; de Sousa, Francisco Stélio; Batista, Joana D'arc Lyra; Magalhães, Isabella Medeiros de Oliveira

    2015-01-01

    Objectives: to validate the content of signs, symptoms and diseases/health problems expressed in LIBRAS for people with deafness Method: methodological development study, which involved 36 people with deafness and three LIBRAS specialists. The study was conducted in three stages: investigation of the signs, symptoms and diseases/health problems, referred to by people with deafness, reported in a questionnaire; video recordings of how people with deafness express, through LIBRA, the signs, symptoms and diseases/health problems; and validation of the contents of the recordings of the expressions by LIBRAS specialists. Data were processed in a spreadsheet and analyzed using univariate tables, with absolute frequencies and percentages. The validation results were analyzed using the Content Validity Index (CVI). Results: 33 expressions in LIBRAS, of signs, symptoms and diseases/health problems were evaluated, and 28 expressions obtained a satisfactory CVI (1.00). Conclusions: the signs, symptoms and diseases/health problems expressed in LIBRAS presented validity, in the study region, for health professionals, especially nurses, for use in the clinical anamnesis of the nursing consultation for people with deafness. PMID:26625991

  3. Cumulative violence exposure, emotional nonacceptance, and mental health symptoms in a community sample of women.

    PubMed

    Sundermann, Jane M; Chu, Ann T; DePrince, Anne P

    2013-01-01

    Women exposed to more types of violence (e.g., emotional, physical, or sexual violence)--referred to here as cumulative violence exposure--are at risk for more severe mental health symptoms compared to women who are exposed to a single type of violence or no violence. Women exposed to violence may also experience greater emotional nonacceptance compared to women with no exposure to violence. Emotional nonacceptance refers to an unwillingness to experience emotional states, including cognitive and behavioral attempts to avoid experiences of emotion. Given the links between cumulative violence exposure, emotional nonacceptance, and mental health symptoms among female victims of violence, the current study tested victims' emotional nonacceptance as a partial mediator between cumulative violence exposure and the severity of 3 types of symptoms central to complex trauma responses: depression, dissociation, and posttraumatic stress disorder (PTSD) symptoms. A non-treatment-seeking community sample of women (N = 89; M age = 30.70 years) completed self-report questionnaires and interviews. Bootstrap procedures were then used to test 3 mediation models for the separate predictions of depression, dissociation, and PTSD symptoms. Results supported our hypotheses that emotional nonacceptance would mediate the relationship between women's cumulative violence exposure and severity for all symptom types. The current findings highlight the role that emotional nonacceptance may play in the development of mental health symptoms for chronically victimized women and point to the need for longitudinal research in such populations.

  4. Mental health symptoms and their relationship to cannabis use in adolescents attending residential treatment.

    PubMed

    Albertella, Lucy; Norberg, Melissa M

    2012-01-01

    The present study examined mental health symptoms and their relationship to cannabis use and treatment outcomes in a sample of adolescents who received treatment for cannabis dependence through a residential substance use program. The sample included 132 adolescents who nominated cannabis as their primary drug of concern upon admission and who completed at least 30 days of treatment. This study found that mental health symptoms of young cannabis users reduced significantly from admission to three-month follow-up. Further, pretreatment symptoms of anxiety were associated with greater pretreatment cannabis use, while symptoms of phobic anxiety were associated with less pretreatment cannabis use. Pretreatment obsessive-compulsive and somatization symptoms were associated with greater follow-up cannabis use, whereas pretreatment paranoid ideation symptoms were associated with less follow-up cannabis use. Further, follow-up somatization, obsessive-compulsive symptoms, hostility, and phobic anxiety were associated with greater follow-up cannabis use while follow-up symptoms of interpersonal sensitivity were associated with less follow-up cannabis use. These findings highlight a variety of areas for further investigation in order to enhance current treatment for cannabis use.

  5. Perceived Racial/Ethnic Discrimination, Posttraumatic Stress Symptoms, and Health Risk Behaviors among Mexican American Adolescents

    ERIC Educational Resources Information Center

    Flores, Elena; Tschann, Jeanne M.; Dimas, Juanita M.; Pasch, Lauri A.; de Groat, Cynthia L.

    2010-01-01

    Utilizing the concept of race-based traumatic stress, this study tested whether posttraumatic stress symptoms explain the process by which perceived discrimination is related to health risk behaviors among Mexican American adolescents. One hundred ten participants were recruited from a large health maintenance organization in Northern California.…

  6. Child anxiety symptoms related to longitudinal cortisol trajectories and acute stress responses: evidence of developmental stress sensitization.

    PubMed

    Laurent, Heidemarie K; Gilliam, Kathryn S; Wright, Dorianne B; Fisher, Philip A

    2015-02-01

    Cross-sectional research suggests that individuals at risk for internalizing disorders show differential activation levels and/or dynamics of stress-sensitive physiological systems, possibly reflecting a process of stress sensitization. However, there is little longitudinal research to clarify how the development of these systems over time relates to activation during acute stress, and how aspects of such activation map onto internalizing symptoms. We investigated children's (n = 107) diurnal hypothalamic-pituitary-adrenal activity via salivary cortisol (morning and evening levels) across 29 assessments spanning 6+ years, and related longitudinal patterns to acute stress responses at the end of this period (age 9-10). Associations with child psychiatric symptoms at age 10 were also examined to determine internalizing risk profiles. Increasing morning cortisol levels across assessments predicted less of a cortisol decline following interpersonal stress at age 9, and higher cortisol levels during performance stress at age 10. These same profiles of high and/or sustained cortisol elevation during psychosocial stress were associated with child anxiety symptoms. Results suggest developmental sensitization to stress-reflected in rising morning cortisol and eventual hyperactivation during acute stress exposure-may distinguish children at risk for internalizing disorders.

  7. Child Anxiety Symptoms Related to Longitudinal Cortisol Trajectories and Acute Stress Responses: Evidence of Developmental Stress Sensitization

    PubMed Central

    Laurent, Heidemarie K.; Gilliam, Kathryn S.; Wright, Dorianne B.; Fisher, Philip A.

    2015-01-01

    Cross-sectional research suggests that individuals at risk for internalizing disorders show differential activation levels and/or dynamics of stress-sensitive physiological systems, possibly reflecting a process of stress sensitization. However, there is little longitudinal research to clarify how the development of these systems over time relates to activation during acute stress, and how aspects of such activation map onto internalizing symptoms. We investigated children’s (n=107) diurnal hypothalamic-pituitary-adrenal activity via salivary cortisol (morning and evening levels) across 29 assessments spanning 6+ years, and related longitudinal patterns to acute stress responses at the end of this period (age 9–10). Associations with child psychiatric symptoms at age 10 were also examined to determine internalizing risk profiles. Increasing morning cortisol levels across assessments predicted less of a cortisol decline following interpersonal stress at age 9, and higher cortisol levels during performance stress at age 10. These same profiles of high and/or sustained cortisol elevation during psychosocial stress were associated with child anxiety symptoms. Results suggest developmental sensitization to stress—reflected in rising morning cortisol and eventual hyperactivation during acute stress exposure—may distinguish children at risk for internalizing disorders. PMID:25688433

  8. Husbands’ and Wives’ Physical Activity and Depressive Symptoms: Longitudinal Findings from the Cardiovascular Health Study

    PubMed Central

    Monin, Joan K.; Levy, Becca; Chen, Baibing; Fried, Terri; Stahl, Sarah T.; Schulz, Richard; Doyle, Margaret; Kershaw, Trace

    2015-01-01

    Background When examining older adults’ health behaviors and psychological health it is important to consider the social context. Purpose To examine in older adult marriages whether each spouse’s physical activity predicted changes in their own (actor effects) and their partner’s (partner effects) depressive symptoms. Gender differences were also examined. Method Each spouse within 1,260 married couples (at baseline) in the Cardiovascular Health Study completed self-report measures at wave 1 (1989–1990), wave 3 (1992–1993), and wave 7 (1996–1997). Dyadic path analyses were performed. Results Husbands’ physical activity significantly predicted own decreased depressive symptoms (actor effect). For both spouses, own physical activity did not significantly predict the spouse’s depressive symptoms (partner effects). However, husbands’ physical activity and depressive symptoms predicted wives’ physical activity and depressive symptoms (partner effects), respectively. Depressive symptoms did not predict physical activity. Conclusion Findings suggest that husbands’ physical activity is particularly influential for older married couples’ psychological health. PMID:25868508

  9. Acute Health Impact of Air Pollution in China

    NASA Astrophysics Data System (ADS)

    Feng, T.; Zhao, Y.; Zheng, M.

    2014-12-01

    Air pollution not only has long term health impact, but can affect health through acute exposure. This paper, using air pollution index (API) as overall evaluation of air quality, blood pressure and vital capacity as health outcomes, focuses on the acute health impact of air pollution in China. Current result suggests that after controlling smoking history, occupational exposure, income and education, API is positively associated with blood pressure and negatively associated with vital capacity. The associations became stronger for people with hypertension or pulmonary functional diseases, which indicates that these people are more sensitive to air pollution. Among three pollutants which API measures, that is inhalable particles (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2), PM10 is most statistically associated with blood pressure increase and vital capacity decrease. Further study will focusing on the following two questions. The first question is how various time lags affect the associations among API, blood pressure and vital capacity. The second question is how differently people in various cohorts reacts to acute exposure to air pollution. The differences in reactions of blood pressure and vital capacity between people in urban and rural areas, genders, various age cohorts, distinct income and education groups will be further studied.

  10. [Clinical symptoms and circumastances of acute poisonings with fly agaric (Amanita muscaria) and panther cap (Amanita pantherina)].

    PubMed

    Łukasik-Głebocka, Magdalena; Druzdz, Artur; Naskret, Maciej

    2011-01-01

    Mushroom poisonings in Poland are quite common, especially in summer and autumn, but fly agaric (Amanita muscaria) and panther cap (Amanita pantherina) are rather rare cause of these intoxications. Fly agaric is a cause of deliberate poisoning, whereas panther cap poisoning also happens accidentally. The main toxins of these two mushrooms are ibotenic acid (pantherine, agarine), muscimol, muscazone and muscaridine. The other bioactive substances are stizolobic and stizolobinic acids and aminodicarboxyethylthiopropanoic acids. All these compounds are responsible for diverse picture of intoxication. An analysis of patients with Amanita muscaria and Amanita pantherina poisoning hospitalized in the Poznan Departament of Toxicology revealed that symptoms occurred after 30 minutes to 2 hours with vomiting, hallucinations, restlessness, increased psychomotor drive and central nervous system depression. Other antycholinergic symptoms like tachycardia and increased blood pressure, mydriasis, dry and red skin were seen only in a few cases. Acute respiratory failure was the most dangerous symptom observed in the course of poisoning.

  11. Mediation and Moderation: Testing Relationships between Symptom Status, Functional Health, and Quality of Life in HIV Patients

    ERIC Educational Resources Information Center

    Ryu, Ehri; West, Stephen G.; Sousa, Karen H.

    2009-01-01

    We extended Wilson and Cleary's (1995) health-related quality of life model to examine the relationships among symptom status (Symptoms), functional health (Disability), and quality of life (QOL). Using a community sample (N = 956) of male HIV positive patients, we tested a mediation model in which the relationship between Symptoms and QOL is…

  12. Health care utilization of mexican patients with medically unexplained physical symptoms

    PubMed Central

    Ramírez Aranda, José Manuel; de los Santos Reséndiz, Homero; Lara Duarte, María Yolanda; Pazaran Zanella, Santiago Oscar; Méndez López, Jafet Felipe; Gil Alfaro, Issa; Islas Ruz, Félix Gilberto; Navarrete Floriano, Gloria; Guillen Salomón, Edith; Texon Fernández, Obdulia; Cruz Duarte, Silvia; Romo Salazar, Juan Carlos; Pérez Ruiz, Claudia Elsa; López Salas, Sara de Jesús; Benítez Amaya, Lizbeth; Zapata Gallardo, Javier Nahum

    2016-01-01

    Objective: To determine the prevalence of medically unexplained physical symptoms and the characteristics and use of health services in a group of patients with medically unexplained physical symptoms and a group of patients with other illnesses. Methods: This was a cross-sectional, retrospective and multicenter study. We included 1,043 patients over 18 years of age from 30 primary care units of a government health institution, in 11 states of Mexico, attended by 39 family physicians. The prevalence of medically unexplained physical symptoms was determined and both groups with or without symptoms were compared with regard to drug use, laboratory and other studies, leaves of absence, and referrals in the last six months. The group with medically unexplained physical symptoms was diagnosed using the Patient Health Questionnaire and the diagnostic criteria of Reid et al. Emergency or terminal illnesses were excluded. The chi square test was used with a statistical significance of p < 0.05. Results: Medically unexplained physical symptoms was diagnosed in 73 patients (7.0%). The majority were women (91.8%); their predominant symptom was from the gastrointestinal system in 56 (76.7%). This group had a greater use of clinical studies and referrals to other services (mean 1.1 vs. 0.5; p <0.0001 and 0.6 vs. 0.8; p < 0.01, respectively). Conclusions: The prevalence of medically unexplained physical symptoms was low, but with a greater impact on some health services. This could represent an overload in medical costs. PMID:27821895

  13. Presenting symptoms and onset-to-arrival time in patients with acute stroke and transient ischemic attack.

    PubMed

    Gargano, Julia Warner; Wehner, Susan; Reeves, Mathew J

    2011-11-01

    Delayed arrival to the emergency department (ED) precludes most stroke patients from receiving thrombolytic treatment. Our objective in this study was to examine the association between presenting symptoms and onset-to-arrival time (ie, time between onset of symptoms to arrival at the ED) in a statewide stroke registry. Demographics, clinical data, and presenting symptoms were collected for patients with acute stroke or symptomatic transient ischemic attack (TIA) admitted to 15 Michigan hospitals (n = 1922). Polytomous logistic regression models were developed to test the association between presenting symptoms and onset-to-arrival time (classified as <2 hours, 2-6 hours, or >6 hours/unknown). Onset-to-arrival time was <2 hours in 19% of the patients, 2-6 hours in 22%, and >6 hours/unknown in 59%. Unilateral symptoms (reported by 40%) and speech difficulties (reported by 22%) were associated with increased likelihood of arriving within 2 hours (unilateral: adjusted odds ratio [aOR], 1.5; 95% confidence interval [CI], 1.1-1.9; speech: aOR, 1.6; 95% CI, 1.2-2.2). Difficulty with walking, balance, or dizziness (12%), confusion (9%), loss of consciousness (6.7%) and falls (3.4%) were associated with lower likelihood of arriving within 2 hours (walking: aOR, 0.7; 95% CI, 0.4-1.0; confusion: aOR, 0.5; 95% CI, 0.3-0.8; consciousness: aOR, 0.5; 95% CI, 0.1-0.9; falls: aOR, 0.4; 95% CI, 0.3-0.9). Presenting symptoms were strongly associated with time of arrival; patients with unilateral symptoms and speech difficulties were more likely to seek care early. Future studies should consider including more specific patient-level data to identify psychosocial and behavioral aspects of recognition and action to stroke symptoms.

  14. mHealth self-care interventions: managing symptoms following breast cancer treatment

    PubMed Central

    Axelrod, Deborah; Guth, Amber A.; Rampertaap, Kavita; El-Shammaa, Nardin; Hiotis, Karen; Scagliola, Joan; Yu, Gary; Wang, Yao

    2016-01-01

    Background Many women suffer from daily distressing symptoms related to lymphedema following breast cancer treatment. Lymphedema, an abnormal accumulation of lymph fluid in the ipsilateral body area or upper limb, remains an ongoing major health problem affecting more than 40% of 3.1 million breast cancer survivors in the United States. Patient-centered care related to lymphedema symptom management is often inadequately addressed in clinical research and practice. mHealth plays a significant role in improving self-care, patient-clinician communication, and access to health information. The-Optimal-Lymph-Flow health IT system (TOLF) is a patient-centered, web-and-mobile-based educational and behavioral mHealth interventions focusing on safe, innovative, and pragmatic electronic assessment and self-care strategies for lymphedema symptom management. The purpose of this paper is to describe the development and test of TOLF system. Methods The development of TOLF was guided by the Model of Self-Care for Lymphedema Symptom Management and designed based on principles fostering accessibility, convenience, and efficiency of mHealth system to enhance training and motivating assessment of and self-care for lymphedema symptoms. Test of TOLF was accomplished by conducting a psychometric study to evaluate reliability, validity, and efficiency of the electronic version of Breast Cancer and Lymphedema Symptom Experience Index (BCLE-SEI), a usability testing and a pilot feasibility testing of mHealth self-care interventions. Results Findings from the psychometric study with 355 breast cancer survivors demonstrated high internal consistency of the electronic version of the instrument: a Cronbach’s alpha coefficient of 0.959 for the total scale, 0.919 for symptom occurrence, and 0.946 for symptom distress. Discriminant validity of the instrument was supported by a significant difference in symptom occurrence (z=–6.938, P<0.000), symptom distress (z=–5.894, P<0.000), and total

  15. Acute-phase proteins in relation to neuropsychiatric symptoms and use of psychotropic medication in Huntington's disease.

    PubMed

    Bouwens, J A; Hubers, A A M; van Duijn, E; Cobbaert, C M; Roos, R A C; van der Mast, R C; Giltay, E J

    2014-08-01

    Activation of the innate immune system has been postulated in the pathogenesis of Huntington's disease (HD). We studied serum concentrations of C-reactive protein (CRP) and low albumin as positive and negative acute-phase proteins in HD. Multivariate linear and logistic regression was used to study the association between acute-phase protein levels in relation to clinical, neuropsychiatric, cognitive, and psychotropic use characteristics in a cohort consisting of 122 HD mutation carriers and 42 controls at first biomarker measurement, and 85 HD mutation carriers and 32 controls at second biomarker measurement. Significant associations were found between acute-phase protein levels and Total Functioning Capacity (TFC) score, severity of apathy, cognitive impairment, and the use of antipsychotics. Interestingly, all significant results with neuropsychiatric symptoms disappeared after additional adjusting for antipsychotic use. High sensitivity CRP levels were highest and albumin levels were lowest in mutation carriers who continuously used antipsychotics during follow-up versus those that had never used antipsychotics (mean difference for CRP 1.4 SE mg/L; P=0.04; mean difference for albumin 3 SE g/L; P<0.001). The associations found between acute-phase proteins and TFC score, apathy, and cognitive impairment could mainly be attributed to the use of antipsychotics. This study provides evidence that HD mutation carriers who use antipsychotics are prone to develop an acute-phase response.

  16. The Relationship between Community Violence Exposure and Mental Health Symptoms in Urban Adolescents

    PubMed Central

    McDonald, Catherine C.; Richmond, Therese R.

    2009-01-01

    Urban adolescents are exposed to a substantial amount of community violence which has the potential to influence psychological functioning. To examine the relationship between community violence exposure and mental health symptoms in urban adolescents, a literature review using MEDLINE, CINAHL, PubMed, PsycINFO, CSA Social Services, and CSA Sociological Abstracts was conducted. Search terms included adolescent/adolescence, violence, urban, mental health, well-being, emotional distress, depression, anxiety, posttraumatic stress disorder, and aggression. Twenty six empirical research articles from 1997–2007 met inclusion criteria for review. Findings indicate an influence of community violence exposure on mental health symptoms, particularly posttraumatic stress and aggression. Mediators and moderators for community violence exposure and mental health symptoms help explain relationships. Limitations in the literature are the lack of consistency in measurement and analysis of community violence exposure, including assessment of proximity and time frame of exposure, and in analysis of victimization and witnessing of community violence. Knowledge about identification of urban adolescents exposed to chronic community violence and who experience mental health symptoms is critical to mental health nursing practice and research. PMID:19012675

  17. Prospective evaluation of the effects of anxiety sensitivity and state anxiety in predicting acute nicotine withdrawal symptoms during smoking cessation.

    PubMed

    Johnson, Kirsten A; Stewart, Sherry; Rosenfield, David; Steeves, Dan; Zvolensky, Michael J

    2012-06-01

    The current investigation explored the main and interactive effects of anxiety sensitivity (AS) and state anxiety in predicting acute nicotine withdrawal symptoms experienced during the initial 14 days of smoking cessation. Participants included 123 adult daily smokers (84 women; Mage = 45.93 years, SD = 10.34) undergoing psychosocial-pharmacological cessation treatment. Results indicated that after controlling for the effects of participant sex and nicotine dependence, state anxiety but not AS significantly predicted initial levels of nicotine withdrawal symptoms. Results also demonstrated that both state anxiety and AS were significantly related to the change in nicotine withdrawal symptoms over time. Finally, our results revealed a significant interaction between AS and state anxiety. Specifically, higher levels of AS were associated with a stronger relation between state anxiety and nicotine withdrawal symptoms experienced during the cessation attempt. Results suggest that among high AS persons, state anxiety may be more relevant, compared to those low in AS, in regard to experiencing withdrawal symptoms as more intense during the early phases of quitting.

  18. Effects of Single Bouts of Walking Exercise and Yoga on Acute Mood Symptoms in People with Multiple Sclerosis

    PubMed Central

    Ensari, Ipek; Sandroff, Brian M.

    2016-01-01

    Background: Little is known about the acute or immediate effects of walking exercise and yoga on mood in people with multiple sclerosis (MS). Such an examination is important for identifying an exercise modality for inclusion in exercise-training interventions that yields mood benefits in MS. We examined the effects of single bouts of treadmill walking and yoga compared with a quiet, seated-rest control condition on acute mood symptoms in MS. Methods: Twenty-four participants with MS completed 20 minutes of treadmill walking, yoga, or quiet rest in a randomized, counterbalanced order with 1 week between sessions. Participants completed the Profile of Mood States questionnaire before and immediately after each condition. Total mood disturbance (TMD) and the six subscales of the Profile of Mood States were analyzed using repeated-measures analysis of variance and paired-samples t tests. Results: There was a significant condition × time interaction on TMD scores (ηp2 = 0.13). Walking and yoga conditions yielded comparable reductions in TMD scores. There was a significant condition × time interaction on vigor (ηp2 = 0.23) whereby walking but not yoga yielded an improvement in vigor. There was a significant main effect of time on anger, confusion, depression, and tension (P < .05) but not on fatigue. Conclusions: Walking and yoga yielded similar improvements in overall acute mood symptoms, and walking improved feelings of vigor. These effects should be further investigated in long-term exercise-training studies. PMID:26917992

  19. Symptoms of Mental Health Problems: Children's and Adolescents' Understandings and Implications for Gender Differences in Help Seeking

    ERIC Educational Resources Information Center

    MacLean, Alice; Hunt, Kate; Sweeting, Helen

    2013-01-01

    Amidst concerns that young people's mental health is deteriorating, it is important to explore their understandings of symptoms of mental health problems and beliefs around help seeking. Drawing on focus group data from Scottish school pupils, we demonstrate how they understood symptoms of mental health problems and how their characterisations of…

  20. Posterior and prefrontal contributions to the development posttraumatic stress disorder symptom severity: an fMRI study of symptom provocation in acute stress disorder.

    PubMed

    Cwik, Jan C; Sartory, Gudrun; Nuyken, Malte; Schürholt, Benjamin; Seitz, Rüdiger J

    2016-07-25

    Acute stress disorder (ASD) is predictive of the development of posttraumatic stress disorder (PTSD). In response to symptom provocation, the exposure to trauma-related pictures, ASD patients showed increased activation of the medial posterior areas of precuneus and posterior cingulate cortex as well as of superior prefrontal cortex in a previous study. The current study aimed at investigating which activated areas are predictive of the development of PTSD. Nineteen ASD patients took part in an fMRI study in which they were shown personalized trauma-related and neutral pictures within 4 weeks of the traumatic event. They were assessed for severity of PTSD 4 weeks later. Activation contrasts between trauma-related and neutral pictures were correlated with subsequent PTSD symptom severity. Greater activation in, among others, right medial precuneus, left retrosplenial cortex, precentral and right superior temporal gyrus as well as less activation in lateral, superior prefrontal and left fusiform gyrus was related to subsequently increased PTSD severity. The results are broadly in line with neural areas related to etiological models of PTSD, namely multisensory associative learning recruiting posterior regions on the one hand and failure to reappraise maladaptive cognitions, thought to involve prefrontal areas, on the other.

  1. Symptoms of Common Mental Disorders and Adverse Health Behaviours in Male Professional Soccer Players.

    PubMed

    Gouttebarge, Vincent; Aoki, Haruhito; Kerkhoffs, Gino

    2015-12-22

    To present time, scientific knowledge about symptoms of common mental disorders and adverse health behaviours among professional soccer players is lacking. Consequently, the aim of the study was to determine the prevalence of symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance) and adverse health behaviours (adverse alcohol behaviour, smoking, adverse nutrition behaviour) among professional soccer players, and to explore their associations with potential stressors (severe injury, surgery, life events and career dissatisfaction). Cross-sectional analyses were conducted on baseline questionnaires from an ongoing prospective cohort study among male professional players. Using validated questionnaires to assess symptoms of common mental disorders and adverse health behaviours as well as stressors, an electronic questionnaire was set up and distributed by players' unions in 11 countries from three continents. Prevalence of symptoms of common mental disorders and adverse health behaviours among professional soccer players ranged from 4% for smoking and 9% for adverse alcohol behaviour to 38% for anxiety/depression and 58% for adverse nutrition behaviour. Significant associations were found for a higher number of severe injuries with distress, anxiety/depression, sleeping disturbance and adverse alcohol behaviour, an increased number of life events with distress, sleeping disturbance, adverse alcohol behaviour and smoking, as well as an elevated level of career dissatisfaction with distress, anxiety/depression and adverse nutrition behaviour. Statistically significant correlations (p<0.01) were found for severe injuries and career dissatisfaction with most symptoms of common mental disorders. High prevalence of symptoms of common mental disorders and adverse health behaviours was found among professional players, confirming a previous pilot-study in a similar study population.

  2. Symptoms of Common Mental Disorders and Adverse Health Behaviours in Male Professional Soccer Players

    PubMed Central

    Gouttebarge, Vincent; Aoki, Haruhito; Kerkhoffs, Gino

    2015-01-01

    To present time, scientific knowledge about symptoms of common mental disorders and adverse health behaviours among professional soccer players is lacking. Consequently, the aim of the study was to determine the prevalence of symptoms of common mental disorders (distress, anxiety/depression, sleep disturbance) and adverse health behaviours (adverse alcohol behaviour, smoking, adverse nutrition behaviour) among professional soccer players, and to explore their associations with potential stressors (severe injury, surgery, life events and career dissatisfaction). Cross-sectional analyses were conducted on baseline questionnaires from an ongoing prospective cohort study among male professional players. Using validated questionnaires to assess symptoms of common mental disorders and adverse health behaviours as well as stressors, an electronic questionnaire was set up and distributed by players’ unions in 11 countries from three continents. Prevalence of symptoms of common mental disorders and adverse health behaviours among professional soccer players ranged from 4% for smoking and 9% for adverse alcohol behaviour to 38% for anxiety/depression and 58% for adverse nutrition behaviour. Significant associations were found for a higher number of severe injuries with distress, anxiety/depression, sleeping disturbance and adverse alcohol behaviour, an increased number of life events with distress, sleeping disturbance, adverse alcohol behaviour and smoking, as well as an elevated level of career dissatisfaction with distress, anxiety/depression and adverse nutrition behaviour. Statistically significant correlations (p<0.01) were found for severe injuries and career dissatisfaction with most symptoms of common mental disorders. High prevalence of symptoms of common mental disorders and adverse health behaviours was found among professional players, confirming a previous pilot-study in a similar study population. PMID:26925182

  3. Mental health nurses' views of recovery within an acute setting.

    PubMed

    Cleary, Michelle; Horsfall, Jan; O'Hara-Aarons, Maureen; Hunt, Glenn E

    2013-06-01

    How the principles of a recovery-oriented mental health service are incorporated in the day-to-day nursing practice of mental health nurses in inpatient settings is unclear. In this study, we interviewed 21 mental health nurses working in acute inpatient mental health units about a range of recovery-focused topics. Three overlapping themes were identified: (i) the perception of recovery; (ii) congruent humanistic approaches; and (iii) practical realities. Only four interviewees had some formal training about recovery. Most respondents recognize that positive attitudes, person-centred care, hope, education about mental illness, medication and side-effects, and the acknowledgement of individual recovery pathways are necessary to prevent readmission, and are central to a better life for people who live with a mental illness. This research supports the view that ideas and practices associated with the recovery movement have been adopted to some degree by nurses working at the acute end of the services continuum. However, most saw the recovery orientation as rhetoric rather than as an appropriately resourced, coordinated, and integrated program. These nurses, however, speak of much more detailed aspects of working with patients and being required to prepare them for the exigencies of living in the community post-discharge.

  4. Estimating Health Conditions for Small Areas: Asthma Symptom Prevalence for State Legislative Districts

    PubMed Central

    Mendez-Luck, Carolyn A; Yu, Hongjian; Meng, Ying-Ying; Jhawar, Mona; Wallace, Steven P

    2007-01-01

    Research Objective To create prevalence estimates of asthma symptoms for California legislative districts. Data Sources. Three main data sources were used for this study: 2001 California Health Interview Survey, 2000 Census, and 2000–2002 March Current Population Surveys. Study Design Secondary data analyses were conducted from cross-sectional data to distribute the joint probability of ever having an asthma diagnosis and symptoms in the last 12 months within an Assembly district. We applied hierarchical logistic regressions to estimate the parameters for selected survey and census data that predicted the probabilities of diagnosed asthmatics with asthma symptoms. Predictors included individual-level variables and contextual variables at zip code levels. Principal Findings Asthma symptom prevalence geographically varied by age within and across Assembly districts throughout California. Conclusions With modest investments in establishing analytic data files and estimating regression parameters for target conditions, small area estimation (SAE) procedures can create health data estimates not otherwise available at the sub-county level. Applying SAE procedures to asthma symptom prevalence suggest that these data can become essential reference tools for advocates and policy makers currently addressing this and other public health concerns in the state. PMID:17995549

  5. An Integrated Review of Psychological Stress in Parkinson's Disease: Biological Mechanisms and Symptom and Health Outcomes.

    PubMed

    Austin, Kim Wieczorek; Ameringer, Suzanne Weil; Cloud, Leslie Jameleh

    2016-01-01

    Parkinson's disease (PD) is characterized by complex symptoms and medication-induced motor complications that fluctuate in onset, severity, responsiveness to treatment, and disability. The unpredictable and debilitating nature of PD and the inability to halt or slow disease progression may result in psychological stress. Psychological stress may exacerbate biological mechanisms believed to contribute to neuronal loss in PD and lead to poorer symptom and health outcomes. The purpose of this integrated review is to summarize and appraise animal and human research studies focused on biological mechanisms, symptom, and health outcomes of psychological stress in PD. A search of the electronic databases PubMed/Medline and CINAHL from 1980 to the present using the key words Parkinson's disease and stress, psychological stress, mental stress, and chronic stress resulted in 11 articles that met inclusion criteria. The results revealed significant associations between psychological stress and increased motor symptom severity and loss of dopamine-producing neurons in animal models of PD and between psychological stress and increased symptom severity and poorer health outcomes in human subjects with PD. Further research is needed to fully elucidate the underlying biological mechanisms responsible for these relationships, for the ultimate purpose of designing targeted interventions that may modify the disease trajectory.

  6. An Integrated Review of Psychological Stress in Parkinson's Disease: Biological Mechanisms and Symptom and Health Outcomes

    PubMed Central

    2016-01-01

    Parkinson's disease (PD) is characterized by complex symptoms and medication-induced motor complications that fluctuate in onset, severity, responsiveness to treatment, and disability. The unpredictable and debilitating nature of PD and the inability to halt or slow disease progression may result in psychological stress. Psychological stress may exacerbate biological mechanisms believed to contribute to neuronal loss in PD and lead to poorer symptom and health outcomes. The purpose of this integrated review is to summarize and appraise animal and human research studies focused on biological mechanisms, symptom, and health outcomes of psychological stress in PD. A search of the electronic databases PubMed/Medline and CINAHL from 1980 to the present using the key words Parkinson's disease and stress, psychological stress, mental stress, and chronic stress resulted in 11 articles that met inclusion criteria. The results revealed significant associations between psychological stress and increased motor symptom severity and loss of dopamine-producing neurons in animal models of PD and between psychological stress and increased symptom severity and poorer health outcomes in human subjects with PD. Further research is needed to fully elucidate the underlying biological mechanisms responsible for these relationships, for the ultimate purpose of designing targeted interventions that may modify the disease trajectory. PMID:28058129

  7. Perceived racial/ethnic discrimination, posttraumatic stress symptoms, and health risk behaviors among Mexican American adolescents.

    PubMed

    Flores, Elena; Tschann, Jeanne M; Dimas, Juanita M; Pasch, Lauri A; de Groat, Cynthia L

    2010-07-01

    Utilizing the concept of race-based traumatic stress, this study tested whether posttraumatic stress symptoms explain the process by which perceived discrimination is related to health risk behaviors among Mexican American adolescents. One hundred ten participants were recruited from a large health maintenance organization in Northern California. Mediational analyses indicated that adolescents who perceived more discrimination reported worse posttraumatic stress symptoms, controlling for covariates. In turn, adolescents who experienced heightened posttraumatic stress symptoms reported more alcohol use, more other drug use, involvement in more fights, and more sexual partners. Perceived discrimination was also directly related to involvement in more fights. Results provide support for the notion of race-based traumatic stress, specifically, that perceived discrimination may be traumatizing for Mexican American adolescents. Counseling psychologists and counselors in schools and community settings should assess Mexican American adolescents for the effects of discrimination and provide appropriate interventions to reduce its negative emotional impact.

  8. Relationship between job stress and subjective oral health symptoms in male financial workers in Japan

    PubMed Central

    YOSHINO, Koichi; SUZUKI, Seitaro; ISHIZUKA, Yoichi; TAKAYANAGI, Atsushi; SUGIHARA, Naoki; KAMIJYO, Hideyuki

    2016-01-01

    Objective: The aim was to assess subjective oral health symptoms and job stress, as measured by self-assessment of how demanding the job is, in male financial workers. Methods: The participants were recruited by applying screening procedures to a pool of Japanese registrants in an online database. For the stress check, 7 items about how demanding the job is were selected from The Brief Job Stress Questionnaire (BJSQ). Participants comprised a total of 950 financial male workers, ages 25 to 64. Results: Participants who answered “I can’t complete my work in the required time” had more decayed teeth (p=0.010). Participants who felt that their job is highly demanding (answered affirmatively to 6 or all 7 items) were more likely to report “often get food stuck between teeth” (p=0.030), “there are some foods I can’t eat” (p=0.005), “bad breath” (p=0.032), and “jaw makes clicking sound” (p=0.032). The independent variable of total stress score of 24–28 was found to be correlated to at least three oral health symptoms (OR: 3.25; 95%CI: 1.66–6.35). Conclusion: These results indicate that certain job stress factors are associated with certain oral health symptoms, and that oral health symptoms are likely predictors of job stress. PMID:27840370

  9. Life-space mobility, perceived health, and depression symptoms in a sample of Mexican older adults.

    PubMed

    González, Bertha Cecilia Salazar; Delgado, Leticia Hernández; Quevedo, Juana Edith Cruz; Gallegos Cabriales, Esther C

    2013-01-01

    Mobility in older adults is essential to preserving their physical independence and health. Changes in mobility are related to cognitive, physical, and emotional factors, among others. We explored symptoms of depression as a mediator variable between chronic diseases and comorbidities and the outcomes of perceived health and life-space mobility in a convenience sample of 135 older Mexican adults. A cross-sectional design was used. Simple and multiple linear regression models were adjusted to verify the assumptions of mediation using Baron and Kenny's model. Chronic diseases and comorbidities served as independent variables in two separate models, perceived health and life-space mobility served as dependent variables, and depressive symptoms as the mediator variable. Results showed that perceived health and life-space mobility are affected by chronic diseases and comorbidities. However, when symptoms of depression enter the equation, the β coefficients decreased suggesting partial mediation. It is important to assess and treat depression symptoms in older adults rather than assuming that, at their age, depression is normal.

  10. Depressive Symptoms and Mental Health Treatment in an Ethnoracially Diverse College Student Sample

    ERIC Educational Resources Information Center

    Herman, Steve; Archambeau, Olga G.; Deliramich, Aimee N.; Kim, Bryan S. K.; Chiu, Pearl H.; Frueh, B. Christopher

    2011-01-01

    Objectives: To study (a) the prevalence of depressive symptoms and (b) the utilization of mental health treatment in an ethnoracially diverse sample consisting primarily of Asian Americans, European Americans, Native Hawaiians, and Pacific Islanders. Participants: Five hundred eighty-nine college students. Method: A questionnaire packet that…

  11. Declines with Age in Childhood Asthma Symptoms and Health Care Use: An Adjustment for Evaluations

    ERIC Educational Resources Information Center

    Ko, Yi-An; Song, Peter X. K.; Clark, Noreen M.

    2014-01-01

    Rationale: Asthma is a variable condition with an apparent tendency for a natural decline in asthma symptoms and health care use occurring as children age. As a result, asthma interventions using a pre-post design may overestimate the intervention effect when no proper control group is available. Objectives: Investigate patterns of natural decline…

  12. Israeli acute paralysis virus associated paralysis symptoms, viral tissue distribution and Dicer-2 induction in bumblebee workers (Bombus terrestris).

    PubMed

    Wang, Haidong; Meeus, Ivan; Smagghe, Guy

    2016-08-01

    Although it is known that Israeli acute paralysis virus (IAPV) can cause bee mortality, the symptoms of paralysis and the distribution of the virus in different body tissues and their potential to respond with an increase of the siRNA antiviral immune system have not been studied. In this project we worked with Bombus terrestris, which is one of the most numerous bumblebee species in Europe and an important pollinator for wild flowers and many crops in agriculture. Besides the classic symptoms of paralysis and trembling prior to death, we report a new IAPV-related symptom, crippled/immobilized forelegs. Reverse-transcriptase quantitative PCR showed that IAPV accumulates in different body tissues (midgut, fat body, brain and ovary). The highest levels of IAPV were observed in the fat body. With fluorescence in situ hybridization (FISH) we detected IAPV in the Kenyon cells of mushroom bodies and neuropils from both antennal and optic lobes of the brain in IAPV-infected workers. Finally, we observed an induction of Dicer-2, a core gene of the RNAi antiviral immune response, in the IAPV-infected tissues of B. terrestris workers. According to our results, tissue tropism and the induction strength of Dicer-2 could not be correlated with virus-related paralysis symptoms.

  13. Development of a user-centered health information service system for depressive symptom management.

    PubMed

    Bae, Jeongyee; Wolpin, Seth; Kim, Eunjung; Lee, Sowoo; Yoon, Sookhee; An, Kyungeh

    2009-06-01

    A user-centered, Web-based depressive symptoms management system might be particularly useful in Korea, where those who seek mental health care face stigmatizing and where personal computers and the Internet have reached saturation levels. The purpose of this article is to describe the development process of a Web-based system for depressive symptom management through user-centered design principles. Our design process included four distinct phases: a needs assessment, analysis, design/development/testing, and the application release. The final revised website was released with the URL address, "http://www.baejy.com/smiles/". In the 3 years since the site was made available publicly, it is notable that 161,604 Koreans have accessed this website, either for educational purposes or for managing their depressive symptoms. A Web-based depressive symptom management system with a high degree of usability was developed. This website can be used to assess depressive symptoms and to serve as an intervention strategy to improve mental health.

  14. The association between vasomotor symptoms and metabolic health in peri- and postmenopausal women: a systematic review.

    PubMed

    van Dijk, Gabriella M; Maneva, Manuela; Colpani, Veronica; Dhana, Klodian; Muka, Taulant; Jaspers, Loes; Kavousi, Maryam; Franco, Oscar H

    2015-02-01

    The objective of this study was to systematically review studies describing the association between vasomotor symptoms and metabolic syndrome, type 2 diabetes and insulin resistance in peri- and postmenopausal women. A systematic search of studies was performed in EMBASE, MEDLINE, Web-of-science, Scopus, PubMed publisher, Cochrane Library, Google scholar. To identify studies eligible for inclusion, the following criteria were defined: randomised trials, cohort, case-control, and cross-sectional studies investigating the association between vasomotor symptoms and metabolic syndrome, type 2 diabetes and insulin resistance in peri- and postmenopausal women with natural menopause. Methodological quality was assessed using a modified NewCastle Ottawa Assessment Scale. After screening 2660 titles and abstracts, four studies, of which two cohort studies met the criteria of high methodological quality, were included in the review. Because of the heterogeneity and the limited number of studies, there is no sufficient evidence on the potential role of vasomotor symptoms in metabolic health. However, both high-quality cohort studies, with large study populations and adjustment for multiple confounding variables showed positive associations between vasomotor symptoms and insulin resistance and type 2 diabetes mellitus. These findings suggest that there is an association between vasomotor symptoms and metabolic health outcomes. To confirm this and to strengthen the evidence, more high quality longitudinal research on this topic is needed.

  15. Relative Influence of Genetics and Shared Environment on Child Mental Health Symptoms Depends on Comorbidity

    PubMed Central

    Van Hulle, Carol A.; Lemery-Chalfant, Kathryn; Maier, Rose; Davidson, Richard J.; Goldsmith, H. Hill

    2014-01-01

    Background Comorbidity among childhood mental health symptoms is common in clinical and community samples and should be accounted for when investigating etiology. We therefore aimed to uncover latent classes of mental health symptoms in middle childhood in a community sample, and to determine the latent genetic and environmental influences on those classes. Methods The sample comprised representative cohorts of twins. A questionnaire-based assessment of mental health symptoms was used in latent class analyses. Data on 3223 twins (1578 boys and 1645 girls) with a mean age of 7.5 years were analyzed. The sample was predominantly non-Hispanic Caucasian (92.1%). Results Latent class models delineated groups of children according to symptom profiles–not necessarily clinical groups but groups representing the general population, most with scores in the normative range. The best-fitting models suggested 9 classes for both girls and boys. Eight of the classes were very similar across sexes; these classes ranged from a “Low Symptom” class to a “Moderately Internalizing & Severely Externalizing” class. In addition, a “Moderately Anxious” class was identified for girls but not boys, and a “Severely Impulsive & Inattentive” class was identified for boys but not girls. Sex-combined analyses implicated moderate genetic influences for all classes. Shared environmental influences were moderate for the “Low Symptom” and “Moderately Internalizing & Severely Externalizing” classes, and small to zero for other classes. Conclusions We conclude that symptom classes are largely similar across sexes in middle childhood. Heritability was moderate for all classes, but shared environment played a greater role for classes in which no one type of symptom predominated. PMID:25077799

  16. Job stress, burnout, depression symptoms, and physical health among Chinese university teachers.

    PubMed

    Zhong, Jie; You, Jianing; Gan, Yiqun; Zhang, Yiwen; Lu, Changqin; Wang, Hongbo

    2009-12-01

    The aim of the present study was to investigate the relationships among job stress, burnout, depression, and health among university teachers in China. Using a stratified random sampling method, a sample of 300 university teachers completed the Occupational Stress Indicator-2 (OSI-2), Maslach Burnout Inventory-General Survey (MBI-GS), Beck Depression Inventory (BDI), and 36-item Short Form Health Survey (SF-36). Path analysis showed that burnout was a mediator among job stress, the occurrence and exacerbation of depressive symptoms, and poor physical health.

  17. Association between N-terminal proB-type Natriuretic Peptide and Depressive Symptoms in Patients with Acute Myocardial Infarction

    PubMed Central

    Ren, Yan; Jia, Jiao; Sa, Jian; Qiu, Li-Xia; Cui, Yue-Hua; Zhang, Yue-An; Yang, Hong; Liu, Gui-Fen

    2017-01-01

    Background: While depression and certain cardiac biomarkers are associated with acute myocardial infarction (AMI), the relationship between them remains largely unexplored. We examined the association between depressive symptoms and biomarkers in patients with AMI. Methods: We performed a cross-sectional study using data from 103 patients with AMI between March 2013 and September 2014. The levels of depression, N-terminal proB-type natriuretic peptide (NT-proBNP), and troponin I (TnI) were measured at baseline. The patients were divided into two groups: those with depressive symptoms and those without depressive symptoms according to Zung Self-rating Depression Scale (SDS) score. Baseline comparisons between two groups were made using Student's t-test for continuous variables, Chi-square or Fisher's exact test for categorical variables, and Wilcoxon test for variables in skewed distribution. Binomial logistic regression and multivariate linear regression were performed to assess the association between depressive symptoms and biomarkers while adjusting for demographic and clinical variables. Results: Patients with depressive symptoms had significantly higher NT-proBNP levels as compared to patients without depressive symptoms (1135.0 [131.5, 2474.0] vs. 384.0 [133.0, 990.0], Z = −2.470, P = 0.013). Depressive symptoms were associated with higher NT-proBNP levels (odds ratio [OR] = 2.348, 95% CI: 1.344 to 4.103, P = 0.003) and higher body mass index (OR = 1.169, 95% confidence interval [CI]: 1.016 to 1.345, P = 0.029). The total SDS score was associated with the NT-proBNP level (β = 0.327, 95% CI: 1.674 to 6.119, P = 0.001) after multivariable adjustment. In particular, NT-proBNP was associated with three of the depressive dimensions, including core depression (β = 0.299, 95% CI: 0.551 to 2.428, P = 0.002), cognitive depression (β = 0.320, 95% CI: 0.476 to 1.811, P = 0.001), and somatic depression (β = 0.333, 95% CI: 0.240 to 0.847, P = 0.001). Neither the

  18. "Aging males" symptoms and general health of adult males: a cross-sectional study.

    PubMed

    Yuen, John W; Ng, Chi-Fai; Chiu, Peter Ka Fung; Teoh, Jeremy Yuen Chun; Yee, C H

    2016-06-01

    A cross-sectional study was conducted to explore the prevalence and severity of health-related complaints perceived by adult males of Hong Kong by using the Hong Kong Traditional Chinese versions of the Aging males' symptoms (AMS) scale and the 5-dimensional and 3-level European Quality of life (EQ-5D-3L) questionnaire. A total of 825 adult males aged 40 years or above were surveyed, and observed that 80% of the population was living with little-to-mild levels of aging symptoms with mean total scores ranged between 26.02 ± 7.91 and 32.99 ± 7.91 in different age groups. Such symptoms were correlated with age, especially for the somato-vegetative and sexual symptoms. The most severe AMS symptoms were observed in the oldest age group at 70 years or above, with 76%, 34% and 70% living with moderate-to-severe levels of somato-vegetative, psychological and sexual symptoms, respectively. The result was highly correlated with the EQ-5D-3L questionnaire. Secondly, the Hong Kong Aging males' symptoms (AMS) scale was shown to have good reliability with test-retest coefficient at 0.79 (ranged 0.66-0.87) and Cronbach's alpha coefficient at 0.88 (ranged 0.70-0.84). In summary, the population of Hong Kong male adults was commonly living with little-to-mild levels of aging symptoms, whereas their severity was correlated with age.

  19. Ecological Momentary Assessment of Acute Alcohol Use Disorder Symptoms: Associations With Mood, Motives, and Use on Planned Drinking Days

    PubMed Central

    Dvorak, Robert D.; Pearson, Matthew R.; Day, Anne M.

    2015-01-01

    Several theories posit that alcohol is consumed both in relation to one’s mood and in relation to different motives for drinking. However, there are mixed findings regarding the role of mood and motives in predicting drinking. Ecological momentary assessment (EMA) methods provide an opportunity to evaluate near real-time changes in mood and motives within individuals to predict alcohol use. In addition, endorsement of criteria of an alcohol use disorder (AUD) may also be sensitive to changes within subjects. The current study used EMA with 74 moderate drinkers who responded to fixed and random mood, motive, alcohol use, and AUD criteria prompts over a 21-day assessment period. A temporal pattern of daytime mood, evening drinking motivation, and nighttime alcohol use and acute AUD symptoms on planned drinking days was modeled to examine how these associations unfold throughout the day. The results suggest considerable heterogeneity in drinking motivation across drinking days. Additionally, an affect regulation model of drinking to cope with negative mood was observed. Specifically, on planned drinking days, the temporal association between daytime negative mood and the experience of acute AUD symptoms was mediated via coping motives and alcohol use. The current study found that motives are dynamic, and that changes in motives may predict differential drinking patterns across days. Further, the study provides evidence that emotion-regulation-driven alcohol involvement may need to be examined at the event level to fully capture the ebb and flow of negative affect motivated drinking. PMID:24932896

  20. Acute health effects of PM10 pollution on symptomatic and asymptomatic children

    SciTech Connect

    Pope, C.A. 3d.; Dockery, D.W. )

    1992-05-01

    This study assessed the association between daily changes in respiratory health and respirable particulate pollution (PM10) in Utah Valley during the winter of 1990-1991. During the study period, 24-h PM10 concentrations ranged from 7 to 251 micrograms/m3. Participants included symptomatic and asymptomatic samples of fifth- and sixth-grade students. Relatively small but statistically significant (p less than 0.01) negative associations between peak expiratory flow (PEF) and PM10 were observed for both the symptomatic and asymptomatic samples. The association was strongest for the symptomatic children. Large associations between the incidence of respiratory symptoms, especially cough, and PM10 pollution were also observed for both samples. Again the association was strongest for the symptomatic sample. Immediate and delayed PM10 effects were observed. Respiratory symptoms and PEF changes were more closely associated with 5-day moving-average PM10 levels than with concurrent-day levels. These associations were also observed at PM10 levels below the 24-h standard of 150 micrograms/m3. This study indicates that both symptomatic and asymptomatic children may suffer acute health effects of respirable particulate pollution, with symptomatic children suffering the most.

  1. Mind-Body Approaches to Treating Mental Health Symptoms Among Disadvantaged Populations: A Comprehensive Review.

    PubMed

    Burnett-Zeigler, Inger; Schuette, Stephanie; Victorson, David; Wisner, Katherine L

    2016-02-01

    Mind-body approaches are commonly used to treat a variety of chronic health conditions, including depression and anxiety. A substantial proportion of individuals with depression and anxiety disorders do not receive conventional treatment; disadvantaged individuals are especially unlikely to receive treatment. Mind-body approaches offer a potentially more accessible and acceptable alternative to conventional mental health treatment for disadvantaged individuals, who may not otherwise receive mental health treatment. This review examines evidence for the efficacy of mind-body interventions for mental health symptoms among disadvantaged populations. While rates of utilization were relatively lower for racial/ethnic minorities, evidence suggests that significant proportions of racial/ethnic minorities are using complementary health approaches as health treatments, especially prayer/healers and natural or herbal remedies. This review of studies on the efficacy of mind-body interventions among disadvantaged populations found evidence for the efficacy of mind-body approaches for several mental and physical health symptoms, functioning, self-care, and overall quality of life.

  2. Mind–Body Approaches to Treating Mental Health Symptoms Among Disadvantaged Populations: A Comprehensive Review

    PubMed Central

    Schuette, Stephanie; Victorson, David; Wisner, Katherine L.

    2016-01-01

    Abstract Mind–body approaches are commonly used to treat a variety of chronic health conditions, including depression and anxiety. A substantial proportion of individuals with depression and anxiety disorders do not receive conventional treatment; disadvantaged individuals are especially unlikely to receive treatment. Mind–body approaches offer a potentially more accessible and acceptable alternative to conventional mental health treatment for disadvantaged individuals, who may not otherwise receive mental health treatment. This review examines evidence for the efficacy of mind–body interventions for mental health symptoms among disadvantaged populations. While rates of utilization were relatively lower for racial/ethnic minorities, evidence suggests that significant proportions of racial/ethnic minorities are using complementary health approaches as health treatments, especially prayer/healers and natural or herbal remedies. This review of studies on the efficacy of mind–body interventions among disadvantaged populations found evidence for the efficacy of mind–body approaches for several mental and physical health symptoms, functioning, self-care, and overall quality of life. PMID:26540645

  3. [Acute paranoid psychotic symptoms after i.m. injection of nandrolone].

    PubMed

    Teuber, Isabel; Freiwald, Daniel; Volz, Hans-Peter

    2003-05-01

    Affective disorders and impulsivity are quite common when using anabolic substances, in this case-study one of the rather rare cases of a psychotic disorder following the abuse of androgenic steroids is described. A 30-year old formerly healthy white male was admitted as inpatient to psychiatric hospital showing symptoms of anxiety and paranoid ideation. In the last 1.5 years he had consumed androgenic steroids, directly before the onset of the first psychotic symptoms 8 weeks before admission he had received an i.m.-injection of nandrolone. Under therapy with neuroleptics the patient recovered completely within 2 months.

  4. The Impact of Demographic, Clinical, Symptom and Psychological Characteristics on the Trajectories of Acute Postoperative Pain After Total Knee Arthroplasty

    PubMed Central

    Miaskowski, Christine; Rustøen, Tone; Rosseland, Leiv Arne; Paul, Steven M.; Cooper, Bruce A.; Lerdal, Anners

    2017-01-01

    Objective. Total knee arthroplasty is a painful procedure. No studies have evaluated modifiable predictors of acute postoperative pain trajectories during hospitalization. Methods. Consecutive patients (N = 188) were enrolled in a longitudinal cohort study and completed a demographic questionnaire, as well as the Brief Pain Inventory, Hospital Depression and Anxiety Scale, Lee Fatigue Scale, Fatigue Severity Scale, and Brief Illness Perception Questionnaire on the day before surgery. Clinical data were extracted from medical records. Setting and Patients. Each patient completed a pain diary that assessed pain at rest and with activity, and hours per day in pain every evening from day of surgery until postoperative day 3. Using hierarchical linear modeling, we investigated which demographic, clinical, symptom, and psychological characteristics predicted initial levels as well as the trajectories of acute pain at rest and with activity, and hours per day in pain. Results. Higher levels of all three acute pain characteristics on the day of surgery resulted in worse trajectories. Higher pain scores with rest and with activity on the day of surgery were associated with more days with femoral block, higher average dose of opioids, and higher emotional response to osteoarthritis. Higher number of comorbidities, higher average dose of opioids, and lower perceived control predicted more hours per day in pain on the day of surgery. Conclusions. This study identified several potentially modifiable predictors of worsening pain trajectories following total knee arthroplasty. Optimal pain management warrants identification of these high-risk patients and treatment of modifiable risk factors. PMID:27165969

  5. Knowledge-based and statistically modeled relationships between residential moisture damage and occupant reported health symptoms

    NASA Astrophysics Data System (ADS)

    Haverinen, Ulla; Vahteristo, Mikko; Moschandreas, Demetrios; Nevalainen, Aino; Husman, Tuula; Pekkanen, Juha

    This study continues to develop a quantitative indicator of moisture damage induced exposure in relation to occupant health in residential buildings. Earlier, we developed a knowledge-based model that links moisture damage variables with health symptoms. This paper presents a statistical model in an effort to improve the knowledge-based model, and formulates a third, simplified model that combines aspects of the both two models. The database used includes detailed information on moisture damage from 164 houses and health questionnaire data from the occupants. Models were formulated using generalized linear model formulation procedures, with 10 moisture damage variables as possible covariates and a respiratory health symptom score as the dependent variable. An 80% random sample of the residences was used for the formulation of models and the remaining 20% were used to evaluate them. Risk ratios (RR) for the respiratory health symptom score among the 80% sample were between 1.32 (1.12-1.55) and 1.48 (1.19-1.83), calculated per 10 points index increase. For the 20% sample, RRs were between 1.71 (1.13-2.58) and 2.34 (1.69-3.23), respectively. Deviance values in relation to degrees of freedom were between 2.00-2.12 (80% sample) and 1.50-1.81 (20% sample). The models developed can be simulated as continuous variables and they all associated significantly with the symptom score, the association being verified with a subset of the database not employed in the model formulation. We concluded that the performance of all models was similar. Therefore, based on the knowledge-based and statistical models, we were able to construct a simple model that can be used in estimating the severity of moisture damage.

  6. A survey and critical review of the literature on indoor air quality, ventilation and health symptoms in schools

    SciTech Connect

    Daisey, J.M.; Angell, W.J.

    1998-03-01

    A survey and critical review were undertaken of existing published literature and reports on indoor air quality (IAQ), ventilation, and IAQ- and building-related health problems in schools, including California schools. Over 450 relevant publications were obtained and reviewed, including papers published in the archival peer-reviewed scientific literature, proceedings of scientific meetings, government reports, 77 NIOSH Health Hazard Evaluation Reports (HHER) and 70 reports on investigations of problem schools in California. Most of the reviewed literature was for complaint or problem schools. The types of health symptoms reported in schools were very similar to those defined as sick building syndrome (SBS) symptoms, although this may be due, at least in part, to the type of health symptom questionnaires used. Some of the symptoms, e.g., wheezing, are indicative of asthma. In the studies in which complaint and noncomplaint buildings or areas were compared, complaint buildings generally had higher rates of health symptoms.

  7. Modeling Acute Health Effects of Astronauts from Exposure to Large Solar Particle Events

    NASA Technical Reports Server (NTRS)

    Hu, Shaowen; Kim, Myung-Hee Y.; Cucinotta, Francis A.

    2011-01-01

    In space exploration outside the Earth s geomagnetic field, radiation exposure from solar particle events (SPE) presents a health concern for astronauts, that could impair their performance and result in possible failure of the mission. Acute risks are of special concern during extra-vehicular activities because of the rapid onset of SPE. However, most SPEs will not lead to acute risks but can lead to mission disruption if accurate projection methods are not available. Acute Radiation Sickness (ARS) is a group of clinical syndromes developing acutely (within several seconds to 3 days) after high dose whole-body or significant partial-body ionizing radiation exposures. The manifestation of these syndromes reflects the disturbance of physiological processes of various cellular groups damaged by radiation. Hematopoietic cells, skin, epithelium, intestine, and vascular endothelium are among the most sensitive tissues of human body to ionizing radiation. Most ARS symptoms are directly related to these tissues and other systems (nervous, endocrine, and cardiovascular, etc.) with coupled regulations. Here we report the progress in bio-mathematical models to describe the dose and time-dependent early human responses to ionizing radiation. The responses include lymphocyte depression, granulocyte modulation, fatigue and weakness syndrome, and upper gastrointestinal distress. The modest dose and dose-rates of SPEs are predicted to lead to large sparing of ARS, however detailed experimental data on a range of proton dose-rates for organ doses from 0.5 to 2 Gy is needed to validate the models. We also report on the ARRBOD code that integrates the BRYNTRN and SUMDOSE codes, which are used to estimate the SPE organ doses for astronauts under various space travel scenarios, with our models of ARS. The more recent effort is to provide easy web access to space radiation risk assessment using the ARRBOD code.

  8. Declines with Age in Childhood Asthma Symptoms and Health Care Use. An Adjustment for Evaluations

    PubMed Central

    Ko, Yi-An; Clark, Noreen M.

    2014-01-01

    Rationale: Asthma is a variable condition with an apparent tendency for a natural decline in asthma symptoms and health care use occurring as children age. As a result, asthma interventions using a pre-post design may overestimate the intervention effect when no proper control group is available. Objectives: Investigate patterns of natural decline over time with increasing age in asthma symptoms and health care use of children. Develop a statistical procedure that enables adjustment that accounts for expected declines in these outcomes and is useable when intervention evaluations must rely solely on pre-post data. Methods: Mixed-effects models with mixture distributions were used to describe the pattern of symptoms and health care use in 3,021 children aged 2 to 15 years in a combined sample from three controlled trials. An adaptive least squares estimation was used to account for overestimation of intervention effects and make adjustments for pre-post only data. Termed “Adjustment for Natural Declines in Asthma Outcomes (ANDAO),” the adjustment method uses bootstrap sampling to create control cohorts comparable to subjects in the intervention study from existing control subjects. ANDAO accounts for expected declines in outcomes and is beneficial when intervention evaluations must rely solely on pre-post data. Measurements and Main Results: Children under 10 years of age experienced 18% (95% confidence interval, 15–21%) fewer symptom days and 28% (95% confidence interval, 24–32%) fewer symptom nights with each additional year of age. The decline was less than 10% after age 10 years, depending on baseline asthma severity. Emergency department visits declined regardless of baseline symptom frequency (P = 0.02). The adjustment method corrected estimates to within 2.4% of true effects through simulations using control cohorts. Conclusions: Because of the declines in symptoms and health care use expected with increasing age of children with asthma, pre

  9. The World Trade Center residents' respiratory health study: new-onset respiratory symptoms and pulmonary function.

    PubMed

    Reibman, Joan; Lin, Shao; Hwang, Syni-An A; Gulati, Mridu; Bowers, James A; Rogers, Linda; Berger, Kenneth I; Hoerning, Anne; Gomez, Marta; Fitzgerald, Edward F

    2005-04-01

    The destruction of the World Trade Center (WTC) on 11 September 2001 in New York City resulted in the massive release of pulverized dust and combustion products. The dust and smoke settled in the surrounding area, which encompassed a large residential community. We hypothesized that previously normal residents in the community surrounding the former WTC would have an increased incidence of persistent respiratory symptoms and abnormalities in screening spirometry. A hybrid cross-sectional and retrospective cohort study using a symptom-based questionnaire and onsite screening spirometry in residents in an exposed area and in a control area was performed 12 +/- 4 months after the collapse. Surveys were analyzed from 2,812 residents. New-onset respiratory symptoms were described by 55.8% of residents in the exposed area, compared with 20.1% in the control area after the event. Persistent new-onset symptoms were identified in 26.4 versus 7.5% of residents in the exposed area versus control area, respectively. No differences in screening spirometry between the groups were detected. A small pilot study suggested the possibility of an increase in bronchial hyperresponsiveness in exposed participants with persistent symptoms. The data demonstrate an increased rate of new-onset and persistent respiratory health effects in residents near the former WTC compared with a control population.

  10. Kaempferol, a dietary flavonoid, ameliorates acute inflammatory and nociceptive symptoms in gastritis, pancreatitis, and abdominal pain.

    PubMed

    Kim, Shi Hyoung; Park, Jae Gwang; Sung, Gi-Ho; Yang, Sungjae; Yang, Woo Seok; Kim, Eunji; Kim, Jun Ho; Ha, Van Thai; Kim, Han Gyung; Yi, Young-Su; Kim, Ji Hye; Baek, Kwang-Soo; Sung, Nak Yoon; Lee, Mi-nam; Kim, Jong-Hoon; Cho, Jae Youl

    2015-07-01

    Kaempferol (KF) is the most abundant polyphenol in tea, fruits, vegetables, and beans. However, little is known about its in vivo anti-inflammatory efficacy and mechanisms of action. To study these, several acute mouse inflammatory and nociceptive models, including gastritis, pancreatitis, and abdominal pain were employed. Kaempferol was shown to attenuate the expansion of inflammatory lesions seen in ethanol (EtOH)/HCl- and aspirin-induced gastritis, LPS/caerulein (CA) triggered pancreatitis, and acetic acid-induced writhing.

  11. The influence of psychological symptoms on mental health literacy of college students.

    PubMed

    Kim, Jin E; Saw, Anne; Zane, Nolan

    2015-11-01

    Psychological problems, such as depression and anxiety, are common among college students, but few receive treatment for it. Mental health literacy may partially account for low rates of mental health treatment utilization. We report 2 studies that investigated mental health literacy among individuals with varying degrees of psychological symptoms, using cross-sectional online survey methodology. Study 1 involved 332 college students, of which 32% were categorized as high depressed using an established measure of depression, and mental health literacy for depression was assessed using a vignette. Logistic regression results showed that high depressed individuals were less likely to recognize depression compared to low depressed individuals, and depression recognition was associated with recommendations to seek help. Study 2 replicated and extended findings of Study 1 using a separate sample of 1,321 college students with varying degrees of psychological distress (32% no/mild distress, 55% moderate distress, and 13% serious distress) and examining mental health literacy for anxiety in addition to depression. Results indicated that compared to those with no/mild distress, those with moderate distress had lower recognition of depression, and those with moderate and serious distress were less likely to recommend help-seeking. In contrast, there were no differences in mental health literacy for anxiety, which was low across all participants. These findings suggest that psychological symptoms can impact certain aspects of mental health literacy, and these results have implications for targeting mental health literacy to increase mental health services utilization among individuals in need of help. (PsycINFO Database Record

  12. The role of acculturative stress on mental health symptoms for immigrant adolescents: a longitudinal investigation.

    PubMed

    Sirin, Selcuk R; Ryce, Patrice; Gupta, Taveeshi; Rogers-Sirin, Lauren

    2013-04-01

    Immigrant-origin adolescents represent the fastest growing segment of youth population in the United States, and in many urban schools they represent the majority of students. In this 3-wave longitudinal study, we explored trajectories of internalizing mental health symptoms (depression, anxiety, and somatic symptoms). The participants included 332 urban-residing first-and second-generation immigrant adolescents (44% male). Participants were recruited in 10th grade (Mage = 16.20 years, SD = 1.19), and 2 additional waves of data were gathered in 12-month intervals. Both generational and racial/ethnic background of the participants reflected the general demographics of urban centers in the United States. With individual growth curve modeling, the results show significant decline in internalizing mental health problems during the high school years. At the same time, greater exposure to acculturative stress predicted significantly more withdrawn, somatic, and anxious/depressed symptoms. Gender and generation status differences in internalizing mental health problems were also identified.

  13. Respiratory viruses, symptoms, and inflammatory markers in acute exacerbations and stable chronic obstructive pulmonary disease.

    PubMed

    Seemungal, T; Harper-Owen, R; Bhowmik, A; Moric, I; Sanderson, G; Message, S; Maccallum, P; Meade, T W; Jeffries, D J; Johnston, S L; Wedzicha, J A

    2001-11-01

    The effects of respiratory viral infection on the time course of chronic obstructive pulmonary disease (COPD) exacerbation were examined by monitoring changes in systemic inflammatory markers in stable COPD and at exacerbation. Eighty-three patients with COPD (mean [SD] age, 66.6 [7.1] yr, FEV(1), 1.06 [0.61] L) recorded daily peak expiratory flow rate and any increases in respiratory symptoms. Nasal samples and blood were taken for respiratory virus detection by culture, polymerase chain reaction, and serology, and plasma fibrinogen and serum interleukin-6 (IL-6) were determined at stable baseline and exacerbation. Sixty-four percent of exacerbations were associated with a cold occurring up to 18 d before exacerbation. Seventy-seven viruses (39 [58.2%] rhinoviruses) were detected in 66 (39.2%) of 168 COPD exacerbations in 53 (64%) patients. Viral exacerbations were associated with frequent exacerbators, colds with increased dyspnea, a higher total symptom count at presentation, a longer median symptom recovery period of 13 d, and a tendency toward higher plasma fibrinogen and serum IL-6 levels. Non-respiratory syncytial virus (RSV) respiratory viruses were detected in 11 (16%), and RSV in 16 (23.5%), of 68 stable COPD patients, with RSV detection associated with higher inflammatory marker levels. Respiratory virus infections are associated with more severe and frequent exacerbations, and may cause chronic infection in COPD. Prevention and early treatment of viral infections may lead to a decreased exacerbation frequency and morbidity associated with COPD.

  14. Serum biomarkers predict acute symptom burden in children after concussion: a preliminary study.

    PubMed

    Mannix, Rebekah; Eisenberg, Matthew; Berry, Mark; Meehan, William P; Hayes, Ronald L

    2014-06-01

    Pediatric emergency department (ED) visits for concussion have nearly tripled in the past decade. Despite this, there are limited bedside tools available to objectively diagnose injury and prognosticate recovery. Here, we perform a preliminary evaluation of the utility of glial fibrillary acidic protein (GFAP) in predicting initial and follow-up symptom burden in children and young adults 11-21 years of age, presenting to the ED after concussion. We enrolled 13 children and young adults presenting to the ED within 24 h of concussion, and obtained initial serum samples at that time as well as follow-up samples within 24-72 h of injury. Initial GFAP levels were associated with initial and follow-up symptom burden up to 1 month after injury, whereas follow-up GFAP levels did not correlate with symptom burden. These preliminary data suggest that GFAP may offer an objective measure of injury and recovery after pediatric concussion, potentially offering clinicians a new tool in the management of this common injury.

  15. Treatment of Acute Cough Due to the Common Cold: Multi-component, Multi-symptom Therapy is Preferable to Single-Component, Single-Symptom Therapy--A Pro/Con Debate.

    PubMed

    Eccles, Ronald; Turner, Ronald B; Dicpinigaitis, Peter V

    2016-02-01

    Acute viral upper respiratory tract infection, or, the common cold, affects essentially every human being, and cough is reported as its most frequent associated symptom. Billions of dollars are spent worldwide annually by individuals seeking relief from this multi-symptom syndrome. Thousands of non-prescription, over-the-counter products are available worldwide, aimed at relieving the various bothersome symptoms induced by the common cold. Differences of opinion exist as to whether optimal therapy for cough associated with the common cold consists of multi-component, multi-symptom cough/cold preparations, or, whether single-component medications, aimed at relief of specific symptoms, represent the optimal therapeutic approach. The 5th American Cough Conference, held in Washington, D.C. in June, 2015, provided an ideal forum for discussion and debate of this issue between two internationally recognized experts in the field of the common cold and its treatment.

  16. Treatment regimens and health care utilization in children with persistent asthma symptoms.

    PubMed

    Yoos, H Lorrie; Kitzman, Harriet; Halterman, Jill S; Henderson, Charles; Sidora-Arcoleo, Kimberly; McMullen, Ann

    2006-01-01

    This study evaluated the anti-inflammatory medication regimens in children with persistent asthma, determined their health care utilization patterns, and evaluated factors associated with failure to seek and/or receive appropriate treatment. Parents of 68% of children who qualified for anti-inflammatory medications by National Asthma Education and Prevention Program (NAEPP) guidelines reported their use. However, only 14% received an optimal regimen (mild intermittent symptoms), while 55% were still symptomatic despite reported medications (suboptimal regimen). Nearly half of symptomatic children did not have a health care visit; of those who did, 61% had no corrective action documented. Factors contributing to variations in regimen and utilization are discussed.

  17. Externalizing symptoms moderate associations among interpersonal skills, parenting, and depressive symptoms in adolescents seeking mental health treatment.

    PubMed

    Rodriguez, Erin M; Donenberg, Geri R; Emerson, Erin; Wilson, Helen W; Javdani, Shabnam

    2015-04-01

    Adolescents' interpersonal skills are associated with fewer teen depressive symptoms and more positive parenting, but little is known about how teens' externalizing problems moderate these relationships. This study examines links among teens' interpersonal skills, parenting, and withdrawn-depressed symptoms in adolescents seeking outpatient psychiatric treatment with elevated or non-elevated externalizing problems. Adolescents (N = 346; 42 % female; 61 % African-American) ages 12-19 years old (M = 14.9; SD = 1.8) and parents completed assessments at baseline and 6 months. At baseline parents and teens reported on teen withdrawn-depressed and externalizing symptoms, and were observed interacting to assess teen interpersonal skills. At 6 months adolescents reported on parenting, and parents and teens reported on teen withdrawn-depressed symptoms. Structural equation modeling tested two models (one with teen reported symptoms and one with parent reported symptoms). Model fit was better for youth with elevated externalizing problems regardless of reporter. For youth with elevated externalizing problems, baseline teen positive interpersonal skills were not directly associated with 6-month withdrawn-depressed symptoms, but more positive parenting was associated with fewer withdrawn-depressed symptoms. In the teen report model, more positive teen interpersonal skills were associated with more positive parenting, and there was a trend for parenting to indirectly account for the relationship between interpersonal skills and withdrawn-depressed symptoms. The findings extend research on the role of externalizing problems in teens' depression risk. Interventions for depression that target interpersonal skills may be particularly effective in youth with elevated externalizing problems.

  18. The Impact of Acute Urinary Retention After Iodine-125 Prostate Brachytherapy on Health-Related Quality of Life

    SciTech Connect

    Roeloffzen, Ellen M.A.; Hinnen, Karel A.; Battermann, Jan J.; Monninkhof, Evelyn M.; Roermund, Joep G.H. van; Gellekom, Marion van; Frank, Steven J.; Vulpen, Marco van

    2010-08-01

    Purpose: To evaluate the impact of acute urinary retention (AUR) in patients treated with {sup 125}I prostate brachytherapy on short- and long-term health-related quality of life (HRQOL); and to assess whether pretreatment HRQOL has additional value in the prediction of AUR. Methods and Materials: For 127 patients treated with {sup 125}I brachytherapy for localized prostate cancer between December 2000 and June 2003, toxicity and HRQOL data were prospectively collected. Patients received a HRQOL questionnaire at five time points: before and 1 month, 6 months, 1 year, and 6 years after treatment. The questionnaire included the RAND-36 generic health survey, the cancer-specific European Organization for Research and Treatment of Cancer core questionnaire (EORTC QLQ-C30), the tumor-specific EORTC prostate cancer module (EORTC QLQ-PR25), and the American Urological Association (AUA) symptom index. Results: Of 127 patients, 13 (10.2%) developed AUR. Patients with AUR had a significantly worse urinary QOL at all time points compared with patients without AUR. The mean difference over time (6 years) between both groups for the EORTC QLQ-PR25 urinary symptom score was 13.0 points (p < 0.001) and for the AUA urinary symptom score was 15.7 points (p = 0.001). Global QOL scores (EORTC QLQ-C30) over time for patients who developed AUR were significantly worse compared with patients without AUR (mean difference 6.7 points; p = 0.043). In multivariate logistic regression analysis, pretreatment International Prostate Symptom Score (p = 0.004) and neoadjuvant hormonal treatment (p = 0.034) were predictors of AUR. Quality of life did not have added predictive value. Conclusion: Acute urinary retention after prostate brachytherapy has a significant negative impact on patient's HRQOL up to 6 years after treatment, in terms of both global QOL measures and urinary symptom scores. Furthermore, our results suggest limited value of pretreatment HRQOL measures for the prediction of AUR.

  19. Health-related quality of life in early Parkinson's disease: the impact of nonmotor symptoms.

    PubMed

    Duncan, Gordon W; Khoo, Tien K; Yarnall, Alison J; O'Brien, John T; Coleman, Shirley Y; Brooks, David J; Barker, Roger A; Burn, David J

    2014-02-01

    Nonmotor symptoms (NMS) are common in patients with established Parkinson's disease (PD) and have a major impact upon quality of life. We investigated the significance of NMS in relation to health-related quality of life (HRQoL) in patients with newly diagnosed PD. Patients and healthy controls were recruited as part of the Incidence of Cognitive Impairment in Cohorts with Longitudinal Evaluation in Parkinson's Disease Study. Prevalence of NMS was determined with the Non-Motor Symptom Questionnaire. HRQoL was recorded with the 39-item Parkinson's Disease Quality of Life Questionnaire (PDQ-39). Further assessments included measures of motor disability, depression, sleep, and cognition. One hundred and fifty-eight patients with newly diagnosed PD and 99 controls participated in this cross-sectional study. Patients reported greater numbers of NMS than controls (mean 8.3 ± 4.3 versus 2.8 ± 2.5 symptoms; P < 0.001). Patients reported lowest HRQoL in the domains assessing bodily discomfort, mobility, and activities of daily living. Motor and nonmotor symptoms impacted negatively upon HRQoL scores. Patients with the postural instability and gait difficulty motor subtype reported worse HRQoL, compared with those with tremor-dominant disease. Depression (P < 0.001), incomplete bowel emptying (P < 0.001), anxiety (P < 0.001), impaired concentration (P < 0.001), memory complaints (P < 0.001), and insomnia (P = 0.001) had the greatest negative impact upon HRQoL. NMS are common in patients with early PD and represent a significant cause of poorer health-related quality of life. Cognitive, neuropsychiatric, and sleep disturbances are particularly associated with reduced well-being. Screening and management of these symptoms should be prioritized at the time of diagnosis.

  20. Preventive use of Lactobacillus plantarum LS/07 and inulin to relieve symptoms of acute colitis.

    PubMed

    Hijová, Emília; Šoltésová, Alena; Salaj, Rastislav; Kuzma, Jozef; Strojný, Ladislav; Bomba, Alojz; Gregová, Kristína

    2015-01-01

    The aim of presented study was to investigate the influence of Lactobacillus plantarum LS/07 and inulin on the activity of β-glucuronidase enzyme, and counts of coliform and lactobacilli in fresh caecal digesta, cytokine levels (IL-6, IL-8), and trancription nuclear factor kappa beta (NFκB) activities in colon tissue and blood samples of rats with dextran sulphate sodium (DSS) induced acute colitis. The rats were randomly divided into four groups - CG, AC, AC+PRE and AC+PRO. Colitis was induced using of 5% DSS in drinking water for 7d. DSS application increased activity of β-glucuronidase (P < 0.001), increased counts of coliforms, and decreased lactobacilli counts (P < 0.05) in comparison to control group. Serum and tissue levels of IL-6 and IL-8 as well as tissue NFκB activities showed increased expression in acute colitis group. Inulin diet modified counts of microorganims and decreased β-glucuronidase activity, suppressed NFκB activities (P < 0.001) and down regulate synthesis of IL-6 (P < 0.01) in serum and colon tissue and tissue IL-8 (P < 0.05). Lactobacillus plantarum LS/07 decreased β-glucuronidase activity (P < 0.05), levels of IL-6 and IL-8 (P < 0.001). These results were consistent with the addition of histological findings. Our results indicate that dietary intake of Lactobacillus plantarum LS/07 and inulin suppressed expression observed markers, which play an important role in the inflammatory process, which predisposes their use in prevention or treatment of acute colitis.

  1. Acute Symptoms in Firefighters who Participated in Collection Work after the Community Hydrogen Fluoride Spill Accident

    PubMed Central

    2013-01-01

    Objectives This study aimed to analyze the relationship between clinical status and work characteristics of firefighters and other public officers who engaged on collection duties in the site of the hydrogen fluoride spill that occurred on September 27, 2012, in Gumi City, South Korea. Methods We investigated the clinical status, personal history, and work characteristics of the study subjects and performed physical examination and several clinical examinations, including chest radiography, echocardiography, pulmonary function test, and blood testing in 348 firefighters, police officers, volunteer firefighters, and special warfare reserved force who worked at the hydrogen fluoride spill area. Results The subjects who worked near the accident site more frequently experienced eye symptoms (p = 0.026), cough (p = 0.017), and headache (p = 0.003) than the subjects who worked farther from the accident site. The longer the working hours at the accident area, the more frequently the subjects experienced pulmonary (p = 0.027), sputum (p = 0.043), and vomiting symptoms (p = 0.003). The subjects who did not wear respiratory protective devices more frequently experienced dyspnea than those who wore respiratory protective devices (p = 0.013). In the pulmonary function test, the subjects who worked near the accident site had a higher decease in forced vital capacity than the subjects who worked farther from the site (p = 0.019); however, no statistical association was found between serum calcium/phosphate level, echocardiography result, chest radiographic result, and probation work characteristics. Conclusions The subjects who worked near the site of the hydrogen fluoride spill, worked for an extended period, or worked without wearing respiratory protective devices more frequently experienced upper/lower respiratory, gastrointestinal, and neurological symptoms. Further follow-up examination is needed for the workers who were exposed to hydrogen

  2. Acute exacerbation of psychiatric symptoms during influenza treatment with oseltamivir in chronic schizophrenia.

    PubMed

    Lan, Chen-Chia; Liu, Chia-Chien; Chen, Ying-Sheue

    2015-06-01

    Influenza treatment and prophylaxis with oseltamivir are critically important in reducing the morbidity and mortality of patients in chronic psychiatric facilities. Abnormal behavior, delusions, perceptual disturbances, mania, and depression have all been reported as oseltamivir-related psychiatric side effects. We hereby report two chronic schizophrenia patients in Taiwan manifesting psychiatric instability who were being treated with oseltamivir for suspected influenza infection, and further discuss other potential contributing factors. The possibility that oseltamivir can cause psychotic or affective symptoms suggests that additional caution is necessary for its use in patients with an established psychiatric diagnosis.

  3. Are students' symptoms and health complaints associated with perceived stress at university? Perspectives from the United Kingdom and Egypt.

    PubMed

    El Ansari, Walid; Oskrochi, Reza; Haghgoo, Ghollamreza

    2014-09-26

    This cross-sectional survey assessed and compared by country, the levels and correlates of 21 self-reported symptoms/health complaints. We examined the associations between self-reported symptoms and perceived stress. Data was collected from universities in the United Kingdom and Egypt (N = 3706 and 3271 undergraduates, respectively). A self-administered questionnaire assessed a range of self-reported symptoms, perceived stress, sociodemographic (gender, age, marital status, year of study, living arrangements during semester, income sufficiency), lifestyle (tobacco smoking, illicit drug/s use, alcohol consumption frequency), and health variables (subjective health status, health awareness, BMI), along with religiosity, and quality of life. Factor analysis categorized the 21 self-reported symptoms into four components. Correlation analysis and linear regression tested the associations between the self-reported symptoms and stress. Factor analysis of the health symptoms generated four symptom groups for each of the UK and Egypt (psychological; circulatory/breathing; gastrointestinal; and, pains/aches), and factor loadings were quite similar for both countries. Whilst the two samples showed similarities as to the kind of symptoms most frequently reported by students, the Egyptian sample had significantly higher frequency than the UK for every symptom. Frequent complaints (both countries) included difficulties to concentrate, fatigue, headaches, nervousness/anxiety, and back pain (UK) and mood swings (Egypt). Significantly more Egyptian students reported ≥ 4 symptoms over the past year than the UK. For each of the UK and Egypt, across each of the four symptom groups, there was a stepladder appearance whereby the frequency of symptoms increased with increasing quartiles of perceived stress. Not controlling for other variables, for both countries, there were significant positive correlations between each of the four symptom groups and stress; the highest correlation

  4. Health-related QOL in acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease: a review of the literature.

    PubMed

    Doll, Helen; Miravitlles, Marc

    2005-01-01

    There is a lack of emphasis on health-related QOL (HR-QOL) changes associated with acute exacerbation of chronic bronchitis (CB) or chronic obstructive pulmonary disease (COPD). The aim of this review is to examine the use of HR-QOL instruments to evaluate acute exacerbation of CB or COPD, so as to form recommendations for future research.A literature search of papers published between 1966 and July 2003 identified more than 300 articles that used acute exacerbation of CB or COPD as the search term. However, only 21 of these studies employed HR-QOL measures as predictors of outcome or in the assessment of the impact, evolution or treatment of acute exacerbations of COPD or CB. A variety of HR-QOL measures were used, both generic and disease specific. The disease-specific St George's Respiratory Questionnaire (SGRQ), devised for patients with stable CB and with a recall period of 1-12 months, was the most widely used measure, with the Chronic Respiratory disease Questionnaire (CRQ) and the Baseline and Transitional Dyspnoea Index (BDI, TDI) being the only other disease-specific measures used. Most measures, both generic and disease specific, performed adequately when used during acute exacerbation of CB or COPD and indicated poor HR-QOL during acute exacerbation, which improved on resolution of the exacerbation. Relationships were evident between HR-QOL during an acute exacerbation and various outcomes, including post-exacerbation functional status, hospital re- admission for acute exacerbation or COPD, and mortality. There is a need for studies of treatments for acute exacerbation of CB or COPD to include an appropriate HR-QOL instrument to aid in the stratification of patients so as to target the right treatment to the right patient group. While a new instrument could be developed to measure HR-QOL during acute exacerbation of CB or COPD, currently available disease-specific measures such as the CRQ and the SGRQ appear to be acceptable to patients during acute

  5. Explanations of mental health symptoms by the Bedouin-Arabs of the Negev.

    PubMed

    al-Krenawi, A

    1999-01-01

    Sixty Bedouin-Arab patients (36 females, 24 males) referred to the psychiatric clinic of the Soroka Medical Centre in the Negev, Israel were interviewed before they met with the psychiatrists and again two weeks later. An open-ended questionnaire was administered during three month period, to examine the patients' explanations of their mental health symptoms. Findings revealed that all patients, male and female alike, perceived and explained their symptoms as being caused by supernatural powers. There were gender differences, however, regarding the perceived nature of, and behaviour of, these supernatural powers. Males explained their symptoms as caused by God's will, whether directly through Him, or indirectly through evil-spirits. In both instances, human behaviour was not a primary concern. In contrast, 97% of the female patients explained their symptoms as a result of sorcery, a phenomenon which integrates human behaviour with supernatural powers. Cultural and language differences between the patients and psychiatrists were also found to cause miscommunications and inappropriate treatment, with the result that 50% of the sample terminated psychiatric treatment after two sessions.

  6. Relationships among symptoms, psychosocial factors and health-related quality of life in hematopoietic stem cell transplant survivors

    PubMed Central

    Kenzik, Kelly; Huang, I-Chan; Rizzo, J. Douglas; Shenkman, Elizabeth; Wingard, John

    2015-01-01

    Objective To evaluate the mediating effect of depressive symptoms on the relationship between physical symptoms and health-related quality of life (HRQOL) in hematopoietic stem cell transplant survivors (HSCT); and to test a conceptual model of psychosocial factors, in addition to physical and psychological symptoms, that might contribute to HRQOL. Methods This is a secondary data analysis using subjects (N=662) identified from the Center for International Blood and Marrow Transplant Research for HSCT survivors who were treated in 40 North American Medical Centers. Data were collected through mailed surveys, phone interviews, and medical records. We used structural equation modeling to test the mediating role of depressive symptoms on the relationship of physical symptoms with HRQOL. We also tested comprehensive pathways from physical symptoms to HRQOL by adding other psychosocial factors including optimism, coping, and social constraints. Results In the depressive symptom mediation analyses, physical symptoms had a stronger direct effect on physical HRQOL (b=−0.98, p<0.001) than depressive symptoms (b=0.23, p>0.05). Depressive symptoms were associated with mental HRQOL and mediated the relationship between physical symptoms and mental HRQOL. In the comprehensive pathway analyses, physical symptoms remained the most significant factor to be associated with physical HRQOL. In contrast, depressive symptoms had a direct effect (b=−0.76, p<0.001) on mental HRQOL and were a significant mediator. Psychosocial factors were directly associated with mental HRQOL and indirectly associated with mental HRQOL through depressive symptoms. Conclusion Physical symptoms are most strongly associated with physical HRQOL; while depressive symptoms and psychosocial factors impact mental HRQOL more than physical HRQOL. Interventions targeting physical/psychological symptoms and psychosocial factors may improve HRQOL of HSCT survivors. PMID:25193598

  7. Health evaluation and reported symptoms in workers with past occupational exposure to elemental mercury

    SciTech Connect

    Kallenbach, L.R.

    1988-01-01

    A comprehensive health evaluation was conducted on 502 workers at the Y-12 plant in Oak Ridge, Tennessee of which approximately half (247) had past exposure to elemental mercury vapor between 1953 and 1966. Extensive urinalysis records were available and a number of exposure indices were generated from these in an attempt to model different aspects of exposure. Selection into the study group was based on an index of cumulative exposure that consisted of the sum of average quarterly mercury urinalyses. Cumulative and peak exposure indices based on workers' average exposure from company work histories were more strongly associated with adverse health effects than corresponding indices based on individual urinary records. Substantial evidence suggested that higher exposed workers were at elevated risk for the development of a mild peripheral neuropathy and sustention tremor. In addition, a small increase in the frequency of mild myelopathies was noted in the mercury-exposed group which was not clearly related to exposure. Reported symptoms of lightheadedness, confused, trouble remembering steps, bothered by clumsiness, and trouble grasping objects were significantly associated with increasing level of elemental mercury. A preliminary evaluation tends to validate the use of symptoms data in epidemiologic surveys. Symptom reports were related to poorer performance on objective tests of psychomotor and other behavioral attributes.

  8. Substance dependence among those without symptoms of substance abuse in the World Mental Health Survey.

    PubMed

    Lago, Luise; Glantz, Meyer D; Kessler, Ronald C; Sampson, Nancy A; Al-Hamzawi, Ali; Florescu, Silvia; Moskalewicz, Jacek; Murphy, Sam; Navarro-Mateu, Fernando; Torres de Galvis, Yolanda; Viana, Maria Carmen; Xavier, Miguel; Degenhardt, Louisa

    2017-02-17

    The World Health Organization (WHO) World Mental Health (WMH) Survey Initiative uses the Composite International Diagnostic Interview (CIDI). The first 13 surveys only assessed substance dependence among respondents with a history of substance abuse; later surveys also assessed substance dependence without symptoms of abuse. We compared results across the two sets of surveys to assess implications of the revised logic and develop an imputation model for missing values of lifetime dependence in the earlier surveys. Lifetime dependence without symptoms of abuse was low in the second set of surveys (0.3% alcohol, 0.2% drugs). Regression-based imputation models were built in random half-samples of the new surveys and validated in the other half. There were minimal differences for imputed and actual reported cases in the validation dataset for age, gender and quantity; more mental disorders and days out of role were found in the imputed cases. Concordance between imputed and observed dependence cases in the full sample was high for alcohol [sensitivity 88.0%, specificity 99.8%, total classification accuracy (TCA) 99.5%, area under the curve (AUC) 0.94] and drug dependence (sensitivity 100.0%, specificity 99.8%, TCA 99.8%, AUC 1.00). This provides cross-national evidence of the small degree to which lifetime dependence occurs without symptoms of abuse. Imputation of substance dependence in the earlier WMH surveys improved estimates of dependence.

  9. The combination of health anxiety and somatic symptoms: Specificity to anxiety sensitivity cognitive concerns among patients in primary care.

    PubMed

    Fergus, Thomas A; Kelley, Lance P; Griggs, Jackson O

    2016-05-30

    Prior research has found that health anxiety is related to poor patient outcomes in primary care settings. Health anxiety is characterized by at least two presentations: with either severe or no/mild somatic symptoms. Preliminary data indicate that anxiety sensitivity may be important for understanding the presentation of health anxiety with severe somatic symptoms. We further examined whether the combination of health anxiety and somatic symptoms was related to anxiety sensitivity. Participants were adults presenting for treatment at a community health center (N=538). As predicted, the interactive effect between health anxiety and somatic symptoms was associated with anxiety sensitivity cognitive concerns. Health anxiety shared a stronger association with anxiety sensitivity cognitive concerns when coupled with severe, relative to mild, somatic symptoms. Contrary to predictions, the interactive effect was not associated with the other dimensions of anxiety sensitivity. We discuss the potential relevancy of anxiety sensitivity cognitive concerns to the combined presentation of health anxiety and severe somatic symptoms, as well as how this dimension of anxiety sensitivity could be treated in primary care settings.

  10. Does cyberchondria overlap with health anxiety and obsessive-compulsive symptoms? An examination of latent structure and scale interrelations.

    PubMed

    Fergus, Thomas A; Russell, Laurie H

    2016-03-01

    Searching for medical information online is a widespread activity that increases distress for many individuals. Researchers have speculated that this phenomenon, referred to as cyberchondria, overlaps substantially with both health anxiety and obsessive-compulsive symptoms. This study sought to examine: (1) the distinguishability of cyberchondria from health anxiety and obsessive-compulsive symptoms and (2) the components of health anxiety and obsessive-compulsive symptoms that cluster most strongly with cyberchondria. The sample consisted of community adults in the United States with no current reported medical problems (N=375). Results from confirmatory factor analyses (CFAs) support the idea that cyberchondria is distinct from, yet related to, health anxiety and obsessive-compulsive symptoms. Results from zero-order correlations and regression analyses suggest that cyberchondria clusters with the affective (health worry) component of health anxiety. Regression results diverged from prior findings, as obsessive-compulsive symptoms did not share associations with cyberchondria after accounting for negative affect and health anxiety. The present results indicate that cyberchondria is possibly discernible from both health anxiety and obsessive-compulsive symptoms, while also providing insight into areas of potential overlap.

  11. Psychotic symptoms are associated with physical health problems independently of a mental disorder diagnosis: results from the WHO World Health Survey.

    PubMed

    Moreno, Carmen; Nuevo, Roberto; Chatterji, Somnath; Verdes, Emese; Arango, Celso; Ayuso-Mateos, José Luis

    2013-10-01

    This study explored whether physical health problems are related to psychotic symptoms independently of a mental disorder diagnosis. A total of 224,254 subjects recruited for the World Health Organization World Health Survey were subdivided into those with both a lifetime diagnosis of psychosis and at least one psychotic symptom in the 12 months prior to the evaluation, those with at least one psychotic symptom in the past 12 months but no lifetime diagnosis of psychosis, and those without psychotic symptoms in the past 12 months and without a lifetime diagnosis of psychosis. The three groups were compared for the presence of medical conditions, health problems, and access to health care. Medical conditions and health problems (angina, asthma, arthritis, tuberculosis, vision or hearing problems, mouth/teeth problems, alcohol consumption, smoking, and accidents), medication consumption, and hospital admissions (but not regular health care visits) were more frequent in individuals with psychotic symptoms but no psychosis diagnosis, compared to those with no symptoms and no diagnosis. The number of medical conditions increased with the number of psychotic symptoms. Given the sample analyzed, this trend seems to be independent from the socio-economic development of the country or the specific health care system.

  12. Associations of physical symptoms with perceived need for and use of mental health services among Latino and Asian Americans.

    PubMed

    Bauer, Amy M; Chen, Chih-Nan; Alegría, Margarita

    2012-09-01

    Although many believe that low rates of perceived mental health need and service use among racial/ethnic minorities are due, in part, to somatization, data supporting this notion are lacking. This study examined two hypotheses: (1) increased physical symptoms are associated with lower perceived need for mental health services and actual service use; and (2) physical symptoms are most strongly associated with perceived mental health need and service use among first-generation individuals. Data come from the National Latino and Asian-American Study, a nationally-representative household survey in the United States conducted from 2002 to 2003. Participants reported on the presence of fourteen physical symptoms within the past year. Perceived mental health need was present for individuals who endorsed having an emotional or substance use problem or thinking they needed treatment for such a problem within the past year. After adjusting for sociodemographic and clinical covariates, the number of physical symptoms was positively associated with perceived mental health need and service, an effect that differed by generation. Among first-generation individuals, physical symptoms were associated with increased perceived need and service use. Physical symptoms were not significantly associated with perceived need or service use among third-generation Latinos, but were associated with service use among third-generation Asian-Americans. Physical symptoms do not appear to interfere with mental health problem recognition or service use. In contrast, individuals, especially of the first-generation, with more physical symptoms were more likely to perceive need for and utilize mental health services. Our findings do not support the notion that physical symptoms account for low rates of perceived mental health need and service use among Latino and Asian-Americans.

  13. Links between depressive symptoms and unmet health and social care needs among older prisoners

    PubMed Central

    O'Hara, Kate; Forsyth, Katrina; Webb, Roger; Senior, Jane; Hayes, Adrian Jonathan; Challis, David; Fazel, Seena; Shaw, Jenny

    2016-01-01

    Background: absolute numbers of older prisoners and their proportion of the total prison population are increasing. They have multiple health and social care needs that are prominent on entry into prison. No previous studies have identified older prisoners' health and social care needs at this crucial point. Objective: to examine unmet health and social care needs among older men entering prison and their links with depressive symptoms. Methods: a cross-sectional survey across nine prisons in the North of England was completed. One hundred male prisoners aged between 60 and 81 were interviewed, using the Camberwell Assessment of Need—Forensic short version (CANFOR-S) and Geriatric Depression Scale—Short Form (GDS-15). Descriptive statistics were generated and χ2 tests performed. Results: participants reported high levels of unmet needs as measured with the CANFOR-S, notably in the domains of knowledge about their condition and treatment (38%); psychological distress (34%); daytime activities (29%); benefits (28%); food (22%) and physical health (21%). The mean total number of unmet needs was 2.74, with a median of 2.0. More than half the sample (56%, 95% CI 45–66%) exhibited clinical signs of depression. A significant association between depressive symptomology and an unmet physical health need, as measured by the CANFOR-S, was detected (χ2 = 6.76, df = 1, P < 0.01). Conclusions: high levels of depressive symptoms were experienced by older prisoners on entry into prison. Personalised health and social care needs assessment and discrete depression screening are required on prison entry to facilitate effective management of unmet needs. PMID:26764402

  14. Smoking initiation and nicotine dependence symptoms in Ukraine: Findings from the Ukraine World Mental Health survey

    PubMed Central

    Webb, Charles P.M.; Bromet, Evelyn J.; Tintle, Nathan L.; Schwartz, Joseph E.; Gluzman, Semyon F.; Kostyuchenko, Stanislav; Havenaar, Johan M.

    2007-01-01

    Summary Objectives Cigarette smoking is a major cause of morbidity and mortality in former Soviet countries. This study examined the personal, familial and psychiatric risk factors for smoking initiation and development of nicotine dependence symptoms in Ukraine. Study Design Cross-sectional survey. Methods Smoking history and dependence symptoms were ascertained from N=1,711 adults in Ukraine as part of a national mental health survey conducted in 2002. Separate analyses were conducted for men and women. Results The prevalence of lifetime regular smoking was 80.5% in men and 18.7% in women, with median ages at initiation among smokers of 17 and 18, respectively. Furthermore, 61.2% of men and 11.9% of women were current smokers; among the subgroup of lifetime smokers, 75.9% of men and 63.1% of women currently smoked. The youngest female cohort (born 1965–1984) was 26 times more likely to start smoking than the oldest. Smoking initiation was also linked to childhood externalizing behaviors and antecedent use of alcohol in both genders, as well as marital status and personal alcohol abuse in men, and childhood urbanicity and birth cohort in women. Dependence symptoms developed in 61.7% of male and 47.1% of female smokers. The rate increased sharply in the first four years after smoking initiation. Dependence symptoms were related to birth cohort and alcohol abuse in both genders, as well as growing up in a suburb or town and childhood externalizing behaviors in men, and parental antisocial behavior in women. Conclusions Increased smoking in young women heralds a rising epidemic in Ukraine and underscores the need for primary prevention programs, especially in urban areas. Our findings support the importance of childhood and alcohol-related risk factors, especially in women, while pre-existing depression and anxiety disorders were only weakly associated with starting to smoke or developing dependence symptoms. PMID:17544466

  15. Incremental Validity of the Minnesota Multiphasic Personality Inventory-2 and Symptom Checklist-90-Revised with Mental Health Inpatients

    ERIC Educational Resources Information Center

    Simonds, Elise C.; Handel, Richard W.; Archer, Robert P.

    2008-01-01

    This study evaluated the incremental validity of scores from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and the Symptom Checklist-90-Revised (SCL-90-R) in a sample of mental health inpatients originally published by Archer, Griffin, and Aiduk (1995). The incremental validity of scores from the SCL-90-R primary symptom dimensions…

  16. Mutual Partner Violence: Mental Health Symptoms among Female and Male Victims in Four Racial/Ethnic Groups

    ERIC Educational Resources Information Center

    Prospero, Moises; Kim, Miseong

    2009-01-01

    This study examines racial/ethnic and sex differences in the prevalence of mutual intimate partner violence (IPV) and mental health symptoms. The authors asked 676 university students in heterosexual relationships if they had experienced IPV, coercive victimization, and/or perpetration as well as symptoms of depression, anxiety, hostility, and…

  17. Stress spillover of health symptoms from healthy spouses to patient spouses in older married couples managing both diabetes and osteoarthritis.

    PubMed

    Yorgason, Jeremy B; Roper, Susanne O; Sandberg, Jonathan G; Berg, Cynthia A

    2012-12-01

    Many studies examining illness within marriage have investigated how illness in one spouse influences the other spouse. In later-life marriages, where both spouses are more likely to have health challenges, there is an increased likelihood that health symptoms from both spouses affect each other. In the current study we examined how health symptoms in a "healthy" spouse may exacerbate health problems in a partner (the patient) who is managing multiple chronic illnesses. Surveys were collected across 14 days from 27 later-life couples where patients had both diabetes and osteoarthritis. Results indicated that higher healthy spouse symptoms were generally associated with higher patient symptoms, suggesting a spillover effect. Spouse reports of positive and negative mood were inversely linked with patient health outcomes. Spouse reports of higher positive marital interactions were surprisingly linked with higher patients' arthritis activity and activity limitations, possibly indicating a compensatory effect where marital interactions increase with symptoms. Daily spouse reports of positive marital interactions and mood were linked with patient health outcomes even after the spillover of health symptoms was taken into account.

  18. Symptom-Adapted Physical Activity Intervention in Minimizing Physical Function Decline in Older Patients With Acute Myeloid Leukemia Undergoing Chemotherapy

    ClinicalTrials.gov

    2017-03-13

    Adult Acute Myeloid Leukemia in Remission; Adult Acute Myeloid Leukemia With 11q23 (MLL) Abnormalities; Adult Acute Myeloid Leukemia With Del(5q); Adult Acute Myeloid Leukemia With Inv(16)(p13;q22); Adult Acute Myeloid Leukemia With t(15;17)(q22;q12); Adult Acute Myeloid Leukemia With t(16;16)(p13;q22); Adult Acute Myeloid Leukemia With t(8;21)(q22;q22); Recurrent Adult Acute Myeloid Leukemia; Untreated Adult Acute Myeloid Leukemia

  19. Associations of Child Insomnia, Sleep Movement, and Their Persistence With Mental Health Symptoms in Childhood and Adolescence

    PubMed Central

    Armstrong, Jeffrey M.; Ruttle, Paula L.; Klein, Marjorie H.; Essex, Marilyn J.; Benca, Ruth M.

    2014-01-01

    Study Objectives: To examine the patterns of insomnia and sleep-related movement from ages 4.5 to 9 years, their concurrent associations with mental health symptoms in childhood, and the longitudinal associations of sleep-problem persistence with mental health symptoms at ages 9 and 18 years. Design: A 14-year prospective follow-up study. Assessments included maternal report on the Children's Sleep Habits Questionnaire at ages 4.5 and 9, and child mental health symptoms via maternal report at age 4.5, multi-informant (child, teacher, mother) report at age 9, and adolescent report at age 18. Setting: Community. Participants: A total of 396 children (51% female). Interventions: N/A. Measurements and Results: Sleep problems were more common at age 4.5 than 9; symptoms of insomnia and abnormal sleep movement both had persistence rates of 9–10%. At age 4.5, insomnia was associated with hostile-aggressive and hyperactive-distractible behavior, but there were no significant associations for sleep movement. At age 9, both insomnia and sleep movement were associated with symptoms of depression, externalizing, and attention deficit hyperactivity disorder (ADHD). Insomnia persistence was associated with symptoms of depression, externalizing, and ADHD at age 9 and anxiety and externalizing at age 18; sleep- movement persistence was associated with externalizing and ADHD at age 9, and ADHD at age 18. The age 18 persistence effects for insomnia and anxiety and for sleep movement and ADHD were significant when controlling for earlier mental health. Conclusions: Childhood insomnia and sleep movement are common and associated with mental health symptoms. Their persistence from middle to late childhood predicts associations with specific types of mental health symptoms at age 18. Citation: Armstrong JM, Ruttle PL, Klein MH, Essex MJ, Benca RM. Associations of child insomnia, sleep movement, and their persistence with mental health symptoms in childhood and adolescence. SLEEP 2014

  20. Depression symptoms, social support and overall health among HIV-positive individuals in Kenya.

    PubMed

    Kingori, Caroline; Haile, Zelalem T; Ngatia, Peter

    2015-03-01

    In Kenya, there was a reported decline in HIV incidence and prevalence among those aged 15 to 64 years and children. Despite the decline, closer assessment of psychosocial issues like depression, contextual factors (family and community), and social support is necessary given the likely impact on overall health and HIV prevention. This paper examines an association between symptoms of depression and social support on overall health among HIV-positive participants recruited from an HIV clinic in Kenya. Descriptive statistics and logistic regression analyses were utilized. Findings reveal that compared to those with minimal depression (referent category) participants with mild, moderate, moderately severe/severe depression had higher odds of having poor health. For social support, compared with participants with no social support (referent category), participants with high social support had lower odds of having poor overall health in both unadjusted and multivariable-adjusted models. In conclusion, this study suggests that HIV clinics and interventions need to focus more on the psychological and/or mental health status of HIV-infected individuals while providing avenues such as social support groups that can be a buffer against the negative impact of HIV infection and depression on overall health outcomes.

  1. Students' Perceived Heat-Health Symptoms Increased with Warmer Classroom Temperatures.

    PubMed

    Bidassey-Manilal, Shalin; Wright, Caradee Y; Engelbrecht, Jacobus C; Albers, Patricia N; Garland, Rebecca M; Matooane, Mamopeli

    2016-06-07

    Temperatures in Africa are expected to increase by the end of the century. Heat-related health impacts and perceived health symptoms are potentially a problem, especially in public schools with limited resources. Students (n = 252) aged ~14-18 years from eight high schools completed an hourly heat-health symptom log over 5 days. Data loggers measured indoor classroom temperatures. A high proportion of students felt tired (97.2%), had low concentration (96.8%) and felt sleepy (94.1%) during at least one hour on any day. There were statistically significant correlations, when controlling for school cluster effect and time of day, between indoor temperatures ≥32 °C and students who felt tired and found it hard to breathe. Consistently higher indoor classroom temperatures were observed in classrooms constructed of prefabricated asbestos sheeting with corrugated iron roof and converted shipping container compared to brick classrooms. Longitudinal studies in multiple seasons and different classroom building types are needed.

  2. Students’ Perceived Heat-Health Symptoms Increased with Warmer Classroom Temperatures

    PubMed Central

    Bidassey-Manilal, Shalin; Wright, Caradee Y.; Engelbrecht, Jacobus C.; Albers, Patricia N.; Garland, Rebecca M.; Matooane, Mamopeli

    2016-01-01

    Temperatures in Africa are expected to increase by the end of the century. Heat-related health impacts and perceived health symptoms are potentially a problem, especially in public schools with limited resources. Students (n = 252) aged ~14–18 years from eight high schools completed an hourly heat-health symptom log over 5 days. Data loggers measured indoor classroom temperatures. A high proportion of students felt tired (97.2%), had low concentration (96.8%) and felt sleepy (94.1%) during at least one hour on any day. There were statistically significant correlations, when controlling for school cluster effect and time of day, between indoor temperatures ≥32 °C and students who felt tired and found it hard to breathe. Consistently higher indoor classroom temperatures were observed in classrooms constructed of prefabricated asbestos sheeting with corrugated iron roof and converted shipping container compared to brick classrooms. Longitudinal studies in multiple seasons and different classroom building types are needed. PMID:27338423

  3. Effects of Health Qigong Exercises on Relieving Symptoms of Parkinson's Disease

    PubMed Central

    Liu, Xiao Lei; Wang, Yongtai

    2016-01-01

    The purpose of this study was to investigate the effects of Health Qigong on the treatment and releasing symptoms of Parkinson's disease (PD). Fifty-four moderate PD patients (N = 54) were randomly divided into experimental and control groups. Twenty-eight PD patients were placed in the experimental group in which the prescribed medication plus Health Qigong exercise will be used as intervention. The other 26 PD patients as the control group were treated only with regular medication. Ten-week intervention had been conducted for the study, and participants completed the scheduled exercises 5 times per week for 60 minutes each time (10 minutes for warm-up, 40 minutes for the exercise, and 10 minutes for cooldown). Data which included the muscle hardness, one-legged blind balance, physical coordination, and stability was collected before, during, and after the intervention. Comparisons were made between the experimental and control groups through the Repeated Measures ANOVA. The results showed that PD patients demonstrate a significant improvement in muscle hardness, the timed “up and go,” balance, and hand-eye coordination (the turn-over-jars test). There were no significant differences between the two groups in gender, age, and course of differences (P < 0.05). The study concluded that Health Qigong exercises could reduce the symptoms of Parkinson's disease and improve the body functions of PD patients in both the mild and moderate stages. It can be added as an effective treatment of rehabilitation therapy for PD. PMID:27891159

  4. Comorbid Mental Health Symptoms and Heart Diseases: Can Health Care and Mental Health Care Professionals Collaboratively Improve the Assessment and Management?

    ERIC Educational Resources Information Center

    Ai, Amy L.; Rollman, Bruce L.; Berger, Candyce S.

    2010-01-01

    On the basis of current epidemiological and clinical research, this article describes how mental health symptoms are associated with heart disease, a major chronic condition that occurs primarily in middle and late life. The article describes the culturally and historically important link between heart and mind. It then describes depression and…

  5. Frequency of Symptoms and Health Seeking Behaviours of Menopausal Women in an Out-Patient Clinic in Port Harcourt, Nigeria

    PubMed Central

    Dienye, Paul Owajionyi; Judah, Funsho; Ndukwu, Geraldine

    2013-01-01

    Objectives: This study was carried out to determine the frequency and severity of menopausal symptoms and health seeking behaviour of women with menopausal symptoms attending the General Outpatient Department of the University of Port Harcourt Teaching Hospital. Method: This is a cross-sectional, descriptive study in which data was collected from menopausal women using a three-part, pre-tested questionnaire for a period of three months (July–September 2010). Part 1 consisted of information regarding socio-demographic and general medical information. Part 2 consisted of the modified version of the menopause rating scale (MRS). Part 3 sought for information on their health seeking behaviour. Data was analysed using EPI INFO version 6.04d software package. Results: A total of 385 women were recruited with ages ranging from 35 to 95 years, and a mean of 58.4 ± 10.39 years. The most prevalent menopausal symptoms were loss of libido (92.47%), muscle pain (87.53%), joint pain (85.45%) and tiredness (80.26%). Urinary symptoms had the least prevalence (7.79%). Results on the severity of menopausal symptoms showed that 28.25%, 49.84% and 21.9% were experiencing severe, moderate and mild menopausal symptoms, respectively. Loss of libido (79.21 %) was the most severe symptom followed by urinary symptoms (40%). The patent drug dealers were the most consulted (51.4%) followed by health workers (44.7%). The traditional healers were consulted by a small percentage (3.8%). Conclusion: The most common menopausal symptom among the patients in this study was loss of libido and the least common was urinary symptoms. The symptoms are similar to findings in other parts of the world but their prevalence and severity differ. In spite of the available health facilities in these communities, the utilization of the services of patent drug dealers is still very high but the traditional healers were poorly utilized. PMID:23777719

  6. Acute Coronary Syndrome Treatment Costs from the Perspective of the Supplementary Health System

    PubMed Central

    Teich, Vanessa; Piha, Tony; Fahham, Lucas; Squiassi, Haline Bianca; Paloni, Everton de Matos; Miranda, Paulo; Araújo, Denizar Vianna

    2015-01-01

    Background Acute coronary syndrome (ACS) is defined as a “group of clinical symptoms compatible with acute myocardial ischemia”, representing the leading cause of death worldwide, with a high clinical and financial impact. In this sense, the development of economic studies assessing the costs related to the treatment of ACS should be considered. Objective To evaluate costs and length of hospital stay between groups of patients treated for ACS undergoing angioplasty with or without stent implantation (stent+ / stent-), coronary artery bypass surgery (CABG) and treated only clinically (Clinical) from the perspective of the Brazilian Supplementary Health System (SHS). Methods A retrospective analysis of medical claims of beneficiaries of health plans was performed considering hospitalization costs and length of hospital stay for management of patients undergoing different types of treatment for ACS, between Jan/2010 and Jun/2012. Results The average costs per patient were R$ 18,261.77, R$ 30,611.07, R$ 37,454.94 and R$ 40,883.37 in the following groups: Clinical, stent-, stent+ and CABG, respectively. The average costs per day of hospitalization were R$ 1,987.03, R$ 4,024.72, R$ 6,033.40 and R$ 2,663.82, respectively. The average results for length of stay were 9.19 days, 7.61 days, 6.19 days and 15.20 days in these same groups. The differences were significant between all groups except Clinical and stent- and between stent + and CABG groups for cost analysis. Conclusion Hospitalization costs of SCA are high in the Brazilian SHS, being significantly higher when interventional procedures are required. PMID:26559980

  7. Acute effects of nicotine and mecamylamine on tobacco withdrawal symptoms, cigarette reward and ad lib smoking.

    PubMed

    Rose, J E; Behm, F M; Westman, E C

    2001-02-01

    Separate and combined effects of nicotine and the nicotinic antagonist mecamylamine were studied in 32 healthy volunteer smokers after overnight abstinence from smoking. Subjects participated in three sessions (3 h each), during which they wore skin patches delivering either 0 mg/24 h, 21 mg/24 h or 42 mg/24 h nicotine. Thirty-two subjects were randomly assigned to two groups receiving oral mecamylamine hydrochloride (10 mg) vs. placebo capsules. Two and one-half hours after drug administration, subjects were allowed to smoke ad lib, rating the cigarettes for rewarding and aversive effects. Transdermal nicotine produced a dose-related reduction in the subjective rewarding qualities of smoking. Nicotine also reduced craving for cigarettes and this effect was attenuated, but not eliminated, by mecamylamine. Mecamylamine blocked the discriminability of high vs. low nicotine puffs of smoke, and increased nicotine intake substantially during the ad lib smoking period. Some of the psychophysiological effects of each drug (elevation in blood pressure from nicotine, sedation and decreased blood pressure from mecamylamine) were offset by the other drug. The results supported the hypothesis that nicotine replacement can alleviate tobacco withdrawal symptoms even in the presence of an antagonist such as mecamylamine. Mecamylamine did not precipitate withdrawal beyond the level associated with overnight cigarette deprivation, suggesting its effects were primarily due to offsetting the action of concurrently administered nicotine as opposed to blocking endogenous cholinergic transmission.

  8. A test of the effects of acute sleep deprivation on general and specific self-reported anxiety and depressive symptoms: an experimental extension.

    PubMed

    Babson, Kimberly A; Trainor, Casey D; Feldner, Matthew T; Blumenthal, Heidemarie

    2010-09-01

    Evidence indicates acute sleep deprivation affects negative mood states. The present study experimentally tested the effects of acute sleep deprivation on self-reported symptoms of state anxiety and depression as well as general distress among 88 physically and psychologically healthy adults. As hypothesized, the effects of acute sleep deprivation increased state anxiety and depression, as well as general distress, relative to a normal night of sleep control condition. Based on the tripartite model of anxiety and depression, these findings replicate and extend prior research by suggesting sleep deprivation among individuals without current Axis I disorders increases both state symptoms of anxiety and depression specifically, and general distress more broadly. Extending this work to clinical samples and prospectively testing mechanisms underlying these effects are important future directions in this area of research.

  9. Acute effects of ginger extract on biochemical and functional symptoms of delayed onset muscle soreness

    PubMed Central

    Hoseinzadeh, Khadijeh; Daryanoosh, Farhad; Baghdasar, Parvin Javad; Alizadeh, Hamid

    2015-01-01

    Background: Inflammation and pain induced by delayed onset muscle soreness (DOMS) as a result of eccentric exercise (EE) or unaccustomed activity cause some difficulties in exercise for athletes. The purpose of this study was to survey the effect of ginger extract on biochemical and functional symptom of delayed onset muscle soreness. Methods: In a quasi-experimental study, 36 healthy female subjects, who were recruited by intra dormitory calls, randomly divided into 3 groups, including: ginger intake 1 hour before exercise (GIBE), ginger intake immediately after exercise (GIAE) and placebo group (PL). Subjects consumed capsules contain 60 mg of ginger extract (equivalent of 2 g dried ginger powder) or placebo before and after exercise. The exercise protocol consisted of a 20 minute step test using a 46cm step at a rate of 15 steps per minute. The blood samples were taken before, 1, 24 and 48 hour after exercise to assay creatine kinase (CK) and interleukin-6 (IL-6). Muscle pain scores, isometric strength and circumference of thigh muscle, and hip range of motion were recorded at mentioned times. The analysis of variance (ANOVA) with repeated measure was used to determine the differences between groups. Results: The results showed a significant reduction of pain in GIBE compared to GIAE after 24 and 48h of EE and GIAE compared to PL (p<0.05). IL-6 changed significantly in GIBE compared to PL (p<0.05) after 1, 24, and 48h after EE. The other factors didn’t change meaningfully. Conclusion: The finding of this study suggests that 2 grams of ginger may have anti-inflammation and analgesic effect on DOMS. PMID:26793652

  10. Intrinsic functional connectivity of insular cortex and symptoms of sickness during acute experimental inflammation.

    PubMed

    Lekander, Mats; Karshikoff, Bianka; Johansson, Emilia; Soop, Anne; Fransson, Peter; Lundström, Johan N; Andreasson, Anna; Ingvar, Martin; Petrovic, Predrag; Axelsson, John; Nilsonne, Gustav

    2016-08-01

    Task-based fMRI has been used to study the effects of experimental inflammation on the human brain, but it remains unknown whether intrinsic connectivity in the brain at rest changes during a sickness response. Here, we investigated the effect of experimental inflammation on connectivity between areas relevant for monitoring of bodily states, motivation, and subjective symptoms of sickness. In a double-blind randomized controlled experiment, 52 healthy volunteers were injected with 0.6ng/kg LPS (lipopolysaccharide) or placebo, and participated in a resting state fMRI experiment after approximately 2h 45min. Resting state fMRI data were available from 48 participants, of which 28 received LPS and 20 received placebo. Bilateral anterior and bilateral posterior insula sections were used as seed regions and connectivity with bilateral orbitofrontal and cingulate (anterior and middle) cortices was investigated. Back pain, headache and global sickness increased significantly after as compared to before LPS, while a non-significant trend was shown for increased nausea. Compared to placebo, LPS was followed by increased connectivity between left anterior insula and left midcingulate cortex. This connectivity was significantly correlated to increase in back pain after LPS and tended to be related to increased global sickness, but was not related to increased headache or nausea. LPS did not affect the connectivity from other insular seeds. In conclusion, the finding of increased functional connectivity between left anterior insula and middle cingulate cortex suggests a potential neurophysiological mechanism that can be further tested to understand the subjective feeling of malaise and discomfort during a sickness response.

  11. The Promise and Potential Perils of Big Data for Advancing Symptom Management Research in Populations at Risk for Health Disparities.

    PubMed

    Bakken, Suzanne; Reame, Nancy

    2016-01-01

    Symptom management research is a core area of nursing science and one of the priorities for the National Institute of Nursing Research, which specifically focuses on understanding the biological and behavioral aspects of symptoms such as pain and fatigue, with the goal of developing new knowledge and new strategies for improving patient health and quality of life. The types and volume of data related to the symptom experience, symptom management strategies, and outcomes are increasingly accessible for research. Traditional data streams are now complemented by consumer-generated (i.e., quantified self) and "omic" data streams. Thus, the data available for symptom science can be considered big data. The purposes of this chapter are to (a) briefly summarize the current drivers for the use of big data in research; (b) describe the promise of big data and associated data science methods for advancing symptom management research; (c) explicate the potential perils of big data and data science from the perspective of the ethical principles of autonomy, beneficence, and justice; and (d) illustrate strategies for balancing the promise and the perils of big data through a case study of a community at high risk for health disparities. Big data and associated data science methods offer the promise of multidimensional data sources and new methods to address significant research gaps in symptom management. If nurse scientists wish to apply big data and data science methods to advance symptom management research and promote health equity, they must carefully consider both the promise and perils.

  12. The impact of killing in war on mental health symptoms and related functioning.

    PubMed

    Maguen, Shira; Metzler, Thomas J; Litz, Brett T; Seal, Karen H; Knight, Sara J; Marmar, Charles R

    2009-10-01

    This study examined the mental health and functional consequences associated with killing combatants and noncombatants. Using the National Vietnam Veterans Readjustment Study (NVVRS) survey data, the authors reported the percentage of male Vietnam theater veterans (N = 1200) who killed an enemy combatant, civilian, and/or prisoner of war. They next examined the relationship between killing in war and a number of mental health and functional outcomes using the clinical interview subsample of the NVVRS (n = 259). Controlling for demographic variables and exposure to general combat experiences, the authors found that killing was associated with posttraumatic stress disorder symptoms, dissociation, functional impairment, and violent behaviors. Experiences of killing in war are important to address in the evaluation and treatment of veterans.

  13. Health utility indexes in patients with acute coronary syndromes

    PubMed Central

    Gencer, Baris; Rodondi, Nicolas; Auer, Reto; Nanchen, David; Räber, Lorenz; Klingenberg, Roland; Pletscher, Mark; Jüni, Peter; Windecker, Stephan; Matter, Christian M; Lüscher, Thomas F; Mach, François; Perneger, Thomas V; Girardin, François R

    2016-01-01

    Background Acute coronary syndromes (ACS) have been associated with lower health utilities (HUs) compared with the general population. Given the prognostic improvements after ACS with the implementation of coronary angiography (eg, percutaneous coronary intervention (PCI)), contemporary HU values derived from patient-reported outcomes are needed. Methods We analysed data of 1882 patients with ACS 1 year after coronary angiography in a Swiss prospective cohort. We used the EuroQol five-dimensional questionnaire (EQ-5D) and visual analogue scale (VAS) to derive HU indexes. We estimated the effects of clinical factors on HU using a linear regression model and compared the observed HU with the average values of individuals of the same sex and age in the general population. Results Mean EQ-5D HU 1-year after coronary angiography for ACS was 0.82 (±0.16) and mean VAS was 0.77 (±0.18); 40.9% of participants exhibited the highest utility values. Compared with population controls, the mean EQ-5D HU was similar (expected mean 0.82, p=0.58) in patients with ACS, but the mean VAS was slightly lower (expected mean 0.79, p<0.001). Patients with ACS who are younger than 60 years had lower HU than the general population (<0.001). In patients with ACS, significant differences were found according to the gender, education and employment status, diabetes, obesity, heart failure, recurrent ischaemic or incident bleeding event and participation in cardiac rehabilitation (p<0.01). Conclusions At 1 year, patients with ACS with coronary angiography had HU indexes similar to a control population. Subgroup analyses based on patients' characteristics and further disease-specific instruments could provide better sensitivity for detecting smaller variations in health-related quality of life. PMID:27252878

  14. Acute health effects in a community after a release of hydrofluoric acid

    SciTech Connect

    Wing, J.S.; Brender, J.D.; Sanderson, L.M.; Perrotta, D.M.; Beauchamp, R.A. )

    1991-05-01

    {approximately} 3,000 persons were evacuated from a Texas community after 24,036 kg (53,000 lb) of caustic hydrofluoric acid (HF) were released from a nearby petrochemical plant. Emergency room and hospital records of 939 persons who were seen at two area hospitals were reviewed. Most persons who presented at the emergency rooms were female (56%) or black (60%), and their mean age was 33.9 y. The most frequently reported symptoms were eye irritation (41.5%), burning throat (21%), headache (20.6%), and shortness of breath (19.4%). Physical examination results were normal for 49% of the cases; however, irritation of the eyes, nose, throat, skin, and lungs were noted on other exams. Decreased pulmonary function was demonstrated by pulmonary function tests (forced expiratory volume in the first second, less than 80% of predicted value, 42.3%); hypoxemia (pO2 less than 80 mm Hg, 17.4%) and hypocalcemia (less than 8.5 mg/dl, 16.3%) were also noted. Ninety-four (10%) of the cases were hospitalized, and more than 83% of all cases were discharged with a primary diagnosis of HF exposure. There are several reports of individuals who are acutely and chronically exposed to HF; however, we are unaware of other published reports that describe exposure of a community to HF. This incident represented a unique opportunity to study the immediate health impact on a community of residents who were exposed to a hazardous materials release. Results of this analysis suggest that (a) initial health problems should be followed up, (b) any long-term health effects of HF exposure must be assessed, and (c) the health impact on the population at risk should be determined.

  15. Acute Mountain Sickness Symptom Severity at the South Pole: The Influence of Self-Selected Prophylaxis with Acetazolamide

    PubMed Central

    Johnson, Jacob B.; Richert, Maile; Miller, Andrew D.

    2016-01-01

    Introduction Acetazolamide, a carbonic anhydrase inhibitor, remains the only FDA approved pharmaceutical prophylaxis for acute mountain sickness (AMS) though its effectiveness after rapid transport in real world conditions is less clear. Methods Over 2 years, 248 healthy adults traveled by airplane from sea level (SL) to the South Pole (ALT, ~3200m) and 226 participants provided Lake Louise Symptom Scores (LLSS) on a daily basis for 1 week; vital signs, blood samples, and urine samples were collected at SL and at ALT. Acetazolamide was available to any participant desiring prophylaxis. Comparisons were made between the acetazolamide with AMS (ACZ/AMS) (n = 42), acetazolamide without AMS (ACZ/No AMS)(n = 49), no acetazolamide with AMS (No ACZ/AMS) (n = 56), and the no acetazolamide without AMS (No ACZ/No AMS) (n = 79) groups. Statistical analysis included Chi-squared and one-way ANOVA with Bonferroni post-hoc tests. Significance was p≤0.05. Results No significant differences were found for between-group characteristics or incidence of AMS between ACZ and No ACZ groups. ACZ/AMS reported greater LLSS, BMI, and red cell distribution width. ACZ/No AMS had the highest oxygen saturation (O2Sat) at ALT. No significant differences were found in serum electrolyte concentrations or PFT results. Discussion Acetazolamide during rapid ascent provided no apparent protection from AMS based on LLSS. However, it is unclear if this lack of effect was directly associated with the drug or if perhaps there was some selection bias with individuals taking ACZ more likely to have symptoms or if there may have been more of perceptual phenomenon related to a constellation of side effects. PMID:26848757

  16. Persistence of symptoms in primary somatoform vertigo and dizziness: a disorder "lost" in health care?

    PubMed

    Tschan, Regine; Best, Christoph; Wiltink, Jörg; Beutel, Manfred E; Dieterich, Marianne; Eckhardt-Henn, Annegret

    2013-04-01

    The aim of this study was to perform a 3-year follow-up of primary somatoform vertigo and dizziness (SVD) regarding health care use and treatment. Ninety-two patients with dizziness underwent detailed vestibular neurophysiological testing and a Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Psychometric assessments comprised the Vertigo Symptom Scale, the Vertigo Handicap Questionnaire, the SCL-90-R, and the Short-Form-36 Health Survey. At the 3-year follow-up, 65 patients with primary SVD (anxiety, n = 29; depression, n = 14; somatoform disorders, n = 22) were reassessed (70.7% response). The patients improved in symptom severity (p < 0.05), handicap (p < 0.01), and physical quality of life (QoL; p < 0.05) but showed no change in emotional distress. A total of 63.1% (of n = 65) had ongoing SVD. A total of 69.2% (of n = 65) received different forms of treatments. A total of 46.1% (of n = 65) searched redundant medical diagnostic procedures. The patients with decreased coping capacity over time obtained the best prognosis. Primary SVD is an ineffectively treated disorder. Recommendations for specific complaint-oriented psychotherapy programs were given.

  17. The impact of mental health symptoms on heavy goods vehicle drivers' performance.

    PubMed

    Hilton, Michael F; Staddon, Zoe; Sheridan, Judith; Whiteford, Harvey A

    2009-05-01

    High levels of psychological distress in fulltime employees are prevalent (4.5% per month). Symptoms of impaired mental health include difficulties with attention, concentration, motivation, decision-making, visuo-motor control, and psychomotor reaction times. There is limited research on the impact these symptoms have on heavy goods vehicle (HGV) drivers' performance. In this study 1324 HGV drivers were surveyed using the Depression, Anxiety, Stress Scale (DASS) and the Health and Performance at Work Questionnaire (HPQ). Depression, anxiety and stress had little effect on driver absenteeism rates or self-rated driving performance. However, severe (1.5% of drivers) and very severe (1.8% of drivers) depression was associated with an increased odds ratio (OR=4.5 and 5.0, respectively) for being involved in an accident or near miss in the past 28 days. This odd ratio is akin to driving with a blood alcohol content of about 0.08%. Given the number of HGV vehicles and the prevalence of depression this equates to 10,950 HGV drivers with an increased statistical risk of an accident or near miss. As the impact of HGV accidents is potentially large, including loss of life, it would be sensible to extend the research findings here into an action plan.

  18. Community Support as a Moderator of Postdisaster Mental Health Symptoms in Urban and Nonurban Communities

    PubMed Central

    West, Jenny S.; Price, Matthew; Gros, Kirstin Stauffacher; Ruggiero, Kenneth J.

    2014-01-01

    Objective We examined the association between disaster exposure, community support, and mental health outcomes in urban and nonurban participants of Galveston and Chambers counties after Hurricane Ike. The moderating effect of community support was evaluated as a protective factor relative to postdisaster mental health. Methods A representative population-based sample of 157 urban and 714 nonurban adults were interviewed 12 to 17 months after the hurricane about their mental health functioning, disaster exposure, and perceptions of community support. A series of multiple regressions demonstrated that disaster exposure was associated with mental health outcomes for both groups. The strength of the association varied across population samples. Results Community support moderated the association between interpersonal effects of the disaster and posttraumatic stress disorder (PTSD) and depression outcomes in nonurban participants and the association between property damage and PTSD in urban participants. Conclusions Community support played a larger role in reducing PTSD and depression symptoms associated with the interpersonal effects of a disaster in the nonurban sample only. Communities may play a more beneficial role in the recovery process in nonurban areas that have elevated levels of injury or death attributed to a disaster. PMID:24274123

  19. Eruptive cherry angiomas and irritant symptoms after one acute exposure to the glycol ether solvent 2-butoxyethanol.

    PubMed

    Raymond, L W; Williford, L S; Burke, W A

    1998-12-01

    Seven clerical workers were evaluated in 1993, 8 months after exposure to vaporized 2-butoxyethanol (2-BE; also called butyl cellosolve or ethylene glycol monobutyl ether [EGMBE or EGBE]), which had been applied overnight to strip the floor of their file room. At the time of exposure, they had noted intense eye and respiratory irritation, marked dyspnea, nausea, and faintness, suggesting a concentration of 2-BE in the air of 200-300 parts per million (ppm). All seven workers later experienced recurrent eye and respiratory irritation, dry cough, and headache. Four months after the exposure, cherry angiomas began to appear on the arms, trunk, and thighs of six workers, who voiced concerns about the possibility of cancer. Our evaluation found no evidence of hematologic, liver, lung, or renal toxicity, but elevations in the erythrocyte sedimentation rate and blood pressure of each subject were found. Workplace air sampling found no detectable 2-BE, but traces (0.1-0.2 ppm) of formaldehyde were identified. Irritant symptoms abated after the group was moved to a room with better ventilation, and the mild hypertension gradually cleared, but new cherry angiomas have continued to appear 5 years after the acute exposure, as the initial ones persisted. These angiomas occur in healthy persons as they age but in this instance appear to have resulted from a single overexposure to 2-BE. We felt confident in reassuring the workers that they would suffer no serious consequences from this exposure.

  20. Health Care Seeking Behavior of Persons with Acute Chagas Disease in Rural Argentina: A Qualitative View

    PubMed Central

    Dinardi, Graciela; Canevari, Cecilia; Torabi, Nahal

    2016-01-01

    Chagas disease (CD) is a tropical parasitic disease largely underdiagnosed and mostly asymptomatic affecting marginalized rural populations. Argentina regularly reports acute cases of CD, mostly young individuals under 14 years old. There is a void of knowledge of health care seeking behavior in subjects experiencing a CD acute condition. Early treatment of the acute case is crucial to limit subsequent development of disease. The article explores how the health outcome of persons with acute CD may be conditioned by their health care seeking behavior. The study, with a qualitative approach, was carried out in rural areas of Santiago del Estero Province, a high risk endemic region for vector transmission of CD. Narratives of 25 in-depth interviews carried out in 2005 and 2006 are analyzed identifying patterns of health care seeking behavior followed by acute cases. Through the retrospective recall of paths for diagnoses, weaknesses of disease information, knowledge at the household level, and underperformance at the provincial health care system level are detected. The misdiagnoses were a major factor in delaying a health care response. The study results expose lost opportunities for the health care system to effectively record CD acute cases. PMID:27829843

  1. A cross-sectional survey of night-time symptoms and impact of sleep disturbance on symptoms and health status in patients with COPD

    PubMed Central

    Ding, Bo; Small, Mark; Bergström, Gina; Holmgren, Ulf

    2017-01-01

    Background Sleep disturbance has been termed the forgotten dimension of chronic obstructive pulmonary disease (COPD), but it is clinically important as most patients are affected. This study examined the incremental burden of illness associated with sleep disturbance in COPD, with reference to health status and disease impact, and the degree of concordance between physicians and patients in reporting night-time COPD symptoms. Methods Real-world data from >2,500 patients with COPD consulting for routine care were derived from respiratory Disease-Specific Programs conducted in Europe, the USA, and China. Night-time COPD symptom burden was assessed from patient and physician perspectives. Patients completed the Jenkins Sleep Evaluation Questionnaire (JSEQ), COPD assessment test (CAT), and EuroQol five-dimension questionnaire (EQ-5D). A regression approach was used to analyze the relationship between sleep disturbance (JSEQ score) and health status (EQ-5D score), adjusting for confounding variables. Results Frequency of night-time symptoms was high and was higher when reported by patients than physicians (69.7% and 65.7%, respectively). According to the JSEQ, 73.3% of patients had trouble falling asleep, 75.3% experienced night-time awakenings, 70.6% had trouble staying asleep, and 67.7% woke after a usual amount of sleep feeling worn out. Over half (52.7%) of patients received maintenance treatment where night-time symptom relief was stated by the physician as a treatment aim. A one unit increase in JSEQ score was associated with increased CAT score (0.7 units in Europe and the USA; 0.2 units in China). Sleep disturbance was significantly associated with worse health status (odds ratio [OR]: 1.27, 95% confidence interval [CI]: 1.18, 1.36, P<0.001 for Europe; OR: 1.23, 95% CI: 1.12, 1.38, P<0.001 for the USA; and OR: 1.19, 95% CI: 1.10, 1.28, P<0.001 for China). Conclusions Night-time symptoms and sleep disturbance are common among patients with COPD, and sleep

  2. The Perceptions, Social Determinants, and Negative Health Outcomes Associated With Depressive Symptoms Among U.S. Chinese Older Adults

    PubMed Central

    Dong, XinQi; Chang, E-Shien; Wong, Esther; Simon, Melissa

    2012-01-01

    Purpose of the Study: Recent demographic growth of the U.S. Chinese aging population calls for comprehensive understanding of their unique health needs. The objective of this study is to examine the perceptions, social determinants of depressive symptoms as well as their impact on health and well-being in a community-dwelling U.S. Chinese aging population in Chicago. Design and Methods: A community-based participatory research approach was implemented to partner with the Chicago Chinatown population in a geographically defined community. Data were collected from questionnaires and semistructured focus group interviews with 78 community-dwelling Chinese older adults. Results: Our findings suggest that the depressive symptoms were common among older adults. It was frequently identified through feelings of helplessness, feelings of dissatisfaction with life, feelings of getting bored, loss of interests in activities, suicidal ideation, and feelings of worthlessness. Societal conflicts, family conflicts, financial constraints, personality, and worsening physical health may be associated with greater depressive symptoms. In addition, depressive symptoms may be detrimental to the overall health and well-being of Chinese older adults. Implications: This study has wide implications for health care professionals, social services agencies, and policy makers. Our results call for improved public health education and awareness programs to highlight the health impact of depressive symptoms on Chinese older adults. Future prospective studies are needed to investigate the prevalence of depressive symptoms among U.S. Chinese older adults. Longitudinal research is needed to quantify the risk and protective factors of depressive symptoms. PMID:22156734

  3. Somatic symptoms and health-related quality of life among treatment-seeking Canadian Forces personnel with PTSD.

    PubMed

    St Cyr, Kate; McIntyre-Smith, Alexandra; Contractor, Ateka A; Elhai, Jon D; Richardson, J Don

    2014-08-15

    This study examined the association between somatic complaints and health-related quality of life (HR-QoL) in treatment-seeking Canadian military personnel with military-related Posttraumatic Stress Disorder (PTSD). Current and former Canadian Forces (CF) members attending the Parkwood Hospital Operational Stress Injury Clinic in London, Ontario (N=291) were administered self-report questionnaires assessing number and severity of somatic complaints, PTSD and depressive symptom severity, and mental and physical health-related quality of life (HR-QoL) prior to commencing treatment. Regression analyses were used to identify the role of somatic complaints on physical and mental HR-QoL, after controlling for PTSD symptom cluster and depressive symptom severity. Somatic symptom severity accounted for only a small amount of the variance in mental HR-QoL after accounting for PTSD symptom cluster and depressive symptom severity, but accounted for a larger proportion of the variance in physical HR-QoL after accounting for PTSD cluster and depressive symptom severity. Understanding the role of somatization in the symptom-presentation of military personnel with PTSD may provide additional avenues for treatment with this population.

  4. Systematic review of patients' participation in and experiences of technology-based monitoring of mental health symptoms in the community

    PubMed Central

    Golden, Eoin; Priebe, Stefan

    2016-01-01

    Objectives To review systematically the literature on patients’ experiences of, and participation in, technology-based monitoring of mental health symptoms. This practice was defined as patients monitoring their mental health symptoms, emotions or behaviours outside of routine clinical appointments by submitting symptom data using technology, with feedback arising from the data (for example, supportive messages or symptom summaries, being sent to the patient, clinician or carer). Design Systematic review following PRISMA guidelines of studies evaluating technology-based symptom monitoring. Tools from narrative synthesis were used to analyse quantitative findings on participation rates and qualitative findings on patient views. Data sources PubMed, EMBASE, PsycINFO, BNI, CINAHL, Cochrane Registers and Web of Science electronic databases were searched using a combination of ‘psychiatry’, ‘symptom monitoring’ and ‘technology’ descriptors. A secondary hand search was performed in grey literature and references. Results 57 papers representing 42 studies met the inclusion criteria for the review. Technology-based symptom monitoring was used for a range of mental health conditions, either independently of a specific therapeutic intervention or as an integrated component of therapeutic interventions. The majority of studies reported moderate-to-strong rates of participation, though a third reported lower rates. Qualitative feedback suggests that acceptability of monitoring is related to perceived validity, ease of practice, convenient technology, appropriate frequency and helpfulness of feedback, as well as the impact of monitoring on participants’ ability to manage health and personal relationships. Conclusions Such symptom monitoring practices appear to be well accepted and may be a feasible complement to clinical practice. However, there is limited availability of data and heterogeneity of studies. Future research should examine robustly patients’ role

  5. Impact of Mid-Life Symptoms of Alcoholism on the Health and Wellbeing of Aging Parents of Adults with Disabilities.

    PubMed

    Ghosh, Subharati; Ha, Jung-Hwa; Pai, Manacy; Essenfeld, Harper; Park, Sang Min

    2016-01-01

    The study examined the effect of adult children's disability on parents' physical health in later life and the extent to which parents' symptoms of alcoholism in mid-life moderates the link between children's disability and later life parental health. Analyses are based on data from the Wisconsin Longitudinal Study. The analytic sample included parents of children with developmental disabilities (n = 145) or mental health problems (n = 200) and 2,432 parents of unaffected children. The results showed that the negative health consequences in later life of having a child with a developmental disability were greater for those who showed more symptoms of alcoholism in mid-life. However, symptoms of alcoholism in mid-life did not significantly moderate the impact of an adult child's mental health problems on parents' later life physical health. The findings suggest a potential area where gerontological social workers could intervene, given the negative impact of symptoms of alcoholism on the health of aging parents of children with a disability who may be significantly more susceptible to the negative health impacts of alcohol compared to their younger counterparts.

  6. The Perceptions, Social Determinants, and Negative Health Outcomes Associated with Depressive Symptoms among U.S. Chinese Older Adults

    ERIC Educational Resources Information Center

    Dong, XinQi; Chang, E-Shien; Wong, Esther; Simon, Melissa

    2012-01-01

    Purpose of the Study: Recent demographic growth of the U.S. Chinese aging population calls for comprehensive understanding of their unique health needs. The objective of this study is to examine the perceptions, social determinants of depressive symptoms as well as their impact on health and well-being in a community-dwelling U.S. Chinese aging…

  7. Relations of Personality to Substance Use Problems and Mental Health Disorder Symptoms in Two Clinical Samples of Adolescents

    ERIC Educational Resources Information Center

    Battista, Susan R.; Pencer, Alissa; McGonnell, Melissa; Durdle, Heather; Stewart, Sherry H.

    2013-01-01

    There is a high overlap between substance misuse and mental health disorders in adolescents. Certain personality traits (i.e., sensation seeking, impulsivity, hopelessness, and anxiety sensitivity) may be related to increased risk for mental health symptoms and/or substance misuse. The current study examined the relationships between personality…

  8. Parental Reports of Global Physical Health at Ages 3 and 6 Predict Self-Reported Depressive Symptoms 17 Years Later

    ERIC Educational Resources Information Center

    Raikkonen, Katri; Schubert, Carla; Pesonen, Anu-Katriina; Heinonen, Kati; Viikari, Jorma; Keltikangas-Jarvinen, Liisa

    2004-01-01

    Research studies testing longitudinal relations between childhood physical health measures and adulthood sub-clinical depressive symptoms are rare. In the Cardiovascular Risk in Young Finns Study, longitudinal relations of parental reports of the global physical health of the child (1 = good, 2 = moderately good, 3 = average/not good) and of…

  9. Paternal Postnatal and Subsequent Mental Health Symptoms and Child Socio-Emotional and Behavioural Problems at School Entry

    ERIC Educational Resources Information Center

    Smith, Hannah R.; Eryigit-Madzwamuse, Suna; Barnes, Jacqueline

    2013-01-01

    Research on the effect of paternal mental health problems, particularly on young children, is based predominantly on clinical levels of depression. Furthermore, potential mediators such as marital discord have often been overlooked. This longitudinal community study assessed the association between paternal mental health symptoms in a community…

  10. Effect of Health Comparisons on Functional Health and Depressive Symptoms - Results of a Population-Based Longitudinal Study of Older Adults in Germany

    PubMed Central

    Hajek, André; König, Hans-Helmut

    2016-01-01

    Objective To investigate the effect of health comparisons on functional health and depressive symptoms in a longitudinal approach. Gender differences were examined. Methods The German Ageing Survey (DEAS) is a nationwide, representative longitudinal study of community dwelling individuals living in Germany aged 40 and older. The surveys in 2008 and 2011 were used, with n = 3,983 respondents taking part in both waves. Health comparisons were quantified by the question “How would you rate your health compared with other people your age” (Much better; somewhat better; the same; somewhat worse, much worse). Functional health was assessed by the subscale “physical functioning” of the 36-Item Short Form Health Survey (SF-36) and depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D). Results Adjusting for sociodemographic factors, self-assessed health, social network, self-efficacy and optimism, and morbidity, fixed effects regressions revealed that functional health decreased significantly and considerably with negative health comparisons in the total sample (transitions from ‘the same’ to ‘much worse’: β = -11.8), predominantly in men. The effects of negative health comparisons (transitions from ‘the same’ to ‘much worse’: β = 4.8) on depressive symptoms were comparable (in terms of significance) to the effects on functional health, with stronger effects in women. Positive comparisons did not affect functional health and depressive symptoms. Conclusion Our findings underline the relevance of negative health comparisons on functional health (men) and depressive symptoms (women). Comparison effects are asymmetric and mostly upwards. PMID:27213731

  11. The education and training needs of qualified mental health nurses working in acute adult mental health services.

    PubMed

    Jones, Julia; Lowe, Trevor

    2003-11-01

    This paper presents findings from a research study that investigated the education and training needs of qualified mental health nurses who work in acute adult mental health services in the UK. The study aimed to address a key knowledge 'gap' highlighted by recent Department of Health reports () that suggest that little is known regarding the education and training expectations, priorities and needs of mental health nurses who work in acute adult mental health services. This study aimed to identify (i) what type of post-registration education and training mental health nurses working in acute settings need; (ii) how the nurses want education and training to be delivered; and (iii) what qualifications and accreditation the nurses want to receive? The research consisted of two methods: focus groups and a questionnaire survey. This paper reports on the findings from the questionnaire survey. The results of the survey demonstrate that there is a real need for post-registration education and training for this group of nurses; to equip them with the relevant knowledge and skills to nurse people in the acute phase of their mental illness in acute inpatient settings.

  12. School Nurse Workload: A Scoping Review of Acute Care, Community Health, and Mental Health Nursing Workload Literature

    ERIC Educational Resources Information Center

    Endsley, Patricia

    2017-01-01

    The purpose of this scoping review was to survey the most recent (5 years) acute care, community health, and mental health nursing workload literature to understand themes and research avenues that may be applicable to school nursing workload research. The search for empirical and nonempirical literature was conducted using search engines such as…

  13. Respiratory Health Symptoms among Students Exposed to Different Levels of Air Pollution in a Turkish City

    PubMed Central

    Gül, Hülya; Gaga, Eftade O.; Döğeroğlu, Tuncay; Özden, Özlem; Ayvaz, Özkan; Özel, Sevda; Güngör, Günay

    2011-01-01

    In this study, we aimed to investigate the frequency of respiratory health symptoms among high school students attending schools at industrial, urban and rural areas in a Turkish city. Three schools located in different zones of the city having different pollution characteristics were chosen based on the pollutant distribution maps using Geographical Information Systems (GIS) software. A cross-sectional survey was performed among 667 high school students in the schools. Outdoor and indoor nitrogen dioxide (NO2) and ozone (O3) concentrations were also measured by passive samplers in the same schools to investigate possible routes of exposure. Chronic pulmonary disease (OR = 1.49; 95%CI: 1.11–1.99; p = 0.008), tightness in the chest (OR = 1.57; 95%CI: 1.22–2.02; p = 0.001), morning cough (OR = 1.81 95%CI: 1.19–2.75; p = 0.006) were higher among students in the industrial zone where nitrogen dioxide and ozone levels were also highest. There were no indoor sources of nitrogen dioxide and ozone exists in the schools except for the dining hall. As a conclusion, this study has noticed that air pollution and respiratory health problems among high school students are high in industrial zones and the use of passive samplers combined with GIS is an effective tool that may be used by public health researchers to identify pollutant zones and persons at risk. PMID:21695031

  14. Reducing recidivism and symptoms in emerging adults with serious mental health conditions and justice system involvement.

    PubMed

    Davis, Maryann; Sheidow, Ashli J; McCart, Michael R

    2015-04-01

    The peak years of offending in the general population and among those with serious mental health conditions (SMHC) are during emerging adulthood. There currently are no evidence-based interventions for reducing offending behavior among 18-21 year olds, with or without SMHC. This open trial examined outcomes from an adaptation of Multisystemic Therapy (MST), an effective juvenile recidivism reduction intervention, modified for use with emerging adults with SMHC and recent justice system involvement. MST for emerging adults (MST-EA) targets MH symptoms, recidivism, problem substance use, and young adult functional capacities. All study participants (n = 41) were aged 17-20 and had a MH diagnosis and recent arrest or incarceration. Implementation outcomes indicated that MST-EA was delivered with strong fidelity, client satisfaction was high, and the majority of participants successfully completed the intervention. Research retention rates also were high. Pre-post-analyses revealed significant reductions in participants' MH symptoms, justice system involvement, and associations with antisocial peers.

  15. Preliminary study on the skin lightening practice and health symptoms among female students in Malaysia.

    PubMed

    Rusmadi, Siti Zulaikha; Syed Ismail, Sharifah Norkhadijah; Praveena, Sarva Mangala

    2015-01-01

    Many cases of dermatologic complication were reported with the use of skin lightening products. This study assessed the skin lightening practice and health symptoms among female students. Self-administered questionnaire was distributed to 104 female students (56 undergraduates and 48 postgraduates) aged 24 ± 2 years in Universiti Putra Malaysia. A total of 60.6% (N = 63) of the female students used skin lightening products (61.9% of undergraduates and 38.1% of postgraduates). Reasonable price (N = 35, 55.6%) and ingredients (N = 29, 46%) were considered the most important factors in the product selection. Most respondents purchased the product from drugstores (N = 39, 61.9%). Twenty-two respondents (34.9%) in this study experienced skin problem from the products they used. Skin peeling (N = 13, 12.5%) and acne (N = 9, 8.7%) were the most frequent symptoms experienced. Most of the respondents have the perception that lighter skin provides high self-esteem (N = 56, 53.8%) and looks beautiful and healthier (N = 54, 51.9%). The use of skin lightening products is common among female students in this study and some of these products can cause skin problems such as skin peeling, acne, and itching.

  16. Preliminary Study on the Skin Lightening Practice and Health Symptoms among Female Students in Malaysia

    PubMed Central

    Rusmadi, Siti Zulaikha; Syed Ismail, Sharifah Norkhadijah; Praveena, Sarva Mangala

    2015-01-01

    Many cases of dermatologic complication were reported with the use of skin lightening products. This study assessed the skin lightening practice and health symptoms among female students. Self-administered questionnaire was distributed to 104 female students (56 undergraduates and 48 postgraduates) aged 24 ± 2 years in Universiti Putra Malaysia. A total of 60.6% (N = 63) of the female students used skin lightening products (61.9% of undergraduates and 38.1% of postgraduates). Reasonable price (N = 35, 55.6%) and ingredients (N = 29, 46%) were considered the most important factors in the product selection. Most respondents purchased the product from drugstores (N = 39, 61.9%). Twenty-two respondents (34.9%) in this study experienced skin problem from the products they used. Skin peeling (N = 13, 12.5%) and acne (N = 9, 8.7%) were the most frequent symptoms experienced. Most of the respondents have the perception that lighter skin provides high self-esteem (N = 56, 53.8%) and looks beautiful and healthier (N = 54, 51.9%). The use of skin lightening products is common among female students in this study and some of these products can cause skin problems such as skin peeling, acne, and itching. PMID:26693230

  17. Reducing Recidivism and Symptoms in Emerging Adults with Serious Mental Health Conditions and Justice System Involvement

    PubMed Central

    Davis, Maryann; Sheidow, Ashli J.; McCart, Michael R.

    2014-01-01

    The peak years of offending in the general population and among those with serious mental health conditions (SMHC) are during emerging adulthood. There currently are no evidence-based interventions for reducing offending behavior among 18–21 year olds, with or without SMHC. This open trial examined outcomes from an adaptation of Multisystemic Therapy (MST), an effective juvenile recidivism reduction intervention, modified for use with emerging adults with SMHC and recent justice system involvement. MST for emerging adults (MST-EA) targets MH symptoms, recidivism, problem substance use, and young adult functional capacities. All study participants (n=41) were aged 17–20 and had a MH diagnosis and recent arrest or incarceration. Implementation outcomes indicated that MST-EA was delivered with strong fidelity, client satisfaction was high, and the majority of participants successfully completed the intervention. Research retention rates also were high. Pre-post analyses revealed significant reductions in participants’ MH symptoms, justice-system involvement, and associations with antisocial peers. PMID:25023764

  18. Health risk behaviors and depressive symptoms among Hispanic adolescents: Examining acculturation discrepancies and family functioning.

    PubMed

    Cano, Miguel Ángel; Schwartz, Seth J; Castillo, Linda G; Unger, Jennifer B; Huang, Shi; Zamboanga, Byron L; Romero, Andrea J; Lorenzo-Blanco, Elma I; Córdova, David; Des Rosiers, Sabrina E; Lizzi, Karina M; Baezconde-Garbanati, Lourdes; Soto, Daniel W; Villamar, Juan Andres; Pattarroyo, Monica; Szapocznik, José

    2016-03-01

    Drawing from a theory of bicultural family functioning 2 models were tested to examine the longitudinal effects of acculturation-related variables on adolescent health risk behaviors and depressive symptoms (HRB/DS) mediated by caregiver and adolescent reports of family functioning. One model examined the effects of caregiver-adolescent acculturation discrepancies in relation to family functioning and HRB/DS. A second model examined the individual effects of caregiver and adolescent acculturation components in relation to family functioning and HRB/DS. A sample of 302 recently immigrated Hispanic caregiver-child dyads completed measures of Hispanic and U.S. cultural practices, values, and identities at baseline (predictors); measures of family cohesion, family communications, and family involvement 6 months postbaseline (mediators); and only adolescents completed measures of smoking, binge drinking, inconsistent condom use, and depressive symptoms 1 year postbaseline (outcomes). Measures of family cohesion, family communications, and family involvement were used to conduct a confirmatory factor analysis to estimate the fit of a latent construct for family functioning. Key findings indicate that (a) adolescent acculturation components drove the effect of caregiver-adolescent acculturation discrepancies in relation to family functioning; (b) higher levels of adolescent family functioning were associated with less HRB/DS, whereas higher levels of caregiver family functioning were associated with more adolescent HRB/DS; (c) and only adolescent reports of family functioning mediated the effects of acculturation components and caregiver-adolescent acculturation discrepancies on HRB/DS.

  19. Health Risk Behaviors and Depressive Symptoms among Hispanic Adolescents: Examining Acculturation Discrepancies and Family Functioning

    PubMed Central

    Cano, Miguel Ángel; Schwartz, Seth J.; Castillo, Linda G.; Unger, Jennifer B.; Huang, Shi; Zamboanga, Byron L.; Romero, Andrea J.; Lorenzo-Blanco, Elma I.; Córdova, David; Des Rosiers, Sabrina E.; Lizzi, Karina M.; Baezconde-Garbanati, Lourdes; Soto, Daniel W.; Villamar, Juan Andres; Pattarroyo, Monica; Szapocznik, José

    2015-01-01

    Drawing from a theory of bicultural family functioning two models were tested to examine the longitudinal effects of acculturation-related variables on adolescent health risk behaviors and depressive symptoms (HRB/DS) mediated by caregiver and adolescent reports of family functioning. One model examined the effects of caregiver-adolescent acculturation discrepancies in relation to family functioning and HRB/DS. A second model examined the individual effects of caregiver and adolescent acculturation components in relation to family functioning and HRB/DS. A sample of 302 recently immigrated Hispanic caregiver-child dyads completed measures of Hispanic and U.S. cultural practices, values, and identities at baseline (predictors); measures of family cohesion, family communications, and family involvement six months post-baseline (mediators); and only adolescents completed measures of smoking, binge drinking, inconsistent condom use, and depressive symptoms one year post-baseline (outcomes). Measures of family cohesion, family communications, and family involvement were used to conduct a confirmatory factor analysis to estimate the fit of a latent construct for family functioning. Key findings indicate that (a) adolescent acculturation components drove the effect of caregiver-adolescent acculturation discrepancies in relation to family functioning, (b) higher levels of adolescent family functioning were associated with less HRB/DS, whereas higher levels of caregiver family functioning were associated with more adolescent HRB/DS, (c) and only adolescent reports of family functioning mediated the effects of acculturation components and caregiver-adolescent acculturation discrepancies on HRB/DS. PMID:26301514

  20. Eating regulation and bulimic symptoms: the differential correlates of health-focused and appearance-focused eating regulation.

    PubMed

    Verstuyf, Joke; Vansteenkiste, Maarten; Soenens, Bart

    2012-01-01

    Based on Self-Determination Theory, this study aimed to gain further insight in the pathway from eating regulation to bulimic symptoms by (a) examining diet-specific need frustration as an intervening mechanism, (b) investigating the associations between different types of goals underlying eating regulation and diet-specific need frustration and bulimic symptoms, and (c) considering body dissatisfaction as an antecedent of eating regulation and eating regulation goals. In a sample of 244 female adolescents, SEM analyses showed that (a) the association between eating regulation and bulimic symptoms can be accounted for by need frustration, (b) appearance-focused and health-focused eating regulation are associated differentially with need frustration and bulimic symptoms, and (c) body dissatisfaction is related positively to eating regulation and appearance-focused eating regulation. These findings suggest that the goals underlying one's eating regulation and the concept of need frustration help to understand when and why eating regulation is associated with bulimic symptoms.

  1. Relationships between self-rated oral health, subjective symptoms, oral health behavior and clinical conditions in Japanese university students: a cross-sectional survey at Okayama University

    PubMed Central

    2013-01-01

    Background Self-rated oral health is a valid and useful summary indicator of overall oral health status and quality of life. However, few studies on perception of oral health have been conducted among Japanese young adults. This study investigated whether oral health behavior, subjective oral symptoms, or clinical oral status were associated with self-rated oral health in Japanese young adults. Methods This cross-sectional survey included 2,087 students (1,183 males, 904 females), aged 18 and 19 years, at Okayama University, Japan. A self-administered questionnaire was distributed and an oral examination was performed. Results In a structural equation modeling analysis, the score of decayed, missing and filled teeth (DMFT) significantly affected self-rated oral health (p <0.05) and the effect size was highest. Malocclusion, subjective symptoms of temporomandibular disorders (TMD) and stomatitis, and poor oral health behavior significantly induced self-rated poor oral health with small effect sizes (p <0.05). Clinical periodontal conditions and Oral Hygiene Index-simplified were not related to self-rated oral health. Conclusion Self-rated oral health was influenced by subjective symptoms of TMD and stomatitis, oral health behavior, the score of DMFT, and malocclusion. The evaluation of these parameters may be a useful approach in routine dental examination to improve self-rated oral health in university students. PMID:24195632

  2. Comparison of workers’ perceptions toward work climate and health symptoms between ceramic and iron foundry workers

    PubMed Central

    Majumder, Joydeep; Bagepally, Bhavani S.; Shah, Priyanka; Kotadiya, Sanjay; Yadav, Suresh; Naha, Nibedita

    2016-01-01

    Background: Workers exposed to heavy manual material handling (MMH) in a hot working environment succumb to severe physical stress and psychological stress. Aims: (1) Recognize the heat load at workplaces of ceramic industry and iron industry, and (2) comparatively examine the characteristics of self-reported physiological responses and heat-health perception among these workers. Settings and Design: Cross-sectional prospective study. Materials and Methods: Workplace microclimate in the ceramic industry and iron industry was monitored. An ergonomic checklist and a questionnaire was used to record self-reported workers’ perceptions toward heat stress at workplace (ceramic workers N = 321, iron foundry workers N = 253). The prevalence rates of subjective symptoms among workers of both the industries were compared. Statistical Analysis: Chi-square test was used to examine the association between stressors and health complaints at a significance level set at P < 0.05. Results: Iron foundries recorded higher mean ambient temperature (43.4 ± 3.7°C) and wet-bulb globe temperature (WGBT) index (31.5 ± 0.7°C) as compared to ceramic industries (39.9 ± 3.3°C and 28 ± 1.5°C, respectively). Heavy sweating, elevated body temperature, sleeplessness, excessive thirst, muscular discomforts, and fatigue were prime symptoms recorded among workers of both industries. Skin-related disorders (red face, dry skin, bumps, itching) were significantly higher among iron foundry workers, whereas sleeplessness, high blood pressure, heavy sweating, kidney stone, decreased urination, muscular discomforts, and fatigue were significantly more among ceramic workers. Young workers reported more sweating and fatigue than older workers. Conclusions: A hot work climate and heavy manual labor designate ceramic and iron industries as arduous. Direct contact with hot surface and continuous MMH in tandem with the mechanical pace of production process makes work in ceramic industries more difficult

  3. Pesticide usage and its association with health symptoms among farmers in rural villages in West Java, Indonesia.

    PubMed

    Sekiyama, Makiko; Tanaka, Mika; Gunawan, Budhi; Abdoellah, Oekan; Watanabe, Chiho

    2007-01-01

    The improper handling of pesticides in agriculture has caused serious health problems in many developing countries. In this study, we report the pesticide usage condition among Indonesian farmers and its association with symptoms of pesticide toxicity. A questionnaire survey on personal history regarding agricultural labor, pesticide storage and disposal, pesticide use and health history was conducted using a structured questionnaire in rural Sundanese villages in West Java, Indonesia. The most frequently used pesticides included dithiocarbamates, pyrethroids and organophosphates. In approximately 80% of sprayings, category II pesticides (World Health Organization (WHO) categorization; "moderately hazardous") were used. Many of the subject farmers worked in a highly unsafe occupational environment; protective measures and safe handling were rarely observed, whereas smoking and drinking during spraying were frequently practiced. Correlation analysis revealed that farmers who wore a long sleeve shirt and headgear showed health symptoms less frequently. Moreover, farmers who had skin contact with the spray solution during measuring or mixing (excluding the hands), who wore wet clothing (skin exposure to pesticide), and who smoked and rubbed their eyes during spraying showed more symptoms. Among these factors, headgear use, wearing wet clothing (skin exposure to pesticide), and smoking during spraying were the significant determining factors for developing health symptoms. Preventing such behaviors will be an effective method of reducing health problems among the subject farmers.

  4. Acute Radiation-Induced Nocturia in Prostate Cancer Patients Is Associated With Pretreatment Symptoms, Radical Prostatectomy, and Genetic Markers in the TGF{beta}1 Gene

    SciTech Connect

    De Langhe, Sofie; De Ruyck, Kim; Ost, Piet; Fonteyne, Valerie; Werbrouck, Joke; De Meerleer, Gert; De Neve, Wilfried; Thierens, Hubert

    2013-02-01

    Purpose: After radiation therapy for prostate cancer, approximately 50% of the patients experience acute genitourinary symptoms, mostly nocturia. This may be highly bothersome with a major impact on the patient's quality of life. In the past, nocturia is seldom reported as a single, physiologically distinct endpoint, and little is known about its etiology. It is assumed that in addition to dose-volume parameters and patient- and therapy-related factors, a genetic component contributes to the development of radiation-induced damage. In this study, we investigated the association among dosimetric, clinical, and TGF{beta}1 polymorphisms and the development of acute radiation-induced nocturia in prostate cancer patients. Methods and Materials: Data were available for 322 prostate cancer patients treated with primary or postoperative intensity modulated radiation therapy (IMRT). Five genetic markers in the TGF{beta}1 gene (-800 G>A, -509 C>T, codon 10 T>C, codon 25 G>C, g.10780 T>G), and a high number of clinical and dosimetric parameters were considered. Toxicity was scored using an symptom scale developed in-house. Results: Radical prostatectomy (P<.001) and the presence of pretreatment nocturia (P<.001) are significantly associated with the occurrence of radiation-induced acute toxicity. The -509 CT/TT (P=.010) and codon 10 TC/CC (P=.005) genotypes are significantly associated with an increased risk for radiation-induced acute nocturia. Conclusions: Radical prostatectomy, the presence of pretreatment nocturia symptoms, and the variant alleles of TGF{beta}1 -509 C>T and codon 10 T>C are identified as factors involved in the development of acute radiation-induced nocturia. These findings may contribute to the research on prediction of late nocturia after IMRT for prostate cancer.

  5. Employment status, depressive symptoms, and waist circumference change in midlife women: The Study of Women's Health Across the Nation (SWAN)

    PubMed Central

    Appelhans, Bradley M.; Segawa, Eisuke; Janssen, Imke; Kazlauskaite, Rasa; Thurston, Rebecca C.; Lewis, Tené T.; Kravitz, Howard M.

    2014-01-01

    Purpose Changes in employment status have shown inconsistent associations with adiposity. This study tested whether the presence of elevated depressive symptoms explains variability in the time-varying association between employment status and central adiposity. Method Employment status, depressive symptoms, and waist circumference were assessed annually over 10 years in a multi-ethnic sample of 3220 midlife women enrolled in the Study of Women’s Health Across the Nation. Linear mixed-effects models tested time-varying associations of employment status, depressive symptoms, and their interaction with waist circumference. Results Waist circumference increases were greatest during years of combined nonemployment and elevated depressive symptoms (1.00 cm/year), and lowest in years of full-time employment and elevated depressive symptoms (0.25 cm/year), compared to years of full-time employment and non-elevated depressive symptoms (0.51 cm/year). Employment status was unrelated to waist circumference in years without elevated depressive symptoms. The pattern of results was unchanged when analyses were restricted to pre-retirement observations, and did not vary according to waist circumference at baseline or ethnicity/race. Conclusions Identifying and managing depressive symptoms in midlife women who are not working may help prevent increases in central adiposity. PMID:24462272

  6. Brain responses to symptom provocation and trauma-related short-term memory recall in coal mining accident survivors with acute severe PTSD.

    PubMed

    Hou, Cailan; Liu, Jun; Wang, Kun; Li, Lingjiang; Liang, Meng; He, Zhong; Liu, Yong; Zhang, Yan; Li, Weihui; Jiang, Tianzi

    2007-05-04

    Functional neuroimaging studies have largely been performed in patients with longstanding chronic posttraumatic stress disorder (PTSD). Additionally, memory function of PTSD patients has been proved to be impaired. We sought to characterize the brain responses of patients with acute PTSD and implemented a trauma-related short-term memory recall paradigm. Individuals with acute severe PTSD (n=10) resulting from a mining accident and 7 men exposed to the mining accident without PTSD underwent functional magnetic resonance imaging (fMRI) while performing the symptom provocation and trauma-related short-term memory recall paradigms. During symptom provocation paradigm, PTSD subjects showed diminished responses in right anterior cingulate gyrus, left inferior frontal gyrus and bilateral middle frontal gyrus and enhanced left parahippocampal gyrus response compared with controls. During the short-term memory recall paradigm, PTSD group showed diminished responses in right inferior frontal gyrus, right middle frontal and left middle occipital gyrus in comparison with controls. PTSD group exhibited diminished right parahippocampal gyrus response during the memory recall task as compared to the symptom provocation task. Our findings suggest that neurophysiological alterations and memory performance deficit have developed in acute severe PTSD.

  7. Anxiety sensitivity and panic reactivity to bodily sensations: relation to quit-day (acute) nicotine withdrawal symptom severity among daily smokers making a self-guided quit attempt.

    PubMed

    Marshall, Erin C; Johnson, Kirsten; Bergman, Jenna; Gibson, Laura E; Zvolensky, Michael J

    2009-10-01

    The current investigation explored the main and interactive effects of panic attacks in response to laboratory-induced bodily sensations and anxiety sensitivity in predicting acute nicotine withdrawal symptoms among daily smokers making a self-guided quit attempt. Participants were 99 daily smokers (58% women; M(age) = 28.4 years, SD = 11.7) who completed a battery of questionnaires, a voluntary hyperventilation challenge, and a measure of nicotine withdrawal symptoms 12 hr after making a self-guided quit attempt. Results indicated that the interaction of anxiety sensitivity and panic responsivity to the challenge predicted quit-day nicotine withdrawal symptom severity above and beyond the main effects (p < .05). The form of the interaction indicated that the relationship between postchallenge panic attack status and acute nicotine withdrawal was more robust among individuals who were low in anxiety sensitivity. Individuals who did not experience a panic attack posthyperventilation who were also low in anxiety sensitivity reported the lowest levels of nicotine withdrawal. Results suggest that anxiety sensitivity may be less relevant with regard to acute nicotine withdrawal severity among individuals with panic-related problems.

  8. Health symptoms in relation to temperature, humidity, and self-reported perceptions of climate in New York City residential environments.

    PubMed

    Quinn, Ashlinn; Shaman, Jeffrey

    2017-01-20

    Little monitoring has been conducted of temperature and humidity inside homes despite the fact that these conditions may be relevant to health outcomes. Previous studies have observed associations between self-reported perceptions of the indoor environment and health. Here, we investigate associations between measured temperature and humidity, perceptions of indoor environmental conditions, and health symptoms in a sample of New York City apartments. We measured temperature and humidity in 40 New York City apartments during summer and winter seasons and collected survey data from the households' residents. Health outcomes of interest were (1) sleep quality, (2) symptoms of heat illness (summer season), and (3) symptoms of respiratory viral infection (winter season). Using mixed-effects logistic regression models, we investigated associations between the perceptions, symptoms, and measured conditions in each season. Perceptions of indoor temperature were significantly associated with measured temperature in both the summer and the winter, with a stronger association in the summer season. Sleep quality was inversely related to measured and perceived indoor temperature in the summer season only. Heat illness symptoms were associated with perceived, but not measured, temperature in the summer season. We did not find an association between any measured or perceived condition and cases of respiratory infection in the winter season. Although limited in size, the results of this study reveal that indoor temperature may impact sleep quality, and that thermal perceptions of the indoor environment may indicate vulnerability to heat illness. These are both important avenues for further investigation.

  9. Health symptoms in relation to temperature, humidity, and self-reported perceptions of climate in New York City residential environments

    NASA Astrophysics Data System (ADS)

    Quinn, Ashlinn; Shaman, Jeffrey

    2017-01-01

    Little monitoring has been conducted of temperature and humidity inside homes despite the fact that these conditions may be relevant to health outcomes. Previous studies have observed associations between self-reported perceptions of the indoor environment and health. Here, we investigate associations between measured temperature and humidity, perceptions of indoor environmental conditions, and health symptoms in a sample of New York City apartments. We measured temperature and humidity in 40 New York City apartments during summer and winter seasons and collected survey data from the households' residents. Health outcomes of interest were (1) sleep quality, (2) symptoms of heat illness (summer season), and (3) symptoms of respiratory viral infection (winter season). Using mixed-effects logistic regression models, we investigated associations between the perceptions, symptoms, and measured conditions in each season. Perceptions of indoor temperature were significantly associated with measured temperature in both the summer and the winter, with a stronger association in the summer season. Sleep quality was inversely related to measured and perceived indoor temperature in the summer season only. Heat illness symptoms were associated with perceived, but not measured, temperature in the summer season. We did not find an association between any measured or perceived condition and cases of respiratory infection in the winter season. Although limited in size, the results of this study reveal that indoor temperature may impact sleep quality, and that thermal perceptions of the indoor environment may indicate vulnerability to heat illness. These are both important avenues for further investigation.

  10. Missed Opportunities To Impact Fast Response to AMI Symptoms.

    ERIC Educational Resources Information Center

    Zapka, Jane G.; Oakes, J. Michael; Simons-Morton, Denise G.; Mann, N. Clay; Goldberg, Robert; Sellers, Deborah E.; Estabrook, Barbara; Gilliland, Janice; Linares, Adriana C.; Benjamin-Garner, Ruby; McGovern, Paul

    2000-01-01

    Examines factors that influence the prompt seeking of care for symptoms of acute myocardial infarction (AMI). Survey of adults in 20 communities in 10 states confirmed the importance of attrition and perceived self-confidence in symptom recognition in care seeking. Concludes that the lack of a significant role of health history and clinician…

  11. Childhood ADHD Symptoms: Association with Parental Social Networks and Mental Health Service Use during Adolescence

    PubMed Central

    Bussing, Regina; Meyer, Johanna; Zima, Bonnie T.; Mason, Dana M.; Gary, Faye A.; Garvan, Cynthia Wilson

    2015-01-01

    Objective: This study examines the associations of childhood attention-deficit/hyperactivity disorder (ADHD) risk status with subsequent parental social network characteristics and caregiver strain in adolescence; and examines predictors of adolescent mental health service use. Methods: Baseline ADHD screening identified children at high risk (n = 207) and low risk (n = 167) for ADHD. At eight-year follow-up, parents reported their social network characteristics, caregiver strain, adolescents’ psychopathology and mental health service utilization, whereas adolescents self-reported their emotional status and ADHD stigma perceptions. Analyses were conducted using ANOVAs and nested logistic regression modeling. Results: Parents of youth with childhood ADHD reported support networks consisting of fewer spouses but more healthcare professionals, and lower levels of support than control parents. Caregiver strain increased with adolescent age and psychopathology. Increased parental network support, youth ADHD symptoms, and caregiver strain, but lower youth stigma perceptions were independently associated with increased service use. Conclusions: Raising children with ADHD appears to significantly impact parental social network experiences. Reduced spousal support and overall lower network support levels may contribute to high caregiver strain commonly reported among parents of ADHD youth. Parental social network experiences influence adolescent ADHD service use. With advances in social networking technology, further research is needed to elucidate ways to enhance caregiver support during ADHD care. PMID:26402692

  12. Mental health problems during puberty: Tanner stage-related differences in specific symptoms. The TRAILS study.

    PubMed

    Oldehinkel, Albertine J; Verhulst, Frank C; Ormel, Johan

    2011-02-01

    The aim of this study was to investigate associations between specific mental health problems and pubertal stage in (pre)adolescents participating in the Dutch prospective cohort study TRAILS (first assessment: N=2230, age 11.09±0.56, 50.8% girls; second assessment: N=2149, age 13.56±0.53, 51.0% girls). Mental health was assessed by the Youth Self-Report, pubertal (Tanner) stage by parent-rated drawings of secondary sex characteristics. Overall, higher Tanner stages were related to more reported tiredness, irritability, rule-breaking behaviors, and substance use; and fewer fears and somatic complaints. Girls showed increases in social uncertainty, depressed mood, and worries; boys a decrease in self-criticism. Increasing problems during puberty were mostly related to the process of physical maturation, whereas decreasing problems were rather related to general age-related developments. Pubertal timing was associated with different symptoms than pubertal status or age. Puberty seems to affect girls more negatively than boys.

  13. Anxiety and physical health problems increase the odds of women having more severe symptoms of depression.

    PubMed

    Weiss, Sandra J; Simeonova, Diana I; Kimmel, Mary C; Battle, Cynthia L; Maki, Pauline M; Flynn, Heather A

    2016-06-01

    Severely depressed women incur substantial disability and suicide risk, necessitating an understanding of factors that may contribute to severe depression. The purpose of this research was to determine the degree to which age, physical morbidity, anxiety, and hormonal status predict the likelihood of severe depression among women with mood disorders (n = 298). Data arose from a standardized battery of measures in a multi-center clinical registry of patients with mood disorders. The women were being treated at 17 participating sites of the National Network of Depression Centers. Results of logistic regression analyses indicate that a woman's level of anxiety was the strongest predictor of her likelihood of having severe depression (Exp(B) = 1.33, p = .000), including thoughts of death or suicide. The number of physical health problems that a woman reported was also a significant predictor (Exp(B) = 1.09, p = .04). Neither age nor hormonal status was significant in the final model, although a trend was observed for women with surgically induced menopause to have more severe depression. Findings support the need to work closely with medical practitioners to address physical health problems as part of the treatment plan for depression and to give comorbid anxiety and depression equal priority in symptom management.

  14. Closeness, chaos and crisis: the attractions of working in acute mental health care.

    PubMed

    Deacon, M; Warne, T; McAndrew, S

    2006-12-01

    This paper makes a case for the attractiveness of acute mental health inpatient nursing (acute nursing) and argues that an altered perception of this work is essential if we are to provide the most acutely mentally ill and vulnerable people with a stable and expert nursing workforce. The discussion draws on an ethnographic study conducted in an inner-city psychiatric unit in England and the advantages of this method for understanding nursing work are described. Within our findings, we set out two overarching themes: the contextual realities of the contemporary acute ward and features of attraction that encourage nurses to work in the acute care setting. The former includes nurses' responsibility for the total ward environment and the latter the 'comfort of closeness' and 'surviving and thriving in chaos and crisis'. In conclusion, we argue that despite the unpopularity of the acute inpatient mental health environment, the highly sophisticated skills employed by acute nurses actually ensure the promotion of health for the majority of service users.

  15. Health-related stress, affect, and depressive symptoms experienced by caregiving mothers of adults with a developmental disability.

    PubMed

    Pruchno, Rachel A; Meeks, Suzanne

    2004-09-01

    The interrelationships among health-related stress, positive and negative affect, and depressive symptoms patterned in the dynamic model of affect (J. Reich, A. Zautra, & M. Davis, 2003) were examined using data from 932 women having an adult child with a developmental disability. Results indicate that women experience a moderate inverse correlation between positive and negative affect under conditions of low levels of health-related stress, whereas at high levels of stress, positive and negative affect become more strongly inversely correlated. Under high-stress conditions, both negative affect and positive affect have a stronger relationship to depressive symptoms than they do under low-stress conditions.

  16. Gender differences in pre-event health status of young patients with acute myocardial infarction: A VIRGO study analysis

    PubMed Central

    Dreyer, Rachel P; Smolderen, Kim G; Strait, Kelly M; Beltrame, John F; Lichtman, Judith H; Lorenze, Nancy P; D’Onofrio, Gail; Bueno, Héctor; Krumholz, Harlan M; Spertus, John A

    2015-01-01

    Aims We assessed gender differences in pre-event health status (symptoms, functioning, quality of life) in young patients with acute myocardial infarction (AMI), and whether or not this association persists following sequential adjustment for important covariates. We also evaluated the interaction between gender and prior coronary artery disease (CAD), given that aggressive symptom control is a cornerstone of care in those with known coronary disease. Methods and Results A total of 3,501 AMI patients (2,349 women) aged 18–55 years were enrolled from 103 United States/24 Spanish hospitals (2008–2012). Clinical/health status information was obtained by medical record abstraction and patient interviews. Pre-event health status was measured by generic [Short Form-12 (SF-12), EuroQoL [EQ-5D)] and disease-specific [Seattle angina questionnaire (SAQ)] measures. T-test/chi-square and multivariable linear/logistic regression analysis was utilized, sequentially adjusting for covariates. Women had more co-morbidities and significantly lower generic mean health scores than men [SF-12 physical health =43±12 vs. 46±11 and mental health= 44±13 vs. 48±11]; EQ-5D utility index=0.7±0.2 vs. 0.8±0.2, and visual analog scale=63±22 vs. 67±20, P<0.0001 for all. Their disease-specific health status was also worse, with more angina [SAQ angina frequency=83±22 vs. 87±18], worse physical function [physical limitation=78±27 vs. 87±21] and poorer quality of life [55±25 vs. 60±22, P<0.0001 for all]. In multivariable analysis, the association between female gender and worse generic physical/mental health persisted, as well as worse disease-specific physical limitation and quality of life. The interaction between gender and prior CAD was not significant in any of the health status outcomes. Conclusion Young women have worse pre-event health status as compared with men, regardless of their CAD history. While future studies of gender differences should adjust for baseline health

  17. The National Institutes of Health/National Institutes of Nursing Research intramural research program and the development of the National Institutes of Health Symptom Science Model.

    PubMed

    Cashion, Ann K; Grady, Patricia A

    2015-01-01

    The National Institute of Nursing Research (NINR) intramural research program conducts basic and biobehavioral symptom science research and provides training opportunities to the next generation of scientists. Recently, the NINR developed the Symptom Science Model to guide research. The model begins by identifying a complex symptom, which is then characterized into a phenotype with biological and clinical data, followed by the application of genomic and other discovery methodologies to illuminate targets for therapeutic and clinical interventions. Using the Symptom Science Model, the intramural program organizes and implements biobehavioral, symptom management, and tissue injury research. The model is also used as a framework for training and career development opportunities including on-campus trainings and research fellowship. The scientific goal of the intramural program is to enhance patient outcomes including health-related quality of life. Achieving this goal requires a long-term vision, continued resource investments, and a commitment to mentoring our next generation of scientists.

  18. Mental health care use in medically unexplained and explained physical symptoms: findings from a general population study

    PubMed Central

    van Eck van der Sluijs, Jonna F; ten Have, Margreet; Rijnders, Cees A; van Marwijk, Harm WJ; de Graaf, Ron; van der Feltz-Cornelis, Christina M

    2016-01-01

    Objective The aim of this study was to explore mental health care utilization patterns in primary and specialized mental health care of people with unexplained or explained physical symptoms. Methods Data were derived from the first wave of the Netherlands Mental Health Survey and Incidence Study-2, a nationally representative face-to-face cohort study among the general population aged 18–64 years. We selected subjects with medically unexplained symptoms (MUS) only (MUSonly; n=177), explained physical symptoms only (PHYonly, n=1,952), combined MUS and explained physical symptoms (MUS + PHY, n=209), and controls without physical symptoms (NONE, n=4,168). We studied entry into mental health care and the number of treatment contacts for mental problems, in both primary care and specialized mental health care. Analyses were adjusted for sociodemographic characteristics and presence of any 12-month mental disorder assessed with the Composite International Diagnostic Interview 3.0. Results At the primary care level, all three groups of subjects with physical symptoms showed entry into care for mental health problems significantly more often than controls. The adjusted odds ratios were 2.29 (1.33, 3.95) for MUSonly, 1.55 (1.13, 2.12) for PHYonly, and 2.25 (1.41, 3.57) for MUS + PHY. At the specialized mental health care level, this was the case only for MUSonly subjects (adjusted odds ratio 1.65 [1.04, 2.61]). In both the primary and specialized mental health care, there were no significant differences between the four groups in the number of treatment contacts once they entered into treatment. Conclusion All sorts of physical symptoms, unexplained as well as explained, were associated with significant higher entry into primary care for mental problems. In specialized mental health care, this was true only for MUSonly. No differences were found in the number of treatment contacts. This warrants further research aimed at the content of the treatment contacts. PMID

  19. An interprofessional nurse-led mental health promotion intervention for older home care clients with depressive symptoms

    PubMed Central

    2014-01-01

    Background Depressive symptoms in older home care clients are common but poorly recognized and treated, resulting in adverse health outcomes, premature institutionalization, and costly use of health services. The objectives of this study were to examine the feasibility and acceptability of a new six-month interprofessional (IP) nurse-led mental health promotion intervention, and to explore its effects on reducing depressive symptoms in older home care clients (≥ 70 years) using personal support services. Methods A prospective one-group pre-test/post-test study design was used. The intervention was a six-month evidence-based depression care management strategy led by a registered nurse that used an IP approach. Of 142 eligible consenting participants, 98 (69%) completed the six-month and 87 (61%) completed the one-year follow-up. Outcomes included depressive symptoms, anxiety, health-related quality of life (HRQoL), and the costs of use of all types of health services at baseline and six-month and one-year follow-up. An interpretive descriptive design was used to explore clients’, nurses’, and personal support workers’ perceptions about the intervention’s appropriateness, benefits, and barriers and facilitators to implementation. Results Of the 142 participants, 56% had clinically significant depressive symptoms, with 38% having moderate to severe symptoms. The intervention was feasible and acceptable to older home care clients with depressive symptoms. It was effective in reducing depressive symptoms and improving HRQoL at six-month follow-up, with small additional improvements six months after the intervention. The intervention also reduced anxiety at one year follow-up. Significant reductions were observed in the use of hospitalization, ambulance services, and emergency room visits over the study period. Conclusions Our findings provide initial evidence for the feasibility, acceptability, and sustained effects of the nurse-led mental health promotion

  20. Persistent reflux symptoms cause anxiety, depression, and mental health and sleep disorders in gastroesophageal reflux disease patients

    PubMed Central

    Kimura, Yoshihide; Kamiya, Takeshi; Senoo, Kyouji; Tsuchida, Kenji; Hirano, Atsuyuki; Kojima, Hisayo; Yamashita, Hiroaki; Yamakawa, Yoshihiro; Nishigaki, Nobuhiro; Ozeki, Tomonori; Endo, Masatsugu; Nakanishi, Kazuhisa; Sando, Motoki; Inagaki, Yusuke; Shikano, Michiko; Mizoshita, Tsutomu; Kubota, Eiji; Tanida, Satoshi; Kataoka, Hiromi; Katsumi, Kohei; Joh, Takashi

    2016-01-01

    Some patients with gastroesophageal reflux disease experience persistent reflux symptoms despite proton pump inhibitor therapy. These symptoms reduce their health-related quality of life. Our aims were to evaluate the relationship between proton pump inhibitor efficacy and health-related quality of life and to evaluate predictive factors affecting treatment response in Japanese patients. Using the gastroesophageal reflux disease questionnaire, 145 gastroesophageal reflux disease patients undergoing proton pump inhibitor therapy were evaluated and classified as responders or partial-responders. Their health-related quality of life was then evaluated using the 8-item Short Form Health Survey, the Pittsburgh Sleep Quality Index, and the Hospital Anxiety and Depression Scale questionnaires. Sixty-nine patients (47.6%) were partial responders. These patients had significantly lower scores than responders in 5/8 subscales and in the mental health component summary of the 8-item Short Form Health Survey. Partial responders had significantly higher Pittsburgh Sleep Quality Index and Hospital Anxiety and Depression Scale scores, including anxiety and depression scores, than those of responders. Non-erosive reflux disease and double proton pump inhibitor doses were predictive factors of partial responders. Persistent reflux symptoms, despite proton pump inhibitor therapy, caused mental health disorders, sleep disorders, and psychological distress in Japanese gastroesophageal reflux disease patients. PMID:27499583

  1. Recognition and treatment of psychotic symptoms: spiritists compared to mental health professionals in Puerto Rico and Brazil.

    PubMed

    Moreira-Almeida, Alexander; Koss-Chioino, Joan D

    2009-01-01

    This article expands psychosocial and cultural perspectives on the experience and expression of psychotic symptoms and the treatment of schizophrenia by exploring how Spiritism, a popular religion in Latin America, provides healing to persons with severe mental illness. Beliefs and treatment by Spiritist healers of persons with psychotic symptoms, some diagnosed with schizophrenia, are described. Reactions by mental health professionals (psychologists, mental health technicians and psychiatrists) to this alternative treatment are described. Qualitative data have been collected through in-depth interviews with 49 Spiritist mediums in Puerto Rico, and case histories of 22 patients and their family members, all of whom gave informed consent. In Brazil, interviews were conducted with a sample of 115 Spiritist mediums, with their informed consent. These mediums responded to semi-structured interviews and standard measures of social adjustment and mental health. As expected, beliefs and practices of Spiritist healers regarding psychotic symptoms, whether manifested by themselves or by clients diagnosed with schizophrenia or other disorders, differ substantively from conventional psychiatric constructs and treatment approaches. According to patients' self reports and researchers' observations, spirit healers often achieve positive results with persons manifesting psychotic symptoms or diagnosed with schizophrenia in that symptoms become less frequent and/or social adjustment improves. We suggest psychosocial mechanisms to explain these findings and raise questions for future research.

  2. Acute adverse event signalling scheme using the Saskatchewan Administrative health care utilization datafiles: results for two benzodiazepines.

    PubMed

    Rawson, N S; Rawson, M J

    1999-01-01

    Linked administrative health care utilization databases offer potential benefits for postmarketing surveillance. The value of the Saskatchewan datafiles in an acute adverse event signalling scheme has been evaluated using two benzodiazepines. The first 20,000 patients dispensed lorazepam and the first 8525 patients dispensed alprazolam were followed through the datafiles over the year after their initial prescription of the relevant drug, and all medical services occurring during treatment were recorded. The most frequent adverse drug reactions to benzodiazepines are drowsiness, depression, impaired intellectual function and memory, lethargy, impaired coordination, dizziness, nausea and/or vomiting, skin rash, and respiratory disturbance. Data from our study showed that sleep disorders, depressive disorders, dizziness and/or vertigo, respiratory symptoms, esophagus and stomach disorders, and inflammatory skin conditions occurred significantly more often in the first 30 days after the initial prescription than in the succeeding six months in both drug groups, indicating that they are important adverse events. There are several limitations to the methodology; however, the results of the analysis indicate that the use of administrative health care utilization datafiles in a systematic assessment to signal potential acute adverse drug reactions is a feasible proposition, but further studies are required to assess whether events are real adverse reactions.

  3. The gender gap in depressive symptoms among Japanese elders: evaluating social support and health as mediating factors.

    PubMed

    Tiedt, Andrew D

    2010-09-01

    Depression has been described as the world's most prevalent illness and a leading cause of disability across age groups. The global literature on aging and depression reports greater prevalence of depressive symptoms among women than men. This research applies data from the Nihon University Japanese Longitudinal Study of Aging to the gender gap in depressive symptoms reported by Japanese elders. This study takes the position that cultural norms centered on obligations to care determine both the prevalence of social support and its application by family members. Since gender is the lens through which social and cultural expectations are filtered, the experiences of men and women are distinguished from one another. This study hypothesized that coresidency and filial obligations should protect elders from depression. At the same time, combative relationships within households were posited to aggravate depressive symptoms among mothers-in-law and daughters-in-law. Weak social support networks, as captured through not being married, living alone and lack of community contact were also hypothesized to exacerbate isolation and heighten depressive symptoms. The analyses found that receipt of support both protected elders as well as worsened depressive symptoms. While women reported greater frequency of depressive symptoms overall, results indicated that men experienced a larger effect of decreased mobility and transitions to poor physical health on depressive symptoms than women.

  4. The Impact of Lifetime Victimization and Polyvictimization on Adolescents in Québec: Mental Health Symptoms and Gender Differences.

    PubMed

    Cyr, Katie; Chamberland, Claire; Clément, Marie-Ève; Wemmers, Jo-Anne; Collin-Vézina, Delphine; Lessard, Geneviève; Gagné, Marie-Hélène; Damant, Dominique

    2017-02-01

    This study documents lifetime experiences of victimizations, polyvictimization, and trauma symptoms among 1,400 adolescents from the province of Québec. The vast majority (81%) of adolescents were victimized during their lifetime, with most victims (82%) being the target of more than one form of victimization. Polyvictimization accounted for most variability in scores of depression, posttraumatic stress disorder (PTSD), and anger/ aggression compared to individual victimization categories. Sexual victimization and maltreatment still made an independent contribution in predicting all trauma scores once polyvictimization was considered. Gender differences were found in the victimization experiences contributing to the prediction of mental health symptoms. Sexual victimization was a significant predictor of PTSD and anger/aggression symptoms for girls, whereas witnessing violence predicted anger and PTSD symptoms for boys, and assault predicted their anger. This study outlines the importance of assessing various types of victimization among adolescents. Systematic data and observation of trends on child victimization are needed in Canada and elsewhere.

  5. Relationship between symptoms of depression, functional health status, and chronic disease among a residential sample of African Americans.

    PubMed

    Larson, Celia; Belue, Rhonda; Schlundt, David G; McClellan, Linda

    2006-01-01

    Depression and psychological distress often go unrecognized and untreated in primary care settings. The association between depression, socioeconomic status, and chronic disease underscore the importance of incorporating mental health education and screening into community-based health initiatives. This is particularly critical for African Americans who bear a disproportionate burden of poverty and chronic disease. This descriptive study assessed associations between symptoms of depression, socioeconomic status, healthcare utilization, physical and mental health functioning, and reactions to race among a sample of low-income African Americans. Consistent with the findings of previous research, respondents with symptoms of depression reported lower levels of physical and mental health functioning, and perceived that they had been treated worse by others at work, and had worse healthcare experiences than those of other races. Community-based programs for reducing disparities in physical illness may need to address the burden of undiagnosed and untreated depression in order to become optimally effective.

  6. Predictive validity of parent- and self-rated ADHD symptoms in adolescence on adverse socioeconomic and health outcomes.

    PubMed

    Du Rietz, Ebba; Kuja-Halkola, Ralf; Brikell, Isabell; Jangmo, Andreas; Sariaslan, Amir; Lichtenstein, Paul; Kuntsi, Jonna; Larsson, Henrik

    2017-02-10

    There is scarcity of research investigating the validity of self-report of attention deficit hyperactivity disorder (ADHD) symptoms compared to other informants, such as parents. This study aimed to compare the predictive associations of ADHD symptoms rated by parents and their children across adolescence on a range of adverse socioeconomic and health outcomes in early adulthood. Parent- and self-rated ADHD symptoms were assessed in 2960 individuals in early (13-14 years) and late adolescence (16-17 years). Logistic regression analyses were used to compare the associations between parent- and self-rated ADHD symptoms at both time points and adverse life outcomes in young adulthood obtained from Swedish national registries. Both parent- and self-ratings of ADHD symptoms were associated with increased risk for adverse outcomes, although associations of parent-ratings were more often statistically significant and were generally stronger (OR = 1.12-1.49, p < 0.05) than self-ratings (OR = 1.07-1.17, p < 0.05). After controlling for the other informant, parent-ratings of ADHD symptoms in both early and late adolescence significantly predicted academic and occupational failure, criminal convictions and traffic-related injuries, while self-ratings of ADHD symptoms only in late adolescence predicted substance use disorder and academic failure. Our findings suggest that both parent- and self-ratings of ADHD symptoms in adolescence provides valuable information on risk of future adverse socioeconomic and health outcomes, however, self-ratings are not valuable once parent-ratings have been taken into account in predicting most outcomes. Thus, clinicians and researchers should prioritize parent-ratings over self-ratings.

  7. Knowledge and Awareness of Acute Human Immunodeficiency Virus Infection Among Mobile App-Using Men Who Have Sex With Men: A Missed Public Health Opportunity

    PubMed Central

    Siegler, Aaron J.; Sanchez, Travis; Sineath, R. Craig; Grey, Jeremy; Kahle, Erin; Sullivan, Patrick S.

    2015-01-01

    In a national online survey, we assessed awareness and knowledge of acute human immunodeficiency virus (HIV) infection manifestation among 1748 men who have sex with men (MSM). Only 39% of respondents were aware that acute HIV infection may be accompanied by symptoms. Education and increased access to acute HIV testing may facilitate MSM to appropriately seek acute HIV testing. PMID:26034766

  8. The association between acculturation patterns and mental health symptoms among Eritrean and Sudanese asylum seekers in Israel.

    PubMed

    Nakash, Ora; Nagar, Maayan; Shoshani, Anat; Lurie, Ido

    2015-07-01

    Past research has documented the role acculturation plays in the process of adjustment to new cultures among migrants. Yet little attention has been paid thus far to the role of acculturation in the context of forced migration. In this study we examined the association between acculturation patterns and mental health symptoms among a convenience sample of Eritrean and Sudanese asylum seekers (n = 118) who accessed health services at the Physicians for Human Rights Open-Clinic in Israel. Participants completed measures on sociodemographic information as well as detention history, mental health symptoms, exposure to traumatic events, and acculturation pattern, in their native language upon accessing services. Consistent with our predictions, findings showed that acculturation predicted depressive symptoms among asylum seekers beyond the effect of history of detention and reports of experiences of traumatic events. Assimilated compared with integrated asylum seekers reported higher depressive symptoms. Findings draw attention to the paradox of assimilation, and the mental health risks it poses among those wishing to integrate into the new culture at the expanse of their original culture. Asylum seekers may be particularly vulnerable to the risks of assimilation in the restrictive policies that characterize many industrial countries in recent years.

  9. Student and Nonstudent National Guard Service Members/Veterans and Their Use of Services for Mental Health Symptoms

    ERIC Educational Resources Information Center

    Bonar, Erin E.; Bohnert, Kipling M.; Walters, Heather M.; Ganoczy, Dara; Valenstein, Marcia

    2015-01-01

    Objective: To compare mental health symptoms and service utilization among returning student and nonstudent service members/veterans (SM/Vs). Participants: SM/Vs (N = 1,439) were predominately white (83%) men (92%), half were over age 30 (48%), and 24% were students. Methods: SM/Vs completed surveys 6 months post deployment (October 2011-July…

  10. Gender as a Moderator of the Relation between Race-Related Stress and Mental Health Symptoms for African Americans

    ERIC Educational Resources Information Center

    Greer, Tawanda M.; Laseter, Adrian; Asiamah, David

    2009-01-01

    The present study tested gender as a moderator of the relationship between race-related stress and mental health symptoms among African American adults. Because African American women are exposed to stressors associated with race and gender, we hypothesized that African American women would have higher levels of race-related stress and more severe…

  11. Cumulative Risk Exposure and Mental Health Symptoms among Maltreated Youth Placed in Out-of-Home Care

    ERIC Educational Resources Information Center

    Raviv, Tali; Taussig, Heather N.; Culhane, Sara E.; Garrido, Edward F.

    2010-01-01

    Objective: Maltreated children placed in out-of-home care are at high risk for exhibiting symptoms of psychopathology by virtue of their exposure to numerous risk factors. Research examining cumulative risk has consistently found that the accumulation of risk factors increases the likelihood of mental health problems. The goal of the current study…

  12. Disability and Psychiatric Symptoms in Men Referred for Treatment with Work-Related Problems to Primary Mental Health Care.

    PubMed

    Bailey, S Kathleen; Mushquash, Christopher J; Haggarty, John M

    2017-03-24

    The relationship between male sex and employment as barriers to accessing mental health care is unclear. The aim of this research was to examine (1) whether the clinical features of men referred to a shared mental health care (SMHC) service through primary care differed when symptoms were affecting them in the work domain; and (2) empirically re-evaluate the effectiveness of a SMHC model for work-related disability using a pre-post chart review of N = 3960 referrals to SMHC. ANOVA and logistic regression were performed to examine symptoms (Patient Health Questionnaire, PHQ) and disability (World Health Organization Disability Assessment Schedule, WHODAS 2) at entry and discharge. Men were RR (relative risk) = 1.8 (95% C.I.: 1.60-2.05) times more likely to be referred to SMHC with work problems than women. Having greater disability and more severe somatic symptoms increased the likelihood of a work-related referral. There were no significant differences after treatment. Problems in the work domain may play an important role in men's treatment seeking and clinicians' recognition of a mental health care need. This study is relevant because men are underrepresented in mental health (MH) treatment and primary care is the main gateway to accessing MH care. Asking men about functioning in the work domain may increase access to helpful psychiatric services.

  13. Health effects of acid aerosols on North American children: Respiratory symptoms

    SciTech Connect

    Dockery, D.W. |; Cunningham, J.; Damokosh, A.I.

    1996-05-01

    We examined the respiratory health effects of exposure to acidic air pollution among 13,369 white children 8 to 12 years old from 24 communities in the United States and Canada between 1988 and 1991. Each child`s parent or guardian completed a questionnaire. Air quality and meteorology were measured in each community for a 1-year period. We used a two-stage logistic regression model to analyze the data, adjusting for the period confounding effects of sex, history of allergies, parental asthma, parental education, and current smoking in the home. Children living in the community with the highest levels of particle strong acidity were significantly more likely [odds ratio (OR) = 1.66; 95% confidence interval (CI) 1.11-2.48] to report at least one episode of bronchitis in the past year compared to children living in the least-polluted community. Fine particulate sulfate was also associated with higher reporting of bronchitis (OR = 1.65; 95% CI 1.12-2.42). No other respiratory symptoms were significantly higher in association with any of the air pollutants of interest. No sensitive subgroups were identified. Reported bronchitis, but neither asthma, wheeze, cough, nor phlegm, were associated with levels of particle strong acidity for these children living in a nonurban environment. 26 refs., 3 figs., 4 tabs.

  14. Efficacy of Synbiotics to Reduce Acute Radiation Proctitis Symptoms and Improve Quality of Life: A Randomized, Double-Blind, Placebo-Controlled Pilot Trial

    SciTech Connect

    Nascimento, Mariana; Aguilar-Nascimento, José Eduardo; Caporossi, Cervantes; Castro-Barcellos, Heloisa Michelon; Motta, Rodrigo Teixeira

    2014-10-01

    Purpose: To evaluate whether the daily intake of synbiotics interferes in radiation-induced acute proctitis symptoms and in quality of life in patients with prostate cancer. Methods and Materials: Twenty patients who underwent 3-dimensional conformal radiation therapy for prostate cancer were randomized to intake either a synbiotic powder containing Lactobacillus reuteri 10{sup 8} colony-forming units and 4.3 g of soluble fiber (Nestlé) or placebo. The questionnaire EORTC QLQ-PRT23 was applied before the beginning of radiation therapy and in every week for the first 4 weeks of treatment. The sum of both the complete (proctitis symptoms plus quality of life) and partial (proctitis symptoms) scores of the EORTC QLQ-PRT23 (European Organization for Research and Treatment of Cancer Quality of Life Module for Proctitis–23 items) questionnaire were the main endpoints. Results: This pilot study showed that the complete questionnaire score (median [range]) was higher in the second (23 [21-30] vs 26.5 [22-34], P<.05) and third (23 [21-32] vs 27.5 [24-33], P<.01) weeks in the placebo group. Proctitis symptoms were highest scored in the placebo group in both the second (19.5 [16-25]) and third (19 [17-24]) weeks than in the synbiotic group (week 2: 16.5 [15-20], P<.05; week 3: 17 [15-23], P<.01). In both scores the placebo group had a significantly higher result (P<.01) than the synbiotic group (repeated-measures analysis of variance). Conclusions: Synbiotics reduce proctitis symptoms and improve quality of life in radiation-induced acute proctitis during radiation therapy for prostate cancer.

  15. A Method for Quantifying the Acute Health Impacts of Residential Non-Biological Exposure Via Inhalation

    SciTech Connect

    Logue, Jennifer M.; Sherman, Max H.; Singer, Bret C.

    2014-08-01

    The inability to monetize the health costs of acute exposures in homes and the benefits of various control options is a barrier to justifying policies and approaches that can reduce exposure and improve health.We synthesized relationships between short-term outdoor concentration changes and health outcomes to estimate the health impacts of short-term in-home exposures. Damage and cost impacts of specific health outcomes were taken from the literature. We assessed the impact of vented and non-vented residential natural gas cooking burners on Southern California occupants for two pollutants (NO2 and CO).

  16. Public Health Response Systems In-Action: Learning from Local Health Departments’ Experiences with Acute and Emergency Incidents

    PubMed Central

    Hunter, Jennifer C.; Yang, Jane E.; Crawley, Adam W.; Biesiadecki, Laura; Aragón, Tomás J.

    2013-01-01

    As part of their core mission, public health agencies attend to a wide range of disease and health threats, including those that require routine, acute, and emergency responses. While each incident is unique, the number and type of response activities are finite; therefore, through comparative analysis, we can learn about commonalities in the response patterns that could improve predictions and expectations regarding the resources and capabilities required to respond to future acute events. In this study, we interviewed representatives from more than 120 local health departments regarding their recent experiences with real-world acute public health incidents, such as infectious disease outbreaks, severe weather events, chemical spills, and bioterrorism threats. We collected highly structured data on key aspects of the incident and the public health response, particularly focusing on the public health activities initiated and community partners engaged in the response efforts. As a result, we are able to make comparisons across event types, create response profiles, and identify functional and structural response patterns that have import for future public health preparedness and response. Our study contributes to clarifying the complexity of public health response systems and our analysis reveals the ways in which these systems are adaptive to the character of the threat, resulting in differential activation of functions and partners based on the type of incident. Continued and rigorous examination of the experiences of health departments throughout the nation will refine our very understanding of what the public health response system is, will enable the identification of organizational and event inputs to performance, and will allow for the construction of rich, relevant, and practical models of response operations that can be employed to strengthen public health systems. PMID:24236137

  17. Acute tubular necrosis as a part of vancomycin induced drug rash with eosinophilia and systemic symptoms syndrome with coincident postinfectious glomerulonephritis

    PubMed Central

    Kim, Kyung Min; Sung, Kyoung; Yang, Hea Koung; Kim, Seong Heon; Kim, Hye Young; Ban, Gil Ho; Park, Su Eun; Lee, Hyoung Doo

    2016-01-01

    Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal condition characterized by skin rash, fever, eosinophilia, and multiorgan involvement. Various drugs may be associated with this syndrome including carbamazepine, allopurinol, and sulfasalazine. Renal involvement in DRESS syndrome most commonly presents as acute kidney injury due to interstitial nephritis. An 11-year-old boy was referred to the Children's Hospital of Pusan National University because of persistent fever, rash, abdominal distension, generalized edema, lymphadenopathy, and eosinophilia. He previously received vancomycin and ceftriaxone for 10 days at another hospital. He developed acute kidney injury with nephrotic range proteinuria and hypocomplementemia. A subsequent renal biopsy indicated the presence of acute tubular necrosis (ATN) and late exudative phase of postinfectious glomerulonephritis (PIGN). Systemic symptoms and renal function improved with corticosteroid therapy after the discontinuation of vancomycin. Here, we describe a biopsy-proven case of severe ATN that manifested as a part of vancomycin-induced DRESS syndrome with coincident PIGN. It is important for clinicians to be aware of this syndrome due to its severity and potentially fatal nature. PMID:27186222

  18. Acute posttraumatic stress symptoms but not generalized anxiety symptoms are associated with severity of exposure to war trauma: A study of civilians under fire

    PubMed Central

    Helpman, Liat; Besser, Avi; Neria, Yuval

    2015-01-01

    Posttraumatic stress (PTSS) and generalized anxiety symptoms (GAS) may ensue following trauma. While they are now thought to represent different psychopathological entities, it is not clear whether both GAS and PTSS show a dose–response to trauma exposure. The current study aimed to address this gap in knowledge and to investigate the moderating role of subjects’ demographics in the exposure-outcome associations. The sample included 249 civilian adults, assessed during the 2014 Israel–Gaza military conflict. The survey probed demographic information, trauma exposure, and symptoms. PTSS but not GAS was associated with exposure severity. Women were at higher risk for both PTSS and GAS than men. In addition, several demographic variables were only associated with PTSS levels. PTSS dose-response effect was moderated by education. These findings are in line with emerging neurobiological and cognitive research, suggesting that although PTSS and GAS have shared risk factors they represent two different psychopathological entities. Clinical and theoretical implications are discussed. PMID:26343559

  19. Suicidal ideation and depressive symptoms among bipolar patients as predictors of the health and well-being of caregivers

    PubMed Central

    Chessick, Cheryl A; Perlick, Deborah A; Miklowitz, David J; Dickinson, L Miriam; Allen, Michael H; Morris, Chad D; Gonzalez, Jodi M; Marangell, Lauren B; Cosgrove, Victoria; Ostacher, Michael

    2009-01-01

    Objectives Few studies have addressed the physical and mental health effects of caring for a family member with bipolar disorder. This study examined whether caregivers’ health is associated with changes in suicidal ideation and depressive symptoms among bipolar patients observed over one year. Methods Patients (N = 500) participating in the Systematic Treatment Enhancement Program for Bipolar Disorder and their primary caregivers (N = 500, including 188 parental and 182 spousal caregivers) were evaluated for up to one year as part of a naturalistic observational study. Caregivers’ perceptions of their own physical health were evaluated using the general health scale from the Medical Outcomes Study 36-item Short-Form Health Survey. Caregivers’ depression was evaluated using the Center for Epidemiological Studies of Depression Scale. Results Caregivers of patients who had increasing suicidal ideation over time reported worsening health over time compared to caregivers of patients whose suicidal ideation decreased or stayed the same. Caregivers of patients who had more suicidal ideation and depressive symptoms reported more depressed mood over a one-year reporting period than caregivers of patients with less suicidal ideation or depression. The pattern of findings was consistent across parent caregivers and spousal caregivers. Conclusions Caregivers, rightly concerned about patients becoming suicidal or depressed, may try to care for the patient at the expense of their own health and well-being. Treatments that focus on the health of caregivers must be developed and tested. PMID:19922556

  20. A Pilot RCT of Psychodynamic Group Art Therapy for Patients in Acute Psychotic Episodes: Feasibility, Impact on Symptoms and Mentalising Capacity

    PubMed Central

    Montag, Christiane; Haase, Laura; Seidel, Dorothea; Bayerl, Martin; Gallinat, Jürgen; Herrmann, Uwe; Dannecker, Karin

    2014-01-01

    This pilot study aimed to evaluate the feasibility of an assessor-blind, randomised controlled trial of psychodynamic art therapy for the treatment of patients with schizophrenia, and to generate preliminary data on the efficacy of this intervention during acute psychotic episodes. Fifty-eight inpatients with DSM-diagnoses of schizophrenia were randomised to either 12 twice-weekly sessions of psychodynamic group art therapy plus treatment as usual or to standard treatment alone. Primary outcome criteria were positive and negative psychotic and depressive symptoms as well as global assessment of functioning. Secondary outcomes were mentalising function, estimated with the Reading the mind in the eyes test and the Levels of emotional awareness scale, self-efficacy, locus of control, quality of life and satisfaction with care. Assessments were made at baseline, at post-treatment and at 12 weeks' follow-up. At 12 weeks, 55% of patients randomised to art therapy, and 66% of patients receiving treatment as usual were examined. In the per-protocol sample, art therapy was associated with a significantly greater mean reduction of positive symptoms and improved psychosocial functioning at post-treatment and follow-up, and with a greater mean reduction of negative symptoms at follow-up compared to standard treatment. The significant reduction of positive symptoms at post-treatment was maintained in an attempted intention-to-treat analysis. There were no group differences regarding depressive symptoms. Of secondary outcome parameters, patients in the art therapy group showed a significant improvement in levels of emotional awareness, and particularly in their ability to reflect about others' emotional mental states. This is one of the first randomised controlled trials on psychodynamic group art therapy for patients with acute psychotic episodes receiving hospital treatment. Results prove the feasibility of trials on art therapy during acute psychotic episodes and justify

  1. Duration of Untreated Psychosis Is Associated with More Negative Schizophrenia Symptoms after Acute Treatment for First-Episode Psychosis

    ERIC Educational Resources Information Center

    Grano, Niklas; Lindsberg, Jenni; Karjalainen, Marjaana; Gronroos, Peter; Blomberg, Ari-Pekka

    2010-01-01

    Evidence of association between duration of untreated psychosis (DUP) and negative symptoms of schizophrenia in first-episode psychosis (FEP) patients is inconsistent in the recent literature. In the present study, DUP, schizophrenia symptoms, duration of medication, and diagnosis were obtained from hospital archives in a sample of FEP patients.…

  2. Mindfulness-Based Stress Reduction in Advanced Nursing Practice: A Nonpharmacologic Approach to Health Promotion, Chronic Disease Management, and Symptom Control.

    PubMed

    Williams, Hants; Simmons, Leigh Ann; Tanabe, Paula

    2015-09-01

    The aim of this article is to discuss how advanced practice nurses (APNs) can incorporate mindfulness-based stress reduction (MBSR) as a nonpharmacologic clinical tool in their practice. Over the last 30 years, patients and providers have increasingly used complementary and holistic therapies for the nonpharmacologic management of acute and chronic diseases. Mindfulness-based interventions, specifically MBSR, have been tested and applied within a variety of patient populations. There is strong evidence to support that the use of MBSR can improve a range of biological and psychological outcomes in a variety of medical illnesses, including acute and chronic pain, hypertension, and disease prevention. This article will review the many ways APNs can incorporate MBSR approaches for health promotion and disease/symptom management into their practice. We conclude with a discussion of how nurses can obtain training and certification in MBSR. Given the significant and growing literature supporting the use of MBSR in the prevention and treatment of chronic disease, increased attention on how APNs can incorporate MBSR into clinical practice is necessary.

  3. COPD symptom burden: impact on health care resource utilization, and work and activity impairment

    PubMed Central

    Ding, Bo; Small, Mark; Bergström, Gina; Holmgren, Ulf

    2017-01-01

    Background Chronic obstructive pulmonary disease (COPD) can greatly impact the quality of life by limiting patients’ activities. However, data on impact of symptomatic burden on the health care resource utilization (HCRU) and employment in COPD are lacking. We examined the association between COPD Assessment Test (CAT) score and direct/indirect costs associated with HCRU and work productivity. Methods Data from >2,100 patients with COPD consulting for routine care were derived from respiratory disease-specific programs in Europe, the USA and China. Questionnaires, including CAT and Work Productivity and Activity Impairment (WPAI), were used to collect the past and current disease status data and HCRU characteristics from physicians (general practitioners/specialists) and patients. A regression approach was used to quantify the association of CAT with HCRU and WPAI variables. CAT score was modeled as a continuous independent variable (range: 0–40). Results Ninety percent of patients with COPD had a CAT score ≥10. Short-acting therapy and maintenance bronchodilator monotherapy, respectively, were currently prescribed to patients with CAT scores of 10–19 (5.8% and 27.6%), 20–29 (5.1% and 13.1%) and 30–40 (2.8% and 6.6%). Prescribing of maintenance bronchodilator dual therapy was low across the CAT score groups (0–9, 7.8%; 10–19, 6.4%; 20–29, 5.9%; 30–40, 4.4%), whereas maintenance triple combination therapy was prescribed more commonly in patients with higher CAT scores (0–9, 16.1%; 10–19, 23.2%; 20–29, 25.9%; 30–40, 35.5%). Increasing CAT scores were significantly associated with a higher frequency of primary care physician visits (P<0.001), pulmonologist visits (P=0.007), exacerbations requiring hospitalization (P<0.001) and WPAI scores (P<0.001). Conclusion Most patients with COPD presented with high symptom levels, despite being treated for COPD. Increasing symptom burden was associated with increasing HCRU and had a detrimental impact

  4. Catastrophic health expenditure on acute coronary events in Asia: a prospective study

    PubMed Central

    Lee, Stephen W-L; Sawhney, Jitendra PS; Ong, Tiong K; Chin, Chee Tang; Kim, Hyo-Soo; Krittayaphong, Rungroj; Nhan, Vo T; Itoh, Yohji; Huo, Yong

    2016-01-01

    Abstract Objective To estimate out-of-pocket costs and the incidence of catastrophic health expenditure in people admitted to hospital with acute coronary syndromes in Asia. Methods Participants were enrolled between June 2011 and May 2012 into this observational study in China, India, Malaysia, Republic of Korea, Singapore, Thailand and Viet Nam. Sites were required to enrol a minimum of 10 consecutive participants who had been hospitalized for an acute coronary syndrome. Catastrophic health expenditure was defined as out-of-pocket costs of initial hospitalization > 30% of annual baseline household income, and it was assessed six weeks after discharge. We assessed associations between health expenditure and age, sex, diagnosis of the index coronary event and health insurance status of the participant, using logistic regression models. Findings Of 12 922 participants, 9370 (73%) had complete data on expenditure. The mean out-of-pocket cost was 3237 United States dollars. Catastrophic health expenditure was reported by 66% (1984/3007) of those without insurance versus 52% (3296/6366) of those with health insurance (P < 0.05). The occurrence of catastrophic expenditure ranged from 80% (1055/1327) in uninsured and 56% (3212/5692) of insured participants in China, to 0% (0/41) in Malaysia. Conclusion Large variation exists across Asia in catastrophic health expenditure resulting from hospitalization for acute coronary syndromes. While insurance offers some protection, substantial numbers of people with health insurance still incur financial catastrophe. PMID:26966330

  5. Nonsteroidal Antiinflammatory Drug Use and Lower Urinary Tract Symptoms: Results From the Boston Area Community Health Survey

    PubMed Central

    Gates, Margaret A.; Hall, Susan A.; Chiu, Gretchen R.; Kupelian, Varant; FitzGerald, Mary P.; Link, Carol L.; McKinlay, John B.

    2011-01-01

    There is evidence for a role of inflammation in the etiology of lower urinary tract symptoms (LUTS), raising the possibility that use of nonsteroidal antiinflammatory drugs (NSAIDs) may inhibit the development or progression of LUTS. The authors examined the association between use of prescription and over-the-counter NSAIDs and LUTS among 1,974 men and 2,661 women in the Boston Area Community Health Survey (2002–2005). Multivariable-adjusted logistic regression was used to estimate odds ratios and 95% confidence intervals for LUTS, voiding symptoms, storage symptoms, and nocturia. There was no clear association between use of prescription or over-the-counter NSAIDs (compared with no NSAID use) and overall LUTS, voiding symptoms, or nocturia in men or women. However, over-the-counter NSAID use was positively associated with storage symptoms in women (odds ratio = 1.37, 95% confidence interval: 1.03, 1.83), and there was a positive association between over-the-counter NSAID use and overall LUTS among women with a history of arthritis (odds ratio = 2.09, 95% confidence interval: 1.20, 3.64). These results do not provide strong support for an association between NSAIDs and LUTS. However, the associations between over-the-counter NSAID use and certain urologic symptoms, particularly among women with arthritis, and the potential mechanisms involved should be evaluated in future studies. PMID:21357657

  6. Medical yoga for patients with stress-related symptoms and diagnoses in primary health care: a randomized controlled trial.

    PubMed

    Köhn, Monica; Persson Lundholm, Ulla; Bryngelsson, Ing-Liss; Anderzén-Carlsson, Agneta; Westerdahl, Elisabeth

    2013-01-01

    An increasing number of patients are suffering from stress-related symptoms and diagnoses. The purpose of this study was to evaluate the medical yoga treatment in patients with stress-related symptoms and diagnoses in primary health care. A randomized controlled study was performed at a primary health care centre in Sweden from March to June, 2011. Patients were randomly allocated to a control group receiving standard care or a yoga group treated with medical yoga for 1 hour, once a week, over a 12-week period in addition to the standard care. A total of 37 men and women, mean age of 53 ± 12 years were included. General stress level (measured using Perceived Stress Scale (PSS)), burnout (Shirom-Melamed Burnout Questionnaire (SMBQ)), anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), insomnia severity (Insomnia Severity Index (ISI)), pain (visual analogue scale (VAS)), and overall health status (Euro Quality of Life VAS (EQ-VAS)) were measured before and after 12 weeks. Patients assigned to the Yoga group showed significantly greater improvements on measures of general stress level (P < 0.000), anxiety (P < 0.019), and overall health status (P < 0.018) compared to controls. Treatment with medical yoga is effective in reducing levels of stress and anxiety in patients with stress-related symptoms in primary health care.

  7. Internet-based remote health self-checker symptom data as an adjuvant to a national syndromic surveillance system.

    PubMed

    Elliot, A J; Kara, E O; Loveridge, P; Bawa, Z; Morbey, R A; Moth, M; Large, S; Smith, G E

    2015-12-01

    Syndromic surveillance is an innovative surveillance tool used to support national surveillance programmes. Recent advances in the use of internet-based health data have demonstrated the potential usefulness of these health data; however, there have been limited studies comparing these innovative health data to existing established syndromic surveillance systems. We conducted a retrospective observational study to assess the usefulness of a national internet-based 'symptom checker' service for use as a syndromic surveillance system. NHS Direct online data were extracted for 1 August 2012 to 1 July 2013; a time-series analysis on the symptom categories self-reported by online users was undertaken and compared to existing telehealth syndromic data. There were 3·37 million online users of the internet-based self-checker compared to 1·43 million callers to the telephone triage health service. There was a good correlation between the online and telephone triage data for a number of syndromic indicators including cold/flu, difficulty breathing and eye problems; however, online data appeared to provide additional early warning over telephone triage health data. This assessment has illustrated some potential benefit of using internet-based symptom-checker data and provides the basis for further investigating how these data can be incorporated into national syndromic surveillance programmes.

  8. Medical Yoga for Patients with Stress-Related Symptoms and Diagnoses in Primary Health Care: A Randomized Controlled Trial

    PubMed Central

    Köhn, Monica; Persson Lundholm, Ulla; Bryngelsson, Ing-Liss; Anderzén-Carlsson, Agneta; Westerdahl, Elisabeth

    2013-01-01

    An increasing number of patients are suffering from stress-related symptoms and diagnoses. The purpose of this study was to evaluate the medical yoga treatment in patients with stress-related symptoms and diagnoses in primary health care. A randomized controlled study was performed at a primary health care centre in Sweden from March to June, 2011. Patients were randomly allocated to a control group receiving standard care or a yoga group treated with medical yoga for 1 hour, once a week, over a 12-week period in addition to the standard care. A total of 37 men and women, mean age of 53 ± 12 years were included. General stress level (measured using Perceived Stress Scale (PSS)), burnout (Shirom-Melamed Burnout Questionnaire (SMBQ)), anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), insomnia severity (Insomnia Severity Index (ISI)), pain (visual analogue scale (VAS)), and overall health status (Euro Quality of Life VAS (EQ-VAS)) were measured before and after 12 weeks. Patients assigned to the Yoga group showed significantly greater improvements on measures of general stress level (P < 0.000), anxiety (P < 0.019), and overall health status (P < 0.018) compared to controls. Treatment with medical yoga is effective in reducing levels of stress and anxiety in patients with stress-related symptoms in primary health care. PMID:23533465

  9. Longitudinal Trajectory of Adolescent Exposure to Community Violence and Depressive Symptoms Among Adolescents and Young Adults: Understanding the Effect of Mental Health Service Usage.

    PubMed

    Chen, Wan-Yi; Corvo, Kenneth; Lee, Yookyong; Hahm, Hyeouk Chris

    2017-01-01

    Research on the impact of exposure to community violence tends to define victimization as a single construct. This study differentiates between direct and indirect violence victimization in their association with mental health problems and mental health service use. This study includes 8947 individuals from four waves of the National Longitudinal Study of Adolescent to Adult Health and examines (1) whether sub-types of adolescent victimization are linked to depressive symptoms; (2) whether adolescent victimization is linked with mental health service use; and (3) the role of mental health service use in attenuating symptoms arising from victimizations. Adolescents witnessing community violence were more likely to experience depressive symptoms during adolescence but not during their young adulthood; direct exposure to violence during adolescence does not predict depressive symptoms in adolescence but does in adulthood. Use of mental health service mediates report of depressive symptoms for adolescent witnessing community violence.

  10. Posttraumatic stress symptoms and work-related accomplishment as predictors of general health and medical utilization among Special Operations Forces personnel.

    PubMed

    Bryan, Craig J; Stephenson, James A; Morrow, Chad E; Staal, Mark; Haskell, Jeremy

    2014-02-01

    Research has established clear links among posttraumatic stress disorder (PTSD), somatic symptoms, and general health among conventional force military personnel. It is possible that the same relationships exist among Special Operations Force (SOF) personnel, but there are very few, if any, studies that examine these relationships. This study investigated correlates of general health and medical visits among SOF personnel and found that the interaction of somatic and PTSD symptoms was associated with worse health and more frequent medical visits. Follow-up analyses indicated that the interaction of avoidance symptoms with somatic symptoms was significantly associated with worse health, whereas the interaction of emotional numbing with somatic symptoms significantly contributed to increased medical visits. In addition, the results suggest that a sense of accomplishment among SOF personnel may serve as a protective factor against poor health. The results suggest developing interactions among SOF personnel that promote a sense of achievement to ultimately improve the health of the force.

  11. Bronchitis - acute

    MedlinePlus

    ... to breathe. Other symptoms of bronchitis are a cough and coughing up mucus. Acute means the symptoms ... diagnosed with chronic bronchitis, you must have a cough with mucus on most days for at least ...

  12. A cognitive-perceptual model of symptom perception in males and females: the roles of negative affect, selective attention, health anxiety and psychological job demands.

    PubMed

    Goodwin, Laura; Fairclough, Stephen H; Poole, Helen M

    2013-06-01

    Kolk et al.'s model of symptom perception underlines the effects of trait negative affect, selective attention and external stressors. The current study tested this model in 263 males and 498 females from an occupational sample. Trait negative affect was associated with symptom reporting in females only, and selective attention and psychological job demands were associated with symptom reporting in both genders. Health anxiety was associated with symptom reporting in males only. Future studies might consider the inclusion of selective attention, which was more strongly associated with symptom reporting than negative affect. Psychological job demands appear to influence symptom reporting in both males and females.

  13. Symptoms in patients with takotsubo syndrome: a qualitative interview study

    PubMed Central

    Ulin, Kerstin; Omerovic, Elmir; Ekman, Inger

    2016-01-01

    Objective The aim of the study was to investigate the meaning of narrated symptoms in connection to takotsubo syndrome. Design, method, participants and setting Qualitative study consisting of 25 interviews, 23 women and 2 men aged 39–84 and living in Region Västra Götaland, Sweden. The transcribed text was analysed with phenomenological hermeneutics. Results The interviewees reported a large number of symptoms before, during and after the acute onset of takotsubo syndrome, including pain, affected breathing, lassitude, malaise and nausea. Several of these have not been reported previously. Symptoms before the acute onset were, even if they had been prominent, ignored by the interviewees for various reasons. During the acute phase, the symptoms could no longer be ignored and the interviewees sought healthcare. The remaining residual symptom after discharge from hospital caused a great deal of worry because the interviewees feared that they would be permanent and they felt they could not live this way. On the whole, becoming ill and having a large number of symptoms greatly impacted the lives of the interviewees and made them re-evaluate how they had been living. Furthermore, they reported feeling alone and lost regarding their symptom burden, especially in relation to their residual symptoms, which affected their health and ability to return to daily life. Conclusions Acute symptoms, and symptoms before and after the acute ones, are a major part of the illness experience for patients with takotsubo syndrome and affect their health and well-being. Assessment of symptoms should be an integrated part of care to promote health. One way of achieving this is through the patients’ own narratives of their experiences, which are an important component in person-centred care. PMID:27707826

  14. [Telemedicine in acute stroke care--a health economics view].

    PubMed

    Günzel, F; Theiss, S; Knüppel, P; Halberstadt, S; Rose, G; Raith, M

    2010-05-01

    Specialized stroke units offer optimal treatment of patients with an acute stroke. Unfortunately, their installation is limited by an acute lack of experienced neurologists and the small number of stroke patients in sparsely populated rural areas. This problem is increasingly being solved by the use of telemedicine, so that neurological expertise is made available to basic and regular care. It has been demonstrated by national and international pilot studies that solidly based and rapid decisions can be made by telemedicine regrading the use of thrombolysis, as the most important acute treatment, but also of other interventions. So far studies have only evaluated improvement in the quality of care achieved by networking, but not of any lasting effect on any economic benefit. Complementary to a medical evaluation, the qualitative economic assessment presented here of German and American concepts of telemetric care indicate no difference in efficacy between various ways of networking. Most noteworthy, when comparing two large American and German studies, is the difference in their priorities. While the American networks achieved targeted improvements in efficacy of care that go beyond the immediate wishes of the doctors involved, this was of only secondary importance in the German studies. Also, in contrast to several American networks, the German telemetry networks have not tended to be organized for future growth. In terms of economic benefits, decentralized organized networks offer a greater potential of efficacy than purely local ones. Furthermore, the integration of inducements into the design of business models is a fundamental factor for achieving successful and lasting existence, especially within a highly competitive market.

  15. Associations between Childhood Parental Mental Health Difficulties and Depressive Symptoms in Late Adulthood: The Influence of Life-Course Socioeconomic, Health and Lifestyle Factors

    PubMed Central

    Angelini, Viola; Klijs, Bart; Smidt, Nynke; Mierau, Jochen O.

    2016-01-01

    Background Depression among older adults (i.e., the 50+) is a major health concern. The objective of this study is to investigate whether growing up with a parent suffering from mental health problems is associated with depressive symptoms in late-adulthood and how this association is influenced by life-course socio-economic, health and lifestyle factors in childhood and late adulthood. Methods We used life-history data from the SHARE survey, consisting of 21,127 participants living in 13 European countries. Symptoms of depression were assessed using the EURO-D scale. Parental mental health was assessed by asking respondents to report whether any of their parents had mental health problems during the respondents’ childhood. Logistic regression models were used to assess the association between parental mental health status and depression. Variables on childhood and late-life socio-economic, health and lifestyle factors were sequentially added to the model to assess the extent to which this association is influenced by life-course circumstances. Results Individuals who were exposed during childhood to a parent with mental health problems suffered from depressive symptoms more often in late adulthood than those who were not (OR 1.76, 95% CI: 1.43–2.17). Adjustment for life-course socio-economic, health and lifestyle factors in childhood and late adulthood diminished this association to an OR of 1.54 (95% CI: 1.24–1.90) and OR of 1.45 (95% CI: 1.16–1.82), respectively. Conclusion Our results indicate a substantial association between parental mental health problems in childhood and depression in late adulthood and that this association is partly explained by childhood as well as late adulthood socio-economic, health and lifestyle factors. PMID:27936078

  16. The Impact of Physical Complaints, Social Environment, and Psychological Functioning on IBS Patients’ Health Perceptions: Looking Beyond GI Symptom Severity

    PubMed Central

    Lackner, Jeffrey M.; Gudleski, Gregory D.; Thakur, Elyse R.; Stewart, Travis J.; Iacobucci, Gary J.; Spiegel, Brennan M.R.

    2016-01-01

    OBJECTIVES In the absence of a reliable biomarker, clinical decisions for a functional gastrointestinal (GI) disorder like irritable bowel syndrome (IBS) depend on asking patients to appraise and communicate their health status. Self-ratings of health (SRH) have proven a powerful and consistent predictor of health outcomes, but little is known about how they relate to those relevant to IBS (e.g., quality of life (QOL), IBS symptom severity). This study examined what psychosocial factors, if any, predict SRH among a cohort of more severe IBS patients. METHODS Subjects included 234 Rome III-positive IBS patients (mean age = 41 years, female = 78%) without comorbid organic GI disease. Subjects were administered a test battery that included the IBS Symptom Severity Scale, Screening for Somatoform Symptoms, IBS Medical Comorbidity Inventory, SF-12 Vitality Scale, Perceived Stress Scale, Beck Depression Inventory, Trait Anxiety Inventory, and Negative Interactions Scale. RESULTS Partial correlations identified somatization, depression, fatigue, stress, anxiety, and medical comorbidities as variables with the strongest correlations with SRH (r values = 0.36–0.41, P values < 0.05). IBS symptom severity was weakly associated with SRH (r = 0.18, P < 0.05). The final regression model explained 41.3% of the variance in SRH scores (F = 8.49, P < 0.001) with significant predictors including fatigue, medical comorbidities, somatization, and negative social interactions. CONCLUSIONS SRH are associated with psychological (anxiety, stress, depression), social (negative interactions), and extraintestinal somatic factors (fatigue, somatization, medical comorbidities). The severity of IBS symptoms appears to have a relatively modest role in how IBS patients describe their health in general. PMID:24419481

  17. Prevalence and Health Outcomes of Functional Gastrointestinal Symptoms in Infants From Birth to 12 Months of Age

    PubMed Central

    Vandenplas, Yvan; Abkari, Abdelhak; Bellaiche, Marc; Benninga, Marc; Chouraqui, Jean Pierre; ÇokuÐraþ, FügenÇullu; Harb, Tracy; Hegar, Badriul; Lifschitz, Carlos; Ludwig, Thomas; Miqdady, Mohamed; de Morais, Mauro Batista; Osatakul, Seksit; Salvatore, Silvia; Shamir, Raanan; Staiano, Annamaria; Szajewska, Hania; Thapar, Nikhil

    2015-01-01

    ABSTRACT Objectives: The aim of the study was to review published evidence and the opinion of practising clinicians on the prevalence and long-term health consequences of functional gastrointestinal symptoms in infants younger than 12 months. Methods: PubMed was searched from inception to November 2014 to find articles reporting the prevalence and long-term health outcomes of infantile colic, regurgitation, functional constipation, functional diarrhoea, and dyschezia in infants younger than <12 months. A questionnaire was sent to practising clinicians worldwide, and a group of 15 international experts met to discuss the likely frequency and longer-term consequences of these symptoms. Results: The literature search identified 30 studies reporting the prevalence of infantile colic (2%–73%), 13 that of regurgitation (3%–87%), 8 that of functional constipation (0.05%–39.3%), 2 that of functional diarrhoea (2%–4.1%), and 3 that of dyschezia (0.9%–5.6%). The studies varied in design, populations investigated, and definition of the symptoms. Questionnaires were received from 369 respondents. The experts agreed that the likely prevalences for colic, regurgitation, and functional constipation were 20%, 30%, and 15%, respectively. The limited data in the literature for functional diarrhoea and dyschezia suggest prevalences <10%. Infantile colic may be associated with future health problems in a subset of infants. Conclusions: Functional gastrointestinal symptoms appear to occur in a significant proportion of infants younger than 12 months and may have an impact on future health outcomes. Prospective collection of data according to agreed criteria is needed to obtain more accurate estimates of the prevalence and consequences of these symptoms. PMID:26308317

  18. Determining acute health hazard ratings in the absence of applicable toxicological data.

    PubMed

    Simmons, Fred; Quigley, David; Freshwater, Dave; Whyte, Helena; Boada-Clista, Lydia; Laul, J C

    2007-11-01

    Health, safety, and emergency planning professionals have a responsibility to identify acute hazards associated with chemicals and to find a way to transmit that information to chemical users, emergency responders, and others. Various organizations such as the Department of Energy are considering acute health hazard ratings as triggers that would mandate various activities. A paradigm shift away from a "lists" based approach to determining whether a chemical is sufficiently hazardous to require further analysis for emergency planning purposes is under way. Various toxicological data sources and approaches in use to develop an acute health hazard rating are discussed. Methods of extrapolating data from published and unpublished supporting documentation to develop an acute health hazard rating in the absence of toxicological data by animal species, chemical structure similarities, MSDS estimated values, and data mining are discussed. The process described analyzes applicable data and allows the analyst to determine reasonable health hazard rating numbers for chemicals without published hazard ratings and for mixtures of chemicals. The level and amount of resources available will determine which methods will be used in the process.

  19. Sustained Obesity and Depressive Symptoms over 6 Years: Race by Gender Differences in the Health and Retirement Study

    PubMed Central

    Carter, Julia D.; Assari, Shervin

    2017-01-01

    Background: Although obesity and physical activity influence psychosocial well-being, these effects may vary based on race, gender, and their intersection. Using 6-year follow-up data of a nationally representative sample of adults over age of 50 in the United States, this study aimed to explore race by gender differences in additive effects of sustained high body mass index (BMI) and physical activity on sustained depressive symptoms (CES-D) and self-rated health (SRH). Methods: Data came from waves 7, 8, and 10 (2004–2010) of the Health and Retirement Study (HRS), an ongoing national cohort started in 1992. The study enrolled a representative sample of Americans (n = 19,280) over the age of 50. Latent factors were used to calculate sustained high BMI and physical activity (predictors) and sustained poor SRH and high depressive symptoms (outcomes) based on measurements in 2004, 2006, and 2010. Age, education, and income were confounders. Multi-group structural equation modeling (SEM) was used to test the additive effects of BMI and physical activity on depressive symptoms and SRH, where the groups were defined based on race by gender. Results: Group differences were apparent in the direction and significance of the association between sustained high BMI and depressive symptoms. The association between sustained high BMI and depressive symptoms was positive and significant for White women (B = 0.03, p = 0.007) and non-significant for White men (B = −0.03, p = 0.062), Black men (B = −0.02, p = 0.564) and Black women (B = 0.03, p = 0.110). No group differences were found in the paths from sustained physical activity to depressive symptoms, or from physical activity or BMI to SRH. Conclusion: Sustained high BMI and high depressive symptoms after age 50 are positively associated only for White women. As the association between sustained health problems such as depression and obesity are not universal across race and gender groups, clinical and public health

  20. Acute porphyric disorders.

    PubMed

    Moore, A W; Coke, J M

    2000-09-01

    Acute porphyrias are classified into 3 distinct groups of rare genetic disorders of metabolic enzyme biosynthesis. Acute porphyrias can significantly impact multiple organ systems, which often provides a challenge to the dentist presented with such a patient. A case of hereditary coproporphyria is reported in a patient with many of the classical signs and symptoms. The patient also had complex dental needs that required special medical and pharmacotherapeutic modifications. The acute porphyrias are reviewed by the authors with presentation of this challenging case. Recommendations for other dental health care professionals encountering these patients are then presented.

  1. Effects of Sleep Quality on the Association between Problematic Mobile Phone Use and Mental Health Symptoms in Chinese College Students

    PubMed Central

    Tao, Shuman; Wu, Xiaoyan; Zhang, Yukun; Zhang, Shichen; Tong, Shilu; Tao, Fangbiao

    2017-01-01

    Problematic mobile phone use (PMPU) is a risk factor for both adolescents’ sleep quality and mental health. It is important to examine the potential negative health effects of PMPU exposure. This study aims to evaluate PMPU and its association with mental health in Chinese college students. Furthermore, we investigated how sleep quality influences this association. In 2013, we collected data regarding participants’ PMPU, sleep quality, and mental health (psychopathological symptoms, anxiety, and depressive symptoms) by standardized questionnaires in 4747 college students. Multivariate logistic regression analysis was applied to assess independent effects and interactions of PMPU and sleep quality with mental health. PMPU and poor sleep quality were observed in 28.2% and 9.8% of participants, respectively. Adjusted logistic regression models suggested independent associations of PMPU and sleep quality with mental health (p < 0.001). Further regression analyses suggested a significant interaction between these measures (p < 0.001). The study highlights that poor sleep quality may play a more significant role in increasing the risk of mental health problems in students with PMPU than in those without PMPU. PMID:28216583

  2. Effects of Sleep Quality on the Association between Problematic Mobile Phone Use and Mental Health Symptoms in Chinese College Students.

    PubMed

    Tao, Shuman; Wu, Xiaoyan; Zhang, Yukun; Zhang, Shichen; Tong, Shilu; Tao, Fangbiao

    2017-02-14

    Problematic mobile phone use (PMPU) is a risk factor for both adolescents' sleep quality and mental health. It is important to examine the potential negative health effects of PMPU exposure. This study aims to evaluate PMPU and its association with mental health in Chinese college students. Furthermore, we investigated how sleep quality influences this association. In 2013, we collected data regarding participants' PMPU, sleep quality, and mental health (psychopathological symptoms, anxiety, and depressive symptoms) by standardized questionnaires in 4747 college students. Multivariate logistic regression analysis was applied to assess independent effects and interactions of PMPU and sleep quality with mental health. PMPU and poor sleep quality were observed in 28.2% and 9.8% of participants, respectively. Adjusted logistic regression models suggested independent associations of PMPU and sleep quality with mental health (p < 0.001). Further regression analyses suggested a significant interaction between these measures (p < 0.001). The study highlights that poor sleep quality may play a more significant role in increasing the risk of mental health problems in students with PMPU than in those without PMPU.

  3. Norovirus Symptoms

    MedlinePlus

    ... Norovirus Infection, National Institutes of Health NoroCORE Food Virology Symptoms Language: English Español (Spanish) Recommend on Facebook ... Norovirus Infection, National Institutes of Health NoroCORE Food Virology Language: English Español (Spanish) File Formats Help: How ...

  4. Daily Health Symptoms of Mothers of Adolescents and Adults with Fragile X Syndrome and Mothers of Adolescents and Adults with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Smith, Leann E.; Seltzer, Marsha Mailick; Greenberg, Jan S.

    2012-01-01

    Health symptoms of mothers of adolescents and adults with fragile X syndrome (FXS; n = 112) were compared to a nationally-representative sample of mothers of similarly-aged children without disabilities (n = 230) as well as to a sample of mothers of adolescents and adults with autism spectrum disorders (ASD; n = 96). Health symptoms experienced in…

  5. Mania Symptoms and HIV-Risk Behavior Among Adolescents in Mental Health Treatment

    PubMed Central

    Stewart, Angela J.; Theodore-Oklota, Christina; Hadley, Wendy; Brown, Larry K.

    2012-01-01

    Objective This study explored whether adolescents with elevated symptoms of mania (ESM+) engage in more HIV risk behaviors than those with other psychiatric disorders and examined factors associated with HIV risk behavior among ESM+ adolescents. Method Eight hundred and forty adolescents (56% female, 58% African American, mean age 14.9 years) who received mental health treatment completed private, computer-based assessments of psychiatric disorders, sexual and substance use behaviors, and provided urine to screen for sexually transmitted infections (STI). Results Eighty-seven percent met criteria for a psychiatric disorder and among these youth 21% were considered ESM+. Compared to those with other psychiatric disorders, ESM+ were more likely to be sexually active (61.6% vs. 53.6%), have multiple sexual partners (58.6% vs. 37.5%), have unprotected sex (38.4% vs. 28.0%), exchange sex for money (4.7% vs. 1.2%) and to test positive for an STI (14.0% vs. 6.3%). Among ESM+ youth, sexual risk behaviors were primarily associated with individual factors (e.g., self-efficacy, impulsivity, and substance use) and varied depending on the type of sexual behavior (e.g., onset of sex, number of partners, and condom use). Conclusions Adolescents with ESM should be regularly screened for sexual risk behaviors and receive HIV prevention skills. Efforts to increase self-efficacy for safer sex, reduce impulsivity, and decrease substance use may be effective targets for sexual risk reduction among adolescents with ESM. PMID:22540428

  6. Acute stress and cardiovascular health: is there an ACE gene connection?

    PubMed

    Holman, E Alison

    2012-10-01

    Cardiovascular disorders (CVD) are associated with acute and posttraumatic stress responses, yet biological processes underlying this association are poorly understood. This study examined whether renin-angiotensin-aldosterone system activity, as indicated by a functional single nucleotide polymorphism (SNP) in the angiotensin converting enzyme (ACE) gene, is associated with both CVD and acute stress related to the September 11, 2001 (9/11) terrorist attacks. European-American respondents (N = 527) from a nationally representative longitudinal study of coping following 9/11 provided saliva for genotyping. Respondents had completed health surveys before 9/11 and annually for 3 years after, and acute stress assessments 9 to 23 days after 9/11. Respondents with rs4291 AA or TT genotypes reported high acute stress twice as often as those with the AT genotype. Individuals with the TT genotype were 43% more likely to report increased physician-diagnosed CVD over 3 years following 9/11, when the following variables were included in the model: (a) pre-9/11 CVD, mental health, and non-CVD ailments; (b) cardiac risk factors; (c) ongoing endocrine disorders; and (d) significant demographics. The ACE rs4291 TT genotype, which has been associated with HPA axis hyperactivity and higher levels of serum angiotensin converting enzyme (ACE), predicted acute stress response and reports of physician-diagnosed CVD in a national sample following collective stress. ACE gene function may be associated with both mental and physical health disorders following collective stress.

  7. Three cases of acute fatty liver of pregnancy: postpartum clinical course depends on interval between onset of symptoms and termination of pregnancy.

    PubMed

    Aso, Kaai; Hojo, Satoshi; Yumoto, Yasuo; Fukushima, Kotaro; Miyazaki, Masayuki; Kotoh, Kazuhiro; Wake, Norio

    2010-09-01

    We report our experience with three cases of acute fatty liver of pregnancy. Case 1 complained of hydrodipsia 4 days before delivery. Case 2 presented with nausea, vomiting and dizziness 6 days before delivery. Case 3 developed loss of appetite and general fatigue with jaundice 10 days before delivery. They underwent termination of pregnancy after diagnosis was made. Case 3 still developed hepatic encephalopathy, and finally she required liver transplantation. We hypothesise that the interval between the onset of symptoms and termination of pregnancy is an important factor for acuity of the disorder and patient morbidity or mortality.

  8. Indoor air pollution: Acute adverse health effects and host susceptibility

    SciTech Connect

    Zummo, S.M.; Karol, M.H.

    1996-01-01

    Increased awareness of the poor quality of indoor air compared with outdoor air has resulted in a significant amount of research on the adverse health effects and mechanisms of action of indoor air pollutants. Common indoor air agents are identified, along with resultant adverse health effects, mechanisms of action, and likely susceptible populations. Indoor air pollutants range from biological agents (such as dust mites) to chemical irritants (such as nitrogen dioxide, carbon monoxide, sulfur dioxide, formaldehyde, and isocyanates). These agents may exert their effects through allergic as well as nonallergic mechanisms. While the public does not generally perceive poor indoor air quality as a significant health risk, increasing reports of illness related to indoor air and an expanding base of knowledge on the health effects of indoor air pollution are likely to continue pushing the issue to the forefront.

  9. HIV stigma and physical health symptoms: do social support, adaptive coping, and/or identity centrality act as resilience resources?

    PubMed

    Earnshaw, Valerie A; Lang, Shawn M; Lippitt, Margaret; Jin, Harry; Chaudoir, Stephenie R

    2015-01-01

    Despite efforts to eliminate it at the societal level, HIV stigma persists and continues to threaten the health of people living with HIV (PLWH). We tested whether social support, adaptive coping, and/or HIV identity centrality act as resilience resources by buffering people from the negative impact of enacted and/or anticipated stigma on stress and ultimately HIV symptoms. Ninety-three PLWH completed a survey, and data analyses tested for evidence of mediation and moderation. Results demonstrated that instrumental social support, perceived community support, and HIV identity centrality buffered participants from the association between anticipated stigma and HIV symptoms. That is, anticipated stigma was associated with HIV symptoms via stress only at low levels of these resources. No resources buffered participants from the impact of enacted stigma. Identifying and enhancing resilience resources among PLWH is critical for protecting PLWH from the harmful effects of stigma.

  10. Prevalence of symptoms at the end of life in an acute care hospital: a retrospective cohort study

    PubMed Central

    Kobewka, Daniel; Ronksley, Paul; McIsaac, Dan; Mulpuru, Sunita; Forster, Alan

    2017-01-01

    Background: There is currently debate over the benefits and harms of physician-assisted death. One of the factors influencing this debate is concern about symptoms in the days before death. The objective of this study was to describe the frequency of symptoms before death and determine patient characteristics associated with these symptoms. Methods: We reviewed the medical record of every patient who died at a multisite academic teaching hospital over a 3-month period. We determined the number of episodes of pain, dyspnea, agitation and nausea during the final 48 hours of life and assessed the patient and encounter characteristics associated with 2 or more episodes of symptoms. Results: A total of 480 patients died during the study period. Of these patients, 29.2% (140/480) had 2 or more symptoms in the final 48 hours of life. Higher Elixhauser comorbidity scores (relative risk [RR] 1.35, 95% confidence interval [CI] 1.23-1.49), having a family doctor (RR 2.33, 95% CI 1.02-5.38), being admitted to the medical oncology service (RR 1.51, 95% CI 1.11-2.05) and having a documented order for no resuscitation written early during the stay in hospital (RR 1.38, 95% CI 1.01-1.89) were independently associated with symptoms. Admission to intensive care was associated with fewer symptoms (RR 0.39, CI 95% 0.19-0.80). Interpretation: Symptoms are common in the final 48 hours of life, particularly in patients with multimorbidity who want limitations on the aggressiveness of their care. An integrated palliative approach is needed for select at-risk patients.

  11. Exploring the impact of health information technology on communication and collaboration in acute care nursing.

    PubMed

    Cashen, Margaret S; Bradley, Victoria; Farrell, Ann; Murphy, Judy; Schleyer, Ruth; Sensmeier, Joyce; Dykes, Patricia C

    2006-01-01

    A focus group using nursing informatics experts as informants was conducted to guide development of a survey to explore the impact of health information technology on the role of nurses and interdisciplinary communication in acute care settings. Through analysis of focus group transcripts, five key themes emerged: information, communication, care coordination, interdisciplinary relationships, workflow, and practice effectiveness and efficiency. This served as the basis for development of a survey that will investigate perceptions of acute care providers across the United States regarding the impact of health information technology on the role of nurses and interdisciplinar communication in acute care settings. The purpose of this paper is to describe the process of survey development including analysis of transcripts, emergence of key themes, and the processes by which the themes will be employed to inform survey development.

  12. Genome-wide association study of generalized anxiety symptoms in the Hispanic Community Health Study/Study of Latinos.

    PubMed

    Dunn, Erin C; Sofer, Tamar; Gallo, Linda C; Gogarten, Stephanie M; Kerr, Kathleen F; Chen, Chia-Yen; Stein, Murray B; Ursano, Robert J; Guo, Xiuqing; Jia, Yucheng; Qi, Qibin; Rotter, Jerome I; Argos, Maria; Cai, Jianwen; Penedo, Frank J; Perreira, Krista; Wassertheil-Smoller, Sylvia; Smoller, Jordan W

    2017-03-01

    Although generalized anxiety disorder (GAD) is heritable and aggregates in families, no genomic loci associated with GAD have been reported. We aimed to discover potential loci by conducting a genome-wide analysis of GAD symptoms in a large, population-based sample of Hispanic/Latino adults. Data came from 12,282 participants (aged 18-74) in the Hispanic Community Health Study/Study of Latinos. Using a shortened Spielberger Trait Anxiety measure, we analyzed the following: (i) a GAD symptoms score restricted to the three items tapping diagnostic features of GAD as defined by DSM-V; and (ii) a total trait anxiety score based on summing responses to all ten items. We first calculated the heritability due to common variants (h(2)SNP ) and then conducted a genome-wide association study (GWAS) of GAD symptoms. Replication was attempted in three independent Hispanic cohorts (Multi-Ethnic Study of Atherosclerosis, Women's Health Initiative, Army STARRS). The GAD symptoms score showed evidence of modest heritability (7.2%; P = 0.03), while the total trait anxiety score did not (4.97%; P = 0.20). One genotyped SNP (rs78602344) intronic to thrombospondin 2 (THBS2) was nominally associated (P = 5.28 × 10(-8) ) in the primary analysis adjusting for psychiatric medication use and significantly associated with the GAD symptoms score in the analysis excluding medication users (P = 4.18 × 10(-8) ). However, meta-analysis of the replication samples did not support this association. Although we identified a genome-wide significant locus in this sample, we were unable to replicate this finding. Evidence for heritability was also only detected for GAD symptoms, and not the trait anxiety measure, suggesting differential genetic influences within the domain of trait anxiety. © 2016 Wiley Periodicals, Inc.

  13. Management of symptoms associated with advanced cancer: olanzapine and mirtazapine. A World Health Organization project.

    PubMed

    Davis, Mellar P; Khawam, Elias; Pozuelo, Leo; Lagman, Ruth

    2002-08-01

    Advanced cancer patients are polysymptomatic and often receive multiple medications for symptom relief. Common symptoms include anorexia, weight loss, delirium and depression. Olanzapine and mirtazapine may have several advantages over older agents despite increased acquisition costs. Both medications can treat several symptoms with a low risk for drug-drug interactions and with only once- or twice-daily dosing. Drug side effects are low, compared with more conventionally used agents. The pharmacokinetics and pharmacodynamics of both agents are unique and explain many of the benefits. More research and clinical experience will be necessary to define their role in the palliation of advanced cancer.

  14. Fear of Severe Acute Respiratory Syndrome (SARS) among Health Care Workers

    ERIC Educational Resources Information Center

    Ho, Samuel M. Y.; Kwong-Lo, Rosalie S. Y.; Mak, Christine W. Y.; Wong, Joe S.

    2005-01-01

    In this study, the authors examined fear related to severe acute respiratory syndrome (SARS) among 2 samples of hospital staff in Hong Kong. Sample 1 included health care workers (n = 82) and was assessed during the peak of the SARS epidemic. Sample 2 included hospital staff who recovered from SARS (n = 97). The results show that participants in…

  15. Acute health effects of the Tasman Spirit oil spill on residents of Karachi, Pakistan

    PubMed Central

    Janjua, Naveed Zafar; Kasi, Pashtoon Murtaza; Nawaz, Haq; Farooqui, Sadia Zohra; Khuwaja, Urooj Bakht; Najam-ul-Hassan; Jafri, Syed Nadim; Lutfi, Shahid Ali; Kadir, Muhammad Masood; Sathiakumar, Nalini

    2006-01-01

    Background On July 27 2003, a ship carrying crude oil run aground near Karachi and after two weeks released 37,000 tons of its cargo into the sea. Oil on the coastal areas and fumes in air raised health concerns among people. We assessed the immediate health impact of oil spill from the tanker Tasman Spirit on residents of the affected coastline in Karachi, Pakistan. Methods We conducted a study consisting of an exposed group including adults living in houses on the affected shoreline and two control groups (A and B) who lived at the distance of 2 km and 20 km away from the sea, respectively. We selected households through systematic sampling and interviewed an adult male and female in each household about symptoms relating to eyes, respiratory tract, skin and nervous system, smoking, allergies, beliefs about the effect on their health and anxiety about the health effects. We used logistic regression procedures to model each symptom as an outcome and the exposure status as an independent variable while adjusting for confounders. We also used linear regression procedure to assess the relationship exposure status with symptoms score; calculated by summation of all symptoms. Results Overall 400 subjects were interviewed (exposed, n = 216; group A, n = 83; and group B, n = 101). The exposed group reported a higher occurrence of one or more symptoms compared to either of the control groups (exposed, 96% vs. group A, 70%, group B 85%; P < 0.001). Mean summary symptom scores were higher among the exposed group (14.5) than control group A (4.5) and control group B (3.8, P < 0.001). Logistic regression models indicated that there were statistically significant, moderate-to-strong associations (Prevalence ORs (POR) ranging from 2.3 to 37.0) between the exposed group and the symptoms. There was a trend of decreasing symptom-specific PORs with increase in distance from the spill site. Multiple linear regression model revealed strong relationship of exposure status with the

  16. Mental- and physical-health effects of acute exposure to media images of the September 11, 2001, attacks and the Iraq War.

    PubMed

    Silver, Roxane Cohen; Holman, E Alison; Andersen, Judith Pizarro; Poulin, Michael; McIntosh, Daniel N; Gil-Rivas, Virginia

    2013-09-01

    Millions of people witnessed early, repeated television coverage of the September 11 (9/11), 2001, terrorist attacks and were subsequently exposed to graphic media images of the Iraq War. In the present study, we examined psychological- and physical-health impacts of exposure to these collective traumas. A U.S. national sample (N = 2,189) completed Web-based surveys 1 to 3 weeks after 9/11; a subsample (n = 1,322) also completed surveys at the initiation of the Iraq War. These surveys measured media exposure and acute stress responses. Posttraumatic stress symptoms related to 9/11 and physician-diagnosed health ailments were assessed annually for 3 years. Early 9/11- and Iraq War-related television exposure and frequency of exposure to war images predicted increased posttraumatic stress symptoms 2 to 3 years after 9/11. Exposure to 4 or more hr daily of early 9/11-related television and cumulative acute stress predicted increased incidence of health ailments 2 to 3 years later. These findings suggest that exposure to graphic media images may result in physical and psychological effects previously assumed to require direct trauma exposure.

  17. Differential Associations of Depressive Symptom Dimensions with Cardio-Vascular Disease in the Community: Results from the Gutenberg Health Study

    PubMed Central

    Michal, Matthias; Wiltink, Jörg; Kirschner, Yvonne; Wild, Philipp S.; Münzel, Thomas; Ojeda, Francisco M.; Zeller, Tanja; Schnabel, Renate B.; Lackner, Karl; Blettner, Maria; Zwiener, Isabella; Beutel, Manfred E.

    2013-01-01

    A current model suggested that the somatic symptom dimension accounts for the adverse effect of depression in patients with coronary heart disease (CHD). In order to test this model we sought to determine in a large population-based sample how symptom dimensions of depression are associated with CHD, biomarkers and traditional risk factors. The associations of cognitive and somatic symptom dimensions of depression with CHD, risk factors, endothelial function, and biomarkers of inflammation and myocardial stress were analyzed cross-sectionally in a sample of n = 5000 Mid-Europeans aged 35–74 years from the Gutenberg Health Study (GHS). Only the somatic symptom dimension of depression was associated with CHD, biomarkers (inflammation, vascular function) and cardio-vascular risk factors. When multivariable adjustment was applied by demographic and cardiovascular risk factors, the weak associations of the somatic symptom dimension with the biomarkers disappeared. However, the associations of the somatic symptom dimension with CHD, myocardial infarction, obesity, dyslipidemia and family history of myocardial infarction remained. Both dimensions of depression were independently associated with a previous diagnosis of depression and distressed personality (type D). Thus, our results partly confirm current models: Somatic, but not cognitive-affective symptom dimensions are responsible for the association between depression and CHD, inflammation, vascular function and cardiovascular risk factors in the general population. However, our findings challenge the assumptions that somatic depression might be due to inflammation or vascular dysfunction as consequence of progressed atherosclerotic disease. They rather emphasize a close interplay with life-style factors and with a family history of MI. PMID:23967272

  18. Odor-related Chronic Somatic Symptoms Are Associated with Self-Reported Asthma and Hay Fever: The Hordaland Health Study.

    PubMed

    Gundersen, Hilde; Harris, Anette; Bråtveit, Magne; Moen, Bente E

    2015-02-01

    The aetiology behind odor-related chronic somatic symptoms (O-RCSS) is unknown, although both immunological and psychiatric causes have been suggested. The aim of this study was to investigate the occurrence of self-reported asthma and hay fever and psychiatric symptoms in individuals having O-RCSS compared to individuals with similar chronic somatic symptoms (CSS) which were not odors-related, and also compared to healthy controls. Data from the Hordaland Health Study were used. 13,799 individuals, 40-45 years, answered a questionnaire including 16 questions related to somatic symptoms. They also indicated if the symptoms were odor-related, and answered questions about asthma and hay fever. Anxiety and depression were measured with the Hospital Anxiety and Depression Scale. 38 (0.6%) men and 106 (1.4%) women had O-RCSS, whereas 88 (1.5%) men and 192 (2.5%) women had CSS. Adjusted logistic regression analyses showed increased odds of self-reported asthma in those with O-RCSS compared to those with CSS (males: 3.81, 1.06-13.8, females: 2.60, 1.05-6.93) and compared to male and female controls (3.56, 1.89-6.68 and 4.81, 1.92-12.1 respectively). Increased odds of self-reported hay fever were in addition seen in females with O-RCSS. There were no differences in psychiatric symptoms between individuals with O-RCSS and CSS, although individuals in both groups showed increased odds compared to male and female controls. Increased occurrence of self-reported asthma was exclusively found among male and females with O-RCSS, compared to CSS and controls. Increased occurrence of psychiatric symptoms was seen both in individuals with O-RCSS and CSS.

  19. Obstetric complications and mother’s age at delivery are predictors of eating disorder symptoms among Health Science college students

    PubMed Central

    Lofrano-Prado, Mara Cristina; do Prado, Wagner Luiz; de Barros, Mauro Virgilio Gomes; Tenório, Thiago Ricardo dos Santos; de Souza, Sandra Lopes

    2015-01-01

    ABSTRACT Objective To identify the association between perinatal/neonatal factors and symptoms of eating disorders among college students. Methods Four hundred and eight college students (283 women), aged 18 to 23 years old, enrolled in the first semester of a Bachelor of Health Science degree program were included in the sample. Eating disorder symptoms and body image dissatisfaction were assessed with the Eating Attitudes Test and Bulimic Investigatory Test of Edinburgh. Information regarding birth weight, breastfeeding, obstetric complications, mother’s age at delivery, type of delivery, and birth order were self-reported by the volunteers after consulting their parents. Association between perinatal and neonatal factors and symptoms of anorexia nervosa and bulimia nervosa were assessed by binary logistic regression adjusted for sex, age, and body mass index. Results The likelihood of presenting with symptoms of anorexia nervosa was 0.5 time lower for those students born from the oldest mothers (odds ratio – OR=0.37; 95% confidence interval – 95%CI: 0.17-0.83). Relative to bulimia nervosa, the risk was higher among students who reported obstetric complications (OR=2.62; 95%CI: 1.03-6.67). Conclusion We observed the association between perinatal and neonatal factors with symptoms of eating disorders in college students. PMID:26676267

  20. Mental and social health during and after acute emergencies: emerging consensus?

    PubMed Central

    van Ommeren, Mark; Saxena, Shekhar; Saraceno, Benedetto

    2005-01-01

    Mental health care programmes during and after acute emergencies in resource-poor countries have been considered controversial. There is no agreement on the public health value of the post-traumatic stress disorder concept and no agreement on the appropriateness of vertical (separate) trauma-focused services. A range of social and mental health intervention strategies and principles seem, however, to have the broad support of expert opinion. Despite continuing debate, there is emerging agreement on what entails good public health practice in respect of mental health. In terms of early interventions, this agreement is exemplified by the recent inclusion of a "mental and social aspects of health" standard in the Sphere handbook's revision on minimal standards in disaster response. This affirmation of emerging agreement is important and should give clear messages to health planners. PMID:15682252

  1. The effects of mental health symptoms and organizational climate on intent to leave the military among combat veterans.

    PubMed

    Wright, Paul J; Kim, Paul Y; Wilk, Joshua E; Thomas, Jeffrey L

    2012-07-01

    Frequent deployments to Iraq and Afghanistan have placed a strain on military retention. There is a need to determine contributing factors predicting intent to leave the military. The purpose of this study was to determine to what extent soldiers' mental health symptoms and perceptions of organizational climate are associated with intent to leave the military. Participants (n = 892) were soldiers of one infantry brigade combat team stationed in the United States, anonymously surveyed approximately 6 months after returning from a combat deployment to Iraq. The survey assessed overall deployment experiences, mental health symptoms, and perceptions of organizational climate. Results showed that soldiers reporting higher perceived organizational support were significantly less likely to report intent to leave and those screening positive for anxiety were significantly more likely to report intent to leave than those not screening positive. Implications of these results for Army clinicians and career counselors are discussed.

  2. A tool for sexual minority mental health research: The Patient Health Questionnaire (PHQ-9) as a depressive symptom severity measure for sexual minority women in Viet Nam

    PubMed Central

    Nguyen, Trang Quynh; Bandeen-Roche, Karen; Bass, Judith K; German, Danielle; Nguyen, Nam Thi Thu; Knowlton, Amy R

    2016-01-01

    In a context with limited attention to mental health and prevalent sexual prejudice, valid measurements are a key first step to understanding the psychological suffering of sexual minority populations. We adapted the Patient Health Questionnaire as a depressive symptom severity measure for Vietnamese sexual minority women, ensuring its cultural relevance and suitability for internet-based research. Psychometric evaluation found that the scale is mostly unidimensional and has good convergent validity, good external construct validity, and excellent reliability. The sample’s high endorsement of scale items emphasizes the need to study minority stress and mental health in this population. PMID:27642381

  3. Association of Childhood Physical and Sexual Abuse with Intimate Partner Violence, Poor General Health and Depressive Symptoms among Pregnant Women

    PubMed Central

    Barrios, Yasmin V.; Gelaye, Bizu; Zhong, Qiuyue; Nicolaidis, Christina; Rondon, Marta B.; Garcia, Pedro J.; Sanchez, Pedro A. Mascaro; Sanchez, Sixto E.; Williams, Michelle A.

    2015-01-01

    Objective We examined associations of childhood physical and sexual abuse with risk of intimate partner violence (IPV). We also evaluated the extent to which childhood abuse was associated with self-reported general health status and symptoms of antepartum depression in a cohort of pregnant Peruvian women. Methods In-person interviews were conducted to collect information regarding history of childhood abuse and IPV from 1,521 women during early pregnancy. Antepartum depressive symptomatology was evaluated using the Patient Health Questionnaire-9. Multivariable logistic regression procedures were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95%CI). Results Any childhood abuse was associated with 2.2-fold increased odds of lifetime IPV (95%CI: 1.72–2.83). Compared with women who reported no childhood abuse, those who reported both, childhood physical and sexual abuse had a 7.14-fold lifetime risk of physical and sexual IPV (95%CI: 4.15–12.26). The odds of experiencing physical and sexual abuse by an intimate partner in the past year was 3.33-fold higher among women with a history of childhood physical and sexual abuse as compared to women who were not abused as children (95%CI 1.60–6.89). Childhood abuse was associated with higher odds of self-reported poor health status during early pregnancy (aOR = 1.32, 95%CI: 1.04–1.68) and with symptoms of antepartum depression (aOR = 2.07, 95%CI: 1.58–2.71). Conclusion These data indicate that childhood sexual and physical abuse is associated with IPV, poor general health and depressive symptoms in early pregnancy. The high prevalence of childhood trauma and its enduring effects of on women’s health warrant concerted global health efforts in preventing violence. PMID:25635902

  4. Successful outcome after endovascular thrombolysis for acute ischemic stroke with basis on perfusion-diffusion mismatch after 24 h of symptoms onset

    PubMed Central

    Mattei, Tobias A.; Rehman, Azeem A.; Goulart, Carlos R.; Sória, Marília G.; Rizelio, Vanessa; Meneses, Murilo S.

    2016-01-01

    Background: Although intravenous thrombolysis is the Food and Drug Administration-approved treatment for acute ischemic stroke (AIS) within 3 h, combined intravenous and intra-arterial thrombolysis with endovascular techniques may be able to extend this traditional time window. Case Description: We present the clinical evolution of a 45-year-old male presenting with acute left hemiparesis. Magnetic resonance imaging revealed a small diffusion restriction at the right basal ganglia with perfusion compromise in the entire right middle cerebral artery (MCA) territory. Angiography revealed a complete occlusion of MCA at its M1 segment. The patient underwent endovascular mechanical thrombectomy with additional intra-arterial thrombolysis more than 24 hours after the onset of the initial symptoms and experienced complete vessel recanalization. At 1 year, the patient had global independence with minor residual motor impairment in the left arm. Conclusions: We report the case of a successful thrombolytic therapy following AIS performed more than 24 h after the initial symptoms based on the presence of a perfusion-diffusion mismatch. This report is expected to stimulate the development of future prospective studies with special focus on the role of perfusion-diffusion mismatch in patient selection for treatment of AIS, especially in those presenting outside the traditional time window. PMID:27313971

  5. Physical health symptoms reported by trafficked women receiving post-trafficking support in Moldova: prevalence, severity and associated factors

    PubMed Central

    2012-01-01

    Background Many trafficked people suffer high levels of physical, sexual and psychological abuse. Yet, there has been limited research on the physical health problems associated with human trafficking or how the health needs of women in post-trafficking support settings vary according to socio-demographic or trafficking characteristics. Methods We analysed the prevalence and severity of 15 health symptoms reported by 120 trafficked women who had returned to Moldova between December 2007 and December 2008 and were registered with the International Organisation for Migration Assistance and Protection Programme. Women had returned to Moldova an average of 5.9 months prior to interview (range 2-12 months). Results Headaches (61.7%), stomach pain (60.9%), memory problems (44.2%), back pain (42.5%), loss of appetite (35%), and tooth pain (35%) were amongst the most commonly reported symptoms amongst both women trafficked for sexual exploitation and women trafficked for labour exploitation. The prevalence of headache and memory problems was strongly associated with duration of exploitation. Conclusions Trafficked women who register for post-trafficking support services after returning to their country of origin are likely to have long-term physical and dental health needs and should be provided with access to comprehensive medical services. Health problems among women who register for post-trafficking support services after returning to their country of origin are not limited to women trafficked for sexual exploitation but are also experienced by victims of labour exploitation. PMID:22834807

  6. Public Health Consequences on Vulnerable Populations from Acute Chemical Releases

    PubMed Central

    Ruckart, Perri Zeitz; Orr, Maureen F.

    2008-01-01

    Data from a large, multi-state surveillance system on acute chemical releases were analyzed to describe the type of events that are potentially affecting vulnerable populations (children, elderly and hospitalized patients) in order to better prevent and plan for these types of incidents in the future. During 2003–2005, there were 231 events where vulnerable populations were within ¼ mile of the event and the area of impact was greater than 200 feet from the facility/point of release. Most events occurred on a weekday during times when day care centers or schools were likely to be in session. Equipment failure and human error caused a majority of the releases. Agencies involved in preparing for and responding to chemical emergencies should work with hospitals, nursing homes, day care centers, and schools to develop policies and procedures for initiating appropriate protective measures and managing the medical needs of patients. Chemical emergency response drills should involve the entire community to protect those that may be more susceptible to harm. PMID:21572842

  7. Design Considerations for Post-Acute Care mHealth: Patient Perspectives.

    PubMed

    Sanger, Patrick; Hartzler, Andrea; Lober, William B; Evans, Heather L; Pratt, Wanda

    2014-01-01

    Many current mobile health applications ("apps") and most previous research have been directed at management of chronic illnesses. However, little is known about patient preferences and design considerations for apps intended to help in a post-acute setting. Our team is developing an mHealth platform to engage patients in wound tracking to identify and manage surgical site infections (SSI) after hospital discharge. Post-discharge SSIs are a major source of morbidity and expense, and occur at a critical care transition when patients are physically and emotionally stressed. Through interviews with surgical patients who experienced SSI, we derived design considerations for such a post-acute care app. Key design qualities include: meeting basic accessibility, usability and security needs; encouraging patient-centeredness; facilitating better, more predictable communication; and supporting personalized management by providers. We illustrate our application of these guiding design considerations and propose a new framework for mHealth design based on illness duration and intensity.

  8. Management of acute respiratory infections by community health volunteers: experience of Bangladesh Rural Advancement Committee (BRAC).

    PubMed Central

    Hadi, Abdullahel

    2003-01-01

    OBJECTIVE: To assess the role of management practices for acute respiratory infections (ARIs) in improving the competency of community health volunteers in diagnosing and treating acute respiratory infections among children. METHODS: Data were collected by a group of research physicians who observed the performance of a sample of 120 health volunteers in 10 sub-districts in Bangladesh in which Bangladesh Rural Advancement Committee (BRAC) had run a community-based ARI control programme since mid-1992. Standardized tests were conducted until the 95% interphysician reliability on the observation of clinical examination was achieved. FINDINGS:The sensitivity, specificity, and overall agreement rates in diagnosing and treating ARIs were significantly higher among the health volunteers who had basic training and were supervised routinely than among those who had not. CONCLUSION: Diagnosis and treatment of ARIs at the household level in developing countries are possible if intensive basic training and the close supervision of service providers are ensured. PMID:12764514

  9. Comparison of Acute Health Effects From Exposures to Diesel and Biodiesel Fuel Emissions

    PubMed Central

    Mehus, Aaron A.; Reed, Rustin J.; Lee, Vivien S. T.; Littau, Sally R.; Hu, Chengcheng; Lutz, Eric A.

    2015-01-01

    Objective: To investigate the comparative acute health effects associated with exposures to diesel and 75% biodiesel/25% diesel (B75) blend fuel emissions. Methods: We analyzed multiple health endpoints in 48 healthy adults before and after exposures to diesel and B75 emissions in an underground mine setting—lung function, lung and systemic inflammation, novel biomarkers of exposure, and oxidative stress were assessed. Results: B75 reduced respirable diesel particulate matter by 20%. Lung function declined significantly more after exposure to diesel emissions. Lung inflammatory cells along with sputum and plasma inflammatory mediators increased significantly to similar levels with both exposures. Urinary 8-hydroxydeoxyguanosine, a marker of oxidative stress, was not significantly changed after either exposure. Conclusions: Use of B75 lowered respirable diesel particulate matter exposure and some associated acute health effects, although lung and systemic inflammation were not reduced compared with diesel use. PMID:26147538

  10. The Health Deviation of Post-Breast Cancer Lymphedema: Symptom Assessment and Impact on Self-Care Agency.

    PubMed

    Armer, Jane M; Henggeler, Mary H; Brooks, Constance W; Zagar, Eris A; Homan, Sherri; Stewart, Bob R

    2008-01-01

    Breast cancer is the leading cancer among women world-wide, affecting 1 of 8 women during their lifetimes. In the US alone, some 2 million breast cancer survivors comprise 20% of all cancer survivors. Conservatively, it is estimated that some 20-40% of all breast cancer survivors will develop the health deviation of lymphedema or treatment-related limb swelling over their lifetimes. This chronic accumulation of protein-rich fluid predisposes to infection, leads to difficulties in fitting clothing and carrying out activities of daily living, and impacts self-esteem, self-concept, and quality of life. Lymphedema is associated with self-care deficits (SCD) and negatively impacts self-care agency (SCA) and physiological and psychosocial well-being. Objectives of this report are two-fold: (1) to explore four approaches of assessing and diagnosing breast cancer lymphedema, including self-report of symptoms and the impact of health deviations on SCA; and (2) to propose the development of a clinical research program for lymphedema based on the concepts of Self-Care Deficit Nursing Theory (SCDNT). Anthropometric and symptom data from a National-Institutes-of-Health-funded prospective longitudinal study were examined using survival analysis to compare four definitions of lymphedema over 24 months post-breast cancer surgery among 140 of 300 participants (all who had passed the 24-month measurement). The four definitions included differences of 200 ml, 10% volume, and 2 cm circumference between pre-op baseline and/or contralateral limbs, and symptom self-report of limb heaviness and swelling. Symptoms, SCA, and SCD were assessed by interviews using a validated tool. Estimates of lymphedema occurrence varied by definition and time since surgery. The 2 cm girth change provided the highest estimation of lymphedema (82% at 24 months), followed by 200 ml volume change (57% at 24 months). The 10% limb volume change converged with symptom report of heaviness and swelling at 24 months

  11. The Health Deviation of Post-Breast Cancer Lymphedema: Symptom Assessment and Impact on Self-Care Agency

    PubMed Central

    Armer, Jane M.; Henggeler, Mary H; Brooks, Constance W.; Zagar, Eris A.; Homan, Sherri; Stewart, Bob R.

    2010-01-01

    Breast cancer is the leading cancer among women world-wide, affecting 1 of 8 women during their lifetimes. In the US alone, some 2 million breast cancer survivors comprise 20% of all cancer survivors. Conservatively, it is estimated that some 20-40% of all breast cancer survivors will develop the health deviation of lymphedema or treatment-related limb swelling over their lifetimes. This chronic accumulation of protein-rich fluid predisposes to infection, leads to difficulties in fitting clothing and carrying out activities of daily living, and impacts self-esteem, self-concept, and quality of life. Lymphedema is associated with self-care deficits (SCD) and negatively impacts self-care agency (SCA) and physiological and psychosocial well-being. Objectives of this report are two-fold: (1) to explore four approaches of assessing and diagnosing breast cancer lymphedema, including self-report of symptoms and the impact of health deviations on SCA; and (2) to propose the development of a clinical research program for lymphedema based on the concepts of Self-Care Deficit Nursing Theory (SCDNT). Anthropometric and symptom data from a National-Institutes-of-Health-funded prospective longitudinal study were examined using survival analysis to compare four definitions of lymphedema over 24 months post-breast cancer surgery among 140 of 300 participants (all who had passed the 24-month measurement). The four definitions included differences of 200 ml, 10% volume, and 2 cm circumference between pre-op baseline and/or contralateral limbs, and symptom self-report of limb heaviness and swelling. Symptoms, SCA, and SCD were assessed by interviews using a validated tool. Estimates of lymphedema occurrence varied by definition and time since surgery. The 2 cm girth change provided the highest estimation of lymphedema (82% at 24 months), followed by 200 ml volume change (57% at 24 months). The 10% limb volume change converged with symptom report of heaviness and swelling at 24 months

  12. Acute health effects after exposure to chlorine gas released after a train derailment.

    PubMed

    Van Sickle, David; Wenck, Mary Anne; Belflower, Amy; Drociuk, Dan; Ferdinands, Jill; Holguin, Fernando; Svendsen, Erik; Bretous, Lena; Jankelevich, Shirley; Gibson, James J; Garbe, Paul; Moolenaar, Ronald L

    2009-01-01

    In January 2005, a train derailment on the premises of a textile mill in South Carolina released 42 to 60 tons of chlorine gas in the middle of a small town. Medical records and autopsy reports were reviewed to describe the clinical presentation, hospital course, and pathology observed in persons hospitalized or deceased as a result of chlorine gas exposure. Eight persons died before reaching medical care; of the 71 persons hospitalized for acute health effects as a result of chlorine exposure, 1 died in the hospital. The mean age of the hospitalized persons was 40 years (range, 4 months-76 years); 87% were male. The median duration of hospitalization was 4 days (range, 1-29 days). Twenty-five (35%) persons were admitted to the intensive care unit; the median length of stay was 3 days. Many surviving victims developed significant pulmonary signs and severe airway inflammation; 41 (58%) hospitalized persons met PO2/FiO2 criteria for acute respiratory distress syndrome or acute lung injury. During their hospitalization, 40 (57%) developed abnormal x-ray findings, 74% of those within the first day. Hypoxia on room air and PO2/FiO2 ratio predicted severity of outcome as assessed by the duration of hospitalization and the need for intensive care support. This community release of chlorine gas caused widespread exposure and resulted in significant acute health effects and substantial health care requirements. Pulse oximetry and arterial blood gas analysis provided early indications of outcome severity.

  13. Chronic and Acute Stress, Gender, and Serotonin Transporter Gene-Environment Interactions Predicting Depression Symptoms in Youth

    ERIC Educational Resources Information Center

    Hammen, Constance; Brennan, Patricia A.; Keenan-Miller, Danielle; Hazel, Nicholas A.; Najman, Jake M.

    2010-01-01

    Background: Many recent studies of serotonin transporter gene by environment effects predicting depression have used stress assessments with undefined or poor psychometric methods, possibly contributing to wide variation in findings. The present study attempted to distinguish between effects of acute and chronic stress to predict depressive…

  14. Acute Recurrent Pancreatitis in Children: A Study From the Pediatric Health Information System.

    PubMed

    Pant, Chaitanya; Sferra, Thomas J; Lee, Brian R; Cocjin, Jose T; Olyaee, Mojtaba

    2016-03-01

    We investigated acute recurrent pancreatitis (ARP) in children using a national health care database. From 2002 to 2014, 26,435 children had a diagnosis of acute pancreatitis (AP); 10,648 discharges were index hospitalizations. A total of 6159 children had a single hospitalization for AP, whereas 4489 (42%) children underwent 15,787 rehospitalizations. Children experienced a median of 2 ARP-related hospitalizations with a median time between admissions of 86 days. Younger patients with a more severe index episode of AP were at a higher risk of ARP. ARP-related hospitalizations had an increased requirement for intensive care unit care compared with an index episode of AP.

  15. Indoor environmental and air quality characteristics, building-related health symptoms, and worker productivity in a federal government building complex.

    PubMed

    Lukcso, David; Guidotti, Tee Lamont; Franklin, Donald E; Burt, Allan

    2016-01-01

    Building Health Sciences, Inc. (BHS), investigated environmental conditions by many modalities in 71 discreet areas of 12 buildings in a government building complex that had experienced persistent occupant complaints despite correction of deficiencies following a prior survey. An online health survey was completed by 7,637 building occupants (49% response rate), a subset of whom voluntarily wore personal sampling apparatus and underwent medical evaluation. Building environmental measures were within current standards and guidelines, with few outliers. Four environmental factors were consistently associated with group-level building-related health complaints: physical comfort/discomfort, odor, job stress, and glare. Several other factors were frequently commented on by participants, including cleanliness, renovation and construction activities, and noise. Low relative humidity was significantly associated with lower respiratory and "sick building syndrome"-type symptoms. No other environmental conditions (including formaldehyde, PM10 [particulate matter with an aerodynamic diameter <10 μm], or mold levels, which were tested by 7 parameters) correlated directly with individual health symptoms. Indicators of atopy or allergy (sinusitis, allergies, and asthma), when present singly, in combinations of 2 conditions, or together, were hierarchically associated with the following: increased absence, increased presenteeism (presence at work but at reduced capacity), and increase in reported symptom-days, including symptoms not related to respiratory disease. We found that in buildings without unusual hazards and with environmental and air quality indicators within the range of acceptable indoor air quality standards, there is an identifiable population of occupants with a high prevalence of asthma and allergic disease who disproportionately report discomfort and lost productivity due to symptoms and that in "normal" buildings these outcome indicators are more closely

  16. Unique PTSD clusters predict intention to seek mental health care and subsequent utilization in US veterans with PTSD symptoms.

    PubMed

    Blais, Rebecca K; Hoerster, Katherine D; Malte, Carol; Hunt, Stephen; Jakupcak, Matthew

    2014-04-01

    Many veterans return from deployment with posttraumatic stress disorder (PTSD), but most attend only a limited number of mental health care visits. Although global PTSD relates to seeking mental health care, it is unclear whether specific features of PTSD inform the low rates of mental health care utilization. This study examined PTSD cluster severities of avoidance, reexperiencing, dysphoria, and hyperarousal as predictors of intention to seek mental health care and prospective treatment utilization. US veterans with at least subthreshold PTSD (N = 189) completed a PTSD symptom measure and indicated whether they intended to seek mental health care. Prospective Department of Veterans Affairs mental health care utilization was extracted from the medical record. At the bivariate level, each cluster was positively associated with a positive intention to seek mental health care and prospective treatment utilization. In multivariate models, however, dysphoria severity (OR = 1.16, 95% CI [1.06, 1.26]) was uniquely and positively correlated with intention to seek mental health care, whereas higher avoidance severity (IRR = 0.86, 95% CI [0.76, 0.98]) predicted lower treatment utilization, and higher reexperiencing severity (IRR = 1.07, 95% CI [1.01, 1.14]) predicted greater treatment utilization. It is critical to tailor interventions to target specific features of PTSD and to meet patients where they are.

  17. Quantitative measurements of relative fluid-attenuated inversion recovery (FLAIR) signal intensities in acute stroke for the prediction of time from symptom onset

    PubMed Central

    Cheng, Bastian; Brinkmann, Mathias; Forkert, Nils D; Treszl, Andras; Ebinger, Martin; Köhrmann, Martin; Wu, Ona; Kang, Dong-Wha; Liebeskind, David S; Tourdias, Thomas; Singer, Oliver C; Christensen, Soren; Luby, Marie; Warach, Steven; Fiehler, Jens; Fiebach, Jochen B; Gerloff, Christian; Thomalla, Götz

    2013-01-01

    In acute stroke magnetic resonance imaging, a ‘mismatch' between visibility of an ischemic lesion on diffusion-weighted imaging (DWI) and missing corresponding parenchymal hyperintensities on fluid-attenuated inversion recovery (FLAIR) data sets was shown to identify patients with time from symptom onset ≤4.5 hours with high specificity. However, moderate sensitivity and suboptimal interpreter agreement are limitations of a visual rating of FLAIR lesion visibility. We tested refined image analysis methods in patients included in the previously published PREFLAIR study using refined visual analysis and quantitative measurements of relative FLAIR signal intensity (rSI) from a three-dimensional, segmented stroke lesion volume. A total of 399 patients were included. The rSI of FLAIR lesions showed a moderate correlation with time from symptom onset (r=0.382, P<0.001). A FLAIR rSI threshold of <1.0721 predicted symptom onset ≤4.5 hours with slightly increased specificity (0.85 versus 0.78) but also slightly decreased sensitivity (0.47 versus 0.58) as compared with visual analysis. Refined visual analysis differentiating between ‘subtle' and ‘obvious' FLAIR hyperintensities and classification and regression tree algorithms combining information from visual and quantitative analysis also did not improve diagnostic accuracy. Our results raise doubts whether the prediction of stroke onset time by visual image judgment can be improved by quantitative rSI measurements. PMID:23047272

  18. Overview of systematic reviews: yoga as a therapeutic intervention for adults with acute and chronic health conditions.

    PubMed

    McCall, Marcy C; Ward, Alison; Roberts, Nia W; Heneghan, Carl

    2013-01-01

    Objectives. Overview the quality, direction, and characteristics of yoga interventions for treatment of acute and chronic health conditions in adult populations. Methods. We searched for systematic reviews in 10 online databases, bibliographic references, and hand-searches in yoga-related journals. Included reviews satisfy Oxman criteria and specify yoga as a primary intervention in one or more randomized controlled trials for treatment in adults. The AMSTAR tool and GRADE approach evaluated the methodological quality of reviews and quality of evidence. Results. We identified 2202 titles, of which 41 full-text articles were assessed for eligibility and 26 systematic reviews satisfied inclusion criteria. Thirteen systematic reviews include quantitative data and six papers include meta-analysis. The quality of evidence is generally low. Sixteen different types of health conditions are included. Eleven reviews show tendency towards positive effects of yoga intervention, 15 reviews report unclear results, and no, reviews report adverse effects of yoga. Yoga appears most effective for reducing symptoms in anxiety, depression, and pain. Conclusion. Although the quality of systematic reviews is high, the quality of supporting evidence is low. Significant heterogeneity and variability in reporting interventions by type of yoga, settings, and population characteristics limit the generalizability of results.

  19. Health-Related Quality of Life, Depression, Anxiety, and Self-Image in Acute Lymphocytic Leukemia Survivors

    PubMed Central

    Baytan, Birol; Aşut, Çiğdem; Çırpan Kantarcıoğlu, Arzu; Sezgin Evim, Melike; Güneş, Adalet Meral

    2016-01-01

    Objective: With increasing survival rates in childhood acute lymphocytic leukemia (ALL), the long-term side effects of treatment have become important. Our aim was to investigate health-related quality of life, depression, anxiety, and self-image among ALL survivors. Materials and Methods: Fifty patients diagnosed with ALL and their siblings were enrolled. The Kovacs Children’s Depression Inventory, State-Trait Anxiety Inventory, Offer Self-Image Questionnaire, and Pediatric Quality of Life InventoryTM were used for collecting data. ANOVA tests were used to determine if there were any significant differences between groups. Results: ALL survivors had higher depression, more anxiety symptoms, lower quality of life, and more negative self-image when compared to their siblings. Conclusion: Continuous diagnostic and interventional mental health services might be necessary for possible emotional side effects of treatment during and after the treatment. Rehabilitation and follow-up programs should be implemented for children during and after treatment for ALL. PMID:27094799

  20. Overview of Systematic Reviews: Yoga as a Therapeutic Intervention for Adults with Acute and Chronic Health Conditions

    PubMed Central

    McCall, Marcy C.; Ward, Alison; Roberts, Nia W.; Heneghan, Carl

    2013-01-01

    Objectives. Overview the quality, direction, and characteristics of yoga interventions for treatment of acute and chronic health conditions in adult populations. Methods. We searched for systematic reviews in 10 online databases, bibliographic references, and hand-searches in yoga-related journals. Included reviews satisfy Oxman criteria and specify yoga as a primary intervention in one or more randomized controlled trials for treatment in adults. The AMSTAR tool and GRADE approach evaluated the methodological quality of reviews and quality of evidence. Results. We identified 2202 titles, of which 41 full-text articles were assessed for eligibility and 26 systematic reviews satisfied inclusion criteria. Thirteen systematic reviews include quantitative data and six papers include meta-analysis. The quality of evidence is generally low. Sixteen different types of health conditions are included. Eleven reviews show tendency towards positive effects of yoga intervention, 15 reviews report unclear results, and no, reviews report adverse effects of yoga. Yoga appears most effective for reducing symptoms in anxiety, depression, and pain. Conclusion. Although the quality of systematic reviews is high, the quality of supporting evidence is low. Significant heterogeneity and variability in reporting interventions by type of yoga, settings, and population characteristics limit the generalizability of results. PMID:23762174

  1. Relations between Concurrent Longitudinal Changes in Cognition, Depressive Symptoms, Self-Rated Health and Everyday Function in Normally Aging Octogenarians

    PubMed Central

    2016-01-01

    Ability to predict and prevent incipient functional decline in older adults may help prolong independence. Cognition is related to everyday function and easily administered, sensitive cognitive tests may help identify at-risk individuals. Factors like depressive symptoms and self-rated health are also associated with functional ability and may be as important as cognition. The purpose of this study was to investigate the relationship between concurrent longitudinal changes in cognition, depression, self-rated health and everyday function in a well-defined cohort of healthy 85 year olds that were followed-up at the age of 90 in the Elderly in Linköping Screening Assessment 85 study. Regression analyses were used to determine if cognitive decline as assessed by global (the Mini-Mental State Examination) and domain specific (the Cognitive Assessment Battery, CAB) cognitive tests predicted functional decline in the context of changes in depressive symptoms and self-rated health. Results showed deterioration in most variables and as many as 83% of these community-dwelling elders experienced functional difficulties at the age of 90. Slowing-down of processing speed as assessed by the Symbol Digits Modality Test (included in the CAB) accounted for 14% of the variance in functional decline. Worsening self-rated health accounted for an additional 6%, but no other variables reached significance. These results are discussed with an eye to possible preventive interventions that may prolong independence for the steadily growing number of normally aging old-old citizens. PMID:27551749

  2. The effect of low ventilation rate with elevated bioeffluent concentration on work performance, perceived indoor air quality and health symptoms.

    PubMed

    Maula, Henna; Hongisto, Valtteri; Naatula, Viivi; Haapakangas, Annu; Koskela, Hannu

    2017-04-05

    The aim of this laboratory experiment was to study the effects of ventilation rate, and related changes in air quality, predominantly bioeffluents, on work performance, perceived indoor air quality and health symptoms in a typical conditions of modern open-plan office with low material and equipment emissions. In Condition A, outdoor air flow rate of 28.2 l/s person (CO2 level 540 ppm) was applied and in Condition B, outdoor air flow rate was 2.3 l/s person (CO2 level 2260 ppm). CO2 concentration level was used as an indicator of bioeffluents. Performance was measured with seven different tasks which measure different cognitive processes. Thirty-six subjects participated in the experiment. The exposure time was 4 hours. Condition B had a weak negative effect on performance only in the information retrieval tasks. Condition B increased slightly subjective workload and perceived fatigue. No effects on health symptoms were found. The intensity of symptoms was low in both conditions. The experimental condition had an effect on perceived air quality and observed odour intensity only in the beginning of the session. Although the room temperature was controlled in both conditions, the heat was perceived to impair the performance more in Condition B. This article is protected by copyright. All rights reserved.

  3. Association Between Depressive Symptoms and Incidence of Crohn’s Disease and Ulcerative Colitis: Results From the Nurses’ Health Study

    PubMed Central

    ANANTHAKRISHNAN, ASHWIN N.; KHALILI, HAMED; PAN, AN; HIGUCHI, LESLIE M.; DE SILVA, PUNYANGANIE; RICHTER, JAMES M.; FUCHS, CHARLES S.; CHAN, ANDREW T.

    2012-01-01

    BACKGROUND & AIMS Depression and psychosocial stress are believed to contribute to the pathogenesis of Crohn’s disease (CD) and ulcerative colitis (UC). Although many mechanisms have been proposed to link these disorders, few prospective studies have examined the relationship between depressed mood and incidence of CD or UC. METHODS We analyzed data from 152,461 women (aged 29–72 years) enrolled since 1992–1993 in the Nurses’ Health Study cohorts I and II. Self-reported depressive symptoms were assessed by using the Mental Health Index (MHI)-5, a validated 5-item subscale of the 36-item Short-Form health survey, which is designed to estimate psychological distress on the basis of scores that range from 0 to 100. Self-reported CD and UC were confirmed through blinded record review by 2 gastroenterologists. Cox proportional hazards models were used to associate recent (within 4 years) and baseline MHI-5 scores with risk for CD or UC, adjusting for other risk factors. RESULTS During 1,787,070 person-years of follow-up, we documented 170 cases of CD and 203 cases of UC. Compared with women with recent MHI-5 scores of 86–100, women with recent depressive symptoms (MHI-5 scores <52) had an increased risk of CD (multivariate-adjusted hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.40–3.98; P trend = .001). Baseline depressive symptoms, assessed from the baseline MHI-5 score, were also associated with CD, although with a lower HR (1.62; 95% CI, 0.94–2.77). Recent (HR, 1.14; 95% CI, 0.68–1.92) and baseline depressive symptoms were not associated with increased risk of UC (HR, 1.07; 95% CI, 0.63–1.83). CONCLUSIONS On the basis of data from the Nurses’ Health Study, depressive symptoms increase the risk for CD, but not UC, among women. Psychological factors might therefore contribute to development of CD. Further studies are needed to determine the mechanisms of this association. PMID:22944733

  4. Prevalence and Correlates of Depressive Symptoms and Resiliency among African American Women in a Community-Based Primary Health Care Center

    PubMed Central

    Holden, Kisha B.; Bradford, L. Dianne; Hall, Stephanie P.; Belton, Allyson S.

    2014-01-01

    The purpose of this cross-sectional pilot study was to determine the prevalence and correlates of depressive symptoms and resiliency among 290 African American women (AAW) in a community-based primary health care center. Descriptive statistics, Pearson product-moment correlation, and logistic regression analyses were conducted. Findings indicate that depressive symptoms are experienced by 49% of the participants, while 10% indicated a history of suicidal ideation. Participants had moderately high resiliency scores that had a statistically significant inverse relationship with depressive symptoms. This suggests that resiliency is potentially a protective factor for depressive symptoms. Depressive symptoms were positively correlated with participants’ diagnosis of at least one chronic disease. The strongest predictors of depressive symptoms were previous diagnoses of a mental health condition and unemployment. This study identifies risk and potential protective factors for depression among a clinic sample of AAW. PMID:24241263

  5. Bullying and Victimization in Adolescence: Concurrent and Stable Roles and Psychological Health Symptoms

    ERIC Educational Resources Information Center

    Menesini, Ersilia; Modena, Marco; Tani, Franca

    2009-01-01

    From an initial sample of 1,278 Italian students, the authors selected 537 on the basis of their responses to a self-report bully and victim questionnaire. Participants' ages ranged from 13 to 20 years (M = 15.12 years, SD = 1.08 years). The authors compared the concurrent psychological symptoms of 4 participant groups (bullies, victims,…

  6. Trauma, gender, and mental health symptoms in individuals with substance use disorders.

    PubMed

    Keyser-Marcus, Lori; Alvanzo, Anika; Rieckmann, Traci; Thacker, Leroy; Sepulveda, Allison; Forcehimes, Alyssa; Islam, Leila Z; Leisey, Monica; Stitzer, Maxine; Svikis, Dace S

    2015-01-01

    Individuals with substance use disorders are often plagued by psychiatric comorbidities and histories of physical and/or sexual trauma. Males and females, although different in their rates of expressed trauma and psychiatric symptomatology, experience comparable adverse consequences, including poorer substance abuse treatment outcomes, diminished psychosocial functioning, and severe employment problems. The goal of the current study was to examine the relationships between trauma history, lifetime endorsement of psychiatric symptoms, and gender in a sample of individuals participating in outpatient substance abuse treatment. Study participants (N = 625) from six psychosocial counseling and five methadone maintenance programs were recruited as part of a larger study conducted through the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN). Study measures included lifetime trauma experience (yes/no), type of trauma experienced (sexual, physical, both), lifetime depression/anxiety, and lifetime suicidal thoughts/attempts (as measured by the Addiction Severity Index-Lite [ASI-Lite]). Lifetime endorsement of psychiatric symptoms was compared between individuals with and without trauma history. The role of gender was also examined. Results indicated that the experience of trauma was associated with an increase in lifetime report of psychiatric symptoms. Experience of physical and combined physical and sexual trauma consistently predicted positive report of psychiatric symptoms in both males and females, even when controlling for demographic and treatment-related variables. Employment outcomes, however, were not predicted by self-reported history of lifetime trauma.

  7. Mania Symptoms and HIV-Risk Behavior among Adolescents in Mental Health Treatment

    ERIC Educational Resources Information Center

    Stewart, Angela J.; Theodore-Oklota, Christina; Hadley, Wendy; Brown, Larry K.; Donenberg, Geri; DiClemente, Ralph

    2012-01-01

    This study explored whether adolescents with elevated symptoms of mania (ESM+) engage in more HIV risk behaviors than those with other psychiatric disorders and examined factors associated with HIV risk behavior among ESM+ adolescents. Eight hundred forty adolescents (56% female, 58% African American, "M" age = 14.9 years) who received mental…

  8. Operation Safe Haven: an evaluation of health surveillance and monitoring in an acute setting.

    PubMed

    Bennett, C; Mein, J; Beers, M; Harvey, B; Vemulpad, S; Chant, K; Dalton, C

    2000-02-17

    From May to June 1999, 3,920 ethnic Albanians from Kosovo arrived in Australia as part of Operation Safe Haven. These people were evacuated from refugee camps in the former Yugoslav Republic of Macedonia. Initial processing in Australia occurred at East Hills Reception Centre, and accommodation for the duration of stay was provided in eight Haven Centres in five States. The arrival of a large number of refugees in a short time frame is unprecedented in Australia. A health surveillance system was developed and critical health data were collected to assess health status and needs, plan care, monitor for potential outbreaks of communicable diseases, track service use, to meet international reporting requirements and document our response to this crisis. In this article the health surveillance system is evaluated and suggestions are offered for the formulation of specific guidelines necessary for health surveillance in acute settings.

  9. Enhancing adult therapeutic interpersonal relationships in the acute health care setting: an integrative review

    PubMed Central

    Kornhaber, Rachel; Walsh, Kenneth; Duff, Jed; Walker, Kim

    2016-01-01

    Therapeutic interpersonal relationships are the primary component of all health care interactions that facilitate the development of positive clinician–patient experiences. Therapeutic interpersonal relationships have the capacity to transform and enrich the patients’ experiences. Consequently, with an increasing necessity to focus on patient-centered care, it is imperative for health care professionals to therapeutically engage with patients to improve health-related outcomes. Studies were identified through an electronic search, using the PubMed, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO databases of peer-reviewed research, limited to the English language with search terms developed to reflect therapeutic interpersonal relationships between health care professionals and patients in the acute care setting. This study found that therapeutic listening, responding to patient emotions and unmet needs, and patient centeredness were key characteristics of strategies for improving therapeutic interpersonal relationships. PMID:27789958

  10. The Prevalence of Natural Health Product Use in Patients with Acute Cardiovascular Disease

    PubMed Central

    Alherbish, Aws; Charrois, Theresa L.; Ackman, Margaret L.; Tsuyuki, Ross T.; Ezekowitz, Justin A.

    2011-01-01

    Background Natural health products (NHP) use may have implications with respect to adverse effects, drug interactions and adherence yet the prevalence of NHP use by patients with acute cardiovascular disease and the best method to ascertain this information is unknown. Objective To identify the best method to ascertain information on NHP, and the prevalence of use in a population with acute cardiovascular disease. Methods Structured interviews were conducted with a convenience sample of consecutive patients admitted with acute cardiovascular disease to the University of Alberta Hospital during January 2009. NHP use was explored using structured and open-ended questions based on Health Canada's definition of NHP. The medical record was reviewed, and documentation of NHP use by physicians, nurses, and pharmacists, compared against the gold-standard structured interview. Results 88 patients were interviewed (mean age 62 years, standard deviation [SD 14]; 80% male; 41% admitted for acute coronary syndromes). Common co-morbidities included hypertension (59%), diabetes (26%) and renal impairment (19%). NHP use was common (78% of patients) and 75% of NHP users reported daily use. The category of NHP most commonly used was vitamins and minerals (73%) followed by herbal products (20%), traditional medicines including Chinese medicines (9%), homeopathic preparations (1%) and other products including amino acids, essential fatty acids and probiotics (35%). In a multivariable model, only older age was associated with increased NHP use (OR 1.5 per age decile [95%CI 1.03 to 2.2]). When compared to the interview, the highest rate of NHP documentation was the pharmacist history (41%). NHP were documented in 22% of patients by the physician and 19% by the nurse. Conclusions NHP use is common in patients admitted with acute cardiovascular disease. However, health professionals do not commonly identify NHP as part of the medication profile despite its potential importance. Structured

  11. Acute effects of aerobic stretching, health and happiness improving movement exercise on cortical activity of children.

    PubMed

    Choi, Hyungsoo; Park, Sangjun; Kim, Kyekyoon Kevin; Lee, Kwanghee; Rhyu, Hyun-Seung

    2016-08-01

    Acute high-intensity physical exercise is known to improve cognitive performance of children, including those with attention-deficit/hyperactivity disorder (ADHD). In this work, we investigated the acute effect of an aerobic stretching and moderate-intensity, health and happiness improving movement (HHIM) exercise on the cortical activity of children with and without ADHD using electroencephalography (EEG). Children aged 12 to 14 yr with combined-type ADHD and age-matched healthy controls participated in the study, performing two individual movements (n=79, 35 controls) and a single exercise bout (n=45, 18 controls). electroencephalographic signals were recorded before and immediately after each movement, and before and after acute exercise under resting conditions, to obtain absolute and relative power estimates for the theta (3.5-8 Hz), alpha (8-12 Hz), sensory motor rhythm (12-16 Hz), and beta (16-25 Hz) bands. After acute HHIM exercise, all children showed significant changes in their relative EEG, mainly in the theta and alpha bands. Individual movements were found to influence relative theta, alpha and beta, and theta-to-beta ratios. He presents aerobic stretching HHIM exercise has demonstrated acute effect on the cortical activity of children.

  12. Evaluating the impact of depression, anxiety & autonomic function on health related quality of life, vocational functioning and health care utilisation in acute coronary syndrome patients: the ADVENT study protocol

    PubMed Central

    2013-01-01

    Background Depression and anxiety are highly prevalent and co-morbid in acute coronary syndrome patients. Somatic and cognitive subtypes of depression and anxiety in acute coronary syndrome have been shown to be associated with mortality although their association with patient outcomes is unknown, as are the mechanisms that underpin these associations. We are conducting a prospective cohort study which aims to examine in acute coronary syndrome patients: (1) the role of somatic subtypes of depression and anxiety as predictors of health related quality of life outcomes; (2) how somatic subtypes of depression and anxiety relate to long term vocational functioning and healthcare utilisation; and (3) the role of the autonomic nervous system assessed by heart rate variability as a moderator of these associations. Methods Patients are being screened after index admission for acute coronary syndrome at a single, high volume centre, MonashHeart, Monash Health, Victoria, Australia. The inclusion criterion is all patients aged > 21 years old and fluent in English admitted to MonashHeart, Monash Health with a diagnosis of acute coronary syndrome. The primary outcome is mean health related quality of life (Short Form-36) Physical and Mental Health Summary scores at 12 and 24 months in subtypes with somatic symptoms of depression and anxiety. Depressive domains are assessed by the Beck Depression Inventory II and the Cardiac Depression Scale. Anxiety is measured using the Speilberger State-Trait Anxiety Inventory and the Crown Crisp Phobic Anxiety questionnaire. Secondary outcomes include clinical variables, healthcare service utilisation and vocational functioning. Discussion This manuscript presents the protocol for a prospective cohort study which will investigate the role of somatic subtypes of depression and anxiety as predictors of health related quality of life, long-term vocational functioning and health service use, and the role of the autonomic nervous system in

  13. Increased systolic blood pressure reactivity to acute stress is related with better self-reported health.

    PubMed

    Wright, Bradley J; O'Brien, Shaun; Hazi, Agnes; Kent, Stephen

    2014-11-13

    The stress reactivity hypothesis posits that the magnitude of cardiovascular reactions to acute stress tasks is related with future blood pressure status, heart hypertrophy, and atherosclerosis. We assessed the stress reactivity hypothesis and aimed to identify which physiological indices (blood pressure, heart-rate, cortisol, salivary immunoglobulin A (sIgA)) related to self-reported mental and physical health. We also assessed if physiological reactions elicited by an acute stressor were more related than basal assessments. Participants provided physiological samples, self-reported stress and health-data before and after an assessed 5-7 minute academic oral presentation. In hierarchical regression models, increased systolic and reduced sIgA reactivity was associated with better perceptions of mental health. Reactivity data were more related to self-reported data than basal data. In line with the only 2 studies to assess the reactivity hypothesis with self-perceived health, increased systolic reactivity was best associated with better perceived physical and mental health. The findings suggest that increased SBP reactivity may also be associated with positive health outcomes. Further research is required to determine if increased or decreased sIgA reactivity is most predictive of future morbidity.

  14. Livestock/Animal Assets Buffer the Impact of Conflict-Related Traumatic Events on Mental Health Symptoms for Rural Women

    PubMed Central

    Glass, Nancy; Perrin, Nancy A.; Kohli, Anjalee; Remy, Mitima Mpanano

    2014-01-01

    Background In the context of multiple adversities, women are demonstrating resilience in rebuilding their futures, through participation in microfinance programs. In addition to the economic benefits of microfinance, there is evidence to suggest that it is an effective vehicle for improving health. Methods The parent study is a community-based trial to evaluate the effectiveness of a livestock microfinance intervention, Pigs for Peace (PFP), on health and economic outcomes with households in 10 villages in eastern Democratic Republic of Congo. The analysis for this manuscript includes only baseline data from female participants enrolled in the ongoing parent study. Multiple regression analysis was used to examine if livestock/animal asset value moderates the relationship between conflict-related traumatic events and current mental health symptoms. Findings The majority of women are 25 years or older, married, have on average 4 children in the home and have never attended school. Nearly 50% of women report having at least one livestock/animal asset at baseline. Over the past 10 years, women report on average more than 4 (M = 4.31, SD 3·64) traumatic events (range 0–18). Women reported symptoms consistent with PTSD with a mean score of ·2.30 (SD = 0·66range 0–4) and depression with a mean score of 1.86 (SD  = 0·49, range 0–3.47). The livestock/animal asset value by conflict-related traumatic events interaction was significant for both the PTSD (p = 0·021) and depression (p = 0·002) symptom models. Interpretation The study provides evidence of the moderating affect of livestock/animal assets on mental health symptoms for women who have experienced conflict. The findings supports evidence about the importance of livestock/animal assets to economics in rural households but expands on previous research by demonstrating the psychosocial effects of these assets on women's health. Trial Registration clinicaltrials.gov NCT02008708 PMID

  15. Infectious etiologies of acute febrile illness among patients seeking health care in south-central Cambodia.

    PubMed

    Kasper, Matthew R; Blair, Patrick J; Touch, Sok; Sokhal, Buth; Yasuda, Chadwick Y; Williams, Maya; Richards, Allen L; Burgess, Timothy H; Wierzba, Thomas F; Putnam, Shannon D

    2012-02-01

    The agents of human febrile illness can vary by region and country suggesting that diagnosis, treatment, and control programs need to be based on a methodical evaluation of area-specific etiologies. From December 2006 to December 2009, 9,997 individuals presenting with acute febrile illness at nine health care clinics in south-central Cambodia were enrolled in a study to elucidate the etiologies. Upon enrollment, respiratory specimens, whole blood, and serum were collected. Testing was performed for viral, bacterial, and parasitic pathogens. Etiologies were identified in 38.0% of patients. Influenza was the most frequent pathogen, followed by dengue, malaria, and bacterial pathogens isolated from blood culture. In addition, 3.5% of enrolled patients were infected with more than one pathogen. Our data provide the first systematic assessment of the etiologies of acute febrile illness in south-central Cambodia. Data from syndromic-based surveillance studies can help guide public health responses in developing nations.

  16. The Effect of Acute Exercise on Affect and Arousal in Inpatient Mental Health Consumers.

    PubMed

    Stanton, Robert; Reaburn, Peter; Happell, Brenda

    2016-09-01

    Acute exercise performed at a self-selected intensity improves affect and may improve long-term adherence. Similarly, in people with severe depression, acute aerobic exercise performed at self-selected intensity improves affect and arousal. However, the relationship between changes in affect and arousal and perceived exercise intensity in people with mental illness has not been evaluated. Affect and arousal were assessed immediately prior to, and immediately following, a group exercise program performed at a self-selected intensity in 40 inpatient mental health consumers who received a diagnosis of anxiety or bipolar or depressive disorders. Exercise intensity was assessed immediately after exercise. Postexercise affect was significantly improved for people with bipolar and depressive disorders but not for people with anxiety disorders. For the group as a whole, results showed a significant curvilinear relationship between ratings of perceived exertion and postexercise affect. These data will inform the development and delivery of future exercise interventions for inpatient mental health consumers.

  17. Oral health-related knowledge, attitudes and habits in relation to perceived oral symptoms among 12-year-old school children.

    PubMed

    Mattila, Marja-Leena; Tolvanen, Mimmi; Kivelä, Johanna; Pienihäkkinen, Kaisu; Lahti, Satu; Merne-Grafström, Marina

    2016-07-01

    Objective The aim of the study was to investigate oral health-related knowledge, attitudes and habits and their relationship to perceived oral symptoms among 12-year-olds and differences between boys and girls. Material and methods The study population consisted of children (n = 588) in 15 randomly selected elementary schools in Turku, Finland. Associations between oral health-related habits, knowledge and attitudes with perceived oral symptoms and gender differences were evaluated with χ(2)-test, Mann-Whitney U-test and logistic regression analysis. Results Oral health promoting habits but not knowledge or attitudes associated significantly with absence of oral symptoms. Girls reported a higher percentage of several health promotional habits than boys. Girls reported more frequently gingival bleeding and less frequently dental calculus than boys did. The most common oral symptom was gingival bleeding. Conclusions The present findings suggest some gender-related differences in oral health habits, attitudes, as well as perceived oral symptoms in 12-year-olds. There seems, however, not to be gender differences in relation to knowledge or the association of health habits with perceived oral symptoms. It is important to maintain health promotion at schools and additional efforts should be aimed at translating knowledge into action.

  18. The Relationships between Mental Health Symptoms and Gambling Behavior in the Transition from Adolescence to Emerging Adulthood.

    PubMed

    Sagoe, Dominic; Pallesen, Ståle; Hanss, Daniel; Leino, Tony; Molde, Helge; Mentzoni, Rune A; Torsheim, Torbjørn

    2017-01-01

    There is a paucity of longitudinal investigations of gambling behavior in the transition from adolescence to emerging adulthood. We conducted a longitudinal investigation of the associations and patterns of change between mental health symptoms and gambling behavior. A representative sample of Norwegians completed questionnaires containing demographic, mental health, and gambling measures at age 17 (N = 2055), and at ages 18 (N = 1334) and 19 (N = 1277). Using latent class analysis, three classes of gambling behavior were identified: consistent non-gambling (71.1%), consistent non-risk gambling (23.8%), and risky-and-problem gambling (5.1%). Being male, showing higher physical and verbal aggression and having more symptoms of depression were associated with greater odds of belonging to the risky-and-problem gambling class at age 17. Overall, the risky-and-problem gambling class had the highest physical and verbal aggression, anxiety, and depression at 19 years. Our findings elucidate the reciprocal relationship between mental health and gambling behavior in the transition from adolescence to emerging adulthood, and the importance of recognizing these factors in designing targeted interventions.

  19. The Relationships between Mental Health Symptoms and Gambling Behavior in the Transition from Adolescence to Emerging Adulthood

    PubMed Central

    Sagoe, Dominic; Pallesen, Ståle; Hanss, Daniel; Leino, Tony; Molde, Helge; Mentzoni, Rune A.; Torsheim, Torbjørn

    2017-01-01

    There is a paucity of longitudinal investigations of gambling behavior in the transition from adolescence to emerging adulthood. We conducted a longitudinal investigation of the associations and patterns of change between mental health symptoms and gambling behavior. A representative sample of Norwegians completed questionnaires containing demographic, mental health, and gambling measures at age 17 (N = 2055), and at ages 18 (N = 1334) and 19 (N = 1277). Using latent class analysis, three classes of gambling behavior were identified: consistent non-gambling (71.1%), consistent non-risk gambling (23.8%), and risky-and-problem gambling (5.1%). Being male, showing higher physical and verbal aggression and having more symptoms of depression were associated with greater odds of belonging to the risky-and-problem gambling class at age 17. Overall, the risky-and-problem gambling class had the highest physical and verbal aggression, anxiety, and depression at 19 years. Our findings elucidate the reciprocal relationship between mental health and gambling behavior in the transition from adolescence to emerging adulthood, and the importance of recognizing these factors in designing targeted interventions.

  20. The significance of patient's age and sex in the interpretation of signs and symptoms in clinically suspected acute deep vein thrombosis.

    PubMed

    Kierkegaard, A

    1982-01-01

    876 consecutive patients with clinically suspected acute deep vein thrombosis (DVR) in the leg were studied with an ascending phlebography, and the patient's age and sex were correlated to the phlebographic diagnosis. In unoperated patients a thrombus was demonstrated significantly more often in males and in older patients than in females and in younger patients. In operated patients no correlation could be noted between the phlebographic diagnosis and patients's age and sex, but a thrombus was demonstrated significantly more often in operated than in unoperated patients. The results suggest that signs and symptoms of thrombosis are less reliable in females and younger patients than in males and older patients, when a DVT is suspected clinically in unoperated patients.

  1. School-Based Mental Health Program Evaluation: Children's School Outcomes and Acute Mental Health Service Use

    ERIC Educational Resources Information Center

    Kang-Yi, Christina D.; Mandell, David S.; Hadley, Trevor

    2013-01-01

    Background: This study examined the impact of school-based mental health programs on children's school outcomes and the utilization of acute mental health services. Methods: The study sample included 468 Medicaid-enrolled children aged 6 to 17 years who were enrolled 1 of 2 school-based mental health programs (SBMHs) in a metropolitan area…

  2. Family Matters: The Role of Mental Health Stigma and Social Support on Depressive Symptoms and Subsequent Help Seeking Among African American Boys

    PubMed Central

    Lindsey, Michael A.; Joe, Sean; Nebbitt, Von

    2010-01-01

    African American adolescent boys underutilize mental health service due to stigma associated with depression. Gaining an increased understanding of how depressed, African American adolescent boys perceive their mental health needs and engage in help-seeking behaviors might play an essential role in efforts to improve their symptoms and access to care. Using a mixed-methods design, this study examined the influence of mental health stigma and social support on depressive symptoms among African American adolescent boys. Findings indicated the protective effects of social support in decreasing depressive symptoms, especially when participants experienced mental health stigma. Results also revealed the pivotal role of family social support over both professional and peer support for participants who struggled with depressive symptoms. The primacy of family support among the sample, combined with the frequent distrust of professionals and peer networks, would indicate that working with families may improve initial identification of depression among African American adolescent boys and decrease their barriers to care. PMID:20953336

  3. Time Interval from Symptom Onset to Hospital Care in Patients with Acute Heart Failure: A Report from the Tokyo Cardiac Care Unit Network Emergency Medical Service Database

    PubMed Central

    Shiraishi, Yasuyuki; Kohsaka, Shun; Harada, Kazumasa; Sakai, Tetsuro; Takagi, Atsutoshi; Miyamoto, Takamichi; Iida, Kiyoshi; Tanimoto, Shuzou; Fukuda, Keiichi; Nagao, Ken; Sato, Naoki; Takayama, Morimasa

    2015-01-01

    Aims There seems to be two distinct patterns in the presentation of acute heart failure (AHF) patients; early- vs. gradual-onset. However, whether time-dependent relationship exists in outcomes of patients with AHF remains unclear. Methods The Tokyo Cardiac Care Unit Network Database prospectively collects information of emergency admissions via EMS service to acute cardiac care facilities from 67 participating hospitals in the Tokyo metropolitan area. Between 2009 and 2011, a total of 3811 AHF patients were registered. The documentation of symptom onset time was mandated by the on-site ambulance team. We divided the patients into two groups according to the median onset-to-hospitalization (OH) time for those patients (2h); early- (presenting ≤2h after symptom onset) vs. gradual-onset (late) group (>2h). The primary outcome was in-hospital mortality. Results The early OH group had more urgent presentation, as demonstrated by a higher systolic blood pressure (SBP), respiratory rate, and higher incidence of pulmonary congestion (48.6% vs. 41.6%; P<0.001); whereas medical comorbidities such as stroke (10.8% vs. 7.9%; P<0.001) and atrial fibrillation (30.0% vs. 26.0%; P<0.001) were more frequently seen in the late OH group. Overall, 242 (6.5%) patients died during hospitalization. Notably, a shorter OH time was associated with a better in-hospital mortality rate (odds ratio, 0.71; 95% confidence interval, 0.51−0.99; P = 0.043). Conclusions Early-onset patients had rather typical AHF presentations (e.g., higher SBP or pulmonary congestion) but had a better in-hospital outcome compared to gradual-onset patients. PMID:26562780

  4. Neurological Findings & Symptoms Associated with Acute Combat-Related Concussion: Impact of Migraine and Other Co-morbidities

    DTIC Science & Technology

    2012-06-01

    Features Unilateral: 26 (68%)              Aura:  2  (5%) Throbbing: 32 (84%)              Dizziness / Vertigo : 10 (26%) Photophobia:  28 (74%)       Nausea...Prescribed by ANSI Std Z39-18 Causes of Concussion Concussion ‐ 4 Symptom Categories • Physical (10) – Headache – Fatigue  – Dizziness

  5. Supplemental Private Health Insurance and Depressive Symptoms in Older Married Couples

    ERIC Educational Resources Information Center

    Min, Meeyoung Oh; Townsend, Aloen L.; Miller, Baila; Rovine, Michael J.

    2005-01-01

    Stress process theory is applied to examine lack of supplemental private health insurance as a risk factor for depressive symptomatology among older married couples covered by Medicare. Dyadic data from 130 African-American couples and 1,429 White couples in the 1993 Asset and Health Dynamics Among the Oldest-Old Survey were analyzed using…

  6. A cross-sectional assessment of the burden of COPD symptoms in the US and Europe using the National Health and Wellness Survey

    PubMed Central

    Ding, Bo; DiBonaventura, Marco; Karlsson, Niklas; Bergström, Gina; Holmgren, Ulf

    2017-01-01

    Introduction Past research has suggested significant relationships between symptoms and health outcomes among patients with COPD. However, these studies have generally focused on a broad COPD sample and may have included those not receiving proper treatment. As a result, the aim of this study was to document the burden of COPD symptoms among those who are currently treated with the standard-of-care (SOC) medications in both the US and Western Europe. Methods Data from the 2013 US (N=75,000) and 2011 (N=57,512)/2013 (N=62,000) European (France, Germany, Italy, Spain, and UK; 5EU) National Health and Wellness Survey (NHWS) were used. The NHWS is a health survey administered to a demographically representative sample of the adult population in each country. A total of 1,666 and 2,006 patients with self-reported physician diagnosis of COPD in the 5EU and US, respectively, were being treated with the appropriate SOC (based on self-reported medication use) and were included in the analyses. Symptoms (eg, dyspnea, coughing, wheezing) were reported descriptively and summed to create a symptom score (with higher score indicating more frequent symptoms). The relationships between the symptom score and patient outcomes (eg, health status using the Short Form-36 version 2 [SF-36v2], work productivity and activity impairment [WPAI], and self-reported health care resource use) were explored using regression modeling. Results Nearly all patients (99.7% and 99.8% in the 5EU and US, respectively) reported experiencing symptoms and >80% reported experiencing at least one symptom “often”. Increasing symptom scores were associated with poorer health status (unstandardized beta [b] =−0.87 and −0.78 for mental component summary and physical component summary, respectively, in the US and b =−0.67 and −0.79 in the 5EU, respectively; all P<0.05). Increasing symptom scores were also associated with greater work impairment (b =0.09 and 0.06 for the US and 5EU, respectively

  7. Encounters between medical specialists and patients with medically unexplained physical symptoms; influences of communication on patient outcomes and use of health care: a literature overview.

    PubMed

    Weiland, Anne; Van de Kraats, Rianne E; Blankenstein, Annette H; Van Saase, Jan L C M; Van der Molen, Henk T; Bramer, Wichor M; Van Dulmen, Alexandra M; Arends, Lidia R

    2012-11-01

    Medically unexplained physical symptoms (MUPS) burden patients and health services due to large quantities of consultations and medical interventions. The aim of this study is to determine which elements of communication in non-psychiatric specialist MUPS care influence health outcomes. Systematic search in PubMed, PsycINFO and Embase. Data extraction comprising study design, patient characteristics, number of patients, communication strategies, outcome measures and results. Elements of doctor-patient communication were framed according to symptoms, health anxiety, satisfaction, daily functioning and use of health care. Eight included studies. Two studies described the effect of communication on patient outcome in physical symptoms, three studies on health anxiety and patient satisfaction and one study on daily functioning. Two studies contained research on use of health care. Qualitative synthesis of findings was conducted. Communication matters in non-psychiatric MUPS specialist care. Perceiving patients' expectations correctly enables specialists to influence patients' cognitions, to reduce patients' anxiety and improve patients' satisfaction. Patients report less symptoms and health anxiety when symptoms are properly explained. Positive interaction and feedback reduces use of health care and improves coping. Development of communication skills focused on MUPS patients should be part of postgraduate education for medical specialists.

  8. Classroom conditions and CO2 concentrations and teacher health symptom reporting in 10 New York State Schools.

    PubMed

    Muscatiello, N; McCarthy, A; Kielb, C; Hsu, W-H; Hwang, S-A; Lin, S

    2015-04-01

    This study assessed the relationship between teacher-reported symptoms and classroom carbon dioxide (CO2 ) concentrations. Previous studies have suggested that poor indoor ventilation can result in higher levels of indoor pollutants, which may affect student and teacher health. Ten schools (9 elementary, 1 combined middle/high school) in eight New York State school districts were visited over a 4-month period in 2010. Carbon dioxide concentrations were measured in classrooms over 48-h, and teachers completed surveys assessing demographic information and self-reported symptoms experienced during the current school year. Data from 64 classrooms (ranging from 1 to 9 per school) were linked with 68 teacher surveys (for four classrooms, two surveys were returned). Overall, approximately 20% of the measured classroom CO2 concentrations were above 1000 parts per million (ppm), ranging from 352 to 1591 ppm. In multivariate analyses, the odds of reporting neuro-physiologic (i.e., headache, fatigue, difficulty concentrating) symptoms among teachers significantly increased (OR = 1.30, 95% CI = 1.02-1.64) for every 100 ppm increase in maximum classroom CO2 concentrations and were non-significantly increased in classrooms with above-median proportions of CO2 concentrations greater than 1000 ppm (OR = 2.26, 95% CI = 0.72-7.12).

  9. Screening for depressive symptoms in older adults in the Family Health Strategy, Porto Alegre, Brazil

    PubMed Central

    Nogueira, Eduardo Lopes; Rubin, Leonardo Librelotto; Giacobbo, Sara de Souza; Gomes, Irenio; Cataldo, Alfredo

    2014-01-01

    OBJECTIVE To analyze the prevalence of depression in older adults and associated factors. METHODS Cross-sectional study using a stratified random sample of 621 individuals aged ≥ 60 from 27 family health teams in Porto Alegre, RS, Southern Brazil, between 2010 and 2012. Community health agents measured depression using the 15-item Geriatric Depression Scale. Scores of ≥ 6 were considered as depression and between 11 and 15 as severe depression. Poisson regression was used to search for independent associations of sociodemographic and self-perceived health with both depression and its severity. RESULTS The prevalence of depression was 30.6% and was significantly higher in women (35.9% women versus 20.9% men, p < 0.001). The variables independently associated with depression were: female gender (PR = 1.4, 95%CI 1.1;1.8); low education, especially illiteracy (PR = 1.8, 95%CI 1.2;2 6); regular self-rated health (OR = 2.2, 95%CI 1.6;3.0); and poor/very poor self-rated health (PR = 4.0, 95%CI 2.9;5.5). Except for education, the strength of association of these factors increases significantly in severe depression. CONCLUSIONS A high prevalence of depression was observed in the evaluations conducted by community health agents, professionals who are not highly specialized. The findings identified using the 15-item Geriatric Depression Scale in this way are similar to those in the literature, with depression more associated with low education, female gender and worse self-rated health. From a primary health care strategic point of view, the findings become still more relevant, indicating that community health agents could play an important role in identifying depression in older adults. PMID:25119932

  10. Radiofrequency electromagnetic field exposure and non-specific symptoms of ill health: a systematic review.

    PubMed

    Röösli, Martin

    2008-06-01

    This article is a systematic review of whether everyday exposure to radiofrequency electromagnetic field (RF-EMF) causes symptoms, and whether some individuals are able to detect low-level RF-EMF (below the ICNIRP [International Commission on Non-Ionizing Radiation Protection] guidelines). Peer-reviewed articles published before August 2007 were identified by means of a systematic literature search. Meta-analytic techniques were used to pool the results from studies investigating the ability to discriminate active from sham RF-EMF exposure. RF-EMF discrimination was investigated in seven studies including a total of 182 self-declared electromagnetic hypersensitive (EHS) individuals and 332 non-EHS individuals. The pooled correct field detection rate was 4.2% better than expected by chance (95% CI: -2.1 to 10.5). There was no evidence that EHS individuals could detect presence or absence of RF-EMF better than other persons. There was little evidence that short-term exposure to a mobile phone or base station causes symptoms based on the results of eight randomized trials investigating 194 EHS and 346 non-EHS individuals in a laboratory. Some of the trials provided evidence for the occurrence of nocebo effects. In population based studies an association between symptoms and exposure to RF-EMF in the everyday environment was repeatedly observed. This review showed that the large majority of individuals who claims to be able to detect low level RF-EMF are not able to do so under double-blind conditions. If such individuals exist, they represent a small minority and have not been identified yet. The available observational studies do not allow differentiating between biophysical from EMF and nocebo effects.

  11. The association of drinking water treatment and distribution network disturbances with Health Call Centre contacts for gastrointestinal illness symptoms.

    PubMed

    Malm, Annika; Axelsson, Gösta; Barregard, Lars; Ljungqvist, Jakob; Forsberg, Bertil; Bergstedt, Olof; Pettersson, Thomas J R

    2013-09-01

    There are relatively few studies on the association between disturbances in drinking water services and symptoms of gastrointestinal (GI) illness. Health Call Centres data concerning GI illness may be a useful source of information. This study investigates if there is an increased frequency of contacts with the Health Call Centre (HCC) concerning gastrointestinal symptoms at times when there is a risk of impaired water quality due to disturbances at water works or the distribution network. The study was conducted in Gothenburg, a Swedish city with 0.5 million inhabitants with a surface water source of drinking water and two water works. All HCC contacts due to GI symptoms (diarrhoea, vomiting or abdominal pain) were recorded for a three-year period, including also sex, age, and geocoded location of residence. The number of contacts with the HCC in the affected geographical areas were recorded during eight periods of disturbances in the water works (e.g. short stops of chlorine dosing), six periods of large disturbances in the distribution network (e.g. pumping station failure or pipe breaks with major consequences), and 818 pipe break and leak repairs over a three-year period. For each period of disturbance the observed number of calls was compared with the number of calls during a control period without disturbances in the same geographical area. In total about 55, 000 calls to the HCC due to GI symptoms were recorded over the three-year period, 35 per 1000 inhabitants and year, but much higher (>200) for children <3 yrs of age. There was no statistically significant increase in calls due to GI illness during or after disturbances at the water works or in the distribution network. Our results indicate that GI symptoms due to disturbances in water works or the distribution network are rare. The number of serious failures was, however limited, and further studies are needed to be able to assess the risk of GI illness in such cases. The technique of using geocoded

  12. Depersonalization experiences are strongly associated with dizziness and vertigo symptoms leading to increased health care consumption in the German general population.

    PubMed

    Tschan, Regine; Wiltink, Jörg; Adler, Julia; Beutel, Manfred E; Michal, Matthias

    2013-07-01

    This study investigated the association of depersonalization (DP) experiences with dizziness and its impact on subjective impairment and health care use. Trained interviewers surveyed a representative sample of 1287 persons using standardized self-rating questionnaires on dizziness, DP, and mental distress. Symptoms of dizziness were reported by 15.8% (n = 201). Thereof, 62.7% endorsed at least one symptom of DP, 40% reported impairment by symptoms of DP, and 8.5% reported clinically significant DP. Regression analyses identified DP as a significant, independent predictor for dizziness symptom severity, health care use, and impairment by dizziness. With regard to the Vertigo Symptom Scale, DP explained 34.1% (p < 0.001) of the variance for severity of symptoms of dysfunction in the balance system. In conclusion, symptoms of DP, highly prevalent in patients complaining of dizziness and vertigo, were independently associated with increased impairment and health care use. The presence of DP symptoms should actively be explored in patients complaining of dizziness.

  13. ‘Complex’ but coping: experience of symptoms of tuberculosis and health care seeking behaviours - a qualitative interview study of urban risk groups, London, UK

    PubMed Central

    2014-01-01

    Background Tuberculosis awareness, grounded in social cognition models of health care seeking behaviour, relies on the ability of individuals to recognise symptoms, assess their risk and access health care (passive case finding). There is scant published research into the health actions of ‘hard-to-reach’ groups with tuberculosis, who represent approximately 17% of the London TB caseload. This study aimed to analyse patients’ knowledge of tuberculosis, their experiences of symptoms and their health care seeking behaviours. Methods Qualitative interviews were conducted with 17 participants, predominantly homeless and attending a major tuberculosis centre in London, UK. Most had complex medical and social needs including drug and alcohol use or immigration problems affecting entitlement to social welfare. Analytical frameworks aimed to reflect the role of broader social structures in shaping individual health actions. Results Although participants demonstrated some knowledge of tuberculosis their awareness of personal risk was low. Symptoms commonly associated with tuberculosis were either not recognised or were attributed to other causes for which participants would not ordinarily seek health care. Many accessed health care by chance and, for some, for health concerns other than tuberculosis. Conclusions Health education, based on increasing awareness of symptoms, may play a limited role in tuberculosis care for populations with complex health and social needs. The findings support the intensification of outreach initiatives to identify groups at risk of tuberculosis and the development of structured care pathways which support people into prompt diagnosis and treatment. PMID:24943308

  14. Pathways to catastrophic health expenditure for acute coronary syndrome in Kerala: ‘Good health at low cost’?

    PubMed Central

    2012-01-01

    Background Universal health coverage through the removal of financial and other barriers to access, particularly for people who are poor, is a global priority. This viewpoint describes the many pathways to catastrophic health expenditure (CHE) for patients with Acute Coronary Syndrome (ACS) based on two case studies and the thematic analysis of field notes regarding 210 patients and their households from a study based in Kerala, India. Discussion There is evidence of the severe financial impact of non-communicable diseases (NCDs), which is in contradiction to the widely acclaimed Kerala model: Good health at low cost. However, it is important to look beyond the out-of-pocket expenditure (OOPE) and CHE to the possible pathways and identify the triggers that make families vulnerable to CHE. The identified pathways include a primary and secondary loop. The primary pathway describes the direct path by which families experience CHE. These include: 1) factors related to the pre-event period that increase the likelihood of experiencing CHE, such as being from the lower socio-economic strata (SES), past financial losses or loans that leave families with no financial shock absorber at the time of illness; 2) factors related to the acute event, diagnosis, treatment and hospitalization and expenditures incurred for the same and; 3) factors related to the post-event period such as loss of gainful employment and means of financing both the acute period and the long-term management particularly through distress financing. The secondary pathway arises from the primary and includes: 1) the impact of distress financing and; 2) the long- and short- term consequences of CHE. These factors ultimately result in a vicious cycle of debt and poverty through non-compliance and repeat acute events. Summary This paper outlines the direct and indirect pathways by which patients with ACS and their families are trapped in a vicious cycle of debt and poverty. It also contradicts the prevailing

  15. The relationship between burnout symptoms and Type D personality among health care professionals in Turkey.

    PubMed

    Tekin, Atilla; Karadağ, Hekim; Yayla, Sinan

    2016-04-27

    The aim of this study was to investigate the relationship between burnout and Type D personality in health care professionals. The study randomly included 120 health care professionals (73 nurses, 47 doctors). Sociodemographic data form, Maslach Burnout Inventory, and Type D Personality Scale were applied to each participant; 38.3% of the health care professionals (n = 46) had the Type D personality. Emotional exhaustion and depersonalization of health care professionals with Type D personality were higher than of those without Type D personality (p = .006 and p = .005). Stepwise regression analysis indicated that Type D personality was a predictor of emotional exhaustion and depersonalization (p = .005 and p = .001, respectively). Our results suggest that Type D personality is associated with higher burnout levels.

  16. Are radiographs needed when MR imaging is performed for non-acute knee symptoms in patients younger than 45 years of age?

    PubMed Central

    ter Braak, Bert P. M.; van Erkel, Arian R.; Bloem, Rolf M.; Napoleon, L. J.; Coene, M. N.; van Luijt, Peter A.; de Lange, Sam; Bloem, Johan L.

    2007-01-01

    Objective The objective was to determine the value of radiographs in young adults with non-acute knee symptoms who are scheduled for magnetic resonance imaging (MRI). Materials and methods Nine hundred and sixty-one consecutive patients aged between 16 and 45 years with knee symptoms of at least 4 weeks’ duration were prospectively included in three participating hospitals. After applying exclusion criteria, 798 patients remained. Exclusion criteria were previous knee surgery (including arthroscopy) or MRI, history of rheumatoid arthritis, clinical diagnosis of retropatellar chondromalacia, contra-indication for MRI and recent trauma. We identified two groups: group A with no history of trauma (n = 332), and group B with an old (>4 weeks) history of trauma (n = 466). Patients had a standardized history taken, and underwent a physical exam, antero-posterior (AP) and lateral radiographs and MRI. We evaluated the radiographs and MRI for osseous lesions, articular surface lesions, fractures, osteoarthritis, loose bodies, bone marrow edema and incidental findings. Subsequently, patients with osseous abnormalities (Kellgren grade 1 and 2 excluded) on radiographs and a matched control group was evaluated again using MRI without radiographs. Results Median duration of symptoms was 20 weeks. In group A, radiographs showed 36 osseous abnormalities in 332 patients (10.8%). Only 13 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 72 (21.7%) additional abnormalities not confirmed on radiographs. In group B, radiographs showed 40 osseous abnormalities (8.6%) in 466 patients. Only 15 of these, all Kellgren grade 1 osteoarthritis, were not confirmed on MRI. MRI showed 194 (41.6%) additional abnormalities not confirmed on radiographs. The second evaluation of MRI without radiographs in 34 patients was identical to the first MRI evaluation. Common lesions were significantly more often diagnosed with MRI than with radiographs

  17. Gender comparisons in non-acute cardiac symptom recognition and subsequent help-seeking decisions: a mixed methods study protocol

    PubMed Central

    Stain, Nolan; Ridge, Damien; Cheshire, Anna

    2014-01-01

    Introduction Coronary heart disease (CHD) is one of the leading causes of death in both men and women worldwide. Despite the common misconception that CHD is a ‘man's disease’, it is now well accepted that women endure worse clinical outcomes than men following CHD-related events. A number of studies have explored whether or not gender differences exist in patients presenting with CHD, and specifically whether women delay seeking help for cardiac conditions. UK and overseas studies on help-seeking for emergency cardiac events are contradictory, yet suggest that women often delay help-seeking. In addition, no studies have looked at presumed cardiac symptoms outside an emergency situation. Given the lack of understanding in this area, an explorative qualitative study on the gender differences in help-seeking for a non-emergency cardiac events is needed. Methods and analysis A purposive sample of 20–30 participants of different ethnic backgrounds and ages attending a rapid access chest pain clinic will be recruited to achieve saturation. Semistructured interviews focusing on help-seeking decision-making for apparent cardiac symptoms will be undertaken. Interview data will be analysed thematically using qualitative software (NVivo) to understand any similarities and differences between the way men and women construct help-seeking. Findings will also be used to inform the preliminary development of a cardiac help-seeking intentions questionnaire. Ethics and dissemination Ethical approvals were sought and granted. Namely, the University of Westminster (sponsor) and St Georges NHS Trust REC, and the Trust Research and Development Office granted approval to host the study on the Queen Mary's Roehampton site. The study is low risk, with interviews being conducted on hospital premises during working hours. Investigators will disseminate findings via presentations and publications. Participants will receive a written summary of the key findings. PMID:25361835

  18. Association Between Health Symptoms and Particulate Matter from Traffic and Residential Heating − Results from RHINE III in Tartu

    PubMed Central

    Pindus, Mihkel; Orru, Hans; Maasikmets, Marek; Kaasik, Marko; Jõgi, Rain

    2016-01-01

    Background: Traffic and residential heating are the main sources of particulate matter (PM) in Northern Europe. Wood is widely used for residential heating and vehicle numbers are increasing. Besides traffic exhaust, studded tires produce road dust that is the main source of traffic-related PM10. Several studies have associated total PM mass with health symptoms; however there has been little research on the effects of PM from specific sources. Objective: To study the health effects resulting from traffic and local heating PM. Methods: Data on respiratory and cardiac diseases were collected within the framework of RHINE III (2011/2012) in Tartu, Estonia. Respondents’ geocoded home addresses were mapped in ArcGIS and linked with local heating-related PM2.5, traffic-related PM10 and total PM2.5 concentrations. Association between self-reported health and PM was assessed using multiple logistic regression analysis. Results: The annual mean modelled exposure for local heating PM2.5 was 2.3 μg/m3, for traffic PM10 3.3 μg/m3 and for all sources PM2.5 5.6 μg/m3. We found relationship between traffic induced PM10 as well as all sources induced PM2.5 with cardiac disease, OR=1.45 (95% CI 1.06−1.93) and 1.42 (95% CI 1.02−1.95), respectively. However, we did not find any significant association between residential heating induced particles and self-reported health symptoms. People with longer and better confirmed exposure period were also significantly associated with traffic induced PM10, all sources induced PM2.5 and cardiac diseases. Conclusion: Traffic-related PM10 and all sources induced PM2.5 associated with cardiac disease; whereas residential heating induced particles did not. PMID:27843509

  19. FINE PARTICLES ARE MORE STRONGLY ASSOCIATED THAN COARSE PARTICLES WITH ACUTE REPIRATORY HEALTH EFFECTS IN SCHOOL CHILDREN

    EPA Science Inventory

    Numerous studies have reported associations between airborne particles and a range of respiratory outcomes from symptoms to mortality. Current attention has been focused on the characteristics of these particles responsible for the adverse health effects. We have reanalyzed three...

  20. Influence of sleep disorders on somatic symptoms, mental health, and quality of life in patients with chronic constipation

    PubMed Central

    Jiang, Ya; Tang, Yu-Rong; Xie, Chen; Yu, Ting; Xiong, Wen-Jie; Lin, Lin

    2017-01-01

    Abstract Background: Sleep disturbance is a common symptom in CC patients, and it is positively related to greater somatic and psychiatric symptoms. Methods: The participants were 126 adult outpatients with CC. The measures were: constipation—Constipation Scoring System (CSS) and Patient Assessment of Constipation-Symptoms (PAC-SYM); sleep—Pittsburgh Sleep Quality Index (PSQI); anxiety—General Anxiety Disorder-7 (GAD-7); depression—Patient Health Questionnaire-9 (PHQ-9); and QOL—Patient Assessment of Constipation Quality of Life (PAC-QOL) and SF-36. Patients were divided into sleep-disorder and normal-sleep groups by their PSQI scores. Results: The sleep-disorder group had significantly higher rates of incomplete defecation and blockage and higher CSS scores, PAC-SYM total scores, and PAC-SYM rectal-item scores than the normal-sleep group. GAD-7 and PHQ-9 scores were significantly higher in patients with poor sleep. Furthermore, sleep disorders, depression, and anxiety were all positively correlated with constipation severity. “Worry/anxiety” score of PAC-QOL scale was significantly higher and scores for seven SF-36 subscales were significantly lower in patients with poor sleep. In addition, correlation analyses showed significant negative relations between QOL and constipation, sleep disturbance, anxiety as well as depression. However, multiple regression revealed that PAC-QOL was positively associated with severe constipation and SF-36 was negatively associated with anxiety and depression. But sleep disturbance was not the independent risk factor for QOL of CC patients. Conclusion: Sleep disorders may worsen the physical- and mental health of CC patients. Sleep disturbance may lower CC patients’ QOL indirectly through the combined effects of anxiety, depression, and constipation. PMID:28207519

  1. Lower Odds of Poststroke Symptoms of Depression When Physical Activity Guidelines Met: National Health and Nutrition Examination Survey 2011–2012

    PubMed Central

    Gregory, Chris M.; Simpson, Annie N.

    2017-01-01

    Background One-third of individuals with stroke report symptoms of depression, which has a negative impact on recovery. Physical activity (PA) is a potentially effective therapy. Our objective was to examine the associations of subjectively assessed PA levels and symptoms of depression in a nationally representative stroke sample. Methods We conducted a cross-sectional study of 175 adults in the National Health and Nutrition Examination Survey 2011–2012 cycle. Moderate, vigorous, and combination equivalent PA metabolic equivalent (MET)-minutes per week averages were derived from the Global Physical Activity Questionnaire, and .the 2008 Physical Activity Guidelines/American College of Sports Medicine recommendations of ≥500 MET-minutes per week of moderate, vigorous, or combination equivalent PA were used as cut points. Depression symptoms were measured using the Patient Health Questionnaire-9. Results Meeting moderate PA guidelines resulted in 74% lower odds of having depression symptoms (P < .0001) and 89% lower odds of major symptoms of depression (P = .0003). Meeting vigorous guidelines showed a 91% lower odds of having mild symptoms of depression (P = .04). Participating in some moderate, vigorous, or combination equivalent PA revealed the odds of depression symptoms 13 times greater compared with meeting guidelines (P = .005); odds of mild symptoms of depression were 9 times greater (P = .01); and odds of major symptoms of depression were 15 times greater (P = .006). Conclusions There is a lower risk of developing mild symptoms of depression when vigorous guidelines for PA are met and developing major symptoms of depression when moderate guidelines met. Participating in some PA is not enough to reduce the risk of depression symptoms. PMID:27145542

  2. Post-traumatic Stress Disorder Symptoms and Mental Health over Time among Low-Income Women at Increased Risk of HIV in the U.S

    PubMed Central

    Golin, Carol E.; Haley, Danielle F.; Wang, Jing; Hughes, James P.; Kuo, Irene; Justman, Jessica; Adimora, Adaora A.; Soto-Torres, Lydia; O’Leary, Ann; Hodder, Sally

    2016-01-01

    Women living in poverty suffer more post-traumatic stress disorder (PTSD) symptoms than do members of the general population; however we know little about factors associated with changes in their PTSD symptoms over time. Using data from HPTN 064, a cohort of women from low-income, high-HIV-prevalence communities across six eastern states (n=1,860), we assessed the prevalence of and changes in PTSD symptoms over 12 months and the effect of potential predictors on symptom acquisition and remission (via the Primary Care-PTSD symptoms scale). Forty-three percent screened positive for PTSD symptoms. Those reporting food insecurity, ongoing abuse, depressive symptoms, or binge drinking were more likely to acquire PTSD symptoms. Those with ongoing abuse or depressive symptoms were less likely to experience PTSD symptom remission. Findings suggest a need to integrate programs to reduce abuse, depression, and economic hardship with those that address sexual health risks among women living in low-income, high-HIV-prevalence neighborhoods. PMID:27180715

  3. Assessment of the Acute and Chronic Health Hazards of Hydraulic Fracturing Fluids.

    PubMed

    Wattenberg, Elizabeth V; Bielicki, Jeffrey M; Suchomel, Ashley E; Sweet, Jessica T; Vold, Elizabeth M; Ramachandran, Gurumurthy

    2015-01-01

    There is growing concern about how hydraulic fracturing affects public health because this activity involves handling large volumes of fluids that contain toxic and carcinogenic constituents, which are injected under high pressure through wells into the subsurface to release oil and gas from tight shale formations. The constituents of hydraulic fracturing fluids (HFFs) present occupational health risks because workers may be directly exposed to them, and general public health risks because of potential air and water contamination. Hazard identification, which focuses on the types of toxicity that substances may cause, is an important step in the complex health risk assessment of hydraulic fracturing. This article presents a practical and adaptable tool for the hazard identification of HFF constituents, and its use in the analysis of HFF constituents reported to be used in 2,850 wells in North Dakota between December 2009 and November 2013. Of the 569 reported constituents, 347 could be identified by a Chemical Abstract Service Registration Number (CASRN) and matching constituent name. The remainder could not be identified either because of trade secret labeling (210) or because of an invalid CASRN (12). Eleven public databases were searched for health hazard information on thirteen health hazard endpoints for 168 identifiable constituents that had at least 25 reports of use. Health hazard counts were generated for chronic and acute endpoints, including those associated with oral, inhalation, ocular, and dermal exposure. Eleven of the constituents listed in the top 30 by total health hazard count were also listed in the top 30 by reports of use. This includes naphthalene, which along with benzyl chloride, has the highest health hazard count. The top 25 constituents reportedly used in North Dakota largely overlap with those reported for Texas and Pennsylvania, despite different geologic formations, target resources (oil vs. gas), and disclosure requirements

  4. Contextual factors associated with health care service utilization for children with acute childhood illnesses in Nigeria

    PubMed Central

    Lilford, Richard J.

    2017-01-01

    Objective To examine the independent contribution of individual, community and state-level factors to health care service utilization for children with acute childhood illnesses in Nigeria. Materials and methods The study was based on secondary analyses of cross-sectional population-based data from the 2013 Nigeria Demographic and Health Survey (DHS). Multilevel logistic regression models were applied to the data on 6,427 under-five children who used or did not use health care service when they were sick (level 1), nested within 896 communities (level 2) from 37 states (level 3). Results About one-quarter of the mothers were between 15 and 24 years old and almost half of them did not have formal education (47%). While only 30% of the children utilized health service when they were sick, close to 67% lived in the rural area. In the fully adjusted model, mothers with higher education attainment (Adjusted odds ratio [aOR] = 1.63; 95% credible interval [CrI] = 1.31–2.03), from rich households (aOR = 1.76; 95% CrI = 1.35–2.25), with access to media (radio, television or magazine) (aOR = 1.18; 95% CrI = 1.08–1.29), and engaging in employment (aOR = 1.18; 95% CrI = 1.02–1.37) were significantly more likely to have used healthcare services for acute childhood illnesses. On the other hand, women who experienced difficulty getting to health facilities (aOR = 0.87; 95% CrI = 0.75–0.99) were less likely to have used health service for their children. Conclusions Our findings highlight that utilization of healthcare service for acute childhood illnesses was influenced by not only maternal factors but also community-level factors, suggesting that public health strategies should recognise this complex web of individual composition and contextual composition factors to guide provision of healthcare services. Such interventions could include: increase in female school enrolment, provision of interest-free loans for small and medium scale enterprises, introduction of

  5. Acute physiology and chronic health evaluation (APACHE II) and Medicare reimbursement

    PubMed Central

    Wagner, Douglas P.; Draper, Elizabeth A.

    1984-01-01

    This article describes the potential for the acute physiology score (APS) of acute physiology and chronic health evaluation (APACHE) II, to be used as a severity adjustment to diagnosis-related groups (DRG's) or other diagnostic classifications. The APS is defined by a relative value scale applied to 12 objective physiologic variables routinely measured on most hospitalized patients shortly after hospital admission. For intensive care patients, APS at admission is strongly related to subsequent resource costs of intensive care for 5,790 consecutive admissions to 13 large hospitals, across and within diagnoses. The APS could also be used to evaluate quality of care, medical technology, and the response to changing financial incentives. PMID:10311080

  6. Risk of malnutrition is associated with mental health symptoms in community living elderly men and women: The Tromsø Study

    PubMed Central

    2011-01-01

    Background Little research has been done on the relationship between malnutrition and mental health in community living elderly individuals. In the present study, we aimed to assess the associations between mental health (particularly anxiety and depression) and both the risk of malnutrition and body mass index (BMI, kg/m2) in a large sample of elderly men and women from Tromsø, Norway. Methods In a cross-sectional survey, with 1558 men and 1553 women aged 65 to 87 years, the risk of malnutrition was assessed by the Malnutrition Universal Screening Tool ('MUST'), and mental health was measured by the Symptoms Check List 10 (SCL-10). BMI was categorised into six groups (< 20.0, 20.0-22.4, 22.5-24.9, 25.0-27.4, 27.5-29.9, ≥ 30.0 kg/m2). Results The risk of malnutrition (combining medium and high risk) was found in 5.6% of the men and 8.6% of the women. Significant mental health symptoms were reported by 3.9% of the men and 9.1% of the women. In a model adjusted for age, marital status, smoking and education, significant mental health symptoms (SCL-10 score ≥ 1.85) were positively associated with the risk of malnutrition (odds ratio 3.9 [95% CI 1.7-8.6] in men and 2.5 [95%CI 1.3-4.9] in women), the association was positive also for subthreshold mental health symptoms. For individuals with BMI < 20.0 the adjusted odds ratio for significant mental health symptoms was 2.0 [95% CI 1.0-4.0]. Conclusions Impaired mental health was strongly associated with the risk of malnutrition in community living elderly men and women and this association was also significant for subthreshold mental health symptoms. PMID:21762535

  7. Maternal Depressive Symptoms when Caring for a Child with Mental Health Problems

    ERIC Educational Resources Information Center

    Gerkensmeyer, Janis E.; Perkins, Susan M.; Day, Jennifer; Austin, Joan K.; Scott, Eric L.; Wu, Jingwei

    2011-01-01

    As primary caregivers of children with mental health problems, mothers face challenges that put them at risk for depression, which is rarely identified or addressed. The aims of this paper were to (a) identify mean differences among demographic, stressor, threat, and resource variables specified in a theoretical model and thought to be associated…

  8. Use of Critical Access Hospital Emergency Rooms by Patients with Mental Health Symptoms

    ERIC Educational Resources Information Center

    Hartley, David; Ziller, Erika C.; Loux, Stephenie L.; Gale, John A.; Lambert, David; Yousefian, Anush E.

    2007-01-01

    Context: National data demonstrate that mental health (MH) visits to the emergency room (ER) comprise a small, but not inconsequential, proportion of all visits; however, we lack a rural picture of this issue. Purpose: This study investigates the use of critical access hospital (CAH) ERs by patients with MH problems to understand the role these…

  9. Mental Health and Functional Outcomes of Maternal and Adolescent Reports of Adolescent Depressive Symptoms

    ERIC Educational Resources Information Center

    Rice, Frances; Lifford, Kate J.; Thomas, Hollie V.; Thapar, Anita

    2007-01-01

    Objective: To assess the value of maternal and self-ratings of adolescent depression by investigating the extent to which these reports predicted a range of mental health and functional outcomes 4 years later. The potential influence of mother's own depressed mood on her ratings of adolescent depression and suicidal ideation on adolescent outcome…

  10. Aging potentiates the acute and chronic neurological symptoms of pyrithiamine-induced thiamine deficiency in the rodent.

    PubMed

    Pitkin, S R; Savage, L M

    2001-03-15

    The present study aimed to assess the role of advanced age in the development and manifestation of thiamine deficiency using an animal model of Wernicke-Korsakoff syndrome (WKS). Interactions between pyrithiamine-induced thiamine deficiency (PTD) and age were examined relative to working memory impairment and neuropathology in Fischer 344 rats. Young (2-3 months) and aged (22-23 months) F344 rats were assigned to one of two treatment conditions: PTD or pair-fed control (PF). Rats in the former group were further divided into three groups according to duration of PTD treatment. Working memory was assessed with an operant matching-to-position (MTP) task; after testing, animals were sacrificed and both gross and immunocytochemical measures of brain pathology were obtained. Aged rats exhibited acute neurological disturbances during the PTD treatment regime earlier than did young rats, and also developed more extensive neuropathology with a shorter duration of PTD. Aged rats displayed increased brain shrinkage (smaller frontal cortical and callosal thickness) as well as enhanced astrocytic activity in the thalamus and a decrease in ChAT-positive cell numbers in the medial septum; the latter two measures of neuropathology were potentiated by PTD. In both young and aged rats, and to a greater degree in the latter group, PTD reduced thalamic volume. Behaviorally, aged rats displayed impaired choice accuracy on the delayed MTP task. Regardless of age, rats with lesions centered on the internal medullary lamina of the thalamus also displayed impaired choice accuracy. Moreover, increased PTD treatment duration led to increased response times on the delayed MTP task. These results suggest that aging does indeed potentiate the neuropathology associated with experimental thiamine deficiency, supporting an age coupling hypothesis of alcohol-related neurological disorders.

  11. Preoperative Pain, Symptoms, and Psychological Factors related to Higher Acute Pain Trajectories during Hospitalization for Total Knee Arthroplasty

    PubMed Central

    Lindberg, Maren Falch; Miaskowski, Christine; Rustøen, Tone; Rosseland, Leiv Arne; Paul, Steven M.

    2016-01-01

    Objectives Unrelieved postoperative pain after total knee arthroplasty (TKA) is a significant problem. This longitudinal study investigated how preoperative pain intensity, as well as a comprehensive list of preoperative and perioperative factors, influenced the severity of acute average and worst pain after TKA. Methods Prior to surgery, 203 patients completed a demographic questionnaire, Lee Fatigue Scale, Fatigue Severity Scale, Hospital Anxiety and Depression Scale, and Brief Illness Perception Questionnaire. Brief Pain Inventory was completed prior to surgery as well as through postoperative days (POD) 0 to 4. Clinical data were extracted from medical records. Results Several factors were associated with higher levels of preoperative and postoperative pain. Lower preoperative average and worst pain intensity scores were associated with increases in average and worst postoperative pain from POD1 to POD4. A higher number of comorbidities, higher C-reactive protein values, and higher pain interference with function were associated with higher preoperative levels of average pain. Older age, higher fatigue levels, and higher scores on identity and emotional responses to osteoarthritis (OA) were associated with higher preoperative levels of worst pain. Lower perceived consequences of OA were associated with higher pain from POD1 to POD4. Males and patients with lower preoperative scores for average pain had higher worst pain following surgery. Discussion Patients at higher risk for more severe postoperative pain can be identified through an assessment of pain and other risk factors identified in this study. Future research needs to test the efficacy of interventions that modify patients’ perceptions of living with OA and pain intensity before surgery on short and long term postoperative outcomes. PMID:27583551

  12. Rare alleles within the CYP2E1 (MEOS system) could be associated with better short-term health outcome after acute methanol poisoning.

    PubMed

    Hubacek, Jaroslav A; Pelclova, Daniela; Seidl, Zdenek; Vaneckova, Manuela; Klempir, Jiri; Ruzicka, Evzen; Ridzon, Petr; Urban, Pavel; Fenclova, Zdenka; Petrik, Vit; Diblik, Pavel; Kuthan, Pavel; Miovsky, Michal; Janikova, Barbara; Adamkova, Vera; Zakharov, Sergey

    2015-02-01

    Genetic polymorphisms influence the metabolism of ethanol and methanol, but the potential effects of genetic predisposition on the clinical course, outcome and short-term health sequelae of acute methanol poisoning are unknown. To evaluate the role of the MEOS system in methanol poisoning, we analysed the effect of three polymorphisms (RsaI - rs2031920; PstI - rs3813867; insertion/deletion I/D) within the CYP2E1 enzyme (MEOS system) in 50 adult survivors of methanol poisoning and compared their genotype frequencies with 460 controls. The minor allele frequencies of all three polymorphisms were below 5% in both groups. We did not detect significant differences in the genotype frequencies between survivors of methanol poisoning and controls (p = 0.34 for the RsaI variant; p = 0.59 for the PstI variant and p = 0.21 for the I/D polymorphism). The carriers of at least one minor allele in the CYP2E1 gene had less severe clinical symptoms and better short-term outcome after acute poisoning. Variants within the CYP2E1 gene are likely not significant genetic determinants of acute methanol poisoning (if survivors are analysed), but they may influence the severity of methanol poisoning and its visual/central nervous system (CNS) outcome.

  13. Nurses' perceptions of multidisciplinary team work in acute health-care.

    PubMed

    Atwal, Anita; Caldwell, Kay

    2006-12-01

    Multidisciplinary teamwork is viewed as one of the key processes through which care is managed in the British National Health Service, and yet is often viewed as one of the most problematic. Working in a multidisciplinary team requires many skills, which involves understanding not only one's own role but also the role of other professionals. The aim of this study was to explore nurses' perceptions of multidisciplinary teamwork in acute health-care. Nineteen nurses were interviewed using the critical incident approach to obtain their perceptions of multidisciplinary teamwork. Direct observation was conducted to record interactions between nurses and health-care professionals in multidisciplinary teams. In total, 14 meetings were attended in elder care and orthopaedics and seven in acute medicine. The findings of this study identified three barriers that hindered teamwork: (i) differing perceptions of teamwork; (ii) different levels of skills acquisitions to function as a team member; and (iii) the dominance of medical power that influenced interaction in teams. Thus, education establishments and nursing managers need to ensure that the acquisition of team-playing skills is an integral part of continued professional development.

  14. Ready, aim fire! Mental health nurses under siege in acute inpatient facilities.

    PubMed

    Ward, Louise

    2013-04-01

    It has been clearly acknowledged and well-documented that physical, emotional, and psychological violence is a central theme and an expected workplace hazard for registered nurses working in acute inpatient mental health care facilities. Limited research, however, has focused on how registered nurses have been able to cope within this environment and adequately protect themselves from harm. A critical feminist research project recently explored the lived experience of 13 Australian, female, registered nurses working in a busy metropolitan acute inpatient mental health care facility. "Fear" was exposed as the precursor to violence and aggression, both "fear as experienced by the nurse" and "fear as experienced by the patient." The participants reported experiencing a sense of fear when they could not accurately or confidently anticipate a patient response or reaction. They identified this relationship with fear as being "part of the job" and part of the unpredictable nature of caring for people experiencing complex distortions in thinking and behavior. The participants believed, however, that additional workplace pressures complicated the therapeutic environment, resulting in a distraction from patient care and observation. This distraction could lead to nurse-patient miscommunication and the potential for violence. This article discusses a major theme to emerge from this study, "Better the devil you know!" The theme highlights how mental health nurses cope with violence and why they choose to continue working in this complex care environment.

  15. Design Considerations for Post-Acute Care mHealth: Patient Perspectives

    PubMed Central

    Sanger, Patrick; Hartzler, Andrea; Lober, William B.; Evans, Heather L.; Pratt, Wanda

    2014-01-01

    Many current mobile health applications (“apps”) and most previous research have been directed at management of chronic illnesses. However, little is known about patient preferences and design considerations for apps intended to help in a post-acute setting. Our team is developing an mHealth platform to engage patients in wound tracking to identify and manage surgical site infections (SSI) after hospital discharge. Post-discharge SSIs are a major source of morbidity and expense, and occur at a critical care transition when patients are physically and emotionally stressed. Through interviews with surgical patients who experienced SSI, we derived design considerations for such a post-acute care app. Key design qualities include: meeting basic accessibility, usability and security needs; encouraging patient-centeredness; facilitating better, more predictable communication; and supporting personalized management by providers. We illustrate our application of these guiding design considerations and propose a new framework for mHealth design based on illness duration and intensity. PMID:25954465

  16. Occupation and the Prevalence of Respiratory Health Symptoms and Conditions: The Atherosclerosis Risk in Communities Study

    PubMed Central

    Mirabelli, Maria C.; London, Stephanie J.; Charles, Luenda E.; Pompeii, Lisa A.; Wagenknecht, Lynne E.

    2011-01-01

    Objectives To examine associations between occupation and respiratory health in a large, population-based cohort of adults in the United States. Methods Data from 15,273 participants, aged 45-64 years, in the Atherosclerosis Risk in Communities (ARIC) study were used to examine associations of current or most recent job held with the prevalence of self-reported chronic cough, chronic bronchitis, wheeze, asthma, and measures of lung function collected by spirometry. Results Eleven percent of participants reported wheeze and 9% were classified as having airway obstruction. Compared to individuals in managerial and administrative jobs, increased prevalences of respiratory outcomes were observed among participants in selected occupations, including construction and extractive trades (wheeze: prevalence ratio [PR]: 1.92, 95% confidence interval [CI]: 1.35, 2.73; airway obstruction: PR: 1.31, 95% CI: 1.05, 1.65). Conclusions Specific occupations are associated with adverse respiratory health. PMID:22157701

  17. The Relationship between Working Conditions and Adverse Health Symptoms of Employee in Solar Greenhouse.

    PubMed

    Zhang, Min; Wang, Xiu Feng; Cui, Xiu Min; Wang, Jian; Yu, Shi Xin

    2015-02-01

    To determine the correlation between the working environment and the health status of employees in solar greenhouse, 1171 employees were surveyed. The results show the 'Greenhouse diseases' are affected by many factors. Among general uncomforts, the morbidity of the bone and joint damage is the highest and closely related to labor time and age. Planting summer squash and wax gourd more easily cause skin pruritus. Asthma-related cough, eye disease, and skin pruritus are significantly correlated with the cultivation of wax gourd. The application of inorganic fertilizer and fertigation dramatically induce the bone and joint damage. The smell of covering film greatly influence skin pruritus. Personal protection is badly scanty and normative occupational health and safety need to be completed.

  18. Lifestyle and Health Factors Associated with Progressing and Remitting Trajectories of Untreated Lower Urinary Tract Symptoms among Elderly Men

    PubMed Central

    Marshall, Lynn M.; Holton, Kathleen F.; Parsons, J. Kellogg; Lapidus, Jodi A.; Ramsey, Katrina; Barrett-Connor, Elizabeth

    2014-01-01

    Background Knowledge of factors associated with the course of lower urinary tract symptoms (LUTS) before treatment is needed to inform preventive interventions. In a prospective study of elderly men untreated for LUTS, we identified factors associated with symptom progression and remission. Methods In community dwelling U.S. men age ≥ 65 years, the American Urological Association Symptom Index (AUA-SI) was repeated four times, once at baseline (2000–2002) and then every two years thereafter. Analyses included 1740 men with all four AUA-SI assessments, who remained free from diagnosed prostate cancer, and who reported no treatment for LUTS or benign prostatic hyperplasia (BPH) during follow-up that averaged 6.9 (±0.4) years. LUTS change was determined with group-based trajectory modeling of the repeated AUA-SI measures. Multivariable logistic regression was then used to determine the baseline factors associated with progressing compared to stable trajectories, and with remitting compared to progressing trajectories. Lifestyle, body mass index (BMI) (kg/m2), mobility, mental health (Short-Form 12), medical history, and prescription medications were considered for selection. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for variables in each model. Results We identified 10 AUA-SI trajectories: four stable (1 277 men, 73%), three progressing (345 men, 20%), two remitting (98 men, 6%), and one mixed (20 men, 1%). Men in progressing compared to stable trajectories were more likely to have mobility limitations (OR=2.0, 95% CI: 1.0–3.8), poor mental health (OR=1.9, 95% CI: 1.1–3.4), BMI ≥ 25.0 kg/m2 (OR=1.7, 95% CI: 1.0–2.8), hypertension (OR=1.5, 95% CI: 1.0–2.4), and back pain (OR=1.5, 95% CI: 1.0–2.4). Men in remitting compared to progressing trajectories more often used central nervous system medications (OR=2.3, 95% CI: 1.1–4.9) and less often had a history of problem drinking (OR=0.4. 95% CI: 0.2–0.9). Conclusions Several non

  19. Mental Health Problems during Puberty: Tanner Stage-Related Differences in Specific Symptoms. The TRAILS Study

    ERIC Educational Resources Information Center

    Oldehinkel, Albertine J.; Verhulst, Frank C.; Ormel, Johan

    2011-01-01

    The aim of this study was to investigate associations between specific mental health problems and pubertal stage in (pre)adolescents participating in the Dutch prospective cohort study TRAILS (first assessment: N = 2230, age 11.09 [plus or minus] 0.56, 50.8% girls; second assessment: N = 2149, age 13.56 [plus or minus] 0.53, 51.0% girls). Mental…

  20. The accuracy of clinical symptoms in detecting cauda equina syndrome in patients undergoing acute MRI of the spine

    PubMed Central

    Ahad, Abdul; Elsayed, Mohammed

    2015-01-01

    A large number of patients do not have cauda equina syndrome (CES) on MRI to account for their clinical findings; consequently, the majority of urgent scans requested are normal. We aimed to determine whether any clinical manifestation of CES, as stated in Royal College of Radiology guidelines, could predict the presence of established CES on MRI. We also aimed to support a larger study to develop a more universal assessment tool for acute lower back pain. A retrospective analysis of consecutive patients who warranted urgent MRI was conducted. Seventy-nine patients were eligible for study. The Kendall’s tau test was used for statistical analysis of all data. A p value of less than 0.05 was considered to be significant. MRI was performed in 62 patients out of 79. A total of 32.9% of patients had scans within 24 hours of admission. Nine of these patients were referred to neurosurgery for urgent neurosurgical review. Of these, 6.3% of patients had an established CES on MRI scan. One patient who had an out-patient MRI spine (15 days from hospital presentation) was found to have an established CES, was urgently referred to spinal surgery and underwent primary fenestration excision of the lumbar vertebra. No clinical features that were able to predict the presence of an established CES on MRI were elucidated. Findings included decreased anal tone 7.6% (p = 0.282), faecal incontinence 3.8% (p = 0.648), urinary retention 7.6% (p = 0.510), bladder incontinence 8.9% (p = 0.474), constipation 2.5% (p = 0.011) and saddle anaesthesia 8.9% (p = 0.368). Patients who had an abnormal MRI spine for back pain prior to this presentation showed a correlation with a newly diagnosed CES on MRI (p = 0.016) with a correlation coefficient of 0.272. PMID:26306934

  1. Public Health Lessons from Severe Acute Respiratory Syndrome a Decade Later

    PubMed Central

    Butler-Jones, David; Tsang, Thomas; Yu, Wang

    2013-01-01

    The outbreak of severe acute respiratory syndrome in 2002–2003 exacted considerable human and economic costs from countries involved. It also exposed major weaknesses in several of these countries in coping with an outbreak of a newly emerged infectious disease. In the 10 years since the outbreak, in addition to the increase in knowledge of the biology and epidemiology of this disease, a major lesson learned is the value of having a national public health institute that is prepared to control disease outbreaks and designed to coordinate a national response and assist localities in their responses. PMID:23739634

  2. An innovative, multidisciplinary, process-driven approach to acute stroke in a community health system network.

    PubMed

    Fessler, Richard D; To, Chiu Yuen; Gordon, Vickie; Stover, Carrie; Dunne, Robert

    2014-01-01

    Stroke is one of the major causes of death and disability in the United States, yet it is undertreated by many major medical centers across the country. Timely recognition and treatment of acute ischemic stroke remains a challenge due to confusing clinical presentations, hospital logistics, communication barriers among providers, and lack of standardized treatment algorithms. By creating a system-wide Code Stroke protocol, St. John Providence Health System improved documentation, increased intravenous tissue plasminogen activator delivery, reduced specialist call-back times, improved door-to-computer tomography scan and door-to-needle time, and identified appropriate patients for endovascular therapy.

  3. Serum and salivary cardiac analytes in acute myocardial infarction related to oral health status

    NASA Astrophysics Data System (ADS)

    Ebersole, Jeffrey L.; Kryscio, Richard J.; Campbell, Charles; Kinane, Denis F.; McDevitt, John T.; Christodoulides, Nicolaos; Floriano, Pierre N.; Miller, Craig S.

    2014-06-01

    With the advent of an increased emphasis on the potential to utilize biomarkers in saliva for systemic diseases, the issue of existing oral disease is an important consideration that could adversely affect the interpretation of diagnostic results obtained from saliva. We addressed the question does a patient's oral inflammation status confound biomarker levels used in diagnosis of acute myocardial infarction (AMI). The results demonstrated that multiple serum biomarkers and a few salivary biomarkers reflected the cardiac event. Importantly, oral health of the individual had minimal impact on the validity of the serum or salivary biomarker effectiveness.

  4. Symptoms of Aspergillosis

    MedlinePlus

    ... at Risk & Prevention Sources Diagnosis & Testing Treatment & Outcomes Health Professionals Statistics More Resources Mucormycosis Definition Symptoms People at Risk & Prevention Sources Diagnosis & Testing ...

  5. Associations of Timing of Sexual Orientation Developmental Milestones and Other Sexual Minority Stressors with Internalizing Mental Health Symptoms Among Sexual Minority Young Adults.

    PubMed

    Katz-Wise, Sabra L; Rosario, Margaret; Calzo, Jerel P; Scherer, Emily A; Sarda, Vishnudas; Austin, S Bryn

    2017-03-07

    Sexual minorities (mostly heterosexual, bisexual, lesbian/gay) are more likely than heterosexuals to have adverse mental health, which may be related to minority stress. We used longitudinal data from 1461 sexual minority women and men, aged 22-30 years, from Wave 2010 of the Growing Up Today Study, to examine associations between sexual minority stressors and mental health. We hypothesized that sexual minority stressors (earlier timing of sexual orientation developmental milestones categorized into early adolescence, middle adolescence, late adolescence/young adulthood; greater sexual orientation mobility; more bullying victimization) would be positively associated with mental health outcomes (depressive and anxious symptoms). Linear regression models stratified by gender and sexual orientation were fit via generalized estimating equations and controlled for age and race/ethnicity. Models were fit for each stressor predicting each mental health outcome. Reaching sexual minority milestones in early versus middle adolescence was associated with greater depressive and anxious symptoms among lesbians and gay men. Reaching sexual minority milestones in late adolescence/young adulthood versus middle adolescence was associated with greater depressive symptoms among lesbians, but fewer depressive and anxious symptoms among gay men. Greater sexual orientation mobility was associated with greater depressive symptoms among mostly heterosexual women. More bullying victimization was associated with greater depressive symptoms among bisexual women and with greater anxious symptoms among mostly heterosexual women. Sexual minority stressors are associated with adverse mental health among some sexual minority young adults. More research is needed to understand what may be protecting some subgroups from the mental health effects of sexual minority stressors.

  6. Exploring the Relationships between the Electronic Health Record System Components and Patient Outcomes in an Acute Hospital Setting

    ERIC Educational Resources Information Center

    Wiggley, Shirley L.

    2011-01-01

    Purpose: The purpose of this study was to examine the relationship between the electronic health record system components and patient outcomes in an acute hospital setting, given that the current presidential administration has earmarked nearly $50 billion to the implementation of the electronic health record. The relationship between the…

  7. Sociodemographic, psychosocial and physical health correlates of common mental disorder symptoms among mothers in Trinidad and Tobago: Examining ethnic variations.

    PubMed

    Krishnakumar, Ambika; Narine, Lutchmie; Roopnarine, Jaipaul L; Logie, Carol

    2016-08-22

    Historical and cultural experiences have shaped the life experiences of cultural communities in Trinidad and Tobago. Using a cultural focus, the goal of this investigation was to examine ethnic variations both in the prevalence of common mental disorder (CMD) symptoms as well as in the associations between sociodemographic, psychosocial, physical health correlates and CMDs among mothers in Trinidad and Tobago. Participants included 1002 mothers (359 African-, 353 Indo- and 290 Mixed-Ethnic Trinidadian). Mean comparisons indicated similarities in the levels of depression, somatisation and anxiety across ethnic groups. The associations between physical ill health, experiences of pain and depression and between physical ill health and somatisation were stronger for Mixed-Ethnic Trinidadian than Indo-Trinidadian mothers. The relationship between early experiences of domestic violence and depression was stronger for Indo-Trinidadian than Mixed-Ethnic Trinidadian mothers. The associations between early experiences of domestic violence and depression and between experiences of pain and somatisation were stronger for African Trinidadian than Mixed-Ethnic Trinidadian mothers. Thus beyond the direct effects, mothers belonging to specific ethnic groups indicated greater or lesser vulnerabilities to CMDs depending on their exposure to specific correlates. Results have applicability for the development of culturally sensitive interventions for mothers experiencing CMDs.

  8. Psychosocial conditions on and off the job and psychological ill health: depressive symptoms, impaired psychological wellbeing, heavy consumption of alcohol

    PubMed Central

    Michelsen, H; Bildt, C

    2003-01-01

    Background: Psychiatric epidemiology has revealed a number of associations between gender, socioeconomic status, and psychiatric disorders. Aims: To examine psychosocial conditions on and off the job in relation to psychological ill health. Methods: Longitudinal design with 24 year follow up of employed persons (190 women, 177 men). Interview and questionnaire data on work and leisure conditions were collected in 1969 and 1993. Risk analyses were performed in relation to three outcomes in 1993: depression within the preceding 12 months, impaired psychological wellbeing, and heavy alcohol use. Results: Thirteen per cent of the women and 11% of the men showed symptoms of depression, 21% and 22% had impaired psychological wellbeing, and 7% and 15% respectively were heavy alcohol users. Dissatisfaction with the quality (women) or quantity (men) of social contacts 24 years earlier was a significant risk factor for depression. Dissatisfaction with the quality of social contacts was also associated with impaired psychological wellbeing (among women), and dissatisfaction with leisure time activities was associated with heavy alcohol use (among men). Frequent overtime work 24 years earlier was associated with heavy alcohol use among women. Cross sectional analyses also showed associations between psychological ill health and some work related factors (mentally demanding work and lack of job pride). Conclusions: Perceived inadequacies in social contacts, and practical obstacles to social relationships are viewed as risk factors for depression. In this longitudinal study, work related factors, including mental demands and time pressure, do not appear sufficiently associated with psychological ill health. PMID:12819282

  9. High level of depressive symptoms as a barrier to reach an ideal cardiovascular health. The Paris Prospective Study III.

    PubMed

    Gaye, B; Prugger, C; Perier, M C; Thomas, F; Plichart, M; Guibout, C; Lemogne, C; Pannier, B; Boutouyrie, P; Jouven, X; Empana, J P

    2016-01-08

    We hypothesized that depression might represent a barrier to reach an ideal cardiovascular health (CVH) as estimated by the 7-item tool proposed by the American Heart Association. Between 2008 and 2012, 9,417 subjects 50-75 years of age were examined in a large health center and enrolled in the Paris Prospective Study III (PPS3). Participants with 0-2, 3-4 and 5-7 health metrics at the ideal level were categorized as having poor, intermediate and ideal CVH, respectively. Participants with a score ≥ 7 on the 13-item Questionnaire of Depression 2nd version, Abridged or who were on antidepressants were referred as having high level of depressive symptoms (HLDS). The mean age of the 9417 study participants was 59.57 (SD 6.28) years and 61.16% were males. A total of 9.55% had HLDS. Poor, intermediate and ideal CVH was present in 40.38%, 49.52% and 10.10% of the participants. In multivariate polytomous logistic regression analysis, HLDS was inversely associated with ideal CVH (odds ratio = 0.70; 95% CI: 0.55;0.90). This was driven by an association with the behavioural component of the CVH. Participants with HLDS had a substantial reduced chance of reaching an ideal CVH.

  10. Lower Urinary Tract Symptoms and Risk of Bladder Cancer in Men: Results from the Health Professionals Follow-Up Study

    PubMed Central

    Zhou, Jiachen; Kelsey, Karl T.; Smith, Scott; Giovannucci, Edward; Michaud, Dominique S.

    2015-01-01

    Objectives To understand the association between Lower urinary tract symptoms (LUTS) and risk of bladder cancer in a large men's cohort. Methods Using data from the Health Professionals Follow-up Study, we examined risk of bladder cancer in relation to severity of LUTS among 30,183 men. During the follow-up period from 1996 until 2010, 476 newly diagnosed cases of bladder cancer occurred. Cox proportional hazards regression was used to adjust for potential confounders. Results Among men with severe LUTS, risk of bladder cancer was 64% higher (relative risk (RR): 1.64, 95% confidence interval (CI): 0.87, 3.08) compared with men who reported no LUTS. Subjects with both voiding and storage dysfunction had a significantly higher risk of bladder cancer (RR: 1.60, 95% confidence interval: 1.00, 2.56). Among individual urinary symptoms, urinary hesitancy was strongly associated with bladder cancer; those who experienced urinary hesitancy at least 50% of the time had more than twice the risk of bladder cancer (RR: 2.21, 95% CI: 1.29, 3.78). Conclusions Our findings suggest that LUTS, especially urinary hesitancy, are associated with the development of bladder cancer in men. PMID:25863833

  11. Behavioral health symptoms associated with chronic traumatic encephalopathy: a critical review of the literature and recommendations for treatment and research.

    PubMed

    Antonius, Daniel; Mathew, Nickie; Picano, John; Hinds, Andrea; Cogswell, Alex; Olympia, Josie; Brooks, Tori; DiGiacomo, Michael; Baker, John; Willer, Barry; Leddy, John

    2014-01-01

    Chronic traumatic encephalopathy (CTE) is a neurodegenerative syndrome that has been linked to serious psychiatric symptoms, including depression, aggression, and suicidal behavior. This review critically examines the extant research on the behavioral manifestations of CTE and concludes that the paucity of longitudinal prospective studies on CTE, combined with a lack of research-accepted diagnostic criteria for identifying individuals who are considered at risk for CTE, makes it difficult to reliably establish a causal relationship between CTE and the onset of behavioral health problems. Selection and reporting bias and inconsistency in data collection methods are other concerns. To advance the field, there is a critical need for more empirical research on the behavioral manifestations of CTE. Recommendations and intervention models are also discussed.

  12. Respiratory symptoms increase health care consumption and affect everyday life – a cross-sectional population-based study from Finland, Estonia, and Sweden

    PubMed Central

    Axelsson, Malin; Lindberg, Anne; Kainu, Annette; Rönmark, Eva; Jansson, Sven-Arne

    2016-01-01

    Background Even though respiratory symptoms are common in the adult population, there is limited research describing their impact on everyday life and association with health care consumption. Aim The main objective of this population-based study was to estimate and compare the prevalence of respiratory symptoms among adults in Finland, Estonia, and Sweden in relation to health care consumption and to identify factors influencing health care consumption. A secondary aim was to assess to which extent the presence of respiratory symptoms affect everyday life. Method In the population-based FinEsS studies consisting of random samples of subjects aged 20 to 69 years from Finland (n=1,337), Estonia (n=1,346), and Sweden (n=1,953), data on demographics, respiratory health, and health care consumption were collected by structured interviews. Prevalence was compared and multiple logistic regression analyses were performed. Results Respiratory symptoms were significantly more common in Finland (66.0%) and Estonia (65.2%) than in Sweden (54.1%). Among subjects with respiratory symptoms, the proportion reporting outpatient care during the past year was fairly similar in the three countries, while specialist consultations were more common in Finland (19.1%), and hospitalisations more common in Estonia (15.0%). Finnish and Estonian residency, female sex, and BMI>25 increased the risk for outpatient care consumption. Wheeze and attacks of shortness of breath in the past 12 months, recurrent sputum production, and cough were associated with an increased risk for health care consumption. Increasing number of respiratory symptoms increased the risk for consuming health care. A larger proportion of subjects in Estonia and Sweden experienced their everyday life being affected by respiratory symptoms compared with subjects in Finland. Conclusion Respiratory symptoms are common in Finland, Estonia, and Sweden and contribute to a negative impact on everyday life as well as increased

  13. Association between Serum Ferritin Concentrations and Depressive Symptoms among Chinese Adults: A Population Study from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIHealth) Cohort Study

    PubMed Central

    Yu, Bin; Yu, Fei; He, Haiyan; Zhang, Qing; Meng, Ge; Wu, Hongmei; Du, Huanmin; Liu, Li; Shi, Hongbin; Xia, Yang; Guo, Xiaoyan; Liu, Xing; Li, Chunlei; Bao, Xue; Liu, Fangfang; Fang, Liyun; Yang, Huijun; Sun, Shaomei; Wang, Xing; Zhou, Ming; Jia, Qiyu; Zhao, Honglin; Song, Kun; Niu, Kaijun

    2016-01-01

    Depressive symptoms have become the most important global public health issue. Iron plays an important role in brain function, cognition, and behavior, and its impacts on depressive symptoms may be multifactorial with both positive and negative effects. Previous observational studies focusing on the association between iron status and depressive symptoms showed inconsistent results. Ferritin is a ubiquitous intracellular protein that can store and release iron and is widely used as a clinical biomarker to evaluate iron status. We performed a cross-sectional study to examine the relationship between serum ferritin and depressive symptoms among 3,839 subjects who were from the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIHealth) cohort. Depressive symptoms were assessed using the Chinese version of 20-item self-rating Depression Scale (SDS) with 4 cutoffs (40, 45, 48 and 50) to indicate elevated depressive symptoms (40 was the primary cut-off). The prevalence of depressive symptoms was 36.5%, 17.6%, 11.0% and 7.0% for SDS ≥40, ≥45, ≥48 and ≥50, respectively. With the primary cut-off point of 40, multiple potential confounding factors were adjusted and the odds ratios (95% confidence interval) of having elevated depressive symptoms by quartiles of serum ferritin concentrations were 1.00 (reference), 1.10 (0.91, 1.34), 0.81 (0.66, 1.01) and 1.02 (0.81, 1.28) for the first, second, third and fourth quartile, respectively (P for trend = 0.76). Similar relations were observed with the use of other cut-offs as a definition of depressive symptoms. In conclusion, there is no significant relationship between serum ferritin concentrations and depressive symptoms among Chinese adults. PMID:27611581

  14. [Access to medicines prescribed for acute health conditions in adults in South and Northeast Brazil].

    PubMed

    Paniz, Vera Maria Vieira; Cechin, Isabel Carolina Coelho Flores; Fassa, Anaclaudia Gastal; Piccini, Roberto Xavier; Tomasi, Elaine; Thumé, Elaine; Silveira, Denise Silva da; Facchini, Luiz Augusto

    2016-01-01

    This was a cross-sectional study within Brazil's Project for the Expansion and Consolidation of Family Health, 2005, with the objective of universal and free access to the medication prescribed in the last medical appointment for acute health problems and to estimate the degree to which access may have improved with inclusion of the medicines in prevailing policies and programs. The sample included 4,060 adults living in the area of primary health care units in 41 municipalities in South and Northeast Brazil. Access was greater in the South (83.2%) than in the Northeast (71%), and free access was similar (37%), with a greater share by the Family Health Program (FHP) when compared to the traditional model, especially in the Northeast. Some 60% of prescribed medicines and 50% of those on the National List of Essential Medicines (RENAME) were paid for. No variation was observed in the proportion of medicines present on the prevailing RENAME list and access. However, 40% of the medicines that were paid for can currently be obtained through the Popular Pharmacy Program. The latter program appears to emerge as a new way to guarantee access to medicines prescribed in the health system.

  15. Care Transitions in Long-term Care and Acute Care: Health Information Exchange and Readmission Rates.

    PubMed

    Yeaman, Brian; Ko, Kelly J; Alvarez del Castillo, Rodolfo

    2015-09-30

    Care transitions between settings are a well-known cause of medical errors. A key component of transition is information exchange, especially in long-term care (LTC). However, LTC is behind other settings in adoption of health information technologies (HIT). In this article, we provide some brief background information about care transitions in LTC and concerns related to technology. We describe a pilot project using HIT and secure messaging in LTC to facilitate electronic information exchange during care transitions. Five LTC facilities were included, all located within Oklahoma and serviced by the same regional health system. The study duration was 20 months. Both inpatient readmission and return emergency department (ED) visit rates were lower than baseline following implementation. We provide discussion of positive outcomes, lessons learned, and limitations. Finally, we offer implications for practice and research for implementation of HIT and information exchange across care settings that may contribute to reduction in readmission rates in acute care and ED settings.

  16. Duration of syphilis symptoms at presentations in men who have sex with men in Australia: are current public health campaigns effective?

    PubMed

    Chow, E P F; Dutt, K; Fehler, G; Denham, I; Chen, M Y; Batrouney, C; Peel, J; Read, T R H; Bradshaw, C S; Fairley, C K

    2016-01-01

    The rapid rise in syphilis cases has prompted a number of public health campaigns to assist men who have sex with men (MSM) recognize and present early with symptoms. This study aimed to investigate the temporal trend of the duration of self-report symptoms and titre of rapid plasma reagin (RPR) in MSM with infectious syphilis. Seven hundred and sixty-one syphilis cases in MSM diagnosed at the Melbourne Sexual Health Centre (MSHC) from 2007-2013 were reviewed. Median duration of symptoms and RPR titres in each year were calculated. The median durations of symptoms with primary and secondary syphilis were 9 [interquartile range (IQR) 6-14] days and 14 (IQR 7-30) days, respectively. The overall median titre of RPR in secondary syphilis (median 128, IQR 64-256) was higher than in primary syphilis (median 4, IQR 1-32) and in early latent syphilis (median 32, IQR 4-64). The median duration of symptoms for primary syphilis, secondary syphilis and titre of RPR level did not change over time. Public health campaigns were not associated with a significant shorter time from onset of symptoms to treatment. Alternative strategies such as more frequent testing of MSM should be promoted to control the syphilis epidemic in Australia.

  17. Effects of dietary nitrate supplementation on symptoms of acute mountain sickness and basic physiological responses in a group of male adolescents during ascent to Mount Everest Base Camp.

    PubMed

    Hennis, Philip J; Mitchell, Kay; Gilbert-Kawai, Edward; Bountziouka, Vassiliki; Wade, Angie; Feelisch, Martin; Grocott, Michael P; Martin, Daniel S

    2016-11-30

    The purpose of this study was to investigate the effects of dietary nitrate supplementation, in the form of beetroot juice, on acute mountain sickness (AMS) symptoms and physiological responses, in a group of young males trekking to Mount Everest Base Camp (EBC). Forty healthy male students (mean age (SD): 16 (1) yrs) trekked to EBC over 11 days. Following an overnight fast, each morning participants completed the Lake Louise AMS questionnaire and underwent a series of physiological tests: resting blood pressure as well as resting and exercising heart rate, respiratory rate, and peripheral oxygen saturation. The exercise test consisted of a standardised 2-min stepping protocol and measurements were taken in the last 10 s. Participants in the intervention arm of the study consumed 140 ml of concentrated beetroot juice daily, containing approximately 10 mmol of nitrate, while those in the control arm consumed 140 ml of concentrated blackcurrant cordial with negligible nitrate content. Drinks were taken for the first seven days at high altitude (days 2-8), in two equal doses; one with breakfast, and one with the evening meal. Mixed modelling revealed no significant between-groups difference in the incidence of AMS (Odds Ratio - nitrate vs.

  18. Ethanol extract of Synurus deltoides (Aiton) Nakai suppresses in vitro LPS-induced cytokine production in RAW 264.7 macrophages and in vivo acute inflammatory symptoms

    PubMed Central

    Jiang, Yunyao

    2014-01-01

    Synurus deltoides (Aiton) Nakai, belonging to the Compositae family, is an edible plant widely distributed in Northeast Asia. In this study, we examined the mechanisms underlying the immunomodulative effects of the ethanol extract of S. deltoides (SDE). The SDE extract strongly down-regulated the mRNA expression of the inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), and tumour necrosis factor (TNF)-α, thereby inhibiting the production of nitric oxide (NO), prostaglandin E2 (PGE2), and TNF-α in the lipopolysaccharide (LPS)-stimulated RAW 264.7 cells. Furthermore, SDE also suppressed the nuclear translocation of the activation protein (AP)-1 and the nuclear factor-κB (NF-κB), and simultaneously decreased the phosphorylation of extracellular signal-regulated protein kinases (ERK), p38, and Akt. In agreement with the in vitro observations, the orally administered SDE ameliorated the acute inflammatory symptoms in the arachidonic acid-induced ear edema and the EtOH/HCl-induced gastritis in mice. Therefore, S. deltoides have a potential anti-inflammatory capacity in vitro and in vivo, suggesting the potential therapeutic use in the inflammation-associated disorders. PMID:24611100

  19. Reduction of Behavioral Psychological Symptoms of Dementia by Multimodal Comprehensive Care for Vulnerable Geriatric Patients in an Acute Care Hospital: A Case Series

    PubMed Central

    Honda, Miwako; Ito, Mio; Ishikawa, Shogo; Takebayashi, Yoichi; Tierney, Lawrence

    2016-01-01

    Management of Behavioral and Psychological Symptoms of Dementia (BPSD) is a key challenge in geriatric dementia care. A multimodal comprehensive care methodology, Humanitude, with eye contact, verbal communication, and touch as its elements, was provided to three geriatric dementia patients for whom conventional nursing care failed in an acute care hospital. Each episode was evaluated by video analysis. All patients had advanced dementia with BPSD. Failure of care was identified by patient's shouting, screaming, or abrupt movements of limbs. In this case series, conventional care failed for all three patients. Each element of care communication was much shorter than in Humanitude care, which was accepted by the patients. The average of the elements performed during the care was eye contact 0.6%, verbal communication 15.7%, and touch 0.1% in conventional care and 12.5%, 54.8%, and 44.5% in Humanitude care, respectively. The duration of aggressive behavior of each patient during care was 25.0%, 25.4%, and 66.3% in conventional care and 0%, 0%, and 0.3% in Humanitude, respectively. In our case series, conventional care was provided by less eye contact, verbal communication, and touch. The multimodal comprehensive care approach, Humanitude, decreased BPSD and showed success by patients' acceptance of care. PMID:27069478

  20. Componential Network for the Recognition of Tool-Associated Actions: Evidence from Voxel-based Lesion-Symptom Mapping in Acute Stroke Patients.

    PubMed

    Martin, Markus; Dressing, Andrea; Bormann, Tobias; Schmidt, Charlotte S M; Kümmerer, Dorothee; Beume, Lena; Saur, Dorothee; Mader, Irina; Rijntjes, Michel; Kaller, Christoph P; Weiller, Cornelius

    2016-08-06

    The study aimed to elucidate areas involved in recognizing tool-associated actions, and to characterize the relationship between recognition and active performance of tool use.We performed voxel-based lesion-symptom mapping in a prospective cohort of 98 acute left-hemisphere ischemic stroke patients (68 male, age mean ± standard deviation, 65 ± 13 years; examination 4.4 ± 2 days post-stroke). In a video-based test, patients distinguished correct tool-related actions from actions with spatio-temporal (incorrect grip, kinematics, or tool orientation) or conceptual errors (incorrect tool-recipient matching, e.g., spreading jam on toast with a paintbrush). Moreover, spatio-temporal and conceptual errors were determined during actual tool use.Deficient spatio-temporal error discrimination followed lesions within a dorsal network in which the inferior parietal lobule (IPL) and the lateral temporal cortex (sLTC) were specifically relevant for assessing functional hand postures and kinematics, respectively. Conversely, impaired recognition of conceptual errors resulted from damage to ventral stream regions including anterior temporal lobe. Furthermore, LTC and IPL lesions impacted differently on action recognition and active tool use, respectively.In summary, recognition of tool-associated actions relies on a componential network. Our study particularly highlights the dissociable roles of LTC and IPL for the recognition of action kinematics and functional hand postures, respectively.

  1. Factors impacting the mental health of the caregivers of children with asthma in china: effects of family socioeconomic status, symptoms control, proneness to shame, and family functioning.

    PubMed

    Zhou, Ting; Yi, Chunli; Zhang, Xuxia; Wang, Yuyin

    2014-12-01

    Caregiver mental health is widely considered to be an important factor influencing children's asthma symptoms. The present study aimed to examine key factors that contribute to caregiver mental health in pediatric asthma with a Chinese sample. Two hundred participants reported their family socioeconomic status (SES), proneness to shame, asthma symptoms control of their child, family functioning, and their depression and anxiety symptoms. Results suggested that low family SES, low family functioning, and a high level of shame proneness were associated with high levels of anxiety and depression for caregivers. Family functioning mediated the effects of SES and shame on caregiver mental health and also moderated the effects of SES and shame on caregiver depression. This study highlights the importance of reducing experience of shame and enhancing family functioning in families affected by pediatric asthma.

  2. Pulmonary symptoms measured by the national institutes of health lung score predict overall survival, nonrelapse mortality, and patient-reported outcomes in chronic graft-versus-host disease.

    PubMed

    Palmer, Jeanne; Williams, Kirsten; Inamoto, Yoshihiro; Chai, Xiaoyu; Martin, Paul J; Tomas, Linus Santo; Cutler, Corey; Weisdorf, Daniel; Kurland, Brenda F; Carpenter, Paul A; Pidala, Joseph; Pavletic, Steven Z; Wood, William; Jacobsohn, David; Arai, Sally; Arora, Mukta; Jagasia, Madan; Vogelsang, Georgia B; Lee, Stephanie J

    2014-03-01

    The 2005 National Institutes of Health (NIH) Consensus Conference recommended assessment of lung function in patients with chronic graft-versus-host disease (GVHD) by both pulmonary function tests (PFTs) and assessment of pulmonary symptoms. We tested whether pulmonary measures were associated with nonrelapse mortality (NRM), overall survival (OS), and patient-reported outcomes (PRO). Clinician and patient-reported data were collected serially in a prospective, multicenter, observational study. Available PFT data were abstracted. Cox regression models were fit for outcomes using a time-varying covariate model for lung function measures and adjusting for patient and transplantation characteristics and nonlung chronic GVHD severity. A total of 1591 visits (496 patients) were used in this analysis. The NIH symptom-based lung score was associated with NRM (P = .02), OS (P = .02), patient-reported symptoms (P < .001) and functional status (P < .001). Worsening of NIH symptom-based lung score over time was associated with higher NRM and lower survival. All other measures were not associated with OS or NRM; although, some were associated with patient-reported lung symptoms. In conclusion, the NIH symptom-based lung symptom score of 0 to 3 is associated with NRM, OS, and PRO measures in patients with chronic GVHD. Worsening of the NIH symptom-based lung score was associated with increased mortality.

  3. Healing by Gentle Touch Ameliorates Stress and Other Symptoms in People Suffering with Mental Health Disorders or Psychological Stress

    PubMed Central

    Leathard, Helen L.; Grange, John; Tiplady, Peter; Stevens, Gretchen

    2007-01-01

    Previous studies on healing by gentle touch in clients with various illnesses indicated substantial improvements in psychological well-being, suggesting that this form of treatment might be helpful for people with impaired quality of mental health. The purpose of this study was to evaluate the effectiveness and safety of healing by gentle touch in subjects with self-reported impairments in their psychological well-being or mental health. One hundred and forty-seven clients who identified themselves as having psychological problems received four treatment sessions. Pre- to post-treatment changes in psychological and physical functioning were assessed by self-completed questionnaires which included visual analogue scales (VAS) and the EuroQoL (EQ-5D). Participants recorded reductions in stress, anxiety and depression scores and increases in relaxation and ability to cope scores (all P < 0.0004). Improvements were greatest in those with the most severe symptoms initially. This open study provides strong circumstantial evidence that healing by gentle touch is safe and effective in improving psychological well-being in participants with self-reported psychological problems, and also that it safely complements standard medical treatment. Controlled trials are warranted. PMID:17342249

  4. Star wars and strategic defense initiatives: work activity and health symptoms of unionized bank tellers during work reorganization.

    PubMed

    Seifert, A M; Messing, K; Dumais, L

    1997-01-01

    Work activity and health symptoms of bank tellers whose work was undergoing reorganization were examined during a university-union study of the health effects of work in women's traditional jobs. Data were gathered through collective and individual interviews, analysis of work activity, and a questionnaire administered to 305 tellers. Employees worked in a standing posture over 80 percent of the time. More than two-thirds frequently suffered pain in back, legs, and feet. The average teller had been involved in 3.7 robberies as a direct victim and six as a witness. Work required feats of memory and concentration. In order to meet job demands, tellers engaged in supportive activities and teamwork. The introduction of individualized objectives threatened the employees' ability to collaborate and induced distress. More than twice as many tellers as other female workers in Québec experience psychological distress (Ilfeld scale), related to: robbery during the past two years (odds ratio = 1.7; confidence interval = 1.0-2.9); difficult relations with superiors (O.R. = 2.6; C.I. = 1.3-5.3); and full-time work (O.R. = 2.3; C.I. = 1.3-3.9). Diverse methods enriched the analysis, and union participation allowed the proposal of concrete correction measures.

  5. Mortgage Delinquency and Changes in Access to Health Resources and Depressive Symptoms in a Nationally Representative Cohort of Americans Older Than 50 Years

    PubMed Central

    Lloyd, Jennifer; Pagán, José A.; Pollack, Craig E.; Shardell, Michelle; Cannuscio, Carolyn

    2011-01-01

    Objectives. We evaluated associations between mortgage delinquency and changes in health and health-relevant resources over 2 years, with data from the Health and Retirement Study, a longitudinal survey representative of US adults older than 50 years. Methods. In 2008, participants reported whether they had fallen behind on mortgage payments since 2006 (n = 2474). We used logistic regression to compare changes in health (incidence of elevated depressive symptoms, major declines in self-rated health) and access to health-relevant resources (food, prescription medications) between participants who fell behind on their mortgage payments and those who did not. Results. Compared with nondelinquent participants, the mortgage-delinquent group had worse health status and less access to health-relevant resources at baseline. They were also significantly more likely to develop incident depressive symptoms (odds ratio [OR] = 8.60; 95% confidence interval [CI] = 3.38, 21.85), food insecurity (OR = 7.53; 95% CI = 3.01, 18.84), and cost-related medication nonadherence (OR = 8.66; 95% CI = 3.72, 20.16) during follow-up. Conclusions. Mortgage delinquency was associated with significant elevations in the incidence of mental health impairments and health-relevant material disadvantage. Widespread mortgage default may have important public health implications. PMID:22021301

  6. Reengineering acute episodic and chronic care delivery: the Geisinger Health System experience.

    PubMed

    Slotkin, Jonathan R; Casale, Alfred S; Steele, Glenn D; Toms, Steven A

    2012-07-01

    Comparative effectiveness research (CER) represents an evolution in clinical decision-making research that allows for the study of heterogeneous groups of patients with complex diseases processes. It has foundations in decision science, reliability science, and health care policy research. Health care finance will increasingly rely on CER for guidance in the coming years. There is increasing awareness of the importance of decreasing unwarranted variation in health care delivery. In the past 7 years, Geisinger Health System has performed broad reengineering of its acute episodic and chronic care delivery models utilizing macrosystem-level application of CER principles. These provider-driven process initiatives have resulted in significant improvement across all segments of care delivery, improved patient outcomes, and notable cost containment. These programs have led to the creation of novel pricing models, and when "hardwired" throughout a care delivery system, they can lead to correct medical decision making by 100% of providers in all patient encounters. Neurosurgery as a specialty faces unique challenges and opportunities with respect to broad adoption and application of CER techniques.

  7. Self-reported TMD Symptoms, Oral Health and Quality of Life of Children in Kindergarten through Grade 5: Does Gender, Race, and Socio-economic Background Matter?

    PubMed Central

    Inglehart, Marita R.; Patel, Manan H.; Widmalm, Sven-Erik; Briskie, Daniel M.

    2015-01-01

    Background The objectives were to determine the percentage of children in Kindergarten through Grade 5 who reported TMD symptoms, to assess whether gender, race, and socioeconomic background mattered, and to explore the relationships between TMD and children’s oral health and oral health-related quality of life (OHRQoL). Methods Face-to-face interviews were conducted with 8,302 children in Kindergarten through Grade 5 (51% female/49% male; 53% African American/42% European American). Oral health screenings were conducted with 7,439 children. Results 23.6% of the children reported pain when chewing tough food and 18.8% when opening their mouth wide; 23.2% reported to hear a sound (clicking) when opening their mouth wide. Female students were more likely than male students and African American children were more likely than European American children to report TMD symptoms. The prevalence of TMD symptoms was not correlated with whether the children had a need for oral health care services, or whether they had an abscess or carious teeth with pulpal involvement. They were significantly associated with children’s OHRQoL. Conclusions Considerable percentages of 4–12 year old children reported TMD symptoms, with girls and African American children being more likely than their counterparts to be affected. Experiencing TMD symptoms is significantly associated with poorer OHRQoL. Practical Implications Dental practitioners need to be aware that substantial percentages of Kindergarten and elementary school age children experience TMD symptoms. Taking a dental history and conducting an oral exam should therefore include assessments of the signs and symptoms of TMD; treatment recommendations should be provided for affected children. PMID:26809694

  8. Premenstrual symptoms.

    PubMed

    1973-03-24

    Data is reviewed on premenstrual symptoms which have been related to high suicide and accident rates, employment absentee rates, poor academic performance and acute psychiatric problems. A recent study of healthy young women indicated that 39% had troublesome premenstrual symptoms, 54% passed clots in their menses, 70% had cyclical localized acneiform eruptions and only 17% failed to experience menstrual pain. Common menstrual disorders are classified as either dysmenorrhea or the premenstrual syndrome. Symptoms for the latter usually begin 2-12 days prior to menstruation and include nervous tension, irritability, anxiety, depression, bloated breasts and abdomen, swollen fingers and legs, headaches, dizziness, occasional hypersomia, excessive thirst and appetite. Some women may display an increased susceptibility to migraine, vasomotor rhinitis, asthma, urticaria and epilepsy. Symptoms are usually relieved with the onset of menses. While a definitive etiological theory remains to be substantiated, symptomatic relief has been reported with salt and water restriction and simple diuretics used 7 to 10 days premenstrually. Diazapam or chlordiazepoxide treatment is recommended before oral contraceptive therapy. The premenstrual syndrome may persist after menopause, is unaffected by parity, and sufferers score highly on neuroticism tests. Primary or spasmodic dysmenorrhea occurs in young women, tends to decline with age and parity and has no correlation with premenstrual symptoms or neuroticism. Spasmodic or colicky pain begins and is most severe on the first day of menstruation and may continue for 2-3 days. Treatment of dysmenorrhea with psychotropic drugs or narcotics is discouraged due to the risk of dependence and abuse. Temporary relief for disabling pain may be obtained with oral contraceptives containing synthetic estrogen and progestogen but the inherent risks should be acknowledged. Both disorders have been correlated to menstrual irregularity. Amenorrhea in

  9. Depressive symptoms and SES among the mid-aged and elderly in China: evidence from the China Health and Retirement Longitudinal Study national baseline.

    PubMed

    Lei, Xiaoyan; Sun, Xiaoting; Strauss, John; Zhang, Peng; Zhao, Yaohui

    2014-11-01

    We examine the prevalence of depressive symptoms among the mid-aged and elderly in China and examine relationships between depression and current SES factors such as gender, age, education and income (per capita expenditures). In addition, we explore associations of depressive symptoms with measures of early childhood health, recent family deaths and current chronic health conditions. We use data from the China Health and Retirement Longitudinal Study (CHARLS) national baseline, fielded in 2011/12, which contains the ten question version of the Center for Epidemiologic Studies-Depression scale (CES-D) for 17,343 respondents aged 45 and older. We fill a major gap by using the CHARLS data to explore the general patterns of depression and risk factors among the Chinese elderly nationwide, which has never been possible before. We find that depressive symptoms are significantly associated with own education and per capita expenditure, and the associations are robust to the inclusion of highly disaggregated community fixed effects and to the addition of several other risk factors. Factors such as good general health during childhood are negatively associated with later depression. There exist strong gender differences, with females having higher depression scores. Being a recent widow or widower is associated with more depressive symptoms, as is having a series of chronic health problems, notably having moderate or severe pain, disability or problems with measures of physical functioning. Adding the chronic health problems to the specification greatly reduces the SES associations with depressive symptoms, suggesting that part of the pathways behind these associations are through these chronic health factors.

  10. Patient satisfaction with treatment for alcohol use disorders: comparing patients with and without severe mental health symptoms

    PubMed Central

    McCallum, Stacey L; Andrews, Jane M; Gaughwin, Matthew D; Turnbull, Deborah A; Mikocka-Walus, Antonina A

    2016-01-01

    Background Previous studies suggest patients with co-occurring alcohol use disorders (AUDs) and severe mental health symptoms (SMHS) are less satisfied with standard AUD treatment when compared to patients with an AUD alone. This study compared patient satisfaction with standard AUD treatment among patients with and without SMHS and explored how standard treatment might be improved to better address the needs of these patients. Methods Eighty-nine patients receiving treatment for an AUD either at an inpatient hospital, outpatient clinic, inpatient detoxification, or residential/therapeutic community services were surveyed. Patient satisfaction with treatment was assessed using the Treatment Perception Questionnaire (range: 0–40). Patients were stratified according to their score on the Depression Anxiety Stress Scale. Forty patients scored in the extremely severe range of depression (score >14) and/or anxiety (score >10) (indicating SMHS) and 49 patients did not. An inductive content analysis was also conducted on qualitative data relating to areas of service improvement. Results Patients with SMHS were found to be equally satisfied with treatment (mean =25.10, standard deviation =8.12) as patients with an AUD alone (mean =25.43, standard deviation =6.91). Analysis revealed that being an inpatient in hospital was associated with reduced treatment satisfaction. Patients with SMHS were found to be significantly less satisfied with staffs’ understanding of the type of help they wanted in treatment, when compared to patients with AUDs alone. Five areas for service improvement were identified, including staff qualities, informed care, treatment access and continuity, issues relating to inpatient stay, and addressing patients’ mental health needs. Conclusion While findings suggest that AUD treatment services adequately meet the needs of patients with SMHS in treatment, patients with SMHS do feel that staff lack understanding of their treatment needs. Findings have

  11. Longitudinal Effects of Latino Parent Cultural Stress, Depressive Symptoms, and Family Functioning on Youth Emotional Well-Being and Health Risk Behaviors.

    PubMed

    Lorenzo-Blanco, Elma I; Meca, Alan; Unger, Jennifer B; Romero, Andrea; Szapocznik, José; Piña-Watson, Brandy; Cano, Miguel Ángel; Zamboanga, Byron L; Baezconde-Garbanati, Lourdes; Des Rosiers, Sabrina E; Soto, Daniel W; Villamar, Juan A; Lizzi, Karina M; Pattarroyo, Monica; Schwartz, Seth J

    2016-10-23

    U.S. Latino parents can face cultural stressors in the form of acculturative stress, perceived discrimination, and a negative context of reception. It stands to reason that these cultural stressors may negatively impact Latino youth's emotional well-being and health risk behaviors by increasing parents' depressive symptoms and compromising the overall functioning of the family. To test this possibility, we analyzed data from a six-wave longitudinal study with 302 recently immigrated (<5 years in the United States) Latino parents (74% mothers, Mage  = 41.09 years) and their adolescent children (47% female, Mage  = 14.51 years). Results of a cross-lagged analysis indicated that parent cultural stress predicted greater parent depressive symptoms (and not vice versa). Both parent cultural stress and depressive symptoms, in turn, predicted lower parent-reported family functioning, which mediated the links from parent cultural stress and depressive symptoms to youth alcohol and cigarette use. Parent cultural stress also predicted lower youth-reported family functioning, which mediated the link from parent cultural stress to youth self-esteem. Finally, mediation analyses indicated that parent cultural stress predicted youth alcohol use by a way of parent depressive symptoms and parent-reported family functioning. Our findings point to parent depressive symptoms and family functioning as key mediators in the links from parent cultural stress to youth emotional well-being and health risk behaviors. We discuss implications for research and preventive interventions.

  12. Prevalence, codetection and seasonal distribution of upper airway viruses and bacteria in children with acute respiratory illnesses with cough as a symptom.

    PubMed

    O'Grady, K F; Grimwood, K; Sloots, T P; Whiley, D M; Acworth, J P; Phillips, N; Goyal, V; Chang, A B

    2016-06-01

    Most studies exploring the role of upper airway viruses and bacteria in paediatric acute respiratory infections (ARI) focus on specific clinical diagnoses and/or do not account for virus-bacteria interactions. We aimed to describe the frequency and predictors of virus and bacteria codetection in children with ARI and cough, irrespective of clinical diagnosis. Bilateral nasal swabs, demographic, clinical and risk factor data were collected at enrollment in children aged <15 years presenting to an emergency department with an ARI and where cough was a symptom. Swabs were tested by polymerase chain reaction for 17 respiratory viruses and seven respiratory bacteria. Logistic regression was used to investigate associations between child characteristics and codetection of the organisms of interest. Between December 2011 and August 2014, swabs were collected from 817 (93.3%) of 876 enrolled children, median age 27.7 months (interquartile range 13.9-60.3 months). Overall, 740 (90.6%) of 817 specimens were positive for any organism. Both viruses and bacteria were detected in 423 specimens (51.8%). Factors associated with codetection were age (adjusted odds ratio (aOR) for age <12 months = 4.9, 95% confidence interval (CI) 3.0, 7.9; age 12 to <24 months = 6.0, 95% CI 3.7, 9.8; age 24 to <60 months = 2.4, 95% CI 1.5, 3.9), male gender (aOR 1.46; 95% CI 1.1, 2.0), child care attendance (aOR 2.0; 95% CI 1.4, 2.8) and winter enrollment (aOR 2.0; 95% CI 1.3, 3.0). Haemophilus influenzae dominated the virus-bacteria pairs. Virus-H. influenzae interactions in ARI should be investigated further, especially as the contribution of nontypeable H. influenzae to acute and chronic respiratory diseases is being increasingly recognized.

  13. The Impact of HIV Status, HIV Disease Progression and Post-Traumatic Stress Symptoms on the Health-Related Quality of Life of Rwandan Women Genocide Survivors

    PubMed Central

    Gard, Tracy L.; Hoover, Donald R.; Shi, Qiuhu; Cohen, Mardge H.; Mutimura, Eugene; Adedimeji, Adebola A.; Anastos, Kathryn

    2014-01-01

    Purpose We examined whether established associations between HIV disease and HIV disease progression on worse health-related quality of life (HQOL) were applicable to women with severe trauma histories, in this case Rwandan women genocide survivors, the majority of whom were HIV infected. Additionally, this study attempted to clarify whether post-traumatic stress symptoms were uniquely associated with HQOL or confounded with depression. Methods The Rwandan Women’s Interassociation Study and Assessment (RWISA) was a longitudinal prospective study of HIV-infected and uninfected women. At study entry 922 women (705 HIV+ and 217 HIV−) completed measures of symptoms of post-traumatic stress and HQOL as well as other demographic, clinical and behavioral characteristics. Results Even after controlling for potential confounders and mediators, HIV+ women, in particular those with the lowest CD4 counts, scored significantly worse on HQOL and overall QOL than did HIV− women. Even after controlling for depression and HIV disease progression, women with more post-traumatic stress symptoms scored worse on HQOL and overall QOL than women with fewer post-traumatic stress symptoms. Conclusions This study demonstrated that post-traumatic stress symptoms were independently associated with HQOL and overall QOL, independent of depression and other confounders or potential mediators. Future research should examine whether the long term impact of treatment on physical and psychological symptoms of HIV and post-traumatic stress symptoms would generate improvement in HQOL. PMID:23271207

  14. Association between psychosomatic health symptoms and common mental illness in Ghanaian adolescents: Age and gender as potential moderators.

    PubMed

    Glozah, Franklin N; Pevalin, David J

    2016-02-22

    Little is known about the role of age and gender in the association between psychosomatic symptoms and common mental illness in Ghanaian adolescents. This cross-sectional study examined age and gender as moderators between psychosomatic symptoms and common mental illness using data from a school-based survey (N = 770). Males reported higher psychosomatic symptoms and common mental illness, while younger adolescents reported higher common mental illness only. Psychosomatic symptoms were positively associated with common mental illness, but age and gender did not moderate this association. Interventions aimed at reducing the prevalence rate in psychosomatic symptoms are crucial in decreasing common mental illness in Ghanaian adolescents.

  15. Lung flute improves symptoms and health status in COPD with chronic bronchitis: A 26 week randomized controlled trial

    PubMed Central

    2014-01-01

    Background Chronic obstructive pulmonary disease (COPD) is characterized by mucus hypersecretion that contributes to disease related morbidity and is associated with increased mortality. The Lung Flute® is a new respiratory device that produces a low frequency acoustic wave with moderately vigorous exhalation to increase mucus clearance. We hypothesized that the Lung Flute, used on a twice daily basis will provide clinical benefit to patients with COPD with chronic bronchitis. Methods We performed a 26 week randomized, non-intervention controlled, single center, open label trial in 69 patients with COPD and Chronic Bronchitis. The primary endpoint was change in respiratory symptoms measured with the Chronic COPD Questionnaire (CCQ). Secondary endpoints included health status, assessed by the St. George Respiratory questionnaire (SGRQ), BODE (Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity) index score and exacerbation frequency. Results While the control patients did not demonstrate any significant changes in the primary endpoint (CCQ change at 26 weeks of +0.01, p = 0.8), a trend (p = 0.08) to decrease (improvement) in the CCQ (-0.23 at 26 weeks) was seen with the Lung Flute. Furthermore, a significant improvement in the symptom domain of the CCQ was seen only with the lung flute (-0.42, p = 0.004). Health status (SGRQ) improvement, was also only seen with the Lung Flute (-3.23, p = 0.03). The BODE score increased in the control group (3.31 at baseline, 4.14 at 26 weeks), however it remained stable in the Lung Flute arm (3.16 at baseline and 26 weeks), with the changes from baseline being significantly different between the 2 arms (p = 0.01). There was a trend for less exacerbations in the Lung Flute group (p = 0.07). Adverse effects were minor, with only 1 patient discontinuing treatment because of lack of efficacy. Serious adverse effects seen were all determined to be unrelated to the device use. Conclusions

  16. Illness behavior: prediction by symptoms, the Grossarth-Maticek and Eysenck Personality Types, neuroticism, life events, coping, health locus of control, social support, and attribution style.

    PubMed

    Orejudo Hernández, Santos; Froján Parga, María Xesús; Malo Aznar, Carmen

    2007-11-01

    A study was carried out with 501 persons to analyze the predictive capacity of various psychosocial variables-symptom perception, neuroticism, Personality Types 2 and 4 of Grossarth-Maticek and Eysenck, beliefs about health, social support, or certain coping styles-on two health-related behaviors: the frequency of visits to the doctor and self-medication. The results were analyzed by two structural equation models that revealed that some of the variables have direct effects on the behaviors, whereas other variables, such as attribution style, coping styles, or the impact of the stressors, have indirect effects via the reported symptoms or neuroticism. In addition, self-medication and the frequency of health service visits are independent of each other, which shows that their determinants are different. It is concluded that to address these factors in the two health indicators, it is also necessary to take in account the psychosocial variables considered herein.

  17. Acute health effects associated with exposure to volcanic air pollution (vog) from increased activity at Kilauea Volcano in 2008.

    PubMed

    Longo, Bernadette M; Yang, Wei; Green, Joshua B; Crosby, Frederick L; Crosby, Vickie L

    2010-01-01

    In 2008, the Kilauea Volcano on the island of Hawai'i increased eruption activity and emissions of sulfurous volcanic air pollution called vog. The purpose of this study was to promptly assess for a relative increase in cases of medically diagnosed acute illnesses in an exposed Hawaiian community. Using a within-clinic retrospective cohort design, comparisons were made for visits of acute illnesses during the 14 wk prior to the increased volcanic emissions (low exposure) to 14 wk of high vog exposure when ambient sulfur dioxide was threefold higher and averaged 75 parts per billion volume per day. Logistic regression analysis estimated effect measures between the low- and high-exposure cohorts for age, gender, race, and smoking status. There were statistically significant positive associations between high vog exposure and visits for medically diagnosed cough, headache, acute pharyngitis, and acute airway problems. More than a sixfold increase in odds was estimated for visits with acute airway problems, primarily experienced by young Pacific Islanders. These findings suggest that the elevated volcanic emissions in 2008 were associated with increased morbidity of acute illnesses in age and racial subgroups of the general Hawaiian population. Continued investigation is crucial to fully assess the health impact of this natural source of sulfurous air pollution. Culturally appropriate primary- and secondary-level health prevention initiatives are recommended for populations in Hawai'i and volcanically active areas worldwide.

  18. Symptoms of depression and anxiety predict treatment response and long-term physical health outcomes in rheumatoid arthritis: secondary analysis of a randomized controlled trial

    PubMed Central

    Norton, Sam; Scott, David L.; Steer, Sophia; Hotopf, Matthew

    2016-01-01

    Objective. The aim of this analysis is to examine the longitudinal impact of symptoms of depression/anxiety on treatment response, long-term disease activity and physical disability in RA. Methods. Secondary analysis of clinical trial data was performed. Data were collected at baseline and at 6-monthly intervals for 2 years. The EuroQoL (EQ-5DTM) indicated depression/anxiety symptom severity. Our primary outcomes of interest were (i) DAS-28 and (ii) physical disability measured via the HAQ. Secondary outcomes were: tender and swollen joint counts, patient global assessment, ESR and odds of reaching clinical remission. Multilevel models were used to assess the impact of baseline and persistent depression/anxiety on outcomes over 2 years. Results. Data from 379 patients were included. After adjusting for covariates, baseline depression/anxiety symptoms were associated with increased DAS-28 outcomes and increased tender joint counts. Persistent depression/anxiety symptoms were associated with increased DAS-28 scores, HAQ scores, tender joint counts and patient global assessment of disease activity, and reduced odds of reaching clinical remission. Patients with symptoms of depression/anxiety at baseline also showed a 50% reduction in prednisolone treatment effect, in comparison with patients with no symptoms of depression/anxiety at baseline. Conclusion. Baseline and persistent symptoms of depression/anxiety are associated with poorer health outcomes over time, as well as reduced treatment response. Mental health should be routinely measured both in clinical practice and in research, and managed alongside rheumatological disease to optimize health outcomes. Further research is required to examine whether treatment of mental disorders can improve rheumatological outcomes. PMID:26350486

  19. A health survey of granite workers in Finland: radiographic findings, respiratory function, hearing, electric sensory thresholds of the fingers and subjective symptoms.

    PubMed

    Ahlman, K; Backman, A L; Partanen, T

    1975-06-01

    Results from a health survey of 777 granite workers, exposed to quartz dust, noise and/or machine vibration, and 122 unexposed "controls" are reported. The survey included chest X-rays, pulmonary function tests, a hearing examination, the determination of the electric sensory thresholds of the fingers, and questionnaires on the subjective symptoms of the respiratory system and upper limbs. The exposed workers' radiographic findings (except for a 2.6 % rate of silicosis), respiratory functions, and sensory thresholds did not differ significantly from those of the controls. Granite drillers had a high prevalence of hearing defects. Respiratory symptoms were common among drillers and sandblasters, and subjective symptoms of the upper limbs due to vibration occurred among the granite dressing workers who used pneumatic hammers. Both primary and secondary measures of prevention are strongly recommended for the granite industry, primarlily for quartz dust exposure and its health effects.

  20. Diversity and Evolutionary Histories of Human Coronaviruses NL63 and 229E Associated with Acute Upper Respiratory Tract Symptoms in Kuala Lumpur, Malaysia.

    PubMed

    Al-Khannaq, Maryam Nabiel; Ng, Kim Tien; Oong, Xiang Yong; Pang, Yong Kek; Takebe, Yutaka; Chook, Jack Bee; Hanafi, Nik Sherina; Kamarulzaman, Adeeba; Tee, Kok Keng

    2016-05-04

    The human alphacoronaviruses HCoV-NL63 and HCoV-229E are commonly associated with upper respiratory tract infections (URTI). Information on their molecular epidemiology and evolutionary dynamics in the tropical region of southeast Asia however is limited. Here, we analyzed the phylogenetic, temporal distribution, population history, and clinical manifestations among patients infected with HCoV-NL63 and HCoV-229E. Nasopharyngeal swabs were collected from 2,060 consenting adults presented with acute URTI symptoms in Kuala Lumpur, Malaysia, between 2012 and 2013. The presence of HCoV-NL63 and HCoV-229E was detected using multiplex polymerase chain reaction (PCR). The spike glycoprotein, nucleocapsid, and 1a genes were sequenced for phylogenetic reconstruction and Bayesian coalescent inference. A total of 68/2,060 (3.3%) subjects were positive for human alphacoronavirus; HCoV-NL63 and HCoV-229E were detected in 45 (2.2%) and 23 (1.1%) patients, respectively. A peak in the number of HCoV-NL63 infections was recorded between June and October 2012. Phylogenetic inference revealed that 62.8% of HCoV-NL63 infections belonged to genotype B, 37.2% was genotype C, while all HCoV-229E sequences were clustered within group 4. Molecular dating analysis indicated that the origin of HCoV-NL63 was dated to 1921, before it diverged into genotype A (1975), genotype B (1996), and genotype C (2003). The root of the HCoV-229E tree was dated to 1955, before it diverged into groups 1-4 between the 1970s and 1990s. The study described the seasonality, molecular diversity, and evolutionary dynamics of human alphacoronavirus infections in a tropical region.

  1. Comparison of acute physiology and chronic health evaluation II and acute physiology and chronic health evaluation IV to predict intensive care unit mortality

    PubMed Central

    Parajuli, Bashu Dev; Shrestha, Gentle S.; Pradhan, Bishwas; Amatya, Roshana

    2015-01-01

    Context: Clinical assessment of severity of illness is an essential component of medical practice to predict the outcome of critically ill-patient. Acute Physiology and Chronic Health Evaluation (APACHE) model is one of the widely used scoring systems. Aims: This study was designed to evaluate the Performance of APACHE II and IV scoring systems in our Intensive Care Unit (ICU). Settings and Design: A prospective study in 6 bedded ICU, including 76 patients all above 15 years. Subjects and Methods: APACHE II and APACHE IV scores were calculated based on the worst values in the first 24 h of admission. All enrolled patients were followed, and outcome was recorded as survivors or nonsurvivors. Statistical Analysis Used: SPSS version 17. Results: The mean APACHE score was significantly higher among nonsurvivors than survivors (P < 0.005). Discrimination for APACHE II and APACHE IV was fair with area under receiver operating characteristic curve of 0.73 and 0.79 respectively. The cut-off point with best Youden index for APACHE II was 17 and for APACHE IV was 85. Above cut-off point, mortality was higher for both models (P < 0.005). Hosmer–Lemeshow Chi-square coefficient test showed better calibration for APACHE II than APACHE IV. A positive correlation was seen between the models with Spearman's correlation coefficient of 0.748 (P < 0.01). Conclusions: Discrimination was better for APACHE IV than APACHE II model however Calibration was better for APACHE II than APACHE IV model in our study. There was good correlation between the two models observed in our study. PMID:25722550

  2. A critical narrative analysis of shared decision-making in acute inpatient mental health care.

    PubMed

    Stacey, Gemma; Felton, Anne; Morgan, Alastair; Stickley, Theo; Willis, Martin; Diamond, Bob; Houghton, Philip; Johnson, Beverley; Dumenya, John

    2016-01-01

    Shared decision-making (SDM) is a high priority in healthcare policy and is complementary to the recovery philosophy in mental health care. This agenda has been operationalised within the Values-Based Practice (VBP) framework, which offers a theoretical and practical model to promote democratic interprofessional approaches to decision-making. However, these are limited by a lack of recognition of the implications of power implicit within the mental health system. This study considers issues of power within the context of decision-making and examines to what extent decisions about patients' care on acute in-patient wards are perceived to be shared. Focus groups were conducted with 46 mental health professionals, service users, and carers. The data were analysed using the framework of critical narrative analysis (CNA). The findings of the study suggested each group constructed different identity positions, which placed them as inside or outside of the decision-making process. This reflected their view of themselves as best placed to influence a decision on behalf of the service user. In conclusion, the discourse of VBP and SDM needs to take account of how differentials of power and the positioning of speakers affect the context in which decisions take place.

  3. Usability and Feasibility of an mHealth Intervention for Monitoring and Managing Pain Symptoms in Sickle Cell Disease: The Sickle Cell Disease Mobile Application to Record Symptoms via Technology (SMART).

    PubMed

    Jonassaint, Charles R; Shah, Nirmish; Jonassaint, Jude; De Castro, Laura

    2015-01-01

    Patients with sickle cell disease frequently experience severe pain events that lead to unplanned healthcare utilization. Mobile health tools (mHealth) may help prevent these events by providing remote monitoring and self-management support. This article describes the feasibility of the Sickle cell disease Mobile Application to Record symptoms via Technology (SMART), an mHealth app developed to help sickle cell disease patients monitor and manage their day-to-day symptoms. Fifteen patients recorded their pain intensity using a paper visual analog scale (VAS) and then repeated this measurement using an electronic VAS pain measure on SMART. Patients continued using SMART to record clinical symptoms, pain intensity, location and perceived severity, and treatment strategies for at least 28 days. Patient median age was 29 years (range 16-54); 60.0% were male. There was a high intraclass correlation between pain measurements entered on the paper VAS and SMART on the iPhone and the iPad We found a strong association between patient perceived pain severity and pain intensity entries using SMART (b = 1.71; p < 0.01). Daily compliance with SMART entries was a mean 75.0%, with a high of 85.7% in week 1 and low of 57.9% in week 4; however, one-third (n = 5) of the patients were 100.0% compliant even in week 4. Patients who were over age 35 or used an iPad for the study had the highest compliance rates. This study showed that SMART is a useable and feasible method for monitoring daily pain symptoms among adolescents and adults with sickle cell disease-related pain.

  4. Health effects in those with acute radiation sickness from the Chernobyl accident.

    PubMed

    Mettler, Fred A; Gus'kova, Angelina K; Gusev, Igor

    2007-11-01

    The Chernobyl accident resulted in almost one-third of the reported cases of acute radiation sickness (ARS) reported worldwide. Cases occurred among the plant employees and first responders but not among the evacuated populations or general population. The diagnosis of ARS was initially considered for 237 persons based on symptoms of nausea, vomiting, and diarrhea. Ultimately, the diagnosis of ARS was confirmed in 134 persons. There were 28 short term deaths of which 95% occurred at whole body doses in excess of 6.5 Gy. Underlying bone marrow failure was the main contributor to all deaths during the first 2 mo. Allogenic bone marrow transplantation was performed on 13 patients and an additional six received human fetal liver cells. All of these patients died except one individual who later was discovered to have recovered his own marrow and rejected the transplant. Two or three patients were felt to have died as a result of transplant complications. Skin doses exceeded bone marrow doses by a factor of 10-30, and at least 19 of the deaths were felt to be primarily due to infection from large area beta burns. Internal contamination was of relatively minor importance in treatment. By the end of 2001, an additional 14 ARS survivors died from various causes. Long term treatment has included therapy for beta burn fibrosis and skin atrophy as well as for cataracts.

  5. HEALTH EFFECTS OF CHRONIC EXPOSURE TO ARSENIC VIA DRINKING WATER IN INNER MONGOLIA. III. NEUROLOGICAL SYMPTOMS AND PIN-PRICK MEASURES

    EPA Science Inventory

    Health Effects of Chronic Exposure to Arsenic via Drinking Water in Inner Mongolia: III. Neurological Symptoms and Pin-prick Measures

    Yanhong Li, M.D.,Yajuan.Xia, M.D., Kegong Wu, M.D., Inner Mongolia Center For Endemic Disease Control and Research, Ling Ling He, B.S., Zhi...

  6. Detection of Symptoms of Prevalent Mental Health Disorders of Childhood with the Parent Form of the Behavioral and Emotional Screening System

    ERIC Educational Resources Information Center

    Dowdy, Erin; Kamphaus, Randy W.; Abdou, Annmary S.; Twyford, Jennifer M.

    2013-01-01

    This study examined the criterion-related validity of score inferences from the "Behavioral and Emotional Screening System Parent Form" (BESS Parent) for the detection of symptoms of prevalent mental health disorders of childhood. The BESS Parent was administered to 99 parents of first- through fifth-grade students, along with the…

  7. Coping Strategies as Moderators of the Relation between Individual Race-Related Stress and Mental Health Symptoms for African American Women

    ERIC Educational Resources Information Center

    Greer, Tawanda M.

    2011-01-01

    The purpose of this investigation was to examine coping strategies as moderators of the relationship between individual race-related stress and mental health symptoms among a sample of 128 African American women. Coping strategies refer to efforts used to resolve problems and those used to manage, endure, or alleviate distress. Culture-specific…

  8. The effect of relational continuity of care in maternity and child health clinics on parenting self-efficacy of mothers and fathers with loneliness and depressive symptoms.

    PubMed

    Tuominen, Miia; Junttila, Niina; Ahonen, Pia; Rautava, Päivi

    2016-06-01

    This study explored the parenting self-efficacy of the parents of 18-month-old children in the context of Finnish maternity and child health clinics. This parenting self-efficacy was observed in relation with the relational continuity of care and parents' experienced loneliness and depressive symptoms. The relational continuity of care was provided by a public health nurse in maternity and child health clinics. The participating parents were drawn from the STEPS study that is being carried out by the Institute for Child and Youth Research at the University of Turku. The results showed that relational continuity of care provided by the same public health nurse in the maternity and child health clinics was associated with mothers' higher emotional loneliness and with lower scores on three dimensions of parents' parenting self-efficacy. Loneliness and depressive symptoms negatively influenced parents' parenting self-efficacy - however, in the case where the family had experienced relational continuity of care, the parents' higher levels of depressive symptoms had not weakened their parenting self-efficacy beliefs. These results are discussed in terms of organizing maternity and child health clinic services.

  9. Does Acute Maternal Stress in Pregnancy Affect Infant Health Outcomes? Examination of a Large Cohort of Infants Born After the Terrorist Attacks of September 11, 2001

    DTIC Science & Technology

    2009-01-01

    Spandorfer S, Grill E, Davis O, Fasouliotis S, Rosenwaks Z: Septem- ber 11th in New York City (NYC): the effect of a catastrophe on IVF outcome in a...Naval Health Research Center Does acute maternal stress in pregnancy affect infant health outcomes ? Examination of A Large Cohort of Infants Born...California 92106 BioMed CentralBMC Public Health ssOpen AcceResearch article Does acute maternal stress in pregnancy affect infant health outcomes

  10. Treatment-Seeking for Tuberculosis-Suggestive Symptoms: A Reflection on the Role of Human Agency in the Context of Universal Health Coverage in Malawi.

    PubMed

    Kumwenda, Moses; Desmond, Nicola; Hart, Graham; Choko, Augustine; Chipungu, Geoffrey A; Nyirenda, Deborah; Shand, Tim; Corbett, Elizabeth L; Chikovore, Jeremiah

    2016-01-01

    Tuberculosis (TB) is highly infectious and one of the leading killers globally. Several studies from sub-Saharan Africa highlight health systems challenges that affect ability to cope with existing disease burden, including TB, although most of these employ survey-type approaches. Consequently, few address community or patient perspectives and experiences. At the same time, understanding of the mechanisms by which the health systems challenges translate into seeking or avoidance of formal health care remains limited. This paper applies the notion of human agency to examine the ways people who have symptoms suggestive of TB respond to and deal with the symptoms vis-à-vis major challenges inherent within health delivery systems. Empirical data were drawn from a qualitative study exploring the ways in which notions of masculinity affect engagement with care, including men's well-documented tendency to delay in seeking care for TB symptoms. The study was carried out in three high-density locales of urban Blantyre, Malawi. Data were collected in March 2011 -March 2012 using focus group discussions, of which eight (mixed sex = two; female only = three; male only = three) were with 74 ordinary community members, and two (both mixed sex) were with 20 health workers; and in-depth interviews with 20 TB patients (female = 14) and 20 un-investigated chronic coughers (female = eight). The research process employed a modified version of grounded theory. Data were coded using a coding scheme that was initially generated from the study aims and subsequently progressively amended to incorporate concepts emerging during the analysis. Coded data were retrieved, re-read, and broken down and reconnected iteratively to generate themes. A myriad of problems were described for health systems at the primary health care level, centring largely on shortages of resources (human, equipment, and drugs) and unprofessional conduct by health care providers. Participants consistently pointed out

  11. Treatment-Seeking for Tuberculosis-Suggestive Symptoms: A Reflection on the Role of Human Agency in the Context of Universal Health Coverage in Malawi

    PubMed Central

    Kumwenda, Moses; Desmond, Nicola; Hart, Graham; Choko, Augustine; Chipungu, Geoffrey A.; Nyirenda, Deborah; Shand, Tim; Corbett, Elizabeth L.; Chikovore, Jeremiah

    2016-01-01

    Tuberculosis (TB) is highly infectious and one of the leading killers globally. Several studies from sub-Saharan Africa highlight health systems challenges that affect ability to cope with existing disease burden, including TB, although most of these employ survey-type approaches. Consequently, few address community or patient perspectives and experiences. At the same time, understanding of the mechanisms by which the health systems challenges translate into seeking or avoidance of formal health care remains limited. This paper applies the notion of human agency to examine the ways people who have symptoms suggestive of TB respond to and deal with the symptoms vis-à-vis major challenges inherent within health delivery systems. Empirical data were drawn from a qualitative study exploring the ways in which notions of masculinity affect engagement with care, including men’s well-documented tendency to delay in seeking care for TB symptoms. The study was carried out in three high-density locales of urban Blantyre, Malawi. Data were collected in March 2011 –March 2012 using focus group discussions, of which eight (mixed sex = two; female only = three; male only = three) were with 74 ordinary community members, and two (both mixed