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Sample records for adult psychosocial outcomes

  1. Exploring the Psychosocial and Behavioral Adjustment Outcomes of Multi-Type Abuse among Homeless Young Adults

    ERIC Educational Resources Information Center

    Ferguson, Kristin M.

    2009-01-01

    This article explores the psychosocial and behavioral adjustment outcomes associated with verbal, emotional, physical, and sexual abuse among homeless young adults as well as the associations among abuse types. Convenience sampling was used to select 28 homeless young adults (ages 18 to 24) from one drop-in center. Overall, subjects experienced…

  2. Adult psychosocial outcomes of children with specific language impairment, pragmatic language impairment and autism

    PubMed Central

    Whitehouse, Andrew J O; Watt, Helen J; Line, E A; Bishop, Dorothy V M

    2009-01-01

    Background: The few studies that have tracked children with developmental language disorder to adulthood have found that these individuals experience considerable difficulties with psychosocial adjustment (for example, academic, vocational and social aptitude). Evidence that some children also develop autistic symptomatology over time has raised suggestions that developmental language disorder may be a high-functioning form of an autism spectrum disorder (ASD). It is not yet clear whether these outcomes vary between individuals with different subtypes of language impairment. Aims: To compare the adult psychosocial outcomes of children with specific language impairment (SLI), pragmatic language impairment (PLI) and ASD. Methods & Procedures: All participants took part in research as children. In total, there were 19 young adults with a childhood history of Specific Language Impairment (M age = 24;8), seven with PLI (M age = 22;3), 11 with high functioning ASD (M age = 21;9) and 12 adults with no history of developmental disorder (Typical; n = 12; M age = 21;6). At follow-up, participants and their parents were interviewed to elicit information about psychosocial outcomes. Outcomes & Results: Participants in the SLI group were most likely to pursue vocational training and work in jobs not requiring a high level of language/literacy ability. The PLI group tended to obtain higher levels of education and work in ‘skilled’ professions. The ASD participants had lower levels of independence and more difficulty obtaining employment than the PLI and SLI participants. All groups had problems establishing social relationships, but these difficulties were most prominent in the PLI and ASD groups. A small number of participants in each group were found to experience affective disturbances. The PLI and SLI groups showed lower levels of autistic symptomatology than the ASD group. Conclusions & Implications: The between-group differences in autistic symptomatology provide

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

    ERIC Educational Resources Information Center

    Mowbray, Carol T.; Mowbray, Orion P.

    2006-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  6. Childhood Sexual Abuse Patterns, Psychosocial Correlates, and Treatment Outcomes among Adults in Drug Abuse Treatment

    ERIC Educational Resources Information Center

    Boles, Sharon M.; Joshi, Vandana; Grella, Christine; Wellisch, Jean

    2005-01-01

    This study reports on the effects of having a history of childhood sexual abuse (CSA) on treatment outcomes among substance abusing men and women (N = 2,434) in a national, multisite study of drug treatment outcomes. A history of CSA was reported by 27.2% of the women and 9.2% of the men. Controlling for gender, compared to patients without CSA,…

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  8. Effects of Yoga on Symptoms, Physical Function, and Psychosocial Outcomes in Adults with Osteoarthritis: A Focused Review.

    PubMed

    Cheung, Corjena; Park, Juyoung; Wyman, Jean F

    2016-02-01

    Osteoarthritis (OA) is a highly prevalent and disabling chronic condition. Because physical activity is a key component in OA management, effective exercise interventions are needed. Yoga is an increasingly popular multimodal mind-body exercise that aims to promote flexibility, strength, endurance, and balance. Its gentle approach is potentially a safe and effective exercise option for managing OA. The purpose of this focused review is to examine the effects of yoga on OA symptoms and physical and psychosocial outcomes. A comprehensive search was conducted using seven electronic databases. Twelve reports met inclusion criteria involving a total of 589 participants with OA-related symptoms. A variety of types, frequencies, and durations of yoga interventions were reported; Hatha and Iyengar yoga were the most commonly used types. Frequency of intervention ranged from once a week to 6 days a week. Duration of the interventions ranged from 45 to 90 mins per session for 6 to 12 wks. Yoga intervention resulted in reductions in pain, stiffness, and swelling, but results on physical function and psychosocial well-being were inconclusive because of a variety of outcome measures being used.

  9. Enhancing psychosocial outcomes for young adult childhood CNS cancer survivors: importance of addressing vocational identity and community integration.

    PubMed

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

    2012-12-01

    The purpose of this study was to examine the relationship between vocational identity, community integration, positive and negative affect, and satisfaction with life in a group of young adult central nervous system (CNS) cancer survivors. Participants in this study included 45 young adult CNS cancer survivors who ranged in age from 18 to 30 years (mean=22, SD=3.62), with a mean age at diagnosis of 8.8 years. Four standardized instruments were used to assess the individual's affect, satisfaction with life, vocational identity, and self-perceived level of community integration. Pearson correlation analyses were carried out to examine the relationships between the satisfaction with life and positive and negative affect, vocational identify, and community integration. A hierarchical linear regression was then performed to determine how well these variables predict satisfaction with life among CNS cancer survivors. Significant positive correlations were found between life satisfaction and positive affect (r=0.423, P<0.01), as well as life satisfaction and community integration (r=-505, P<0.001). A positive correlation between life satisfaction and vocational identity was only marginally significant (r=0.312, P<0.05). Regression results indicate that the model explained 29% of the variance with community integration making a unique contribution. The largest contribution of this study is that the findings provide initial evidence that addressing vocational identity and community integration may be important constructs in improving young adult CNS survivors' overall levels of satisfaction with life. These constructs have not been typically addressed in psychosocial cancer treatment programs.

  10. Family Structure and Children's Psychosocial Outcomes

    ERIC Educational Resources Information Center

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

    2008-01-01

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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  12. Psychosocial and Neurocognitive Outcomes in Adult Survivors of Adolescent and Early Young Adult Cancer: A Report From the Childhood Cancer Survivor Study

    PubMed Central

    Prasad, Pinki K.; Hardy, Kristina K.; Zhang, Nan; Edelstein, Kim; Srivastava, Deokumar; Zeltzer, Lonnie; Stovall, Marilyn; Seibel, Nita L.; Leisenring, Wendy; Armstrong, Gregory T.; Robison, Leslie L.; Krull, Kevin

    2015-01-01

    Purpose To characterize psychological and neurocognitive function in long-term cancer survivors diagnosed during adolescence and early young adulthood (AeYA). Methods Six thousand one hundred ninety-two survivors and 390 siblings in the Childhood Cancer Survivor Study completed the Brief Symptom Inventory-18 and a Neurocognitive Questionnaire. Treatment and demographic predictors were examined, and associations with social attainment (employment, education, and living independently) were evaluated. Logistic regression models were used to compute odds ratios (ORs) and corresponding 95% CIs. Results Among survivors, 2,589 were diagnosed when AeYA (11 to 21 years old). Adjusted for current age and sex, these survivors, compared with siblings, self-reported higher rates of depression (11.7% v 8.0%, respectively; OR, 1.55; 95% CI, 1.04 to 2.30) and anxiety (7.4% v 4.4%, respectively; OR, 2.00; 95% CI, 1.17 to 3.43) and more problems with task efficiency (17.2% v 10.8%, respectively; OR, 1.72; 95% CI, 1.21 to 2.43), emotional regulation (19.1% v 14.1%, respectively; OR, 1.74; 95% CI, 1.26 to 2.40), and memory (25.9% v 19.0%, respectively; OR, 1.44; 95% CI, 1.09 to 1.89). Few differences were noted between survivors diagnosed with leukemia or CNS tumor before 11 years old versus during later adolescence, although those diagnosed with lymphoma or sarcoma during AeYA were at reduced risk for self-reported psychosocial and neurocognitive problems. Unemployment was associated with self-reports of impaired task efficiency (OR, 2.93; 95% CI, 2.28 to 3.77), somatization (OR, 2.29; 95% CI, 1.77 to 2.98), and depression (OR, 1.94; 95% CI, 1.43 to 2.63). Conclusion We demonstrated that risk for poor functional outcome is not limited to survivors' diagnoses in early childhood. AeYA is a critical period of development, and cancer during this period can impact neurocognitive and emotional function and disrupt vocational attainment. PMID:26150441

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-03-01

    Mental disorders are prevalent and can lead to significant impairment. Some progress has been made toward establishing treatments; however, effect sizes are small to moderate, gains may not persist, and many patients derive no benefit. Our goal is to highlight the potential for empirically supported psychosocial treatments to be improved by incorporating insights from cognitive psychology and research on education. Our central question is: If it were possible to improve memory for the content of sessions of psychosocial treatments, would outcome substantially improve? We leverage insights from scientific knowledge on learning and memory to derive strategies for transdiagnostic and transtreatment cognitive support interventions. These strategies can be applied within and between sessions and to interventions delivered via computer, the Internet, and text message. Additional novel pathways to improving memory include improving sleep, engaging in exercise, and using imagery. Given that memory processes change across the lifespan, services to children and older adults may benefit from different types and amounts of cognitive support.

  15. Psychosocial Impact of Epilepsy in Older Adults

    PubMed Central

    Manacheril, Rinu; Faheem, Urooba; Labiner, David; Drake, Kendra; Chong, Jenny

    2015-01-01

    Objective: The purpose of our study was to describe the quality of life of older adults with seizures or epilepsy and compare its psychosocial impact between those who were new diagnosed and those diagnosed before the age of 65. Methods: In-depth face to face interviews with open ended questions were conducted with two participant groups: Incident group: 42 older adults (>65 years) with new onset or newly diagnosed after age of 65; and Prevalent group: 15 older adults (>65 years) diagnosed before age of 65. Interviews were reviewed and coded using a list of themes and results were compared between the two groups. Eight topics were selected from the participants’ responses to questions about the psychosocial impact of epilepsy and seizures. The topics were then analyzed and compared between the two groups. Results: The topics analyzed were: Emotional and physical impact, significant life changes, co-morbidities, information gathering, stigma, AED side effects, changes in relationships and attitude toward diagnosis. Conclusion: We concluded that the age at onset and duration does seem to have a negative correlation with health related quality of life. However, the perceived health status of older adults with chronic epilepsy was significantly better and reflected in their more positive approach to the diagnosis of seizures or epilepsy probably because they have had a longer opportunity to learn to cope with their diagnosis. PMID:27417823

  16. Psychosocial issues and outcomes in maternal PKU.

    PubMed

    Koch, Richard; Trefz, Friedrich; Waisbren, Susan

    2010-01-01

    Elevated phenylalanine (Phe) levels in pregnant women with PKU are teratogenic. Fetal damage due to elevated maternal Phe levels during pregnancy is known as maternal phenylketonuria (MPKU). The risk of birth defects in MPKU, including global developmental delays, microcephaly, congenital heart disease, and low birth weight, can be dramatically reduced by controlling Phe levels during pregnancy (metabolic control). Phe levels should be maintained in the range of 120-360 micromol/L, ideally starting before pregnancy begins (i.e., when planning a pregnancy). If control is not achieved before pregnancy (e.g., if the pregnancy was unplanned), good outcomes are still possible if metabolic control is established by 8 weeks of pregnancy. Unfortunately, metabolic control before and during pregnancy can be poor. As well, many mothers stop treatment after pregnancy, which can decrease the mother's ability to focus on her child and increase her risk of behavioral and psychological problems. This can have a negative effect on the home environment. Many factors affect adherence to the strict diet used to control Phe levels, including poor access to medical care, lack of reimbursement for medical foods (in some regions, such as parts of the United States), practical difficulties with implementing the diet, financial constraints, demographics, and psychosocial issues. A comprehensive treatment approach that begins prior to pregnancy and continues after the infant is born may help to improve the management of MPKU. This approach should include education of girls about MPKU at an early age, interventions to prevent unplanned pregnancies, psychosocial support, improved treatment access and reimbursement for medical foods, and treatment guidelines. Treatments such as sapropterin may also have a role in improving metabolic control during pregnancy.

  17. A Systematic Review of Psychosocial Interventions for Adults with Autism Spectrum Disorders

    PubMed Central

    Bishop-Fitzpatrick, Lauren; Minshew, Nancy J.; Eack, Shaun M.

    2012-01-01

    Individuals with autism spectrum disorders (ASD) spend the majority of their lives as adults, and psychosocial interventions show promise for improving outcomes in this population. This research conducted a systematic review of all peer-review studies evaluating psychosocial interventions for adults with ASD. A total of 1217 studies were reviewed, only 13 met inclusion criteria. The majority of studies were single case studies or non-randomized controlled trials, and most focused on applied behavior analysis or social cognition training. Effects of psychosocial treatment in adult ASD were largely positive ranging from d = .14 to 3.59, although the quantity and quality of studies is limited. There is substantial need for the rigorous development and evaluation of psychosocial treatments for adults with ASD. PMID:22825929

  18. Tracking Psychosocial Health in Adults with Epilepsy—Estimates from the 2010 National Health Interview Survey

    PubMed Central

    Kobau, R; Cui, W; Kadima, N; Zack, MM; Sajatovic, M; Kaiboriboon, K; Jobst, B

    2015-01-01

    Objective This study provides population-based estimates of psychosocial health among U.S. adults with epilepsy from the 2010 National Health Interview Survey. Methods Multinomial logistic regression was used to estimate the prevalence of the following measures of psychosocial health among adults with and those without epilepsy: 1) the Kessler-6 scale of Serious Psychological Distress; 2) cognitive limitation; the extent of impairments associated with psychological problems; and work limitation; 3) Social participation; and 4) the Patient Reported Outcome Measurement Information System Global Health scale. Results Compared with adults without epilepsy, adults with epilepsy, especially those with active epilepsy, reported significantly worse psychological health, more cognitive impairment, difficulty in participating in some social activities, and reduced health-related quality of life (HRQOL). Conclusions These disparities in psychosocial health in U.S. adults with epilepsy serve as baseline national estimates of their HRQOL, consistent with Healthy People 2020 national objectives on HRQOL. PMID:25305435

  19. A Literature Review of the Psychosocial Development of Older Adults

    ERIC Educational Resources Information Center

    Moon, Paul J.

    2005-01-01

    The purpose of this literature review is to examine existing models of psychosocial development of older adults especially framed around human mortality as a point of discussion that informs all aspects of human development in older adulthood. Well known, in addition to burgeoning, human psychosocial development models that considered older…

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

    PubMed Central

    Sonne, Charlotte; Carlsson, Jessica; Bech, Per; Vindbjerg, Erik; Mortensen, Erik Lykke; Elklit, Ask

    2016-01-01

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

  1. A Review of Psychosocial Outcomes for Patients Seeking Cosmetic Surgery

    PubMed Central

    Honigman, Roberta J.; Phillips, Katharine A.; Castle, David J.

    2006-01-01

    The authors reviewed the literature on psychological and psychosocial outcomes for individuals undergoing cosmetic surgery, to address whether elective cosmetic procedures improve psychological well-being and psychosocial functioning and whether there are identifiable predictors of an unsatisfactory psychological outcome. They conducted a search of appropriate computerized databases for studies that evaluated psychological and psychosocial status both before and after elective cosmetic surgery. They identified 37 relevant studies of varying cosmetic procedures that utilized disparate methodologies. Overall, patients appeared generally satisfied with the outcome of their procedures, although some exhibited transient and some exhibited longer-lasting psychological disturbance. Factors associated with poor psychosocial outcome included being young, being male, having unrealistic expectations of the procedure, previous unsatisfactory cosmetic surgery, minimal deformity, motivation based on relationship issues, and a history of depression, anxiety, or personality disorder. Body dysmorphic disorder was also recognized by some studies as a predictor of poor outcome, a finding reinforced by reference to the psychiatric literature. The authors conclude that although most people appear satisfied with the outcome of cosmetic surgical procedures, some are not, and attempts should be made to screen for such individuals in cosmetic surgery settings. PMID:15083026

  2. Infantile autism: adult outcome.

    PubMed

    Korkmaz, B

    2000-07-01

    Although the core features of autism do not change qualitatively, a gradual overall symptomatic improvement including an increase in adaptive skills is observed in most cases with age. Follow-up studies show that the diagnostic features, the differential diagnosis, and clinical problems of adult autistics differ substantially from that of autistic children. The differential diagnosis of older autistics include personality disorders, learning disabilities, and mood disorder. Depression, epilepsy, and behavioral problems such as aggression and agitation may be major clinical problems during adolescence. The early indicators of a better outcome include a higher level of IQ and language. Among the neuropsychological variables, measures of flexibility and cognitive shift are important as prognostic factors. Early behavioral and educational intervention may especially increase the adaptive skills of the patients and promote the in-family communication. The outcome studies of autism are particularly helpful in addressing the appropriate and most effective programs of remediation for adult autistics.

  3. Adult Children as Informants about Parents' Psychosocial Preferences

    ERIC Educational Resources Information Center

    Carpenter, Brian D.; Lee, Monica; Ruckdeschel, Katy; Van Haitsma, Kimberly S.; Feldman, Penny H.

    2006-01-01

    Utilizing data from 80 adult children-older parent dyads, this study examined the degree to which adult children could predict the psychosocial preferences of their older parents. Overall, children demonstrated good knowledge about parent preferences, although there was wide variability within the sample and across preference domains. Children…

  4. Nursing Home Work Environment Characteristics: Associated Outcomes in Psychosocial Care

    PubMed Central

    Bonifas, Robin P.

    2008-01-01

    Little is known about how work environment characteristics influence social services professionals' ability to deliver effective psychosocial services in skilled nursing facilities (SNFs) and how such influence translates into resident-centered outcomes. This study combines data from a survey of facility social services directors in Washington State with State inspection outcomes from the Online Survey Certification Reporting database. Logistic regression is used to examine how facility structure and facility culture impact receipt of a survey inspection deficiency in medically-related social services. Results indicate that non-metropolitan location and larger caseload size are the strongest predictors of receiving such a deficiency. PMID:19361114

  5. Which psychosocial factors best predict cognitive performance in older adults?

    PubMed

    Zahodne, Laura B; Nowinski, Cindy J; Gershon, Richard C; Manly, Jennifer J

    2014-05-01

    Negative affect (e.g., depression) is associated with accelerated age-related cognitive decline and heightened dementia risk. Fewer studies examine positive psychosocial factors (e.g., emotional support, self-efficacy) in cognitive aging. Preliminary reports suggest that these variables predict slower cognitive decline independent of negative affect. No reports have examined these factors in a single model to determine which best relate to cognition. Data from 482 individuals 55 and older came from the normative sample for the NIH Toolbox for the Assessment of Neurological and Behavioral Function. Negative and positive psychosocial factors, executive functioning, working memory, processing speed, and episodic memory were measured with the NIH Toolbox Emotion and Cognition modules. Confirmatory factor analysis and structural equation modeling characterized independent relations between psychosocial factors and cognition. Psychosocial variables loaded onto negative and positive factors. Independent of education, negative affect and health status, greater emotional support was associated with better task-switching and processing speed. Greater self-efficacy was associated with better working memory. Negative affect was not independently associated with any cognitive variables. Findings support the conceptual distinctness of negative and positive psychosocial factors in older adults. Emotional support and self-efficacy may be more closely tied to cognition than other psychosocial variables.

  6. Development of Food Safety Psychosocial Questionnaires for Young Adults

    ERIC Educational Resources Information Center

    Byrd-Bredbenner, C.; Wheatley, V.; Schaffner, D.; Bruhn, C.; Blalock, L.; Maurer, J.

    2007-01-01

    Food mishandling is thought to be more acute among young adults; yet little is known about why they may engage in risky food handling behaviors. The purpose of this study was to create valid, reliable instruments for assessing key food safety psychosocial measures. Development of the measures began by examining published studies and behavior…

  7. Adult outcomes of preterm children.

    PubMed

    Hack, Maureen

    2009-10-01

    The survivors of the initial years of neonatal intensive care of preterm infants reached adulthood during the last decade. Reports of their adult outcomes examined have included neurodevelopmental, behavioral and health outcomes as well as social functioning and reproduction. Despite statistically significant differences between preterm young adults and controls in most outcomes studied, the majority of preterm survivors do well and live fairly normal lives. The two major predictors of adult outcomes are lower gestational age that reflect perinatal injury and family sociodemographic status which reflects both genetic and environmental effects.

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

    PubMed

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

    2016-01-01

    The aim of the study was to review the literature on animal assisted therapy (AAT) in people with intellectual disabilities (ID) measuring psychosocial outcomes (behavioural, social, cognitive and emotional). Quantitative studies were found through a systematic search that identified studies using AAT in people with ID and measuring psychosocial outcomes (behavioural, cognitive, emotional and social). The quality of studies was assessed using a standardised tool and rated as strong, moderate or weak. Only published articles from peer-reviewed journals were included. No language or age restrictions were applied. Over half of the included studies were identified outside standard database searches (e.g. hand searching reference lists from included articles, references from AAT websites and using Google Scholar and a Grey Literature Database). Ten studies were included in the final review; two were rated as moderate quality and eight were rated as weak quality. Overall there was a positive improvement reported from studies for all psychosocial outcomes (with some cognitive, behavioural, social, emotional components reaching statistical significance p ≤ 0.01). Despite having no age restrictions, the included studies had participants that were mainly children and adolescents, in particular favouring male participants, which may limit generalisation. More rigorous methodology is required to improve the quality of future studies including in the main multicentre randomised designs and improved reporting according to CONSORT criteria. Further research should expand to include adults with ID and specific disorders such as challenging behaviour or mental illness. PMID:26773215

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

    PubMed

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

    2016-01-01

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

  10. Monitoring and Evaluating Psychosocial Intervention Outcomes in Humanitarian Aid

    PubMed Central

    de Jong, Kaz; Ariti, Cono; van der Kam, Saskia; Mooren, Trudy; Shanks, Leslie; Pintaldi, Giovanni; Kleber, Rolf

    2016-01-01

    Existing tools for evaluating psychosocial interventions (un-validated self-reporting questionnaires) are not ideal for use in non-Western conflict settings. We implement a generic method of treatment evaluation, using client and counsellor feedback, in 18 projects in non-Western humanitarian settings. We discuss our findings from the perspective of validity and suggestions for future research. A retrospective analysis is executed using data gathered from psychosocial projects. Clients (n = 7,058) complete two (complaints and functioning) rating scales each session and counsellors rate the client’s status at exit. The client-completed pre- and post-intervention rating scales show substantial changes. Counsellor evaluation of the clients’ status shows a similar trend in improvement. All three multivariable models for each separate scale have similar associations between the scales and the investigated variables despite different cultural settings. The validity is good. Limitations are: ratings give only a general impression and clinical risk factors are not measured. Potential ceiling effects may influence change of scales. The intra and inter-rater reliability of the counsellors’ rating is not assessed. The focus on client and counsellor perspectives to evaluate treatment outcome seems a strong alternative for evaluation instruments frequently used in psychosocial programming. The session client rated scales helps client and counsellor to set mutual treatment objectives and reduce drop-out risk. Further research should test the scales against a cross-cultural valid gold standard to obtain insight into their clinical relevance. PMID:27315263

  11. Monitoring and Evaluating Psychosocial Intervention Outcomes in Humanitarian Aid.

    PubMed

    de Jong, Kaz; Ariti, Cono; van der Kam, Saskia; Mooren, Trudy; Shanks, Leslie; Pintaldi, Giovanni; Kleber, Rolf

    2016-01-01

    Existing tools for evaluating psychosocial interventions (un-validated self-reporting questionnaires) are not ideal for use in non-Western conflict settings. We implement a generic method of treatment evaluation, using client and counsellor feedback, in 18 projects in non-Western humanitarian settings. We discuss our findings from the perspective of validity and suggestions for future research. A retrospective analysis is executed using data gathered from psychosocial projects. Clients (n = 7,058) complete two (complaints and functioning) rating scales each session and counsellors rate the client's status at exit. The client-completed pre- and post-intervention rating scales show substantial changes. Counsellor evaluation of the clients' status shows a similar trend in improvement. All three multivariable models for each separate scale have similar associations between the scales and the investigated variables despite different cultural settings. The validity is good. Limitations are: ratings give only a general impression and clinical risk factors are not measured. Potential ceiling effects may influence change of scales. The intra and inter-rater reliability of the counsellors' rating is not assessed. The focus on client and counsellor perspectives to evaluate treatment outcome seems a strong alternative for evaluation instruments frequently used in psychosocial programming. The session client rated scales helps client and counsellor to set mutual treatment objectives and reduce drop-out risk. Further research should test the scales against a cross-cultural valid gold standard to obtain insight into their clinical relevance. PMID:27315263

  12. Childhood Psychosocial Stressors and Adult Onset Arthritis: Broad Spectrum Risk Factors and Allostatic Load

    PubMed Central

    Von Korff, Michael; Alonso, Jordi; Ormel, Johan; Angermeyer, Matthais; Bruffaerts, Ronny; Fleiz, Clara; de Girolamo, Giovanni; Kessler, Ronald C.; Kovess-Masfety, Viviane; Posada-Villa, José; Scott, Kate M.; Uda, Hidenori

    2009-01-01

    Neural, endocrine and immune stress mediators are hypothesized to increase risks of diverse chronic diseases, including arthritis. Retrospective data from the World Mental Health Surveys (N=18,309) were employed to assess whether adult onset of arthritis was associated with childhood adversities and early onset psychological disorder. Cox proportional hazard models assessed the association of number of childhood adversities and the presence of early onset psychological disorder with arthritis age of onset. Controlling for age, sex and early onset mental disorder, relative to persons with no childhood adversities, persons with two adversities had increased risk of adult onset arthritis (Hazard ratio=1.27, 95% CI= 1.08, 1.50), while persons with three or more adversities had higher risk (HR=1.44, CI=1.24,1.67). Early onset depressive and/or anxiety disorder was associated with increased risk of adult-onset arthritis after controlling for childhood adversities (HR=1.43, CI=1.28, 1.61). Since psychosocial stressors may be broad spectrum risk factors that increase risks of diverse chronic conditions in later life (e.g., arthritis, heart disease, diabetes, asthma, chronic pain), prospective studies of childhood psychosocial stressors may be most productive if multiple disease outcomes are assessed in the same study. Results from this study provide methodological guidance for future prospective studies of the relationship between childhood psychosocial stressors and subsequent risk of adult onset arthritis. PERSPECTIVE Retrospective reports of early onset mood-anxiety disorder and multiple childhood adversities were independently associated with increased risk of adult onset arthritis. Carrying out prospective studies of these relationships entails significant challenges. Since childhood psychosocial stressors may be broad spectrum risk factors for diverse chronic conditions, multiple disease outcomes should be assessed in prospective studies assessing health consequences

  13. Antenatal psychosocial risk factors associated with adverse postpartum family outcomes.

    PubMed Central

    Wilson, L M; Reid, A J; Midmer, D K; Biringer, A; Carroll, J C; Stewart, D E

    1996-01-01

    OBJECTIVE: To determine the strength of the association between antenatal psychosocial risk factors and adverse postpartum outcomes in the family, such as assault of women by their partner, child abuse, postpartum depression, marital dysfunction and physical illness. DATA SOURCES: MEDLINE, Cinahl, Famli, Psych Abstracts and the Oxford Database of Perinatal Trials were searched from relevant articles published from Jan. 1, 1980, to Dec. 31, 1993, with the use of MeSH terms "depression, involutional," "child abuse," "child neglect," "domestic violence," "family," "marital adjustment," "family health," "newborn health," "child health," "physical illness," "social support," "psychosocial risk," "prediction," "risk factors," "obstetrics" and "prenatal care." Further articles were identified from bibliographies. STUDY SELECTION: Of the 370 articles identified through the search, 118 were included for review. Studies were included if they examined the association between psychosocial risk factors and the outcomes of interest. Articles were excluded if they were reviews of poor quality or they had one or more of the following features: insufficient description of the sample, a high attrition rate, a lack of standardized outcome measures, outcomes other than the ones of interest or results that had already been reported in a previous study. DATA EXTRACTION: The strength of evidence of each study was evaluated. On the basis of the evidence, each risk factor was assigned a rating of the strength of its association with each of the postpartum outcomes. The ratings were class A (good evidence of association), class B (fair evidence) and class C (no clear evidence). Of the 129 antenatal psychosocial risk factors studied, 15 were found to have a class A association with at least one of the postpartum outcomes. DATA SYNTHESIS: Child abuse and abuse of the mother by her partner were most strongly correlated (class A evidence) with a history of lack of social support, recent life

  14. Long-term seizure and psychosocial outcomes of vagus nerve stimulation for intractable epilepsy.

    PubMed

    Wasade, Vibhangini S; Schultz, Lonni; Mohanarangan, Karthik; Gaddam, Aryamaan; Schwalb, Jason M; Spanaki-Varelas, Marianna

    2015-12-01

    Vagus nerve stimulation (VNS) is a widely used adjunctive treatment option for intractable epilepsy. Most studies have demonstrated short-term seizure outcomes, usually for up to 5 years, and thus far, none have reported psychosocial outcomes in adults. We aimed to assess long-term seizure and psychosocial outcomes in patients with intractable epilepsy on VNS therapy for more than 15 years. We identified patients who had VNS implantation for treatment of intractable epilepsy from 1997 to 2013 at our Comprehensive Epilepsy Program and gathered demographics including age at epilepsy onset and VNS implantation, epilepsy type, number of antiepilepsy drugs (AEDs) and seizure frequency before VNS implantation and at the last clinic visit, and the most recent stimulation parameters from electronic medical records (EMR). Phone surveys were conducted by research assistants from May to November 2014 to determine patients' current seizure frequency and psychosocial metrics, including driving, employment status, and use of antidepressants. Seizure outcomes were based on modified Engel classification (I: seizure-free/rare simple partial seizures; II: >90% seizure reduction (SR), III: 50-90% SR, IV: <50% SR; classes I to III (>50% SR)=favorable outcome). A total of 207 patients underwent VNS implantation, 15 of whom were deceased at the time of the phone survey, and 40 had incomplete data for medical abstraction. Of the remaining 152, 90 (59%) were contacted and completed the survey. Of these, 51% were male, with the mean age at epilepsy onset of 9.4 years (range: birth to 60 years). There were 35 (39%) patients with extratemporal epilepsy, 19 (21%) with temporal, 18 (20%) with symptomatic generalized, 5 (6%) with idiopathic generalized, and 13 (14%) with multiple types. Final VNS settings showed 16 (18%) patients with an output current >2 mA and 14 (16%) with rapid cycling. Of the 80 patients with seizure frequency information, 16 (20%) had a modified Engel class I outcome, 14

  15. Long-term seizure and psychosocial outcomes of vagus nerve stimulation for intractable epilepsy.

    PubMed

    Wasade, Vibhangini S; Schultz, Lonni; Mohanarangan, Karthik; Gaddam, Aryamaan; Schwalb, Jason M; Spanaki-Varelas, Marianna

    2015-12-01

    Vagus nerve stimulation (VNS) is a widely used adjunctive treatment option for intractable epilepsy. Most studies have demonstrated short-term seizure outcomes, usually for up to 5 years, and thus far, none have reported psychosocial outcomes in adults. We aimed to assess long-term seizure and psychosocial outcomes in patients with intractable epilepsy on VNS therapy for more than 15 years. We identified patients who had VNS implantation for treatment of intractable epilepsy from 1997 to 2013 at our Comprehensive Epilepsy Program and gathered demographics including age at epilepsy onset and VNS implantation, epilepsy type, number of antiepilepsy drugs (AEDs) and seizure frequency before VNS implantation and at the last clinic visit, and the most recent stimulation parameters from electronic medical records (EMR). Phone surveys were conducted by research assistants from May to November 2014 to determine patients' current seizure frequency and psychosocial metrics, including driving, employment status, and use of antidepressants. Seizure outcomes were based on modified Engel classification (I: seizure-free/rare simple partial seizures; II: >90% seizure reduction (SR), III: 50-90% SR, IV: <50% SR; classes I to III (>50% SR)=favorable outcome). A total of 207 patients underwent VNS implantation, 15 of whom were deceased at the time of the phone survey, and 40 had incomplete data for medical abstraction. Of the remaining 152, 90 (59%) were contacted and completed the survey. Of these, 51% were male, with the mean age at epilepsy onset of 9.4 years (range: birth to 60 years). There were 35 (39%) patients with extratemporal epilepsy, 19 (21%) with temporal, 18 (20%) with symptomatic generalized, 5 (6%) with idiopathic generalized, and 13 (14%) with multiple types. Final VNS settings showed 16 (18%) patients with an output current >2 mA and 14 (16%) with rapid cycling. Of the 80 patients with seizure frequency information, 16 (20%) had a modified Engel class I outcome, 14

  16. Online support for employed informal caregivers: psychosocial outcomes.

    PubMed

    Klemm, Paula R; Hayes, Evelyn R; Diefenbeck, Cynthia A; Milcarek, Barry

    2014-01-01

    The overall objectives of this project were to evaluate whether psychosocial outcomes in employed family caregivers of people with chronic disease, who participate in online support, differ from nonactive participants and whether psychosocial outcomes differ based on the format of online group support. A randomized longitudinal design comparing two types of online support groups and nonactive participants, on the basis of three principal measures, was utilized. Eighty-six self-reported family caregivers of people with chronic disease, who spoke English and had Internet access, took part in the study. Subjects were randomly assigned to professionally facilitated/psychoeducational or moderated/peer-directed online support groups for a period of 12 weeks. The setting was a password-protected Web page housed on a university server. Independent variables were type of online support groups and level of participation; the dependent variables were depressive symptoms, caregiver burden, and caregiver quality of life. There were significant differences in depressive symptoms and quality of life among nonactive participants and either of the two intervention groups, but not between the two intervention groups. Results suggest that professionally facilitated/psychoeducational and moderated/peer-directed online support groups help reduce depressive symptoms and improve quality of life for those who actively participate and that both types of online support groups provided similar benefits. Men and minorities should be targeted in future caregiver research.

  17. Online support for employed informal caregivers: psychosocial outcomes.

    PubMed

    Klemm, Paula R; Hayes, Evelyn R; Diefenbeck, Cynthia A; Milcarek, Barry

    2014-01-01

    The overall objectives of this project were to evaluate whether psychosocial outcomes in employed family caregivers of people with chronic disease, who participate in online support, differ from nonactive participants and whether psychosocial outcomes differ based on the format of online group support. A randomized longitudinal design comparing two types of online support groups and nonactive participants, on the basis of three principal measures, was utilized. Eighty-six self-reported family caregivers of people with chronic disease, who spoke English and had Internet access, took part in the study. Subjects were randomly assigned to professionally facilitated/psychoeducational or moderated/peer-directed online support groups for a period of 12 weeks. The setting was a password-protected Web page housed on a university server. Independent variables were type of online support groups and level of participation; the dependent variables were depressive symptoms, caregiver burden, and caregiver quality of life. There were significant differences in depressive symptoms and quality of life among nonactive participants and either of the two intervention groups, but not between the two intervention groups. Results suggest that professionally facilitated/psychoeducational and moderated/peer-directed online support groups help reduce depressive symptoms and improve quality of life for those who actively participate and that both types of online support groups provided similar benefits. Men and minorities should be targeted in future caregiver research. PMID:24284908

  18. The psychosocial effects of adult strabismus: a review.

    PubMed

    Durnian, Jonathan M; Noonan, Carmel P; Marsh, Ian B

    2011-04-01

    Correction of adult strabismus is not a cosmetic procedure but one that restores normality to an individual's appearance that has been altered by a disease process. Two fundamental principles underpinning facial attractiveness are symmetry and averageness-manifest strabismus affects both of these giving an unconscious signal of poor genetic history. The presence of manifest strabismus adversely affects many aspects of patients' lives including finding a partner, job prospects and interaction with peers, and may manifest more seriously as psychiatric disorders. Surgical correction has been shown to be safe and effective for the functional problems of strabismus in adults but the hugely positive effects on the psychosocial aspects are only now becoming apparent. The advent of a new adult strabismus specific quality-of-life questionnaire and its subsequent validation will make this quantification of improvement easier. The wider medical community and the public at large should be made aware of the benefits of corrective strabismus surgery in adults. PMID:20852320

  19. Chronic psychosocial stressors and salivary biomarkers in emerging adults

    PubMed Central

    Bergen, Andrew W.; Mallick, Aditi; Nishita, Denise; Wei, Xin; Michel, Martha; Wacholder, Aaron; David, Sean P.; Swan, Gary E.; Reid, Mark W.; Simons, Anne; Andrews, Judy A.

    2013-01-01

    Summary We investigated whole saliva as a source of biomarkers to distinguish individuals who have, and who have not, been chronically exposed to severe and threatening life difficulties. We evaluated RNA and DNA metrics, expression of 37 candidate genes, and cortisol release in response to the Trier Social Stress Test, as well as clinical characteristics, from 48 individuals stratified on chronic exposure to psychosocial stressors within the last year as measured by the Life Events and Difficulties Schedule. Candidate genes were selected based on their differential gene expression ratio in circulating monocytes from a published genome-wide analysis of adults experiencing different levels of exposure to a chronic stressor. In univariate analyses, we observed significantly decreased RNA integrity (RIN) score (P = 0.04), and reduced expression of glucocorticoid receptor-regulated genes (Ps < 0.05) in whole saliva RNA from individuals exposed to chronic stressors, as compared to those with no exposure. In those exposed, we observed significantly decreased BMI (P < 0.001), increased ever-smoking and increased lifetime alcohol abuse or dependence (P ≤ 0.03), and a reduction of cortisol release. In post hoc multivariate analyses including clinical and biospecimen-derived variables, we consistently observed significantly decreased expression of IL8 (Ps < 0.05) in individuals exposed, with no significant association to RIN score. Alcohol use disorders, tobacco use, a reduced acute stress response and decreased salivary IL8 gene expression characterize emerging adults chronically exposed to severe and threatening psychosocial stressors. PMID:22172638

  20. [Attention deficit hyperactivity disorder outcome in adults].

    PubMed

    Bange, F

    2011-07-01

    Attention deficit hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood. Although some symptoms of ADHD may diminish this does not mean that functioning is unimpaired in adults. Follow-up studies of children with ADHD show that it persists into adulthood in the majority of cases. Due to genetic factors high rates of ADHD exist among the parents of children with ADHD. More females are identified and become diagnosed in adulthood. There is a greater persistence of inattentive than of hyperactive/impulsive childhood symptoms of ADHD in adulthood. Some experts conceptualise ADHD as primarily a deficit of executive functions impairing planification, time perception and emotional regulation. ADHD often presents as a lifelong condition in adults associated with a range of clinical and psychosocial impairments. Young adults with comorbid antisocial or substance use disorder in adolescence are at significantly increased risk for criminal behaviors. Some predictors of the outcome have been identified such as childhood symptom profile and severity, comorbidity and childhood family adversities.

  1. Psychosocial problem assessment and end-stage renal disease patient outcomes.

    PubMed

    Vourlekis, B S; Rivera-Mizzoni, R A

    1997-04-01

    The diagnostic process of psychosocial problem assessment enhances the end-stage renal disease (ESRD) treatment team's ability to identify or rule out in a timely and consistent way problematic circumstances that may contribute to poorer patient outcomes, both psychosocial and medical. Psychosocial diagnostic reasoning is informed by empirical and clinical knowledge concerning the characteristic impact of psychosocial factors in illness generally and ESRD specifically. The focus and process of problem assessment is explained and illustrated with four signal medical conditions-anemia, low albumin level, inadequate dialysis, and high blood pressure-that are negative indicators for chronic dialysis (CD) patient medical outcomes. Use of a norm-referenced assessment tool and a standardized psychosocial problem list aids clinicians both in systematic identification of priority concerns and in documenting circumstances and changes for outcomes monitoring.

  2. Recidivism, Costs, and Psychosocial Outcomes for a Post-Arrest Juvenile Diversion Program

    ERIC Educational Resources Information Center

    Hodges, Kay; Martin, Lisa A.; Smith, Cynthia; Cooper, Shaun

    2011-01-01

    Recidivism, costs, and psychosocial outcomes are reported for a post-arrest diversion program in Wayne County (Detroit), MI. Program features included: rapid, standardized assessment of psychosocial functioning with the Juvenile Inventory For Functioning[R], an individualized plan for addressing needs, engagement of caregivers, service provision…

  3. Psychosocial interventions for adolescents and young adult cancer patients: A systematic review and meta-analysis.

    PubMed

    Richter, Diana; Koehler, Michael; Friedrich, Michael; Hilgendorf, Inken; Mehnert, Anja; Weißflog, Gregor

    2015-09-01

    Adolescent and young adult (AYA) cancer patients experience unique psychosocial needs and developmental challenges. A cancer diagnosis can stress this development and disrupt AYAs in their normal life. The aim of this systematic review and meta-analysis was to assess the impact of psychosocial interventions on mental health in AYAs. A literature research was conducted, which resulted in twelve eligible studies. The standardized mean difference between intervention and control conditions was 0.13 (95% CI: -0.16 to 0.42) for quality of life, 0.27 (95% CI: -0.22 to 0.76) for cancer-related knowledge and -0.16 (95% CI: -0.73 to 0.42) on psychological distress indicating, small and non-significant effects for interventions improving mental health. This work strengthens the need for age-appropriated interventions in psycho-oncology. Future research should develop interventions more graduated by age. Randomized intervention studies with larger samples and focusing psychosocial outcomes are needed to establish evidence-based psycho-oncological interventions for AYAs.

  4. Adult phenylketonuria outcome and management.

    PubMed

    Trefz, F; Maillot, F; Motzfeldt, K; Schwarz, M

    2011-01-01

    The problem to evaluate treatment outcome in adult PKU (phenylketonuric) patients lies in the heterogeneity of the adult PKU population. This heterogeneity is not only based on the different treatment history of every individual patient but also on the different severity of the underlying defect of the enzyme phenylalanine hydroxylase. Recent, partly double blind studies in adult PKU patients further support recommendation for lifelong treatment. However, it has become evident that dietary treatment is suboptimal and continuation to adulthood often not accepted. Late detected PKU patients (up to 4-6 years of age) benefit from strict dietary treatment and are able to catch up in intellectual performance. Untreated, severely retarded patients with behavioral changes may benefit from introduction of dietary treatment. However, individual decision is necessary and based on the personal situation of the patient. In early and well treated patients a number of studies have demonstrated that cognitive and neurosychologic tests are different from controls. In addition there is evidence that patients with higher blood phenylalanine (phe) levels demonstrate more often psychiatric symptoms like depression and anxiety. Medical problems are more often observed: there are certain risks as impaired growth, decreased bone mineral density and nutrional deficits probably caused by dietary treatment with an artificial protein substitute and/or missing compliance with an unpleasant diet. The long term risk of a strict dietary treatment must be balanced with the risk of higher blood phe (mean blood phenylalanine >600-900 μmol/L) on cognitive and neuropsychological functions and psychiatric symptoms. Further studies should consider the role of blood phe exposure for brain development in childhood and for brain function in all ages. Besides mean blood phe, fluctuation of blood phe over time is important. Fluctuation of blood phe is decreased by sapropterin treatment in responsive

  5. Influence of psychosocial factors and biopsychosocial interventions on outcomes after myocardial infarction.

    PubMed

    Buselli, E F; Stuart, E M

    1999-04-01

    Management of the myocardial infarction patient may extend beyond the physiologic to include psychosocial factors that may adversely affect cardiac health. Psychosocial factors such as depression, coronary-prone behavior, hostility, social isolation, anxiety, anger, and stress are related to increased cardiac death and illness. Various interventions including cognitive-behavioral therapies, techniques that elicit the relaxation response, meditation, exercise, and increasing social networks, may play a role in improving health outcomes. This article explores the relationship of these psychosocial factors to cardiac health and proposes a biopsychosocial model of care.

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  7. Achievement for All: Improving Psychosocial Outcomes for Students with Special Educational Needs and Disabilities

    ERIC Educational Resources Information Center

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

    2013-01-01

    Students with special educational needs and disabilities (SEND) are at a greatly increased risk of experiencing poor psychosocial outcomes. Developing effective interventions that address the cause of these outcomes has therefore become a major policy priority in recent years. We report on a national evaluation of the Achievement for All (AfA)…

  8. Psychosocial outcomes following spinal cord injury in Iran.

    PubMed

    Khazaeipour, Zahra; Norouzi-Javidan, Abbas; Kaveh, Mahboobeh; Khanzadeh Mehrabani, Fatemeh; Kazazi, Elham; Emami-Razavi, Seyed-Hasan

    2014-05-01

    Objective/background In patients with spinal cord injury (SCI), SCI causes psychosocial complications that vary based on culture, conditions, and the amenities of each community. Health planners and social services should have full knowledge of these issues in order to plan schedules that address them. In this study, we aimed to understand the psychosocial problems of persons with SCI in Iran and to explore the requirements for minimizing these difficulties. Design This was a descriptive cross-sectional study. Setting Brain and Spinal Cord Injury Research (BASIR) Center, Tehran University of Medical Sciences, Tehran, Iran. Participants One hundred nineteen persons with SCI referred to BASIR clinic to receive outpatient rehabilitation. Methods In this study, trained interviewers administered a questionnaire to the participants. The questionnaire consisted of socio-demographic variables and psychosocial questions about finances, employment, housing, education, and social communication problems. Results Psychosocial problems for persons with SCI are mainly associated with financial hardship due to unemployment and the high cost of living, followed by difficulties with transportation, house modification, education, marriage, social communication, sports, and entertainment. Psychological problems include sadness, depression, irritability/anger, suicidal thoughts, and a lack of self-confidence. The levels of the aforementioned problems differ with respect to sex. Conclusion Persons suffering from SCI can face some serious psychosocial problems that may vary according to sex. For example, transportation difficulties can lead to problems such as unsociability. After recognizing these problems, the next step would be providing services to facilitate a productive lifestyle, enhancing social communication and psychological health, and ultimately creating a higher quality of life.

  9. Psychosocial Correlates of Sunburn among Young Adult Women

    PubMed Central

    Heckman, Carolyn J.; Darlow,  Susan; Cohen-Filipic,  Jessye; Kloss,  Jacqueline D.; Munshi,  Teja; Perlis,  Clifford S.

    2012-01-01

    Skin cancer is an increasingly common disease, particularly among young adult women. Sunburn early in life is a risk factor for skin cancer. Few studies have reported on psychosocial correlates of sunburn. The current study consisted of an online survey of undergraduate women from a university in the northeastern part of the USA. A logistic regression demonstrated that young women who reported a history of four or more sunburns were significantly more likely to report fair skin, higher perceived susceptibility to skin cancer, greater perceived benefits of tanning (e.g., appearance enhancement), lower perceived control over skin protection, and more frequent sunscreen use. Sunbathing was not associated with a greater number of sunburns. These results suggest that young women who sunburn more often possess other skin cancer risk factors, are aware of their susceptibility to skin cancer, and try to use sunscreen, but feel limited control over their skin protection behavior and are not less likely to sunbathe than others. Therefore, interventions are needed to assist high risk young women in asserting more control over their sun protection behavior and perhaps improve the effectiveness of the sunscreen or other skin protection methods they do employ. PMID:22829801

  10. Psychosocial correlates of sunburn among young adult women.

    PubMed

    Heckman, Carolyn J; Darlow, Susan; Cohen-Filipic, Jessye; Kloss, Jacqueline D; Manne, Sharon L; Munshi, Teja; Perlis, Clifford S

    2012-06-01

    Skin cancer is an increasingly common disease, particularly among young adult women. Sunburn early in life is a risk factor for skin cancer. Few studies have reported on psychosocial correlates of sunburn. The current study consisted of an online survey of undergraduate women from a university in the northeastern part of the USA. A logistic regression demonstrated that young women who reported a history of four or more sunburns were significantly more likely to report fair skin, higher perceived susceptibility to skin cancer, greater perceived benefits of tanning (e.g., appearance enhancement), lower perceived control over skin protection, and more frequent sunscreen use. Sunbathing was not associated with a greater number of sunburns. These results suggest that young women who sunburn more often possess other skin cancer risk factors, are aware of their susceptibility to skin cancer, and try to use sunscreen, but feel limited control over their skin protection behavior and are not less likely to sunbathe than others. Therefore, interventions are needed to assist high risk young women in asserting more control over their sun protection behavior and perhaps improve the effectiveness of the sunscreen or other skin protection methods they do employ.

  11. Effects of psychosocial and situational variables on substance abuse among homeless adults.

    PubMed

    Stein, Judith A; Dixon, Elizabeth L; Nyamathi, Adeline M

    2008-09-01

    Finding direct and indirect influences of salient psychosocial and situational variables on problem substance use among homeless people is important in designing evidence-based, effective, and relevant interventions for this special population. A stress-coping paradigm in conjunction with situational items specialized for homeless people was used to explore predictive relationships in a sample of homeless adults (N = 664) among (a) psychosocial variables of self-esteem, social support, positive and negative coping, and emotional distress, (b) situational variables of homelessness history and quality of recent housing, and (c) outcomes of alcohol use, injection drug use (IDU), and non-IDU. Lower self-esteem predicted greater emotional distress, lower positive coping, greater negative coping, and more alcohol use. Social support predicted less emotional distress and more positive coping. Chronic homelessness predicted more emotional distress, less positive coping, greater alcohol use, and IDU. Poor housing was associated with more alcohol use and IDU. Substance abuse interventions among the homeless should have a dual focus that includes attention to psychological issues and negative coping patterns while also addressing situational, environmental factors, including encouraging provision of permanent supportive housing.

  12. Adult Outcome of Children Reared for Long-Term Periods in Foster Families.

    ERIC Educational Resources Information Center

    Dumaret, Annick-Camille; Coppel-Batsch, Marthe; Couraud, Simone

    1997-01-01

    Assessment of adult outcomes of 59 children from severely psychosocially dysfunctional families, who were placed in foster families for at least five years, found most had overcome their childhood adversities with 56% well-integrated socially and only 10% in situations of failure. Difficulties were linked to multiple family disturbances, traumatic…

  13. Psychosocial correlates of sun protection behaviors among U.S. Hispanic adults.

    PubMed

    Coups, Elliot J; Stapleton, Jerod L; Manne, Sharon L; Hudson, Shawna V; Medina-Forrester, Amanda; Rosenberg, Stephen A; Gordon, Marsha; Tatum, Kristina S; Robinson, June K; Natale-Pereira, Ana; Goydos, James S

    2014-12-01

    The incidence of skin cancer among U.S. Hispanics increased 1.3% annually from 1992 to 2008. However, little research has focused on skin cancer prevention among the rapidly growing Hispanic population. In this study, we examined theory-driven, psychosocial correlates of sun protection behaviors in a population-based sample of 787 Hispanic adults (49.6% female, mean age = 41.0 years) residing in five southern or western U.S. states. Participants completed an English- or Spanish-language online survey in September 2011. The outcomes of focus were sunscreen use, shade seeking, and use of sun protective clothing. The correlates included suntan benefits, sun protection benefits and barriers, skin color preference, perceived natural skin protection, photo-aging concerns, perceived skin cancer risk, skin cancer worry, skin cancer fatalism, and sun protection descriptive norms. Results of multiple linear regression analyses revealed the following: sun protection barriers were negatively associated with each outcome; descriptive norms were positively associated with each outcome; perceived natural skin protection was inversely associated with sunscreen use; skin cancer worry was positively associated with shade seeking and use of sun protective clothing; skin cancer fatalism was negatively associated with shade seeking; and skin color preference was negatively associated with use of sun protective clothing. A number of additional statistically significant associations were identified in bivariate correlation analyses. This study informs the potential content of interventions to promote engagement in sun protection behaviors among U.S. Hispanics.

  14. Sequelae of Cesarean and Vaginal Deliveries: Psychosocial Outcomes for Mothers and Infants.

    ERIC Educational Resources Information Center

    Durik, Amanda M.; Hyde, Janet Shibley; Clark, Roseanne

    2000-01-01

    Compared psychosocial outcomes for mothers and their infants who had been delivered vaginally or by planned or unplanned cesarean deliveries. Found that women low in neuroticism who delivered by unplanned cesarean showed less positive affect toward infants at 4 months than did women in other groups. Found some evidence that maternal appraisal of…

  15. Goal Attainment Scaling as an Outcome Measure in Randomized Controlled Trials of Psychosocial Interventions in Autism

    ERIC Educational Resources Information Center

    Ruble, Lisa; McGrew, John H.; Toland, Michael D.

    2012-01-01

    Goal attainment scaling (GAS) holds promise as an idiographic approach for measuring outcomes of psychosocial interventions in community settings. GAS has been criticized for untested assumptions of scaling level (i.e., interval or ordinal), inter-individual equivalence and comparability, and reliability of coding across different behavioral…

  16. Community Violence, School-Related Protective Factors, and Psychosocial Outcomes in Urban Youth

    ERIC Educational Resources Information Center

    Ludwig, Kristy A.; Warren, Jared S.

    2009-01-01

    This study examined the relationship of two putative school-based protective factors--student identification with school and perceived teacher support--to psychosocial outcomes in a sample of urban youth exposed to community violence. Participants were 175 high school students ages 14-19 in grades 9-12 from a large urban school district. Results…

  17. An integrated randomized intervention to reduce behavioral and psychosocial risks: pregnancy and neonatal outcomes.

    PubMed

    Subramanian, Siva; Katz, Kathy S; Rodan, Margaret; Gantz, Marie G; El-Khorazaty, Nabil M; Johnson, Allan; Joseph, Jill

    2012-04-01

    While biomedical risks contribute to poor pregnancy and neonatal outcomes in African American (AA) populations, behavioral and psychosocial risks (BPSR) may also play a part. Among low income AA women with psychosocial risks, this report addresses the impacts on pregnancy and neonatal outcomes of an integrated education and counseling intervention to reduce BPSR, as well as the contributions of other psychosocial and biomedical risks. Subjects were low income AA women ≥18 years living in the Washington, DC, metropolitan area and seeking prenatal care. Subjects (n = 1,044) were screened for active smoking, environmental tobacco smoke exposure (ETSE), depression, or intimate partner violence (IPV) and then randomized to intervention (IG) or usual care (UCG) groups. Data were collected prenatally, at delivery, and postpartum by maternal report and medical record abstraction. Multiple imputation methodology was used to estimate missing variables. Rates of pregnancy outcomes (miscarriage, live birth, perinatal death), preterm labor, Caesarean section, sexually transmitted infection (STI) during pregnancy, preterm birth (<37 weeks), low birth weight (<2,500 g), very low birth weight (<1,500 g), small for gestational age, neonatal intensive care unit (NICU) admission, and >2 days of hospitalization were compared between IG and UCG. Logistic regression models were created to predict outcomes based on biomedical risk factors and the four psychosocial risks (smoking, ETSE, depression, and IPV) targeted by the intervention. Rates of adverse pregnancy and neonatal outcomes were high and did not differ significantly between IG and UCG. In adjusted analysis, STI during the current pregnancy was associated with IPV (OR = 1.41, 95% CI 1.04-1.91). Outcomes such as preterm labor, caesarian section in pregnancy and preterm birth, low birth weight, small for gestational age, NICU admissions and >2 day hospitalization of the infants were associated with biomedical risk

  18. Depression and Psychosocial Risk Factors among Community-Dwelling Older Adults in Singapore.

    PubMed

    Li, Jinhui; Theng, Yin-Leng; Foo, Schubert

    2015-12-01

    Depression is the most common mental and emotional disorder that emerges in the late stages of life. It is closely associated with poor health, disability, mortality, and suicide. The study examines the risk factors of depression in late life, especially the psychosocial factors, among a sample comprising 162 community-dwelling Singaporean adults aged 65 years and above. An interview-based structured survey was conducted in multiple senior activity centers located in different parts of Singapore. Results from the hierarchical regression analysis show that 32.9% of the variance in geriatric depression can be explained by the three psychosocial factors, among which loneliness, perceived social support, and the emotional regulation component of resilience are significantly associated with depression in older adults. Large-scale studies should be conducted to confirm the findings of the present study, and to further examine the predictive effects of these psychosocial factors on depression among older adults.

  19. Meeting the Psychosocial Needs of Adolescents and Adults with LD.

    ERIC Educational Resources Information Center

    Ness, Jean; Price, Lynda A.

    1990-01-01

    This article examines psychosocial needs of learning-disabled individuals making transitions from secondary to postsecondary education and ways in which service providers can address these needs. A transition project at the University of Minnesota is described, and techniques such as individual and group counseling, disability awareness training,…

  20. Psychosocial stress and changes in estimated glomerular filtration rate among adults with diabetes mellitus

    PubMed Central

    Annor, Francis B.; Masyn, Katherine E.; Okosun, Ike S.; Roblin, Douglas W.; Goodman, Michael

    2015-01-01

    Background Psychosocial stress has been hypothesized to impact renal changes, but this hypothesis has not been adequately tested. The aim of this study was to examine the relationship between psychosocial stress and estimated glomerular filtration rate (eGFR) and to examine other predictors of eGFR changes among persons with diabetes mellitus (DM). Methods Data from a survey conducted in 2005 by a major health maintenance organization located in the southeastern part of the United States, linked to patients’ clinical and pharmacy records (n=575) from 2005 to 2008, was used. Study participants were working adults aged 25–59 years, diagnosed with DM but without advanced microvascular or macrovascular complications. eGFR was estimated using the Modification of Diet in Renal Disease equation. A latent psychosocial stress variable was created from five psychosocial stress subscales. Using a growth factor model in a structural equation framework, we estimated the association between psychosocial stress and eGFR while controlling for important covariates. Results The psychosocial stress variable was not directly associated with eGFR in the final model. Factors found to be associated with changes in eGFR were age, race, insulin use, and mean arterial pressure. Conclusion Among fairly healthy DM patients, we did not find any evidence of a direct association between psychosocial stress and eGFR changes after controlling for important covariates. Predictors of eGFR change in our population included age, race, insulin use, and mean arterial pressure. PMID:26484039

  1. Examining Type A behavior pattern to explain the relationship between job stressors and psychosocial outcomes.

    PubMed

    Day, Arla L; Jreige, Steve

    2002-04-01

    Despite cautions against using a global measure of Type A behavior pattern (TABP), few studies have examined the TABP components of Achievement Striving (AS) and Impatience/Irritability (II). The authors examined these 2 components to assess whether they moderated the relationships between job stressors and psychosocial outcomes. Results based on 106 employees from a large Canadian organization supported the independence of the 2 TABP components. After controlling for the job stressors (i.e., overload, ambiguity, intrarole conflict, and lack of job control), II and AS accounted for additional variance in job satisfaction, perceived stress, and life satisfaction, although these components were uniquely related to different outcomes. Finally, AS and II moderated several of the stressor-psychosocial outcome relationships. PMID:12003364

  2. Investigating the psychosocial determinants of physical activity in older adults: A qualitative approach

    PubMed Central

    Kosteli, Maria-Christina; Williams, Sarah E.; Cumming, Jennifer

    2016-01-01

    Objective: Despite the benefits of physical activity (PA), only one-third of older adults meet the recommended levels. The present study focused on psychosocial determinants of PA following retirement. Social cognitive theory (SCT) was used to better understand pre- and post-retirement adults’ thoughts about PA, the reasons why some individuals are more active than others, and how PA is incorporated into daily life after retirement. Design: Seven focus groups of older adults (N = 37, M = 64, SD = 5.20; males = 20) representing a range of PA levels and retirement length participated in one of seven focus groups. Results: Aligned with SCT, self-efficacy beliefs along with perceptions about barriers and benefits of PA were among the major determinants of PA. Findings highlighted the importance of social support, positive outcome expectations and self-regulatory strategies as motivators. The lack of structure in retirement was a hindrance to incorporating PA into daily routine but, when incorporated, PA provided a sense of purpose in the lives of retired individuals. Conclusion: It is important to understand the meaning of retirement as a life transition and how it affects beliefs about PA to inform SCT-based health promotion interventions targeting individuals in retirement age. PMID:26964473

  3. Psychosocial outcomes in patients with recurrent major depressive disorder during 2 years of maintenance treatment with venlafaxine extended release

    PubMed Central

    Trivedi, Madhukar H.; Dunner, David L.; Kornstein, Susan G.; Thase, Michael E.; Zajecka, John M.; Rothschild, Anthony J.; Friedman, Edward S.; Shelton, Richard C.; Keller, Martin B.; Kocsis, James H.; Gelenberg, Alan

    2013-01-01

    Background Psychosocial outcomes from the Prevention of Recurrent Episodes of Depression with Venlafaxine ER for Two Years (PREVENT) study were evaluated. Methods Adult outpatients with recurrent major depressive disorder (MDD) and response or remission following 6-month continuation treatment with venlafaxine extended release (ER) were randomized to receive venlafaxine ER or placebo for 1 year. Patients without recurrence on venlafaxine ER during year 1 were randomized to venlafaxine ER or placebo for year 2. Psychosocial functioning was assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire—Short Form (Q-LES-Q), Life EnjoymentScale—Short Version (LES-S), Social Adjustment Scale—Self-Report (SAS-SR) total and individual factors, Short Form Health Survey (SF-36) (vitality, social functioning, and role function-emotional items), and Longitudinal Interval Follow-up Evaluation (LIFE). Results At year 1 end, better overall psychosocial functioning was seen among patients randomly assigned to venlafaxine ER (n=129) vs placebo (n=129), with significant differences at end point on SF-36 role function-emotional, Q-LES-Q, and SAS-SR total, and work, house work, social/leisure, and extended-family factor scores (p≤0.05). At year 2 end, significant differences favored venlafaxine ER (n=43) vs placebo (n=40)on SF-36 vitality and rolefunction-emotional, Q-LES-Q, LES-S, LIFE, and SAS-SR total, social/leisure, and extended-family factor scores (p≤0.05). Limitations Patients with chronic MDD or treatment resistance were excluded and long-term specialist care was a financial incentive for treatment compliance. Discontinuation-related adverse events may have compromised the integrity of the treatment blind. Conclusions For patients with recurrent MDD, 2 years’ maintenance therapy with venlafaxine ER may improve psychosocial functioning vs placebo. PMID:20510459

  4. Attention-Deficit/Hyperactivity Disorder Symptom Profiles in Medication-Treated Adults Entering a Psychosocial Treatment Program

    PubMed Central

    Knouse, Laura E.; Sprich, Susan; Cooper-Vince, Christine; Safren, Steven A.

    2015-01-01

    , and uniquely related to clinician ratings of both illness severity and functioning. Conclusions In this sample, disorganization and distractibility were the most frequent and clinically significant residual symptoms; therefore, these should be important targets in psychosocial treatments for this population. Scoring symptom rating scales in medication-treated adults with ADHD using Hyperactivity. Restlessness, Impulsivity/Poor Prospective Memory, and Inattention factors may be more informative with respect to evaluating psychosocial treatment outcome than overall scale scores alone. PMID:26478756

  5. Variation in Functioning, Psychosocial Characteristics, and Six-Month Outcomes among Suicidal Youth in Comprehensive Community Mental Health Services

    ERIC Educational Resources Information Center

    Mandell, David S.; Walrath, Christine M.; Goldston, David B.

    2006-01-01

    In this study we compared the psychosocial (n = 7,896) and clinical (n = 4,664) characteristics and 6-month functional outcomes (n = 2,594) of suicidal and nonsuicidal youth. Repeat and previous attempters were more likely than first-time and never attempters to experience psychosocial problems and to be functionally impaired in a variety of…

  6. Evaluating a theory of stress and adjustment when predicting long-term psychosocial outcome after brain injury.

    PubMed

    Rutterford, Neil A; Wood, Rodger L

    2006-05-01

    Kendall and Terry (1996) include many psychosocial predictors in their theoretical model that explains individual differences in psychosocial adjustment (Lazarus & Folkman, 1984). The model depicts appraisal and coping variables as mediating relationships between situation factors, environmental and personal resources, and multidimensional outcome. The aim of this study was to explore these theoretical relationships at very late stages of recovery from traumatic brain injury. A total of 131 participants who were more than 10 years post-injury (mean = 15.31 years) completed several psychosocial measures relating to outcome dimensions comprising employment, community integration, life satisfaction, quality of life (QoL), and emotion. There was no evidence that appraisal and coping variables mediated relationships between psychosocial and any of the outcome variables. However, when appraisal and coping variables were combined with psychosocial variables as direct predictors of outcome, every outcome except employment status was reliably predicted, accounting for between 31 and 46% of the variance. Personality significantly influenced all predicted outcomes. Self-efficacy contributed to the prediction of all outcomes except QoL. Data did not support for the theory of stress and adjustment as a framework for explaining the nature of predictive relationships between psychosocial variables and very long-term, multidimensional outcome after brain injury.

  7. Racial Differences in Clinical Characteristics, Perceptions and Behaviors, and Psychosocial Impact of Adult Female Acne

    PubMed Central

    Alexis, Andrew F.; Daniels, Selena R.; Kawata, Ariane K.; Burk, Caroline T.; Wilcox, Teresa K.; Taylor, Susan C.

    2014-01-01

    Objective: Limited data are available on racial differences in clinical characteristics and burden in adult female acne. The objective was to describe racial differences in clinical characteristics, psychosocial impact, perceptions, behaviors, and treatment satisfaction in facial adult female acne. Design: Cross-sectional, web-based survey. Setting: Diverse sample of United States women. Participants: Women between the ages of 25 and 45 years with facial acne (≥25 visible lesions). Measurements: Outcomes included sociodemographic characteristics, psychosocial impacts, perceptions, behaviors, and treatment satisfaction. Racial differences were evaluated using descriptive statistics and t-test/chi-square analyses. Results: 208 females participated (mean age 35±6 years); 51.4 percent were White/Caucasian and 48.6 percent were non-White/Caucasian women [Black/African American (n=51); Hispanic/Latina (n=23); Asian (n=16); Other (n=ll)]. Age of acne onset (mean 14.8±5 vs. 17.0±8 years, p<0.05) and acne concern occurred earlier (16.6±7 vs. 19.3±9 years, p<0.05) in White/Caucasian than non-White/Caucasian subjects. Facial acne primarily presented on chin (28.0%) and cheeks (30.8%) for White/Caucasian women versus cheeks (58.4%) for non-White/Caucasian women. Non-White/Caucasian women experienced more postinflammatory hyperpigmentation than White/Caucasian women (p<0.0001). Facial acne negatively affected quality of life (QoL) in both groups, and most participants (>70%) reported some depression/anxiety symptoms. More White/Caucasian than non-White/Caucasian women were troubled by facial acne (88.8% vs. 76.2%, p<0.05). Lesion clearance was most important to White/Caucasian women (57.9 vs. non-White/Caucasian 31.7%, p<0.001); non-White/Caucasian females focused on postinflammatory hyperpigmentation clearance (41.6% vs. Caucasian 8.4%, p<0.0001). Conclusion: Results highlight racial differences in participant-reported clinical characteristics, attitudes, behaviors, and

  8. Early stage cervical cancer: psychosocial and sexual outcomes of treatment.

    PubMed

    Cull, A; Cowie, V J; Farquharson, D I; Livingstone, J R; Smart, G E; Elton, R A

    1993-12-01

    Eighty-three women, mean age 45 years, successfully treated by surgery (S) or radiotherapy (RT) for stage 1b cervical cancer were assessed a mean of 97 weeks post treatment. Forty to 50% reported persistent tiredness, lack of energy and weight gain. Sixty per cent had not resumed their full premorbid functional status. Mean scores for anxiety and depression were higher than general population means and this sample scored higher for psychological distress than published data quoted for disease free cancer patients. These women reported many concerns about cervical cancer, most commonly fear of recurrent disease (91%). More than one-third blamed themselves for the disease. There were no significant differences in functional outcome or psychological status between treatment groups or by age or time since treatment. Psychological distress scores were significantly correlated with physical complaints (P < 0.001) and functional outcomes (P < 0.02). For the 61 women who were sexually active, sexual function post-treatment was rated as significantly poorer than subjectively recalled premorbid sexual function (P < 0.005). RT treated patients were more likely to report pain on intercourse and loss of enjoyment. Psychological as well as physical problems were highly correlated with sexual outcome (P < 0.01) 44% were unable to talk adequately with their partners about their experience. The majority felt they needed more information about cervical cancer, its treatment and how to help themselves rehabilitate. Forty-nine per cent would have liked to have had counselling. Even with the same physical morbidity the functional, emotional and sexual status of these women could be improved by giving more attention to their psychological and sexual concerns. PMID:8260376

  9. Adolescent health and adult labor market outcomes.

    PubMed

    Lundborg, Petter; Nilsson, Anton; Rooth, Dan-Olof

    2014-09-01

    Whereas a large literature has shown the importance of early life health for adult socioeconomic outcomes, there is little evidence on the importance of adolescent health. We contribute to the literature by studying the impact of adolescent health status on adult labor market outcomes using a unique and large-scale dataset covering almost the entire population of Swedish males. We show that most types of major conditions have long-run effects on future outcomes, and that the strongest effects result from mental conditions. Including sibling fixed effects or twin pair fixed effects reduces the magnitudes of the estimates, but they remain substantial.

  10. Life-Course Pathways and the Psychosocial Adjustment of Young Adult Women

    ERIC Educational Resources Information Center

    Amato, Paul R.; Kane, Jennifer B.

    2011-01-01

    We examined 7 life-course pathways from adolescence through the early adult years and their links with general health and psychosocial adjustment among 2,290 women from the National Longitudinal Study of Adolescent Health. Young women who followed a pathway involving college attendance to full-time employment with no family-formation transitions…

  11. Psychosocial Treatments for Major Depression and Dysthymia in Older Adults: A Review of the Research Literature

    ERIC Educational Resources Information Center

    Zalaquett, Carlos P.; Stens, Andrea N.

    2006-01-01

    Older adults represent a growing segment of the population with the highest suicide rate and an increasing need of counseling services for major depression and dysthymia. The present study examined the literature with the purpose of identifying research addressing psychosocial treatments of depression in later life. A summary of treatments…

  12. Further Validation of the Psychosocial Costs of Racism to Whites Scale among Employed Adults

    ERIC Educational Resources Information Center

    Poteat, V. Paul; Spanierman, Lisa B.

    2008-01-01

    To examine the validity and test the generalizability of the Psychosocial Costs of Racism to Whites Scale (PCRW) beyond the original college student sample, a geographically dispersed sample of employed White adults (N = 284) in eight states completed the measure to assess for White empathic reactions toward racism, White guilt, and White fear of…

  13. Gender-Nonconforming Lesbian, Gay, Bisexual, and Transgender Youth: School Victimization and Young Adult Psychosocial Adjustment

    ERIC Educational Resources Information Center

    Toomey, Russell B.; Ryan, Caitlin; Diaz, Rafael M.; Card, Noel A.; Russell, Stephen T.

    2010-01-01

    Past research documents that both adolescent gender nonconformity and the experience of school victimization are associated with high rates of negative psychosocial adjustment. Using data from the Family Acceptance Project's young adult survey, we examined associations among retrospective reports of adolescent gender nonconformity and adolescent…

  14. Acceptance and Commitment Therapy for Adults Who Stutter: Psychosocial Adjustment and Speech Fluency

    ERIC Educational Resources Information Center

    Beilby, Janet M.; Byrnes, Michelle L.; Yaruss, J. Scott

    2012-01-01

    The aim of the present study was to assess the effectiveness of an Acceptance and Commitment Therapy group intervention program for adults who stutter (N = 20). The program consisted of 2-h therapeutic sessions conducted weekly for eight consecutive weeks. It was an integrated program designed to improve: (a) psychosocial functioning, (b)…

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

    PubMed Central

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

    2010-01-01

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

  16. Socioeconomic Outcomes from Adult Education.

    ERIC Educational Resources Information Center

    Gooderham, Paul N.

    1991-01-01

    The degree to which age and gender influence completion of higher secondary education (HSE) and employment status was measured with a sample of 350 Norwegian adults. Application of a Status Attainment model revealed that post-HSE educational attainment is an important determinant of socioeconomic status for both men and women. (SK)

  17. More Than Just the Heart: Transition and Psychosocial Issues in Adult Congenital Heart Disease.

    PubMed

    Kovacs, Adrienne H; Utens, Elisabeth M

    2015-11-01

    Most infants born with congenital heart disease (CHD) are now expected to reach adulthood. However, adults with CHD of moderate or great complexity remain at elevated risk of heart failure, arrhythmias, additional surgeries and interventional procedures, and premature mortality. This creates a need for lifelong specialized cardiac care and leads to 2 sets of potential challenges: (1) the transition from pediatric to adult care and (2) the psychosocial implications of coping with a chronic and often life-shortening medical condition. Many adolescents struggle with the transition to adult care, and mood and anxiety disorders are not uncommon in the adult setting.

  18. Prosocial Behavior: Long-Term Trajectories and Psychosocial Outcomes

    PubMed Central

    Flynn, Elinor; Ehrenreich, Samuel E.; Beron, Kurt J.; Underwood, Marion K.

    2015-01-01

    This study investigated developmental trajectories for prosocial behavior for a sample followed from age 10 – 18 and examined possible adjustment outcomes associated with membership in different trajectory groups. Participants were 136 boys and 148 girls, their teachers, and their parents (19.4% African American, 2.4% Asian, 51.9% Caucasian, 19.5% Hispanic, and 5.8% other). Teachers rated children’s prosocial behavior yearly in grades 4 – 12. At the end of the 12th grade year, teachers, parents, and participants reported externalizing behaviors and participants reported internalizing symptoms, narcissism, and features of borderline personality disorder. Results suggested that prosocial behavior remained stable from middle childhood through late adolescence. Group-based mixture modeling revealed three prosocial trajectory groups: low (18.7%), medium (52.8%), and high (29.6%). Membership in the high prosocial trajectory group predicted lower levels of externalizing behavior as compared to the low prosocial trajectory group, and for girls, lower levels of internalizing symptoms. Membership in the medium prosocial trajectory group also predicted being lower on externalizing behaviors. Membership in the high prosocial trajectory group predicted lower levels of borderline personality features for girls only. PMID:26236108

  19. Psychosocial Outcomes of Sport Concussions in Youth Hockey Players.

    PubMed

    Mrazik, Martin; Brooks, Brian L; Jubinville, Andrea; Meeuwisse, Willem H; Emery, Carolyn A

    2016-06-01

    The objective is to evaluate the psychological outcomes arising from sport concussions. Participants included AA and AAA level Bantam and Midget hockey players (n = 672) between 12 and 17 years of age (mean = 15.0 years; SD = 1.2) enrolled in a large cohort study. All participants completed baseline tests including the Behavior Assessment System for Children, 2nd Edition (BASC2) and a pre-season medical questionnaire (PSQ) completed by parents that included a retrospective report of prior concussions and injuries. Players were assigned to 4 groups: no injury (NONE), concussion (CO) and musculoskeletal (MSK) injuries or both (COMB). Participants in the CO and COMB groups demonstrated significantly higher rates of psychological difficulties compared with other groups [F(63, 1800) = 1.43, p = .016, partial η(2) = 0.05) and on select clinical scales measuring atypicality, locus of control, anxiety, depression, sense of inadequacy, somatization, and attention. In addition, results from the composite clinical scales reached statistical significance for internalizing problems and emotional symptom index. Effect sizes were minimal with the exception of comparisons between the NONE and COMB groups where effect sizes were medium to large. Proportions above clinical cut-off scores set by the BASC2 were higher for the COMB group compared with CO, MSK, or NONE groups. Results suggest smaller percentage of youth may be more prone to psychological sequelae following concussion. PMID:27084731

  20. Associations of frailty and psychosocial factors with autonomy in daily activities: a cross-sectional study in Italian community-dwelling older adults.

    PubMed

    Mulasso, Anna; Roppolo, Mattia; Giannotta, Fabrizia; Rabaglietti, Emanuela

    2016-01-01

    Frailty has been recognized as a risk factor for geriatric adverse events. Little is known of the role of psychosocial factors associated with frailty in explaining negative outcomes of aging. This study was aimed at 1) evaluating the differences in psychosocial factors among robust, prefrail, and frail individuals and 2) investigating whether there was any interaction effect of frailty status with empirically identified clusters of psychosocial factors on autonomy in the activities of daily living (ADLs). Two-hundred and ten older adults (age 73±6 years, 66% women) were involved in this study. Frailty was assessed using an adapted version of the frailty phenotype. The psychosocial factors investigated were depressive symptoms using the 20-item Center for Epidemiologic Studies Depression Scale, social isolation using the Friendship Scale, and loneliness feeling using the eight-item UCLA Loneliness Scale. The autonomy in ADLs was measured with the Groningen Activity Restriction Scale. Thirty-one percent of participants were robust, 55% prefrail, and 14% frail. We performed an analysis of covariance which showed differences between robust, prefrail, and frail individuals for all the psychosocial variables: Center for Epidemiologic Studies Depression Scale, F(2, 205)=18.48, P<0.001; Friendship Scale, F(2, 205)=4.59, P=0.011; UCLA Loneliness Scale, F(2, 205)=5.87, P=0.003, controlling for age and sex. Using the same covariates, the two-way analysis of covariance indicated an interaction effect of frailty with psychosocial factors in determining ADLs, F(4, 199)=3.53, P=0.008. This study demonstrates the close relationship between frailty and psychosocial factors, suggesting the need to take into account simultaneously physical and psychosocial components of human functioning. PMID:26811675

  1. Associations of frailty and psychosocial factors with autonomy in daily activities: a cross-sectional study in Italian community-dwelling older adults

    PubMed Central

    Mulasso, Anna; Roppolo, Mattia; Giannotta, Fabrizia; Rabaglietti, Emanuela

    2016-01-01

    Frailty has been recognized as a risk factor for geriatric adverse events. Little is known of the role of psychosocial factors associated with frailty in explaining negative outcomes of aging. This study was aimed at 1) evaluating the differences in psychosocial factors among robust, prefrail, and frail individuals and 2) investigating whether there was any interaction effect of frailty status with empirically identified clusters of psychosocial factors on autonomy in the activities of daily living (ADLs). Two-hundred and ten older adults (age 73±6 years, 66% women) were involved in this study. Frailty was assessed using an adapted version of the frailty phenotype. The psychosocial factors investigated were depressive symptoms using the 20-item Center for Epidemiologic Studies Depression Scale, social isolation using the Friendship Scale, and loneliness feeling using the eight-item UCLA Loneliness Scale. The autonomy in ADLs was measured with the Groningen Activity Restriction Scale. Thirty-one percent of participants were robust, 55% prefrail, and 14% frail. We performed an analysis of covariance which showed differences between robust, prefrail, and frail individuals for all the psychosocial variables: Center for Epidemiologic Studies Depression Scale, F(2, 205)=18.48, P<0.001; Friendship Scale, F(2, 205)=4.59, P=0.011; UCLA Loneliness Scale, F(2, 205)=5.87, P=0.003, controlling for age and sex. Using the same covariates, the two-way analysis of covariance indicated an interaction effect of frailty with psychosocial factors in determining ADLs, F(4, 199)=3.53, P=0.008. This study demonstrates the close relationship between frailty and psychosocial factors, suggesting the need to take into account simultaneously physical and psychosocial components of human functioning. PMID:26811675

  2. Development of a New Psychosocial Treatment for Adult ADHD

    ERIC Educational Resources Information Center

    Solanto, Mary V.; Marks, David J.; Mitchell, Katherine J.; Wasserstein, Jeanette; Kofman, Michele D.

    2008-01-01

    Objective: The purpose of this study was to assess the effectiveness of a new manualized group Meta-Cognitive Therapy (MCT) for adults with ADHD that extends the principles and practices of cognitive-behavioral therapy to the development of executive self-management skills. Method: Thirty adults diagnosed with ADHD completed an 8- or 12-week…

  3. Gender-nonconforming lesbian, gay, bisexual, and transgender youth: school victimization and young adult psychosocial adjustment.

    PubMed

    Toomey, Russell B; Ryan, Caitlin; Diaz, Rafael M; Card, Noel A; Russell, Stephen T

    2010-11-01

    Past research documents that both adolescent gender nonconformity and the experience of school victimization are associated with high rates of negative psychosocial adjustment. Using data from the Family Acceptance Project's young adult survey, we examined associations among retrospective reports of adolescent gender nonconformity and adolescent school victimization due to perceived or actual lesbian, gay, bisexual, or transgender (LGBT) status, along with current reports of life satisfaction and depression. The participants included 245 LGBT young adults ranging in age from 21 to 25 years. Using structural equation modeling, we found that victimization due to perceived or actual LGBT status fully mediates the association between adolescent gender nonconformity and young adult psychosocial adjustment (i.e., life satisfaction and depression). Implications are addressed, including specific strategies that schools can implement to provide safer environments for gender-nonconforming LGBT students.

  4. Predictors of positive psychosocial functioning of older adults in residential care facilities.

    PubMed

    Schanowitz, Jeff Y; Nicassio, Perry M

    2006-04-01

    This research examined the contributions of active and passive coping for health problems, and meaning-based coping, to positive psychosocial functioning in a sample of 100 individuals in residential care with a mean age of 83.11 years old. Study participants resided in skilled care, intermediate care, or assisted living facilities. Based on interview data collected on site in participants' residential settings, hierarchical multiple regression analyses revealed that active and passive coping and meaning-based coping had separate influences on measures of positive psychosocial functioning. Active coping was correlated with higher positive affect, whereas passive coping was associated with higher negative affect and self-acceptance. Positive reappraisal, a meaning-based coping strategy, was uniquely associated with higher positive affect, positive social relations, and self-acceptance. Positive religious coping was not independently associated with positive psychosocial functioning indices, whereas negative religious coping was related to higher negative affect. Health functioning did not contribute to positive psychosocial functioning in this sample. The results confirm the separate importance of health-related and meaning-based coping strategies in explaining positive psychosocial functioning in older adults living in residential care settings. PMID:16453068

  5. Report of the Psychosocial Outcomes Workgroup of the Nursing and Social Sciences Council of the International Society for Heart and Lung Transplantation: present status of research on psychosocial outcomes in cardiothoracic transplantation: review and recommendations for the field.

    PubMed

    Cupples, Sandra; Dew, Mary Amanda; Grady, Kathleen L; De Geest, Sabina; Dobbels, Fabienne; Lanuza, Dorothy; Paris, Wayne

    2006-06-01

    Cardiothoracic transplantation's success at prolonging life--and its economic costs--must be considered relative to its psychosocial benefits and costs. Moreover, psychosocial outcomes themselves influence long-term post-transplant morbidity and mortality rates. Although psychosocial outcomes--encompassing patients' physical, psychologic and social functioning, their management of their medical regimen and global quality of life--are the focus of many recent studies, these investigations have yet to yield many evidence-based interventions that are routinely applied to improve patient outcomes. Our goals were to summarize existing work on psychosocial outcomes, delineate areas requiring attention, offer recommendations for steps to advance the field, and thereby provide an impetus for the conduct of clinical trials of interventions to improve these outcomes. We concluded that research must generally shift away from descriptive studies and toward prospective and clinical trial designs to: (a) examine a full range of risk factors and clinical sequelae of patients' psychosocial status; and (b) evaluate the effectiveness of psychosocial interventions. In addition, these issues must be considered across all cardiothoracic recipients, including not only heart recipients but the less-studied populations of lung and heart-lung recipients, and must include longer-term (5+ years) outcomes than is typical in most work. The importance of adequately sized samples to ensure statistical power, and the need to construct study samples representative of the larger cardiothoracic transplant population, cannot be overestimated. Implementing these changes in research design and substantive focus will ensure that psychosocial outcomes research will have maximum impact on transplant recipients' clinical care. PMID:16730578

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

    PubMed

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

    2016-01-01

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

  7. The psychosocial difficulties in brain disorders that explain short term changes in health outcomes

    PubMed Central

    2013-01-01

    Background This study identifies a set of psychosocial difficulties that are associated with short term changes in health outcomes across a heterogeneous set of brain disorders, neurological and psychiatric. Methods Longitudinal observational study over approximately 12 weeks with three time points of assessment and 741 patients with bipolar disorders, depression, migraine, multiple sclerosis, parkinson’s disease, stroke and traumatic brain injury. The data on disability was collected with the checklist of the International Classification of Functioning, Disability and Health. The selected health outcomes were the Short Form 36 and the World Health Organization Disability Assessment Schedule. Multilevel models for change were applied controlling for age, gender and disease severity. Results The psychosocial difficulties that explain the variability and change over time of the selected health outcomes were energy and drive, sleep, and emotional functions, and a broad range of activities and participation domains, such as solving problems, conversation, areas of mobility and self-care, relationships, community life and recreation and leisure. Conclusions Our findings are of interest to researchers and clinicians for interventions and health systems planning as they show that in addition to difficulties that are diagnostic criteria of these disorders, there are other difficulties that explain small changes in health outcomes over short periods of time. PMID:23497332

  8. A systematic review of the psychosocial correlates of intuitive eating among adult women.

    PubMed

    Bruce, Lauren J; Ricciardelli, Lina A

    2016-01-01

    Intuitive eating has been proposed as an eating style that fosters a positive attitude towards food, the body, and physical activity. A systematic review of the literature was undertaken to examine intuitive eating in relation to disordered eating, body image, emotional functioning, and other psychosocial correlates in adult women. Articles were identified through Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Health Source (Nursing and Academic Edition), Medline Complete, PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences Collection, PubMed and Scopus. Eligible studies were those that examined women aged 18 years and older, measured intuitive eating, and assessed a psychosocial correlate of intuitive eating. Twenty-four cross-sectional studies, published between 2006 and September 2015, met eligibility criteria. Intuitive eating was associated with less disordered eating, a more positive body image, greater emotional functioning, and a number of other psychosocial correlates that have been examined less extensively. However, given that all studies used cross-sectional designs, no conclusions regarding the direction of the relationship between intuitive eating and psychosocial correlates can be drawn. Participants in the majority of studies were university students in the United States so findings cannot be generalised to the wider population of female adults. Prospective studies are now needed to verify these cross-sectional findings, and show if intuitive eating may reduce disordered eating and body image concerns, and promote women's psychological health and well-being. PMID:26474781

  9. A systematic review of the psychosocial correlates of intuitive eating among adult women.

    PubMed

    Bruce, Lauren J; Ricciardelli, Lina A

    2016-01-01

    Intuitive eating has been proposed as an eating style that fosters a positive attitude towards food, the body, and physical activity. A systematic review of the literature was undertaken to examine intuitive eating in relation to disordered eating, body image, emotional functioning, and other psychosocial correlates in adult women. Articles were identified through Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Health Source (Nursing and Academic Edition), Medline Complete, PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences Collection, PubMed and Scopus. Eligible studies were those that examined women aged 18 years and older, measured intuitive eating, and assessed a psychosocial correlate of intuitive eating. Twenty-four cross-sectional studies, published between 2006 and September 2015, met eligibility criteria. Intuitive eating was associated with less disordered eating, a more positive body image, greater emotional functioning, and a number of other psychosocial correlates that have been examined less extensively. However, given that all studies used cross-sectional designs, no conclusions regarding the direction of the relationship between intuitive eating and psychosocial correlates can be drawn. Participants in the majority of studies were university students in the United States so findings cannot be generalised to the wider population of female adults. Prospective studies are now needed to verify these cross-sectional findings, and show if intuitive eating may reduce disordered eating and body image concerns, and promote women's psychological health and well-being.

  10. Outcomes in Adults with Asperger Syndrome

    ERIC Educational Resources Information Center

    Barnhill, Gena P.

    2007-01-01

    This article explores the current research literature on adult outcomes of individuals with Asperger syndrome (AS). Specific areas addressed are the characteristics associated with adulthood AS, including employment issues, comorbid mental and physical health conditions, neurological issues, possible problems with the legal system, mortality…

  11. College Quality and Early Adult Outcomes

    ERIC Educational Resources Information Center

    Long, Mark C.

    2008-01-01

    This paper estimates the effects of various college qualities on several early adult outcomes, using panel data from the National Education Longitudinal Study. I compare the results using ordinary least squares with three alternative methods of estimation, including instrumental variables, and the methods used by Dale and Krueger [(2002).…

  12. Young Adult Outcome of Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Eaves, Linda C.; Ho, Helena H.

    2008-01-01

    To learn about the lives of young adults with ASD, families with children born 1974-1984, diagnosed as preschoolers and followed into adolescence were contacted by mail. Of 76 eligible, 48 (63%) participated in a telephone interview. Global outcome scores were assigned based on work, friendships and independence. At mean age 24, half had good to…

  13. Physical and psychosocial challenges in adult hemophilia patients with inhibitors

    PubMed Central

    duTreil, Sue

    2014-01-01

    Numerous challenges confront adult hemophilia patients with inhibitors, including difficulty in controlling bleeding episodes, deterioration of joints, arthritic pain, physical disability, emotional turmoil, and social issues. High-intensity treatment regimens often used in the treatment of patients with inhibitors also impose significant scheduling, economic, and emotional demands on patients and their families or primary caregivers. A comprehensive multidisciplinary assessment of the physical, emotional, and social status of adult hemophilia patients with inhibitors is essential for the development of treatment strategies that can be individualized to address the complex needs of these patients. PMID:25093002

  14. Psychosocial functioning in a group of Swedish adults with Asperger syndrome or high-functioning autism.

    PubMed

    Engström, I; Ekström, L; Emilsson, B

    2003-03-01

    This study reports on psychosocial functioning in Swedish adults with Asperger syndrome (AS) or high-functioning autism (HFA). A systematically selected sample of patients and relatives was interviewed concerning their psychosocial situation. The majority was living independently. All persons but one were unemployed. None was married and none had children. Only a few had some kind of partner. Most persons needed a high level of public and/or private support. The overall adjustment was rated good in 12 percent, fair in 75 percent and poor in 12 percent. Adult persons with AS/HFA have extensive need for support from their families and/or society. This information is important in order to provide adequate interventions that are in accordance with the expressed needs of the individuals themselves.

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

    PubMed Central

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

    2014-01-01

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

  16. Friendship quality and psychosocial outcomes among children with traumatic brain injury.

    PubMed

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

    2014-08-01

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

  17. Psychosocial Predictors of Emerging Adults' Risk and Reckless Behaviors.

    ERIC Educational Resources Information Center

    Bradley, Graham; Wildman, Karen

    2002-01-01

    Studied risk and reckless behavior in 375 emerging adults using self-report measures and a cross-sectional design. Risk behaviors were found to be reliably predicted by sensation seeking, but not by antisocial peer pressure, while the reverse pattern was more true in relation to "reckless" behaviors. (SLD)

  18. Sensory-motor and psychosocial correlates of adaptive locomotor performance in older adults

    PubMed Central

    Deshpande, Nandini; Metter, E. Jeffrey; Ferrucci, Luigi

    2011-01-01

    Objectives To identify sensory-motor and psychosocial factors independently associated with inability to perform adaptive walking tasks in older adults Design Cross-sectional cohort study Setting Population-based older cohort Participants Community-living elderly (age≥65 years) who could walk 7 m at self-selected normal speed (n=720). Interventions Not applicable Main Outcome Measures Walking performance was assessed in four walking tests: fast walking, obstacle crossing, narrow-based walking and walking while talking. Possible correlates of the inability to perform the walking test included knee extensor strength, lower limb coordination, Cumulative Somatosensory Impairment Index (CSII), visual acuity and contrast sensitivity, cognition, depression, personal mastery, social support and years of education. Results The results of binary logistic regression analyses, adjusted for demographics and self-selected normal speed, demonstrated that poor knee extensor strength was associated with inability to perform tasks demanding increase in walking speed (fast walking and obstacle crossing). Both, poor lower limb coordination and higher CSII were significantly associated with failure in tests that demanded precise control over foot placement (obstacle crossing and narrow-base walking). Higher CSII was associated with failure in all tests except in the walking while talking. In contrast, poor cognition was associated with inability to perform walking while talking. Poor personal mastery was the only variable that was associated with failure in all walking tests. Conclusion The results demonstrated a systematic and coherent pattern in these associations and indicated possible sensory-motor and psychological parameters that should be specifically investigated and should be intervened if a patient reports a difficulty/inability in walking in certain situations. PMID:21704787

  19. The Chauvet 2014 Meeting Report: Psychiatric and Psychosocial Evaluation and Outcomes of Upper Extremity Grafted Patients.

    PubMed

    Jowsey-Gregoire, Sheila G; Kumnig, Martin; Morelon, Emmanuel; Moreno, Elisa; Petruzzo, Palmina; Seulin, Christian

    2016-07-01

    Under the auspices for the International Society on Hand and Composite Tissue Allotransplantation, a section of The Transplantation Society (IHCTAS), a meeting was convened on March 21-22, 2014 in Paris to review the following areas that were deemed significant in the understanding of the psychosocial evaluation and outcomes of upper extremity transplant recipients: required domains of the evaluation, screening instruments, clinical monitoring pretransplant, clinical monitoring posttransplant, patient and team expectations, body image, psychiatric complications, functional goals and quality of life, ethics and media relations. Experts in the fields of psychiatry and psychology, transplantation, social work, ethics, and transplant administration met and reviewed center experiences and literature. The attendees highlighted the importance and the complexity of the psychiatric assessment in this field of transplantation. Moreover, the necessity to develop common instruments and evaluation protocols to predict psychosocial outcomes as well as to understand whether we are transplanting the right patients and how the transplantation is affecting the patients were pointed out. Psychiatric complications in upper extremity transplanted patients have been reported by the majority of teams. Preexisting psychiatric difficulties, the initial trauma of amputation, or adjusting to the transplantation process itself (especially the medical follow-up and rehabilitation process) appeared to be important factors. Monitoring during the whole follow-up was recommended to detect psychiatric issues and to facilitate and ensure long-term adherence. The participants proposed an annual meeting format to build upon the findings of this inaugural meeting to be called the Chauvet Workgroup meeting. PMID:26636738

  20. Relationship between Cumulative BMI and Symptomatic, Psychosocial, and Medical Outcomes in Patients with Borderline Personality Disorder

    PubMed Central

    Frankenburg, Frances R.; Zanarini, Mary C.

    2011-01-01

    We examined the relationship between cumulative body mass index (BMI) and symptomatic, psychosocial, and medical outcomes in patients with borderline personality disorder (BPD). Two hundred female borderline patients were weighed and measured during their index admission. They were subsequently interviewed at six, eight, and 10 years intervals. Over 10 years of prospective follow-up, increases in cumulative BMI were significantly associated with self-mutilation and dissociation (but not suicide attempts). Increases in cumulative BMI were also significantly associated with having no life partner, a poor work or school history, being on disability, being rated with a GAF score in the fair or poor range, and having a low income. In addition, increases in BMI were related to having two or more obesity-related medical conditions and using costly forms of health care. Increases in cumulative BMI may be a marker for adverse symptomatic, functional, and medical outcomes in patients with BPD. PMID:21838559

  1. Adult Hospice Social Work Intervention Outcomes in the United States.

    PubMed

    Alcide, Amary; Potocky, Miriam

    2015-01-01

    A descriptive and critical analysis of the available empirical literature on social work psychosocial intervention outcomes for adult hospice patients and caregivers was conducted. The electronic bibliographic databases CINHAL (EBSCO), MEDLINE, ProQuest, EMBASE, Campbell Collaboration, and The Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library) were searched. Search criteria were (a) social work interventions, (b) intervention was tested, (c) adult hospice patients and/or caregivers, (d) studies within the United States, (e) and studies between 2004 and 2014. Of the 21 studies that met the initial search criteria, 5 publications met all review criteria. Based on assessment of study results, intervention effect, and quality of evidence, the ADAPT Problem-Solving Intervention (PSI) and the Hospice Caregiver Support Project have some indications of practical effect on caregiver quality of life, anxiety, stress, and problem-solving skills. The Caregiver Life Line (CaLL) intervention had little to no effect on caregiver role stress or coping skills. The few available studies provide foundational insight into the need for the expansion of research efforts to evaluate hospice social work interventions and document the contributions of social work to the field.

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

    PubMed Central

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

    2014-01-01

    Context The death of a child from cancer affects the entire family. Little is known about the long-term psychosocial outcomes of bereaved siblings. Objectives To describe: (1) the prevalence of risky health-behaviors, psychological distress, and social support among bereaved siblings; (2) potentially modifiable factors associated with poor outcomes. Methods Bereaved siblings were eligible for this dual-center, cross-sectional, survey-based study if they were ≥16 years-old and their parents had enrolled in one of three prior studies about caring for children with cancer at end of life. Linear regression models identified associations between personal perspectives before, during, and after the family's cancer experience and outcomes (health-behaviors, psychological distress, and social support). Results Fifty-eight siblings completed surveys (62% response rate). They were approximately 12 years bereaved, with a mean age of 26 years at the time of the survey (SD=7.8). Anxiety, depression, and illicit substance use increased during the year following their brother/sister's death, but then returned to baseline. Siblings who reported dissatisfaction with communication, poor preparation for death, missed opportunities to say “goodbye,” and/or a perceived negative impact of the cancer experience on relationships tended to have higher distress and lower social support scores (p<0.001-0.031). Almost all siblings reported their loss still affected them; half stated the experience impacted current educational and career goals. Conclusion How siblings experience the death of a child with cancer may impact their long-term psychosocial well-being. Sibling-directed communication and concurrent supportive care during the cancer experience and the year following sibling death may mitigate poor long-term outcomes. PMID:24880001

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

    PubMed

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

    2013-04-01

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

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

    PubMed

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

    2013-04-01

    Students with special educational needs and disabilities (SEND) are at a greatly increased risk of experiencing poor psychosocial outcomes. Developing effective interventions that address the cause of these outcomes has therefore become a major policy priority in recent years. We report on a national evaluation of the Achievement for All (AfA) programme that was designed to improve outcomes for students with SEND through: (1) academic assessment, tracking and intervention, (2) structured conversations with parents, and (3) developing provision to improve wider outcomes (e.g. positive relationships). Using a quasi-experimental, pre-test-post-test control group design, we assessed the impact of AfA on teacher ratings of the behaviour problems, positive relationships and bullying of students with SEND over an 18-month period. Participants were 4758 students with SEND drawn from 323 schools across England. Our main impact analysis demonstrated that AfA had a significant impact on all three response variables when compared to usual practice. Hierarchical linear modelling of data from the intervention group highlighted a range of school-level contextual factors and implementation activities and student-level individual differences that moderated the impact of AfA on our study outcomes. The implications of our findings are discussed, and study strengths and limitations are noted. PMID:23380579

  5. Improved Cardiovascular Disease Outcomes in Older Adults

    PubMed Central

    Forman, Daniel E.; Alexander, Karen; Brindis, Ralph G.; Curtis, Anne B.; Maurer, Mathew; Rich, Michael W.; Sperling, Laurence; Wenger, Nanette K.

    2016-01-01

    Longevity is increasing and the population of older adults is growing. The biology of aging is conducive to cardiovascular disease (CVD), such that prevalence of coronary artery disease, heart failure, valvular heart disease, arrhythmia and other disorders are increasing as more adults survive into old age.  Furthermore, CVD in older adults is distinctive, with management issues predictably complicated by multimorbidity, polypharmacy, frailty and other complexities of care that increase management risks (e.g., bleeding, falls, and rehospitalization) and uncertainty of outcomes.  In this review, state-of-the-art advances in heart failure, acute coronary syndromes, transcatheter aortic valve replacement, atrial fibrillation, amyloidosis, and CVD prevention are discussed.  Conceptual benefits of treatments are considered in relation to the challenges and ambiguities inherent in their application to older patients. PMID:26918183

  6. Successful Aging: A Psychosocial Resources Model for Very Old Adults

    PubMed Central

    Randall, G. Kevin; Martin, Peter; Johnson, Mary Ann; Poon, Leonard W.

    2012-01-01

    Objectives. Using data from the first two phases of the Georgia Centenarian Study, we proposed a latent factor structure for the Duke OARS domains: Economic Resources, Mental Health, Activities of Daily Living, Physical Health, and Social Resources. Methods. Exploratory and confirmatory factor analyses were conducted on two waves of the Georgia Centenarian Study to test a latent variable measurement model of the five resources; nested model testing was employed to assess the final measurement model for equivalency of factor structure over time. Results. The specified measurement model fit the data well at Time 1. However, at Time 2, Social Resources only had one indicator load significantly and substantively. Supplemental analyses demonstrated that a model without Social Resources adequately fit the data. Factorial invariance over time was confirmed for the remaining four latent variables. Discussion. This study's findings allow researchers and clinicians to reduce the number of OARS questions asked of participants. This has practical implications because increased difficulties with hearing, vision, and fatigue in older adults may require extended time or multiple interviewer sessions to complete the battery of OARS questions. PMID:22900180

  7. Seizure and Psychosocial Outcomes of Childhood and Juvenile Onset Generalized Epilepsies: Wolf in Sheep's Clothing, or Well-Dressed Wolf?

    PubMed Central

    2015-01-01

    Studies of generalized electroclinical syndromes can provide guidance regarding long-term seizure, cognitive, and psychosocial outcomes. Childhood absence epilepsy, juvenile absence epilepsy, juvenile myoclonic epilepsy, and idiopathic generalized epilepsy with generalized tonic–clonic seizures alone are electroclinical syndromes typically associated with normal intellect and good response to antiseizure medications. However, studies have demonstrated significantly poorer psychosocial outcomes than expected for these syndromes, regardless of seizure control. Potential causes for this include underlying abnormalities in social skills, social stigma, and underlying abnormalities in brain development and maturation. PMID:26316843

  8. Seizure and Psychosocial Outcomes of Childhood and Juvenile Onset Generalized Epilepsies: Wolf in Sheep's Clothing, or Well-Dressed Wolf?

    PubMed

    Nickels, Katherine

    2015-01-01

    Studies of generalized electroclinical syndromes can provide guidance regarding long-term seizure, cognitive, and psychosocial outcomes. Childhood absence epilepsy, juvenile absence epilepsy, juvenile myoclonic epilepsy, and idiopathic generalized epilepsy with generalized tonic-clonic seizures alone are electroclinical syndromes typically associated with normal intellect and good response to antiseizure medications. However, studies have demonstrated significantly poorer psychosocial outcomes than expected for these syndromes, regardless of seizure control. Potential causes for this include underlying abnormalities in social skills, social stigma, and underlying abnormalities in brain development and maturation. PMID:26316843

  9. Psychosocial factors in adults with chronic kidney disease: characteristics of pilot participants in the Tasmanian Chronic Kidney Disease study

    PubMed Central

    2013-01-01

    Background Psychosocial factors including depression, anxiety and lower social support are common in patients with chronic kidney disease (CKD). However the influence of these potentially modifiable risk factors on morbidity and mortality in this renal population is unknown. The Tasmanian Chronic Kidney Disease study is a prospective cohort study which aims to examine the influence of both biomedical and psychosocial factors on disease progression, decision making and length and quality of life in adults with severe CKD, prior to kidney replacement therapy (KRT). This paper describes the recruitment, baseline characteristics and initial follow-up of pilot participants. Methods Adults aged > 18 years with stage 4 CKD (eGFR 15–29 mls/min/1.73 m2) and not receiving dialysis were recruited via treating physicians. Measures included depression (9-item Patient Health Questionnaire), anxiety (Beck Anxiety Inventory) and social support (Multidimensional Scale of Perceived Social Support). Primary outcomes were kidney disease progression, use of KRT and health-related quality of life (Kidney Disease and Quality of Life Short Form and the EQ-5D). Results Of those invited (n = 105), 49 provided consent and completed baseline assessment. There were no significant differences between responders and non-responders in age, gender and socio-economic status (all p > 0.05). Participants were predominantly male (63.3%) with a mean age of 72.6 ± 10.2 years. Mean serum creatinine was 241 ± 62 μmol/L with mean eGFR 22 ± 5 mls/min/1.73 m2. Prevalence of major depression and moderate to severe anxiety was 10% and 9% respectively. Less severe depression and fewer anxiety symptoms were associated with higher health-related quality of life. Follow-up at 10-months showed CKD progression in 34% of participants (use of KRT in 16%, stage 5 CKD without KRT in 18%), one death, with the remainder stable at CKD stage 3 or 4. Conclusions Results indicate that a

  10. Protocol for a systematic review of telephone delivered psychosocial interventions on relapse prevention, adherence to psychiatric medication and health risk behaviours in adults with a psychotic disorder

    PubMed Central

    Beck, Alison K; Baker, Amanda; Turner, Alyna; Haddock, Gillian; Kelly, Peter J; Berry, Katherine; Bucci, Sandra

    2015-01-01

    Introduction The mental and physical health of individuals with a psychotic illness are typically poor. When adhered to, medication can reduce relapse. However, despite adherence, relapse remains common and functional outcomes often remain compromised. Compliance is also typically low. Cardiovascular-related morbidity and mortality is also elevated, along with several important modifiable health risk behaviours. Access to psychosocial interventions is therefore important, but currently limited. Telephone delivered interventions represent a promising solution, although further clarity is needed. Accordingly, we aim to provide an overview and critical analysis of the current state of evidence for telephone delivered psychosocial interventions targeting key health priorities in adults with a psychotic disorder, including (1) relapse, (2) adherence to psychiatric medication and/or (3) modifiable cardiovascular health risk behaviours. Methods and analysis Our methods are informed by published guidelines. The review is registered and any protocol amendments will be tracked. Ten electronic peer-reviewed and four grey literature databases have been identified. Preliminary searches have been conducted for literature on psychosocial telephone interventions targeting relapse, medication adherence and/or health risk behaviours in adults with a psychotic disorder. Articles classified as ‘evaluation’ will be assessed against standardised criteria and checked by an independent assessor. The searches will be re-run just before final analyses and further studies retrieved for inclusion. A narrative synthesis will be reported, structured around intervention type and content, population characteristics and outcomes. Where possible, ‘summary of findings’ tables will be generated for each comparison. For the primary outcome of each trial, when data are available, we will calculate a risk ratio and its 95% CI (dichotomous outcomes) and/or effect size according to Cohen's formula

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

    PubMed

    Beijers, Roseriet; Buitelaar, Jan K; de Weerth, Carolina

    2014-10-01

    Accumulating evidence from preclinical and clinical studies indicates that maternal psychosocial stress and anxiety during pregnancy adversely affect child outcomes. However, knowledge on the possible mechanisms underlying these relations is limited. In the present paper, we review the most often proposed mechanism, namely that involving the HPA axis and cortisol, as well as other less well-studied but possibly relevant and complementary mechanisms. We present evidence for a role of the following mechanisms: compromised placental functioning, including the 11β-HSD2 enzyme, increased catecholamines, compromised maternal immune system and intestinal microbiota, and altered health behaviors including eating, sleep, and exercise. The roles of (epi)genetics, the postnatal environment and the fetus are also discussed. We conclude that maternal prenatal psychosocial stress is a complex phenomenon that affects maternal emotions, behavior and physiology in many ways, and may influence the physiology and functioning of the fetus through a network of different pathways. The review concludes with recommendations for future research that helps our understanding of the mechanisms by which maternal prenatal stress exerts its effect on the fetus.

  12. Psychosocial Effects of Health Disparities of Lesbian, Gay, Bisexual, and Transgender Older Adults.

    PubMed

    Zelle, Andraya; Arms, Tamatha

    2015-07-01

    The 1.5 million older adults who self-identify as lesbian, gay, bisexual, and transgender (LGBT) are expected to double in number by 2030. Research suggests that health disparities are closely linked with societal stigma, discrimination, and denial of civil and human rights. More LGBT older adults struggle with depression, substance abuse, social isolation, and acceptance compared to their heterosexual counterparts. Despite individual preferences, most health care providers recognize the right of any individual to have access to basic medical services. The U.S. Department of Health and Human Services requires that all hospitals receiving funds from Medicare and Medicaid respect visitation and medical decision-making rights to all individuals identifying as LGBT. The Joint Commission also requires a non-discrimination statement for accreditation. The current literature review examines LGBT health disparities and the consequential psychosocial impact on LGBT older adults as well as brings awareness to the needs of this underserved and underrepresented population. PMID:26151148

  13. Psychosocial Experiences Associated with Confirmed and Self-Identified Dyslexia: A Participant-Driven Concept Map of Adult Perspectives

    ERIC Educational Resources Information Center

    Nalavany, Blace Arthur; Carawan, Lena Williams; Rennick, Robyn A.

    2011-01-01

    Concept mapping (a mixed qualitative-quantitative methodology) was used to describe and understand the psychosocial experiences of adults with confirmed and self-identified dyslexia. Using innovative processes of art and photography, Phase 1 of the study included 15 adults who participated in focus groups and in-depth interviews and were asked to…

  14. Environmental enrichment requires adult neurogenesis to facilitate the recovery from psychosocial stress

    PubMed Central

    Schloesser, R J; Lehmann, M; Martinowich, K; Manji, H K; Herkenham, M

    2010-01-01

    The subgranular zone of the adult hippocampal dentate gyrus contains a pool of neural stem cells that continuously divide and differentiate into functional granule cells. It has been shown that production of new hippocampal neurons is necessary for amelioration of stress-induced behavioral changes by antidepressants in animal models of depression. The survival of newly born hippocampal neurons is decreased by chronic psychosocial stress and increased by exposure to enriched environments. These observations suggest the existence of a link between hippocampal neurogenesis, stress-induced behavioral changes, and the beneficial effects of enriched environment. To show causality, we subjected transgenic mice with conditionally suppressed neurogenesis to psychosocial stress followed by environmental enrichment. First, we showed that repeated social defeat coupled with chronic exposure to an aggressor produces robust and quantifiable indices of submissive and depressive-like behaviors; second, subsequent exposure to an enriched environment led to extinction of the submissive phenotype, while animals exposed to an impoverished environment retained the submissive phenotype; and third, enrichment was not effective in reversing the submissive and depressive-like behaviors in transgenic mice lacking neurogenesis. Our data show two main findings. First, living in an enriched environment is highly effective in extinguishing submissive behavioral traits developed during chronic social stress, and second, these effects are critically dependent on adult neurogenesis, indicating that beneficial behavioral adaptations are dependent on intact adult neurogenesis. PMID:20308988

  15. Coaching behaviors, motivational climate, and psychosocial outcomes among female adolescent athletes.

    PubMed

    Weiss, Maureen R; Amorose, Anthony J; Wilko, Anna Marie

    2009-11-01

    Based on Harter's (12,13) competence motivation theory, this study examined the relationship of coaches' performance feedback and motivational climate with female athletes' perceived competence, enjoyment, and intrinsic motivation. Female adolescent soccer players (N = 141) completed measures of relevant constructs toward the latter part of their season. Canonical correlation analysis revealed that athletes' perceptions of greater positive and informational feedback given by coaches in response to successful performance attempts, greater emphasis placed on a mastery climate, and less emphasis placed on a performance climate, were significantly related to greater ability perceptions, enjoyment, and intrinsic motivation. Exploratory analyses also showed that the relationship between feedback and the psychosocial outcomes may vary as a function of the perceived motivational climate. Overall, these results suggest that coaching feedback and motivational climate are important contributors to explaining adolescent females' continued motivation to participate in sport.

  16. The Costs of Policing: Psychosocial Capital and Mental Health Outcomes in a Nigeria Police Sample.

    PubMed

    Ojedokun, Oluyinka; Balogun, Shyngle K

    2015-10-14

    This study examined the influence of psychosocial capital (psychological and workplace social capital) on mental health outcomes among 340 police personnel in Nigeria. Data were collected via anonymously completed questionnaires. The hypotheses were tested using structural equation modeling, and the results revealed that in the context of stress and traumatic stress, resilience p < .05, optimism p < .05, self-efficacy p < .05, hope p < .05, and workplace social capital p < .05 can influence the development of mental health problems or adaptation. The findings imply that it is important that both researchers and police organization pay attention to how psychological capital influence the development of psychopathology or resilience and how such issues can be addressed through psychological training in the workplace.

  17. Overcoming psychosocial and developmental barriers to blood and marrow transplantation (BMT) in an adolescent/young adult (AYA) transgender patient with chronic myelogenous leukemia.

    PubMed

    Khazal, Sajad; Abdel-Azim, Hisham; Kapoor, Neena; Mahadeo, Kris M

    2014-11-01

    Adolescents/young adults (AYAs) afflicted with cancer face unique barriers to potentially standard curative therapies, such as blood and marrow transplantation (BMT). Transgender AYAs face additional barriers and there is a dearth of published literature regarding their oncology-related experience. We present the case of an AYA male-to-female (MTF) transgender patient on cross-sex hormone therapy, with a history of Chronic Myelogenous Leukemia (CML) and significant psychosocial barriers, which initially served as a barrier to BMT at two different centers; we modified our standard consent and education process and was able to successfully proceed with BMT and subsequently cure her CML. Despite unique challenges, AYA and transgender patients with significant psychosocial barriers may achieve successful outcomes with BMT. Research is needed regarding guidelines for cross-sex hormone therapy administration for patients undergoing BMT and other issues, which may be unique to the transgender experience.

  18. Ethical and psychosocial issues raised by the practice in cases of mistreatment of older adults.

    PubMed

    Beaulieu, Marie; Leclerc, Nancy

    2006-01-01

    Intervention regarding older adult mistreatment raises many questions for practitioners. They have to interact with the victim, the abuser, and, in many cases, with both of them at the same time. In such cases, five themes emerge from the literature review on psycho-social and ethical issues in practice: practitioners' pre-construction and axiological frameworks, victims' capacity, confidentiality versus collaboration between practitioners or between agencies, social and family responsibilities and the balance between competing values in practice. Practitioners are well placed to offer a critical reflection on their practice and on ways of improving it. The goal of our qualitative study is to identify issues and ethical dilemmas in elderly mistreatment situations as represented in the discourses of practitioners in reference to interventions in their psychosocial practice. Sixteen practitioners from the public and community (non-profit organization) sectors were interviewed using a practice history approach. This paper presents the main ethical and psychosocial issues raised by practitioners and some ideas to improve the practice. It is motivated by the crucial question haunting the practitioners' minds: "How far should we go?"

  19. Psychosocial issues affecting adults with congenital heart disease: one patient's perspective.

    PubMed

    Livecchi, Tracy A

    2004-12-01

    This article addresses a number of psychosocial issues that advance practice nurses and other health care providers should be aware of when working with patients who have congenital heart disease. If not properly addressed, particularly during adolescence, these issues can have a strong impact on a person's medical care and over-all quality of life. This article includes information from medical literature, conversations with adult patients, and my own experiences as both a patient with congenital heart disease and as a clinical social worker.

  20. Psychosocial treatments for ADHD in teens and adults: a practice-friendly review.

    PubMed

    Murphy, Kevin

    2005-05-01

    Although stimulant medication is a cornerstone of treatment for attention deficit hyperactivity disorder (ADHD), numerous nonpharmacological treatments can be employed in combination with medication to assist in the lifelong management of the disorder. A multimodal treatment combining psychoeducation, medication, psychotherapy, compensatory behavioral/self-management skills, technological tools and devices, coaching, advocacy, and reasonable school or workplace accommodations is probably the most comprehensive and effective. This article describes a variety of psychosocial treatments that are commonly used for adolescents and adults suffering from ADHD.

  1. Childhood income volatility and adult outcomes.

    PubMed

    Hardy, Bradley L

    2014-10-01

    Using data linked across generations in the Panel Study of Income Dynamics, I estimate the relationship between exposure to volatile income during childhood and a set of socioeconomic outcomes in adulthood. The empirical framework is an augmented intergenerational income mobility model that includes controls for income volatility. I measure income volatility at the family level in two ways: (1) instability as measured by squared deviations around a family-specific mean; and (2) instability as percentage changes of 25 % or more. Volatility enters the model both separately and interacted with income level. I find that family income volatility during childhood has a modest negative association with educational attainment. Volatility has a smaller descriptive role in explaining intergenerational outcomes relative to permanent income. Across the income distribution, the negative association between volatility exposure and educational attainment is largest for young adults from moderate-income families.

  2. Outcomes in adults with autism spectrum disorders: a historical perspective.

    PubMed

    Henninger, Natalie A; Taylor, Julie Lounds

    2013-01-01

    In this review, we examine the ways in which researchers have defined successful adult outcomes for individuals with autism spectrum disorders (ASDs) from the first systematic follow-up reports to the present day. The earliest outcome studies used vague and unreliable outcome criteria, and institutionalization was a common marker of poor outcomes. In the past decade, researchers have begun to standardize the measurement of adult outcomes with specific criteria based on friendships, employment, and living arrangements. Although nearly all of these studies have agreed that the majority of adults with ASD have poor outcomes, evolving concepts of what it means to be an adult could have an impact on outcomes measured. For example, some researchers have suggested that taking into account the person-environment fit could reveal a more optimistic picture of outcomes for these adults. Suggestions for future research are discussed.

  3. Is involvement in school bullying associated with general health and psychosocial adjustment outcomes in adulthood?

    PubMed

    Sigurdson, J F; Wallander, J; Sund, A M

    2014-10-01

    The aim was to examine prospectively associations between bullying involvement at 14-15 years of age and self-reported general health and psychosocial adjustment in young adulthood, at 26-27 years of age. A large representative sample (N=2,464) was recruited and assessed in two counties in Mid-Norway in 1998 (T1) and 1999/2000 (T2) when the respondents had a mean age of 13.7 and 14.9, respectively, leading to classification as being bullied, bully-victim, being aggressive toward others or non-involved. Information about general health and psychosocial adjustment was gathered at a follow-up in 2012 (T4) (N=1,266) with a respondent mean age of 27.2. Logistic regression and ANOVA analyses showed that groups involved in bullying of any type in adolescence had increased risk for lower education as young adults compared to those non-involved. The group aggressive toward others also had a higher risk of being unemployed and receiving any kind of social help. Compared with the non-involved, those being bullied and bully-victims had increased risk of poor general health and high levels of pain. Bully-victims and those aggressive toward others during adolescence subsequently had increased risk of tobacco use and lower job functioning than non-involved. Further, those being bullied and aggressive toward others had increased risk of illegal drug use. Relations to live-in spouse/partner were poorer among those being bullied. Involvement in bullying, either as victim or perpetrator, has significant social costs even 12 years after the bullying experience. Accordingly, it will be important to provide early intervention for those involved in bullying in adolescence.

  4. Is involvement in school bullying associated with general health and psychosocial adjustment outcomes in adulthood?

    PubMed

    Sigurdson, J F; Wallander, J; Sund, A M

    2014-10-01

    The aim was to examine prospectively associations between bullying involvement at 14-15 years of age and self-reported general health and psychosocial adjustment in young adulthood, at 26-27 years of age. A large representative sample (N=2,464) was recruited and assessed in two counties in Mid-Norway in 1998 (T1) and 1999/2000 (T2) when the respondents had a mean age of 13.7 and 14.9, respectively, leading to classification as being bullied, bully-victim, being aggressive toward others or non-involved. Information about general health and psychosocial adjustment was gathered at a follow-up in 2012 (T4) (N=1,266) with a respondent mean age of 27.2. Logistic regression and ANOVA analyses showed that groups involved in bullying of any type in adolescence had increased risk for lower education as young adults compared to those non-involved. The group aggressive toward others also had a higher risk of being unemployed and receiving any kind of social help. Compared with the non-involved, those being bullied and bully-victims had increased risk of poor general health and high levels of pain. Bully-victims and those aggressive toward others during adolescence subsequently had increased risk of tobacco use and lower job functioning than non-involved. Further, those being bullied and aggressive toward others had increased risk of illegal drug use. Relations to live-in spouse/partner were poorer among those being bullied. Involvement in bullying, either as victim or perpetrator, has significant social costs even 12 years after the bullying experience. Accordingly, it will be important to provide early intervention for those involved in bullying in adolescence. PMID:24972719

  5. Outcomes and patients’ perspectives of transition from paediatric to adult care in inflammatory bowel disease

    PubMed Central

    Bennett, Alice L; Moore, David; Bampton, Peter A; Bryant, Robert V; Andrews, Jane M

    2016-01-01

    AIM: To describe the disease and psychosocial outcomes of an inflammatory bowel disease (IBD) transition cohort and their perspectives. METHODS: Patients with IBD, aged > 18 years, who had moved from paediatric to adult care within 10 years were identified through IBD databases at three tertiary hospitals. Participants were surveyed regarding demographic and disease specific data and their perspectives on the transition process. Survey response data were compared to contemporaneously recorded information in paediatric service case notes. Data were compared to a similar age cohort who had never received paediatric IBD care and therefore who had not undergone a transition process. RESULTS: There were 81 returned surveys from 46 transition and 35 non-transition patients. No statistically significant differences were found in disease burden, disease outcomes or adult roles and responsibilities between cohorts. Despite a high prevalence of mood disturbance (35%), there was a very low usage (5%) of psychological services in both cohorts. In the transition cohort, knowledge of their transition plan was reported by only 25/46 patients and the majority (54%) felt they were not strongly prepared. A high rate (78%) of discussion about work/study plans was recorded prior to transition, but a near complete absence of discussion regarding sex (8%), and other adult issues was recorded. Both cohorts agreed that their preferred method of future transition practices (of the options offered) was a shared clinic appointment with all key stakeholders. CONCLUSION: Transition did not appear to adversely affect disease or psychosocial outcomes. Current transition care processes could be optimised, with better psychosocial preparation and agreed transition plans. PMID:26937149

  6. Effect of HIV diagnosis disclosure on psychosocial outcomes in Thai children with perinatal HIV-Infection

    PubMed Central

    Boon-yasidhi, V; Naiwatanakul, T; Chokephaibulkit, K; Lolekha, R; Leowsrisook, P; Chotpitayasunond, T; Wolfe, M

    2015-01-01

    Summary A provider-assisted, counseling-based, pediatric HIV disclosure model was developed and implemented at two tertiary-care hospitals in Bangkok, Thailand. All undisclosed perinatally acquired HIV-infected children, ages 7–18 years, and their caretakers were offered the four-step disclosure service, including: screening, readiness assessments and preparation, disclosure sessions, and follow-up evaluations. To assess psychosocial outcomes of disclosure, we compared the scores of the Children Depression Inventory and the PedsQL 4.0™ at baseline and at 2-month and 6-month follow-up visits, and compared the scores of the Child Behavioral Checklist at baseline and at 6-month follow-up. Disclosure was made to 186 children, 160 of whom completed post-disclosure assessments. The median Children’s Depression Inventory score in 135 children decreased significantly from 11 at baseline to 8 at 2-month and 6-month follow-up (p < 0.01). The median PedsQL 4.0™ scores in 126 children increased significantly from 78 at baseline to 80 at 2-month and 84 at 6-month follow-up (p = 0.04). The median Child Behavioral Checklist scores were not significantly changed. In conclusion, pediatric HIV diagnosis disclosure using this model was found to have positive effect on the children’s mood and quality of life, and no negative effect on children’s behaviours. This disclosure program should be expanded to improve psychosocial health of HIV-infected children. PMID:25829519

  7. Trauma experience among homeless female veterans: correlates and impact on housing, clinical, and psychosocial outcomes.

    PubMed

    Tsai, Jack; Rosenheck, Robert A; Decker, Suzanne E; Desai, Rani A; Harpaz-Rotem, Ilan

    2012-12-01

    This study examined lifetime exposure to traumatic events as reported by 581 homeless female veterans enrolled in a Homeless Women Veterans Program across 11 sites to characterize the types of trauma they experienced; their correlation with baseline characteristics; and their association with housing, clinical outcomes, and psychosocial functioning over a 1-year treatment period. Almost all participants endorsed multiple types and episodes of traumatic events. Among the most common were having someone close experience a serious or life-threatening illness (82%) and rape (67%). Exploratory factor analysis revealed 6 potential trauma categories: being robbed, experiencing accident or disasters, illness or death of others, combat, sexual assault, and physical assault. At baseline, trauma from sexual assault was associated with more days homeless (β = .18, p < .001), trauma from accidents or disasters was associated with poorer physical health (β = -.23, p < .001), and trauma from being robbed was related to greater use of drugs (β = .22, p < .001). Trauma reported at baseline, however, was not predictive of 1-year outcomes, suggesting type and frequency of trauma does not negatively affect the housing gains homeless women veterans can achieve through homeless services.

  8. Psychosocial and Quality of Life Outcomes of Prosthetic Auricular Rehabilitation with CAD/CAM Technology

    PubMed Central

    Tam, Chi Keung; McGrath, Colman Patrick; Ho, Samuel Mun Yin; Pow, Edmond Ho Nang; Luk, Henry Wai Kuen; Cheung, Lim Kwong

    2014-01-01

    Introduction. The psychosocial and quality of life (QoL) of patients with deformed or missing ears are frequently compromised. The aim of this study is to develop innovative techniques using CAD/CAM technology in prosthetic auricular rehabilitation and provide improvement in the treatment outcomes, including their psychology and QoL. Methods. This is a preliminary clinical cohort study. Six patients requesting for auricular reconstruction were recruited and rehabilitated with implant-supported prosthesis using CAD/CAM technology. Different treatment outcomes including QoL and psychological changes were assessed at different time points. Results. A significant reduction in severity of depressive symptoms (P = 0.038) and an improving trend of satisfaction with life were found at 1 year postoperatively when compared with the preoperative findings. The domain scores in ‘‘Body image”, ‘‘Family/friends/strangers”, and ‘‘Mood” were also significantly higher (P < 0.05) at 1 year postoperatively than 1 week postoperatively. However, only 50% of the patients wear their auricular prosthesis regularly. Conclusion. This preliminary study has confirmed that implant-supported auricular prosthesis could induce improvement in the psychology and QoL with statistically significant differences in the domains of the body image, social interaction, and mood. Our present findings can inform research design and hypotheses generation of future studies. PMID:24799904

  9. Psychosocial and quality of life outcomes of prosthetic auricular rehabilitation with CAD/CAM technology.

    PubMed

    Tam, Chi Keung; McGrath, Colman Patrick; Ho, Samuel Mun Yin; Pow, Edmond Ho Nang; Luk, Henry Wai Kuen; Cheung, Lim Kwong

    2014-01-01

    Introduction. The psychosocial and quality of life (QoL) of patients with deformed or missing ears are frequently compromised. The aim of this study is to develop innovative techniques using CAD/CAM technology in prosthetic auricular rehabilitation and provide improvement in the treatment outcomes, including their psychology and QoL. Methods. This is a preliminary clinical cohort study. Six patients requesting for auricular reconstruction were recruited and rehabilitated with implant-supported prosthesis using CAD/CAM technology. Different treatment outcomes including QoL and psychological changes were assessed at different time points. Results. A significant reduction in severity of depressive symptoms (P = 0.038) and an improving trend of satisfaction with life were found at 1 year postoperatively when compared with the preoperative findings. The domain scores in ''Body image", ''Family/friends/strangers", and ''Mood" were also significantly higher (P < 0.05) at 1 year postoperatively than 1 week postoperatively. However, only 50% of the patients wear their auricular prosthesis regularly. Conclusion. This preliminary study has confirmed that implant-supported auricular prosthesis could induce improvement in the psychology and QoL with statistically significant differences in the domains of the body image, social interaction, and mood. Our present findings can inform research design and hypotheses generation of future studies. PMID:24799904

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

    PubMed Central

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

    2014-01-01

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

  11. The mid-life transition: a period in adult psychosocial development.

    PubMed

    Levinson, D J

    1977-05-01

    For the past nine years my colleagues and I have been working on a theory of adult psychosocial development in men (Levinson et al., 1974, 1977; Levinson, 1977). We have started some research on women (Stewart, 1977), but it is too early yet to report definitive theory or findings. Our aim is to encompass the many components of a man's life-all of his relationships with individuals, groups, and institutions that have significance for him. The components of life include his occupation and its evolution over the years, his love relationships, marriage, and family life, his various other roles and careers in numerous social contexts. This psychosocial approach includes the man's personality and the ways in which it influences and is influenced by the evolution of his careers in occupation, family, and other systems. The resulting theory is not a theory of personality development, nor of occupational development, nor of development in any single aspect of living. It deals, rather, with the development of the individual life in the broadest sense, encompassing all of these segments. This theory provides a context within which we can study in more detail the development of personality and of particular careers. I shall briefly describe the developmental periods we discovered in early and middle adulthood, giving major emphasis to one period, the Mid-life Transition. Like childhood and adolescence, these periods are found in the lives of all men. Of ourse, men traverse them in myriad ways, as a result of differences in class, ethnicity, personality, and other factors. My primary aim is to present some of our major concepts, hypotheses, findings, and ways of thinking about adult development. None of them have been fully validated. Together, they comprise a framework for the analysis of adult development. No doubt the theory will be modified an extended as a result of further investigation. PMID:870922

  12. Outcomes in Adults with Autism Spectrum Disorders: A Historical Perspective

    ERIC Educational Resources Information Center

    Henninger, Natalie A.; Taylor, Julie Lounds

    2013-01-01

    In this review, we examine the ways in which researchers have defined successful adult outcomes for individuals with autism spectrum disorders (ASDs) from the first systematic follow-up reports to the present day. The earliest outcome studies used vague and unreliable outcome criteria, and institutionalization was a common marker of poor outcomes.…

  13. Effects of early menarche on physical and psychosocial health problems in adolescent girls and adult women

    PubMed Central

    2016-01-01

    The menarcheal age of Korean women has been rapidly decreasing for the last 50 years, and the average menarcheal age of women born in the 1990s is approaching 12.6 years. In addition, interest in early puberty has been increasing recently owing to the rapid increase in precocious puberty. Generally, out of concern for short stature and early menarche, idiopathic central precocious puberty in female adolescents is treated with gonadotropin-releasing hormone analogs. Studies to date have described the association between early menarche and psychosocial problems such as delinquency and risky sexual behavior, as well as physical health problems such as obesity, diabetes, cardiovascular diseases, and breast cancer throughout the lifespan of women. However, the pathophysiological mechanism underlying this association has not been clarified thus far. In this article, we review and discuss the existing literature to describe the current understanding of the effects of early menarche on the physical and psychosocial health of adolescent girls and adult women. PMID:27721839

  14. Sociodemographic and psychosocial factors in childhood as predictors of adult mortality.

    PubMed Central

    Schwartz, J E; Friedman, H S; Tucker, J S; Tomlinson-Keasey, C; Wingard, D L; Criqui, M H

    1995-01-01

    OBJECTIVES: Childhood sociodemographic, psychosocial, and environmental factors are often assumed to affect adult health and longevity. These relationships were prospectively tested by using the 7-decade Terman Life Cycle Study of Children With High Ability (n = 1285). METHODS: Parental socioeconomic status, childhood health, objective childhood stressors (e.g., death or divorce of parents), and childhood personality were considered as potential predictors in hazard regression analyses of longevity through 1991. RESULTS: Parental divorce during childhood predicted decreased longevity, with sex controlled. Other potential social predictors failed to show significant associations with longevity. Three dimensions of childhood personality--conscientiousness, lack of cheerfulness, and permanency of mood (males only)--predicted increased longevity. The effects of parental divorce and childhood personality were largely independent and did not account for any of the gender difference in mortality. CONCLUSIONS: A small number of childhood factors significantly predicted mortality across the life span in this sample. Further research should focus on how these psychosocial factors influence longevity. PMID:7661231

  15. Healthy for Life: A Randomized Trial Examining Physical Activity Outcomes and Psychosocial Mediators

    PubMed Central

    Williams, David M.; Martinson, Brian C.; Dunsiger, Shira; Marcus, Bess H.

    2012-01-01

    Background Researchers theorize that interventions increase physical activity by influencing key theory-based mediators (e.g., behavioral processes). However, few studies have been adequately powered to examine the importance of mediators. Purpose This study examined both physical activity behavior and psychosocial mediators in a randomized trial specifically powered to detect mediation. Methods Healthy, sedentary adults (n=448; 70% Caucasian, 87% women, mean age was 43) were randomly assigned to either a six-month print-based theory tailored physical activity intervention (n=224) or a six-month health/wellness contact control arm (n=224). Results The print intervention arm exhibited greater increases in physical activity than the control arm at six and 12 months (p<.05). Additionally, behavioral processes were found to be an important mediator of physical activity behavior. Conclusions It is important for researchers and practitioners to focus on increasing behavioral strategies for physical activity adoption. Future studies should examine other potential mediators of physical activity. PMID:23229158

  16. Identification and Analysis of Learning Preferences of Mentally Ill Adults in Rehabilitative Psychosocial Therapy at the Anderson Mental Health Center.

    ERIC Educational Resources Information Center

    Newman, Michael K.

    A study identified and analyzed the learning preferences of 17 seriously and chronically mentally ill adults participating in the rehabilitative psychosocial therapy program at the Toxaway Church Site of the Anderson Mental Health Center. Staff perceived as boring and unfocused the traditional treatment approach that relied mainly upon…

  17. Psychosocial Adaptation to Visual Impairment and Its Relationship to Depressive Affect in Older Adults with Age-Related Macular Degeneration

    ERIC Educational Resources Information Center

    Tolman, Jennifer; Hill, Robert D.; Kleinschmidt, Julia J.; Gregg, Charles H.

    2005-01-01

    Purpose: In this study we examined psychosocial adaptation to vision loss and its relationship to depressive symptomatology in legally blind older adults with age-related macular degeneration (ARMD). Design and Methods: The 144 study participants were outpatients of a large regional vision clinic that specializes in the diagnosis and treatment of…

  18. The Ethnic Identity, Other-Group Attitudes, and Psychosocial Functioning of Asian American Emerging Adults from Two Contexts

    ERIC Educational Resources Information Center

    Juang, Linda P.; Nguyen, Huong H.; Lin, Yunghui

    2006-01-01

    Drawing from two samples of Asian American emerging adults, one in an ethnically concentrated context (n = 108) and the other in an ethnically-dispersed, mainly White context (n = 153), we examined (a) how ethnic identity and other-group attitudes were related to psychosocial functioning (i.e., depression, self-esteem, and connectedness to…

  19. The Impact of the Developmental Timing of Trauma Exposure on PTSD Symptoms and Psychosocial Functioning among Older Adults

    ERIC Educational Resources Information Center

    Ogle, Christin M.; Rubin, David C.; Siegler, Ilene C.

    2013-01-01

    The present study examined the impact of the developmental timing of trauma exposure on posttraumatic stress disorder (PTSD) symptoms and psychosocial functioning in a large sample of community-dwelling older adults (N = 1,995). Specifically, we investigated whether the negative consequences of exposure to traumatic events were greater for traumas…

  20. Psychological outcomes and health beliefs in adolescent and young adult survivors of childhood cancer and controls.

    PubMed

    Kazak, Anne E; Derosa, Branlyn Werba; Schwartz, Lisa A; Hobbie, Wendy; Carlson, Claire; Ittenbach, Richard F; Mao, Jun J; Ginsberg, Jill P

    2010-04-20

    PURPOSE The purpose of this study was to compare adolescent and young adult (AYA) pediatric cancer survivors and peers without a history of serious illness on psychological distress, health-related quality of life (HRQOL), health beliefs; examine age at diagnosis and cancer treatment intensity on these outcomes; and examine relationships between number of health problems and the outcomes. PATIENTS AND METHODS AYA cancer survivors (n = 167) and controls (n = 170), recruited during visits to a cancer survivorship clinic and primary care, completed self-report questionnaires of distress, health problems, and health beliefs. For survivors, providers rated treatment intensity and health problems. Results There were no statistically significant differences between survivors and controls in psychological distress or HRQOL. Cancer survivors had less positive health beliefs. Survivors diagnosed as adolescents had significantly greater psychological distress and fewer positive health beliefs than those diagnosed earlier. Survivors with the highest level of treatment intensity had greater anxiety and fewer positive health beliefs than those with less intense treatments. Provider report of current health problems related to survivors' beliefs and mental HRQOL only, whereas patient report of health problems correlated significantly with most psychosocial outcomes and beliefs. CONCLUSION AYA cancer survivors did not differ from peers in psychological adjustment but did endorse less adaptive health beliefs. Survivors diagnosed during adolescence and who had more intensive cancer treatments evidenced poorer psychosocial outcomes. Beliefs about health may be identified and targeted for intervention to improve quality of life, particularly when patient perceptions of current health problems are considered.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  4. Psychosocial outcomes of three triage methods for the management of borderline abnormal cervical smears: an open randomised trial

    PubMed Central

    Irwig, Les; Turner, Robin; Chan, Siew Foong; Macaskill, Petra; Lewicka, Mary; Clarke, Judith; Weisberg, Edith; Barratt, Alex

    2010-01-01

    Objective To assess which of three triage strategies for women with borderline abnormal cervical smear results in the best psychosocial outcomes. Design Pragmatic, non-blinded, multicentre, randomised controlled trial. Setting 18 family planning clinics across Australia, covering both urban and rural areas, between January 2004 and October 2006. Participants Women aged 16-70 years (n=314) who attended routine cervical screening and received a borderline cervical smear. Interventions Patients were randomly assigned to human papillomavirus (HPV) DNA testing (n=104), a repeat smear test at six months (n=106), or the patient’s informed choice of either test supported by a decision aid (n=104). Psychosocial outcomes were assessed at multiple time points over 12 months by postal questionnaire. Main outcome measures We assessed health related quality of life (SF36 mental health subscale), cognitive effects (such as perceived risk of cervical cancer, intrusive thoughts), affective outcomes (general anxiety [state-trait anxiety inventory]), specific anxiety about an abnormal smear (cervical screening questionnaire), and behavioural outcomes (sexual health behaviour and visits to the doctor) over 12 months of follow-up. Results At two weeks, some psychosocial outcomes were worse for women allocated to HPV testing compared with those in the smear testing group (SF36 vitality subscale: t=−1.63, df=131, P=0.10; intrusive thoughts χ2=8.14, df=1, P<0.01). Over 12 months, distress about the abnormal smear was lowest in women allocated to HPV testing and highest in the repeat smear testing group (t=−2.89, df=135, P<0.01). Intrusive thoughts were highest in patients allocated to HPV testing (25%, compared with 13% in the informed choice group; difference=12%, 95% CI −1.1% to 25.1%). Women in the HPV DNA group and the informed choice group were more satisfied with their care than women allocated to repeat smear testing. Conclusions Although the psychosocial effect was

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

    ERIC Educational Resources Information Center

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

    2016-01-01

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

  6. Self-control forecasts better psychosocial outcomes but faster epigenetic aging in low-SES youth.

    PubMed

    Miller, Gregory E; Yu, Tianyi; Chen, Edith; Brody, Gene H

    2015-08-18

    There are persistent socioeconomic disparities in many aspects of child development in America. Relative to their affluent peers, children of low socioeconomic status (SES) complete fewer years of education, have a higher prevalence of health problems, and are convicted of more criminal offenses. Based on research indicating that low self-control underlies some of these disparities, policymakers have begun incorporating character-skills training into school curricula and social services. However, emerging data suggest that for low-SES youth, self-control may act as a "double-edged sword," facilitating academic success and psychosocial adjustment, while at the same time undermining physical health. Here, we examine this hypothesis in a five-wave study of 292 African American teenagers from rural Georgia. From ages 17 to 20 y, we assessed SES and self-control annually, along with depressive symptoms, substance use, aggressive behavior, and internalizing problems. At age 22 y, we obtained DNA methylation profiles of subjects' peripheral blood mononuclear cells. These data were used to measure epigenetic aging, a methylation-derived biomarker reflecting the disparity between biological and chronological aging. Among high-SES youth, better mid-adolescent self-control presaged favorable psychological and methylation outcomes. However, among low-SES youth, self-control had divergent associations with these outcomes. Self-control forecasted lower rates of depressive symptoms, substance use, aggressive behavior, and internalizing problems but faster epigenetic aging. These patterns suggest that for low-SES youth, resilience is a "skin-deep" phenomenon, wherein outward indicators of success can mask emerging problems with health. These findings have conceptual implications for models of resilience, and practical implications for interventions aimed at ameliorating social and racial disparities.

  7. Self-control forecasts better psychosocial outcomes but faster epigenetic aging in low-SES youth.

    PubMed

    Miller, Gregory E; Yu, Tianyi; Chen, Edith; Brody, Gene H

    2015-08-18

    There are persistent socioeconomic disparities in many aspects of child development in America. Relative to their affluent peers, children of low socioeconomic status (SES) complete fewer years of education, have a higher prevalence of health problems, and are convicted of more criminal offenses. Based on research indicating that low self-control underlies some of these disparities, policymakers have begun incorporating character-skills training into school curricula and social services. However, emerging data suggest that for low-SES youth, self-control may act as a "double-edged sword," facilitating academic success and psychosocial adjustment, while at the same time undermining physical health. Here, we examine this hypothesis in a five-wave study of 292 African American teenagers from rural Georgia. From ages 17 to 20 y, we assessed SES and self-control annually, along with depressive symptoms, substance use, aggressive behavior, and internalizing problems. At age 22 y, we obtained DNA methylation profiles of subjects' peripheral blood mononuclear cells. These data were used to measure epigenetic aging, a methylation-derived biomarker reflecting the disparity between biological and chronological aging. Among high-SES youth, better mid-adolescent self-control presaged favorable psychological and methylation outcomes. However, among low-SES youth, self-control had divergent associations with these outcomes. Self-control forecasted lower rates of depressive symptoms, substance use, aggressive behavior, and internalizing problems but faster epigenetic aging. These patterns suggest that for low-SES youth, resilience is a "skin-deep" phenomenon, wherein outward indicators of success can mask emerging problems with health. These findings have conceptual implications for models of resilience, and practical implications for interventions aimed at ameliorating social and racial disparities. PMID:26170291

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

    PubMed Central

    2011-01-01

    Background A number of studies have examined the effects of prenatal exposure to stress on birth outcomes but few have specifically focused on psychosocial job strain. In the present protocol, we aim to examine if work characterised by high demands and low control, during pregnancy, is associated with the risk of giving birth to a child born preterm or small for gestational age. Methods and design We will use the Danish National Birth Cohort where 100.000 children are included at baseline. In the present study 49,340 pregnancies will be included. Multinomial logistic regression will be applied to estimate odds ratios for the outcomes: preterm; full term but small for gestational age; full term but large for gestational age, as a function of job-strain (high strain, active and passive versus low strain). In the analysis we control for maternal age, Body Mass Index, parity, exercise, smoking, alcohol use, coffee consumption, type of work (manual versus non-manual), maternal serious disease and parents' heights as well as gestational age at interview. Discussion The prospective nature of the design and the high number of participants strengthen the study. The large statistical power allows for interpretable results regardless of whether or not the hypotheses are confirmed. This is, however, not a controlled study since all kinds of 'natural' interventions takes place throughout pregnancy (e.g. work absence, medical treatment and job-redesign). The analysis will be performed from a public health perspective. From this perspective, we are not primarily interested in the effect of job strain per se but if there is residual effect of job strain after naturally occurring preventive measures have been taken. PMID:21510894

  9. BRCA1/2 genetic testing uptake and psychosocial outcomes in men

    PubMed Central

    Gatammah, Rhoda; Peshkin, Beth N.; Krieger, Ayelet; Gell, Christy; Valdimarsdottir, Heiddis B.; Schwartz, Marc D.

    2011-01-01

    Few studies have quantitatively evaluated the uptake and outcomes of BRCA1/2 genetic counseling and testing in men. We conducted a prospective longitudinal study to describe and compare uptake of and psychosocial outcomes following BRCA1/2 testing in a sample of men and women at high-risk for carrying a BRCA1/2 mutation. Men (n = 98) and women (n = 243) unaffected with cancer completed baseline assessments prior to genetic counseling and testing and then 6- and 12-months post-testing. Most men (n = 94; 95.9%) opted to have genetic testing, of whom 44 received positive BRCA1/2 genetic test results and 50 received true negative results. Among women, 93.4% had genetic testing, of whom 79 received positive results and 148 received negative results. In multivariate models, male BRCA1/2 carriers reported significantly higher genetic testing distress (6-months: Z = 4.48, P < 0.0001; 12-months: Z = 2.78, P < 0.01) than male non-carriers. After controlling for baseline levels of distress, no statistically significant differences emerged between male and female BRCA1/2 carriers in psychological distress at 12-months post-testing, although absolute differences were evident over time. Predictors of distress related to genetic testing among male carriers at 12-months included higher baseline cancer-specific distress (Z = 4.73, P < 0.0001) and being unmarried (Z = 2.18, P < 0.05). Similarly, baseline cancer-specific distress was independently associated with cancer-specific distress at 6- (Z = 3.66, P < 0.001) and 12-months (Z = 4.44, P < 0.0001) post-testing among male carriers. Clinically, our results suggest that pre-test assessment of distress and creation of educational materials specifically tailored to the needs and concerns of male carriers may be appropriate in this important but understudied high-risk group. PMID:21365268

  10. Self-control forecasts better psychosocial outcomes but faster epigenetic aging in low-SES youth

    PubMed Central

    Miller, Gregory E.; Yu, Tianyi; Chen, Edith; Brody, Gene H.

    2015-01-01

    There are persistent socioeconomic disparities in many aspects of child development in America. Relative to their affluent peers, children of low socioeconomic status (SES) complete fewer years of education, have a higher prevalence of health problems, and are convicted of more criminal offenses. Based on research indicating that low self-control underlies some of these disparities, policymakers have begun incorporating character-skills training into school curricula and social services. However, emerging data suggest that for low-SES youth, self-control may act as a “double-edged sword,” facilitating academic success and psychosocial adjustment, while at the same time undermining physical health. Here, we examine this hypothesis in a five-wave study of 292 African American teenagers from rural Georgia. From ages 17 to 20 y, we assessed SES and self-control annually, along with depressive symptoms, substance use, aggressive behavior, and internalizing problems. At age 22 y, we obtained DNA methylation profiles of subjects’ peripheral blood mononuclear cells. These data were used to measure epigenetic aging, a methylation-derived biomarker reflecting the disparity between biological and chronological aging. Among high-SES youth, better mid-adolescent self-control presaged favorable psychological and methylation outcomes. However, among low-SES youth, self-control had divergent associations with these outcomes. Self-control forecasted lower rates of depressive symptoms, substance use, aggressive behavior, and internalizing problems but faster epigenetic aging. These patterns suggest that for low-SES youth, resilience is a “skin-deep” phenomenon, wherein outward indicators of success can mask emerging problems with health. These findings have conceptual implications for models of resilience, and practical implications for interventions aimed at ameliorating social and racial disparities. PMID:26170291

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

    PubMed Central

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

    2016-01-01

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

  12. The quality of parent/child relationships in adolescence is associated with poor adult psychosocial adjustment.

    PubMed

    Raudino, Alessandra; Fergusson, David M; Horwood, L John

    2013-04-01

    This study used data gathered over the course of a New Zealand longitudinal study (N = 924) to examine the relationships between measures of parental bonding and attachment in adolescence (age 15-16) and later personal adjustment (major depression; anxiety disorder; suicidal behaviour; illicit drug abuse/dependence; crime) assessed up to the age of 30. Key findings included: 1) There were significant (p < 0.05) and pervasive associations between all measures of attachment and bonding and later outcomes. 2) Structural equation modelling showed that all measures of bonding and attachment loaded on a common factor reflecting the quality of parent/child relationships in adolescence. 3) After adjustment for covariates there were modest relationships (β = 0.16-0.17) between the quality of parent/child relationships in adolescence factor and later adjustment. The study findings suggest that the quality of parent/child relationships in adolescence is modestly related to later psychosocial functioning in adulthood.

  13. Psychosocial and Functional Outcomes in Long-Term Survivors of Osteosarcoma: A Comparison of Limb-Salvage Surgery and Amputation

    PubMed Central

    Robert, Rhonda S.; Ottaviani, Giulia; Huh, Winston W.; Palla, Shana; Jaffe, Norman

    2009-01-01

    Background Traditionally, physicians have believed that limb-salvage surgery has functional and cosmetic advantages over amputation, yet the literature is equivocal. Therefore, we sought to compare the psychosocial and functional outcomes in osteosarcoma survivors after limb-salvage surgery and amputation. We hypothesized there to be neither psychosocial nor functional outcome differences between groups. Procedure Participants received treatment of extremity osteosarcoma, had received their cancer diagnosis at least 2 years prior, and were at least 16 years old. A comprehensive set of validated psychosocial and functional measures was used to assess outcome. Results Fifty-seven patients participated in this study (33 who underwent limb-salvage surgery and 24 who underwent amputation). Participants had gone 12–24 years since diagnosis and were 16–52 years old at study participation. We used multiple linear regression models to examine differences in quality of life, body image, self-esteem, and social support between the two groups and found no differences. Lower limb function was a significant predictor of quality of life (p < 0.001), whereas surgery type did not impact this relationship. Body image was rated significantly worse by those who underwent late amputation, amputation after failed limb salvage, than by those who did not. Conclusions Participants with more functional lower limbs had better quality of life than did those with less functional lower limbs regardless of whether they underwent amputation or limb-salvage surgery. PMID:20135700

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

    PubMed Central

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

    2016-01-01

    Patients with chronic kidney disease (CKD) form organized beliefs regarding their illness and treatment. These perceptions influence the coping strategies employed by an individual to manage his/her illness and may act as a predictor for his/her willingness to engage in self-management behaviours. While illness perceptions have been identified as predictors of non-adherence, depression and mortality in dialysis patients, there is a paucity of research in CKD patients not requiring renal replacement therapy. This narrative review synthesizes the existing literature regarding the role of illness perceptions and associated clinical and psychosocial outcomes in non-dialysis CKD patients. Studies were identified following database searches of AMED, BNI, CINAHL, EMBASE, Health Business Elite, HMIC, Medline, PsycINFO and Google Scholar in January 2016. Despite the small evidence base, existing studies indicate that negative illness perceptions are associated with disease progression and a number of psychosocial outcomes in non-dialysis CKD patients. Evidence from other clinical populations suggests that illness perceptions are modifiable through psychological intervention, which may be most effective if delivered early before beliefs have the chance to become more established. Therefore, targeting illness perceptions in the earlier stages of CKD may be optimal. Further studies are now required to ascertain the mechanisms through which illness perceptions predict psychosocial and clinical outcomes in CKD patients and to ultimately test the efficacy of illness perception–based interventions. PMID:27274839

  15. Physical and Psychosocial Functions of Adults with Lower Limb Congenital Deficiencies and Amputations in Childhood.

    PubMed

    Montesinos-Magraner, Ll; Issa-Benítez, D; Pagès-Bolíbar, E; Meléndez-Plumed, M; González-Viejo, M A; Castellano-Tejedor, C

    2016-01-01

    Objectives. (1) To describe the epidemiological and medical features of a sample with LLA and LLD in childhood and (2) to explore their relationship with subsequent physical and psychosocial functions in adulthood. Methods. Cross-sectional survey. Demographics, medical data, Locomotor Capabilities Index (LCI), and Discomfort-Engagement in Everyday Activities Involving Revealing the Body Scale (D-EEARB) were collected from thirty-two adults who suffered from LLA in childhood or LLD. Results. Most of the sample (53.1% males) was working (84.4%), living independently (75%), and single (75%). Mean age was 33.16 (SD = 7.64, range 18-50). Leading causes for LLA were traumatic (40.6%) and oncologic (25%). LLD was present in 6 cases (18.8%). LCI scores revealed a high performance among males (t 17,464 = 2.976, p = .008). D-EEARB scores showed that 56.25% stated feeling "quite" or "totally comfortable" in situations which involved revealing their body, but 43.75% stated the contrary ("uncomfortable" or "very uncomfortable"). LLD and traumatic LLA show higher scores in D-EEARB than vascular and oncological LLA (χ (2) = 7.744, df = 3, p = .05). Conclusions. Adults suffering from LLDs and LLAs during childhood seem to perform well once they are adults. However, 43.75% of patients express considerable discomfort in situations that involve revealing the body.

  16. Physical and Psychosocial Functions of Adults with Lower Limb Congenital Deficiencies and Amputations in Childhood

    PubMed Central

    Montesinos-Magraner, Ll.; Issa-Benítez, D.; Pagès-Bolíbar, E.; Meléndez-Plumed, M.; González-Viejo, M. A.; Castellano-Tejedor, C.

    2016-01-01

    Objectives. (1) To describe the epidemiological and medical features of a sample with LLA and LLD in childhood and (2) to explore their relationship with subsequent physical and psychosocial functions in adulthood. Methods. Cross-sectional survey. Demographics, medical data, Locomotor Capabilities Index (LCI), and Discomfort-Engagement in Everyday Activities Involving Revealing the Body Scale (D-EEARB) were collected from thirty-two adults who suffered from LLA in childhood or LLD. Results. Most of the sample (53.1% males) was working (84.4%), living independently (75%), and single (75%). Mean age was 33.16 (SD = 7.64, range 18–50). Leading causes for LLA were traumatic (40.6%) and oncologic (25%). LLD was present in 6 cases (18.8%). LCI scores revealed a high performance among males (t17,464 = 2.976, p = .008). D-EEARB scores showed that 56.25% stated feeling “quite” or “totally comfortable” in situations which involved revealing their body, but 43.75% stated the contrary (“uncomfortable” or “very uncomfortable”). LLD and traumatic LLA show higher scores in D-EEARB than vascular and oncological LLA (χ2 = 7.744, df = 3, p = .05). Conclusions. Adults suffering from LLDs and LLAs during childhood seem to perform well once they are adults. However, 43.75% of patients express considerable discomfort in situations that involve revealing the body. PMID:27195152

  17. Adult psychosocial assets and depressive mood over time. Effects of internalized childhood attachments.

    PubMed

    Richman, J A; Flaherty, J A

    1987-12-01

    This paper discusses contrasting assumptions in psychiatric epidemiological research regarding the relative significance of childhood and adult social experiences as etiological factors in adult psychopathology. It delineates a set of hypotheses that relate internal parental representations to subsequent depressed mood and to psychosocial assets assumed to mediate the relationships between parental representations and mood states. These hypotheses were prospectively tested using a cohort of medical students surveyed at medical school entrance and 7 months later. The data show that earlier paternal affectivity perceived at time 1 is inversely predictive of time 2 depressed mood, holding time 1 mood constant, whereas earlier maternal and paternal overprotection perceived at time 1 are directly predictive of time 2 depressed mood, holding time 1 mood constant. In addition, parental representations at time 1 are significantly linked to particular personality characteristics at time 1 and 2. However, it is not clear whether these personality characteristics are antecedents or consequences of depressed mood. The paper concludes with a discussion of theoretical and methodological issues involved in the retrospective assessment of remote social experiences as etiological factors in adult psychopathology. PMID:3681282

  18. Functional Impairment and Occupational Outcome in Adults with ADHD

    ERIC Educational Resources Information Center

    Gjervan, Bjorn; Torgersen, Terje; Nordahl, Hans M.; Rasmussen, Kirsten

    2012-01-01

    Objective: ADHD is associated with poor functional outcomes. The objectives were to investigate the prevalence of functional impairment and occupational status in a clinically referred sample of adults with ADHD and explore factors predicting occupational outcome. Method: A sample of 149 adults with a confirmed diagnosis of ADHD participated in…

  19. Adult functional outcomes of common childhood psychiatric problems: A prospective, longitudinal study

    PubMed Central

    Copeland, William E.; Wolke, Dieter; Shanahan, Lilly; Costello, E. Jane

    2016-01-01

    Context Psychiatric problems are among the most common health problems of childhood. Objective To test whether these health problems adversely affect adult functioning even if the problems themselves do not persist. Design Prospective, population-based study of 1420 participants assessed with structured interviews up to 6 times in childhood (ages 9 to 16; 6674 observations) for common psychiatric diagnoses and subthreshold psychiatric problems. Setting and population Community sample. Main outcome measure Participants were then assessed 3 times in young adulthood (ages 19, 21, and 24–26; 3215 observations of 1273 subjects) for adverse outcomes related to health, legal, financial, and social functioning. Results Participants with a childhood disorder had 6 times higher odds of at least one adverse adult outcome as compared to those with no history of psychiatric problems and 9 times higher odds of 2 or more such indicators (1 indicator: 59.5% vs. 19.9%, p <0.001; 2+ indicators: 34.2% vs. 5.6%, p <0.001). These associations persisted after statistically controlling for childhood psychosocial hardships and adult psychiatric problems. Risk was not limited to those with a diagnosis: participants with subthreshold psychiatric problems had 3 times higher odds of adult adverse outcomes and 5 time higher odds of 2 or more outcomes (1 indicator: 41.9% vs. 19.9%, p <0.001; 2+ indicators: 23.2% vs. 5.6%, p <0.001). The best diagnostic predictor of adverse outcomes was cumulative childhood exposure to psychiatric disorders. Conclusions Common, typically moderately-impairing, childhood psychiatric problems are associated with a disrupted transition to adulthood even if the problems do not persist into adulthood and even if the problems are subthreshold. Such problems provide potential target for public health efforts to ameliorate adult suffering and morbidity. PMID:26176785

  20. Clinical implications of the Women's Ischemia Syndrome Evaluation: inter-relationships between symptoms, psychosocial factors and cardiovascular outcomes.

    PubMed

    Handberg, Eileen M; Eastwood, Jo-Ann; Eteiba, Wafia; Johnson, B Delia; Krantz, David S; Thompson, Diane V; Vaccarino, Viola; Bittner, Vera; Sopko, George; Pepine, Carl J; Merz, Noel Bairey; Rutledge, Thomas R

    2013-09-01

    Cardiovascular disease remains the leading cause of death in the USA and is associated with several modifiable (hypertension, diabetes, high cholesterol, tobacco use, physical inactivity, obesity and unhealthy diet) and nonmodifiable (age, gender and family history) risk factors. The role of psychosocial risk factors in the development of cardiovascular disease has a growing body of literature, and differences in men and women have been identified. The Women's Ischemia Syndrome Evaluation provides insight into psychosocial risk factors in a cohort of women presenting with chest pain who had a comprehensive battery of psychosocial assessments and long-term follow-up. This review focuses on symptom presentation for chest pain and its relationship to cardiovascular disease morbidity and mortality, quality of life, healthcare costs and psychosocial predictor variables, including anxiety, depression, hostility and social networks. In the Women's Ischemia Syndrome Evaluation, persistent chest pain was associated with an increased rate of adverse events and relatively high rates of depression and anxiety, with reduced functional capacity and impaired quality of life, over a median of 6 years of follow-up. More research is needed to better understand the relationships between symptoms and negative emotions and to determine whether psychological (pharmacologic and/or cognitive) interventions might impact both psychological and cardiovascular outcomes. PMID:24007253

  1. A qualitative study of migrant-related stressors, psychosocial outcomes and HIV risk behaviour among truck drivers in Zambia.

    PubMed

    Michalopoulos, Lynn Murphy; Ncube, Nomagugu; Simona, Simona J; Kansankala, Brian; Sinkala, Emmanuel; Raidoo, Jasmin

    2016-09-01

    Truck drivers are part of mobile populations which have been noted as a key population at risk of HIV in Zambia. This study was aimed at: (1) determining potentially traumatic events (PTEs), labour migrant-related stressors, psychosocial problems and HIV risk behaviours among truck drivers in Zambia; and (2) examining the relationship between PTEs, migrant-related stressors, psychosocial outcomes and HIV sexual risk behaviour among truck drivers in Zambia. We conducted 15 semi-structured interviews with purposively sampled male truck drivers at trucking companies in Lusaka, Zambia. Findings indicate that truck drivers experience multiple stressors and potentially traumatic incidences, including delays and long waiting hours at borders, exposure to crime and violence, poverty, stress related to resisting temptation of sexual interactions with sex workers or migrant women, and job-related safety concerns. Multiple psychosocial problems such as intimate partner violence, loneliness, anxiety and depression-like symptoms were noted. Transactional sex, coupled with inconsistent condom use, were identified as HIV sexual risk behaviours. Findings suggest the critical need to develop HIV-prevention interventions which account for mobility, potentially traumatic events, psychosocial problems, and the extreme fear of HIV testing among this key population. PMID:27681145

  2. Clinical implications of the Women's Ischemia Syndrome Evaluation: inter-relationships between symptoms, psychosocial factors and cardiovascular outcomes.

    PubMed

    Handberg, Eileen M; Eastwood, Jo-Ann; Eteiba, Wafia; Johnson, B Delia; Krantz, David S; Thompson, Diane V; Vaccarino, Viola; Bittner, Vera; Sopko, George; Pepine, Carl J; Merz, Noel Bairey; Rutledge, Thomas R

    2013-09-01

    Cardiovascular disease remains the leading cause of death in the USA and is associated with several modifiable (hypertension, diabetes, high cholesterol, tobacco use, physical inactivity, obesity and unhealthy diet) and nonmodifiable (age, gender and family history) risk factors. The role of psychosocial risk factors in the development of cardiovascular disease has a growing body of literature, and differences in men and women have been identified. The Women's Ischemia Syndrome Evaluation provides insight into psychosocial risk factors in a cohort of women presenting with chest pain who had a comprehensive battery of psychosocial assessments and long-term follow-up. This review focuses on symptom presentation for chest pain and its relationship to cardiovascular disease morbidity and mortality, quality of life, healthcare costs and psychosocial predictor variables, including anxiety, depression, hostility and social networks. In the Women's Ischemia Syndrome Evaluation, persistent chest pain was associated with an increased rate of adverse events and relatively high rates of depression and anxiety, with reduced functional capacity and impaired quality of life, over a median of 6 years of follow-up. More research is needed to better understand the relationships between symptoms and negative emotions and to determine whether psychological (pharmacologic and/or cognitive) interventions might impact both psychological and cardiovascular outcomes.

  3. Predicting functional remission in patients with schizophrenia: a cross-sectional study of symptomatic remission, psychosocial remission, functioning, and clinical outcome

    PubMed Central

    Valencia, Marcelo; Fresán, Ana; Barak, Yoram; Juárez, Francisco; Escamilla, Raul; Saracco, Ricardo

    2015-01-01

    Background New approaches to assess outcome in schizophrenia include multidimensional measures such as remission, cognition, psychosocial functioning, and quality of life. Clinical and psychosocial measures have been recently introduced to assess functional outcome. Objective The study presented here was designed to examine the rates of symptomatic remission, psychosocial remission, global functioning, and clinical global impressions in a sample of schizophrenia outpatients in order to assess functional remission and to identify predictive factors for functional remission. Methods A total of 168 consecutive Mexican outpatients receiving pharmacological treatment at the National Institute of Psychiatry in Mexico City were enrolled in a cross-sectional study. Symptomatic remission was assessed according to the definition and criteria proposed by the Remission in Schizophrenia Working Group using the Positive and Negative Symptom Scale. Psychosocial remission was assessed according to Barak criteria using the Psychosocial Remission in Schizophrenia scale. Functioning was measured with the Global Assessment of Functioning, and clinical outcome with the Clinical Global Impressions (CGI) Scale. Results Findings showed that 45.2% of patients fulfilled the symptomatic remission criteria, 32.1% achieved psychosocial remission, and 53% reported adequate functioning. However, the combination of these three outcome criteria – symptomatic, psychosocial remission, and functioning – indicated that 14.9% of the patients achieved our predefined functional remission outcome. The logistic regression model included five predictive variables for functional remission: (1) being employed, (2) use of atypical antipsychotics, (3) lower number of medications, (4) lower negative symptom severity, and (5) lower excitement symptom severity. Conclusion The study demonstrated that symptomatic remission, psychosocial remission, and functioning could be achievable goals for a considerable

  4. Adverse psychosocial outcomes associated with drug use among US high school seniors: a comparison of alcohol and marijuana

    PubMed Central

    Palamar, Joseph J.; Fenstermaker, Michael; Kamboukos, Dimitra; Ompad, Danielle C.; Cleland, Charles M.; Weitzman, Michael

    2015-01-01

    Objectives There is debate about whether marijuana (cannabis) use is more dangerous than alcohol use. Although difficult to make objective comparisons, research is needed to compare relative dangers in order to help inform preventive efforts and policy. Methods Data were analyzed from a nationally representative sample of high school seniors in the Monitoring the Future study (2007–2011; Weighted n = 7437; modal age: 18) who reported lifetime use of alcohol or marijuana. Students were asked to indicate whether they experienced various adverse psychosocial outcomes resulting from use of each substance. We examined which outcomes were more prevalent for each substance. Results Compared to alcohol use, marijuana use was more commonly reported to compromise relationships with teachers or supervisors, result in less energy or interest, and result in lower school or job performance. Compared to marijuana use, alcohol was more commonly reported to compromise relationships with friends and significant others; it was also reported to lead to more regret (particularly among females), and driving unsafely. Marijuana users were more likely to report no adverse outcomes. Females and white students were more likely to report various adverse outcomes and higher frequency use of each substance also increased occurrences of reported adverse outcomes. Conclusions Marijuana and alcohol are associated with unique adverse psychosocial outcomes. Outcomes differ by sex and race/ethnicity, and perception or experience of outcomes may also be related to legal status and associated stigma. Public health interventions may be more effective by focusing on harm reduction strategies for these drug-specific outcomes. PMID:25169838

  5. Childhood Symptoms of ADHD Overrule Comorbidity in Relation to Psychosocial Outcome at Age 15: A Longitudinal Study

    PubMed Central

    Norén Selinus, Eva; Molero, Yasmina; Lichtenstein, Paul; Larson, Tomas; Lundström, Sebastian; Anckarsäter, Henrik; Gumpert, Clara Hellner

    2015-01-01

    Objective Neurodevelopmental problems (NDPs) may influence the transition from childhood to adolescence. Our aim was to study long-term psychosocial outcomes of NDPs, focusing on ADHD. Method Data was collected through a telephone interview with parents of twins at ages 9 or 12 years. NDP screen-positive children were clinically assessed at age 15; N = 450. Psychosocial outcome concerning peers, school, internalizing problems, antisocial behavior, alcohol misuse, drug misuse, and impaired daily functioning was examined. Results Even after controlling for other NDP comorbidity, screen-positivity for ADHD doubled or tripled the odds of later psychosocial problems. When controlling for parental education level, the significant effect of ADHD remained only for antisocial behavior and impaired daily functioning. Conclusions Signs of NDPs as well as other psychiatric diagnoses at ages 9 or 12 years are associated with a more problematic adolescence. However, despite the presence of comorbidity, early ADHD symptoms stand out as the most important risk factor for later antisocial development and impaired daily functioning. PMID:26360378

  6. Health behaviors, quality of life, and psychosocial health among survivors of adolescent and young adult cancers

    PubMed Central

    Nam, Gina E.; Zhang, Yingying; McFadden, Molly; Wright, Jennifer; Spraker-Perlman, Holly; Kinney, Anita Y.; Oeffinger, Kevin C.; Kirchhoff, Anne C.

    2016-01-01

    Purpose Survivors of adolescent and young adult (AYA) cancer may engage in unhealthy lifestyles (e.g., smoking), potentially heightening their risk for long-term health problems. We assessed health behaviors and constructs including quality of life (QOL) and psychosocial well-being among survivors of AYA cancer compared to the general population. Methods We used 2009 Behavioral Risk Factor Surveillance System data to evaluate health behaviors for survivors of AYA cancer compared to AYAs without cancer. Multivariable regressions assessed health behaviors (smoking, binge drinking, physical inactivity, and low fruit/vegetable intake) by sex and age between AYA survivors and controls, and among survivors to determine the effects of demographic, QOL, psychosocial, and cancer factors on behaviors. Results A greater proportion of female survivors of AYA cancer smoked than controls (currently aged 20–39: 27 vs. 14.3%, respectively; currently aged 40–64: 29.3 vs. 18.4%, respectively). Generally, survivors and controls were non-adherent to national health behavior guidelines. Uninsured survivors were at greater risk of smoking vs. insured (females, Relative Risk (RR)=1.64, 95 % confidence interval (CI) 1.43–1.90; males, RR=2.62, 95 % CI 1.71–4.02). Poor social/emotional support was associated with smoking (RR= 1.26, 95 % CI 1.07–1.48) among female survivors and was associated with low fruit/vegetable intake among male (RR= 1.12, 95 % CI 1.01–1.23) and female (RR=1.12, 95 % CI 1.05–1.19) survivors. Female survivors >10 years from diagnosis had higher risk of smoking (RR=1.26–1.91, all p<0.01) than survivors 5–10 years from diagnosis. Conclusions Unhealthy lifestyle behaviors are common in survivors of AYA cancer. Implications for Cancer Survivors AYA survivors require health behavior support. PMID:26248766

  7. Gender, Race-Ethnicity, and Psychosocial Barriers to Mental Health Care: An Examination of Perceptions and Attitudes among Adults Reporting Unmet Need

    ERIC Educational Resources Information Center

    Ojeda, Victoria D.; Bergstresser, Sara M.

    2008-01-01

    Though researchers have described psychosocial barriers to mental health care-seeking, limited research has examined ways in which gender and race-ethnicity are associated with individuals' perceptions and attitudes. This study investigates correlates of psychosocial barriers to mental health care in a population of adults reporting unmet need for…

  8. LGBTQ adolescents and young adults raised within a Christian religious context: positive and negative outcomes.

    PubMed

    Dahl, Angie L; Galliher, Renee V

    2012-12-01

    Religious contexts have traditionally been understood as protective for a variety of psychosocial health outcomes. However, the generalizability of these findings to youth who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ) is questioned due to denominational teachings on same-sex attractions and sexual behavior. Eight adolescents (15-17 years) and 11 young adults (19-24 years) who identify as LGBTQ raised in Christian religious affiliations (16 participants raised in the Church of Jesus Christ of Latter Day Saints, 2 participants raised Catholic and 1 participant raised Presbyterian) participated in individual in-depth interviews, journal writings, and focus groups to provide greater insight into the lived experiences of LGBTQ individuals raised within a Christian religious environment. Findings suggest the religious context is related to both positive and negative outcomes. Eight themes are explored using participant's own words and experiences. Directions for future research and implications are discussed. PMID:22910195

  9. BRCA1/2 genetic testing uptake and psychosocial outcomes in men.

    PubMed

    Graves, Kristi D; Gatammah, Rhoda; Peshkin, Beth N; Krieger, Ayelet; Gell, Christy; Valdimarsdottir, Heiddis B; Schwartz, Marc D

    2011-06-01

    Few studies have quantitatively evaluated the uptake and outcomes of BRCA1/2 genetic counseling and testing in men. We conducted a prospective longitudinal study to describe and compare uptake of and psychosocial outcomes following BRCA1/2 testing in a sample of men and women at high-risk for carrying a BRCA1/2 mutation. Men (n = 98) and women (n = 243) unaffected with cancer completed baseline assessments prior to genetic counseling and testing and then 6- and 12-months post-testing. Most men (n = 94; 95.9%) opted to have genetic testing, of whom 44 received positive BRCA1/2 genetic test results and 50 received true negative results. Among women, 93.4% had genetic testing, of whom 79 received positive results and 148 received negative results. In multivariate models, male BRCA1/2 carriers reported significantly higher genetic testing distress (6-months: Z = 4.48, P < 0.0001; 12-months: Z = 2.78, P < 0.01) than male non-carriers. After controlling for baseline levels of distress, no statistically significant differences emerged between male and female BRCA1/2 carriers in psychological distress at 12-months post-testing, although absolute differences were evident over time. Predictors of distress related to genetic testing among male carriers at 12-months included higher baseline cancer-specific distress (Z = 4.73, P < 0.0001) and being unmarried (Z = 2.18, P < 0.05). Similarly, baseline cancer-specific distress was independently associated with cancer-specific distress at 6- (Z = 3.66, P < 0.001) and 12-months (Z = 4.44, P < 0.0001) post-testing among male carriers. Clinically, our results suggest that pre-test assessment of distress and creation of educational materials specifically tailored to the needs and concerns of male carriers may be appropriate in this important but understudied high-risk group.

  10. Children and mothers in war: an outcome study of a psychosocial intervention program.

    PubMed

    Dybdahl, R

    2001-01-01

    The present study was designed to evaluate the effects on children (age: M = 5.5 years) in war-torn Bosnia and Herzegovina of a psychosocial intervention program consisting of weekly group meetings for mothers for 5 months. An additional aim was to investigate the children's psychosocial functioning and the mental health of their mothers. Internally displaced mother-child dyads were randomly assigned to an intervention group receiving psychosocial support and basic medical care (n = 42) or to a control group receiving medical care only (n = 45). Participants took part in interviews and tests to provide information about war exposure, mental health, psychosocial functioning, intellectual abilities, and physical health. Results showed that although all participants were exposed to severe trauma, their manifestations of distress varied considerably. The intervention program had a positive effect on mothers' mental health, children's weight gain, and several measures of children's psychosocial functioning and mental health, whereas there was no difference between the two groups on other measures. The findings have implications for policy. PMID:11480943

  11. Psychosocial Interventions for the Acute Treatment of Late-life Major Depression: A Systematic Review of Evidence-based Treatments, Predictors of Treatment Outcomes and Moderators of Treatment Effects

    PubMed Central

    Kiosses, Dimitris N.; Leon, Andrew C.; Areán, Patricia A.

    2011-01-01

    The goal of this systematic review is to evaluate the efficacy of psychosocial interventions for the acute treatment of late-life depression and identify predictors of treatment outcomes and moderators of treatment effects. The results of the systematic review may help to advance the development of personalized psychosocial treatments for late-life major depression. Based on our criteria, Problem Solving Therapy (PST), Cognitive Behavioral Therapy (CBT), and Treatment Initiation and Participation Program (TIP) have supportive evidence of efficacy, pending replication. Even though the data on the predictors of treatment outcomes and moderators of treatment effects are still preliminary, it appears that baseline anxiety and stress level, personality pathology, endogenous depression, and reduced self-rated health are associated with worse depression outcomes. More research is also recommended to examine the moderating effects of baseline depression severity; for instance, our review indicates that Interpersonal Psychotherapy (IPT) may work better in participants with high baseline depression severity than in participants with low depression severity. Recommendations for future novel psychosocial interventions for the acute treatment of late-life major depression include application of these interventions in non-traditional settings, involvement of the caregivers in the treatment of cognitively and functionally impaired older adults with major depression, and expansion of research to include more racially and ethnically diverse populations as the samples of the examined studies is highly selective, i.e. overly healthy, cognitively intact, Caucasian, and highly educated. PMID:21536164

  12. Child Health and Young Adult Outcomes

    ERIC Educational Resources Information Center

    Currie, Janet; Stabile, Mark; Manivong, Phongsack; Roos, Leslie L.

    2010-01-01

    Research has shown a strong connection between birth weight and future outcomes. We ask how health problems after birth affect outcomes using data from public health insurance records for 50,000 children born between 1979 and 1987 in the Canadian province of Manitoba. We compare children to siblings born an average of three years apart. We find…

  13. Prediction of outcomes in young adults with aneurysmal subarachnoid hemorrhage.

    PubMed

    Chotai, Silky; Ahn, Sung-Yong; Moon, Hong-Joo; Kim, Jong-Hyun; Chung, Heung-Seob; Chung, Yong-Gu; Kwon, Taek-Hyun

    2013-01-01

    Subarachnoid hemorrhage (SAH) is rare in young adults and little is known about aneurysms in this subgroup. The effect of clinical and prognostic factors on the outcome based on the Glasgow Outcome Scale (GOS) scores and the predictors of unfavorable outcomes were analyzed in young adults with aneurysmal SAH. A retrospective review of the clinical parameters, including age, sex, hypertension, smoking status, hyperlipidemia, location of the cerebral aneurysm, size of the aneurysm, multiplicity, perioperative complication such as hydrocephalus, vasospasm, and hematoma, and Hunt and Hess and Fisher grading on presentation, was conducted in 108 young adults (mean age 34.8 years) managed at our institute. The outcome was classified based on GOS grading into unfavorable (GOS scores 1-3) or favorable (GOS scores 4 or 5). The overall mortality rate was 3.7% (4/108 patients). Univariate regression analysis for the outcomes at discharge found that age at the time of presentation, male sex, size of aneurysm, multiple aneurysms, hyperlipidemia, and poor Hunt and Hess and Fischer grades were associated with unfavorable outcome. Multivariate regression analysis found independent effects of sex, multiple aneurysms, size of aneurysm, and Hunt and Hess grade on the outcome at discharge. Size of aneurysm, presence of multiple aneurysms, Hunt and Hess grade, and hypertension were the predictors of outcome at mean 2-year follow up based on multivariate exact regression analysis. The multimodal approach with aggressive medical management, early intervention, and surgical treatment might contribute to favorable long-term outcomes in patients with poor expected outcomes.

  14. Parental divorce during early adolescence in Caucasian families: the role of family process variables in predicting the long-term consequences for early adult psychosocial adjustment.

    PubMed

    Summers, P; Forehand, R; Armistead, L; Tannenbaum, L

    1998-04-01

    The relationship between parental divorce occurring during adolescence and young adult psychosocial adjustment was examined, as was the role of family process variables in clarifying this relationship. Participants were young Caucasian adults from divorced (n = 119) and married (n = 123) families. Assessments were conducted during adolescence and 6 years later during early adulthood. Young adults from married families reported more secure romantic attachments than those from divorced families; however, differences were not evident in other domains of psychosocial adjustment after demographic variables were controlled. Three family process variables (parent-adolescent relationship, interparental conflict, and maternal depressive symptoms) were examined as potential mediators and moderators of the association between parental divorce and young adult adjustment. No evidence supporting mediation or moderation was found; however, the parent-adolescent and parent-young adult relationships, particularly when the identified parent was the father, emerged as significant predictors of young adult psychosocial adjustment. PMID:9583336

  15. Outcomes in Adult Life among Siblings of Individuals with Autism

    ERIC Educational Resources Information Center

    Howlin, Patricia; Moss, Philippa; Savage, Sarah; Bolton, Patrick; Rutter, Michael

    2015-01-01

    Little is known about adult siblings of individuals with autism. We report on cognitive, social and mental health outcomes in 87 adult siblings (mean age 39 years). When younger all had been assessed either as being "unaffected" by autism (n = 69) or as meeting criteria for the "Broader Autism Phenotype" (BAP, n = 18). As…

  16. Functional Outcomes in the Treatment of Adults with ADHD

    ERIC Educational Resources Information Center

    Adler, Lenard A.; Spencer, Thomas J.; Levine, Louise R.; Ramsey, Janet L.; Tamura, Roy; Kelsey, Douglas; Ball, Susan G.; Allen, Albert J.; Biederman, Joseph

    2008-01-01

    Objective: ADHD is associated with significant functional impairment in adults. The present study examined functional outcomes following 6-month double-blind treatment with either atomoxetine or placebo. Method: Patients were 410 adults (58.5% male) with "DSM-IV"--defined ADHD. They were randomly assigned to receive either atomoxetine 40 mg/day to…

  17. Impact of Choice on Social Outcomes of Adults with ASD

    ERIC Educational Resources Information Center

    Mehling, Margaret H.; Tassé, Marc J.

    2015-01-01

    This study explores social outcomes for adults with autism spectrum disorder (ASD) in comparison to adults with developmental disabilities other than ASD by investigating the relationships between the constructs Social Participation and Relationships, Social Determination, and Personal Control. Structural equation modeling (SEM) was used to test a…

  18. Adolescent Employment and Psychosocial Outcomes: A Comparison of Two Employment Contexts.

    ERIC Educational Resources Information Center

    Hansen, David M.; Jarvis, Patricia A.

    2000-01-01

    Investigated psychosocial variables among adolescents who worked in family-owned businesses and in nonfamilial contexts, focusing on work stressors, parental support, academic achievement, work-school connections, substance use, and coping. Survey data indicated that working in a family business related to students' reporting greater perceived…

  19. Attention and Language as Mediators of Academic Outcomes Following Early Psychosocial Deprivation

    ERIC Educational Resources Information Center

    Merz, Emily C.; McCall, Robert B.; Wright, Amanda J.

    2013-01-01

    Children adopted from institutions at older ages are at increased risk of persistent attention problems, lower cognition, and academic difficulties. This study examined cognitive and behavior problems as mediators of the association between early psychosocial deprivation and academic functioning. Participants were 8-17-year-old children adopted…

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

    ERIC Educational Resources Information Center

    Shaffer, Anne; Egeland, Byron

    2011-01-01

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

  1. Psychosocial Outcomes at 15 Years of Children with a Preschool History of Speech-Language Impairment

    ERIC Educational Resources Information Center

    Snowling, Margaret J.; Bishop, D. V. M.; Stothard, Susan E.; Chipchase, Barry; Kaplan, Carole

    2006-01-01

    Background: Evidence suggests there is a heightened risk of psychiatric disorder in children with speech-language impairments. However, not all forms of language impairment are strongly associated with psychosocial difficulty, and some psychiatric disorders (e.g., attention deficit/hyperactivity disorder (ADHD)) are more prevalent than others in…

  2. Children and Mothers in War: An Outcome Study of a Psychosocial Intervention Program.

    ERIC Educational Resources Information Center

    Dybdahl, Ragnhild

    2001-01-01

    Evaluated effects on children in Bosnia and Herzegovina of a 5-month psychosocial intervention program of weekly group meetings for mothers. Found that although all participants were exposed to severe trauma, their distress varied considerably. The intervention program had a positive effect on mothers' mental health, children's weight gain, and…

  3. Adult Outcomes in Autism: Community Inclusion and Living Skills

    ERIC Educational Resources Information Center

    Gray, Kylie M.; Keating, Caroline M.; Taffe, John R.; Brereton, Avril V.; Einfeld, Stewart L.; Reardon, Tessa C.; Tonge, Bruce J.

    2014-01-01

    Longitudinal research has demonstrated that social outcomes for adults with autism are restricted, particularly in terms of employment and living arrangements. However, understanding of individual and environmental factors that influence these outcomes is far from complete. This longitudinal study followed a community sample of children and…

  4. Outcomes and Pathways in Adult and Community Education.

    ERIC Educational Resources Information Center

    Adult, Community, and Further Education Board, Melbourne (Australia).

    A project examined the outcomes and pathways of 1992 participants in adult and community education (ACE) courses in Victoria, New South Wales, and South Australia. It explored participant characteristics, vocational skills gained from completing ACE courses, educational and employment outcomes, and personal benefits and benefits to families and…

  5. An increase in salivary interleukin-6 level following acute psychosocial stress and its biological correlates in healthy young adults.

    PubMed

    Izawa, Shuhei; Sugaya, Nagisa; Kimura, Kenta; Ogawa, Namiko; Yamada, Kosuke C; Shirotsuki, Kentaro; Mikami, Ikuyo; Hirata, Kanako; Nagano, Yuichiro; Nomura, Shinobu

    2013-10-01

    Although interleukin-6 (IL-6) has been investigated frequently in stress research, knowledge regarding the biological processes of IL-6 in association with psychosocial stress remains incomplete. This study focused on salivary IL-6 and reports its temporal variation and biological correlates following acute psychosocial stress. Fifty healthy young adults (39 male and 11 female students) were subjected to the psychosocial stress test 'Trier Social Stress Test' (TSST), wherein the participants were asked to deliver a speech and perform a mental arithmetic task in front of 2 audiences. Collection of saliva samples, measurement of heart rate, and assessment of negative moods by visual analogue scales were conducted before, during, and after TSST. Salivary IL-6 levels increased by approximately 50% in response to the TSST and remained elevated for 20 min after the stress tasks were completed. Cluster analyses revealed that individuals with sustained elevation of IL-6 levels following the TSST exhibited a lower cortisol response compared to individuals with lower IL-6 levels. In the correlation analyses, a greater IL-6 response was associated with a higher heart rate during the mental arithmetic task (r=.351, p<.05) and with a lower cortisol response (r=-.302, p<.05). This study demonstrates that salivary IL-6 levels are elevated for a relatively long period following acute psychosocial stress, and suggests that sympathetic activity and cortisol secretion are involved in elevation of salivary IL-6 levels.

  6. Predictors of CBT outcome in older adults with GAD.

    PubMed

    Hundt, Natalie E; Amspoker, Amber B; Kraus-Schuman, Cynthia; Cully, Jeffrey A; Rhoades, Howard; Kunik, Mark E; Stanley, Melinda A

    2014-12-01

    The current study is a secondary analysis of data from a randomized controlled trial of CBT for late-life GAD (Stanley et al., 2014) which provided an opportunity to examine predictors of outcome among those who received CBT. Participants were 150 older adults who were randomized to receive 10 sessions of CBT. Completer analyses found that homework completion, number of sessions attended, lower worry severity, lower depression severity, and recruitment site predicted 6-month worry outcome on the PSWQ-A, whereas homework completion, credibility of the therapy, lower anxiety severity, and site predicted 6-month anxiety outcome on the STAI-T. In intent-to-treat multivariate analyses, however, only initial worry and anxiety severity, site, and number of sessions completed predicted treatment outcome. These results are largely consistent with predictors of outcome in younger adults and suggest that lower initial symptom severity and variables consistent with greater engagement in treatment predict outcome. PMID:25445074

  7. Sense of humor, childhood cancer stressors, and outcomes of psychosocial adjustment, immune function, and infection.

    PubMed

    Dowling, Jacqueline S; Hockenberry, Marilyn; Gregory, Richard L

    2003-01-01

    The diagnosis, treatment, and side effects of childhood cancer have been described as extremely stressful experiences in the life of a child. Anecdotally, children report that a sense of humor helps them cope with the daily experiences of living with cancer; however, no research has examined sense of humor and childhood cancer stressors. This study investigated the effect of sense of humor on the relationship between cancer stressors and children's psychosocial adjustment to cancer, immune function, and infection using Lazarus and Folkman's theory of stress, appraisal, and coping. A direct relationship was observed between sense of humor and psychosocial adjustment to cancer, such that children with a high sense of humor had greater psychological adjustment, regardless of the amount of cancer stressors. A moderating effect was observed for incidence of infection. As childhood cancer stressors increase, children with high coping humor scores reported fewer incidences of infection than low scorers.

  8. Childhood Sexual Abuse and Adult Work Outcomes

    ERIC Educational Resources Information Center

    Lee, Shawna J.; Tolman, Richard M.

    2006-01-01

    The authors explored the relationship among childhood sexual abuse (CSA), physical and mental health work barriers, and employment outcomes using a large panel study of current and former welfare recipients. Controlling for human capital and demographic characteristics, they found CSA was associated with significantly fewer months worked over the…

  9. Adult Outcome for Children with Autism

    ERIC Educational Resources Information Center

    Howlin, Patricia; Goode, Susan; Hutton, Jane; Rutter, Michael

    2004-01-01

    Background: Information on long-term prognosis in autism is limited. Outcome is known to be poor for those with an IQ below 50, but there have been few systematic studies of individuals with an IQ above this. Method: Sixty-eight individuals meeting criteria for autism and with a performance IQ of 50 or above in childhood were followed up as…

  10. Psychosocial Treatment of Bipolar Disorders in Adolescents: A Proposed Cognitive-Behavioral Intervention

    ERIC Educational Resources Information Center

    Danielson, Carla Kmett; Feeny, Norah C.; Findling, Robert L.; Youngstrom, Eric A.

    2004-01-01

    Despite the severity of bipolar disorder (BP) and the amount of attention the psychosocial treatment of BP among adults has been given (e.g., Basco & Rush, 1996; Miklowitz, Frank, & George, 1996), no published outcome study or psychosocial treatment manual to date exists for children with this disorder. Based upon what is known about the…

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

    PubMed

    Larsen, Ann Dyreborg

    2015-02-01

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

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

    PubMed Central

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

    2011-01-01

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

  13. The Relationship Between Early Sexual Debut and Psychosocial Outcomes: A Longitudinal Study of Dutch Adolescents

    PubMed Central

    Sandfort, Theo; Reitz, Ellen; Bos, Henny; Dekovic, Maja

    2010-01-01

    In a longitudinal dataset of 470 Dutch adolescents, the current study examined the ways in which early sexual initiation was related to subsequent attachment, self-perception, internalizing problems, and externalizing problems. For male adolescents, analyses revealed general attachment to mother and externalizing problems at Wave 1 to predict to early transition at Wave 2. However, there was no differential change in these psychosocial factors over time for early initiators of sexual intercourse and their non-initiating peers. For female adolescents, the model including psychosocial factors at Wave 1 did not predict to sexual initiation at Wave 2. However, univariate repeated measures analyses revealed early initiators to have significantly larger increases in self-concept and externalizing problems than their non-initiating female peers. While the difference between female early initiators and non-initiators were statistically significant, the mean levels of problem behaviors were very low. The findings suggest that, contrary to previous research, early sexual initiation does not seem to be clustered with problem behaviors for this sample of Dutch adolescents. PMID:20119696

  14. The relationships of personal and cultural identity to adaptive and maladaptive psychosocial functioning in emerging adults.

    PubMed

    Schwartz, Seth J; Zamboanga, Byron L; Weisskirch, Robert S; Wang, Sherry C

    2010-01-01

    The present study examined the extent to which cultural identity would be associated with adaptive and maladaptive psychosocial functioning, both directly and indirectly through a personal identity consolidation. A sample of 773 White, Black, and Hispanic university students completed measures of cultural identity, personal identity consolidation, adaptive psychosocial functioning, internalizing symptoms, and proclivity toward externalizing symptoms. Both heritage and American cultural identity were positively related to adaptive psychosocial functioning; American-culture identity was negatively associated with internalizing symptoms; and heritage-culture identity was negatively related to proclivity toward externalizing symptoms. All of these findings were mediated by personal identity consolidation and were fully consistent across ethnic groups. We discuss implications in terms of broadening the study of identity to include both personal and cultural dimensions of self.

  15. Developmental Communication Impairments in Adults: Outcomes and Life Experiences of Adults and Their Parents

    ERIC Educational Resources Information Center

    Clegg, Judy; Ansorge, Lydia; Stackhouse, Joy; Donlan, Chris

    2012-01-01

    Purpose: This study identifies the outcomes and documents the longitudinal life experiences of adults who attended a specialist residential school for children with pervasive and complex developmental communication impairments. Method: Semistructured interviews were carried out with 26 adult ex-pupils who had attended the school and the parents of…

  16. Benefits of Career and Technical Student Organizations' on Female and Racial Minority Students' Psychosocial and Achievement Outcomes

    ERIC Educational Resources Information Center

    Aragon, Steven R.; Alfeld, Corinne; Hansen, David M.

    2013-01-01

    The purpose of this study was to determine to what extent do CTSOs affect student psychosocial and achievement outcomes (above and beyond stand-alone CTE programs) when controlling for gender and race. Using a cross-sectional descriptive research design, a total of 5,677 students from 10 states were surveyed regarding their high school…

  17. Outcomes of Adult Learning: Taking the Debate Forward.

    ERIC Educational Resources Information Center

    Jones, Huw, Ed.; Mace, Jackie, Ed.

    The four papers in this collection are intended to stimulate debate in the adult education sector and to set the agenda for further development work. "Learning Outcomes: Towards a Synthesis of Progress" (Peter Lavender) provides a summary of recent efforts to identify, record, and value learning that does not lead to qualifications. "Learning…

  18. Texas Effectiveness Study: Adult Outcome Follow-Up.

    ERIC Educational Resources Information Center

    Norris, Deborah; Schumacker, Randall E.

    The Texas Effectiveness Study is an evaluation of the effectiveness of special education programs and services in developing life skills related to the transition planning process for Texas special education. One of the three components of the Texas Effectiveness Study is a study of adult outcomes. This component was implemented in the summer of…

  19. Vocational Outcomes for Young Adults with Multiple Learning Disabilities

    ERIC Educational Resources Information Center

    Harth, Robert; Burns, Carol

    2004-01-01

    This study investigated the vocational outcomes for a group of young adults with multiple learning disabilities who attended a two-year post-secondary program. One hundred graduates of the program representing the first 15 years of the program participated in the study. Results indicated that large numbers of graduates were employed in both full…

  20. Early Adult Outcomes of Adolescents Who Deliberately Poisoned Themselves

    ERIC Educational Resources Information Center

    Harrington, Richard; Pickles, Andrew; Aglan, Azza; Harrington, Val; Burroughs, Heather; Kerfoot, Michael

    2006-01-01

    Objective: To describe the early adult psychopathological and social outcomes of adolescents who deliberately poisoned themselves. Method: Prospective cohort study with a 6-year follow-up of 132 of 158 (84%) adolescents who, between ages 11 and 16 years, had taken part in a randomized trial of a brief family intervention after deliberate…

  1. Engagement with Young Adult Literature: Outcomes and Processes

    ERIC Educational Resources Information Center

    Ivey, Gay; Johnston, Peter H.

    2013-01-01

    This study examines students' perceptions of the outcomes and processes of engaged reading in classrooms prioritizing engagement through self-selected, self-paced reading of compelling young adult literature. The primary data were 71 end-of-year student interviews, supported by end-of-year teacher interviews, biweekly observational data,…

  2. Adolescence as a gateway to adult health outcomes.

    PubMed

    Raphael, Dennis

    2013-06-01

    Adolescence has long been regarded as a transition from childhood to adulthood. More recently it is become a concern of those wishing to avoid adverse health outcomes during middle and late adulthood. Most of this effort has been focused on behavioural risk factors such as tobacco and excessive alcohol use, physical exercise habits, dietary habits, as well as sexual and injury-related behaviours. The concern is that these habits are established during adolescence, continue into adulthood, and come to constitute ongoing risk factors for adverse health outcomes during middle and late adulthood. There is good reason to criticize this approach. These behaviours are themselves shaped by adolescents' living and working conditions and even then constitute a small proportion of the variance predicting adverse health outcomes during adulthood. More complex models of how adolescence serves as a gateway to adult health outcomes are presented. These are the socio-environmental, public policy, and political economy approaches. The argument is made that adolescence is a period during which public policy plays an especially important role in predicting future health outcomes. Yet, these public policies influence health all across the life span with adolescence providing only one of many important periods during which public policy shapes health prospects during middle and later adulthood. Ultimately one should consider a range of approaches ranging from the behavioural to the political to examine how adolescence serves as a gateway towards future adult prospects. An Adolescent Gateway Towards Adult Health Model is provided to assist in this process.

  3. Family interventions to improve diabetes outcomes for adults

    PubMed Central

    Baig, Arshiya A.; Benitez, Amanda; Quinn, Michael T.; Burnet, Deborah L.

    2015-01-01

    Diabetes self-care is a critical aspect of disease management for adults with diabetes. Since family members can play a vital role in a patient’s disease management, involving them in self-care interventions may positively influence patients’ diabetes outcomes. We systematically reviewed family-based interventions for adults with diabetes published from 1994 to 2014 and assessed their impact on patients’ diabetes outcomes and the extent of family involvement. We found 26 studies describing family-based diabetes interventions for adults. Interventions were conducted across a range of patient populations and settings. The degree of family involvement varied across studies. We found evidence for improvement in patients’ self-efficacy, perceived social support, diabetes knowledge, and diabetes self-care across the studies. Owing to the heterogeneity of the study designs, types of interventions, reporting of outcomes, and family involvement, it is difficult to determine how family participation in diabetes interventions may affect patients’ clinical outcomes. Future studies should clearly describe the role of family in the intervention, assess quality and extent of family participation, and compare patient outcomes with and without family involvement. PMID:26250784

  4. The Effect of Preventive Consultations on Young Adults with Psychosocial Problems: A Randomized Trial

    ERIC Educational Resources Information Center

    Freund, Kirsten S.; Lous, Jorgen

    2012-01-01

    Patients with many problems often face difficulties in modifying their behavior as desired. Uncovered basic needs may be an important barrier. This research tests the effect of patient-centered consultations for 20- to 44-year-old patients with multiple psychosocial and lifestyle problems. We focus on resources and barriers for obtaining…

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

    ERIC Educational Resources Information Center

    Bromfield, Pauline V.

    2009-01-01

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

  6. Distinct health behavior and psychosocial profiles of young adult survivors of childhood cancers: a mixed methods study

    PubMed Central

    Lowe, Kincaid; Escoffery, Cam; Mertens, Ann C.; Berg, Carla J.

    2016-01-01

    Background We used a mixed-methods approach to examine health behavior profiles of young adult cancer survivors and characterize related sociodemographic and psychosocial factors. Methods We conducted a mail-based survey assessing sociodemographics, cancer treatment, health behaviors (e.g., tobacco use, physical activity), healthcare provider interactions, and psychosocial factors (e.g., Profile of Moods States [POMS]) among 106 young adult survivors from a southeastern cancer center and semi-structured interviews among a subset of 26. Results A k-means cluster analysis using eight health behaviors yielded three distinct health behavior profiles: high risk (n = 25), moderate risk (n = 39), and low risk (n = 40). High risks had the highest current alcohol, tobacco, and marijuana use; physical activity; and number of sexual partners (p’s < 0.001). They had higher symptoms of POMS tension-anxiety, depression-dejection, fatigue-inertia, and confusion-bewilderment (p’s < 0.05). Moderate risks had lowest physical activity (p < 0.05) but otherwise had moderate health behaviors. Low risks had the lowest alcohol, tobacco, and marijuana use and fewest sexual partners (p’s < 0.05). They had the lowest levels of tension-anxiety, depression-dejection, fatigue-inertia, and confusion-bewilderment (p’s < 0.05). Qualitative interviews showed that cancer had a range of effects on health behaviors and variable experiences regarding how healthcare providers address these behaviors. Conclusions Assessing health behavior profiles, rather than individual health behaviors, is informative in characterizing young adult cancer survivors and targeting survivorship care. Implications for Cancer Survivors Young adult cancer survivors demonstrate distinct health behavior profiles and are differentially impacted by the experience of cancer. Healthcare providers should be consistently intervening to ensure that survivors understand their specific health risks. PMID:26688575

  7. Treatment outcomes, quality of life, and impact of hemophilia on young adults (aged 18-30 years) with hemophilia.

    PubMed

    Witkop, Michelle; Guelcher, Christine; Forsyth, Angela; Hawk, Sarah; Curtis, Randall; Kelley, Laureen; Frick, Neil; Rice, Michelle; Rosu, Gabriela; Cooper, David L

    2015-12-01

    The Hemophilia Experiences, Results and Opportunities (HERO) initiative assessed psychosocial issues reported by people with moderate to severe hemophilia and was led by a multidisciplinary international advisory board. This analysis reports data from young adult respondents (aged 18-30 years), including both US and overall global (including US respondents) results, and investigates treatment outcomes, quality of life, and impacts of hemophilia on relationships. More young adults in HERO received prophylaxis than on-demand treatment, although a majority reported not using factor products exactly as prescribed, and 50% of global respondents and 26% of US respondents reported issues with access to factor replacement therapy in the previous 5 years. Many young adults with hemophilia reported comorbidities, including bone/skeletal arthritis, chronic pain, and viral infections, and nearly half of young adults reported anxiety/depression. Most reported pain interference with daily activities in the past 4 weeks, although a majority reported participating in lower-risk activities and approximately half in intermediate-risk activities. Most young adults were very or quite satisfied with the support of partners/spouses, family, and friends, although roughly one-third reported that hemophilia affected their ability to develop close relationships with a partner. A majority of young adults reported that hemophilia has had a negative impact on employment, and 62% of global respondents and 78% of US respondents were employed at least part-time. Together these data highlight the psychosocial issues experienced by young adults with hemophilia and suggest that increased focus on these issues may improve comprehensive care during the transition to adulthood.

  8. Treatment outcomes, quality of life, and impact of hemophilia on young adults (aged 18-30 years) with hemophilia.

    PubMed

    Witkop, Michelle; Guelcher, Christine; Forsyth, Angela; Hawk, Sarah; Curtis, Randall; Kelley, Laureen; Frick, Neil; Rice, Michelle; Rosu, Gabriela; Cooper, David L

    2015-12-01

    The Hemophilia Experiences, Results and Opportunities (HERO) initiative assessed psychosocial issues reported by people with moderate to severe hemophilia and was led by a multidisciplinary international advisory board. This analysis reports data from young adult respondents (aged 18-30 years), including both US and overall global (including US respondents) results, and investigates treatment outcomes, quality of life, and impacts of hemophilia on relationships. More young adults in HERO received prophylaxis than on-demand treatment, although a majority reported not using factor products exactly as prescribed, and 50% of global respondents and 26% of US respondents reported issues with access to factor replacement therapy in the previous 5 years. Many young adults with hemophilia reported comorbidities, including bone/skeletal arthritis, chronic pain, and viral infections, and nearly half of young adults reported anxiety/depression. Most reported pain interference with daily activities in the past 4 weeks, although a majority reported participating in lower-risk activities and approximately half in intermediate-risk activities. Most young adults were very or quite satisfied with the support of partners/spouses, family, and friends, although roughly one-third reported that hemophilia affected their ability to develop close relationships with a partner. A majority of young adults reported that hemophilia has had a negative impact on employment, and 62% of global respondents and 78% of US respondents were employed at least part-time. Together these data highlight the psychosocial issues experienced by young adults with hemophilia and suggest that increased focus on these issues may improve comprehensive care during the transition to adulthood. PMID:26619194

  9. Adult outcomes in autism: community inclusion and living skills.

    PubMed

    Gray, Kylie M; Keating, Caroline M; Taffe, John R; Brereton, Avril V; Einfeld, Stewart L; Reardon, Tessa C; Tonge, Bruce J

    2014-12-01

    Longitudinal research has demonstrated that social outcomes for adults with autism are restricted, particularly in terms of employment and living arrangements. However, understanding of individual and environmental factors that influence these outcomes is far from complete. This longitudinal study followed a community sample of children and adolescents with autism into adulthood. Social outcomes in relation to community inclusion and living skills were examined, including the predictive role of a range of individual factors and the environment (socio-economic disadvantage). Overall, the degree of community inclusion and living skills was restricted for the majority, and while childhood IQ was an important determinant of these outcomes, it was not the sole predictor. The implications of these findings in relation to interventions are discussed.

  10. Physicians' Decision-making Style and Psychosocial Outcomes Among Cancer Survivors

    PubMed Central

    Arora, Neeraj K.; Weaver, Kathryn E.; Clayman, Marla L.; Oakley-Girvan, Ingrid; Potosky, Arnold L.

    2009-01-01

    Objective We evaluated pathways linking physicians' decision-making style with cancer survivors' health-related quality of life (HRQOL) Methods We analyzed survey data from 623 survivors diagnosed with leukemia, colorectal, or bladder cancer in Northern California, 2–5 years prior to the study. Of these, 395 reported making a medical decision in the past 12 months and were asked about their physician's decision-making style. We evaluated the association of physician style with proximal communication outcomes (trust, participation self-efficacy), intermediate cognitive outcomes (perceived control, uncertainty), and distal health outcomes (physical and mental HRQOL). Results Overall, 54% of survivors reported a sub-optimal decision-making style for their physician. With the exception of physical health, physician style was associated with all proximal, intermediate, and distal outcomes (p≤0.01). We identified two significant pathways by which a participatory physician style may be associated with survivors' mental health: 1) by increasing survivors' participation self-efficacy and thereby enhancing their perceptions of personal control (p<0.01); 2) by enhancing survivors' level of trust and thereby reducing their perceptions of uncertainty (p<0.05). Conclusion A participatory physician style may improve survivors' mental health by a complex two step mechanism of improving survivors' proximal communication and intermediate cognitive outcomes. Practice Implications Physicians who adopt a participatory decision-making style are likely to facilitate patient empowerment and enhance patients' HRQOL. PMID:19892508

  11. Psychosocial adjustment of adult survivors of a paediatric dialysis and transplant programme.

    PubMed

    Reynolds, J M; Morton, M J; Garralda, M E; Postlethwaite, R J; Goh, D

    1993-01-01

    The social adjustment of 45 young adult renal patients who commenced treatment for end stage renal disease (ESRD) as children and of 48 age and sex matched controls were compared. Renal patients were less socially mature than controls. More lived with their parents, fewer had an intimate relationship outside the family, they had fewer school qualifications, and there was more unemployment among them. The majority, however, were in employment and the level of subjective stress and support derived from most of these areas was comparable in renal patients and in controls. Having a close relationship with a member of the opposite sex was the only domain in which renal patients reported more stress than controls. Early start of illness and current health problems were associated with poorer social outcome. A lifelong history of ESRD leads to suboptimal or delayed social functioning on conventional indicators. However this does not lead to increased overall distress in the patients about their social circumstances and quality of life does not appear to be substantially impaired.

  12. Assessing outcome expectations in older adults: the multidimensional outcome expectations for exercise scale.

    PubMed

    Wójcicki, Thomas R; White, Siobhan M; McAuley, Edward

    2009-01-01

    Outcome expectations, an important element of social cognitive theory, have been associated with physical activity in older adults. Yet, the measurement of this construct has often adopted a unidimensional approach. We examined the validity of a theoretically consistent three-factor (physical, social, and self-evaluative) outcome expectations exercise scale in middle-aged and older adults (N = 320; M age = 63.8). Participants completed questionnaires assessing outcome expectations, physical activity, self-efficacy, and health status. Comparisons of the hypothesized factor structure with competing models indicated that a three-factor model provided the best fit for the data. Construct validity was further demonstrated by significant association with physical activity and self-efficacy and differential associations with age and health status. Further evidence of validity and application to social cognitive models of physical activity is warranted.

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

    ERIC Educational Resources Information Center

    Serpell, Robert; Marfo, Kofi; Abubakar, Amina

    2014-01-01

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

  14. HEALTH RELATED QUALITY OF LIFE AND PSYCHOSOCIAL CORRELATES AMONG HIV-INFECTED ADOLESCENT AND YOUNG ADULT WOMEN IN THE US

    PubMed Central

    Andrinopoulos, Katherine; Clum, Gretchen; Murphy, Debra A.; Harper, Gary; Perez, Lori; Xu, Jiahong; Cunningham, Shayna; Ellen, Jonathan M.

    2012-01-01

    In this study HIV health-related quality of life (HIV-HRQOL) is examined among 179 behaviorally infected adolescent and young adult women. Modifiable psychosocial variables including depression, stigma, social support, and illness acceptance, and the biological end-points of CD4 cell count and viral load were explored in relation to HIV-HRQOL. The three factors of the HIV-HRQOL measure include current life satisfaction, illness related anxiety and illness burden. Bivariate linear regression analysis demonstrated statistically significant associations for all psychosocial variables and HIV-HRQOL factors (p < .01), but not for biological end-points. In multivariate linear regression analysis significant associations remained between: depression (p = .006), illness acceptance (p < .001), social support (p = .001), and current life satisfaction, and depression (p = .012), illness acceptance (p = .015), and illness burden. A trend in association was noted for HIV stigma, with current life satisfaction and illness related anxiety but did not reach statistical significance (p = .097 and p = .109 respectively). Interventions that effectively decrease stigma and depression and increase social support and illness acceptance will likely improve the well-being and quality of life of HIV-infected adolescent women. PMID:21966746

  15. Outcomes in adult life among siblings of individuals with autism.

    PubMed

    Howlin, Patricia; Moss, Philippa; Savage, Sarah; Bolton, Patrick; Rutter, Michael

    2015-03-01

    Little is known about adult siblings of individuals with autism. We report on cognitive, social and mental health outcomes in 87 adult siblings (mean age 39 years). When younger all had been assessed either as being "unaffected" by autism (n = 69) or as meeting criteria for the "Broader Autism Phenotype" (BAP, n = 18). As adults, all scored within the average range on tests of intelligence, numeracy and literacy. "Unaffected" siblings were functioning well in terms of jobs, independence and social relationships. Levels of social relationships and employment were significantly lower in the BAP group; autism traits and mental health problems were significantly higher. The data suggest that the "broader autism phenotype" is a meaningful concept but more sensitive diagnostic measures are required.

  16. Young adult outcomes of very-low-birth-weight children.

    PubMed

    Hack, Maureen

    2006-04-01

    Information on the young adult outcomes of the initial survivors of neonatal intensive care has been reported from the United States, Canada, Australia, Great Britain and other European countries. The studies have varied with regard to whether they were regional or hospital-based, their birth-weight group and gestational age, rates of survival, socio-demographic background, and measures of assessment and types of outcome studied. Despite these differences the overall results reveal that neurodevelopment and growth sequelae persist to young adulthood. Very-low-birth-weight young adults have, with few exceptions, poorer educational achievement than normal-birth-weight controls, and fewer continue with post-high-school study. Rates of employment are, however, similar. There are no major differences in general health status, but the young adults demonstrate poorer physical abilities, higher mean blood pressure and poorer respiratory function. There is no evidence of major psychiatric disorder, although anxiety and depression are reported more often. The young adults report less risk-taking than control populations. They report fairly normal social lives and quality of life. When differences are noted they are usually due to neurosensory disabilities. Longer-term studies are needed to evaluate ultimate educational and occupational achievement. It will also be important to assess the effects of preterm birth, early growth failure and catch-up growth on later metabolic and cardiovascular health.

  17. Faith Is Confidence: The Implication of Psychosocial Components in Faith-Based Educational Programs on Expressive Communication Skills of Adult Learners

    ERIC Educational Resources Information Center

    Lynch, Erin M.

    2016-01-01

    Faith-based programs for adult learners have environmental factors that differentiate them from non-faith based programs, but explicit empirical studies evaluating the impact of the psychosocial factors have been lacking in the literature. This study comparatively examines the achievement level of expressive communication skills as measured…

  18. Co-rumination via cellphone moderates the association of perceived interpersonal stress and psychosocial well-being in emerging adults.

    PubMed

    Murdock, Karla Klein; Gorman, Sarah; Robbins, Maia

    2015-01-01

    Adolescents' and emerging adults' social interactions increasingly revolve around cellphone use, but little research has investigated the psychological properties of cellphone interactions. The current study explored co-rumination via cellphone; that is, the use of cellphone functions to excessively communicate about problems or negative feelings. Face-to-face co-rumination and co-rumination via cellphone were examined as potential moderators of the association between perceived interpersonal stress and psychosocial well-being (i.e., positive mental health and social burnout) in a sample of 142 college students. Face-to-face co-rumination was not a moderator. However, co-rumination via cellphone was a significant moderator such that higher levels of perceived interpersonal stress were associated with lower levels of well-being only among college students who reported higher levels of co-rumination via cellphone. Co-rumination via cellphone should be further investigated to elucidate its developmental trajectory and mental health correlates.

  19. Full-Time Instructional Staffing and Outcomes of Advanced Adult Learners

    ERIC Educational Resources Information Center

    Patterson, Margaret Becker

    2016-01-01

    Two core adult education outcomes for advanced adult learners in U.S. states under the National Reporting System are learning gains in adult secondary education and entry into postsecondary education (PSE). Advanced learner outcomes are associated with key functions in an adult education programming framework, as well as with adequate…

  20. Psychosocial Predictors of Sexual HIV Transmission Risk Behavior among HIV-Positive Adults with a Sexual Abuse History in Childhood

    PubMed Central

    Sikkema, Kathleen J.; Hansen, Nathan B.; Meade, Christina S.; Kochman, Arlene; Fox, Ashley M.

    2015-01-01

    Childhood sexual abuse (CSA) is associated with HIV sexual risk behavior. Although many psychosocial correlates of sexual risk among HIV-positive persons have been identified, studies predicting continued risk among HIV-positive adults with histories of CSA are limited. This cross-sectional study identified variables predictive of sexual transmission risk behavior among an ethnically diverse sample of 256 HIV-positive adults (women and men who have sex with men; MSM) with CSA histories. Participants were assessed for trauma symptoms, shame related to HIV and sexual trauma, substance use, coping style, and sexual risk behavior. Logistic regression analyses were conducted to identify variables predictive of unprotected sexual behavior in the past 4 months. Unprotected sex was significantly associated with substance use and trauma-related behavioral difficulties among women and men, and less spiritual coping among men. Unprotected sex with HIV negative or serostatus unknown partners was significantly associated with greater trauma-related behavioral difficulties, more HIV-related shame, and fewer active coping strategies. Thus, trauma symptoms, shame, coping style, and substance use were significantly associated with sexual risk behavior among HIV-positive adults with histories of CSA, with models of prediction differing by gender and partner serostatus. HIV prevention intervention for persons with HIV and CSA histories should address trauma-related behavioral difficulties and enhance coping skills to reduce sexual transmission risk behavior. PMID:17999171

  1. Tailored and Integrated Web-Based Tools for Improving Psychosocial Outcomes of Cancer Patients: The DoTTI Development Framework

    PubMed Central

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

    2014-01-01

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

  2. Effects of a Psychosocial Couple-Based Prevention Program on Adverse Birth Outcomes

    PubMed Central

    Roettger, Michael E.; Jones, Damon E.; Paul, Ian M.; Kan, Marni L.

    2015-01-01

    Although maternal stress and depression have been linked to adverse birth outcomes (ABOs), few studies have investigated preventive interventions targeting maternal mental health as a means of reducing ABOs. This randomized controlled study examines the impact of Family Foundations (FF)—a transition to parenthood program for couples focused on promoting coparenting quality, with previously documented impact on maternal stress and depression—on ABOs. We also examine whether intervention buffers birth outcomes from the negative effect of elevated salivary cortisol levels. We use intent-to-treat analyses to assess the main effects of the FF intervention on ABOs (prematurity, birth weight, pregnancy complications, Cesarean section, and days in hospital for mothers and infants) among 148 expectant mothers. We also test the interaction of cortisol with intervention condition status in predicting ABOs. FF participation was associated with reduced risk of C-section (OR .357, p < 0.05, 95 % CI 0.149, 0.862), but did not have main effects on other ABOs. FF significantly buffered (p < 0.05) the negative impact of maternal cortisol on birth weight, gestational age, and days in hospital for infants; that is, among women with relatively higher levels of prenatal cortisol, the intervention reduced ABOs. These results demonstrate that a psycho-educational program for couples reduces incidence of ABOs among higher risk women. Future work should test whether reduced maternal stress and depression mediate these intervention effects. PMID:24969352

  3. Effects of a psychosocial couple-based prevention program on adverse birth outcomes.

    PubMed

    Feinberg, Mark E; Roettger, Michael E; Jones, Damon E; Paul, Ian M; Kan, Marni L

    2015-01-01

    Although maternal stress and depression have been linked to adverse birth outcomes (ABOs), few studies have investigated preventive interventions targeting maternal mental health as a means of reducing ABOs. This randomized controlled study examines the impact of Family Foundations (FF)-a transition to parenthood program for couples focused on promoting coparenting quality, with previously documented impact on maternal stress and depression-on ABOs. We also examine whether intervention buffers birth outcomes from the negative effect of elevated salivary cortisol levels. We use intent-to-treat analyses to assess the main effects of the FF intervention on ABOs (prematurity, birth weight, pregnancy complications, Cesarean section, and days in hospital for mothers and infants) among 148 expectant mothers. We also test the interaction of cortisol with intervention condition status in predicting ABOs. FF participation was associated with reduced risk of C-section (OR .357, p < 0.05, 95 % CI 0.149, 0.862), but did not have main effects on other ABOs. FF significantly buffered (p < 0.05) the negative impact of maternal cortisol on birth weight, gestational age, and days in hospital for infants; that is, among women with relatively higher levels of prenatal cortisol, the intervention reduced ABOs. These results demonstrate that a psycho-educational program for couples reduces incidence of ABOs among higher risk women. Future work should test whether reduced maternal stress and depression mediate these intervention effects.

  4. Psychosocial and Family Functioning in Spina Bifida

    PubMed Central

    Holmbeck, Grayson N.; Devine, Katie A.

    2010-01-01

    A developmentally-oriented bio-neuropsychosocial model is introduced to explain variation in family functioning and psychosocial adjustment in youth and young adults with spina bifida (SB). Research on the family functioning and psychosocial adjustment of individuals with SB is reviewed. The findings of past research on families of youth with SB support a resilience-disruption view of family functioning. That is, the presence of a child with SB disrupts normative family functioning, but many families adapt to such disruption and exhibit considerable resilience in the face of adversity. Parents of youth with SB, and particularly those from lower SES homes, are at-risk for psychosocial difficulties. Individuals with SB are at-risk for developing internalizing symptoms, attention problems, educational difficulties, social maladjustment, and delays in the development of independent functioning. Emerging adults are often delayed in achieving milestones related to this stage of development (e.g., vocational and educational achievements). Methodologically-sound, longitudinal, and theory-driven studies of family and psychosocial functioning are needed, as are randomized family-based intervention trials, to promote adaptive functioning and better psychosocial outcomes in families of individuals with SB. PMID:20419770

  5. Maternal and Paternal Parenting during Adolescence: Forecasting Early Adult Psychosocial Adjustment.

    ERIC Educational Resources Information Center

    Jones, Deborah J.; Forehand, Rex; Beach, Steven R. H.

    2000-01-01

    Investigates the relationship of maternal and paternal parenting behavior during adolescence to four domains of early adult functioning. Higher levels of maternal firm control were associated with more secure early adult romantic attachment and lower levels of educational achievement. There were no main effects for fathers, but paternal parenting…

  6. LGBTQ Adolescents and Young Adults Raised within a Christian Religious Context: Positive and Negative Outcomes

    ERIC Educational Resources Information Center

    Dahl, Angie L.; Galliher, Renee V.

    2012-01-01

    Religious contexts have traditionally been understood as protective for a variety of psychosocial health outcomes. However, the generalizability of these findings to youth who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ) is questioned due to denominational teachings on same-sex attractions and sexual behavior. Eight adolescents…

  7. Allopurinol and Cardiovascular Outcomes in Adults With Hypertension.

    PubMed

    MacIsaac, Rachael L; Salatzki, Janek; Higgins, Peter; Walters, Matthew R; Padmanabhan, Sandosh; Dominiczak, Anna F; Touyz, Rhian M; Dawson, Jesse

    2016-03-01

    Allopurinol lowers blood pressure in adolescents and has other vasoprotective effects. Whether similar benefits occur in older individuals remains unclear. We hypothesized that allopurinol is associated with improved cardiovascular outcomes in older adults with hypertension. Data from the United Kingdom Clinical Research Practice Datalink were used. Multivariate Cox-proportional hazard models were applied to estimate hazard ratios for stroke and cardiac events (defined as myocardial infarction or acute coronary syndrome) associated with allopurinol use over a 10-year period in adults aged >65 years with hypertension. A propensity-matched design was used to reduce potential for confounding. Allopurinol exposure was a time-dependent variable and was defined as any exposure and then as high (≥300 mg daily) or low-dose exposure. A total of 2032 allopurinol-exposed patients and 2032 matched nonexposed patients were studied. Allopurinol use was associated with a significantly lower risk of both stroke (hazard ratio, 0.50; 95% confidence interval, 0.32-0.80) and cardiac events (hazard ratio, 0.61; 95% confidence interval, 0.43-0.87) than nonexposed control patients. In exposed patients, high-dose treatment with allopurinol (n=1052) was associated with a significantly lower risk of both stroke (hazard ratio, 0.58; 95% confidence interval, 0.36-0.94) and cardiac events (hazard ratio, 0.65; 95% confidence interval, 0.46-0.93) than low-dose treatment (n=980). Allopurinol use is associated with lower rates of stroke and cardiac events in older adults with hypertension, particularly at higher doses. Prospective clinical trials are needed to evaluate whether allopurinol improves cardiovascular outcomes in adults with hypertension.

  8. Returning to Paid Employment after Stroke: The Psychosocial Outcomes In StrokE (POISE) Cohort Study

    PubMed Central

    Hackett, Maree L.; Glozier, Nick; Jan, Stephen; Lindley, Richard

    2012-01-01

    Objectives To determine which early modifiable factors are associated with younger stroke survivors' ability to return to paid work in a cohort study with 12-months of follow-up conducted in 20 stroke units in the Stroke Services NSW clinical network. Participants Were aged >17 and <65 years, recent (within 28 days) stroke, able to speak English sufficiently to respond to study questions, and able to provide written informed consent. Participants with language or cognitive impairment were eligible to participate if their proxy provided consent and completed assessments on the participants' behalf. The main outcome measure was return to paid work during the 12 months following stroke. Results Of 441 consented participants (average age 52 years, 68% male, 83% with ischemic stroke), 218 were in paid full-time and 53 in paid part-time work immediately before their stroke, of whom 202 (75%) returned to paid part- or full-time work within 12 months. Being male, female without a prior activity restricting illness, younger, independent in activities of daily living (ADL) at 28 days after stroke, and having private health insurance was associated with return to paid work, following adjustment for other illnesses and a history of depression before stroke (C statistic 0·81). Work stress and post stroke depression showed no such independent association. Conclusions Given that independence in ADL is the strongest predictor of return to paid work within 12 months of stroke, these data reinforce the importance of reducing stroke-related disability and increasing independence for younger stroke survivors. Trial Registration Australian New Zealand Clinical Trials Registry ANZCTRN 12608000459325 PMID:22848610

  9. Psychosocial Results from a Phase I Trial of a Nonsurgical Circumcision Device for Adult Men in Zimbabwe.

    PubMed

    Kasprzyk, Danuta; Montaño, Daniel E; Hamilton, Deven T; Down, Kayla L; Marrett, Karl D; Tshimanga, Mufuta; Xaba, Sinokuthemba; Mugurungi, Owen

    2016-01-01

    Male circumcision (MC), an effective HIV prevention tool, has been added to Zimbabwe's Ministry of Health and Child Care HIV/AIDS Prevention Program. A Phase I safety trial of a nonsurgical male circumcision device was conducted and extensive psychosocial variables were assessed. Fifty-three men (18 and older) were recruited for the device procedure; 13 follow-up clinical visits were completed. Interviews conducted three times (before the procedure, at 2 weeks and 90 days post-procedure) assessed: Satisfaction; expectations; actual experience; activities of daily living; sexual behavior; and HIV risk perception. Using the Integrated Behavioral Model, attitudes towards MC, sex, and condoms, and sources of social influence and support were also assessed. Men (mean age 32.5, range 18-50; mean years of education = 13.6; 55% employed) were satisfied with device circumcision results. Men understand that MC is only partially protective against HIV acquisition. Most (94.7%) agreed that they will continue to use condoms to protect themselves from HIV. Pain ratings were surprisingly negative for a procedure billed as painless. Men talked to many social networks members about their MC experience; post-procedure (mean of 14 individuals). Minimal impact on activities of daily living and absenteeism indicate possible cost savings of device circumcisions. Spontaneous erections occurred frequently post-procedure. The results had important implications for changes in the pre-procedure clinical counseling protocol. Clear-cut counseling to manage pain and erection expectations should result in improved psychosocial outcomes in future roll-out of device circumcisions. Men's expectations must be managed through evidence-based counseling, as they share their experiences broadly among their social networks. PMID:26745142

  10. Psychosocial Functioning of Adults who Experienced Substance Use Disorders as Adolescents

    PubMed Central

    Rohde, Paul; Lewinsohn, Peter M.; Seeley, John R.; Klein, Daniel N.; Andrews, Judy A.; Small, Jason W.

    2008-01-01

    We examined whether substance use disorder (SUD) before age 19 was associated with functioning at age 30 in 773 individuals assessed twice during adolescence, and at ages 24 and 30. Eight of 14 adult measures were associated with adolescent SUD: education, unemployment, income, risky sexual behavior, suicide attempt, coping, stressful life events, and global adjustment. Controlling for adolescent comorbidity and functioning and adult SUD, education and unemployment remained associated, and three variables emerged as significant: being a parent (significant only for participants without adult SUD), and being currently married and decreased life satisfaction (significant only for participants with adult SUD). Adolescent SUD is associated with numerous functioning difficulties at age 30, some of which appear to be related to recurrent SUD, comorbid adolescent disorders, or functioning problems already evident in adolescence. PMID:17563135

  11. Psychosocial determinants of fruit and vegetable intake in adult population: a systematic review

    PubMed Central

    2010-01-01

    Background Accumulating evidence suggests that fruit and vegetable intake (FVI) plays a protective role against major diseases. Despite this protective role and the obesity pandemic context, populations in Western countries usually eat far less than five servings of fruits and vegetables per day. In order to increase the efficiency of interventions, they should be tailored to the most important determinants or mediators of FVI. The objective was to systematically review social cognitive theory-based studies of FVI and to identify its main psychosocial determinants. Methods Published papers were systematically sought using Current Contents (2007-2009) and Medline, Embase, PsycINFO, Proquest and Thesis, as well as Cinhal (1980-2009). Additional studies were identified by a manual search in the bibliographies. Search terms included fruit, vegetable, behaviour, intention, as well as names of specific theories. Only studies predicting FVI or intention to eat fruits and vegetables in the general population and using a social cognitive theory were included. Independent extraction of information was carried out by two persons using predefined data fields, including study quality criteria. Results A total of 23 studies were identified and included, 15 studying only the determinants of FVI, seven studying the determinants of FVI and intention and one studying only the determinants of intention. All pooled analyses were based on random-effects models. The random-effect R2 observed for the prediction of FVI was 0.23 and it was 0.34 for the prediction of intention. Multicomponent theoretical frameworks and the theory of planned behaviour (TPB) were most often used. A number of methodological moderators influenced the efficacy of prediction of FVI. The most consistent variables predicting behaviour were habit, motivation and goals, beliefs about capabilities, knowledge and taste; those explaining intention were beliefs about capabilities, beliefs about consequences and perceived

  12. Surgical Outcome of Adult Idiopathic Chiari Malformation Type 1

    PubMed Central

    Yuh, Woon Tak; Kim, Chi Heon; Kim, Hyun-Jib; Jahng, Tae-Ahn; Park, Sung Bae

    2016-01-01

    Objective The pathophysiology of idiopathic Chiari malformation (CM) type 1 is disturbance of free cerebrospinal fluid (CSF) flow and restoration of normal CSF flow is the mainstay of treatment. Additional migration of the medulla oblongata in pediatric patients is referred to as CM type 1.5, but its significance in adult patients is unknown. This study is to compare surgical outcomes of adult idiopathic CM type 1.5 with that of type 1. Methods Thirty-eight consecutive adult patients (M : F=11 : 27; median, 33.5; range, 18–63) with syringomyelia due to idiopathic CM type 1 were reviewed. Migration of the medulla oblongata was noted in 13 patients. The modified McCormick scale (MMS) was used to evaluate functional status before and one year after surgery. All patients underwent foramen magnum decompression and duroplasty. Factors related to radiological success (≥50% decrease in the diameter of the syrinx) were investigated. The follow-up period was 72.7±55.6 months. Results Preoperative functional status were MMS I in 11 patients and MMS II in 14 of CM type 1 and MMS I in 8 and II in 5 of CM type 1.5. Of patients with MMS II, 5/14 patients in group A and 3/5 patients in group B showed improvement and there was no case of deterioration. Radiological success was achieved in 32 (84%) patients and restoration of the cisterna magna (p=0.01; OR, 46.5) was the only significant factor. Conclusion Migration of the medulla oblongata did not make a difference in the surgical outcome when the cisterna magna was restored. PMID:27651871

  13. Surgical Outcome of Adult Idiopathic Chiari Malformation Type 1

    PubMed Central

    Yuh, Woon Tak; Kim, Chi Heon; Kim, Hyun-Jib; Jahng, Tae-Ahn; Park, Sung Bae

    2016-01-01

    Objective The pathophysiology of idiopathic Chiari malformation (CM) type 1 is disturbance of free cerebrospinal fluid (CSF) flow and restoration of normal CSF flow is the mainstay of treatment. Additional migration of the medulla oblongata in pediatric patients is referred to as CM type 1.5, but its significance in adult patients is unknown. This study is to compare surgical outcomes of adult idiopathic CM type 1.5 with that of type 1. Methods Thirty-eight consecutive adult patients (M : F=11 : 27; median, 33.5; range, 18–63) with syringomyelia due to idiopathic CM type 1 were reviewed. Migration of the medulla oblongata was noted in 13 patients. The modified McCormick scale (MMS) was used to evaluate functional status before and one year after surgery. All patients underwent foramen magnum decompression and duroplasty. Factors related to radiological success (≥50% decrease in the diameter of the syrinx) were investigated. The follow-up period was 72.7±55.6 months. Results Preoperative functional status were MMS I in 11 patients and MMS II in 14 of CM type 1 and MMS I in 8 and II in 5 of CM type 1.5. Of patients with MMS II, 5/14 patients in group A and 3/5 patients in group B showed improvement and there was no case of deterioration. Radiological success was achieved in 32 (84%) patients and restoration of the cisterna magna (p=0.01; OR, 46.5) was the only significant factor. Conclusion Migration of the medulla oblongata did not make a difference in the surgical outcome when the cisterna magna was restored.

  14. Identifying Psychosocial Variables That Predict Safer Sex Intentions in Adolescents and Young Adults.

    PubMed

    Brüll, Phil; Ruiter, Robert A C; Wiers, Reinout W; Kok, Gerjo

    2016-01-01

    Young people are especially vulnerable to sexually transmitted infections (STIs). The triad of deliberate and effective safer sex behavior encompasses condom use, combined with additional information about a partner's sexual health, and the kind of sex acts usually performed. To identify psychosocial predictors of young people's intentions to have safer sex, as related to this triad, we conducted an online study with 211 sexually active participants aged between 18 and 24 years. Predictors [i.e., perceived behavioral control (PBC), subjective norms, and intention] taken from Fishbein and Ajzen's Reasoned Action Approach (RAA), were combined with more distal variables (e.g., behavioral inhibition, sensation seeking, parental monitoring, and knowledge about STIs). Beyond the highly predictive power of RAA variables, additional variance was explained by the number of instances of unprotected sexual intercourse (SI) during the last 12 months and reasons for using barrier protection during first SI. In particular, past condom non-use behavior moderated PBC related to intended condom use. Further, various distal variables showed significant univariate associations with intentions related to the three behaviors of interest. It may, therefore, be helpful to include measures of past behavior as well as certain additional distal variables in future safer sex programs designed to promote health-sustaining sexual behavior.

  15. Identifying Psychosocial Variables That Predict Safer Sex Intentions in Adolescents and Young Adults.

    PubMed

    Brüll, Phil; Ruiter, Robert A C; Wiers, Reinout W; Kok, Gerjo

    2016-01-01

    Young people are especially vulnerable to sexually transmitted infections (STIs). The triad of deliberate and effective safer sex behavior encompasses condom use, combined with additional information about a partner's sexual health, and the kind of sex acts usually performed. To identify psychosocial predictors of young people's intentions to have safer sex, as related to this triad, we conducted an online study with 211 sexually active participants aged between 18 and 24 years. Predictors [i.e., perceived behavioral control (PBC), subjective norms, and intention] taken from Fishbein and Ajzen's Reasoned Action Approach (RAA), were combined with more distal variables (e.g., behavioral inhibition, sensation seeking, parental monitoring, and knowledge about STIs). Beyond the highly predictive power of RAA variables, additional variance was explained by the number of instances of unprotected sexual intercourse (SI) during the last 12 months and reasons for using barrier protection during first SI. In particular, past condom non-use behavior moderated PBC related to intended condom use. Further, various distal variables showed significant univariate associations with intentions related to the three behaviors of interest. It may, therefore, be helpful to include measures of past behavior as well as certain additional distal variables in future safer sex programs designed to promote health-sustaining sexual behavior. PMID:27148520

  16. A follow-up study of adults with suicidal burns: psychosocial adjustment and quality of life.

    PubMed

    Daigeler, Adrien; Langer, Stefan; Hüllmann, Kathrin; Illes, Franziska; Juckel, Georg; Echterhoff, Silke; Selbach, David; Steinsträsser, Lars; Steinau, Hans-Ulrich; Lehnhardt, Marcus

    2009-01-01

    The severity of the burn injuries, accompanying injuries, and the often concomitant psychiatric disease complicate the treatment of patients with suicidal burns. Data from 45 patients who were treated for suicidal burn injuries from 1994 to 2005 were acquired from the patients' charts and interviews with standardized questionnaires (n = 11) concerning their psychological status pretrauma and posttrauma, as well as their quality of life with special reference to psychosocial adjustments. None of the patients survived more than 69% TBSA burns; no one with 41% or less died. Most of the patients had prediagnosed psychiatric disorders. The educational and social background of the patients and religious beliefs played a minor role for choosing this method of suicide. Aggression levels were above the average population, whereas self-direction was underdeveloped. Forty percent, albeit unsuccessfully, committed subsequent suicide attempts. Most patients felt only moderate social impairment by the burn wound residuals, the majority had intensified and improved their social contacts, and most felt no relevant decrease of quality of life compared with their personal situation before the suicide attempt. Patients who survive the suicide attempt can become integrated in social life again. More data are needed to reliably identify patients at risk in advance.

  17. Identifying Psychosocial Variables That Predict Safer Sex Intentions in Adolescents and Young Adults

    PubMed Central

    Brüll, Phil; Ruiter, Robert A. C.; Wiers, Reinout W.; Kok, Gerjo

    2016-01-01

    Young people are especially vulnerable to sexually transmitted infections (STIs). The triad of deliberate and effective safer sex behavior encompasses condom use, combined with additional information about a partner’s sexual health, and the kind of sex acts usually performed. To identify psychosocial predictors of young people’s intentions to have safer sex, as related to this triad, we conducted an online study with 211 sexually active participants aged between 18 and 24 years. Predictors [i.e., perceived behavioral control (PBC), subjective norms, and intention] taken from Fishbein and Ajzen’s Reasoned Action Approach (RAA), were combined with more distal variables (e.g., behavioral inhibition, sensation seeking, parental monitoring, and knowledge about STIs). Beyond the highly predictive power of RAA variables, additional variance was explained by the number of instances of unprotected sexual intercourse (SI) during the last 12 months and reasons for using barrier protection during first SI. In particular, past condom non-use behavior moderated PBC related to intended condom use. Further, various distal variables showed significant univariate associations with intentions related to the three behaviors of interest. It may, therefore, be helpful to include measures of past behavior as well as certain additional distal variables in future safer sex programs designed to promote health-sustaining sexual behavior. PMID:27148520

  18. Cardiovascular Responses to Psychosocial Stress Reflect Motivation State in Adults Born at Extremely Low Birth Weight.

    PubMed

    Mathewson, Karen J; Pyhälä, Riikka; Hovi, Petteri; Räikkönen, Katri; Van Lieshout, Ryan J; Boyle, Michael H; Saigal, Saroj; Morrison, Katherine M; Kajantie, Eero; Schmidt, Louis A

    2015-01-01

    Background. Adults born extremely preterm appear to have more difficulty managing the stresses of early adulthood than their term-born peers. Objective. To examine the effects of being born at extremely low birth weight (ELBW; birth weight < 1000 g) versus at full term on cardiovascular responses to stress. Method. Cardiovascular responses were elicited during administration of a widely used laboratory stressor, the Trier Social Stress Test (TSST). Results. Term-born adults exhibited a larger decrease in total peripheral resistance and larger increase in cardiac output for TSST performance, reflecting greater resilience, than did ELBW adults. Furthermore, in ELBW participants but not controls, cardiovascular responses were correlated with anxiety, suggesting that their responses reflected feelings of stress. Conclusions. Skills-training and practice with relevant stressors may be necessary to increase the personal resources of ELBW participants for managing stress as they transition to adulthood. PMID:27335948

  19. Long-term functional outcome in adult prison inmates with ADHD receiving OROS-methylphenidate.

    PubMed

    Ginsberg, Ylva; Hirvikoski, Tatja; Grann, Martin; Lindefors, Nils

    2012-12-01

    In a recent randomized, double-blind, placebo-controlled trial, we established a robust efficacy (Cohen's d = 2.17) of osmotic release oral system-methylphenidate (OROS-methylphenidate) delivered 72 mg daily for 5 weeks versus placebo on attention deficit hyperactivity disorder (ADHD) symptoms, global severity and global functioning in 30 adult male prison inmates with ADHD and coexisting disorders. Outcomes continued to improve during the subsequent 47-week open-label extension with OROS-methylphenidate delivered at a flexible daily dosage of up to 1.3 mg/kg body weight. In the present study, we evaluated long-term effectiveness and maintenance of improvement over the cumulated 52-week trial on cognition, motor activity, institutional behaviour and quality of life. Post hoc, we explored the associations between investigators' and self-ratings of ADHD symptoms and between ratings of symptoms and functioning, respectively. Outcomes, calculated by repeated measures ANOVA, improved from baseline until week 16, with maintenance or further improvement until week 52. Both verbal and visuospatial working memory, and abstract verbal reasoning improved significantly over time, as well as several cognition-related measures and motor activity. No substance abuse was detected and a majority of participants took part in psychosocial treatment programmes. The quality of life domains of Learning, and Goals and values improved over time; the latter domain was at open-label endpoint significantly related to improvements in attention. Investigators' and self-ratings of ADHD symptoms, as well as global symptom severity related most significantly to global functioning at week 52. Finally, investigators' and self-ratings of ADHD symptoms associated significantly at baseline with increasing convergence over time.

  20. Autonomic and Neuroendocrine Responses to a Psychosocial Stressor in Adults with Autistic Spectrum

    ERIC Educational Resources Information Center

    Jansen, Lucres M. C.; Gispen-de Wied, Christine C.; Wiegant, Victor M.; Westenberg, Herman G. M.; Lahuis, Bertine E.; van Engeland, Herman

    2006-01-01

    Objective of the study was to replicate in adults our previous findings of decreased heart rate and normal endocrine responses to stress in autistic children and to elucidate the discrepancy between autonomic and endocrine stress responses by including epinephrine, norepinephrine, oxytocin and vasopressin measurements. Ten autistic spectrum…

  1. Patterns of Romantic Involvement among Emerging Adults: Psychosocial Correlates and Precursors

    ERIC Educational Resources Information Center

    Shulman, Shmuel; Scharf, Miri; Livne, Yaara; Barr, Tamuz

    2013-01-01

    The present study examined patterns of romantic involvement in 100 Israeli emerging adults (54 males) who were followed from age 22 to 29 years. Analyses of interviews at age 29 yielded four distinctive relational patterns that are associated with different levels of concurrent wellbeing: Intimately committed, Intimate, Non- intimately committed,…

  2. Perceived Social Support from Friends and Family and Psychosocial Functioning in Bisexual Young Adult College Students

    ERIC Educational Resources Information Center

    Sheets, Raymond L., Jr.; Mohr, Jonathan J.

    2009-01-01

    In this study, the authors investigated the degree to which perceived social support was associated with depression, life satisfaction, and internalized binegativity in a sample of 210 bisexual young adult college students. Two types of social support (general and sexuality specific) and 2 sources of social support (family and friends) were…

  3. Training Effects on Older Adults in Information and Communication Technologies Considering Psychosocial Variables

    ERIC Educational Resources Information Center

    Ferreira, Sónia; Torres, Ana; Mealha, Óscar; Veloso, Ana

    2015-01-01

    The main aim of this study is to contribute knowledge about the impact of the use of information and communication technologies (ICT) on the self-concept, mood, and quality of life of institutionalized older adults in retirement homes and day care centers (Portuguese institutions). It also studies the influence of independent variables such as…

  4. Career Pursuit Pathways among Emerging Adult Men and Women: Psychosocial Correlates and Precursors

    ERIC Educational Resources Information Center

    Shulman, Shmuel; Barr, Tamuz; Livneh, Yaara; Nurmi, Jari-Erik; Vasalampi, Kati; Pratt, Michael

    2015-01-01

    The present study examined career pursuit pathways in 100 Israeli emerging adults (54 men) who were followed from age 22 to 29. Employing a semi-structured interview at the age of 29, participants were asked about current work and educational status, work and educational goals and status changes in recent years, and to reflect on the meaning of…

  5. Longitudinal psychosocial factors related to symptoms of Internet addiction among adults in early midlife.

    PubMed

    Zhang, Chenshu; Brook, Judith S; Leukefeld, Carl G; Brook, David W

    2016-11-01

    In this longitudinal study, we applied structural equation modeling (SEM) to examine the psychosocial factors from adolescence to adulthood as related to symptoms of Internet addiction (IA) during early midlife. We gathered longitudinal data on a prospective cohort of community-dwelling men and women (N=548) followed from adolescence to early midlife (mean age=43; SD=2.8). The findings supported a meditational model: adolescent (mean age=16) conflictual parent-child relationship was associated with internalizing problem behaviors at mean age 21 in emerging adulthood (b=0.13, p<0.01), which, in turn, were associated with both alcohol/drug use problems at mean age 27-32 (b=0.24, p<0.001) and affective disorders at mean age 37 (b=0.29, p<0.001), which, ultimately, were associated with symptoms of IA in early midlife (b=0.23, p<0.01; b=0.21, p<0.05, respectively). In addition, alcohol/drug use problems were associated with affective disorders (b=0.22, p<0.05). Among the constructs, alcohol/drug use problems had the greatest total effects on symptoms of IA in early midlife (b=0.28, p<0.001). Findings suggest that family therapy focused on an increase in the affectionate relationship between the adolescent and his/her parents, cognitive-behavioral treatment of internalizing problem behaviors, and effective treatment of individuals who have alcohol/drug use problems may reduce the likelihood of having symptoms of IA in early midlife. PMID:27341513

  6. Psychosocial perception of adults with onychomycosis: a blinded, controlled comparison of 1,017 adult Hong Kong residents with or without onychomycosis

    PubMed Central

    2014-01-01

    treatment outcomes, which would lead to reduced psychosocial impact on those with fungal nail infections. PMID:25057286

  7. Improving outcomes for teenagers and young adults (TYA) with cancer.

    PubMed

    Stark, D; Lewis, I

    2013-11-01

    The management of TYA with cancer is characterized by biological features in comparison to children. Therefore specialized treatment units have been established within professional structures of care for this group, and a European multidisciplinary framework for the treatment of TYA with cancer was founded.Objectives are to promote interdisciplinary collaboration and provide strategic concepts to improve patient care centered to the special needs of this age group. Access to clinical trials for all TYA in the EU will be improved and research initiated, examining biology, epidemiology and health services.Special goals of the interprofessional cooperation are:Different measurements are discussed improving outcomes for TYA is proceeding at different speeds in different parts of the world. In some there are established teams, bringing together paediatric and adult specialists from many healthcare professions, reviewing and contributing to the optimal care of all TYA with cancer as part of national health policy.

  8. Exploring psychosocial support online: a content analysis of messages in an adolescent and young adult cancer community.

    PubMed

    Love, Brad; Crook, Brittani; Thompson, Charee M; Zaitchik, Sarah; Knapp, Jessica; Lefebvre, Leah; Jones, Barbara; Donovan-Kicken, Erin; Eargle, Emily; Rechis, Ruth

    2012-10-01

    The increased usage of online cancer support groups as a resource for health-related information and social support has sparked numerous discussions about the role of online support in healthcare. However, little is known about the role of social-networking groups focused on supporting adolescents and young adults (AYAs) dealing with cancer. The current investigation report findings from a content analysis designed to explore how AYAs use an online support group to meet their psychosocial needs. Overall, members of the community focused on exchanging emotional and informational support, coping with difficult emotions through expression, describing experiences of being an AYA dealing with cancer through language (metaphors), enacting identity through evaluations of the new normal (life with and after cancer), and communicating membership as an AYA with cancer. This study highlights the unique needs of the AYA cancer community and offers a preliminary roadmap for practitioners, and network members, such as family and friends, to attempt to meet the needs of this unique community. PMID:22970826

  9. Effect of structured physical activity on respiratory outcomes in sedentary elderly adults with mobility limitations

    Technology Transfer Automated Retrieval System (TEKTRAN)

    OBJECTIVES: To evaluate the effect of structured physical activity on respiratory outcomes in community dwelling elderly adults with mobility limitations. DESIGN: Multicenter, randomized trial of physical activity vs health education, with respiratory variables prespecified as tertiary outcomes over...

  10. The effects of mindfulness-based stress reduction on psychosocial outcomes and quality of life in early-stage breast cancer patients: a randomized trial

    PubMed Central

    Henderson, Virginia P.; Clemow, Lynn; Massion, Ann O.; Hurley, Thomas G.; Druker, Susan

    2013-01-01

    The aim of this study was determine the effectiveness of a mindfulness-based stress-reduction (MBSR) program on quality of life (QOL) and psychosocial outcomes in women with early-stage breast cancer, using a three-arm randomized controlled clinical trial (RCT). This RCT consisting of 172 women, aged 20–65 with stage I or II breast cancer consisted of the 8-week MBSR, which was compared to a nutrition education program (NEP) and usual supportive care (UC). Follow-up was performed at three post-intervention points: 4 months, 1, and 2 years. Standardized, validated self-administered questionnaires were adopted to assess psychosocial variables. Statistical analysis included descriptive and regression analyses incorporating both intention-to-treat and post hoc multivariable approaches of the 163 women with complete data at baseline, those who were randomized to MBSR experienced a significant improvement in the primary measures of QOL and coping outcomes compared to the NEP, UC, or both, including the spirituality subscale of the FACT-B as well as dealing with illness scale increases in active behavioral coping and active cognitive coping. Secondary outcome improvements resulting in significant between-group contrasts favoring the MBSR group at 4 months included meaningfulness, depression, paranoid ideation, hostility, anxiety, unhappiness, and emotional control. Results tended to decline at 12 months and even more at 24 months, though at all times, they were as robust in women with lower expectation of effect as in those with higher expectation. The MBSR intervention appears to benefit psychosocial adjustment in cancer patients, over and above the effects of usual care or a credible control condition. The universality of effects across levels of expectation indicates a potential to utilize this stress reduction approach as complementary therapy in oncologic practice. PMID:21901389

  11. Bivariate Trajectories of Substance Use and Antisocial Behavior: Associations with Emerging Adult Outcomes in a High-Risk Sample

    PubMed Central

    Trim, Ryan S.; Worley, Matthew J.; Wall, Tamara L.; Hopfer, Christian J.; Crowley, Thomas J.; Hewitt, John K.; Brown, Sandra A.

    2015-01-01

    Substance use and antisocial behavior are complex, interrelated behaviors. The current study identified model trajectory classes defined by concurrent substance use and antisocial behavior and examined trajectory associations with emerging adult outcomes. Participants from a high-risk sample of youth (n=536; 73% male) completed interviews at baseline (mean age= 16.1 years) and followup (mean age= 22.6 years). Latent class growth analyses identified five trajectory classes based on alcohol/drug use (AOD) and antisocial behavior (ASB): Dual Chronic, Increasing AOD/Persistent ASB, Persistent AOD/Adolescent ASB, Decreasing Drugs/Persistent ASB, and Resolved. Many individuals (56%) exhibited elevated/increasing AOD, and most (91%) reported ASB decreases. Those associated with the Dual Chronic class had the highest rates of substance dependence, antisocial personality disorder (ASPD), and negative psychosocial outcomes. There were no differences in adult role attainment across classes. Conjoint examination of these behaviors provides greater detail regarding clinical course and can inform secondary prevention and intervention efforts. PMID:26889401

  12. Elements of Psychocardiology in the Psychosocial Handling of Adults with Congenital Heart Disease

    PubMed Central

    Callus, Edward; Quadri, Emilia; Chessa, Massimo

    2010-01-01

    When it comes to the role of the clinical psychology in the cardiac settings, or psychocardiology, there is often a focus on acquired cardiac illnesses in the rehabilitation settings. However, the increase of adults with congenital heart disease due to technological advances in cardiology and cardiac surgery have created a new emergency. It is thus necessary to reflect upon the elements of psychocardiology adapting them to this new population, also when it comes to interventional hospital settings of cardiology and cardiac surgery. This perspective article is an effort in this direction. PMID:21833204

  13. Food addiction in adults seeking weight loss treatment. Implications for psychosocial health and weight loss.

    PubMed

    Burmeister, Jacob M; Hinman, Nova; Koball, Afton; Hoffmann, Debra A; Carels, Robert A

    2013-01-01

    The present study examined food addiction symptomology and its relationship to eating pathology and psychological distress among adults seeking weight loss treatment. A primary interest was an examination of the relationship between food addiction symptoms and short-term weight loss. Adults beginning a behavioral weight loss program (N=57) were given the Yale Food Addiction Scale (YFAS) as well as measures of psychological distress, disordered eating, weight bias, and weight-focused attitudes. Weight loss was measured after 7 weeks. Severity of food addiction was related to increased depression, emotional eating, binge eating, anti-fat attitudes, internalized weight bias, body shame, and low eating self-efficacy, but not body satisfaction. Increased food addiction symptomology was also related to less weight lost at 7 weeks. Findings suggest that individuals attempting to lose weight while combating symptoms of food addiction may be especially prone to eating-related pathologies, internalized weight bias, and body shame. Importantly, findings provide evidence that food addiction may undermine efforts to lose weight. The pathology associated with addiction (e.g., tolerance, withdrawal) could make the adoption of more healthful eating habits especially difficult.

  14. Effects of gender and psychosocial factors on "friends with benefits" relationships among young adults.

    PubMed

    Owen, Jesse; Fincham, Frank D

    2011-04-01

    Friends with benefits relationships (FWB) are a blend of friendship and physical intimacy outside of a committed romantic relationship. This study examined young adults' (n = 889) engagement in, and reactions to, a FWB relationship in the past year based on their gender, psychological distress, alcohol use, and relationship attitudes. Men (54.3%) were more likely than women (42.9%) to report at least one FWB relationship and both men and women reported that FWB relationships were associated with more positive emotional reactions than negative ones although this difference was larger for men. Greater alcohol use was related to engaging in a FWB relationship and this relationship was stronger for women. Further, thoughtfulness about relationship decisions moderated the relationship between alcohol use and engaging in FWB relationships, and again this moderation effect was stronger for women than men. Young adults with more psychological distress and who felt constrained in the FWB relationship were more likely to report negative emotional reactions. Implications for psychoeducational programs and future research are offered.

  15. The Effects of a School-Based Psychosocial Intervention on Resilience and Health Outcomes among Vulnerable Children

    ERIC Educational Resources Information Center

    Olowokere, A. E.; Okanlawon, F. A.

    2014-01-01

    Responding to the psychosocial health needs of the vulnerable population has been considered as a significant public health issue that must be addressed through access to public health professionals. The study adopted a quasi-experimental design to evaluate the impact of a training program on nurses and teachers' knowledge of psychosocial…

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

    ERIC Educational Resources Information Center

    Ashford, Roslyn La'Toya

    2014-01-01

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

  17. Cognitive and Psychosocial Consequences of Hurricanes Katrina and Rita Among Middle-Aged, Older, and Oldest-Old Adults in the Louisiana Healthy Aging Study (LHAS).

    PubMed

    Cherry, Katie E; Su, L Joseph; Welsh, David A; Galea, Sandro; Jazwinski, S Michal; Silva, Jennifer L; Erwin, Marla J

    2010-10-01

    This study examined the impact of Hurricanes Katrina and Rita on cognitive and psychosocial functioning among middle-aged (45-64 years), older (65-89 years) and oldest-old adults (90 years and over) in the Louisiana Healthy Aging Study (LHAS). Analyses of pre- and post-disaster cognitive data showed storm-related decrements in working memory for the middle-aged and older adults, but not for the oldest-old adults. Regression analyses confirmed that measures of social engagement and storm-related disruption significantly predicted pre- to post-disaster differences in short-term and working memory performance for the middle-aged and older adults only. These results are consistent with a burden perspective on post-disaster psychological reactions. Implications for current views of disaster reactions are discussed.

  18. Efficacy of psychosocial interventions for psychological and pregnancy outcomes in infertile women and men: a systematic review and meta-analysis

    PubMed Central

    Frederiksen, Yoon; Farver-Vestergaard, Ingeborg; Skovgård, Ninna Grønhøj; Ingerslev, Hans Jakob; Zachariae, Robert

    2015-01-01

    Objective To evaluate the evidence on the efficacy of psychosocial interventions for improving pregnancy rates and reducing distress for couples in treatment with assisted reproductive technology (ART). Design Systematic review and meta-analysis. Data sources PsycINFO, PubMed, EMBASE, CINAHL, Web of Science and The Cochrane Library between 1978 and April 2014. Study selection Studies were considered eligible if they evaluated the effect of any psychosocial intervention on clinical pregnancy and/or distress in infertile participants, used a quantitative approach and were published in English. Data extraction Study characteristics and results were extracted and the methodological quality was assessed. Effect sizes (ES; Hedges g) were pooled using a random effects model. Heterogeneity was assessed using the Q statistic and I2, and publication bias was evaluated using Egger’s method. Possible moderators and mediators were explored with meta-analyses of variances (ANOVAs) and meta-regression. Results We identified 39 eligible studies (total N=2746 men and women) assessing the effects of psychological treatment on pregnancy rates and/or adverse psychological outcomes, including depressive symptoms, anxiety, infertility stress and marital function. Statistically significant and robust overall effects of psychosocial intervention were found for both clinical pregnancy (risk ratio=2.01; CI 1.48 to 2.73; p<0.001) and combined psychological outcomes (Hedges g=0.59; CI 0.38 to 0.80; p=0.001). The pooled ES for psychological outcomes were generally larger for women (g: 0.51 to 0.73) than men (0.13 to 0.34), but the difference only reached statistical significance for depressive symptoms (p=0.004). Meta-regression indicated that larger reductions in anxiety were associated with greater improvement in pregnancy rates (Slope 0.19; p=0.004). No clear-cut differences were found between effects of cognitive–behavioural therapy (CBT; g=0.84), mind–body interventions (0.61) and

  19. Preattentive sensory processing as indexed by the MMN and P3a brain responses is associated with cognitive and psychosocial functioning in healthy adults.

    PubMed

    Light, Gregory A; Swerdlow, Neal R; Braff, David L

    2007-10-01

    Understanding the basic neural processes that underlie complex higher order cognitive operations and psychosocial functioning is a fundamental goal of cognitive neuroscience. Event-related potentials allow investigators to probe the earliest stages of information processing. Mismatch negativity (MMN) and P3a are auditory event-related potential components that reflect automatic sensory discrimination. The aim of the present study was to determine if MMN and P3a are associated with higher order cognitive operations and psychosocial functioning in clinically normal healthy subjects. Twenty adults were assessed using standardized clinical, cognitive, and psychosocial functional instruments. All individuals were within the normal range on cognitive tests and functional ratings. Participants were also tested on a duration-deviant MMN/P3a paradigm (50-msec standard tones, p = .90; 100-msec deviant tones, p = .10; stimulus onset asynchrony [SOA] = 505 msec). Across fronto-central electrode regions, significant correlations were observed between psychosocial functioning and MMN (r = -.62, p < .01) and P3a (r = .63, p < .01) amplitudes. P3a amplitude was also highly associated with immediate and delayed recall of verbal information with robust correlations widely distributed across fronto-central recording areas (e.g., r = .72, p < .001). The latency of the P3a response was significantly associated with both working memory performance (r = -.53, p < .05) and functional ratings (r = -.48, p < .05). Neurophysiological measures of relatively automatic auditory sensory information processing are associated with higher order cognitive abilities and psychosocial functioning in normal subjects. Efficiency at elementary levels of information processing may underlie the successful encoding, retrieval, and discrimination of task-relevant information, which, in turn, facilitates the iterative and responsive processing necessary for adaptive cognitive and social functioning. PMID

  20. Effect of Statin Use on Outcomes of Adults with Candidemia

    PubMed Central

    Cuervo, Guillermo; Garcia-Vidal, Carolina; Nucci, Marcio; Puchades, Francesc; Fernández-Ruiz, Mario; Mykietiuk, Analía; Manzur, Adriana; Gudiol, Carlota; Pemán, Javier; Viasus, Diego; Ayats, Josefina; Carratalà, Jordi

    2013-01-01

    Background Statins have immunomodulatory properties and hinder Candida growth. However, it is unknown whether they may improve prognosis in patients with candidemia. We sought to determine the effect of prior statin use on the clinical outcomes of patients suffering candidemia. Methods and Findings Multicenter cohort study of hospitalized adults with candidemia between 2005 and 2011 in six hospitals in Spain, Brazil and Argentina. Of 326 candidemias, 44 (13.5%) occurred in statin users and 282 (86.5%) in statin non-users. The median value of APACHE II at candidemia diagnosis was similar between groups (18 vs. 16; p=.36). Candida albicans was the most commonly isolated species, followed by C. parapsilosis, C. tropicalis, C. glabrata, and C. krusei. There were no differences regarding appropriate empirical antifungal treatment. Statin users had a lower early (5 d) case-fatality rate than non-users (4.5 vs. 17%; p=.031). This effect was not observed with other cardiovascular drugs (aspirin, beta blockers and ACE inhibitors). Independent factor related to early case-fatality rate was APACHE II score (AOR, 1.08; 95% CI, 1.03–1.14; p=.002). An appropriate empirical antifungal therapy (AOR, 0.11; 95% CI, 0.04–0.26; p=<.001) and prior statin use were independently associated with lower early case-fatality (AOR, 0.17; 95% CI, 0.03–0.93; p=.041). Fourteen days (14d) and overall (30d) case-fatality rates were similar between groups (27% vs. 29%; p=0.77 and 40% vs. 44%; p=.66). Conclusions The use of statins might have a beneficial effect on outcomes of patients with candidemia. This hypothesis deserves further evaluation in randomized trials. PMID:24155941

  1. Hypoalbuminaemia predicts outcome in adult patients with congenital heart disease

    PubMed Central

    Kempny, Aleksander; Diller, Gerhard-Paul; Alonso-Gonzalez, Rafael; Uebing, Anselm; Rafiq, Isma; Li, Wei; Swan, Lorna; Hooper, James; Donovan, Jackie; Wort, Stephen J; Gatzoulis, Michael A; Dimopoulos, Konstantinos

    2015-01-01

    Background In patients with acquired heart failure, hypoalbuminaemia is associated with increased risk of death. The prevalence of hypoproteinaemia and hypoalbuminaemia and their relation to outcome in adult patients with congenital heart disease (ACHD) remains, however, unknown. Methods Data on patients with ACHD who underwent blood testing in our centre within the last 14 years were collected. The relation between laboratory, clinical or demographic parameters at baseline and mortality was assessed using Cox proportional hazards regression analysis. Results A total of 2886 patients with ACHD were included. Mean age was 33.3 years (23.6–44.7) and 50.1% patients were men. Median plasma albumin concentration was 41.0 g/L (38.0–44.0), whereas hypoalbuminaemia (<35 g/L) was present in 13.9% of patients. The prevalence of hypoalbuminaemia was significantly higher in patients with great complexity ACHD (18.2%) compared with patients with moderate (11.3%) or simple ACHD lesions (12.1%, p<0.001). During a median follow-up of 5.7 years (3.3–9.6), 327 (11.3%) patients died. On univariable Cox regression analysis, hypoalbuminaemia was a strong predictor of outcome (HR 3.37, 95% CI 2.67 to 4.25, p<0.0001). On multivariable Cox regression, after adjusting for age, sodium and creatinine concentration, liver dysfunction, functional class and disease complexity, hypoalbuminaemia remained a significant predictor of death. Conclusions Hypoalbuminaemia is common in patients with ACHD and is associated with a threefold increased risk of risk of death. Hypoalbuminaemia, therefore, should be included in risk-stratification algorithms as it may assist management decisions and timing of interventions in the growing ACHD population. PMID:25736048

  2. Trajectories, Long-Term Outcomes and Family Experiences of 76 Adults with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Chamak, Brigitte; Bonniau, Béatrice

    2016-01-01

    The aim of this retrospective study was to retrace the trajectories and long-term outcomes of individuals with autism in France, and to explore the family experiences. Data obtained from parents enables us to follow the trajectories of 76 adults. Two-thirds of adults with severe autism had a very poor outcome. Those with moderate autism had a…

  3. Student Outcomes: Investigating Competency-Based Curriculum in Adult Basic Education. Research Report No. 5.

    ERIC Educational Resources Information Center

    Hazell, Pat

    The outcomes attained by Australian adults enrolled in competency-based Certificate in Adult Foundation Education (CAFE) courses were examined. Special attention was paid to the outcomes achieved by students in the two lowest of the CAFE program's four levels. The main data sources were as follows: literature review; enrollment data from the…

  4. Reframing Adult Literacy and Numeracy Outcomes: A Social Capital Perspective. Support Document

    ERIC Educational Resources Information Center

    Balatti, Jo; Black, Stephen; Falk, Ian

    2006-01-01

    This document was produced by the authors based on their research for the report "Reframing Adult Literacy and Numeracy Outcomes: A Social Capital Perspective" [ED493887] and is an added resource for further information. The original report investigated whether adult literacy and numeracy courses produced social capital outcomes, which are changes…

  5. The Social Outcomes of Older Adult Learning in Taiwan: Evaluation Framework and Indicators

    ERIC Educational Resources Information Center

    Lin, Li-Hui

    2015-01-01

    The purpose of this study is to explore the social outcomes of older adult learning in Taiwan. In light of our society's aging population structure, the task of establishing evaluation framework and indicators for the social outcomes of learning (SOL) as applied to older adults is urgent. In order to construct evaluation indicators for older…

  6. Psychosocial predictors of reported HIV-preventive behaviour change among adults in Bulawayo, Zimbabwe.

    PubMed

    Wilson, D; Dubley, I; Msimanga, S; Lavelle, L

    1991-07-01

    In order to reduce HIV transmission, improved understanding of factors that motivate safer sexual behaviour is needed. The Health Belief Model attempts to explain health-related behaviour, including HIV-preventive behaviour. The association of six elements of this model--AIDS knowledge, perceived susceptibility to HIV infection, perceived effectiveness of HIV-preventive measures, self-efficacy, barriers to behaviour change, accessibility of health care/advice and social support for safer sexual behaviour--to three indices of HIV-related behavioural risk reduction--reduced number of sexual partners, increased consistency of condom use and (among males only) reduced prostitute contact--was examined by self-report inventory among 202 men and 100 women in Bulawayo, Zimbabwe. Multiple logistic regression identified social support for behaviour change, followed by accessibility of health care/advice, as the most consistent predictors of risk reduction across sex and outcome measures. The remaining predictors were not consistently associated with behaviour change. It is concluded that AIDS campaigns must foster the perception that there is concerted normative support for HIV-related behaviour change and that community and small group, face-to-face AIDS education, which may have more impact on perceived social support than mass media campaigns, must be emphasised. PMID:1811902

  7. Psychosocial predictors of reported HIV-preventive behaviour change among adults in Bulawayo, Zimbabwe.

    PubMed

    Wilson, D; Dubley, I; Msimanga, S; Lavelle, L

    1991-07-01

    In order to reduce HIV transmission, improved understanding of factors that motivate safer sexual behaviour is needed. The Health Belief Model attempts to explain health-related behaviour, including HIV-preventive behaviour. The association of six elements of this model--AIDS knowledge, perceived susceptibility to HIV infection, perceived effectiveness of HIV-preventive measures, self-efficacy, barriers to behaviour change, accessibility of health care/advice and social support for safer sexual behaviour--to three indices of HIV-related behavioural risk reduction--reduced number of sexual partners, increased consistency of condom use and (among males only) reduced prostitute contact--was examined by self-report inventory among 202 men and 100 women in Bulawayo, Zimbabwe. Multiple logistic regression identified social support for behaviour change, followed by accessibility of health care/advice, as the most consistent predictors of risk reduction across sex and outcome measures. The remaining predictors were not consistently associated with behaviour change. It is concluded that AIDS campaigns must foster the perception that there is concerted normative support for HIV-related behaviour change and that community and small group, face-to-face AIDS education, which may have more impact on perceived social support than mass media campaigns, must be emphasised.

  8. Sexual Orientation and Gender Identity/Expression Related Peer Victimization in Adolescence: A Systematic Review of Associated Psychosocial and Health Outcomes

    PubMed Central

    Collier, Kate L.; van Beusekom, Gabriël; Bos, Henny M. W.; Sandfort, Theo G. M.

    2012-01-01

    This article reviews research on psychosocial and health outcomes associated with peer victimization related to adolescent sexual orientation and gender identity or expression. Using four electronic databases and supplementary methods, we identified 39 relevant studies. These studies were published between 1995 and 2012 and conducted in 12 different countries. The studies were diverse in terms of their approaches to sampling participants, assessing participants’ sexual orientation, operationalizing peer victimization, and with regard to the psychosocial and health outcomes studied in relation to peer victimization. Despite the methodological diversity across studies, there is fairly strong evidence that peer victimization related to sexual orientation and gender identity or expression is associated with a diminished sense of school belonging and higher levels of depressive symptoms; findings regarding the relationship between peer victimization and suicidality have been more mixed. Peer victimization related to sexual orientation and gender identity or expression is also associated with disruptions in educational trajectories, traumatic stress, and alcohol and substance use. Recommendations for future research and interventions are discussed. PMID:23480074

  9. Sexual orientation and gender identity/expression related peer victimization in adolescence: a systematic review of associated psychosocial and health outcomes.

    PubMed

    Collier, Kate L; van Beusekom, Gabriël; Bos, Henny M W; Sandfort, Theo G M

    2013-01-01

    This article reviews research on psychosocial and health outcomes associated with peer victimization related to adolescent sexual orientation and gender identity or expression. Using four electronic databases and supplementary methods, we identified 39 relevant studies. These studies were published between 1995 and 2012 and conducted in 12 different countries. The studies were diverse in terms of their approaches to sampling participants, assessing participants' sexual orientation, operationalizing peer victimization, and with regard to the psychosocial and health outcomes studied in relation to peer victimization. Despite the methodological diversity across studies, there is fairly strong evidence that peer victimization related to sexual orientation and gender identity or expression is associated with a diminished sense of school belonging and higher levels of depressive symptoms; findings regarding the relationship between peer victimization and suicidality have been more mixed. Peer victimization related to sexual orientation and gender identity or expression is also associated with disruptions in educational trajectories, traumatic stress, and alcohol and substance use. Recommendations for future research and interventions are discussed.

  10. A Study of Childhood Social Competence, Adult Premorbid Competence, and Psychiatric Outcome in Three Schizophrenic Subtypes

    ERIC Educational Resources Information Center

    Lewine, R. J.; And Others

    1978-01-01

    School and hospital records were used to examine childhood social competence, adult premorbid competence, and psychiatric outcome in adult schizoaffective, paranoid, and undifferentiated schizophrenics. A significant difference existed in childhood interpersonal competence and adult social competence among the subtypes. Results reflect…

  11. Alcohol-Specific Coping Styles of Adult Children of Individuals with Alcohol Use Disorders and Associations with Psychosocial Functioning.

    PubMed

    Drapkin, Michelle L; Eddie, David; Buffington, Angela J; McCrady, Barbara S

    2015-07-01

    Parental alcohol use disorders (AUDs) have been conceptualized as a chronic stressor that can lead to deleterious long-term outcomes in children of individuals with AUDs. Yet, while many individuals are detrimentally affected by their parents' problematic alcohol use, and go on to manifest psychological problems, others do not. How individuals cope with the stress of having a parent with an AUD is believed to be an important moderator of this differential outcome. This study assessed whether individuals' alcohol-specific coping styles predicted alcohol use, positive or negative life events, and depression, using a sample of 465 college students, of whom 20% were adult children of individuals with alcohol use disorders, colloquially known as adult children of alcoholics (ACOAs), and a battery of well-validated, self-report measures. Participant ACOAs reported less 'engaged' and 'total' alcohol-specific coping strategies and more 'withdrawal' alcohol-specific coping strategies than their non adult children of alcoholics (NACOAs) counterparts. Across participants, women reported more 'engaged', 'tolerant/inactive', and 'total' coping than men. Although ACOAs reported significantly more negative life events, which predicted more passive coping styles, they did not differ significantly from NACOAs on measures of problematic alcohol use or depression, supporting theories of resilience in ACOAs regardless of their alcohol-specific coping styles. For NACOAs, 'tolerant' coping predicted greater depression and alcohol-related problems; 'engaged' coping predicted fewer alcohol problems. Results suggest that ACOAs cope differently with problematic alcohol use among relatives and friends compared with NACOAs and are more likely to experience negative life events. Additionally, alcohol-related coping strategies have more predictive utility in NACOAs than ACOAs. PMID:25802055

  12. Reframing Adult Literacy and Numeracy Course Outcomes: A Social Capital Perspective. An Adult Literacy National Project Report

    ERIC Educational Resources Information Center

    Balatti, Jo; Black, Stephen; Falk, Ian

    2006-01-01

    This study investigated whether adult literacy and numeracy courses produced social capital outcomes, which are changes in students' connections with networks of people. Interviews seeking information about participation in adult literacy and numeracy courses were conducted with 57 students and 18 teachers in four courses, one each in the Northern…

  13. Longitudinal Assessment of Cognitive and Psychosocial Functioning After Hurricanes Katrina and Rita: Exploring Disaster Impact on Middle-Aged, Older, and Oldest-Old Adults.

    PubMed

    Cherry, Katie E; Brown, Jennifer Silva; Marks, Loren D; Galea, Sandro; Volaufova, Julia; Lefante, Christina; Su, L Joseph; Welsh, David A; Jazwinski, S Michal

    2011-12-01

    The authors examined the effects of Hurricanes Katrina and Rita (HKR) on cognitive and psychosocial functioning in a lifespan sample of adults 6 to 14 months after the storms. Participants were recruited from the Louisiana Healthy Aging Study (LHAS). Most were assessed during the immediate impact period and retested for this study. Analyses of pre-and post-disaster cognitive data confirmed that storm-related decrements in working memory for middle-aged and older adults observed in the immediate impact period had returned to pre-hurricane levels in the post-disaster recovery period. Middle-aged adults reported more storm-related stressors and greater levels of stress than the two older groups at both waves of testing. These results are consistent with a burden perspective on post-disaster psychological reactions.

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

    PubMed Central

    Hennegan, Julie; Montgomery, Paul

    2016-01-01

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

  15. Impact of Multiplayer Online Role-Playing Games upon the Psychosocial Well-Being of Adolescents and Young Adults: Reviewing the Evidence

    PubMed Central

    Porter-Armstrong, Alison P.

    2013-01-01

    Introduction. For many people, the online environment has become a significant arena for everyday living, and researchers are beginning to explore the multifaceted nature of human interaction with the Internet. The burgeoning global popularity and distinct design features of massively multiplayer online role-playing games (MMORPGs) have received particular attention, and discourses about the phenomenon suggest both positive and negative impact upon gamer health. Aim. The purpose of this paper was to critically appraise the research literature to determine if playing MMORPGs impacts upon the psychosocial well-being of adolescents and young adults. Method. Initial searches were conducted on nine databases spanning the years 2002 to 2012 using key words, such as online gaming, internet gaming, psychosocial, and well-being, which, in addition to hand searching, identified six studies meeting the inclusion and exclusion criteria for this review. Results. All six studies strongly associated MMORPG playing with helpful and harmful impact to the psychosocial well-being of the populations under study; however due to the methodologies employed, only tentative conclusions may be drawn. Conclusion. Since both helpful and harmful effects were reported, further multidisciplinary research is recommended to specifically explore the clinical implications and therapeutic potentialities of this modern, growing phenomenon. PMID:24236279

  16. Impact of Multiplayer Online Role-Playing Games upon the Psychosocial Well-Being of Adolescents and Young Adults: Reviewing the Evidence.

    PubMed

    Scott, Jonathan; Porter-Armstrong, Alison P

    2013-01-01

    Introduction. For many people, the online environment has become a significant arena for everyday living, and researchers are beginning to explore the multifaceted nature of human interaction with the Internet. The burgeoning global popularity and distinct design features of massively multiplayer online role-playing games (MMORPGs) have received particular attention, and discourses about the phenomenon suggest both positive and negative impact upon gamer health. Aim. The purpose of this paper was to critically appraise the research literature to determine if playing MMORPGs impacts upon the psychosocial well-being of adolescents and young adults. Method. Initial searches were conducted on nine databases spanning the years 2002 to 2012 using key words, such as online gaming, internet gaming, psychosocial, and well-being, which, in addition to hand searching, identified six studies meeting the inclusion and exclusion criteria for this review. Results. All six studies strongly associated MMORPG playing with helpful and harmful impact to the psychosocial well-being of the populations under study; however due to the methodologies employed, only tentative conclusions may be drawn. Conclusion. Since both helpful and harmful effects were reported, further multidisciplinary research is recommended to specifically explore the clinical implications and therapeutic potentialities of this modern, growing phenomenon.

  17. Dietary supplement consumption among urban adults influenced by psychosocial stress: its pronounced influence upon persons with a less healthy lifestyle.

    PubMed

    Shi, Hui-Jing; Nakamura, Keiko; Shimbo, Mari; Takano, Takehito

    2005-09-01

    In order to examine the consumption of dietary supplements among urban adults and the impact of psychological stress on supplement use in relation to lifestyle, 375 interviews of a population-based sample of urban Japanese in 2002 were analysed. The usage of various supplements, stress process (daily stressors, psychological moderators, stress outcomes), personal health practices (smoking, alcohol drinking, physical exercise, fruit and vegetable juice consumption, health-conscious eating habits) and other background factors were measured. We examined the impacts of stress on the use of vitamin tablets and capsules, vitamin-enriched health drinks and health drinks for intestinal adjustment. The percentages of these three categories of supplement user were 26.9, 18.7 and 35.7%, respectively. After adjusting for potential confounders, subjects with 'two or more' daily stressors out of the eight stressors investigated consistently showed 2-fold higher levels of consumption of either vitamin tablets and capsules or vitamin-enriched drinks compared with their counterparts with 'one or less' daily stressors. Stress-outcome indicators also related, to a greater or less extent, to the elevated consumption of various supplements. Further lifestyle-stratified analyses revealed that the stress-supplementation relationships were weaker in subjects fulfilling more than three of the five investigated health practices (i.e. the healthy lifestyle group), but stronger in subjects with fewer than two healthy practices (i.e. the less healthy lifestyle group). In conclusion, dietary supplement consumption is independently associated with stress in urban adults. The uncontrolled use of supplements for the self-medication of stress or to compensate for unhealthy behaviour represents a health concern for the general population.

  18. Demographic and Clinical Characteristics of Middle-Aged versus Younger Adults Enrolled in a Clinical Trial of a Web-Delivered Psychosocial Treatment for Substance Use Disorders

    PubMed Central

    Kalapatapu, Raj K.; Campbell, Aimee; Aharonovich, Efrat; Hu, Mei-Chen; Levin, Frances R.; Nunes, Edward V.

    2012-01-01

    Objective Evidence suggests that substance abuse is becoming more prevalent in middle-aged adults. The objective of this secondary analysis was to add to the growing empirical literature on the unique features of middle-aged substance abuse populations. Methods We descriptively compared baseline demographic and clinical characteristics of middle-aged (age 45–62, n = 111) and younger (age 18–44, n = 395) substance abusers entering a web-based psychosocial treatment study as part of the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN). Results A significantly greater percentage of middle-aged adults were non-Caucasian and had a marital status other than single/never married. There was a significant association between frequency of Internet use and the age group. Forty-six percent of middle-aged adults versus 21% of younger adults reported no Internet use in the prior 90 days. A significantly greater percentage of middle-aged adults used cocaine, and a significantly greater percentage of younger adults used marijuana and opioids. Clinically significant cognitive impairment (z less than −1.0) was found for the average participant in both groups on logical association of familiar concepts. Conclusions This secondary analysis of a NIDA CTN study provides additional information on the unique features of middle-aged substance abusers. Increasing knowledge of similarities and differences between younger and middle-aged substance abusers can help with potential age-specific substance abuse treatment planning. PMID:23340711

  19. Reciprocal effects of treatment-induced increases in exercise and improved eating, and their psychosocial correlates, in obese adults seeking weight loss: a field-based trial

    PubMed Central

    2013-01-01

    Background A better understanding of interrelations of exercise and improved eating, and their psychosocial correlates of self-efficacy, mood, and self-regulation, may be useful for the architecture of improved weight loss treatments. Theory-based research within field settings, with samples possessing high probabilities of health risks, might enable rapid application of useful findings. Methods Adult volunteers with severe obesity (body mass index [BMI] 35–50 kg/m2; age = 43.0 ± 9.5 y; 83% female) were randomly assigned to six monthly cognitive-behavioral exercise support sessions paired with either group-based nutrition education (n = 145) or cognitive behavioral methods applied to improved eating (n = 149). After specification of mediation models using a bias-corrected bootstrapping procedure, a series of reciprocal effects analyses assessed: a) the reciprocal effects of changes in exercise and fruit and vegetable intake, resulting from the treatments, b) the reciprocal effects of changes in the three psychosocial variables tested (i.e. self-efficacy, mood, and self-regulation) and fruit and vegetable change, resulting from change in exercise volume, and c) the reciprocal effects of changes in the three psychosocial variables and exercise change, resulting from change in fruit and vegetable intake. Results Mediation analyses suggested a reciprocal effect between changes in exercise volume and fruit and vegetable intake. After inclusion of psychosocial variables, also found were reciprocal effects between change in fruit and vegetable intake and change in mood, self-efficacy for controlled eating, and self-regulation for eating; and change in exercise volume and change in mood and exercise-related self-regulation. Conclusion Findings had implications for behavioral weight-loss theory and treatment. Specifically, results suggested that treatments should focus upon, and leverage, the transfer effects from each of the primary weight

  20. Early Developmental and Psychosocial Risks and Longitudinal Behavioral Adjustment Outcomes for Preschool-Age Girls Adopted from China

    ERIC Educational Resources Information Center

    Tan, Tony Xing; Marfo, Kofi; Dedrick, Robert F.

    2010-01-01

    The central goal of this longitudinal study was to examine behavioral adjustment outcomes in a sample of preschool-age adopted Chinese girls. Research examining the effects of institutional deprivation on post-adoption behavioral outcomes for internationally adopted children has been constrained by the frequent unavailability of data on the…

  1. Neuropsychological Motor Outcomes in Adults from Airborne Manganese Exposure

    EPA Science Inventory

    Background: The literature on manganese (Mn) is dominated by occupational exposures of adults exposed often to high levels without protection. Neuropsychological adverse health effects are similar to Parkinson’s Disease with psychomotor slowing, tremor, cognitive and mood ...

  2. The Costs of Services and Employment Outcomes Achieved by Adults with Autism in the US

    ERIC Educational Resources Information Center

    Cimera, Robert Evert; Cowan, Richard J.

    2009-01-01

    This article examines the cost of services and employment outcomes obtained by adults with autism within the United States vocational rehabilitation (VR) system. It found that the number of such individuals has increased by more than 121 percent from 2002 to 2006. Moreover, though adults with autism were employed at higher rates than most…

  3. Evaluating Employment Outcomes of Adults Who Are Deaf and Hard of Hearing

    ERIC Educational Resources Information Center

    Hartmann, Eva Ayers

    2010-01-01

    This study evaluated employment outcomes of adults who were deaf and hard of hearing. The 200 subjects were deaf and hard of hearing adults 18 years and older. They completed a survey consisting of 20 multiple choice questions and three additional questions that required written responses. The results indicated there were significant associations…

  4. Foster Care Experiences and Educational Outcomes of Young Adults Formerly Placed in Foster Care

    ERIC Educational Resources Information Center

    Havalchak, Anne; White, Catherine Roller; O'Brien, Kirk; Pecora, Peter J.; Sepulveda, Martin

    2009-01-01

    This study contributes to the body of research on the educational outcomes of young adults who were formerly placed in foster care. Telephone interviews were conducted with 359 young adults (a 54.6% response rate). Participants must have been served for at least one year by one private foster care agency in one of its twenty-two offices. Results…

  5. Treatment of Human-Caused Trauma: Attrition in the Adult Outcomes Research

    ERIC Educational Resources Information Center

    Matthieu, Monica; Ivanoff, Andre

    2006-01-01

    Attrition or dropout is the failure of a participant to complete, comply, or the prematurely discontinuation or discharge from treatment, resulting in lost data and affecting outcomes. This review of 10 years of adult posttraumatic stress disorder (PTSD) treatment outcome literature specific to Criterion A events of human origin examines how…

  6. Predicting Young Adult Outcome among More and Less Cognitively Able Individuals with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Anderson, Deborah K.; Liang, Jessie W.; Lord, Catherine

    2014-01-01

    Background: The range of outcomes for young adults with Autism Spectrum Disorders (ASD) and the early childhood factors associated with this diversity have implications for clinicians and scientists. Methods: This prospective study provided a unique opportunity to predict outcome 17 years later for a relatively large sample of children diagnosed…

  7. Naturally Acquired Mentoring Relationships and Young Adult Outcomes among Adolescents with Learning Disabilities

    ERIC Educational Resources Information Center

    Ahrens, Kym; DuBois, David Lane; Lozano, Paula; Richardson, Laura P.

    2010-01-01

    We evaluated whether having a naturally acquired mentor during adolescence was associated with improved adult outcomes among youth with learning disabilities (YLD). Mentored youth were more likely to have graduated from high school, reported a higher level of self-esteem, and reported a higher overall number of positive outcomes than nonmentored…

  8. Outdoor Behavioral Health Care: Client and Treatment Characteristics Effects on Young Adult Outcomes

    ERIC Educational Resources Information Center

    Roberts, Sean D.; Stroud, Daniel; Hoag, Matthew J.; Combs, Katie M.

    2016-01-01

    A lack of clarity exists regarding how different clients respond to outdoor behavioral health care (OBH). In this study, specific client and treatment characteristics were assessed for 186 young adults completing an OBH therapeutic wilderness program. Clinical outcomes were measured with the Outcome Questionnaire-45.2. Hierarchical linear modeling…

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

    Peer teaching is recognized as a powerful instructional method; however, there is a paucity of studies that have evaluated the outcomes experienced by peer-teachers and their student recipients in the context of trained, non-reciprocal, high school physical education (PE). Accordingly, the effectiveness of a formalized and trained non-reciprocal peer teaching (T-PT) program upon psychosocial, behavioral, pedagogical, and student learning outcomes within high school PE classes was investigated. Students from eight intact classes (106 males, 94 females, Mage = 12.46, SD = 0.59) were randomly assigned to either a T-PT intervention group (taught by a volunteer peer-teacher who was trained in line with a tactical games approach) or untrained group (U-PT; where volunteer peer-teachers received no formal training, but did receive guidance on the game concepts to teach). Data were collected over 10 lessons in a 5-week soccer unit. Mixed-model ANOVAs/MANOVAs revealed that, in comparison to U-PT, the T-PT program significantly enhanced in-game performance actions and academic learning time among student recipients. Those in the T-PT also provided greater levels of feedback and structured learning time, as well as reporting more positive feelings about peer teaching and fewer perceived barriers to accessing learning outcomes. These findings show that non-reciprocal peer-teachers who receive formalized support through training and tactical games approach-based teaching resources can enhance behavioral, pedagogical, and motor performance outcomes in PE. PMID:25741309

  11. [Transition of adolescents with the exstrophy-epispadias complex to adult medicine: influence of long-term outcome results on management].

    PubMed

    Ebert, A-K; Reutter, H; Neissner, C; Rösch, W

    2012-11-01

    Today, young individuals with rare congenital anomalies as the Exstrophy-Epispadias-Complex (EEC) are mostly monitored interdisciplinary with a high standard of care and enthusiasm during childhood. However, when growing up through adolescence to adulthood adequate care-givers are not available at the moment in adult medicine in Germany and a concrete transition process has yet not been established. Over the past years, we put much effort in systematic evaluation of long-term outcome after reconstruction of the EEC in the newborn period to further improve outcome results. Beside predictive parameters for continence and long-term bladder function, genital function and fertility, as well as postoperative pelvic floor morphology and gynecological outcome, orthopedic results and psychosexual and psychosocial development in EEC were of major interest. As a consequence we currently develop a German-wide follow-up concept in EEC patients regarding age- and gender specific outcome issues. Long-term observations of the EEC outcome however, underline the unrestricted importance of careful long-term follow-up of all EEC patients, as well as the necessity of close cooperation of pediatric urologist, pediatric surgeons, urologists, orthopedic surgeons, gynecologists, andrologists, psychologists and urotherapists from early childhood and the need of knowledge transfer and hopefully a successful transition of the EEC individuals to general medicine.

  12. Attention-deficit/hyperactivity disorder and adverse health outcomes in adults.

    PubMed

    Spencer, Thomas J; Faraone, Stephen V; Tarko, Laura; McDermott, Katie; Biederman, Joseph

    2014-10-01

    Whereas the adverse impact of attention-deficit/hyperactivity disorder (ADHD) on emotional and psychosocial well-being has been well investigated, its impact on physical health has not. The main aim of this study was to assess the impact of ADHD on lifestyle behaviors and measures of adverse health risk indicators. Subjects were 100 untreated adults with ADHD and 100 adults without ADHD of similar age and sex. Unhealthy lifestyle indicators included assessments of bad health habits, frequency of visits to healthcare providers, and follow through with recommended prophylactic tests. Assessments of adverse health risk indicators included measurements of cardiovascular and metabolic parameters, weight, body mass index, and waist circumference. No differences were identified in health habits between subjects with and without ADHD, but robust differences were found in a wide range of adverse health risk indicators. ADHD is associated with an adverse impact in health risk indicators well known to be associated with high morbidity and mortality. PMID:25211634

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

    PubMed

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

    2015-11-01

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

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

    PubMed Central

    Li, Dongmei; Davis, James; Arakaki, Richard

    2015-01-01

    Asian Americans and Pacific Islanders are twice as likely to be diagnosed with type 2 diabetes compared to Caucasians. The objective was to determine the effect of cognitive behavioral therapy on quality of life, general health perceptions, depressive symptoms, and glycemia in Asians and Pacific Islanders with type 2 diabetes. The design was a randomized controlled clinical trial comparing cognitive behavioral therapy to diabetes education and support for six weekly sessions. Participants were recruited from two endocrinology practices; 207 were enrolled. The cognitive behavioral therapy group was provided self-management tools which included biofeedback, breathing exercises, and stress relievers, while the diabetes education and support group included diabetes education and group discussions. Assessments of psychosocial and clinical outcomes were obtained before and after sessions and 12 months PostSession. Differences between the two groups were examined using linear mixed-effects models with linear contrasts. The cognitive behavioral therapy group had improved depressive symptom scores from PreSession to EndSession compared to the diabetes education and support group (P < .03), but the improvement did not extend to 12 months PostSession. Similar results were observed with misguided support scores in the Multidimensional Diabetes Questionnaire (P < .03) and susceptibility in health beliefs (P < .01), but no significant differences in HbA1c improvement were found between the two groups. Both interventions improved outcomes from baseline but were not sustained for 1 year. PMID:26568899

  15. Prognosis and psychosocial outcomes of attempted suicide by early adolescence: a 6-year follow-up of school students into early adulthood.

    PubMed

    Nrugham, Latha; Holen, Are; Sund, Anne Mari

    2015-04-01

    Adulthood psychiatric and psychosocial outcomes of early adolescence suicidal acts were studied. A representative sample of school adolescents (T1, mean age, 13.7 years; n = 2464; 50.8% female; 88.3% participation) was followed up a year later with the same questionnaire (T2). High scorers of depression were matched with low or moderate scorers and interviewed using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime version (mean age, 14.9 years; n = 345; 94% participation). They were reassessed after 5 years (T3, mean age, 20.0 years; n = 242; 73% participation). Those who attempted suicide before the age of 14 years and repeated suicidal acts between ages 14 and 15 years had worser prognostic profiles than incident cases between ages 14 and 15 years. Male attempters had better psychiatric prognosis than female attempters. Attempters were more likely to have contacted child protection services but not mental health services. Clinicians need to be aware of long-term pervasive outcomes of adolescent suicidality. PMID:25768349

  16. Barriers to information access, perceived health competence, and psychosocial health outcomes: test of a mediation model in a breast cancer sample.

    PubMed

    Arora, Neeraj K; Johnson, Pauley; Gustafson, David H; McTavish, Fiona; Hawkins, Robert P; Pingree, Suzanne

    2002-05-01

    This study examined the relationship between breast cancer patients' experience of barriers to accessing health information and their psychosocial health outcomes and explored the extent to which this relationship was mediated by patient perceptions of competence in dealing with health-related issues. Study sample consisted of 225 women surveyed within 6 months of diagnosis. Regression analyses suggested that patients who reported greater difficulty in accessing needed information experienced lower emotional (P=0.05), functional (P<0.05), and social/family (P<0.05) well-being as well as lower perceptions of health competence (P<0.001). Also, patient perceptions of health competence mediated the relationship between barriers to accessing information and patient outcomes (emotional well-being, P<0.05; functional well-being. P<0.01; social/family well-being, P=0.01). Breast cancer patients often report dissatisfaction with the extent to which their information needs are addressed by their health care providers. Our findings underscore the need for designing and implementing interventions that would aid providers in better meeting the information needs of their patients.

  17. The effects of a support group on selected psychosocial outcomes of bereaved parents whose child died from cancer.

    PubMed

    Heiney, S P; Ruffin, J; Goon-Johnson, K

    1995-04-01

    Group support for bereaved parents whose child died from cancer has been suggested as a means of helping parents express emotions about their loss and improve their coping. Using a quasi-experimental design, we sought to determine the selected psychosocial effects of participation in a support group for bereaved parents whose child died from cancer. Five bereaved parents completed the Emotions Profile Index, the Family Adaptability and Cohesion Evaluation Scales, and the Social Adjustment Scale Self-Report before and after the seven group sessions. No statistically significant differences were found. Descriptive data were analyzed from the co-therapists' process log and the participants' evaluation forms. The group process log revealed intense pain and grief over the loss of the child and the parents' conscious struggle to adapt to the present and prepare for the future. The discussions poignantly indicated the great extent to which the child's death had changed their lives. Using the group evaluation form parents reported high satisfaction with the group sessions. Tentative conclusions support the value of such a group in providing a forum for some bereaved parents to ventilate feelings and thoughts and validate the normalcy of their reactions. PMID:7612198

  18. Questionnaires for outcome expectancy, self-regulation, and behavioral expectation for resistance training among young-old adults: development and preliminary validity.

    PubMed

    Williams, David M; Savla, Jyoti; Davy, Brenda M; Kelleher, Sarah A; Marinik, Elaina L; Winett, Richard A

    2015-04-01

    The purpose of the present research was to develop questionnaires to assess outcome expectancy for resistance training (RT), behavioral expectation in the context of perceived barriers to RT, and self-regulation strategies for RT among young-old adults (50-69 years). Measurement development included (a) item generation through elicitation interviews (N = 14) and open-ended questionnaires (N = 56), (b) expert feedback on a preliminary draft of the questionnaires (N = 4), and (c) a quantitative longitudinal study for item-reduction and psychometric analyses (N = 94). Elicitation procedures, expert feedback, and item reduction yielded four questionnaires with a total of 33 items. Positive outcome expectancy (α = .809), negative outcome expectancy (α = .729), behavioral expectation (α = .925), and self-regulation (α = .761) had-with one exception-moderate bivariate associations with two different indicators of self-reported RT behavior at one-month follow-up (r = .298 to .506). The present research provides preliminary support for newly developed questionnaires to facilitate understanding of the psychosocial determinants of RT among young-old adults.

  19. The Adult Roles Models Program: Feasibility, Acceptability, and Initial Outcomes

    PubMed Central

    Silver, Ellen Johnson; Dean, Randa; Perez, Amanda; Rivera, Angelic

    2014-01-01

    We present the feasibility and acceptability of a parent sexuality education program led by peer educators in community settings. We also report the results of an outcome evaluation with 71 parents who were randomized to the intervention or a control group, and surveyed one month prior to and six months after the 4-week intervention. The program was highly feasible and acceptable to participants, and the curriculum was implemented with a high level of fidelity and facilitator quality. Pilot data show promising outcomes for increasing parental knowledge, communication, and monitoring of their adolescent children. PMID:24883051

  20. Training with a Vocational Outcome for Adults with Intellectual Handicaps.

    ERIC Educational Resources Information Center

    Hart, Cathy; Boehm, Barbara

    To show that training programs for adults with intellectual handicaps can be successfully carried out regardless of the size of the community, information is provided on vocationally oriented programs in place at two Canadian community colleges: the Consumer and Job Preparation Program (CJPP) at Douglas College, in New Westminster, British…

  1. Positive Outcomes Enhance Incidental Learning for Both Younger and Older Adults

    PubMed Central

    Mather, Mara; Schoeke, Andrej

    2011-01-01

    Previous studies suggest that memory encoding is enhanced when people are anticipating a potential reward, consistent with the idea that dopaminergic systems that respond to motivationally relevant information also enhance memory for that information. In the current study, we examined how anticipating and receiving rewards versus losses affect incidental learning of information. In addition, we compared the modulatory effects of reward anticipation and outcome on memory for younger and older adults. Forty-two younger (aged 18–33 years) and 44 older (aged 66–92 years) adults played a game involving pressing a button as soon as they saw a target. Gain trials began with a cue that they would win $0.25 if they pressed the button fast enough, loss trials began with a cue that they would avoid losing $0.25 if they pressed the button fast enough, and no-outcome trials began with a cue indicating no monetary outcome. The target was a different photo-object on each trial (e.g., balloon, dolphin) and performance outcomes were displayed after the photo disappeared. Both younger and older adults recalled and recognized pictures from trials with positive outcomes (either rewarding or loss avoiding) better than from trials with negative outcomes. Positive outcomes were associated with not only enhanced memory for the picture just seen in that trial, but also with enhanced memory for the pictures shown in the next two trials. Although anticipating a reward also enhanced incidental memory, this effect was seen only in recognition memory of positive pictures and was a smaller effect than the outcome effect. The fact that older adults showed similar incidental memory effects of reward anticipation and outcome as younger adults suggests that reward–memory system interactions remain intact in older age. PMID:22125509

  2. Parental Problem-Drinking and Adult Children's Labor Market Outcomes

    ERIC Educational Resources Information Center

    Balsa, Ana I.

    2008-01-01

    Current estimates of the societal costs of alcoholism do not consider the impact of parental drinking on children. This paper analyzes the consequences of parental problem-drinking on children's labor market outcomes in adulthood. Using the NLSY79, I show that having a problem-drinking parent is associated with longer periods out of the labor…

  3. Differential Outcomes of Adult Education on Adult Learners' Increase in Social Inclusion

    ERIC Educational Resources Information Center

    de Greef, Maurice; Verté, Dominique; Segers, Mien

    2015-01-01

    To date a significant share of the European population can be considered at risk of social exclusion. It has been argued that adult education programmes are a powerful tool to support vulnerable adults increasing their social inclusion. This study aims to answer the question if and which subgroups of vulnerable adults experience an increase in…

  4. Feasibility and preliminary outcomes from a pilot study of coping skills training for adolescent--young adult survivors of childhood cancer and their parents.

    PubMed

    Judge Santacroce, Sheila; Asmus, Kirsten; Kadan-Lottick, Nina; Grey, Margaret

    2010-01-01

    Uncertainty is a central feature of long-term childhood cancer survivorship during which time it principally has to do with late effects. Therefore, the purposes of this article are (a) to assess feasibility of a randomized clinical trial of a telephone-delivered coping skills training (CST) intervention in terms of recruitment, retention, and timeline, as well as the performance of the study measures; and (b) to demonstrate trends in change on outcomes within the context of a small pilot study. The results of this pilot study suggest that HEROS PLUS CST has clinical relevance and that in-person long-term follow-up plus telephone-delivered psychosocial care is a practical way to deliver integrated care to adolescent-young adult childhood cancer survivors and their parents.

  5. Psychosocial Determinants of Promotores and Selected Outcomes for a Cancer Education Intervention Implemented in South Texas Colonias

    ERIC Educational Resources Information Center

    St. John, Julie Parrish

    2013-01-01

    Hispanics have a disproportionate burden of poorer cancer outcomes. "Promotores" (community health workers) have been shown to be effective in delivering interventions to this population. However, little is known about what aspects of the "promotores" influence the delivery of a cancer education intervention as well what…

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

    PubMed Central

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

    2015-01-01

    Background Digital technologies show promise for increasing treatment accessibility and improving quality of care, but little is known about gender differences. This secondary analysis uses data from a multi-site effectiveness trial of a computer-assisted behavioral intervention, conducted within NIDA's National Drug Abuse Clinical Trials Network, to explore gender differences in intervention acceptability and treatment outcomes. Methods Men (n=314) and women (n=192) were randomly assigned to 12-weeks of treatment-as-usual (TAU) or modified TAU + Therapeutic Education System (TES), whereby TES substituted for 2 hours of TAU per week. TES is comprised of 62 web-delivered, multimedia modules, covering skills for achieving and maintaining abstinence plus prize-based incentives contingent on abstinence and treatment adherence. Outcomes were: (1) abstinence from drugs and heavy drinking in the last 4 weeks of treatment, (2) retention, (3) social functioning, and (4) drug and alcohol craving. Acceptability was the mean score across five indicators (i.e., interesting, useful, novel, easy to understand, and satisfaction). Results Gender did not moderate the effect of treatment on any outcome. Women reported higher acceptability scores at week 4 (p=.02), but no gender differences were detected at weeks 8 or 12. Acceptability was positively associated with abstinence, but only among women (p=.01). Conclusions Findings suggest that men and women derive similar benefits from participating in a computer-assisted intervention, a promising outcome as technology-based treatments expand. Acceptability was associated with abstinence outcomes among women. Future research should explore characteristics of women who report less satisfaction with this modality of treatment and ways to improve overall acceptability. PMID:25613105

  7. Long-term psychosocial outcomes of BRCA1/BRCA2 testing: Differences across affected status and risk-reducing surgery choice

    PubMed Central

    Graves, Kristi D.; Vegella, Patti; Poggi, Elizabeth A.; Peshkin, Beth N.; Tong, Angie; Isaacs, Claudine; Finch, Clinton; Kelly, Scott; Taylor, Kathryn L.; Luta, George; Schwartz, Marc D.

    2012-01-01

    Background Numerous studies have documented the short-term impact of BRCA1/BRCA2 (BRCA1/2) testing; however, little research has examined the long-term impact of testing. We conducted the first long-term prospective study of psychosocial outcomes in a U.S. sample of women who had BRCA1/2 testing. Methods Participants were 464 women who underwent genetic testing for BRCA1/2 mutations. Prior to testing, we measured sociodemographics, clinical variables, and cancer specific and general distress. At long-term follow-up (Median=5.0 years; Range=3.4 to 9.1 years), we assessed cancer specific and genetic testing distress, perceived stress and perceived cancer risk. We evaluated the impact of BRCA1/2 test result and risk reducing surgery on long-term psychosocial outcomes. Results Among participants who had been affected with breast or ovarian cancer, BRCA1/2 carriers reported higher genetic testing distress (β=0.41, P<0.0001), uncertainty (β=0.18, P<0.0001) and perceived stress (β=0.17, P=0.005) compared to women who received negative (i.e., uninformative) results. Among women unaffected with breast/ovarian cancer, BRCA1/2 carriers reported higher genetic testing distress (β=0.39, P<0.0001) and lower positive testing experiences (β=0.25, P=0.008) than women with negative results. Receipt of risk-reducing surgery was associated with lower perceived cancer risk (P<0.0001). Conclusions In this first prospective long-term study in a U.S. sample, we found modestly increased distress in BRCA1/2 carriers compared to women who received uninformative or negative test results. Despite this modest increase in distress, we found no evidence of clinically significant dysfunction. Impact While a positive BRCA1/2 result remains salient among carriers years after testing, testing does not appear to impact long-term psychological dysfunction. PMID:22328347

  8. Effect of restorative yoga vs. stretching on diurnal cortisol dynamics and psychosocial outcomes in individuals with the metabolic syndrome: the PRYSMS randomized controlled trial

    PubMed Central

    Corey, Sarah M.; Epel, Elissa; Schembri, Michael; Pawlowsky, Sarah B.; Cole, Roger J.; Araneta, Maria Rosario G.; Barrett-Connor, Elizabeth; Kanaya, Alka M.

    2014-01-01

    Purpose Chronic stimulation and dysregulation of the neuroendocrine system by stress may cause metabolic abnormalities. We estimated how much cortisol and psychosocial outcomes improved with a restorative yoga (relaxation) versus a low impact stretching intervention for individuals with the metabolic syndrome. Methods We conducted a 1-year multi-center randomized controlled trial (6-month intervention and 6-month maintenance phase) of restorative yoga vs. stretching. Participants completed surveys to assess depression, social support, positive affect, and stress at baseline, 6 months and 12 months. For each assessment, we collected saliva at four points daily for three days and collected response to dexamethasone on the fourth day for analysis of diurnal cortisol dynamics. We analyzed our data using multivariate regression models, controlling for study site, medications (antidepressants, hormone therapy), body mass index, and baseline cortisol values. Results Psychosocial outcome measures were available for 171 study participants at baseline, 140 at 6 months, and 132 at the 1 year. Complete cortisol data were available for 136 of 171 study participants (72 in restorative yoga and 64 in stretching) and were only available at baseline and 6 months. At 6 months, the stretching group had decreased cortisol at waking and bedtime compared to the restorative yoga group, The pattern of changes in stress mirrored this improvement, with the stretching group showing reductions in chronic stress severity and perseverative thoughts about their stress. Perceived stress decreased by 1.5 points (−0.4; 3.3, p=0.11) at 6 months, and by 2.0 points (0.1; 3.9, p=0.04) at 1 year in the stretching compared to restorative yoga groups. Post hoc analyses suggest that in the stretching group only, perceived increases in social support (particularly feelings of belonging), but not changes in stress were related to improved cortisol dynamics. Conclusions We found significant decreases in

  9. Hepatic haemangioendothelioma in adults: excellent outcome following liver transplantation.

    PubMed

    Lerut, Jan P; Orlando, Giuseppe; Sempoux, Christine; Ciccarelli, Olga; Van Beers, Bernard E; Danse, Etienne; Horsmans, Yves; Rahier, Jacques; Roggen, Francine

    2004-05-01

    Hepatic epithelioid haemangioendotheliomas (HEHEs) are rare, low-grade vascular tumours. Five adults with HEHEs and one adult with a vascular tumour showing combined features of haemangioma and haemangioendothelioma underwent liver transplantation. Two HEHE patients had extrahepatic metastases at the time of transplantation. Median survival time following diagnosis was 10.7 years (range 40 months to 195 months). One patient needed resection of a HEHE in the breast 13 years post-transplantation. All six patients are surviving free from disease 22 to 166 months after transplantation (median 77 months). One HEHE-patient who had been treated for 8 years for vertebral and cerebral localisations is free of disease without immunosuppression 56 months after transplantation. We can conclude that liver transplantation is a valuable treatment for hepatic haemangioendothelioma, even in cases of extrahepatic localisation of the disease. PMID:15114438

  10. Long-Term Treatment Outcome in Adult Male Prisoners With Attention-Deficit/Hyperactivity Disorder: Three-Year Naturalistic Follow-Up of a 52-Week Methylphenidate Trial.

    PubMed

    Ginsberg, Ylva; Långström, Niklas; Larsson, Henrik; Lindefors, Nils

    2015-10-01

    Despite high rates of attention-deficit/hyperactivity disorder (ADHD) among adult lawbreakers, particularly the long-term effects of ADHD pharmacotherapy remain unclear, not the least because of ethical challenges with preventing control subjects in randomized controlled trials from receiving medication over prolonged time. We followed up adult male prisoners with ADHD who completed a 5-week randomized, double-blind, placebo-controlled trial followed by a 47-week open-label extension of osmotic-release oral system methylphenidate in a Swedish high-security prison from 2007 to 2010 (ClinicalTrials.gov: NCT00482313). Twenty-five trial completers were prospectively followed up clinically 1 year (24/25, 96% participated fully or in part) and 3 years (20/25, 80% participation) after trial regarding ADHD symptoms (observer and self-reports), psychosocial functioning, substance misuse, and criminal reoffending. Methylphenidate-related improvements in ADHD symptoms and psychosocial functioning obtained during the 52-week trial were maintained at 1- and 3-year follow-ups. Specifically, after 3 years, 75% (15/20) of the respondents had been released from prison, and 67% of these (10/15) had employment, usually full time. In contrast, nonmedicated respondents at the 3-year follow-up (5/20) reported more ADHD symptoms, functional impairment, and substance misuse compared with currently medicated respondents (15/20). Further, 40% of the respondents self-reported reoffending, indicating a substantially lower relapse rate than expected (70%-80%).In summary, although these observations need validation from new and larger samples, positive effects were maintained after 4 years of methylphenidate treatment. Most study completers were employed and had no relapse in substance misuse or criminality. These results suggest that motivational support and continued medication are important for improved outcome in adult criminal offenders with ADHD.

  11. Relations of Behavioral Autonomy to Health Outcomes Among Emerging Adults With and Without Type 1 Diabetes

    PubMed Central

    Reynolds, Kerry A.; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

    2014-01-01

    Objective To examine the relation of behavioral autonomy to psychological, behavioral, and physical health among emerging adults with and without type 1 diabetes. Methods High school seniors with (n = 118) and without type 1 diabetes (n = 122) completed online questionnaires for three consecutive years. Behavioral autonomy, psychological health, risk behaviors, and diabetes outcomes were assessed. Regression analyses were conducted to predict Time 2 and 3 outcomes, controlling for Time 1 outcomes. Results There were no group differences in behavioral autonomy. Behavioral autonomy predicted better psychological health but only for emerging adults without diabetes. Behavioral autonomy was related to increased risk behavior for both groups. Behavioral autonomy was unrelated to self-care but predicted better glycemic control for females. Conclusions Behavioral autonomy may be beneficial for psychological health, but is related to increased risk behavior. The implications of behavioral autonomy for emerging adults with type 1 diabetes require careful consideration. PMID:25157070

  12. Optimizing Survival Outcomes For Adult Patients With Nontraumatic Cardiac Arrest.

    PubMed

    Jung, Julianna

    2016-10-01

    Patient survival after cardiac arrest can be improved significantly with prompt and effective resuscitative care. This systematic review analyzes the basic life support factors that improve survival outcome, including chest compression technique and rapid defibrillation of shockable rhythms. For patients who are successfully resuscitated, comprehensive postresuscitation care is essential. Targeted temperature management is recommended for all patients who remain comatose, in addition to careful monitoring of oxygenation, hemodynamics, and cardiac rhythm. Management of cardiac arrest in circumstances such as pregnancy, pulmonary embolism, opioid overdose and other toxicologic causes, hypothermia, and coronary ischemia are also reviewed.

  13. Trajectories, Long-Term Outcomes and Family Experiences of 76 Adults with Autism Spectrum Disorder.

    PubMed

    Chamak, Brigitte; Bonniau, Béatrice

    2016-03-01

    The aim of this retrospective study was to retrace the trajectories and long-term outcomes of individuals with autism in France, and to explore the family experiences. Data obtained from parents enables us to follow the trajectories of 76 adults. Two-thirds of adults with severe autism had a very poor outcome. Those with moderate autism had a better outcome. In adulthood, the majority were in residential accommodation. None were living independently. The trajectories of people with Asperger syndrome or high-functioning autism were more positive since all of them attended school for a long time and some went to university. All of them had a good outcome but they remained dependent on aging parents who had few available supports. PMID:26572660

  14. Outcomes and intentions in children's, adolescents', and adults' second- and third-party punishment behavior.

    PubMed

    Gummerum, Michaela; Chu, Maria T

    2014-10-01

    Theories of morality maintain that punishment supports the emergence and maintenance of moral behavior. This study investigated developmental differences in the role of outcomes and the violator's intentions in second-party punishment (where punishers are victims of a violation) and third-party punishment (where punishers are unaffected observers of a violation). Four hundred and forty-three adults and 8-, 12-, and 15-year-olds made choices in mini-ultimatum games and newly-developed mini-third-party punishment games, which involved actual incentives rather than hypothetical decisions. Adults integrated outcomes and intentions in their second- and third-party punishment, whereas 8-year-olds consistently based their punishment on the outcome of the violation. Adolescents integrated outcomes and intentions in second- but not third-party punishment.

  15. Outcomes and intentions in children's, adolescents', and adults' second- and third-party punishment behavior.

    PubMed

    Gummerum, Michaela; Chu, Maria T

    2014-10-01

    Theories of morality maintain that punishment supports the emergence and maintenance of moral behavior. This study investigated developmental differences in the role of outcomes and the violator's intentions in second-party punishment (where punishers are victims of a violation) and third-party punishment (where punishers are unaffected observers of a violation). Four hundred and forty-three adults and 8-, 12-, and 15-year-olds made choices in mini-ultimatum games and newly-developed mini-third-party punishment games, which involved actual incentives rather than hypothetical decisions. Adults integrated outcomes and intentions in their second- and third-party punishment, whereas 8-year-olds consistently based their punishment on the outcome of the violation. Adolescents integrated outcomes and intentions in second- but not third-party punishment. PMID:24997554

  16. Show Me the Child at Seven: The Consequences of Conduct Problems in Childhood for Psychosocial Functioning in Adulthood

    ERIC Educational Resources Information Center

    Fergusson, David M.; Horwood, L. John; Ridder, Elizabeth M.

    2005-01-01

    Background: This paper seeks to extend research into the adult sequelae of childhood conduct problems by investigating the associations between conduct problems in middle childhood and psychosocial outcomes in adulthood. Method: Data were gathered during the course of a 25-year longitudinal study of a birth cohort of New Zealand young people.…

  17. Psychosocial Aspects of Obesity.

    PubMed

    Beck, Amy R

    2016-01-01

    This article is the sixth in a series of the comorbidities of childhood obesity and reviews psychosocial aspects with a focus on weight-based victimization and discrimination stemming from weight bias and stigma. Outcomes from these bullying and discriminatory experiences are pervasive and impact youth across all settings, including school. Lastly, this article provides recommendations on how to reduce bias and stigma to better serve these students in the school environment. PMID:26739931

  18. The Experiences of Adult Undergraduate Students--What Shapes Their Learning?

    ERIC Educational Resources Information Center

    Graham, Steven W.; Donaldson, Joe F.; Kasworm, Carol; Dirkx, John

    The Model of College Outcomes for Adults explains why adults might do as well as traditional students, despite limited participation and involvement in traditional residential learning experiences. The model's six components are prior experience and personal biographies; psychosocial and value orientation; adult cognition; life-world environment;…

  19. The relationship between child maltreatment and substance abuse treatment outcomes among emerging adults and adolescents.

    PubMed

    Garner, Bryan R; Hunter, Brooke D; Smith, Douglas C; Smith, Jane Ellen; Godley, Mark D

    2014-01-01

    Emerging adulthood is the period of greatest risk for problematic substance use. The primary aim of the current study was to examine the relationship between a broad measure of child maltreatment and several key outcomes for a large clinical sample of emerging adults (n = 858) and adolescents (n = 2,697). The secondary aim was to examine the extent to which the relationship between child maltreatment and treatment outcomes differed between emerging adults and adolescents. Multilevel latent growth curve analyses revealed emerging adults and adolescents who experienced child maltreatment reported significantly greater reductions over time on several treatment outcomes (e.g., substance use, substance-related problems, and emotional problems). Overall, analyses did not support differential relationships between child maltreatment and changes over time in these substance use disorder treatment outcomes for emerging adults and adolescents. The one exception was that although emerging adults with child maltreatment did reduce their HIV risk over time, their improvements were not as great as were the improvements in HIV risk reported by adolescents who had experienced child maltreatment.

  20. Understanding the Mechanisms Through Which an Influential Early Childhood Program Boosted Adult Outcomes

    PubMed Central

    Heckman, James; Pinto, Rodrigo

    2013-01-01

    A growing literature establishes that high quality early childhood interventions targeted toward disadvantaged children have substantial impacts on later life outcomes. Little is known about the mechanisms producing these impacts. This paper uses longitudinal data on cognitive and personality traits from an experimental evaluation of the influential Perry Preschool program to analyze the channels through which the program boosted both male and female participant outcomes. Experimentally induced changes in personality traits explain a sizable portion of adult treatment effects. PMID:24634518

  1. Association between psychopathology and problems of psychosocial functioning in the long-term outcome of patients diagnosed with schizophrenic, schizoaffective and affective disorders.

    PubMed

    Bottlender, Ronald; Strauss, Anton; Möller, Hans-Jürgen

    2013-03-01

    Mental health problems do significantly impact on a person's functioning. In the past, problems with psychosocial functioning were mainly associated with the diagnoses of schizophrenia. However, nowadays it is clear that impaired psychosocial functioning is also a common phenomenon in people suffering from affective disorders. Only few studies have investigated psychosocial functioning in patients with affective, schizoaffective and schizophrenic disorders in the long-term and in a comparative approach. In the present study, we analysed the association between psychopathology and psychosocial functioning. This question is relevant as symptom remission and sufficient levels of functioning are considered as important indicators of patients' recovery from their mental health problems. The here reported findings refer to the data of a sample of 177 patients with life-time diagnoses belonging to the schizophrenic, schizoaffective or affective spectrum according to the ICD-10 criteria. Psychopathological, socio-demographic and other illness-related variables were assessed at the index hospitalisation and at the 15-year follow-up evaluation. In the present study, psychopathology is focused on data assessed with the PANSS (Positive and Negative Syndrome Scale). Information about patients' psychosocial functioning was assessed by using a modified and extended version of the WHO disability assessment scale (WHO-DAS-M). The association between psychosocial functioning and psychopathology was analysed by correlation analyses with the total sample and diagnostic subsamples. The consistency of correlations across the diagnostic groups and domains of psychosocial functioning was calculated. Findings revealed for all diagnostic groups that higher levels of psychopathology were associated with higher levels of problems in psychosocial functioning in various domains. Though there seem to be some differences between psychopathological dimensions and their effects on different aspects

  2. The costs of services and employment outcomes achieved by adults with autism in the US.

    PubMed

    Cimera, Robert Evert; Cowan, Richard J

    2009-05-01

    This article examines the cost of services and employment outcomes obtained by adults with autism within the United States vocational rehabilitation (VR) system. It found that the number of such individuals has increased by more than 121 percent from 2002 to 2006. Moreover, though adults with autism were employed at higher rates than most disability groups investigated, they tended to work far fewer hours and earn less in wages per week. The study also found that adults with autism were among the most costly individuals to serve.

  3. Surgical complications and their impact on patients’ psychosocial well-being: a systematic review and meta-analysis

    PubMed Central

    Pinto, Anna; Faiz, Omar; Davis, Rachel; Almoudaris, Alex; Vincent, Charles

    2016-01-01

    Objective Surgical complications may affect patients psychologically due to challenges such as prolonged recovery or long-lasting disability. Psychological distress could further delay patients’ recovery as stress delays wound healing and compromises immunity. This review investigates whether surgical complications adversely affect patients’ postoperative well-being and the duration of this impact. Methods The primary data sources were ‘PsychINFO’, ‘EMBASE’ and ‘MEDLINE’ through OvidSP (year 2000 to May 2012). The reference lists of eligible articles were also reviewed. Studies were eligible if they measured the association of complications after major surgery from 4 surgical specialties (ie, cardiac, thoracic, gastrointestinal and vascular) with adult patients’ postoperative psychosocial outcomes using validated tools or psychological assessment. 13 605 articles were identified. 2 researchers independently extracted information from the included articles on study aims, participants’ characteristics, study design, surgical procedures, surgical complications, psychosocial outcomes and findings. The studies were synthesised narratively (ie, using text). Supplementary meta-analyses of the impact of surgical complications on psychosocial outcomes were also conducted. Results 50 studies were included in the narrative synthesis. Two-thirds of the studies found that patients who suffered surgical complications had significantly worse postoperative psychosocial outcomes even after controlling for preoperative psychosocial outcomes, clinical and demographic factors. Half of the studies with significant findings reported significant adverse effects of complications on patient psychosocial outcomes at 12 months (or more) postsurgery. 3 supplementary meta-analyses were completed, 1 on anxiety (including 2 studies) and 2 on physical and mental quality of life (including 3 studies). The latter indicated statistically significantly lower physical and

  4. A Review of Complications and Outcomes following Vertebral Column Resection in Adults.

    PubMed

    Iyer, Sravisht; Nemani, Venu M; Kim, Han Jo

    2016-06-01

    The correction of rigid spinal deformities in adult patients can require a three-column osteotomy (pedicle subtraction osteotomy [PSO] or vertebral column resection [VCR]) to obtain spinal balance. Unfortunately, the existing adult deformity literature frequently reports the outcomes and complications of these procedures together even though VCR is a more extensive procedure with potentially higher rates of complications. We sought to address this shortcoming and provide clinicians with an overview of the existing literature regarding VCR in adult patients. The goals of this review are: to determine the rate of overall and neurologic complications following VCR, the rate of complications with VCR compared to PSO, and the impact of VCR on clinical and radiographic outcomes. An electronic literature search was used to identify studies reporting outcomes or complications following VCR in adult patients. Raw data on patient demographics, case information, radiographic outcomes, complications and clinical outcomes were extracted. Data were pooled to report a rate of overall complications and neurologic complications. A pooled relative risk of complications following PSO vs. VCR was also calculated. Eleven retrospective studies (Level IV) met our inclusion criteria. The overall rate of complications was 69.2%. The reoperation rate was 9.6%. The rate of neurologic complications was 13.3% (range, 6.3% to 15.8%) with most cases being transient. The rate of permanent neurologic deficits was 2.0%. We found a significantly higher rate of all complications with VCR compared to PSO (relative risk, 1.36; 95% confidence interval, 1.24-1.49; p<0.001). All studies reporting clinical outcomes showed significant improvements in functional outcome postoperatively. PMID:27340543

  5. A Review of Complications and Outcomes following Vertebral Column Resection in Adults

    PubMed Central

    Iyer, Sravisht; Nemani, Venu M.

    2016-01-01

    The correction of rigid spinal deformities in adult patients can require a three-column osteotomy (pedicle subtraction osteotomy [PSO] or vertebral column resection [VCR]) to obtain spinal balance. Unfortunately, the existing adult deformity literature frequently reports the outcomes and complications of these procedures together even though VCR is a more extensive procedure with potentially higher rates of complications. We sought to address this shortcoming and provide clinicians with an overview of the existing literature regarding VCR in adult patients. The goals of this review are: to determine the rate of overall and neurologic complications following VCR, the rate of complications with VCR compared to PSO, and the impact of VCR on clinical and radiographic outcomes. An electronic literature search was used to identify studies reporting outcomes or complications following VCR in adult patients. Raw data on patient demographics, case information, radiographic outcomes, complications and clinical outcomes were extracted. Data were pooled to report a rate of overall complications and neurologic complications. A pooled relative risk of complications following PSO vs. VCR was also calculated. Eleven retrospective studies (Level IV) met our inclusion criteria. The overall rate of complications was 69.2%. The reoperation rate was 9.6%. The rate of neurologic complications was 13.3% (range, 6.3% to 15.8%) with most cases being transient. The rate of permanent neurologic deficits was 2.0%. We found a significantly higher rate of all complications with VCR compared to PSO (relative risk, 1.36; 95% confidence interval, 1.24–1.49; p<0.001). All studies reporting clinical outcomes showed significant improvements in functional outcome postoperatively. PMID:27340543

  6. Neurocognitive dysfunction and psychosocial outcome in patients with bipolar I disorder at 15-year follow-up

    PubMed Central

    Burdick, K. E.; Goldberg, J. F.; Harrow, M.

    2010-01-01

    Objective Despite increasing interest in cognitive dysfunction in bipolar disorder, little is known about its impact on functional outcome relative to affective symptoms. Method A total of 33 bipolar I subjects were evaluated at index hospitalization and prospectively followed up 15 years later. Affective symptoms, cognition, global functioning, work, and social adjustment were assessed at follow-up and analyzed by linear regression. Results Global functional impairment was significantly associated with poor performance on a cognitive measure of processing speed (WAIS Digit Symbol). Digit symbol performance also was the sole significant predictor of social functioning. Neither symptom severity nor course of illness features significantly contributed to global and social functioning. In contrast, verbal learning deficits, recent depression, and lifetime hospitalizations all were independently associated with work disability. Conclusion Processing speed is robustly associated with social and global functioning in bipolar disorder. Poor work functioning is significantly related to subsyndromal depression, course of illness, and verbal learning deficits. Cognitive and mood symptoms warrant consideration as independent determinants of functioning in patients with bipolar disorder many years after an index manic episode. PMID:20637012

  7. Weight maintenance from young adult weight predicts better health outcomes

    PubMed Central

    Votruba, Susanne B; Thearle, Marie S; Piaggi, Paolo; Knowler, William C; Hanson, Robert L; Krakoff, Jonathan

    2014-01-01

    Objective Defining groups of individuals within a larger population with similar patterns of weight change over time may provide insight into influences of weight stability or gain. Methods Latent class growth modeling was used to define subgroups of weight change in adult members of the Gila River Indian Community participating in at least 4 non-diabetic health exams including OGTTs (N=1157, 762F/395M; 78.4±19.0 kg). In a separate study, 152 individuals had 24-hr EE measured in a respiratory chamber. Results Eight groups with baseline weights of 54.6±7.3 (n=124), 64.2±7.7 (n=267), 73.6±7.8 (n=298), 86.1±10.2 (n=194), 95.5±6.7 (n=90), 97.9±10.4 (n=92), 110.9±11.9 (n=61), and 122.1±13.6 (n=31) kg (P<0.001) were delineated. Group 5, (initial weight=95.5±6.7 kg) maintained a comparatively stable weight over time (+3.3±10.3 kg, +3.8±11.2% of initial weight; median follow-up time: 13.1 years). All other groups gained weight over time (+29.9±21.1% of initial weight; median follow-up time: 16.3 years). Higher starting weight defined weight gain in most groups, but higher 2hr glucose predicted membership in the lower weight trajectories. The weight stable group had higher rates of impaired glucose regulation at baseline and higher 24-hr EE. Conclusions Weight in young adulthood defined weight gain trajectory underscoring the importance of intervening early to prevent weight gain. PMID:25131650

  8. Early-Onset Psychoses: Comparison of Clinical Features and Adult Outcome in 3 Diagnostic Groups

    ERIC Educational Resources Information Center

    Ledda, Maria Giuseppina; Fratta, Anna Lisa; Pintor, Manuela; Zuddas, Alessandro; Cianchetti, Carlo

    2009-01-01

    A comparison of clinical features and adult outcome in adolescents with three types of psychotic disorders: schizophrenic (SPh), schizoaffective (SA) and bipolar with psychotic features (BPP). Subjects (n = 41) were finally diagnosed (DSM-IV criteria) with SPh (n = 17), SA (n = 11) or BPP (n = 13). Clinical evaluation took place at onset and at a…

  9. Adult Arrests Records and Court Outcomes of Adolescents with Serious Emotional Disturbance.

    ERIC Educational Resources Information Center

    Davis, Maryann; Cooper, Deborah K.

    This study used archival data to examine adult charges and court outcomes for 82 individuals who had been treated in public mental health programs as adolescents. Subjects' clinical records from their adolescent day treatment (18 percent), residential (23 percent) or hospital program (58 percent) were reviewed for sociodemographics, clinical…

  10. Parent Expectations Mediate Outcomes for Young Adults with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Kirby, Anne V.

    2016-01-01

    Understanding the complex relationships among factors that may predict the outcomes of young adults with autism spectrum disorder (ASD) is of utmost importance given the increasing population undergoing and anticipating the transition to adulthood. With a sample of youth with ASD (n = 1170) from the National Longitudinal Transition Study-2,…

  11. Adolescents' Cognitive "Habitus", Learning Environments, Affective Outcomes of Schooling, and Young Adults' Educational Attainment

    ERIC Educational Resources Information Center

    Marjoribanks, Kevin

    2006-01-01

    A moderation-mediation model was constructed to examine relationships among adolescents' cognitive "habitus" (their cognitive dispositions), learning environments, affective outcomes of schooling, and young adults' educational attainment. Data were collected as part of a longitudinal survey of Australian youth (4,171 females, 3,718 males). The…

  12. Does Prison-Based Adult Basic Education Improve Postrelease Outcomes for Male Prisoners in Florida?

    ERIC Educational Resources Information Center

    Cho, Rosa Minhyo; Tyler, John H.

    2013-01-01

    The authors use administrative data from Florida to determine the extent to which prison-based adult basic education (ABE) improves inmate's postrelease labor market outcomes, such as earnings and employment. Using two nonexperimental comparison groups, the authors find evidence that ABE participation is associated with higher postrelease…

  13. Inclusion of Adults with Disability in Australia: Outcomes, Legislation and Issues

    ERIC Educational Resources Information Center

    Stancliffe, Roger J.

    2014-01-01

    This paper focuses on adults with disability and their inclusion in Australian society by examining various outcomes: community living, community participation and inclusive social roles such as open (competitive) employment, participation in university education, as well as use of generic community services like public transport. Australian…

  14. Minimal Brain Dysfunction in Childhood: 1. Outcome in Late Adolescence and Early Adult Years. Final Version.

    ERIC Educational Resources Information Center

    Milman, Doris H.

    Seventy-three patients, diagnosed in childhood as having either maturational lag or organic brain syndrome, were followed for an average of 12 years into late adolescence and early adult life for the purpose of discovering the outcome with respect to ultimate psychiatric status, educational attainment, social adjustment, and global adjustment. At…

  15. Late Adolescent and Young Adult Outcomes of Girls Diagnosed with ADHD in Childhood: An Exploratory Investigation

    ERIC Educational Resources Information Center

    Babinski, Dara E.; Pelham, William E., Jr.; Molina, Brooke S. G.; Gnagy, Elizabeth M.; Waschbusch, Daniel A.; Yu, Jihnhee; MacLean, Michael G.; Wymbs, Brian T.; Sibley, Margaret H.; Biswas, Aparajita; Robb, Jessica A.; Karch, Kathryn M.

    2011-01-01

    Objective: To characterize the late adolescent and young adult outcomes of girls diagnosed with ADHD in childhood. Method: The study included 58 women from a larger longitudinal study of ADHD. A total of 34 (M = 19.97 years old) met "DSM" criteria for ADHD in childhood, whereas the remaining 24 (M = 19.83 years old) did not. Self- and…

  16. Trends in Outcomes of the Vocational Rehabilitation Program for Adults with Developmental Disabilities: 1995-2005

    ERIC Educational Resources Information Center

    Migliore, Alberto; Butterworth, John

    2008-01-01

    This article describes national trends in outcomes of the vocational rehabilitation (VR) program, with a focus on adults with developmental disabilities during the period of 1995 to 2005. Findings show that the VR program has made substantial progress in excluding extended employment from the array of possible employment closures. Efforts are…

  17. Improving Adult Literacy Outcomes: Lessons from Cognitive Research for Developing Countries. Directions in Development.

    ERIC Educational Resources Information Center

    Abadzi, Helen

    Adult literacy program outcomes have been disappointing. A number of principals and methods from cognitive and neuropsychological research can be used to make literacy instruction more effective, including the following: improving cognitive function; fast reading; reading practice; literacy as a motivator; and improving use of class time.…

  18. Determinants of Adult Functional Outcome in Adolescents Receiving Special Educational Assistance

    ERIC Educational Resources Information Center

    McGeown, H. R.; Johnstone, E. C.; McKirdy, J.; Owens, D. C.; Stanfield, A. C.

    2013-01-01

    Background: This study investigates the role of IQ, autistic traits and challenging behaviours in affecting adult outcomes among adolescents who receive special educational assistance. Methods: A total of 58 participants were recruited from an ongoing longitudinal study. All received assessments of IQ, behavioural patterns (using the Childhood…

  19. The Smoking Consequences Questionnaire-Adult: Measurement of Smoking Outcome Expectancies of Experienced Smokers.

    ERIC Educational Resources Information Center

    Copeland, Amy L.; And Others

    1995-01-01

    Two versions of the Smoking Consequences Questionnaire for adults were developed and tested with 407 smokers and nonsmokers. The version with probability items appeared to have greater construct validity than the version with subjective expected utility items. The scale reflects the refinement of smokers' outcome expectancies with experience. (SLD)

  20. Running Away from Home: A Longitudinal Study of Adolescent Risk Factors and Young Adult Outcomes

    ERIC Educational Resources Information Center

    Tucker, Joan S.; Edelen, Maria Orlando; Ellickson, Phyllis L.; Klein, David J.

    2011-01-01

    Little is known about the adolescent risk factors and young adult health-related outcomes associated with running away from home. We examined these correlates of running away using longitudinal data from 4,329 youth (48% female, 85% white) who were followed from Grade 9 to age 21. Nearly 14% of the sample reported running away in the past year at…

  1. Program Completion and Recidivism Outcomes among Adult Offenders Ordered to Complete a Community Service Sentence

    ERIC Educational Resources Information Center

    Bouffard, Jeffrey A.; Muftic, Lisa R.

    2006-01-01

    Relatively little research has examined the outcomes (either program completion or recidivism) of community service (CS) sentences among adult offenders in the United States, despite the fact that this form of alternative sanction has been employed in the United States for nearly 40 years. What little research exists, primarily from Europe,…

  2. Adult Outcomes of Childhood Dysregulation: A 14-Year Follow-up Study

    ERIC Educational Resources Information Center

    Althoff, Robert R.; Verhulst, Frank C.; Rettew, David C.; Hudziak, James J.; van der Ende, Jan

    2010-01-01

    Objective: Using a general population sample, the adult outcomes of children who presented with severe problems with self-regulation defined as being concurrently rated highly on attention problems, aggressive behavior, and anxious-depression on the Child Behavior Checklist-Dysregulation Profile (CBCL-DP) were examined. Method: Two thousand…

  3. Knowledge of an Aboriginal Language and School Outcomes for Children and Adults

    ERIC Educational Resources Information Center

    Guevremont, Anne; Kohen, Dafna E.

    2012-01-01

    This study uses data from the child and adult components of the 2001 Canadian Aboriginal Peoples Survey to examine what factors are related to speaking an Aboriginal language and how speaking an Aboriginal language is related to school outcomes. Even after controlling for child and family factors (age, sex, health status, household income, number…

  4. The Differential Outcomes Effect (DOE) in Spatial Localization: An Investigation with Adults

    ERIC Educational Resources Information Center

    Legge, Eric L. G.; Spetch, Marciar L.

    2009-01-01

    We investigated whether search accuracy of adult humans could be enhanced using differential reward contingencies in landmark-based spatial tasks conducted on a computer screen. We found that search accuracy was significantly enhanced by differential outcomes in a conditional spatial search task, in which the landmark-to-goal relationship depended…

  5. C(1) metabolism and CVD outcomes in older adults.

    PubMed

    McNulty, Helene; Strain, J J; Pentieva, Kristina; Ward, Mary

    2012-05-01

    CVD is the most common cause of death in people over 65 years. This review considers the latest evidence for a potential protective effect of C(1) donors (folate and the metabolically related B-vitamins) in CVD. Such an effect may or may not be mediated via the role of these nutrients in maintaining plasma homocysteine concentrations within a desirable range. Despite predictions from epidemiological studies that lowering plasma homocysteine would reduce cardiovascular risk, several secondary prevention trials in at-risk patients published since 2004 have failed to demonstrate a benefit of homocysteine-lowering therapy with B-vitamins on CVD events generally. All these trials were performed in CVD patients with advanced disease; thus current evidence suggests that intervention with high-dose folic acid is of no benefit in preventing another event, at least in the case of heart disease. The evidence at this time, however, is stronger for stroke, with meta-analyses of randomised trials showing that folic acid reduces the risk of stroke, particularly in people with no history of stroke. Genetic studies provide convincing evidence to support a causal relationship between sub-optimal B-vitamin status and CVD. People homozygous for the common C677T variant in the gene encoding the folate-metabolising enzyme, methylenetetrahydrofolate reductase (MTHFR), typically have a 14-21% higher risk of CVD. Apart from folate, riboflavin is required as a co-factor for MTHFR. New evidence shows that riboflavin intervention results in marked lowering of blood pressure, specifically in patients with the MTHFR 677TT genotype. This novel gene-nutrient interaction may provide insights as to the mechanism that links C(1) metabolism with CVD outcomes. PMID:22152927

  6. VERTEBRAL OSTEOMYELITIS IN ADULT PATIENTS--CHARACTERISTICS AND OUTCOME.

    PubMed

    Mustapić, Matej; Višković, Klaudija; Borić, Igor; Marjan, Domagoj; Zadravec, Dijana; Begovac, Josip

    2016-03-01

    The aim of the study was to assess disease characteristics and outcome in patients with vertebral osteomyelitis (VO). A two medical centre retrospective cohort study was performed by chart review after discharge of 110 patients with confirmed VO treated during a 5-year period. Patients were divided in two groups: patients with uncomplicated VO and patients with complicated VO. All patients underwent clinical and biological examinations and magnetic resonance imaging (MRI) according to the same protocol. Patients with complicated VO were significantly older (p = 0.038). They were longer treated with antibiotics parenterally (p = 0.047) and more often surgically (p < 0.001). In these patients, high Charlson comorbidity index (CCI) score was more often observed (p = 0.024), as well as liver cirrhosis (p = 0.013) and degenerative spine disease (p = 0.007) as comorbidities. Patients with advanced MRI changes of VO had a modified CCI score of 2 or more (p = 0.006). They more often experienced neurological deficit (p = 0.021). Staphylococcus aureus was the most frequently isolated bacterium from blood and tissue samples. Advanced MRI changes and complicated VO were more often observed in patients with high CCI score due to impaired immune system caused by chronic comorbid disease(s) or modulation of immunity with medications. High CCI scores were more frequently associated with positive blood cultures due to bacteremia because of impaired immunity. Patients with complicated VO were longer treated with antibiotics parenterally and more often surgically treated for phlegmon and abscess formation. Liver cirrhosis and degenerative spine disease, which were more often found in patients with complicated VO, obviously impacted the course of the disease. PMID:27333712

  7. Factors that mediate between child sexual abuse and adult psychological outcome.

    PubMed

    Romans, S E; Martin, J L; Anderson, J C; O'Shea, M L; Mullen, P E

    1995-01-01

    The psychological outcome for a random community sample of women who had experienced significant childhood sexual abuse was assessed, using two outcome measures: (i) psychiatric morbidity (measured with the short PSE); (ii) self-esteem. Sexual abused women with a good outcome, i.e. who were not a PSE 'case' or who had high self-esteem were compared with abused women with a poor outcome. This paper describes the post-abuse factors that modified the two outcomes. In general, a range of variables, all correlated with each other in a complex manner, distinguished good outcome subjects from poor outcome subjects. Post-abuse adolescent variables included family factors (poor mother-father and parent-child relationships), high school factors (poor academic, sporting and social performance) and early pregnancy. Women who had a good adolescent relationship with their father did better than expected statistically. Sport emerged as an alternative at secondary school to academic achievement in catalysing a good psychological outcome. Adult factors included the quality of relationship with partner, which was associated with a good outcome on both measures. Current paid employment was linked to high self-esteem but not to lowered psychiatric morbidity, while the converse applied for high socio-economic status. These findings imply that different processes operate for each outcome measure. A clear recognition by the school of childhood sexual abuse may help to provide the opportunity for the girl to experience success in some arena; this in turn may protect her against the likely adult consequences of low self-esteem and increased psychiatric morbidity.

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

    PubMed Central

    Salminger, Stefan; Sturma, Agnes; Roche, Aidan D.; Hruby, Laura A.; Paternostro-Sluga, Tatjana; Kumnig, Martin; Ninkovic, Marina; Pierer, Gerhard; Schneeberger, Stefan; Gabl, Markus; Chelmonski, Adam; Jablecki, Jerzy; Aszmann, Oskar C.

    2016-01-01

    Background Hand-transplantation and improvements in the field of prostheses opened new frontiers in restoring hand function in below-elbow amputees. Both concepts aim at restoring reliable hand function, however, the indications, advantages and limitations for each treatment must be carefully considered depending on level and extent of amputation. Here we report our findings of a multi-center cohort study comparing hand function and quality-of-life of people with transplanted versus prosthetic hands. Methods Hand function in amputees with either transplant or prostheses was tested with Action Research Arm Test (ARAT), Southampton Hand Assessment Procedure (SHAP) and the Disabilities of the Arm, Shoulder and Hand measure (DASH). Quality-of-life was compared with the Short-Form 36 (SF-36). Results Transplanted patients (n = 5) achieved a mean ARAT score of 40.86 ± 8.07 and an average SHAP score of 75.00 ± 11.06. Prosthetic patients (n = 7) achieved a mean ARAT score of 39.00 ± 3.61 and an average SHAP score of 75.43 ± 10.81. There was no significant difference between transplanted and prosthetic hands in ARAT, SHAP or DASH. While quality-of-life metrics were equivocal for four scales of the SF-36, transplanted patients reported significantly higher scores in “role-physical” (p = 0.006), “vitality” (p = 0.008), “role-emotional” (p = 0.035) and “mental-health” (p = 0.003). Conclusions The indications for hand transplantation or prosthetic fitting in below-elbow amputees require careful consideration. As functional outcomes were not significantly different between groups, patient’s best interests and the route of least harm should guide treatment. Due to the immunosuppressive side-effects, the indication for allotransplantation must still be restrictive, the best being bilateral amputees. PMID:27589057

  9. Physical Activity Interventions with Healthy Minority Adults: Meta-Analysis of Behavior and Health Outcomes

    PubMed Central

    Conn, Vicki S.; Phillips, Lorraine J.; Ruppar, Todd M.; Chase, Jo-Ana D.

    2014-01-01

    This meta-analysis is a systematic compilation of research focusing on various exercise interventions and their impact on the health and behavior outcomes of healthy African American, Hispanic, Native American, and Native Hawaiian adults. Comprehensive searching located published and unpublished studies. Random-effects analyses synthesized data to calculate effect sizes (ES) as a standardized mean difference (d) and variability measures. Data were synthesized across 21,151 subjects in 100 eligible samples. Supervised exercise significantly improved fitness (ES=.571–.584). Interventions designed to motivate minority adults to increase physical activity changed subsequent physical activity behavior (ES=.172–.312) and anthropometric outcomes (ES=.070–.124). Some ES should be interpreted in the context of limited statistical power and heterogeneity. Attempts to match intervention content and delivery with minority populations were inconsistently reported. Healthy minority adults experienced health improvements following supervised exercise. Interventions designed to motivate subjects to increase physical activity have limited magnitude heterogeneous effects. PMID:22643462

  10. Genetic and environmental influences on adult life outcomes: evidence from the Texas Adoption Project.

    PubMed

    Loehlin, John C; Horn, Joseph M; Ernst, Jody L

    2007-05-01

    A short mail questionnaire was sent to individuals, now adults, who had been studied over 30 years ago as children in the Texas Adoption Project. Their parents and (in many cases) siblings also described them using the same questionnaire, and the parents described themselves as well. The questionnaire was designed to obtain information about educational, occupational, and marital outcomes, as well as adult problems and personality. Results were obtained for 324 adopted and 142 biological children from the original 300 families, and for 266 parents. Although both the adopted and biological offsprings' outcomes were generally positive, those for the adopted offspring were somewhat less so. Biologically related family members tended to be more similar in their life outcomes than biologically unrelated family members, suggesting that genes were playing an important role.

  11. A best practice fall prevention exercise program to improve balance, strength / power, and psychosocial health in older adults: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background With increasing age neuromuscular deficits (e.g., sarcopenia) may result in impaired physical performance and an increased risk for falls. Prominent intrinsic fall-risk factors are age-related decreases in balance and strength / power performance as well as cognitive decline. Additional studies are needed to develop specifically tailored exercise programs for older adults that can easily be implemented into clinical practice. Thus, the objective of the present trial is to assess the effects of a fall prevention program that was developed by an interdisciplinary expert panel on measures of balance, strength / power, body composition, cognition, psychosocial well-being, and falls self-efficacy in healthy older adults. Additionally, the time-related effects of detraining are tested. Methods/Design Healthy old people (n = 54) between the age of 65 to 80 years will participate in this trial. The testing protocol comprises tests for the assessment of static / dynamic steady-state balance (i.e., Sharpened Romberg Test, instrumented gait analysis), proactive balance (i.e., Functional Reach Test; Timed Up and Go Test), reactive balance (i.e., perturbation test during bipedal stance; Push and Release Test), strength (i.e., hand grip strength test; Chair Stand Test), and power (i.e., Stair Climb Power Test; countermovement jump). Further, body composition will be analysed using a bioelectrical impedance analysis system. In addition, questionnaires for the assessment of psychosocial (i.e., World Health Organisation Quality of Life Assessment-Bref), cognitive (i.e., Mini Mental State Examination), and fall risk determinants (i.e., Fall Efficacy Scale – International) will be included in the study protocol. Participants will be randomized into two intervention groups or the control / waiting group. After baseline measures, participants in the intervention groups will conduct a 12-week balance and strength / power exercise intervention 3 times per week, with

  12. Psychosocial and Family Functioning in Spina Bifida

    ERIC Educational Resources Information Center

    Holmbeck, Grayson N.; Devine, Katie A.

    2010-01-01

    A developmentally oriented bio-neuropsychosocial model is introduced to explain the variation in family functioning and psychosocial adjustment in youth and young adults with spina bifida (SB). Research on the family functioning and psychosocial adjustment of individuals with SB is reviewed. The findings of past research on families of youth with…

  13. Evaluating psychosocial function in elderly dental patients.

    PubMed

    Gironda, Melanie W

    2007-03-01

    Comprehensive dental care for older adults includes an understanding of, and sensitivity to, the psychosocial changes with age that can influence oral health care, including emotional functioning, anxiety, depression, cognitive functioning, alcohol and substance use, social support, and elder abuse and neglect. A case vignette highlights the contribution of an interdisciplinary psychosocial assessment to the oral health care of elderly patients.

  14. Psychosocial judgements and perceptions of adolescents with acne vulgaris: A blinded, controlled comparison of adult and peer evaluations

    PubMed Central

    2011-01-01

    Background The purpose of the current survey was to evaluate how teenagers and adults view teens with acne as compared to those with smooth, clear skin. We also surveyed teens and adults about their experiences with acne. Methods We hypothesized that teens with acne would be perceived in a more negative fashion as compared to teens with smooth, clear skin. We presented digitally altered photographs to our responders and asked how they perceived the two groups. No mention was made of acne. In the first survey (n = 1,002), both adults and teens provided their impressions on photo images of teenagers with either clear skin or acne. In the second survey (n = 1,006), the adults and teens also answered questions about their own experiences with acne. Results Survey 1. With respect to impressions of photo images, the first thing teens and adults noticed about a person with acne was their skin (65% and 75%, respectively). Teenagers with acne were perceived most often by other teens and adults (teen responder %, adult responder %) as being shy (39%, 43%), nerdy (31%, 21%), stressed (24%, 20%), lonely (23%, 22%), boring (15%, 6%), unkempt (13%, 7%), unhealthy (12%, 8%), introverted (9%, 23%), and rebellious (7%, 5%). Survey 2. Most teenagers with acne (64%) felt embarrassed by it and thought that getting acne was the most difficult aspect of puberty (55%). Teenagers with acne reported lower self-confidence or shyness (71%); difficulty finding dates (43%), problems making friends (24%), challenges with school (21%), and trouble getting a job (7%). Conclusions Teens with smooth, clear skin were rated higher on every favorable characteristic and lower on every unfavorable characteristic by both teens and adults. In most cases, the first thing that respondents noticed was the skin of teens with acne. Teenagers and adults alike perceived other teens with acne as generally being shy, less socially active, more likely to be bullied, and less successful in terms of finding a job

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

    PubMed Central

    Santa Mina, Daniel; Guglietti, Crissa L.; de Jesus, Danilo R.; Azargive, Saam; Matthew, Andrew G.; Alibhai, Shabbir M. H.; Trachtenberg, John; Daskalakis, Jeffrey Z.; Ritvo, Paul

    2014-01-01

    Purpose: Regular exercise improves psychological well-being in men treated for prostate cancer (PCa). For this population and among cancer survivors in general, the effect of a single bout of exercise on self-report or objective measures of psychological well-being has not been examined. We examined the acute effect of a single bout of exercise on the cortical silent period (CSP) and on self-reported mood in men that have received treatment for PCa. Methods: Thirty-six PCa survivors were randomly assigned to 60 min of low to moderate intensity exercise or to a control condition. Outcomes were assessed immediately before and after either the exercise or the control condition. Results: No significant between-group differences were observed in CSP or mood were observed following the exercise session or control conditions. Participants with higher scores of trait anxiety had significantly shorter CSP at baseline, as well as those receiving androgen deprivation therapy. Age and baseline CSP had a low-moderate, but significant negative correlation. Changes in CSP following the exercise condition were strongly negatively correlated with changes in self-reported vigor. Conclusion: While we did not observe any acute effect of exercise on the CSP in this population, the associations between CSP and trait anxiety, age, and vigor are novel findings requiring further examination. Implications for Cancer Survivors: Exercise did not acutely affect our participants in measures of psychological well-being. Additional mechanisms to explain the chronic psychosocial benefits of exercise previously observed in men with PCa require further exploration. Clinicaltrials.gov Identifier: NCT01715064 (http://clinicaltrials.gov/show/NCT01715064). PMID:25505413

  16. The outcome of lumbar disc herniation surgery is worse in old adults than in young adults.

    PubMed

    Strömqvist, Fredrik; Strömqvist, Björn; Jönsson, Bo; Karlsson, Magnus K

    2016-10-01

    Background and purpose - The outcome of surgical treatment of lumbar disc herniation (LDH) has been thoroughly evaluated in middle-aged patients, but less so in elderly patients. Patients and methods - With validated patient-reported outcome measures (PROMs) and using SweSpine (the national Swedish Spine Surgery Register), we analyzed the preoperative clinical status of LDH patients and the 1-year postoperative outcome of LDH surgery performed over the period 2000-2012. We included 1,250 elderly patients (≥ 65 years of age) and 12,840 young and middle-aged patients (aged 20-64). Results - Generally speaking, elderly patients were referred for LDH surgery with worse PROM scores than young and middle-aged patients, they improved less by surgery, they experienced more complications, they had inferior 1-year postoperative PROM scores, and they were less satisfied with the outcome (with all differences being statistically significant). Interpretation - Elderly patients appear to have a worse postoperative outcome after LDH surgery than young and middle-aged patients, they are referred to surgery with inferior clinical status, and they improve less after the surgery. PMID:27391663

  17. The outcome of lumbar disc herniation surgery is worse in old adults than in young adults

    PubMed Central

    Strömqvist, Fredrik; Strömqvist, Björn; Jönsson, Bo; Karlsson, Magnus K

    2016-01-01

    Background and purpose The outcome of surgical treatment of lumbar disc herniation (LDH) has been thoroughly evaluated in middle-aged patients, but less so in elderly patients. Patients and methods With validated patient-reported outcome measures (PROMs) and using SweSpine (the national Swedish Spine Surgery Register), we analyzed the preoperative clinical status of LDH patients and the 1-year postoperative outcome of LDH surgery performed over the period 2000–2012. We included 1,250 elderly patients (≥ 65 years of age) and 12,840 young and middle-aged patients (aged 20–64). Results Generally speaking, elderly patients were referred for LDH surgery with worse PROM scores than young and middle-aged patients, they improved less by surgery, they experienced more complications, they had inferior 1-year postoperative PROM scores, and they were less satisfied with the outcome (with all differences being statistically significant). Interpretation Elderly patients appear to have a worse postoperative outcome after LDH surgery than young and middle-aged patients, they are referred to surgery with inferior clinical status, and they improve less after the surgery. PMID:27391663

  18. Psychosocial Interventions for Cancer Survivors, Caregivers and Family Members—One Size Does Not Fit All: My Perspective as a Young Adult Survivor, Advocate and Oncology Social Worker” a personal reflection by Mary Grace Bontempo - Office of Cancer Survivorship

    Cancer.gov

    Psychosocial Interventions for Cancer Survivors, Caregivers and Family Members—One Size Does Not Fit All: My Perspective as a Young Adult Survivor, Advocate and Oncology Social Worker” a personal reflection by Mary Grace Bontempo page

  19. Sexual history disclosure polygraph outcomes: do juvenile and adult sex offenders differ?

    PubMed

    Jensen, Todd M; Shafer, Kevin; Roby, C Y; Roby, Jini L

    2015-03-01

    Despite the empirical and theoretical chasm between the opponents and proponents of polygraphy, its use is prominent among sex offender agencies in the United States. However, current research on polygraph examination outcomes among juvenile sex offenders, along with potential differences from their adult counterparts, is scarce and outdated. In the present study, we assess the difference between juvenile and adult sex offenders in terms of the propensity for passing a sexual history disclosure polygraph examination. A sample of 324 sex offenders (86 juveniles and 238 adults) who engaged in a sexual history disclosure polygraph examination as part of their treatment in an Intermountain West sex offender treatment agency was used for the analysis. Results from preliminary and logistic regression analyses indicate that juvenile and adult offenders do not significantly differ in the likelihood of passing a sexual history disclosure polygraph examination. Implications and limitations are discussed. PMID:25049032

  20. Sexual history disclosure polygraph outcomes: do juvenile and adult sex offenders differ?

    PubMed

    Jensen, Todd M; Shafer, Kevin; Roby, C Y; Roby, Jini L

    2015-03-01

    Despite the empirical and theoretical chasm between the opponents and proponents of polygraphy, its use is prominent among sex offender agencies in the United States. However, current research on polygraph examination outcomes among juvenile sex offenders, along with potential differences from their adult counterparts, is scarce and outdated. In the present study, we assess the difference between juvenile and adult sex offenders in terms of the propensity for passing a sexual history disclosure polygraph examination. A sample of 324 sex offenders (86 juveniles and 238 adults) who engaged in a sexual history disclosure polygraph examination as part of their treatment in an Intermountain West sex offender treatment agency was used for the analysis. Results from preliminary and logistic regression analyses indicate that juvenile and adult offenders do not significantly differ in the likelihood of passing a sexual history disclosure polygraph examination. Implications and limitations are discussed.

  1. Building Psychosocial Programming in Geriatrics Fellowships: A Consortium Model

    ERIC Educational Resources Information Center

    Adelman, Ronald D.; Ansell, Pamela; Breckman, Risa; Snow, Caitlin E.; Ehrlich, Amy R.; Greene, Michele G.; Greenberg, Debra F.; Raik, Barrie L.; Raymond, Joshua J.; Clabby, John F.; Fields, Suzanne D.; Breznay, Jennifer B.

    2011-01-01

    Geriatric psychosocial problems are prevalent and significantly affect the physical health and overall well-being of older adults. Geriatrics fellows require psychosocial education, and yet to date, geriatrics fellowship programs have not developed a comprehensive geriatric psychosocial curriculum. Fellowship programs in the New York tristate area…

  2. Mechanisms in Psychosocial Interventions for Adults Living with Cancer: Opportunity for Integration of Theory, Research, and Practice

    ERIC Educational Resources Information Center

    Stanton, Annette L.; Luecken, Linda J.; MacKinnon, David P.; Thompson, Elizabeth H.

    2013-01-01

    Objective: The diagnosis and treatment of cancer are highly stressful experiences that can profoundly affect emotional and physical well-being. Hundreds of longitudinal investigations that identify risk and protective factors for psychological and physical adjustment in adults living with cancer and numerous randomized controlled psychosocial…

  3. Young adult educational and vocational outcomes of children diagnosed with ADHD.

    PubMed

    Kuriyan, Aparajita B; Pelham, William E; Molina, Brooke S G; Waschbusch, Daniel A; Gnagy, Elizabeth M; Sibley, Margaret H; Babinski, Dara E; Walther, Christine; Cheong, Jeewon; Yu, Jihnhee; Kent, Kristine M

    2013-01-01

    Decreased success at work and educational attainment by adulthood are of concern for children with ADHD given their widely documented academic difficulties; however there are few studies that have examined this empirically and even fewer that have studied predictors and individual variability of these outcomes. The current study compares young adults with and without a childhood diagnosis of ADHD on educational and occupational outcomes and the predictors of these outcomes. Participants were from the Pittsburgh ADHD Longitudinal Study (PALS), a prospective study with yearly data collection. Significant group differences were found for nearly all variables such that educational and occupational attainment was lower for adults with compared to adults without histories of childhood ADHD. Despite the mean difference, educational functioning was wide-ranging. High school academic achievement significantly predicted enrollment in post-high school education and academic and disciplinary problems mediated the relationship between childhood ADHD and post-high school education. Interestingly, ADHD diagnosis and disciplinary problems negatively predicted occupational status while enrollment in post-high school education was a positive predictor. Job loss was positively predicted by a higher rate of academic problems and diagnosis of ADHD. This study supports the need for interventions that target the child and adolescent predictors of later educational and occupational outcomes in addition to continuing treatment of ADHD in young adulthood targeting developmentally appropriate milestones, such as completing post-high school education and gaining and maintaining stable employment.

  4. Differential outcomes training improves face recognition memory in children and in adults with Down syndrome.

    PubMed

    Esteban, Laura; Plaza, Victoria; López-Crespo, Ginesa; Vivas, Ana B; Estévez, Angeles F

    2014-06-01

    Previous studies have demonstrated that the differential outcomes procedure (DOP), which involves paring a unique reward with a specific stimulus, enhances discriminative learning and memory performance in several populations. The present study aimed to further investigate whether this procedure would improve face recognition memory in 5- and 7-year-old children (Experiment 1) and adults with Down syndrome (Experiment 2). In a delayed matching-to-sample task, participants had to select the previously shown face (sample stimulus) among six alternatives faces (comparison stimuli) in four different delays (1, 5, 10, or 15s). Participants were tested in two conditions: differential, where each sample stimulus was paired with a specific outcome; and non-differential outcomes, where reinforcers were administered randomly. The results showed a significantly better face recognition in the differential outcomes condition relative to the non-differential in both experiments. Implications for memory training programs and future research are discussed.

  5. Tuberculosis case burden and treatment outcomes in children, adults and older adults, Vanuatu, 2007-2011.

    PubMed

    Tagaro, M; Harries, A D; Kool, B; Ram, S; Viney, K; Marais, B; Tarivonda, L

    2014-06-21

    Contexte : Les cinq centres DOTS du Vanuatu.Objectifs : Déterminer le fardeau de la tuberculose (TB) à travers les classes d'âge, le profil de la maladie et les résultats du traitement des patients enregistré entre 2007 et 2011.Schema : Etude de cohorte rétrospective impliquant des registres de TB et des cartes de traitement.Resultats : Sur 588 patients enregistrés, 142 (24%) étaient des enfants (âgés de 0–14 ans), 327 étaient des adultes (âgés de 15–54 ans) et 119 des adultes plus âgés (âgés de ⩾55 ans, subdivisés en 55–64 et ⩾65 ans). Parmi eux, 568 étaient des nouveaux patients, et 13 avaient déjà été traités ; pour 7 d'entre eux, le statut était inconnu. Comparés aux adultes, les enfants avec une TB nouvelle avaient une plus grande prévalence de TB extra pulmonaire (75% contre 34% ; OR 5,7 ; IC95% 3,6–9,0) et une prévalence plus faible de TB pulmonaire frottis positif (11% contre 45% ; OR 0,15 ; IC95% 0,3–0,3). Les adultes âgés de ⩾55 ans avaient une prévalence plus élevée de TB pulmonaire à frottis négatif (38% contre 21% ; OR 2,4 ; IC95% 1,5–3,8). Le succès du traitement de la TB a été de 83% pour l'ensemble du groupe, mais seulement de 67% pour les patients âgés de ⩾65 ans avec un taux de létalité de 18%.Conclusion : Les enfants et les adultes plus âgés constituent 45% du fardeau de la TB au Vanuatu. Les différences constatées en termes de profil de la maladie et de résultats thérapeutiques moins bons chez les adultes âgés ont des implications en matière de politique et de pratiques.

  6. Impact of Mentors During Adolescence on Outcomes Among Gay Young Adults.

    PubMed

    Drevon, Daniel D; Almazan, Elbert P; Jacob, Susan; Rhymer, Katrina N

    2016-06-01

    Using the National Longitudinal Study of Adolescent Health and the Adolescent Health and Academic Achievement study datasets, this study examined whether natural mentoring relationships during adolescence were associated with young adult outcomes among lesbian, gay, and bisexual (LGB) persons. Outcomes in three domains were investigated: education and employment, psychological wellbeing, and substance use and abuse. Results indicated that LGB persons reporting natural mentors during adolescence were about three times as likely to graduate from high school as those without. Discussion surrounds strategies to foster mentoring relationships within the school environment or community. PMID:26566579

  7. Determinants of Cat Choice and Outcomes for Adult Cats and Kittens Adopted from an Australian Animal Shelter.

    PubMed

    Zito, Sarah; Paterson, Mandy; Vankan, Dianne; Morton, John; Bennett, Pauleen; Phillips, Clive

    2015-04-29

    The percentage of adult cats euthanized in animal shelters is greater than that of kittens because adult cats are less likely to be adopted. This study aimed to provide evidence to inform the design of strategies to encourage adult cat adoptions. One such strategy is to discount adoption prices, but there are concerns that this may result in poor adoption outcomes. We surveyed 382 cat adopters at the time of adoption, to assess potential determinants of adopters' cat age group choice (adult or kitten) and, for adult cat adopters, the price they are willing to pay. The same respondents were surveyed again 6-12 months after the adoption to compare outcomes between cat age groups and between adult cats in two price categories. Most adopters had benevolent motivations for adopting from the shelter and had put considerable thought into the adoption and requirements for responsible ownership. However, adult cat adopters were more likely to have been influenced by price than kitten adopters. Adoption outcomes were generally positive for both adult cats and kittens and for adult cats adopted at low prices. The latter finding alleviates concerns about the outcomes of "low-cost" adoptions in populations, such as the study population, and lends support for the use of "low-cost" adoptions as an option for attempting to increase adoption rates. In addition, the results provide information that can be used to inform future campaigns aimed at increasing the number of adult cat adoptions, particularly in devising marketing strategies for adult cats.

  8. Determinants of Cat Choice and Outcomes for Adult Cats and Kittens Adopted from an Australian Animal Shelter.

    PubMed

    Zito, Sarah; Paterson, Mandy; Vankan, Dianne; Morton, John; Bennett, Pauleen; Phillips, Clive

    2015-01-01

    The percentage of adult cats euthanized in animal shelters is greater than that of kittens because adult cats are less likely to be adopted. This study aimed to provide evidence to inform the design of strategies to encourage adult cat adoptions. One such strategy is to discount adoption prices, but there are concerns that this may result in poor adoption outcomes. We surveyed 382 cat adopters at the time of adoption, to assess potential determinants of adopters' cat age group choice (adult or kitten) and, for adult cat adopters, the price they are willing to pay. The same respondents were surveyed again 6-12 months after the adoption to compare outcomes between cat age groups and between adult cats in two price categories. Most adopters had benevolent motivations for adopting from the shelter and had put considerable thought into the adoption and requirements for responsible ownership. However, adult cat adopters were more likely to have been influenced by price than kitten adopters. Adoption outcomes were generally positive for both adult cats and kittens and for adult cats adopted at low prices. The latter finding alleviates concerns about the outcomes of "low-cost" adoptions in populations, such as the study population, and lends support for the use of "low-cost" adoptions as an option for attempting to increase adoption rates. In addition, the results provide information that can be used to inform future campaigns aimed at increasing the number of adult cat adoptions, particularly in devising marketing strategies for adult cats. PMID:26479236

  9. Situational determinants of use and treatment outcomes in marijuana dependent adults.

    PubMed

    Blevins, Claire E; Stephens, Robert S; Walker, Denise D; Roffman, Roger A

    2014-03-01

    Research and theory strongly support the importance of situational determinants of substance use as targets for intervention, but few studies have systematically examined situational use characteristics in marijuana dependent adults. The present study describes situational use of marijuana in a population of 87 marijuana dependent adults and reports relationships with outcomes of treatment. Use in negative affective situations was independently associated with psychological distress, maladaptive coping strategies, lower self-efficacy, and poorer outcomes post-treatment. The findings were consistent with research on using drugs to cope with negative affect providing evidence of convergence between two different methods of assessing high risk situations for substance use. The results support continued emphasis on coping with negative affect as a target in treatments for marijuana dependence.

  10. Clinical features and outcomes of focal segmental glomerulosclerosis pathologic variants in Korean adult patients

    PubMed Central

    2014-01-01

    Background Many studies have shown that clinical characteristics and outcomes differ depending on pathologic variants of focal segmental glomerulosclerosis (FSGS). However, these are not well defined in Asian populations. Methods This retrospective study evaluated clinical features and outcomes of pathologic FSGS variants in 111 adult patients between January 2004 and December 2012. Primary outcome was the composite of doubling of baseline serum creatinine concentrations (D-SCr) or onset of end-stage renal disease (ESRD). Secondary outcome included complete (CR) or partial remission (PR). Results There were 70 (63.1%), 20 (18.0%), 17 (15.3%), 3 (2.7%), and 1 (0.9%) patients with not-otherwise specified (NOS), tip, perihilar, cellular, and collapsing variants, respectively. At presentation, nephrotic-range proteinuria occurred more commonly in tip lesion than in other variants. The overall 5-year renal survival rate was 76.8%. During a median follow-up of 34.5 months, only 1 (5.0%) patient with a tip lesion reached the composite end point compared to 2 (11.8%) and 12 (17.1%) patients in perihilar and NOS variants, but this difference was not statistically significant in an adjusted Cox model. However, tip lesion was associated with a significantly increased probability of achieving CR (P = 0.044). Conclusion Similar to other populations, Korean adult patients with FSGS have distinct clinical features with the exception of a rare frequency of cellular and collapsing variants. Although pathologic variants were not associated with overall outcome, the tip variant exhibited favorable outcome in terms of achieving remission. Further studies are required to delineate long-term outcome and response to treatment of the pathologic variants. PMID:24666814

  11. Characteristics and Outcomes of Young Adult Opiate Users Receiving Residential Substance Abuse Treatment.

    PubMed

    Morse, Siobhan; MacMaster, Samuel

    2015-01-01

    Opiate use patterns, user characteristics, and treatment response among young adults are of interest due to current high use prevalence and historical low levels of treatment engagement relative to older populations. Prior research in this population suggests that overall, young adults present at treatment with different issues. In this study the authors investigated potential differences between young adult (18-25 years of age) and older adult (26 and older) opiate users and the impact of differences relative to treatment motivation, length and outcomes. Data for this study was drawn from 760 individuals who entered voluntary, private, residential treatment. Study measures included the Addiction Severity Index (ASI), the Treatment Service Review (TSR), and University of Rhode Island Change Assessment (URICA). Interviews were conducted at program intake and 6-month post-discharge. Results indicate that older adults with a history of opiate use present at treatment with higher levels of severity for alcohol, medical, and psychological problems and young adults present at treatment with greater drug use and more legal issues. Significant improvement for both groups was noted at 6 months post treatment; there were also fewer differences between the two age groups of opiate users. Results suggest different strategies within treatment programs may provide benefit in targeting the disparate needs of younger opiate users. Overall, however, results suggest that individualized treatment within a standard, abstinence-based, residential treatment model can be effective across opiate users at different ages and with different issues, levels of severity, and impairment at intake.

  12. Characteristics and Outcomes of Young Adult Opiate Users Receiving Residential Substance Abuse Treatment.

    PubMed

    Morse, Siobhan; MacMaster, Samuel

    2015-01-01

    Opiate use patterns, user characteristics, and treatment response among young adults are of interest due to current high use prevalence and historical low levels of treatment engagement relative to older populations. Prior research in this population suggests that overall, young adults present at treatment with different issues. In this study the authors investigated potential differences between young adult (18-25 years of age) and older adult (26 and older) opiate users and the impact of differences relative to treatment motivation, length and outcomes. Data for this study was drawn from 760 individuals who entered voluntary, private, residential treatment. Study measures included the Addiction Severity Index (ASI), the Treatment Service Review (TSR), and University of Rhode Island Change Assessment (URICA). Interviews were conducted at program intake and 6-month post-discharge. Results indicate that older adults with a history of opiate use present at treatment with higher levels of severity for alcohol, medical, and psychological problems and young adults present at treatment with greater drug use and more legal issues. Significant improvement for both groups was noted at 6 months post treatment; there were also fewer differences between the two age groups of opiate users. Results suggest different strategies within treatment programs may provide benefit in targeting the disparate needs of younger opiate users. Overall, however, results suggest that individualized treatment within a standard, abstinence-based, residential treatment model can be effective across opiate users at different ages and with different issues, levels of severity, and impairment at intake. PMID:25879396

  13. Excision of Painful Bipartite Patella: Good Long-term Outcome in Young Adults

    PubMed Central

    Parviainen, Mickael; Pihlajamäki, Harri K.

    2008-01-01

    Excision of the accessory bipartite fragment is widely used, but its long-term outcome is not known. We evaluated the outcome after surgical excision of a symptomatic accessory bipartite or multipartite patella fragment in young adult men performing their compulsory military service and determined the incidence of painful bipartite patellae in this group of skeletally mature adults. We followed 25 of 32 patients for a minimum of 10 years (mean, 15 years; range, 10–22 years). The incidence of painful, surgically treated bipartite patella was 9.2 per 100,000 recruits. Patients’ median age at surgery was 20 years. There were 19 superolateral and six lateral bipartite fragments. Other radiographic findings were rare. At followup, the Kujala score mean was 95 points (range, 75–100 points), and osteoarthrotic changes (Kellgren-Lawrence Grade 1) were seen in two knees. No reoperations related to bipartite patella occurred during the followup. Symptomatic bipartite patella is rare and does not seem primarily associated with anatomic deviations, but when incapacitating pain persists despite nonoperative treatment, surgical excision seems to yield reasonable functional outcome and quick recovery with no apparent adverse sequelae. Our data suggest there is no reason to avoid this technically undemanding procedure for treating persistent symptoms of bipartite patella in young adults. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18607662

  14. [Psychosocial aspects of preeclampsia].

    PubMed

    Szita, Bernadett; Baji, Ildikó; Rigó, János

    2015-12-13

    Distress conditions during pregnancy may contribute to the development of preeclampsia by altering functions of the neuroendocrine and immune systems, e.g. activation of the hypothalamic-pituitary-adrenal axis and increase in plasma proinflammatory cytokines. Preeclampsia may also precipitate mental health problems due to long-term hospitalization or unpredictable and uncontrollable events such as preterm labor and newborn complications. Besides, preeclampsia may induce persistent neurocognitive complaints with a negative impact on patients' quality of life. As growing evidence indicates that poor maternal mental health has an adverse effect on pregnancy outcome and fetal development, psychosocial interventions may be beneficial for women with preeclampsia.

  15. Fundamental resource dis/advantages, youth health and adult educational outcomes.

    PubMed

    Elman, Cheryl; Wray, Linda A; Xi, Juan

    2014-01-01

    Recent studies find lasting effects of poor youth health on educational attainment but use young samples and narrow life course windows of observation to explore outcomes. We apply a life course framework to three sets of Health and Retirement Study birth cohorts to examine early health status effects on education and skills attainment measured late in life. The older cohorts that we study were the earliest recipients of U.S. policies promoting continuing education through the GI Bill, community college expansions and new credentials such as the GED. We examine a wide range of outcomes but focus on GEDs, postsecondary school entry and adult human capital as job-related training. We find that older U.S. cohorts had considerable exposure to these forms of attainment and that the effects of youth health on them vary by outcome: health selection and ascription group effects are weak or fade, respectively, in outcomes associated with delayed or adult attainment. However, poorer health and social disadvantage in youth and barriers associated with ascription carry forward to limit attainment of key credentials such as diplomas and college degrees. We find that the human capital - health gradient is dynamic and that narrow windows of observation in existing studies miss much of it. National context also matters for studying health-education linkages over the life course.

  16. Emergency Department Discharge Diagnosis and Adverse Health Outcomes in Older Adults

    PubMed Central

    Hastings, S. Nicole; Whitson, Heather E.; Purser, Jama L.; Sloane, Richard J.; Johnson, Kimberly S.

    2010-01-01

    Objectives To determine the relationship between the reason for an emergency department (ED) visit and subsequent risk of adverse health outcomes in older adults discharged from the ED. Design Secondary analysis of data from the Medicare Current Beneficiary Survey. Setting ED. Participants One thousand eight hundred fifty-one community-dwelling Medicare fee-for-service enrollees aged 65 and older discharged from the ED between January 2000 and September 2002. Measurements Independent variables were ED discharge diagnosis groups: injury or musculoskeletal (MSK) (e.g., fracture, open wound), chronic condition (e.g., chronic obstructive pulmonary disorder, heart failure), infection, non-MSK symptom (e.g., chest pain, abdominal pain), and unclassified. Adverse health outcomes were hospitalization or death within 30 days of the index ED visit. Results Injury or MSK was the largest ED diagnosis group (31.4%), followed by non-MSK symptom (22.2%), chronic condition (20.9%), and infection (7.8%); 338 (17.8%) had ED discharge diagnoses that were unclassified. In adjusted analyses, a discharge diagnosis of injury or MSK condition was associated with lower risk of subsequent adverse health outcomes (hazard ratio (HR) = 0.69, 95% confidence interval (CI) = 0.50–0.96) than for all other diagnosis groups. Patients seen in the ED for chronic conditions were at greater risk of adverse outcomes (HR = 1.86, 95% CI = 1.37–2.52) than all others. There were no significant differences in risk between patients with infections, those with non-MSK symptoms, and the unclassified group. Conclusion Adverse health outcomes were common in older patients with an ED discharge diagnosis classified as a chronic condition. ED discharge diagnosis may improve risk assessment and inform the development of targeted interventions to reduce adverse health outcomes in older adults discharged from the ED. PMID:19694872

  17. Role of Place in Explaining Racial Heterogeneity in Cognitive Outcomes among Older Adults.

    PubMed

    Liu, Sze Yan; Glymour, M Maria; Zahodne, Laura B; Weiss, Christopher; Manly, Jennifer J

    2015-10-01

    Racially patterned disadvantage in Southern states, especially during the formative years of primary school, may contribute to enduring disparities in adult cognitive outcomes. Drawing on a lifecourse perspective, we examine whether state of school attendance affects cognitive outcomes in older adults and partially contributes to persistent racial disparities. Using data from older African American and white participants in the national Health and Retirement Study (HRS) and the New York based Washington Heights Inwood Cognitive Aging Project (WHICAP), we estimated age-and gender-adjusted multilevel models with random effects for states predicting years of education and cognitive outcomes (e.g., memory and vocabulary). We summarized the proportion of variation in outcomes attributable to state of school attendance and compared the magnitude of racial disparities across states. Among WHICAP African Americans, state of school attendance accounted for 9% of the variance in years of schooling, 6% of memory, and 12% of language. Among HRS African Americans, state of school attendance accounted for 13% of the variance in years of schooling and also contributed to variance in cognitive function (7%), memory (2%), and vocabulary (12%). Random slope models indicated state-level African American and white disparities in every Census region, with the largest racial differences in the South. State of school attendance may contribute to racial disparities in cognitive outcomes among older Americans. Despite tremendous within-state heterogeneity, state of school attendance also accounted for some variability in cognitive outcomes. Racial disparities in older Americans may reflect historical patterns of segregation and differential access to resources such as education. PMID:26412671

  18. Upper and Lower Urinary Tract Outcomes in Adult Myelomeningocele Patients: A Systematic Review

    PubMed Central

    Veenboer, Paul W.; Bosch, J. L. H. Ruud; van Asbeck, Floris W. A.; de Kort, Laetitia M. O.

    2012-01-01

    Background The introduction of sophisticated treatment of bladder dysfunction and hydrocephalus allows the majority of SB patients to survive into adulthood. However, no systematic review on urological outcome in adult SB patients is available and no follow-up schemes exist. Objectives To systematically summarize the evidence on outcome of urinary tract functioning in adult SB patients. Methods A literature search in PubMed and Embase databases was done. Only papers published in the last 25 years describing patients with open SB with a mean age >18 years were included. We focused on finding differences in the treatment strategies, e.g., clean intermittent catheterization and antimuscarinic drugs versus early urinary diversion, with regard to long-term renal and bladder outcomes. Results A total of 13 articles and 5 meeting abstracts on urinary tract status of adult SB patients were found describing a total of 1564 patients with a mean age of 26.1 years (range 3–74 years, with a few patients <18 years). All were retrospective cohort studies with relatively small and heterogeneous samples with inconsistent reporting of outcome; this precluded the pooling of data and meta-analysis. Total continence was achieved in 449/1192 (37.7%; range 8–85%) patients. Neurological level of the lesion and hydrocephalus were associated with incontinence. Renal function was studied in 1128 adult patients. In 290/1128 (25.7%; range 3–81.8%) patients some degree of renal damage was found and end-stage renal disease was seen in 12/958 (1.3%) patients. Detrusor-sphincter dyssynergy and detrusor-overactivity acted as adverse prognostic factors for the development of renal damage. Conclusions These findings should outline follow-up schedules for SB patients, which do not yet exist. Since renal and bladder deterioration continues beyond adolescence, follow-up of these individuals is needed. We recommend standardization in reporting the outcome of urinary tract function in adult SB

  19. ReDirection: Options for Policy and Practice in Adult Literacy in Washington State. Goals and Outcomes. A Series of Discussion Papers for the Adult Education Advisory Council.

    ERIC Educational Resources Information Center

    Fish, Susan; Sampson, Lynne

    This discussion paper endeavors to inform decision makers about the goals and outcomes for adult basic education in Washington State. It first examines the current goals operating in adult literacy programs in the state, concluding that, although there may appear to be agreement about the very general purposes of literacy education in the state,…

  20. Occupational Outcome in Adult ADHD: Impact of Symptom Profile, Comorbid Psychiatric Problems, and Treatment--A Cross-Sectional Study of 414 Clinically Diagnosed Adult ADHD Patients

    ERIC Educational Resources Information Center

    Halmoy, Anne; Fasmer, Ole Bernt; Gillberg, Christopher; Haavik, Jan

    2009-01-01

    Objective: To determine the effects of symptom profile, comorbid psychiatric problems, and treatment on occupational outcome in adult ADHD patients. Method: Adult ADHD patients (N = 414) responded to questionnaires rating past and present symptoms of ADHD, comorbid conditions, treatment history, and work status. Results: Of the patients, 24%…

  1. Psychosocial correlates of internet use among Italian students.

    PubMed

    Casale, Silvia; Fioravanti, Giulia

    2011-08-01

    Davis (2001) introduced a cognitive-behavioral theory of generalized pathological internet use (GPIU) that attempts to model the etiology, development, and outcomes associated with PIU. According to this model, pre-existing psychosocial problems (depression, loneliness, or low levels of social support) predispose an individual to GPIU cognitions, behaviors, and negative outcomes. An exploratory study intended to investigate whether GPIU is associated with psychosocial health (loneliness, depression, self-esteem, and shyness), also taking account of types of internet services used, was conducted in a sample of Italian undergraduate students. A cross-sectional and descriptive correlational design was used. The participants were 157 undergraduate students (34 male and 123 female) enrolled at The University of Florence. The results revealed a stronger correlation between the frequency of use of communicative services (as opposed to leisure or informational services) and GPIU levels. Among services, the most significant predictor of GPIU was the frequency of use of chat rooms and "adult" websites. All psychosocial health variables were correlated with GPIU, with the exception of shyness; however, general loneliness was the only significant predictor of GPIU. Depression and self-esteem were not significant predictors of GPIU. These results are consistent with the assumption that GPIU is related to the social aspect of the internet (e.g., online chatting) and arises from the unique communicative environment found online. In accordance with recent studies, social wellbeing (i.e. loneliness) seems to play a greater role than psychological health in deriving negative effects from internet use. PMID:22044272

  2. Predicting Long-Term Outcomes for Women Sexually Abused in Childhood: Contribution of Abuse Severity Versus Family Environment

    ERIC Educational Resources Information Center

    Fassler, I.R.; Amodeo, M.; Griffin, M.L.; Clay, C.M.; Ellis, M.A.

    2005-01-01

    Objective:: Child sexual abuse (CSA) has been associated with adverse adult psychosocial outcomes, although some reports describe minimal long-term effects. The search for explanations for the heterogeneous outcomes in women with CSA has led to an examination of a range of CSA-related factors, from the severity of individual CSA incidents to the…

  3. Predicting Long-Term Outcomes for Women Physically Abused in Childhood: Contribution of Abuse Severity versus Family Environment

    ERIC Educational Resources Information Center

    Griffin, Margaret L.; Amodeo, Maryann

    2010-01-01

    Objective: Child physical abuse (CPA) has been associated with adverse adult psychosocial outcomes, although some reports describe minimal long-term effects. The search for the explanation for heterogeneous outcomes in women with CPA has led to an examination of a range of CPA-related factors, from the severity of CPA incidents to the childhood…

  4. Elevated Fecal Calprotectin Associates with Adverse Outcomes from Clostridium difficile Infection in Older Adults

    PubMed Central

    Rao, Krishna; Santhosh, Kavitha; Mogle, Jill A.; Higgins, Peter D. R.; Young, Vincent B.

    2016-01-01

    Background Clostridium difficile infection (CDI) causes a mild to moderate colitis in most patients, but some, especially older adults, develop severe, adverse outcomes. Biomarkers predicting outcomes are needed to optimize treatments. This study tested whether fecal calprotectin associated with a composite primary outcome of complicated CDI (intensive care unit admission, colectomy, or death due to CDI within 30 days of diagnosis) and/or 8-week recurrence. Methods Stool was collected in Cary-Blair media at the time of diagnosis from inpatients of age >60 years that tested positive for C. difficile (enzyme immunoassay [EIA] for toxin A/B or polymerase chain reaction for the tcdB gene). Fecal calprotectin was measured and normalized to solid stool weight. Analysis was performed using logistic regression. Variables were selected for the final model using likelihood ratio tests. Results Fifty patients were included with a mean age 72.8 (± 7.5), and 13 (26%) developed the primary outcome. Clinical variables such as age, gender, and comorbid disease did not associate with complicated CDI/recurrence, nor did traditional biomarkers such as serum albumin or white blood cell count. A high normalized fecal calprotectin (>2000 µg/g) associated with the primary outcome in the final model after adjustment for gender and detectable fecal toxin(s) by EIA (OR 24.9, 95% CI 2.4–257.9, P=.007) with a specificity of 91.9%. Conclusion This study provides evidence that fecal calprotectin level associates with complications from CDI in older adults. Further studies are required to validate these findings in larger cohorts and incorporate them into clinical prediction algorithms. PMID:27206404

  5. Adult-Onset Familial Mediterranean Fever in Northwestern Iran; Clinical Feature and Treatment Outcome

    PubMed Central

    Nobakht, H; Zamani, F; Ajdarkosh, H; Mohamadzadeh, Z; Fereshtehnejad, SM; Nassaji, M

    2011-01-01

    BACKGROUND Familial Mediterranean fever (FMF) is an autosomal recessive disorder characterized by sporadic, paroxysmal attacks of fever and serosal inflammation. Although the disease usually begins before the age of 20 years, we aimed to evaluate the demography, clinical features and treatment outcome of familial Mediterranean fever in Iranian adult patients above 20 years old. METHODS In this cross-sectional study, adult patients (first attack at the age of >20 years) with a diagnosis of FMF who referred to the gastroenterology and rheumatology Clinics of Ardebil University of Medical Science (situated in north west of Iran) over the period of 2004-2009 were enrolled. FMF diagnosis was based on clinical criteria. RESULTS Forty four FMF patients (30 male and 14 female) with the mean [± Standard Deviation (SD)] age of first attack of 29 ± 7.8 years were enrolled. Abdominal pain (95.5%) and fever (91%) were the most common clinical findings. All of the patients had satisfactorily responded to therapy. Response was complete in 76.7% and partial in 23.3% of the patients. There was no clinical or laboratory evidence of amyloidosis at the time of diagnosis or during follow-up. CONCLUSION Our findings demonstrated that adult-onset FMF in Iran has different characteristics (more common in males, lesser prevalence of arthritis and erysipelas-like erythema, less delay in diagnosis) and treatment outcome (favorable response even to low-dose colchicine) in comparison with the previous data on early onset patients. PMID:25197532

  6. Adult-onset familial mediterranean Fever in northwestern iran; clinical feature and treatment outcome.

    PubMed

    Nobakht, H; Zamani, F; Ajdarkosh, H; Mohamadzadeh, Z; Fereshtehnejad, Sm; Nassaji, M

    2011-03-01

    BACKGROUND Familial Mediterranean fever (FMF) is an autosomal recessive disorder characterized by sporadic, paroxysmal attacks of fever and serosal inflammation. Although the disease usually begins before the age of 20 years, we aimed to evaluate the demography, clinical features and treatment outcome of familial Mediterranean fever in Iranian adult patients above 20 years old. METHODS In this cross-sectional study, adult patients (first attack at the age of >20 years) with a diagnosis of FMF who referred to the gastroenterology and rheumatology Clinics of Ardebil University of Medical Science (situated in north west of Iran) over the period of 2004-2009 were enrolled. FMF diagnosis was based on clinical criteria. RESULTS Forty four FMF patients (30 male and 14 female) with the mean [± Standard Deviation (SD)] age of first attack of 29 ± 7.8 years were enrolled. Abdominal pain (95.5%) and fever (91%) were the most common clinical findings. All of the patients had satisfactorily responded to therapy. Response was complete in 76.7% and partial in 23.3% of the patients. There was no clinical or laboratory evidence of amyloidosis at the time of diagnosis or during follow-up. CONCLUSION Our findings demonstrated that adult-onset FMF in Iran has different characteristics (more common in males, lesser prevalence of arthritis and erysipelas-like erythema, less delay in diagnosis) and treatment outcome (favorable response even to low-dose colchicine) in comparison with the previous data on early onset patients.

  7. Antisocial Behavioral Syndromes and Three-Year Quality of Life Outcomes in United States Adults

    PubMed Central

    Goldstein, Risë B.; Dawson, Deborah A.; Smith, Sharon M.; Grant, Bridget F.

    2013-01-01

    Objective To examine 3-year quality-of-life (QOL) outcomes among United States adults with Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV) antisocial personality disorder (ASPD), syndromal adult antisocial behavior without conduct disorder (CD) before age 15 (AABS, not a DSM-IV diagnosis), or no antisocial behavioral syndrome at baseline. Method Face-to-face interviews (n= 34,653). Psychiatric disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule – DSM-IV Version. Health-related QOL was assessed using the Short-Form 12-Item Health Survey, version 2 (SF-12v2). Other outcomes included past-year Perceived Stress Scale-4 (PSS-4) scores, employment, receipt of Supplemental Security Income (SSI), welfare, and food stamps, and participation in social relationships. Results ASPD and AABS predicted poorer employment, financial dependency, social relationship, and physical health outcomes. Relationships of antisociality to SSI and food stamp receipt and physical health scales were modified by baseline age. Both antisocial syndromes predicted higher PSS-4, AABS predicted lower SF-12v2 Vitality, and ASPD predicted lower SF-12v2 Social Functioning scores in women. Conclusion Similar prediction of QOL by ASPD and AABS suggests limited utility of requiring CD before age 15 to diagnose ASPD. Findings underscore the need to improve prevention and treatment of antisocial syndromes. PMID:22375904

  8. Renal outcomes of bariatric surgery in obese adults with diabetic kidney disease.

    PubMed

    Rao, Bhavana B; Bhattacharya, Abhik; Agrawal, Varun

    2014-08-01

    Obesity is a pandemic with several significant adverse health outcomes. Chronic kidney disease has been an overlooked consequence of obesity. Among diabetics, obesity is known to amplify the risk for kidney disease. Although bariatric surgery promises significant and sustained weight reduction with favorable impact on metabolic parameters such as glycemic control, hypertension and dyslipidemia, its impact on the renal complications of diabetes is poorly understood. This paper aims to comprehensively evaluate the evidence in the published literature on the impact of bariatric surgery on renal outcomes in obese adults with diabetic kidney disease. While many observational studies have demonstrated significant reduction in proteinuria after bariatric surgery, there is paucity of data regarding changes in renal filtration function such as doubling of serum creatinine or progression to end stage kidney disease. No randomized controlled trials comparing medical vs. surgical therapy in obese adults with diabetic kidney disease exist, hence assessing the metabolic benefits vs. the surgical risks is important before recommending bariatric surgery to this growing patient population. Future studies require a collaborative effort between bariatric surgeons and nephrologists to measure long-term effects of bariatric surgery on renal outcomes incorporating evolving markers of kidney injury to advance this field.

  9. An innovative outcomes-based medical education program built on adult learning principles.

    PubMed

    McNeil, H Patrick; Hughes, Chris S; Toohey, Susan M; Dowton, S Bruce

    2006-09-01

    An innovative medical curriculum at the University of New South Wales (UNSW) has been developed through a highly collaborative process aimed at building faculty ownership and ongoing sustainability. The result is a novel capability-based program that features early clinical experience and small-group teaching, which offers students considerable flexibility and achieves a high degree of alignment between graduate outcomes, learning activities and assessments. Graduate capabilities that focus student learning on generic outcomes are described (critical evaluation, reflection, communication and teamwork) along with traditional outcomes in biomedical science, social aspects, clinical performance and ethics. Each two-year phase promotes a distinctive learning process to support and develop autonomous learning across six years. The approaches emphasize important adult education themes: student autonomy; learning from experience; collaborative learning; and adult teacher-learner relationships. Teaching in each phase draws on stages of the human life cycle to provide an explicit organization for the vertical integration of knowledge and skills. A learning environment that values the social nature of learning is fostered through the program's design and assessment system, which supports interdisciplinary integration and rewards students who exhibit self-direction. Assessment incorporates criterion referencing, interdisciplinary examinations, a balance between continuous and barrier assessments, peer feedback and performance assessments of clinical competence. A portfolio examination in each phase, in which students submit evidence of reflection and achievement for each capability, ensures overall alignment.

  10. Impact of Hospital Volume on Outcomes of Endovascular Stenting for Adult Aortic Coarctation.

    PubMed

    Bhatt, Parth; Patel, Nileshkumar J; Patel, Achint; Sonani, Rajesh; Patel, Aashay; Panaich, Sidakpal S; Thakkar, Badal; Savani, Chirag; Jhamnani, Sunny; Patel, Nilay; Patel, Nish; Pant, Sadip; Patel, Samir; Arora, Shilpkumar; Dave, Abhishek; Singh, Vikas; Chothani, Ankit; Patel, Jay; Ansari, Mohammad; Deshmukh, Abhishek; Bhimani, Ronak; Grines, Cindy; Cleman, Michael; Mangi, Abeel; Forrest, John K; Badheka, Apurva O

    2015-11-01

    Use of transcatheter endovascular stenting has been increasing in the treatment of coarctation of aorta (CoA). The present study was undertaken on adults with CoA who underwent stent placement from 2000 to 2011 to analyze the relation of hospital volumes to the outcomes of stenting in adults with CoA. It was a retrospective study based on Healthcare Cost and Utilization Project's Nationwide Inpatient Sample (NIS) database from 2000 to 2011 and identified subjects using the International Classification of Diseases, Ninth Revision, Clinical Modification procedure code of 747.10 (CoA). Annual hospital volume was calculated using unique hospital identifiers. Weights provided by the Nationwide Inpatient Sample were used to generate national estimates. A total of 105 (weighted 521) subjects were identified with International Classification of Diseases, Ninth Revision, code of 39.90 (Endovascular stent). Hospital volumes were divided into tertiles. We compared the highest tertile (≥3 procedures annually) with other tertiles (<3 procedure annually). The composite outcomes of the analysis were procedure-related complications, length of stay (LOS), and cost in relation to the hospital volume. No inhospital death was reported in either group. Hospitals with ≥3 procedures annually had significantly lower incidence of complications (9.5% vs 23.0%) compared to the hospitals with <3 procedures annually (p-value 0.002). Similar results were obtained after multivariate regression analysis in relation to hospital volume. Shorter LOS and lower cost were observed with annual hospital volume of ≥3 procedures. In conclusion, stenting adults for CoA is remarkably safe, and the outcomes of the procedure have improved in centers with annual hospital volume of ≥3 procedures. There is also decreasing trend of procedure-related complications, shorter LOS, and lower costs compared to centers with annual volume <3 procedures.

  11. Adult health outcomes and their implications for experiences of childhood nutritional stress in Jamaica.

    PubMed

    Nelson, Robin G

    2009-01-01

    With insights from the developmental origins of health and disease paradigm (DOHaD), this study explores the impact of childhood nutritional stress on adult health outcomes in Jamaica. Jamaica experienced a lengthy period of political and economic instability beginning in the postcolonial period of the early 1960s. This study tests whether decreased government spending on public resources and limited access to imported food products during the early postcolonial period will be reflected in increased adiposity and body mass index among Jamaican adults. Ethnographic and anthropometric data were collected from individuals born between 1958 and 1988. Variability in health outcomes was assessed using Z-score values for body mass index and summed skinfold thickness measures. Age was employed as both a continuous and categorical independent variable. In partial correlation models controlling for economic status, body mass index values and summed skinfold thickness increased with age. Birth cohort and gender effects were also apparent. Women born between 1959 and 1968 had higher body mass index Z-score values than younger women. Both men and women born between 1959 and 1968 had significantly higher skinfold thickness measures than younger individuals. Individuals born between 1959 and 1968 were children during the immediate postcolonial era in Jamaica. Experiences of nutritional stress during critical developmental periods may have contributed to the observed age-related increases in adipose tissue and body mass index values. This study informs our understanding of the ways that fluctuations in the sociopolitical environment during development can mediate and contribute to poor adult health outcomes.

  12. Impact of Hospital Volume on Outcomes of Endovascular Stenting for Adult Aortic Coarctation.

    PubMed

    Bhatt, Parth; Patel, Nileshkumar J; Patel, Achint; Sonani, Rajesh; Patel, Aashay; Panaich, Sidakpal S; Thakkar, Badal; Savani, Chirag; Jhamnani, Sunny; Patel, Nilay; Patel, Nish; Pant, Sadip; Patel, Samir; Arora, Shilpkumar; Dave, Abhishek; Singh, Vikas; Chothani, Ankit; Patel, Jay; Ansari, Mohammad; Deshmukh, Abhishek; Bhimani, Ronak; Grines, Cindy; Cleman, Michael; Mangi, Abeel; Forrest, John K; Badheka, Apurva O

    2015-11-01

    Use of transcatheter endovascular stenting has been increasing in the treatment of coarctation of aorta (CoA). The present study was undertaken on adults with CoA who underwent stent placement from 2000 to 2011 to analyze the relation of hospital volumes to the outcomes of stenting in adults with CoA. It was a retrospective study based on Healthcare Cost and Utilization Project's Nationwide Inpatient Sample (NIS) database from 2000 to 2011 and identified subjects using the International Classification of Diseases, Ninth Revision, Clinical Modification procedure code of 747.10 (CoA). Annual hospital volume was calculated using unique hospital identifiers. Weights provided by the Nationwide Inpatient Sample were used to generate national estimates. A total of 105 (weighted 521) subjects were identified with International Classification of Diseases, Ninth Revision, code of 39.90 (Endovascular stent). Hospital volumes were divided into tertiles. We compared the highest tertile (≥3 procedures annually) with other tertiles (<3 procedure annually). The composite outcomes of the analysis were procedure-related complications, length of stay (LOS), and cost in relation to the hospital volume. No inhospital death was reported in either group. Hospitals with ≥3 procedures annually had significantly lower incidence of complications (9.5% vs 23.0%) compared to the hospitals with <3 procedures annually (p-value 0.002). Similar results were obtained after multivariate regression analysis in relation to hospital volume. Shorter LOS and lower cost were observed with annual hospital volume of ≥3 procedures. In conclusion, stenting adults for CoA is remarkably safe, and the outcomes of the procedure have improved in centers with annual hospital volume of ≥3 procedures. There is also decreasing trend of procedure-related complications, shorter LOS, and lower costs compared to centers with annual volume <3 procedures. PMID:26471501

  13. Final Height and Cardiometabolic Outcomes in Young Adults with Very Low Birth Weight (<1500 g)

    PubMed Central

    Sato, Ryosuke; Maekawa, Masato; Genma, Rieko; Shirai, Kenji; Ohki, Shigeru; Morita, Hiroshi; Suda, Takafumi; Watanabe, Hiroshi

    2014-01-01

    Objective Individuals with very low birth weight (VLBW; <1500 g) are known to be predisposed to both short final height and cardiometabolic disorders. However, associations between final height and cardiometabolic outcomes including glucose metabolism in VLBW individuals in young adulthood are not fully investigated. Methods We investigated glucose metabolism and other cardiometabolic outcomes such as lipid profiles, blood pressure, renal function, urinary albumin, and thyroid function in young adults with VLBW born between 1980 and 1990. Short stature was defined as a final height <10th percentile. Glucose intolerance [diabetes, impaired glucose tolerance (IGT), and impaired fasting glucose (IFG)] was determined using 75-g oral glucose tolerance tests. Associations between final height and cardiometabolic outcomes were examined using logistic or multiple linear regression. Results A total of 628 VLBW individuals were screened and 111 young adults with VLBW (19–30 years) participated in the study. Of the participants, 40 subjects (36%) had short stature with a final height <10th percentile. Eight subjects (7.2%) had glucose intolerance (1, diabetes; 6, IGT; 1, IFG). Short stature was correlated with glucose intolerance (odds ratio 11.1; 95% CI 1.92, 99.7; P = 0.006). Final height was inversely associated with the homeostatic model assessment (HOMA) of insulin resistance, HOMA-β, insulinogenic index, and total/LDL-cholesterol. The associations of final height with insulin sensitivity and lipid profiles remained after adjustment for target height and age at puberty onset. Conclusions Shorter final height was associated with less favorable metabolic profiles in young adults with VLBW, and may be partly mediated by reduced insulin sensitivity. These associations were independent of target height or age at puberty onset. PMID:25397968

  14. Immune thrombocytopenia in adults: a prospective cohort study of clinical features and predictors of outcome

    PubMed Central

    Grimaldi-Bensouda, Lamiae; Nordon, Clémentine; Michel, Marc; Viallard, Jean-François; Adoue, Daniel; Magy-Bertrand, Nadine; Durand, Jean-Marc; Quittet, Philippe; Fain, Olivier; Bonnotte, Bernard; Morin, Anne-Sophie; Morel, Nathalie; Costedoat-Chalumeau, Nathalie; Pan-Petesch, Brigitte; Khellaf, Mehdi; Perlat, Antoinette; Sacre, Karim; Lefrere, François; Abenhaim, Lucien; Godeau, Bertrand

    2016-01-01

    This prospective observational cohort study aimed to explore the clinical features of incident immune thrombocytopenia in adults and predictors of outcome, while determining if a family history of autoimmune disorder is a risk factor for immune thrombocytopenia. All adults, 18 years of age or older, recently diagnosed with immune thrombocytopenia were consecutively recruited across 21 hospital centers in France. Data were collected at diagnosis and after 12 months. Predictors of chronicity at 12 months were explored using logistic regression models. The association between family history of autoimmune disorder and the risk of developing immune thrombocytopenia was explored using a conditional logistic regression model after matching each case to 10 controls. One hundred and forty-three patients were included: 63% female, mean age 48 years old (Standard Deviation=19), and 84% presented with bleeding symptoms. Median platelet count was 10×109/L. Initial treatment was required in 82% of patients. After 12 months, only 37% of patients not subject to disease-modifying interventions achieved cure. The sole possible predictor of chronicity at 12 months was a higher platelet count at baseline [Odds Ratio 1.03; 95%CI: 1.00, 1.06]. No association was found between outcome and any of the following features: age, sex, presence of either bleeding symptoms or antinuclear antibodies at diagnosis. Likewise, family history of autoimmune disorder was not associated with incident immune thrombocytopenia. Immune thrombocytopenia in adults has been shown to progress to a chronic form in the majority of patients. A lower platelet count could be indicative of a more favorable outcome. PMID:27229715

  15. Employment Outcomes of Transition-Aged Adults with Autism Spectrum Disorders: A State of the States Report

    ERIC Educational Resources Information Center

    Burgess, Sloane; Cimera, Robert E.

    2014-01-01

    The primary purpose of this study was to evaluate the employment outcomes of transition-aged adults with autism spectrum disorders (ASD) served by vocational rehabilitation services (VR) over the last 10 years by state. A secondary purpose was to compare employment outcomes of individuals with ASD to those of the overall transition-aged population…

  16. Young Adult Outcomes of Children Born to Teen Mothers: Effects of Being Born during Their Teen or Later Years

    ERIC Educational Resources Information Center

    Lipman, Ellen L.; Georgiades, Katholiki; Boyle, Michael H.

    2011-01-01

    Objective: Children of teen mothers exhibit adverse outcomes through adolescence. It is unclear whether these adverse outcomes extend to adulthood and apply to all of her children, or only those born when she was a teen. We examine the associations between young adult functioning and being born to a teen mother aged less than or equal to 20 years…

  17. Birth Status, Child Growth, and Adult Outcomes in Low- and Middle-Income Countries☆

    PubMed Central

    Stein, Aryeh D.; Barros, Fernando C.; Bhargava, Santosh K.; Hao, Wei; Horta, Bernardo L.; Lee, Nanette; Kuzawa, Christopher W.; Martorell, Reynaldo; Ramji, Siddarth; Stein, Alan; Richter, Linda

    2013-01-01

    Objective To assess the impact of being born preterm or small for gestational age (SGA) on several adult outcomes. Study design We analyzed data for 4518 adult participants in 5 birth cohorts from Brazil, Guatemala, India, the Philippines, and South Africa. Results In the study population, 12.8% of males and 11.9% of females were born preterm, and 26.8% of males and 22.4% of females were born term but SGA. Adults born preterm were 1.11 cm shorter (95% CI, 0.57-1.65 cm), and those born term but SGA were 2.35 cm shorter (95% CI, 1.93-2.77 cm) compared with those born at term and appropriate size for gestational age. Blood pressure and blood glucose level did not differ by birth category. Compared with those born term and at appropriate size for gestational age, schooling attainment was 0.44 years lower (95% CI, 0.17-0.71 years) in those born preterm and 0.41 years lower (95% CI, 0.20-0.62 years) in those born term but SGA. Conclusion Being born preterm or term but SGA is associated with persistent deficits in adult height and schooling, but is not related to blood pressure or blood glucose level in low- and middle-income settings. Increased postnatal growth is associated with gains in height and schooling regardless of birth status, but not with increases in blood pressure or blood glucose level. PMID:24064150

  18. Epidemiology and outcome of articular complications in adult onset Still's disease.

    PubMed

    Mahfoudhi, Madiha; Shimi, Rafik; Turki, Sami; Kheder, Adel

    2015-01-01

    The adult onset Still's disease is a rare inflammatory pathology of unknown pathogeny. The clinical features are variable. The diagnosis is difficult since exclusion of infectious, systemic and tumoral pathologies should be done. The articular complications are frequent and can be revelatory of this pathology. The articular prognosis depends on the diagnosis delay and the treatment efficiency. Our study aims to analyze different aspects of articular manifestations complicating adult onset Still disease to define epidemiological, clinical and evolving characteristics of these complications. It was a cross-sectional study concerning 18 cases of adult onset Still disease diagnosed from 1990 to 2014 in the internal medicine A department of Charles Nicolle Hospital in Tunis, meeting Yamaguchi criteria. We identified clinical, radiological, evolving and therapeutic profile of the articular manifestations occurred in these patients. There were 11 women and 7 men. The average age was 27 years. The arthralgias were reported in all cases; while, the arthritis interested thirteen patients. A hand deformation was found in four patients. A wrist ankylosis was noted in one case and a flexion elbow in one patient. The Standard articular radiographs were normal in ten cases. The treatment associated essentially non-steroidal anti-inflammatory and/or corticosteroids and/or methotrexate. Concerning the evolving profile, the monocyclic form was present in 25% of the cases, the intermittent form in 40% and the chronic articular form in 35% of our patients. The adult onset Still's disease is rare and heterogeneous. The articular disturbances are frequent and have various outcomes.

  19. Adult Sexual Outcomes of Child Sexual Abuse Vary According to Relationship Status.

    PubMed

    Vaillancourt-Morel, Marie-Pier; Godbout, Natacha; Sabourin, Stéphane; Briere, John; Lussier, Yvan; Runtz, Marsha

    2016-04-01

    This study tested a moderation model in which the association between child sexual abuse severity and negative sexual outcomes (i.e., sexual avoidance and compulsivity) differed as a function of relationships status (i.e., single, cohabiting, and married individuals). A sample of 1,033 adults completed self-report questionnaires online, and 21.5% reported childhood sexual abuse. Path analyses indicated that child sexual abuse severity was associated with higher sexual compulsivity in single individuals, both higher sexual avoidance and compulsivity in cohabiting individuals, and higher sexual avoidance in married individuals. The moderation model was invariant across men and women. These results suggest that the time course of negative sexual outcomes associated with child sexual abuse may follow distinct patterns of expression according to relationship status. PMID:26804731

  20. Restructuring a rehabilitation program for older adults: effects on patient outcomes and staff perspectives.

    PubMed

    Klein, Jennifer; Hopper, Tammy

    2013-06-01

    The purpose of this mixed-methods research study was to examine the impact of organizational change on patient outcomes and staff experiences in a rehabilitation program for older adults. Program restructuring focused on reducing patient length of stay and increasing admissions to the rehabilitation program. Study findings revealed that patients admitted after restructuring, as compared to the time period just prior, experienced shorter lengths of stay yet made similar progress towards rehabilitation goals. The average discharge Functional Independence Measure (FIM) scores between the two time periods were not significantly different. Yet FIM efficiency scores improved after the restructuring. With this reorganization, rehabilitation staff reported working harder to help patients achieve satisfactory outcomes, although initially staff reported lower morale. Findings extend the current literature and have practical implications for health care professionals interested in facilitating successful organizational change.

  1. Effectiveness and predictors of outcome in routine out-patient mental health care for older adults.

    PubMed

    Veerbeek, Marjolein A; Oude Voshaar, Richard C; Pot, Anne Margriet

    2014-04-23

    ABSTRACT Background: Meta-analyses show efficacy of several psychological and pharmacological interventions for late-life psychiatric disorders, but generalization of effects to routine mental health care for older people remains unknown. Aim of this study is to investigate the improvement of functioning within one year of referral to an outpatient mental health clinic for older adults. Methods: Pre-post measurement of the Health of Nations Outcome Scale 65+ (HoNOS 65+) in 704 older people referred for psychiatric problems (no dementia) to any of the seven participating mental health care organizations. Results: The pre-post-test Cohen's d effect size was 1.08 in the total group and 1.23 in depressed patients, the largest subgroup. Linear regression identified better functioning at baseline, comorbid personality disorder, somatic comorbidity and life events during treatment as determinants of a worse outcome. Conclusions: Functioning of older persons with psychiatric problems largely improves after treatment in routine mental health care.

  2. Body-related pride in young adults: an exploration of the triggers, contexts, outcomes and attributions.

    PubMed

    Castonguay, Andree L; Gilchrist, Jenna D; Mack, Diane E; Sabiston, Catherine M

    2013-06-01

    This study explored body-related emotional experiences of pride in young adult males (n=138) and females (n=165). Data were collected using a relived emotion task and analyzed using inductive content analysis. Thirty-nine codes were identified and grouped into six categories (triggers, contexts, cognitive attributions, and affective, cognitive, and behavioral outcomes) for each of two themes (hubristic and authentic pride). Hubristic pride triggers included evaluating appearance/fitness as superior. Cognitions centered on feelings of superiority. Behaviors included strategies to show off. Triggers for authentic pride were personal improvements/maintenance in appearance and meeting or exceeding goals. Feeling accomplished was a cognitive outcome, and physical activity was a behavioral strategy. Contexts for the experience of both facets of pride primarily involved sports settings, swimming/beach, and clothes shopping. These findings provide theoretical support for models of pride as it applies to body image, and advances conceptual understanding of positive body image.

  3. Applying the Gender Lens to Risk Factors and Outcome after Adult Cardiac Surgery

    PubMed Central

    Eifert, Sandra; Guethoff, Sonja; Kaczmarek, Ingo; Beiras-Fernandez, Andres; Seeland, Ute; Gulbins, Helmut; Seeburger, Jörg; Deutsch, Oliver; Jungwirth, Bettina; Katsari, Elpiniki; Dohmen, Pascal; Pfannmueller, Bettina; Hultgren, Rebecka; Schade, Ina; Kublickiene, Karolina; Mohr, Friedrich W.; Gansera, Brigitte

    2014-01-01

    Summary Background Applying the gender lens to risk factors and outcome after adult cardiac surgery is of major clinical interest, as the inclusion of sex and gender in research design and analysis may guarantee more comprehensive cardiovascular science and may consecutively result in a more effective surgical treatment as well as cost savings in cardiac surgery. Methods We have reviewed classical cardiovascular risk factors (diabetes, arterial hypertension, hyperlipidemia, smoking) according to a gender-based approach. Furthermore, we have examined comorbidities such as depression, renal insufficiency, and hormonal influences in regard to gender. Gender-sensitive economic aspects have been evaluated, surgical outcome has been analyzed, and cardiovascular research has been considered from a gender perspective. Results The influence of typical risk factors and outcome after cardiac surgery has been evaluated from a gender perspective, and the gender-specific distribution of these risk factors is reported on. The named comorbidities are listed. Economic aspects demonstrated a gender gap. Outcome after coronary and valvular surgeries as well as after heart transplantation are displayed in this regard. Results after postoperative use of intra-aortic balloon pump are shown. Gender-related aspects of clinical and biomedical cardiosurgical research are reported. Conclusions Female gender has become an independent risk factor of survival after the majority of cardiosurgical procedures. Severely impaired left ventricular ejection fraction independently predicts survival in men, whereas age does in females. PMID:26288584

  4. The CORE study protocol: a stepped wedge cluster randomised controlled trial to test a co-design technique to optimise psychosocial recovery outcomes for people affected by mental illness in the community mental health setting

    PubMed Central

    Palmer, Victoria J; Chondros, Patty; Piper, Donella; Callander, Rosemary; Weavell, Wayne; Godbee, Kali; Potiriadis, Maria; Richard, Lauralie; Densely, Konstancja; Herrman, Helen; Furler, John; Pierce, David; Schuster, Tibor; Iedema, Rick; Gunn, Jane

    2015-01-01

    Introduction User engagement in mental health service design is heralded as integral to health systems quality and performance, but does engagement improve health outcomes? This article describes the CORE study protocol, a novel stepped wedge cluster randomised controlled trial (SWCRCT) to improve psychosocial recovery outcomes for people with severe mental illness. Methods An SWCRCT with a nested process evaluation will be conducted over nearly 4 years in Victoria, Australia. 11 teams from four mental health service providers will be randomly allocated to one of three dates 9 months apart to start the intervention. The intervention, a modified version of Mental Health Experience Co-Design (MH ECO), will be delivered to 30 service users, 30 carers and 10 staff in each cluster. Outcome data will be collected at baseline (6 months) and at completion of each intervention wave. The primary outcome is improvement in recovery score using the 24-item Revised Recovery Assessment Scale for service users. Secondary outcomes are improvements to user and carer mental health and well-being using the shortened 8-item version of the WHOQOL Quality of Life scale (EUROHIS), changes to staff attitudes using the 19-item Staff Attitudes to Recovery Scale and recovery orientation of services using the 36-item Recovery Self Assessment Scale (provider version). Intervention and usual care periods will be compared using a linear mixed effects model for continuous outcomes and a generalised linear mixed effects model for binary outcomes. Participants will be analysed in the group that the cluster was assigned to at each time point. Ethics and dissemination The University of Melbourne, Human Research Ethics Committee (1340299.3) and the Federal and State Departments of Health Committees (Project 20/2014) granted ethics approval. Baseline data results will be reported in 2015 and outcomes data in 2017. Trial registration number Australian and New Zealand Clinical Trials Registry ACTRN

  5. Determinants of Cat Choice and Outcomes for Adult Cats and Kittens Adopted from an Australian Animal Shelter

    PubMed Central

    Zito, Sarah; Paterson, Mandy; Vankan, Dianne; Morton, John; Bennett, Pauleen; Phillips, Clive

    2015-01-01

    Simple Summary Commonly, more adult cats than kittens are euthanized in animal shelters. We surveyed 382 cat adopters to assess adoption outcomes and potential determinants of adopters’ choice of cat age group and price. Most adopters had benevolent motivations for adopting from the shelter and had put considerable thought into the adoption and responsible ownership requirements. However, adult cat adopters were more likely to have been influenced by price than kitten adopters. Adoption outcomes were generally positive in all age and adoption price groups. This study provides evidence to inform the design of strategies to encourage adult cat adoptions. Abstract The percentage of adult cats euthanized in animal shelters is greater than that of kittens because adult cats are less likely to be adopted. This study aimed to provide evidence to inform the design of strategies to encourage adult cat adoptions. One such strategy is to discount adoption prices, but there are concerns that this may result in poor adoption outcomes. We surveyed 382 cat adopters at the time of adoption, to assess potential determinants of adopters’ cat age group choice (adult or kitten) and, for adult cat adopters, the price they are willing to pay. The same respondents were surveyed again 6–12 months after the adoption to compare outcomes between cat age groups and between adult cats in two price categories. Most adopters had benevolent motivations for adopting from the shelter and had put considerable thought into the adoption and requirements for responsible ownership. However, adult cat adopters were more likely to have been influenced by price than kitten adopters. Adoption outcomes were generally positive for both adult cats and kittens and for adult cats adopted at low prices. The latter finding alleviates concerns about the outcomes of “low-cost” adoptions in populations, such as the study population, and lends support for the use of “low-cost” adoptions as an option for

  6. Life Impairments in Adults with Medication-Treated ADHD

    ERIC Educational Resources Information Center

    Safren, Steven A.; Sprich, Susan E.; Cooper-Vince, Christine; Knouse, Laura E.; Lerner, Jonathan A.

    2010-01-01

    Objective: In developing psychosocial approaches to augment outcomes for medication-treated adults with ADHD, it is important to understand what types of life-impairments are most affected by continued ADHD symptoms that occur despite medication treatment. This may assist in delineating targets for interventions, as well as assessments of…

  7. Adult People with Language Impairment and Their Life Situation

    ERIC Educational Resources Information Center

    Torrnqvist, Maria Carlson; Thulin, Sofia; Segnestam, Ylva; Horowitz, Laura

    2009-01-01

    Psychosocial outcome of language impairment (LI) was explored in interviews with three adults with LI (as children attended specialized boarding school) and four of their parents. The informants with LI expressed acceptance of LI and described themselves as independent. With driving education with adjusted pedagogy and initial governmental…

  8. The impact of childhood sickness on adult socioeconomic outcomes: Evidence from late 19th century America

    PubMed Central

    Warren, John Robert; Knies, Laurie; Haas, Steven; Hernandez, Elaine M.

    2013-01-01

    We use family fixed-effects models to estimate the impact of childhood health on adult literacy, labor force outcomes, and marital status among pairs of white brothers observed as children in the 1880 U.S. Census and then as adults in the 1900–1930 Censuses. Given our focus on the 19th century, we observed a wider array of infectious, chronic, and traumatic health problems than is observed using data that are more recent; our results thus provide some insights into circumstances in modern developing countries where similar health problems are more frequently observed. Compared to their healthy siblings, sick brothers were less likely to be located (and thus more likely to be dead) 20–50 years after their 1880 enumeration. Sick brothers were also less likely to be literate, to have ever been married, and to have reported an occupation. However, among those with occupations, sick and healthy brothers tended to do similar kinds of work. We discuss the implications of our results for research on the impact of childhood health on socioeconomic outcomes in developed and developing countries. PMID:22809795

  9. Late Adolescent and Young Adult Outcomes of Girls Diagnosed with ADHD in Childhood: An Exploratory Investigation

    PubMed Central

    Babinski, Dara E.; Pelham, William E.; Molina, Brooke S.G.; Gnagy, Elizabeth M.; Waschbusch, Daniel A.; Yu, Jihnhee; MacLean, Michael G.; Wymbs, Brian T.; Sibley, Margaret H.; Biswas, Aparajita; Robb, Jessica A.; Karch, Kathryn M.

    2010-01-01

    Objective The study aims to characterize the late adolescent and young adult outcomes of girls diagnosed with ADHD in childhood. Method The study included 58 females from a larger longitudinal study of ADHD. Thirty-four (M=19.97 years old) met DSM criteria for ADHD in childhood, while the remaining 24 (M=19.83 years old) did not. Self- and parent-reports of psychopathology, delinquency, interpersonal relationships, academic achievement, job performance, and substance use were collected. Results The findings suggest that girls with ADHD experience difficulties in late adolescence and young adulthood, such as more conflict with their mothers, being involved in fewer romantic relationships, and experiencing more depressive symptoms than comparison women. However, differences did not emerge in all domains, such as job performance, substance use, and self-reported ADHD symptomatology. Conclusion The findings of this study add to the literature on the negative late adolescent and young adult outcomes associated with childhood ADHD in females. PMID:20562386

  10. Outcomes of Older Adults with Burn Injury: University Clinical Center of Kosovo

    PubMed Central

    B. Duci, Shkelzen; M. Arifi, Hysni; R. Ahmeti, Hasan; K. Zatriqi, Violeta; A. Buja, Zejn; T. Hoxha, Enver; Y. Mekaj, Agon

    2015-01-01

    BACKGROUND Advances in burn care over the past 50 years have brought about remarkable improvement in mortality rates such that survival has become an expected outcome even in patients with extensive injuries. Although these improvements have occurred in all age groups, survival in older adults still lags far behind that in younger cohorts. This study determines the outcomes of older adults with burn injury in University Clinical Center of Kosovo. METHODS This is a retrospective study that includes 56 burn patients, older than 60 years who were admitted at the Department of Plastic Surgery, between 1 January 2004 and 31 December 2013. Data processing was done with the statistical package of Stat 3. From the statistical parameters the structural index, arithmetic median, and standard deviation were calculated. RESULTS Fifty six burned patient older than 60 years were included during a 10-year period. Of the 56 elderly patients 29 were women and 27 were men with a mean age of 66.7 years (range, 60-85 years). The differences were not statistically significant for both genders regarding the causes of burn injury. CONCLUSION Considering the gradual increase of the elderly population in our country based on the data of the Ministry of Public Services, an increase is expected to the incidence of burn injuries in the population of this category of our country. PMID:26284184

  11. Insulin sensitivity following exercise interventions: systematic review and meta-analysis of outcomes among healthy adults

    PubMed Central

    Conn, Vicki S.; Koopman, Richelle J.; Ruppar, Todd M.; Phillips, Lorraine J.; Mehr, David R.; Hafdahl, Adam R.

    2015-01-01

    Objective Although exercise can improve insulin sensitivity, no adequate synthesis exists of exercise intervention studies with regard to their effect on insulin sensitivity. This comprehensive meta-analysis synthesized the insulin sensitivity outcomes of supervised exercise interventions. Method Extensive literature searching located published and unpublished intervention studies that measured insulin sensitivity outcomes. Eligible studies tested supervised exercise interventions among healthy adults. Primary study characteristics and results were coded. Random-effects meta-analyses of standardized mean differences included moderator analyses. Results Data were synthesized across 2,509 subjects (115 samples, 78 reports). The overall mean effect size for two-group post-intervention comparisons was 0.38 (95% CI [0.25, 0.51], I2 = 0%) and for two-group pre-post comparisons was 0.43 (95% CI [0.30, 0.56], I2 = 52%) (higher mean insulin sensitivity for treatment than control subjects). The post-intervention mean of 0.38 is consistent with treatment subjects ending studies with a mean fasting insulin of 6.8 mU/l if control participants’ mean fasting insulin were 7.9 mU/l. Exploratory moderator analyses did not document different insulin sensitivity effect sizes across intervention characteristics or sample attributes. Conclusion This study documented that exercise is a valuable primary care and community health strategy for healthy adults to improve insulin sensitivity and lower the risk for diabetes conferred by insulin resistance. PMID:24474665

  12. Peri-Transplant Psychosocial Factors and Neutrophil Recovery following Hematopoietic Stem Cell Transplantation

    PubMed Central

    Knight, Jennifer M.; Moynihan, Jan A.; Lyness, Jeffrey M.; Xia, Yinglin; Tu, Xin; Messing, Susan; Hunter, Bryan C.; Huang, Li-Shan; Obi, Rosemary O.; Gaisser, D'Arcy; Liesveld, Jane L.; Sahler, Olle Jane Z.

    2014-01-01

    Objective Multiple psychosocial factors appear to affect cancer progression in various populations; however, research investigating the relationship between psychosocial factors and outcomes following hematopoietic stem cell transplantation (HCT) is scarce. Subject to adverse immunological and psychological conditions, HCT patients may be especially vulnerable to psychosomatic health sequelae; therefore, we studied whether optimism and anxiety influence the pertinent clinical outcome of days to neutrophil engraftment (DTE). Method 54 adults undergoing either autologous or allogeneic HCT completed self-report questionnaires measuring optimism and anxiety. We assessed the association between these psychosocial variables and DTE. Results Greater optimism and less anxiety were associated with the favorable outcome of fewer DTE in autologous HCT recipients, though this relationship was no longer significant when reducing the sample size to only subjects who filled out their baseline survey by the time of engraftment. Conclusion Our findings are suggestive that optimism and anxiety may be associated with time to neutrophil recovery in autologous, but not allogeneic, adult HCT recipients. Further investigation in larger, more homogeneous subjects with consistent baseline sampling is warranted. PMID:24915544

  13. A systematic review of patient-reported outcome instruments measuring sleep dysfunction in adults.

    PubMed

    Devine, Emily Beth; Hakim, Zafar; Green, Jesse

    2005-01-01

    Sleep dysfunction can manifest in several ways, ranging from insomnia to somnolence, and from disrupted sleep to lack of restful sleep. Measuring sleep dysfunction is an area of active research and there exist a number of patient-reported outcome instruments that measure various aspects of sleep dysfunction. However, these instruments have not been evaluated systematically. We used a conceptual model of sleep that included four physical domains of general interest to patients and investigators, and cover the breadth of this disorder: sleep initiation; sleep maintenance; sleep adequacy; and somnolence. We next considered the additional health-related quality-of-life (HR-QOL) domains of psychological and social functioning, progressing along the continuum to include health perceptions and opportunity. We then conducted a literature review to identify instruments and, using criteria developed by the Medical Outcomes Trust Scientific Advisory Committee, evaluated these instruments for their potential use in measuring sleep dysfunction. Twenty-two instruments were identified. Six instruments were found to include the four physical domains defined a priori (Basic Nordic Sleep Questionnaire, Leeds Sleep Evaluation Questionnaire, Medical Outcomes Study - Sleep Problems Measures, Pittsburgh Sleep Diary, Pittsburgh Sleep Quality Index, Self-Rated Sleep Questionnaire and the Sleep Dissatisfaction Questionnaire). Several additional instruments addressed at least some of the domains and thus may be useful for specific purposes. A few instruments addressed overall HR-QOL, but did not include all four domains of interest (Functional Outcomes of Sleep Questionnaire, Quality of Life in Insomniacs and the Sleep-Wake Activity Inventory). Two instruments had undergone extensive psychometric evaluation (Medical Outcomes Study - Sleep Problems Measures and Pittsburgh Sleep Quality Index), with only the latter reporting information about interpretability. Our review indicates that

  14. Spontaneous gram-negative bacillary meningitis in adult patients: characteristics and outcome

    PubMed Central

    2013-01-01

    Background Spontaneous meningitis caused by gram-negative bacilli in adult patients is uncommon and poorly characterized. Our objective is to describe and compare the characteristics and the outcome of adult patients with spontaneous gram-negative bacilli meningitis (GNBM) and spontaneous meningitis due to other pathogens. Methods Prospective single hospital-based observational cohort study conducted between 1982 and 2006 in a university tertiary hospital in Barcelona (Spain). The Main Outcome Measure: In-hospital mortality. Results Gram-negative bacilli meningitis was diagnosed in 40 (7%) of 544 episodes of spontaneous acute bacterial meningitis. The most common pathogens were Escherichia coli and Pseudomonas species. On admission, characteristics associated with spontaneous gram-negative bacilli meningitis by multivariate modeling were advanced age, history of cancer, nosocomial acquisition of infection, urinary tract infection as distant focus of infection, absence of rash, hypotension, and a high cerebrospinal fluid white-cell count. Nine (23%) episodes were acquired in the hospital and they were most commonly caused by Pseudomonas. The in-hospital mortality rate was 53%. The mortality rate was higher among patients with Gram-negative bacillary meningitis than among those with other bacterial meningitis and their risk of death was twenty times higher than among patients infected with Neisseria meningitidis (odds ratio 20.47; 95% confidence interval 4.03-103.93; p<0.001). Conclusions Gram-negative bacilli cause 9% of spontaneous bacterial meningitis of known etiology in adults. Characteristics associated with GNBM include advanced age, history of cancer, nosocomial acquisition, and urinary tract infection as distant focus of infection. The mortality rate is higher among patients with gram-negative bacillary meningitis than among those with other bacterial meningitides. PMID:24079517

  15. Health Outcomes in Young Adults From Foster Care and Economically Diverse Backgrounds

    PubMed Central

    Garrison, Michelle M.; Courtney, Mark E.

    2014-01-01

    BACKGROUND AND OBJECTIVES: Foster youth have high rates of health problems in childhood. Little work has been done to determine whether they are similarly vulnerable to increased health problems once they transition to adulthood. We sought to prospectively evaluate the risk of cardiovascular risk factors and other chronic conditions among young adults formerly in foster care (FC) and young adults from economically insecure (EI) and economically secure (ES) backgrounds in the general population. METHODS: We used data from the Midwest Evaluation of the Adult Functioning of Former Foster Youth (FC group; N = 596) and an age-matched sample from the National Longitudinal Study of Adolescent Health (EI and ES groups; N = 456 and 1461, respectively). After controlling for covariates, we performed multivariate regressions to evaluate health outcomes and care access by group at 2 time points (baseline at late adolescence, follow-up at 25–26 years). RESULTS: Data revealed a consistent pattern of graduated increase in odds of most health outcomes, progressing from ES to EI to FC groups. Health care access indicators were more variable; the FC group was most likely to report having Medicaid or no insurance but was least likely to report not getting needed care in the past year. CONCLUSIONS: Former foster youth appear to have a higher risk of multiple chronic health conditions, beyond that which is associated with economic insecurity. Findings may be relevant to policymakers and practitioners considering the implementation of extended insurance and foster care programs and interventions to reduce health disparities in young adulthood. PMID:25367543

  16. A Systematic Review of Music Therapy Practice and Outcomes with Acute Adult Psychiatric In-Patients

    PubMed Central

    Carr, Catherine; Odell-Miller, Helen; Priebe, Stefan

    2013-01-01

    Background and Objectives There is an emerging evidence base for the use of music therapy in the treatment of severe mental illness. Whilst different models of music therapy have been developed in mental health care, none have specifically accounted for the features and context of acute in-patient settings. This review aimed to identify how music therapy is provided for acute adult psychiatric in-patients and what outcomes have been reported. Review Methods A systematic review using medical, psychological and music therapy databases. Papers describing music therapy with acute adult psychiatric in-patients were included. Analysis utilised narrative synthesis. Results 98 papers were identified, of which 35 reported research findings. Open group work and active music making for nonverbal expression alongside verbal reflection was emphasised. Aims were engagement, communication and interpersonal relationships focusing upon immediate areas of need rather than longer term insight. The short stay, patient diversity and institutional structure influenced delivery and resulted in a focus on single sessions, high session frequency, more therapist direction, flexible use of musical activities, predictable musical structures, and clear realistic goals. Outcome studies suggested effectiveness in addressing a range of symptoms, but were limited by methodological shortcomings and small sample sizes. Studies with significant positive effects all used active musical participation with a degree of structure and were delivered in four or more sessions. Conclusions No single clearly defined model exists for music therapy with adults in acute psychiatric in-patient settings, and described models are not conclusive. Greater frequency of therapy, active structured music making with verbal discussion, consistency of contact and boundaries, an emphasis on building a therapeutic relationship and building patient resources may be of particular importance. Further research is required to

  17. Sleep problems: predictor or outcome of media use among emerging adults at university?

    PubMed

    Tavernier, Royette; Willoughby, Teena

    2014-08-01

    The pervasiveness of media use in our society has raised concerns about its potential impact on important lifestyle behaviours, including sleep. Although a number of studies have modelled poor sleep as a negative outcome of media use, a critical assessment of the literature indicates two important gaps: (i) studies have almost exclusively relied on concurrent data, and thus have not been able to assess the direction of effects; and (ii) studies have largely been conducted with children and adolescents. The purpose of the present 3-year longitudinal study, therefore, was to examine whether both sleep duration and sleep problems would be predictors or outcomes of two forms of media use (i.e. television and online social networking) among a sample of emerging adults. Participants were 942 (71.5% female) university students (M = 19.01 years, SD = 0.90) at Time 1. Survey measures, which were assessed for three consecutive years starting in the first year of university, included demographics, sleep duration, sleep problems, television and online social networking use. Results of a cross-lagged model indicated that the association between sleep problems and media use was statistically significant: sleep problems predicted longer time spent watching television and on social networking websites, but not vice versa. Contrary to our hypotheses, sleep duration was not associated with media use. Our findings indicate no negative effects of media use on sleep among emerging adults, but instead suggest that emerging adults appear to seek out media as a means of coping with their sleep problems. PMID:24552437

  18. Symptoms and socio-economic impact of ependymoma on adult patients: results of the Adult Ependymoma Outcomes Project 2.

    PubMed

    Walbert, Tobias; Mendoza, Tito R; Vera-Bolaños, Elizabeth; Acquaye, Alvina; Gilbert, Mark R; Armstrong, Terri S

    2015-01-01

    Ependymoma is a rare central nervous system tumor of adults. Reports of patient symptoms, interference patterns and costs encountered by patients and families are limited. Adult ependymoma patients completed the online Ependymoma Outcomes Questionnaire II. The survey assesses disease and functional status as well as socio-economic factors. Descriptive statistics were used to report disease characteristics as well as economic and social impact. Independent samples t test was used to test if differences exist between high- and low-income groups in terms of symptom severity. Correlations were calculated between symptoms and cost estimates. 86 international patients participated (male = 50 %). The economic analysis focused on 78 respondents from the US. 48 % were employed and 55 % earned ≥$60,000. Tumors were located in the brain (44 %), spine (44 %) or both (12 %). Spine patients compared to brain patients reported significantly worse pain (4.4 versus 2.2, p < .003), numbness (5.3 versus 2.2, p < .001), fatigue (5.1 versus 3.6, p < .03), changes in bowel patterns (3.8 versus 1.4, p < .003) and weakness (4.2 versus 2.1, p < .006). Brain patients compared with spine patients had increased lack of appetite (.4 versus 2, p < .014). Patients with lower income (≤$59,999) had more problems concentrating (p < .024) and worse cognitive module severity scores (p < .024). Estimated average monthly out-of-pocket spending was $168 for medical co-pays and $59 for prescription medication. Patients with ependymoma are highly affected by their symptoms. Spinal patients report higher severity of symptoms. Patients in the lower income group report significantly higher severity of cognitive symptoms independent of disease site.

  19. Symptoms and socio-economic impact of ependymoma on adult patients: results of the Adult Ependymoma Outcomes Project 2.

    PubMed

    Walbert, Tobias; Mendoza, Tito R; Vera-Bolaños, Elizabeth; Acquaye, Alvina; Gilbert, Mark R; Armstrong, Terri S

    2015-01-01

    Ependymoma is a rare central nervous system tumor of adults. Reports of patient symptoms, interference patterns and costs encountered by patients and families are limited. Adult ependymoma patients completed the online Ependymoma Outcomes Questionnaire II. The survey assesses disease and functional status as well as socio-economic factors. Descriptive statistics were used to report disease characteristics as well as economic and social impact. Independent samples t test was used to test if differences exist between high- and low-income groups in terms of symptom severity. Correlations were calculated between symptoms and cost estimates. 86 international patients participated (male = 50 %). The economic analysis focused on 78 respondents from the US. 48 % were employed and 55 % earned ≥$60,000. Tumors were located in the brain (44 %), spine (44 %) or both (12 %). Spine patients compared to brain patients reported significantly worse pain (4.4 versus 2.2, p < .003), numbness (5.3 versus 2.2, p < .001), fatigue (5.1 versus 3.6, p < .03), changes in bowel patterns (3.8 versus 1.4, p < .003) and weakness (4.2 versus 2.1, p < .006). Brain patients compared with spine patients had increased lack of appetite (.4 versus 2, p < .014). Patients with lower income (≤$59,999) had more problems concentrating (p < .024) and worse cognitive module severity scores (p < .024). Estimated average monthly out-of-pocket spending was $168 for medical co-pays and $59 for prescription medication. Patients with ependymoma are highly affected by their symptoms. Spinal patients report higher severity of symptoms. Patients in the lower income group report significantly higher severity of cognitive symptoms independent of disease site. PMID:25359395

  20. Nursing-sensitive outcome change scores for hospitalized older adults with heart failure: a preliminary descriptive study.

    PubMed

    Park, Hyejin

    2013-10-01

    Nursing has a social mandate to ensure effective practice within its domain and to be accountable for the outcomes of nursing care. Using standardized nursing terminologies makes it possible to measure aspects of nursing care. The purpose of this study was to determine whether a significant difference in outcome ratings exists from admission to discharge for hospitalized older adults with heart failure (HF) using Nursing Outcomes Classification (NOC). A retrospective descriptive research design was used. Data were obtained from 268 inpatient records of patients discharged with HF during a 1-year period. All top 10 NOC outcomes demonstrated statistically significant improvement in outcome ratings from admission to discharge. Findings from this study provide insight on the possible contribution of nursing to outcomes of hospitalized older adults with HF. Validating and incorporating nursing-sensitive outcome measures in future prospective experimental research can contribute to the advancement of science regarding effective treatment of older adults hospitalized with HF, while highlighting the contribution of nursing care to outcomes.

  1. Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel – a cross-sectional study

    PubMed Central

    2012-01-01

    Background Reviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel. Methods Data were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1,691) and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. Results Ambulance personnel have half the prevalence of poor self-rated health compared to the core work force (5% vs. 10%). Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%). The ambulance personnel had higher levels of emotional demands and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor that was associated with both poorer mental health and worse sleep quality. Conclusions Ambulance personnel have similar levels of mental health but substantially higher levels of musculoskeletal pain than the work force in general. They are more exposed to emotional demands and these demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal problems and the presence

  2. Does obesity influence labour market outcomes among working-age adults? Evidence from Canadian longitudinal data.

    PubMed

    Larose, Samantha L; Kpelitse, Koffi A; Campbell, M Karen; Zaric, Gregory S; Sarma, Sisira

    2016-03-01

    Although a negative association between obesity and labour market outcomes is commonly reported in many studies, the causal nature of this relationship remains unclear. Using nationally representative longitudinal data from the last six confidential master files (2000/2001-2010/2011) of the National Population Health Survey, we examine the association between obesity and employment participation and earnings among working-age adults in Canada. After controlling for demographic and socioeconomic characteristics, lifestyle factors and time-invariant individual heterogeneity, our results show that obesity is not significantly associated with employment participation but is associated with reduced hourly wage rate and annual income among women by about 4% and 4.5%, respectively. The corresponding results for men show that obesity is associated with about 2% reduction in wage rate and income, but significant at 10% level. However, after controlling for the potential reverse causality bias using the lagged measure of obesity, the effect of obesity on wage rate and income became positive or statistically non-significant. Our findings suggest that obesity is not causally associated with negative labour market outcomes among working-age men in Canada. For working-age women, we find limited evidence of negative labour market outcomes. PMID:26650919

  3. Does obesity influence labour market outcomes among working-age adults? Evidence from Canadian longitudinal data.

    PubMed

    Larose, Samantha L; Kpelitse, Koffi A; Campbell, M Karen; Zaric, Gregory S; Sarma, Sisira

    2016-03-01

    Although a negative association between obesity and labour market outcomes is commonly reported in many studies, the causal nature of this relationship remains unclear. Using nationally representative longitudinal data from the last six confidential master files (2000/2001-2010/2011) of the National Population Health Survey, we examine the association between obesity and employment participation and earnings among working-age adults in Canada. After controlling for demographic and socioeconomic characteristics, lifestyle factors and time-invariant individual heterogeneity, our results show that obesity is not significantly associated with employment participation but is associated with reduced hourly wage rate and annual income among women by about 4% and 4.5%, respectively. The corresponding results for men show that obesity is associated with about 2% reduction in wage rate and income, but significant at 10% level. However, after controlling for the potential reverse causality bias using the lagged measure of obesity, the effect of obesity on wage rate and income became positive or statistically non-significant. Our findings suggest that obesity is not causally associated with negative labour market outcomes among working-age men in Canada. For working-age women, we find limited evidence of negative labour market outcomes.

  4. The Differential Outcomes Effect in Normal Human Adults Using a Concurrent-Task Within-Subjects Design and Sensory Outcomes

    ERIC Educational Resources Information Center

    Mok, Leh Woon; Overmier, J. Bruce

    2007-01-01

    The differential outcomes effect is a phenomenon where use of a choice-unique outcome for each type of correct choice in a conditional discrimination task increases rate of learning and overall accuracy, as compared to the traditional use of a single, common outcome for all types of correct choices. This phenomenon was successfully demonstrated…

  5. Young Adult Outcomes of Children Growing up with Chronic Illness: An analysis of the National Longitudinal Study of Adolescent Health

    PubMed Central

    Maslow, Gary R.; Haydon, Abigail; Ford, Carol Ann; Halpern, Carolyn Tucker

    2012-01-01

    Objective To examine young adult outcomes in a nationally representative US cohort of young adults who grew up with a chronic illness. Design Secondary analysis of nationally representative data from Wave III (2001) of the National Longitudinal Study of Adolescent Health. Setting United States Participants The analytic sample included 13,236 young adults 18–28 years old at Wave III. Main Exposure Self-report of a chronic physical illness (asthma, cancer, diabetes or epilepsy) in adolescence. Respondents with (1) asthma or (2) non-asthma chronic illness (cancer, diabetes, or epilepsy) were compared to subjects without these conditions. Main Outcome Measures Self-report of high school graduation, ever having a job, having a current job, living with parents, and ever receiving public assistance. Results Three percent of young adults had non-asthma chronic illness (cancer, diabetes, or epilepsy) and 16% had asthma. The majority of young adults with chronic illness graduated high school (81%) and were currently employed (60%). However, compared to healthy young adults, those with a non-asthma chronic illness were significantly less likely to graduate high school, ever have a job, or have a current job and were more likely to receive public assistance. When compared to young adults with asthma, young adults with non-asthma chronic illness again had significantly worse young adult outcomes on all measures. Conclusions Most young adults growing up with chronic illness graduate high school and are employed. However, these young adults are significantly less likely than their healthy peers to achieve these important educational and vocational milestones. PMID:21383274

  6. Epidemiology and outcome of articular complications in adult onset still's disease

    PubMed Central

    Mahfoudhi, Madiha; Shimi, Rafik; Turki, Sami; Kheder, Adel

    2015-01-01

    The adult onset Still's disease is a rare inflammatory pathology of unknown pathogeny. The clinical features are variable. The diagnosis is difficult since exclusion of infectious, systemic and tumoral pathologies should be done. The articular complications are frequent and can be revelatory of this pathology. The articular prognosis depends on the diagnosis delay and the treatment efficiency. Our study aims to analyze different aspects of articular manifestations complicating adult onset Still disease to define epidemiological, clinical and evolving characteristics of these complications. It was a cross-sectional study concerning 18 cases of adult onset Still disease diagnosed from 1990 to 2014 in the internal medicine A department of Charles Nicolle Hospital in Tunis, meeting Yamaguchi criteria. We identified clinical, radiological, evolving and therapeutic profile of the articular manifestations occurred in these patients. There were 11 women and 7 men. The average age was 27 years. The arthralgias were reported in all cases; while, the arthritis interested thirteen patients. A hand deformation was found in four patients. A wrist ankylosis was noted in one case and a flexion elbow in one patient. The Standard articular radiographs were normal in ten cases. The treatment associated essentially non-steroidal anti-inflammatory and/or corticosteroids and/or methotrexate. Concerning the evolving profile, the monocyclic form was present in 25% of the cases, the intermittent form in 40% and the chronic articular form in 35% of our patients. The adult onset Still's disease is rare and heterogeneous. The articular disturbances are frequent and have various outcomes. PMID:26834930

  7. Employment outcomes of transition-aged adults with autism spectrum disorders: a state of the States report.

    PubMed

    Burgess, Sloane; Cimera, Robert E

    2014-01-01

    The primary purpose of this study was to evaluate the employment outcomes of transition-aged adults with autism spectrum disorders (ASD) served by vocational rehabilitation services (VR) over the last 10 years by state. A secondary purpose was to compare employment outcomes of individuals with ASD to those of the overall transition-aged population served by VR for the same time period. Although there was variability both within and among states, the results of this study indicate that, over time, the number of young adults with ASD seeking VR services has increased; however, employment outcomes including the percent of adults with ASD achieving employment, the number of hours worked, and wages earned have not improved for this group. The cost to provide VR services to transition-aged adults with ASD was relatively stable over time. Transition-aged adults with ASD were more likely to become successfully employed as a result of receiving VR services than the overall population of transition-aged adults served by VR. However, the employed transition-aged adults consistently worked fewer hours and earned lower wages than those in the overall population. Factors that may influence variability within and among states, and between groups, and implications for research and practice are discussed.

  8. Long-Term Outcomes of Cultivated Limbal Epithelial Transplantation: Evaluation and Comparison of Results in Children and Adults

    PubMed Central

    Ganger, Anita; Vanathi, M.; Mohanty, Sujata; Tandon, Radhika

    2015-01-01

    Purpose. To compare the long-term clinical outcomes of cultivated limbal epithelial transplantation (CLET) in children and adults with limbal stem cell deficiency. Design. Retrospective case series. Methods. Case records of patients with limbal stem cell deficiency (LSCD) who underwent CLET from April 2004 to December 2014 were studied. Outcome measures were compared in terms of anatomical success and visual improvement. Parameters for total anatomical success were avascular, epithelized, and clinically stable corneal surface without conjunctivalization, whereas partial anatomical success was considered when mild vascularization (sparing centre of cornea) and mild conjunctivalization were noted along with complete epithelization. Results. A total of 62 cases underwent the CLET procedure: 38 (61.3%) were children and 24 (38.7%) were adults. Patients with unilateral LSCD (33 children and 21 adults) had autografts and those with bilateral LSCD (5 children and 3 adults) had allografts. Amongst the 54 autografts partial and total anatomical success were noted in 21.2% and 66.6% children, respectively, and 19.0% and 80.9% in adults, respectively (p value 0.23). Visual improvement of 1 line and ≥2 lines was seen in 57.5% and 21.2% children, respectively, and 38% and 38% in adults, respectively (p value 0.31). Conclusion. Cultivated limbal epithelial transplantation gives good long-term results in patients with LSCD and the outcomes are comparable in children and adults. PMID:26770973

  9. A review of primary care interventions to improve health outcomes in adult survivors of adverse childhood experiences.

    PubMed

    Korotana, Laurel M; Dobson, Keith S; Pusch, Dennis; Josephson, Trevor

    2016-06-01

    Research has consistently demonstrated a link between the experience of adverse childhood experiences (ACEs) and adult health conditions, including mental and physical health problems. While a focus on the prevention or mitigation of adversity in childhood is an important direction of many programs, many individuals do not access support services until adulthood, when health problems may be fairly engrained. It is not clear which interventions have the strongest evidence base to support the many adults who present to services with a history of ACEs. The current review examines the evidence base for psychosocial interventions for adults with a history of ACEs. The review focuses on interventions that may be provided in primary care, as that is the setting where most patients will first present and are most likely to receive treatment. A systematic review of the literature was completed using PsycInfo and PubMed databases, with 99 studies identified that met inclusion and exclusion criteria. These studies evaluated a range of interventions with varying levels of supportive evidence. Overall, cognitive-behavioral therapies (CBT) have the most evidence for improving health problems - in particular, improving mental health and reducing health-risk behaviors - in adults with a history of ACEs. Expressive writing and mindfulness-based therapies also show promise, whereas other treatments have less supportive evidence. Limitations of the current literature base are discussed and research directions for the field are provided. PMID:27179348

  10. A review of primary care interventions to improve health outcomes in adult survivors of adverse childhood experiences.

    PubMed

    Korotana, Laurel M; Dobson, Keith S; Pusch, Dennis; Josephson, Trevor

    2016-06-01

    Research has consistently demonstrated a link between the experience of adverse childhood experiences (ACEs) and adult health conditions, including mental and physical health problems. While a focus on the prevention or mitigation of adversity in childhood is an important direction of many programs, many individuals do not access support services until adulthood, when health problems may be fairly engrained. It is not clear which interventions have the strongest evidence base to support the many adults who present to services with a history of ACEs. The current review examines the evidence base for psychosocial interventions for adults with a history of ACEs. The review focuses on interventions that may be provided in primary care, as that is the setting where most patients will first present and are most likely to receive treatment. A systematic review of the literature was completed using PsycInfo and PubMed databases, with 99 studies identified that met inclusion and exclusion criteria. These studies evaluated a range of interventions with varying levels of supportive evidence. Overall, cognitive-behavioral therapies (CBT) have the most evidence for improving health problems - in particular, improving mental health and reducing health-risk behaviors - in adults with a history of ACEs. Expressive writing and mindfulness-based therapies also show promise, whereas other treatments have less supportive evidence. Limitations of the current literature base are discussed and research directions for the field are provided.

  11. The WHO-DAS II: Measuring Outcomes of Hearing Aid Intervention for Adults

    PubMed Central

    McArdle, Rachel; Chisolm, Theresa H.; Abrams, Harvey B.; Wilson, Richard H.; Doyle, Patrick J.

    2005-01-01

    The World Health Organization's Disability Assessment Scale II (WHO-DAS II) is a generic health-status instrument that provides six domain scores and a total, aggregate score. Two of the domain scores, communication and participation, and the total score, have good validity, internal-consistency reliability, and test-retest stability in individuals with adult-onset hearing loss. As such, these two domain scores and the total WHO-DAS II score may be useful as generic outcome measures to assess the effectiveness of hearing aid intervention for this population. Before the use of the WHO-DAS II in hearing aid clinical trials, however, the responsiveness of the instrument and the short- and long-term outcomes to hearing aid intervention had to be determined. Responsiveness and outcomes were assessed in 380 veterans (approximately half received hearing aids and half served as controls) by examining group differences, effect-size estimates, and individual differences as a function of hearing aid intervention. For comparison, data also were obtained on two disease-specific measures, the APHAB and the HHIE. The WHO-DAS II communication domain and total scores were sufficiently responsive to hearing aid intervention for use in future studies in which group differences are to be detected. The WHO-DAS II participation domain was not sufficiently responsive to hearing aid intervention. The APHAB and HHIE, both disease-specific measures, were more sensitive to hearing aid intervention than the generic measure. The short- and long-term outcomes of hearing aid intervention were also examined in the present study. Group outcomes for hearing aid intervention can be expected to be stable for at least 6 months when measured by WHO-DAS II total score and for at least 12 months when measured by the WHO-DAS II communication domain scores. Effect-size estimates and examination of the number of individuals exhibiting change scores exceeding 90% critical differences for true changes in

  12. Time well spent: the duration of foster care and early adult labor market, educational, and health outcomes.

    PubMed

    Fallesen, Peter

    2013-12-01

    Individuals who spent time in foster care as children fare on average worse than non-placed peers in early adult life. Recent research on the effect of foster care placement on early adult life outcomes provides mixed evidence. Some studies suggest negative effects of foster care placement on early adult outcomes, others find null effects. This study shows that differences in the average duration of foster care stays explain parts of these discordant findings and then test how foster care duration shapes later life outcomes using administrative data on 7220 children. The children experienced different average durations of foster care because of differences in exposure to a reform. Later born cohorts spent on average 3 months longer in foster care than earlier born cohorts. Isolating exogenous variation in duration of foster care, the study finds positive effects of increased duration of foster care on income and labor market participation. PMID:24215947

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

    PubMed Central

    Maindal, Helle Terkildsen

    2014-01-01

    Objectives In Denmark, the local and regional health authorities share responsibility for cardiac rehabilitation (CR). The objective was to assess effectiveness of CR across sectors coordinated by a nurse case manager (NCM). Design A one-year follow-up study. Setting A CR programme (GoHeart) was evaluated in a cohort at Lillebaelt Hospital Vejle, DK from 2010 to 2011. Participants Consecutive patients admitted to CR were included. The inclusion criteria were the event of acute myocardial infarction or stable angina and invasive revascularization (left ventricular ejection fraction (LVEF) ≥45%). Main outcome measures Cardiac risk factors, stratified self-care and self-reported psychosocial factors (SF12 and Hospital Anxiety and Depression Scale (HADS)) were assessed at admission (phase IIa), at three months at discharge (phase IIb) and at one-year follow-up (phase III). Intention-to-treat and predefined subgroup analysis on sex was performed. Results Of 241 patients, 183 (75.9%) were included (mean age 63.8 years). At discharge improvements were found in total-cholesterol (p < 0.001), low density lipoprotein (LDL; p < 0.001), functional capacities (metabolic equivalent of tasks (METS), p < 0.01), self-care management (p < 0.001), Health status Short Form 12 version (SF12; physical; p < 0.001 and mental; p < 0.01) and in depression symptoms (p < 0.01). At one-year follow-up these outcomes were maintained; additionally there was improvement in body mass index (BMI; p < 0.05), and high density lipoprotein (HDL; p < 0.05). There were no sex differences. Conclusion CR shared between local and regional health authorities led by a NCM (GoHeart) improves risk factors, self-care and psychosocial factors. Further improvements in most variables were at one-year follow-up. PMID:25396055

  14. Psychosocial impact of cystic fibrosis in adolescence.

    PubMed

    Harrop, Michele

    2007-12-01

    Over 8,000 children, young people and adults in the UK are affected by cystic fibrosis and although no cure exists, comprehensive therapy started early and administered consistently delays disease progression. This article explores three aspects of the psychosocial effects of cystic fibrosis on the adolescent/young adult: the effect on the family, the effect on relationships and adherence to treatment. Much of the early research on the psychosocial impact of cystic fibrosis on the adolescent and the family presented a dismal picture of dysfunction. More recent studies indicate that cystic fibrosis patients generally lead active, age-appropriate social lives, that good information and support can reduce negative effects on families and that treatment regimes continue to cause difficulties for young people. Further research is needed into the psychosocial impact of cystic fibrosis on the increasing numbers of young people and adults with the disease.

  15. Psychodynamic psychotherapy with adolescents and young adults: Outcome in routine practice.

    PubMed

    Nemirovski Edlund, Julia; Carlberg, Gunnar

    2016-01-01

    This naturalistic study examined the outcome of psychodynamic psychotherapy with 218 adolescents and young adults aged 14-24 years. Analysis of variance showed significant improvement of general functioning on Children's Global Assessment Scale (CGAS) and Global Assessment of Functioning (GAF) and decreased symptom severity on Symptoms Checklist-90 (SCL-90) upon completion of psychotherapy, as well as a clinically significant improvement in a large percentage of cases. Effect sizes were equivalent to those evident in a clinical comparison group and larger than in prior research. The main limitation of this study was the lack of a control group, partially compensated for through the use of comparison groups and high external validity. The study seeks to fill a gap in an important yet overlooked field of research.

  16. Does aberrant membrane transport contribute to poor outcome in adult acute myeloid leukemia?

    PubMed Central

    Chigaev, Alexandre

    2015-01-01

    Acute myeloid leukemia in adults is a highly heterogeneous disease. Gene expression profiling performed using unsupervised algorithms can be used to distinguish specific groups of patients within a large patient cohort. The identified gene expression signatures can offer insights into underlying physiological mechanisms of disease pathogenesis. Here, the analysis of several related gene expression clusters associated with poor outcome, worst overall survival and highest rates of resistant disease and obtained from the patients at the time of diagnosis or from previously untreated individuals is presented. Surprisingly, these gene clusters appear to be enriched for genes corresponding to proteins involved in transport across membranes (transporters, carriers and channels). Several ideas describing the possible relationship of membrane transport activity and leukemic cell biology, including the “Warburg effect,” the specific role of chloride ion transport, direct “import” of metabolic energy through uptake of creatine phosphate, and modification of the bone marrow niche microenvironment are discussed. PMID:26191006

  17. Impact of Increasing Age on Outcomes of Spinal Fusion in Adult Idiopathic Scoliosis

    PubMed Central

    Verla, Terence; Adogwa, Owoicho; Toche, Ulysses; Farber, S. Harrison; Petraglia, Frank; Murphy, Kelly R.; Thomas, Steven; Fatemi, Parastou; Gottfried, Oren; Bagley, Carlos A.; Lad, Shivanand P.

    2016-01-01

    Objective To investigate the role of advancing age on postoperative complications and revision surgery after fusion for scoliosis. Methods A retrospective, cohort study was performed using the Thomson Reuters MarketScan database, examining patients with adult scoliosis who underwent spinal fusion from 2000 to 2009. Primary outcomes included infection, hemorrhage and pulmonary embolism (PE) within 90 days of surgery, and refusion. The effect of increasing age was estimated using the odds ratio (OR) of complications in a multivariate logistic regression analysis, and a Cox proportional hazard model estimated the hazard ratio of refusion. Results A total of 8432 patients were included in this study. Overall, the average age was 53.3 years, with 26.90% males and 39% with a Charlson Comorbidity Score of ≥1. Most patients had commercial insurance (66.81%), with 26.03% and 7.16% covered by Medicare and Medicaid, respectively. Increasing age (per 5-year increment) was a significant predictor of hemorrhagic complication (OR, 1.06; confidence interval [CI], 1.01–1.11; P = 0.0196), PE (OR, 1.09; CI, 1.03–1.16; P = 0.0031), infection (OR, 1.04; CI, 1.01–1.07; P = 0.0053), and refusion (hazard ratio, 1.07; CI, 1.02–1.13; P = 0.0103). Conclusions In this study, age was associated with increased risk of hemorrhage, PE, infection, and refusion. With the aging population, the role of patient age on postoperative healing and outcomes deserves deeper investigation after repair of adult idiopathic scoliosis. PMID:26546999

  18. Characterizing Objective Quality of Life and Normative Outcomes in Adults with Autism Spectrum Disorder: An Exploratory Latent Class Analysis.

    PubMed

    Bishop-Fitzpatrick, Lauren; Hong, Jinkuk; Smith, Leann E; Makuch, Renee A; Greenberg, Jan S; Mailick, Marsha R

    2016-08-01

    This study aims to extend the definition of quality of life (QoL) for adults with autism spectrum disorder (ASD, n = 180, ages 23-60) by: (1) characterizing the heterogeneity of normative outcomes (employment, independent living, social engagement) and objective QoL (physical health, neighborhood quality, family contact, mental health issues); and (2) identifying predictors of positive normative outcomes and good objective QoL. Findings of an exploratory latent class analysis identified three groups of adults with ASD-Greater Dependence, Good Physical and Mental Health, and Greater Independence. Findings indicate that better daily living skills, better executive function, and more maternal warmth are associated with assignment to better outcome groups. Findings have implications for interventions designed to enhance achievement of normative outcomes and objective QoL. PMID:27207091

  19. Characterizing Objective Quality of Life and Normative Outcomes in Adults with Autism Spectrum Disorder: An Exploratory Latent Class Analysis.

    PubMed

    Bishop-Fitzpatrick, Lauren; Hong, Jinkuk; Smith, Leann E; Makuch, Renee A; Greenberg, Jan S; Mailick, Marsha R

    2016-08-01

    This study aims to extend the definition of quality of life (QoL) for adults with autism spectrum disorder (ASD, n = 180, ages 23-60) by: (1) characterizing the heterogeneity of normative outcomes (employment, independent living, social engagement) and objective QoL (physical health, neighborhood quality, family contact, mental health issues); and (2) identifying predictors of positive normative outcomes and good objective QoL. Findings of an exploratory latent class analysis identified three groups of adults with ASD-Greater Dependence, Good Physical and Mental Health, and Greater Independence. Findings indicate that better daily living skills, better executive function, and more maternal warmth are associated with assignment to better outcome groups. Findings have implications for interventions designed to enhance achievement of normative outcomes and objective QoL.

  20. Outcomes of anti-bullying intervention for adults with intellectual disabilities.

    PubMed

    McGrath, Linda; Jones, Robert S P; Hastings, Richard P

    2010-01-01

    Although existing research is scarce, evidence suggests that children and adults with intellectual disabilities may be at increased risk of being bullied (as they are for maltreatment generally) and possibly more likely than those without disabilities to also engage in bullying behavior. Despite significant clinical interest in bullying, we could find no published research on the outcomes of bullying intervention for individuals with intellectual disabilities. Adults with intellectual disabilities in three work center settings participated in one of two interventions for perpetrators and/or victims of bullying: (a) psychoeducational intervention with a cognitive behavioral orientation (n=20), or (b) the same intervention but with additional involvement of community stakeholders such as parents, the police, and local schools (n=22). A third work center (n=18) acted as a waiting list control comparison. Pre-intervention, 43% of participants reported that they had been bullied within the preceding three months and 28% identified themselves as having bullied others. Reports of being bullied decreased significantly within the two intervention groups over time but not in the control group. There were no differences between the two intervention groups, and no statistically significant reduction in self-reported bullying behavior. Initial data on this intervention suggest that its effects might be clinically meaningful with an associated Numbers Needed to Treat for reduction in exposure to bullying of 5.55. PMID:19897338

  1. Diet Quality and Cancer Outcomes in Adults: A Systematic Review of Epidemiological Studies

    PubMed Central

    Potter, Jennifer; Brown, Leanne; Williams, Rebecca L.; Byles, Julie; Collins, Clare E.

    2016-01-01

    Dietary patterns influence cancer risk. However, systematic reviews have not evaluated relationships between a priori defined diet quality scores and adult cancer risk and mortality. The aims of this systematic review are to (1) describe diet quality scores used in cohort or cross-sectional research examining cancer outcomes; and (2) describe associations between diet quality scores and cancer risk and mortality. The protocol was registered in Prospero, and a systematic search using six electronic databases was conducted through to December 2014. Records were assessed for inclusion by two independent reviewers, and quality was evaluated using a validated tool. Sixty-four studies met inclusion criteria from which 55 different diet quality scores were identified. Of the 35 studies investigating diet quality and cancer risk, 60% (n = 21) found a positive relationship. Results suggest no relationship between diet quality scores and overall cancer risk. Inverse associations were found for diet quality scores and risk of postmenopausal breast, colorectal, head, and neck cancer. No consistent relationships between diet quality scores and cancer mortality were found. Diet quality appears to be related to site-specific adult cancer risk. The relationship with cancer mortality is less conclusive, suggesting additional factors impact overall cancer survival. Development of a cancer-specific diet quality score for application in prospective epidemiology and in public health is warranted. PMID:27399671

  2. Comparable outcomes between autologous and allogeneic transplant for adult acute myeloid leukemia in first CR.

    PubMed

    Mizutani, M; Hara, M; Fujita, H; Aoki, J; Kanamori, H; Ohashi, K; Usuki, K; Fukuda, T; Chou, T; Tanaka, J; Atsuta, Y; Takami, A

    2016-05-01

    Although allogeneic hematopoietic stem cell transplantation from an HLA-matched sibling donor (MSD) is a potentially curative post-remission treatment for adults with acute myeloid leukemia (AML) in their first CR, transplant-related morbidity and mortality remains a major drawback. We retrospectively compared the outcomes of patients who underwent autologous peripheral blood stem cell transplantation (auto-PBSCT; n=375) with those who underwent allogeneic bone marrow transplantation (allo-BMT; n=521) and allo-PBSCT (n=380) from MSDs for adults with AML/CR1, in which propensity score models were used to adjust selection biases among patients, primary physicians and institutions to overcome ambiguity in the patients' background information. Both the multivariate analysis and propensity score models indicated that the leukemia-free survival rate of auto-PBSCT was not significantly different from that of allo-BMT (hazard ratio (HR), 1.23; 95% confidence interval (CI), 0.92 to 1.66; P=0.16) and allo-PBSCT (HR, 1.13; 95% CI, 0.85-1.51; P=0.40). The current results suggest that auto-PBSCT remains a promising alternative treatment for patients with AML/CR1 in the absence of an available MSD. PMID:26808566

  3. Functional outcomes of adults with 22q11.2 deletion syndrome

    PubMed Central

    Butcher, Nancy J.; Chow, Eva W.C.; Costain, Gregory; Karas, Dominique; Ho, Andrew; Bassett, Anne S.

    2012-01-01

    Purpose The 22q11.2 deletion syndrome is a common multisystem genomic disorder with congenital and later-onset manifestations, including congenital heart disease, intellectual disability, and psychiatric illness, that may affect long-term functioning. There are limited data on adult functioning in 22q11.2 deletion syndrome. Methods We used the Vineland Adaptive Behavior Scales to assess functioning in 100 adults with 22q11.2 deletion syndrome (n = 46 male; mean age = 28.8 (standard deviation = 9.7) years) where intellect ranged from average to borderline (n = 57) to mild intellectual disability (n = 43). Results More than 75% of the subjects scored in the functional deficit range. Although personal, vocational, and financial demographics confirmed widespread functional impairment, daily living skills and employment were relative strengths. Intelligence quotient was a significant predictor (P < 0.001) of overall and domain-specific adaptive functioning skills. A diagnosis of schizophrenia was a significant predictor (P < 0.05) of overall adaptive functioning, daily living skills, and socialization scores. Notably, congenital heart disease, history of mood/anxiety disorders, sex, and age were not significant predictors of functioning. Conclusion Despite functional impairment in adulthood that is primarily mediated by cognitive and psychiatric phenotypes, relative strengths in activities of daily living and employment have important implications for services and long-term planning. These results may help to inform expectations about outcomes for patients with 22q11.2 deletion syndrome. PMID:22744446

  4. The association between exposure to violence, alcohol, and drugs and psychosocial and behavioral outcomes among Mexican-American adolescents of low socioeconomic status.

    PubMed

    Peinado, Jesus; Theresa Villanos, Maria; Singh, Namrata; Leiner, Marie

    2014-01-01

    The objective of this study was to investigate the association exposure to violence, drugs and alcohol has in shaping the psychosocial and behavioral profiles of Mexican American adolescents of low socioeconomic status. A cross-sectional study was conducted in which 881 Mexican-American adolescents described their exposure to violence, drugs, and alcohol, while their parents responded to a questionnaire about their children’'s behavioral, emotional, and social problems. Participant information was extracted from electronic record databases maintained in six university-based clinics in El Paso, Texas on the U.S. side of the border with Mexico. A total of 463 (52.6%) adolescents reported they had not been exposed to violence, alcohol, or drugs. The remaining 418 (47.4%) adolescents indicated only a single category of exposure: violence (25.1%), alcohol (24.9%), or drugs (8.6%). In addition, some adolescents reported combined exposure to violence and alcohol (13.4%), alcohol and drugs (14.6%), or violence, alcohol, and drugs (13.4%). The association between combined exposure to violence, drugs, and/or alcohol and the psychosocial and behavioral profiles of these Mexican-American adolescents showed an increased risk of emotional and behavioral problems. Little is known about the mental health of Mexican Americans who are exposed to alcohol, violence, and drugs, especially adolescents living in poverty in neighborhoods along the U.S.-Mexico border, who are at a high risk for these exposures. These findings highlight the risks associated with adolescent exposure to violence, drugs, and alcohol and the need for effective interventions within this subgroup of Mexican-American youth and their families. PMID:24652396

  5. Hypocellular acute myeloid leukemia in adults: analysis of the clinical outcome of 123 patients

    PubMed Central

    Al-Kali, Aref; Konoplev, Sergej; Lin, Erpei; Kadia, Tapan; Faderl, Stefan; Ravandi, Farhad; Ayoubi, Mohamad; Brandt, Mark; Cortes, Jorge E.; Kantarjian, Hagop; Borthakur, Gautam

    2012-01-01

    Background The hypocellular variant of acute myeloid leukemia accounts for less than 10% of all cases of adult acute myeloid leukemia. It is defined by having less than 20 percent of cellular bone marrow in a biopsy at presentation. It is unclear in the literature whether the outcome of hypocellular acute myeloid leukemia differs from that of non-hypocellular acute myeloid leukemia. Design and Methods We retrospectively analyzed all the cases reported to be hypocellular acute myeloid leukemia between 2000 and 2009. A second pathology review was conducted and the diagnosis was confirmed in all cases. Results One hundred twenty-three (9%) patients were identified: patients with hypocellular acute myeloid leukemia were older than those with non-hypocellular acute myeloid leukemia (P=0.009) and more frequently presented with cytopenias (P<0.001). Forty-one patients with hypocellular acute myeloid leukemia had an antecedent hematologic disorder and 11 patients had received prior chemo-radiotherapy for non-hematopoietic neoplasms. On multivariate analysis, overall survival, remission duration and event-free survival were comparable to those of other patients with acute myeloid leukemia. Conclusions The outcome of hypocellular acute myeloid leukemia does not differ from that of non-hypocellular acute myeloid leukemia. PMID:22058194

  6. Oncogenetics and minimal residual disease are independent outcome predictors in adult patients with acute lymphoblastic leukemia.

    PubMed

    Beldjord, Kheira; Chevret, Sylvie; Asnafi, Vahid; Huguet, Françoise; Boulland, Marie-Laure; Leguay, Thibaut; Thomas, Xavier; Cayuela, Jean-Michel; Grardel, Nathalie; Chalandon, Yves; Boissel, Nicolas; Schaefer, Beat; Delabesse, Eric; Cavé, Hélène; Chevallier, Patrice; Buzyn, Agnès; Fest, Thierry; Reman, Oumedaly; Vernant, Jean-Paul; Lhéritier, Véronique; Béné, Marie C; Lafage, Marina; Macintyre, Elizabeth; Ifrah, Norbert; Dombret, Hervé

    2014-06-12

    With intensified pediatric-like therapy and genetic disease dissection, the field of adult acute lymphoblastic leukemia (ALL) has evolved recently. In this new context, we aimed to reassess the value of conventional risk factors with regard to new genetic alterations and early response to therapy, as assessed by immunoglobulin/T-cell receptor minimal residual disease (MRD) levels. The study was performed in 423 younger adults with Philadelphia chromosome-negative ALL in first remission (265 B-cell precursor [BCP] and 158 T-cell ALL), with cumulative incidence of relapse (CIR) as the primary end point. In addition to conventional risk factors, the most frequent currently available genetic alterations were included in the analysis. A higher specific hazard of relapse was independently associated with postinduction MRD level ≥10(-4) and unfavorable genetic characteristics (ie, MLL gene rearrangement or focal IKZF1 gene deletion in BCP-ALL and no NOTCH1/FBXW7 mutation and/or N/K-RAS mutation and/or PTEN gene alteration in T-cell ALL). These 2 factors allowed definition of a new risk classification that is strongly associated with higher CIR and shorter relapse-free and overall survival. These results indicate that genetic abnormalities are important predictors of outcome in adult ALL not fully recapitulated by early response to therapy. Patients included in this study were treated in the multicenter GRAALL-2003 and GRAALL-2005 trials. Both trials were registered at http://www.clinicaltrials.gov as #NCT00222027 and #NCT00327678, respectively. PMID:24740809

  7. Oncogenetics and minimal residual disease are independent outcome predictors in adult patients with acute lymphoblastic leukemia.

    PubMed

    Beldjord, Kheira; Chevret, Sylvie; Asnafi, Vahid; Huguet, Françoise; Boulland, Marie-Laure; Leguay, Thibaut; Thomas, Xavier; Cayuela, Jean-Michel; Grardel, Nathalie; Chalandon, Yves; Boissel, Nicolas; Schaefer, Beat; Delabesse, Eric; Cavé, Hélène; Chevallier, Patrice; Buzyn, Agnès; Fest, Thierry; Reman, Oumedaly; Vernant, Jean-Paul; Lhéritier, Véronique; Béné, Marie C; Lafage, Marina; Macintyre, Elizabeth; Ifrah, Norbert; Dombret, Hervé

    2014-06-12

    With intensified pediatric-like therapy and genetic disease dissection, the field of adult acute lymphoblastic leukemia (ALL) has evolved recently. In this new context, we aimed to reassess the value of conventional risk factors with regard to new genetic alterations and early response to therapy, as assessed by immunoglobulin/T-cell receptor minimal residual disease (MRD) levels. The study was performed in 423 younger adults with Philadelphia chromosome-negative ALL in first remission (265 B-cell precursor [BCP] and 158 T-cell ALL), with cumulative incidence of relapse (CIR) as the primary end point. In addition to conventional risk factors, the most frequent currently available genetic alterations were included in the analysis. A higher specific hazard of relapse was independently associated with postinduction MRD level ≥10(-4) and unfavorable genetic characteristics (ie, MLL gene rearrangement or focal IKZF1 gene deletion in BCP-ALL and no NOTCH1/FBXW7 mutation and/or N/K-RAS mutation and/or PTEN gene alteration in T-cell ALL). These 2 factors allowed definition of a new risk classification that is strongly associated with higher CIR and shorter relapse-free and overall survival. These results indicate that genetic abnormalities are important predictors of outcome in adult ALL not fully recapitulated by early response to therapy. Patients included in this study were treated in the multicenter GRAALL-2003 and GRAALL-2005 trials. Both trials were registered at http://www.clinicaltrials.gov as #NCT00222027 and #NCT00327678, respectively.

  8. Renal outcome in adults with renal insufficiency and irregular asymmetric kidneys

    PubMed Central

    Neild, Guy H; Thomson, Gill; Nitsch, Dorothea; Woolfson, Robin G; Connolly, John O; Woodhouse, Christopher RJ

    2004-01-01

    Background The commonest cause of end-stage renal failure (ESRF) in children and young adults is congenital malformation of the kidney and urinary tract. In this retrospective review, we examine whether progression to ESRF can be predicted and whether treatment with angiotensin converting enzyme inhibitors (ACEI) can delay or prevent this. Methods We reviewed 78 patients with asymmetric irregular kidneys as a consequence of either primary vesico-ureteric reflux or renal dysplasia (Group 1, n = 44), or abnormal bladder function (Group 2, n = 34). Patients (median age 24 years) had an estimated GFR (eGFR) < 60 ml/min/1.73 m2 with at least 5 years of follow up (median 143 months). 48 patients received ACEI. We explored potential prognostic factors that affect the time to ESRF using Cox-regression analyses. Results At start, mean (SE) creatinine was 189 (8) μmol/l, mean eGFR 41 (1) ml/min 1.73 m2, mean proteinuria 144 (14) mg/mmol creatinine (1.7 g/24 hrs). Of 78 patients, 36 (46%) developed ESRF, but none of 19 with proteinuria less than 50 mg/mmol and only two of 18 patients with eGFR above 50 ml/min did so. Renal outcome between Groups 1 and 2 appeared similar with no evidence for a difference. A benefit in favour of treatment with ACEI was observed above an eGFR of 40 ml/min (p = 0.024). Conclusion The similar outcome of the two groups supports the nephrological nature of progressive renal failure in young men born with abnormal bladders. There is a watershed GFR of 40–50 ml/min at which ACEI treatment can be successful at improving renal outcome. PMID:15462683

  9. Impact of hydrocortisone hemisuccinate use on outcome of severe scorpion-envenomed adult patients.

    PubMed

    Bahloul, Mabrouk; Chaari, Anis; Dammak, Hassen; Ben Algia, Najla; Medhioub, Fatma; Ben Hamida, Chokri; Chelly, Hedi; Bouaziz, Mounir

    2014-01-01

    The aim of this study is to analyze if the infusion of hydrocortisone hemisuccinate improve outcome in severe scorpion-envenomated adult patients admitted to intensive care unit (ICU). Pairwise retrospective case-control study with 1:1 matching was designed. Patients were defined as cases when they received hydrocortisone hemisuccinate (as alone steroids) during hospitalization and as controls when they did not received any steroids. Patients were matched according to age, severity factors at admission represented by the presence of pulmonary edema and grades of severity of scorpion envenomation, and scorpion antivenom administration. Eighty-four patients were included as follows: 42 patients in the cases group and 42 patients in the control group. The mean age (±SD) was 40±21 years, ranging from 16 to 90 years. Moreover, 67 (80%) patients have a systemic inflammatory response syndrome on ICU admission. The comparison between cases group and control group showed that age is not significantly different. There were the same proportions of patients with pulmonary edema in 2 groups. Moreover, 23 (54%) patients in case group and 23 (54%) in the control group received scorpion antivenom (P>0.05). The mean temperature on admission was also not significantly different. The presence of systemic inflammatory response syndrome was again not significantly different between 2 groups. The comparison of outcome of the 2 groups showed that the use of mechanical ventilation and its duration, the ICU stay length, and ICU mortality was not significantly different between the 2 groups. Although our study has some limitations, it confirms that the use of hydrocortisone hemisuccinate in severe scorpion-envenomed patients did not improve their outcome. PMID:23584312

  10. Outcomes of a community-based lifestyle programme for adults with diabetes or pre-diabetes.

    PubMed

    Higgs, Chris; Skinner, Margot; Hale, Leigh

    2016-06-01

    INTRODUCTION Diabetes, a long-term condition increasing in prevalence, requires ongoing healthcare management. Exercise alongside lifestyle education and support is effective for diabetes management. AIM To investigate clinical outcomes and acceptability of a community-based lifestyle programme for adults with diabetes/prediabetes at programme completion and 3-month follow-up. METHODS The 12-week community programme included twice-weekly sessions of self-management education and exercise, supervised by a physiotherapist, physiotherapy students and a nurse. Clinical outcomes assessed were cardiorespiratory fitness, waist circumference, exercise behaviour and self-efficacy. A standardised evaluation form was used to assess programme acceptability. RESULTS Clinically significant improvements were found from baseline (n = 36) to programme completion (n = 25) and 3-months follow-up (n = 20) for the six minute walk test (87 m (95%CI 65-109; p ≤ 0.01), 60 m (95%CI 21-100; p ≤ 0.01)), waist circumference (-3 cm (95%CI -6 to -1), -3 cm (95%CI -6 to 1)), exercise behaviour (aerobic exercise 53 min/week (95%CI 26 to 81; p ≤ 0.01), 71 min/week (95%CI 25 to 118; p ≤ 0.01)) and self-efficacy (0.7 (95%CI -0.2 to 1.6), 0.8 (95%CI 0.04 to 1.5)). Good programme acceptability was demonstrated by themes suggesting a culturally supportive, motivating, friendly, informative atmosphere within the programme. The attrition rate was 30% but there were no adverse medical events related to the programme. DISCUSSION The programme was safe and culturally acceptable and outcomes demonstrated clinical benefit to participants. The attrition rate was largely due to medical reasons unrelated to the programme. This model of a community-based lifestyle programme has the potential to be reproduced in other regions and in adults with similar long-term conditions. KEYWORDS Diabetes Mellitus Type II; Prediabetic state; Co-morbidity; Exercise; Self-management.

  11. Outcomes of a community-based lifestyle programme for adults with diabetes or pre-diabetes.

    PubMed

    Higgs, Chris; Skinner, Margot; Hale, Leigh

    2016-06-01

    INTRODUCTION Diabetes, a long-term condition increasing in prevalence, requires ongoing healthcare management. Exercise alongside lifestyle education and support is effective for diabetes management. AIM To investigate clinical outcomes and acceptability of a community-based lifestyle programme for adults with diabetes/prediabetes at programme completion and 3-month follow-up. METHODS The 12-week community programme included twice-weekly sessions of self-management education and exercise, supervised by a physiotherapist, physiotherapy students and a nurse. Clinical outcomes assessed were cardiorespiratory fitness, waist circumference, exercise behaviour and self-efficacy. A standardised evaluation form was used to assess programme acceptability. RESULTS Clinically significant improvements were found from baseline (n = 36) to programme completion (n = 25) and 3-months follow-up (n = 20) for the six minute walk test (87 m (95%CI 65-109; p ≤ 0.01), 60 m (95%CI 21-100; p ≤ 0.01)), waist circumference (-3 cm (95%CI -6 to -1), -3 cm (95%CI -6 to 1)), exercise behaviour (aerobic exercise 53 min/week (95%CI 26 to 81; p ≤ 0.01), 71 min/week (95%CI 25 to 118; p ≤ 0.01)) and self-efficacy (0.7 (95%CI -0.2 to 1.6), 0.8 (95%CI 0.04 to 1.5)). Good programme acceptability was demonstrated by themes suggesting a culturally supportive, motivating, friendly, informative atmosphere within the programme. The attrition rate was 30% but there were no adverse medical events related to the programme. DISCUSSION The programme was safe and culturally acceptable and outcomes demonstrated clinical benefit to participants. The attrition rate was largely due to medical reasons unrelated to the programme. This model of a community-based lifestyle programme has the potential to be reproduced in other regions and in adults with similar long-term conditions. KEYWORDS Diabetes Mellitus Type II; Prediabetic state; Co-morbidity; Exercise; Self-management. PMID:27477555

  12. Developmental Perspectives on Optimizing Educational and Vocational Outcomes in Child and Adult Survivors of Cancer

    ERIC Educational Resources Information Center

    Rey-Casserly, Celiane; Meadows, Mary Ellen

    2008-01-01

    Over the last few decades, long-term survival rates of children diagnosed with the two most common forms of childhood cancer, acute lymphoblastic leukemia (ALL) and brain tumors have improved substantially. Neurodevelopmental and psychosocial sequelae resulting from these diseases and their treatment have a direct impact on the developing brain…

  13. The Psychosocial Problems of Cancer Patients: A Prospective Study.

    ERIC Educational Resources Information Center

    Gordon, Wayne; And Others

    The course of psychosocial adjustment to cancer was examined in 105 adults with cancer of the lung, breast and skin. Half of the patients received a program of systematic psychosocial rehabilitation plus evaluation, and the other half received only an evaluation, consisting of a series of psychometric instruments and a problem-oriented structured…

  14. Psychobiology and psychosocial functioning of schizoaffective disorder.

    PubMed

    Correll, Christoph U

    2011-02-01

    Data from neurobiologic and psychosocial outcomes research suggest that, phenomenologically, clinically, and neurobiologically, patients with schizoaffective disorder occupy an intermediate position between more severely disturbed schizophrenia patients and similarly or less severely impaired affective disorder patients. Some biologic-genetic abnormalities are shared between these disorders, while other abnormalities are specific to particular symptoms. Premorbid functioning, especially in academic areas, is better in patients with schizoaffective disorder than in those with schizophrenia, but negative symptoms and cognitive deficits are influential and should be addressed to improve psychosocial outcomes.

  15. [Early outcomes of Asperger's syndrome].

    PubMed

    Bobrov, A E; Somova, V M

    2013-01-01

    Mental state of adult patients, who since childhood had features of Asperger's syndrome (AS), was studied. We examined 107 patients (89 men and 18 women). At the moment of inclusion in the study, all the patients met criteria of ICD=10 for AS. This was confirmed by the examination of the patients with the help of ASDASQ and ASDI scales. Based on the results of psychopathological and psychological five variants of AS outcomes in the age of early adulthood were identified as follows: integrated, inhibitory, peculiar, border-line and hypernormative. At the moment of examination, psychosocial compensation was observed in 38% of patients, only 28% of patients were on treatment and 20% had a history of transitory psychotic episodes. The authors conclude that the results of the study suggest the relatively favorable prognosis of AS. The differential clinical evaluation of this group as well as implication of adequate psychosocial and psychotherapeutic methods in their treatment is needed.

  16. Self-Efficacy for Refusal Mediated by Outcome Expectancies in the Prediction of Alcohol-Dependence amongst Young Adults.

    ERIC Educational Resources Information Center

    Williams, Robert J.; Connor, Jason P.; Ricciardelli, Lina A.

    1998-01-01

    Examines the relative importance of outcome expectancies and self-efficacy in the production of alcohol dependence and alcohol consumption in a sample of young adult drinkers drawn from a milieu previously reported as supportive of risky drinking. Results suggest that heavy drinking women are particularly at risk of developing drinking-related…

  17. Characterizing Objective Quality of Life and Normative Outcomes in Adults with Autism Spectrum Disorder: An Exploratory Latent Class Analysis

    ERIC Educational Resources Information Center

    Bishop-Fitzpatrick, Lauren; Hong, Jinkuk; Smith, Leann E.; Makuch, Renee A.; Greenberg, Jan S.; Mailick, Marsha R.

    2016-01-01

    This study aims to extend the definition of quality of life (QoL) for adults with autism spectrum disorder (ASD, n = 180, ages 23-60) by: (1) characterizing the heterogeneity of normative outcomes (employment, independent living, social engagement) and objective QoL (physical health, neighborhood quality, family contact, mental health issues); and…

  18. Outcomes of a New Residential Scheme for Adults with Intellectual Disabilities in Taiwan: A 2-Year Follow-Up

    ERIC Educational Resources Information Center

    Chou, Y-C.; Pu, C.; Kroger, T.; Lee, W.; Chang, S.

    2011-01-01

    Background: The Taiwanese government launched a new programme in November 2004 to support adults with intellectual disabilities living in smaller facilities. This paper aims to evaluate the service outcomes of this new residential scheme over 2 years including those residents who moved from an institution and those who moved from their family.…

  19. Long-Term Impact of Parental Well-Being on Adult Outcomes and Dementia Status in Individuals with Down Syndrome

    ERIC Educational Resources Information Center

    Esbensen, Anna J.; Mailick, Marsha R.; Silverman, Wayne

    2013-01-01

    Parental characteristics were significant predictors of health, functional abilities, and behavior problems in adults with Down syndrome ("n" ?=? 75) over a 22-year time span, controlling for initial levels and earlier changes in these outcomes. Lower levels of behavior problems were predicted by improvements in maternal depressive…

  20. Adult Outcomes as a Function of an Early Childhood Educational Program: An Abecedarian Project Follow-Up

    ERIC Educational Resources Information Center

    Campbell, Frances A.; Pungello, Elizabeth P.; Burchinal, Margaret; Kainz, Kirsten; Pan, Yi; Wasik, Barbara H.; Barbarin, Oscar A.; Sparling, Joseph J.; Ramey, Craig T.

    2012-01-01

    Adult (age 30) educational, economic, and social-emotional adjustment outcomes were investigated for participants in the Abecedarian Project, a randomized controlled trial of early childhood education for children from low-income families. Of the original 111 infants enrolled (98% African American), 101 took part in the age 30 follow-up. Primary…

  1. Food- and Nonfood-Related Differential Outcomes in Equivalence Learning by Adults with Prader-Willi Syndrome.

    ERIC Educational Resources Information Center

    Joseph, Beth; And Others

    1997-01-01

    Five adults with Prader-Willi syndrome (characterized by short stature, learning difficulties, incomplete sexual development, and uncontrollable eating) learned the conditional relations necessary for the formation of two equivalence classes under differential/nondifferential and edible/nonedible outcomes. Performance on test trials was better…

  2. Associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults

    PubMed Central

    Makino, Keitaro; Ihira, Hikaru; Mizumoto, Atsushi; Shimizu, Kotaro; Ishida, Toyoaki; Furuna, Taketo

    2015-01-01

    [Purpose] The purpose of this study was to examine the associations between the settings of exercise habits and health-related outcomes in community-dwelling older adults. [Subjects] A total of 304 Japanese community-dwelling older adults (70.3 ± 4.1 years; 113 males and 191 females) participated in this study. [Methods] Demographic characteristics, medical conditions, exercise habits, and health-related outcomes were assessed by face-to-face interviews and self-reported questionnaires. Older adults who had exercise habits were classified into two groups: individual- and group-based exercise habits groups, and the health-related outcomes were compared between groups. [Results] The scores for the Geriatric Depression Scale, exercise self-efficacy, and dietary variety of older adults who had group-based exercise habits were better than those of older adults who had individual-based exercise habits. In addition, the exercise settings (individual- and group-based) were significantly associated with scores for the Geriatric Depression Scale (odds ratio = 0.76) and exercise self-efficacy (odds ratio = 1.26), even after adjusting for age and gender. [Conclusion] These results implied that habitual exercise in group settings may have an effective role in promoting exercise self-efficacy and mental health. PMID:26311955

  3. Dietary Patterns and Relationship to Obesity-Related Health Outcomes and Mortality in Adults 75 Years of Age or Greater

    PubMed Central

    Hsiao, P.Y.; Mitchell, D.C.; Coffman, D.L.; Wood, G. Craig; Hartman, T.J.; Still, C.; Jensen, G.L.

    2015-01-01

    Background The prevalence of obesity-related adverse health outcomes is increasing among older adults. Because it is thought that nutrition plays an important role in successful aging, there has been considerable interest in the association between dietary patterns of older adults and obesity-related health outcomes. Objective This study examined the association between dietary patterns and mortality and prevalence of obesity-related health outcomes, namely cardiovascular disease (CVD), type 2 diabetes mellitus, hypertension, and metabolic syndrome (MetSyn), over a 5-year follow-up period in adults aged 75 years or greater. Design A longitudinal observational study with cross-sectional dietary assessment. Setting Rural Central Pennsylvania. Participants Community-dwelling older adults (N = 449; 76.5 years old; 57% female). Measurements Multiple, unannounced, 24-hour dietary recalls were used to collect dietary intake. Cluster analysis was used to derive dietary patterns. Prevalence of CVD, diabetes mellitus, hypertension, and MetSyn was extracted from outpatient electronic medical records. Logistic regression was used to examine the associations between dietary patterns and health outcomes and mortality. Results ‘Sweets and Dairy’, ‘Health-Conscious’ and ‘Western’ dietary patterns were identified. Compared to the ‘Health-Conscious’ pattern, those in the ‘Sweets and Dairy’ pattern had increased odds of hypertension over the follow-up period; adjusted odds ratio (95% CI) was 2.18 (1.11-4.30). No significant associations were found for CVD, diabetes mellitus, MetSyn or mortality with dietary patterns. Conclusions These findings support the potential value of healthy dietary patterns in the management of hypertension in older adults. We did not observe any other strong associations between dietary patterns and health outcomes or mortality in persons ≥ 75 years of age; thus failing to support the use of overly restrictive diet prescriptions for

  4. Assessment of adult hip dysplasia and the outcome of surgical treatment.

    PubMed

    Troelsen, Anders

    2012-06-01

    rapid ultrasound examination performed by an experienced examiner can potentially alter the traditional diagnostic algorithm in which magnetic resonance arthrography remains the gold standard. PERIACETABULAR OSTEOTOMY FOR SURGICAL TREATMENT OF HIP DYSPLASIA IN ADULTS: Encouraging hip joint survival and clinical outcome were reported at medium-term follow-up after periacetabular osteotomy. The small number of studies reporting the outcome beyond a 5-year follow-up is in contrast to the wide application of the periacetabular osteotomy. The performed analysis of predictors of conversion to total hip replacement following periacetabular osteotomy documented the importance of different biomechanical and degenerative factors. Knowledge about factors predicting early conversion to total hip replacement has the potential to refine patient selection and to improve treatment by periacetabular osteotomy. Cartilage thickness was documented to be preserved up to 2,5 years after periacetabular osteotomy. All but 1 hip joint had acetabular labral tears, thus indicating that the presence of labral tears does not accelerate cartilage degeneration after periacetabular osteotomy. PMID:22677250

  5. Comorbidities and factors associated with endoscopic surgical outcomes in adult laryngotracheal stenosis.

    PubMed

    Kocdor, Pelin; Siegel, Eric R; Suen, James Y; Richter, Gresham; Tulunay-Ugur, Ozlem E

    2016-02-01

    This study which is a retrospective chart review aims to characterize the comorbidities associated with adult laryngotracheal stenosis and evaluate the relationship of these with stenosis grade, length, surgical interventions, and surgical intervals. Patients' demographics, medical and surgical comorbidities, grade of stenosis, quantity and degree of balloon dilations, dilation intervals, open airway procedures, and tracheotomy status were recorded from 2002 to 2012, at a tertiary voice and airway center. Surgical outcomes were evaluated in relation to patient comorbidities, stenosis quality, and surgical procedures. A total of 101 patients with laryngotracheal stenosis were examined with female patients comprising 71 % of the population. Seventeen patients (16.8 %) had idiopathic stenosis. Number of balloon dilations ranged from 0 to 24 (mean = 3.3). The average time between dilations was 38.4 weeks (range = 1.14-215.8 weeks). The patients with idiopathic stenosis were found to have a lower grade (p = 0.0066). Fifty-two patients (51.5 %) received a tracheotomy at one point during their management. The 14 patients (13.9 %) who remained tracheotomy dependent had a body mass index (BMI) of >30. No statistically significant correlation was found when the patients' age, BMI and comorbidites were compared with the grade of stenosis, number of balloon dilatations needed and other surgical interventions. On the other hand, interval in between surgeries was found to be longer in patients without an intubation history, and in idiopathic SGS (p = 0.004, p = 0.015, respectively). There was no significant relationship between surgical interval and gender, BMI, length of stenosis, grade (p = 0.059, p = 0.47, p = 0.97, p = 0.36, respectively). Airway stenosis in adults is complicated by the presence of multiple comorbidities. Better understanding of the etiology could aid in the prevention of the injury before it forms.

  6. Digestive physiological outcomes related to polydextrose and soluble maize fibre consumption by healthy adult men.

    PubMed

    Boler, Brittany M Vester; Serao, Mariana C Rossoni; Bauer, Laura L; Staeger, Michael A; Boileau, Thomas W; Swanson, Kelly S; Fahey, George C

    2011-12-01

    The objective of the present study was to evaluate digestive physiological outcomes elicited by functional fibres fed to healthy adult men. A total of twenty-one healthy adult men were utilised in a cross-over design. Each subject received polydextrose (PDX) or soluble maize fibre (SCF) (21 g/d) or no supplemental fibre (no fibre control; NFC) in a snack bar. Periods were 21 d and faeces were collected during the last 5 d of each period. Food intake, including fibre intake, did not differ among treatments. Flatulence (P = 0·001) and distention (P = 0·07) were greatest when subjects consumed PDX or SCF. Reflux was greater (P = 0·04) when subjects consumed SCF compared with NFC. All tolerance scores were low ( < 2·5), indicating only slight discomfort. Faecal ammonia, 4-methylphenol, indole and branched-chain fatty acid concentrations were decreased (P < 0·01) when subjects consumed the functional fibre sources compared with NFC. Faecal acetate, propionate and butyrate concentrations were lower (P < 0·05) when subjects consumed PDX compared with SCF and NFC. Faecal pH was lower (P = 0·01) when subjects consumed SCF compared with NFC, while PDX was intermediate. Faecal wet weight was greatest (P = 0·03) when subjects consumed SCF compared with NFC. Faecal dry weight tended to be greater (P = 0·07) when subjects consumed PDX compared with NFC. The functional fibres led to 1·4 and 0·9 g (PDX and SCF, respectively) increases in faecal dry mass per g supplemental fibre intake. Bifidobacterium spp. concentrations were greater (P < 0·05) when subjects consumed SCF compared with NFC. These functional fibres appear to be beneficial to gut health while leading to minimal gastrointestinal upset. PMID:21736814

  7. Coblation vs. Electrocautery Tonsillectomy: A Prospective Randomized Study Comparing Clinical Outcomes in Adolescents and Adults

    PubMed Central

    Hong, Sung-Moon; Cho, Jae-Gu; Chae, Sung Won; Lee, Heung-Man

    2013-01-01

    Objectives Coblation is operated in low temperature, so it is proposed that tonsillectomy with coblation involves less postoperative pain and allows accelerated healing of the tonsillar fossae compared with other methods involving heat driven processes. However, the results of the previous studies showed that the effect of coblation tonsillectomy has been equivocal in terms of postoperative pain and hemorrhage. Though, most of the previous studies which evaluated coblation tonsillectomy were performed in children. Recently, electrocautery tonsillectomy has been used most widely because of the reduced intraoperative blood loss and shorter operative time compared to other techniques. This prospective study compared intraoperative records and postoperative clinical outcomes in adolescents and adults following coblation and electrocautery tonsillectomies. Methods Eighty patients over 16 years of age with histories of recurrent tonsillitis were enrolled. The patients were randomly allocated into coblation (n=40) and electrocautery tonsillectomy groups (n=40). All operations were performed by one surgeon who was skilled in both surgical techniques. Intraoperative parameters and postoperative outcomes were checked. Results Postoperative pain and otalgia were not significantly different between the two groups; however, there was a tendency towards reduced pain and otalgia in the coblation group. More cotton balls for swabbing the operative field were used introoperatively in the electrocautery group (P=0.00). There was no significant difference in postoperative hemorrhage, wound healing, commencement of a regular diet, and foreign body sensation between the groups. Conclusion Only cotton use, which represented the amount of blood loss, was less in the coblation tonsillectomy group. Coblation tonsillectomy warrants further study with respect to the decreased postoperative pain and otalgia. PMID:23799166

  8. Epidemiology, Co-Infections, and Outcomes of Viral Pneumonia in Adults

    PubMed Central

    Crotty, Matthew P.; Meyers, Shelby; Hampton, Nicholas; Bledsoe, Stephanie; Ritchie, David J.; Buller, Richard S.; Storch, Gregory A.; Micek, Scott T.; Kollef, Marin H.

    2015-01-01

    Abstract Advanced technologies using polymerase-chain reaction have allowed for increased recognition of viral respiratory infections including pneumonia. Co-infections have been described for several respiratory viruses, especially with influenza. Outcomes of viral pneumonia, including cases with co-infections, have not been well described. This was observational cohort study conducted to describe hospitalized patients with viral pneumonia including co-infections, clinical outcomes, and predictors of mortality. Patients admitted from March 2013 to November 2014 with a positive respiratory virus panel (RVP) and radiographic findings of pneumonia within 48 h of the index RVP were included. Co-respiratory infection (CRI) was defined as any organism identification from a respiratory specimen within 3 days of the index RVP. Predictors of in-hospital mortality on univariate analysis were evaluated in a multivariate model. Of 284 patients with viral pneumonia, a majority (51.8%) were immunocompromised. A total of 84 patients (29.6%) were found to have a CRI with 48 (57.6%) having a bacterial CRI. Viral CRI with HSV, CMV, or both occurred in 28 patients (33.3%). Fungal (16.7%) and other CRIs (7.1%) were less common. Many patients required mechanical ventilation (54%) and vasopressor support (36%). Overall in-hospital mortality was high (23.2%) and readmissions were common with several patients re-hospitalized within 30 (21.1%) and 90 days (36.7%) of discharge. Predictors of in-hospital mortality on multivariate regression included severity of illness factors, stem-cell transplant, and identification of multiple respiratory viruses. In conclusion, hospital mortality is high among adult patients with viral pneumonia and patients with multiple respiratory viruses identified may be at a higher risk. PMID:26683973

  9. Buried penis: evaluation of outcomes in children and adults, modification of a unified treatment algorithm, and review of the literature.

    PubMed

    King, I C C; Tahir, A; Ramanathan, C; Siddiqui, H

    2013-01-01

    Introduction. Buried penis is a difficult condition to manage in children and adults and conveys significant physical and psychological morbidity. Surgery is often declined due to morbid obesity, forcing patients to live in disharmony for years until the desired weight reduction is achieved. No single operative technique fits all. We present our experience and surgical approach resulting in an improved algorithm unifying the treatment of adults and children. Methods. We conducted a retrospective analysis of patients treated for buried penis between 2011 and 2012. All patients underwent penile degloving and basal anchoring. Penile shaft coverage was achieved with skin grafts. Suprapubic lipectomies were performed on adult patients. Results. Nine patients were identified: four children and five obese adults. Average postoperative stay was three days for children and five for adults. Three adults were readmitted with superficial wound problems. One child had minor skin breakdown. All patients were pleased with their outcomes. Conclusion. Buried penis is a complex condition, and treatment should be offered by services able to deal with all aspects of reconstruction. Obesity in itself should not delay surgical intervention. Local and regional awareness is essential to manage expectations in these challenging patients aspiring to both aesthetic and functional outcomes.

  10. Indicators for Improving Educational, Employment, and Economic Outcomes for Youth and Young Adults with Intellectual and Developmental Disabilities: A National Report on Existing Data Sources

    ERIC Educational Resources Information Center

    Sulewski, Jennifer Sullivan; Zalewska, Agnes; Butterworth, John

    2012-01-01

    This report summarizes available national data on educational, employment and economic outcomes for youth and young adults with intellectual disabilities (ID) over the years 2000-2010. These data can be used to benchmark progress in improving these outcomes for young adult population across the country and within individual states. Data is…

  11. Socioeconomic and Psychosocial Predictors of Interleukin-6 in the MIDUS National Sample

    PubMed Central

    Morozink, Jennifer A.; Friedman, Elliot M.; Coe, Christopher L.; Ryff, Carol D.

    2010-01-01

    Objective To investigate whether psychosocial factors (i.e., depression, anxiety, and well-being) moderate educational gradients in interleukin-6 (IL-6) levels using data from the Survey of Mid-life Development in the U.S. (MIDUS). The influences of educational attainment and psychosocial factors on IL-6 in middle aged and older adults were also examined. Design Telephone interviews and mail surveys were utilized to collect educational attainment and psychosocial information from participants (N = 1028). Respondents also participated in an overnight clinic visit, during which health information and a fasting blood sample was obtained. Main Outcome Measures Serum levels of IL-6. Results . Greater educational attainment predicted lower levels of IL-6 independent of age and gender, although this effect was attenuated after taking health behaviors, body mass index, waist-to-hip ratio, and chronic illnesses into account. Psychological well-being interacted with education to predict IL-6, such that for those with less education, higher well-being was associated with lower levels of IL-6. Conclusion The findings indicate a strong association between education and inflammation, which can be further moderated by psychosocial factors. The health benefits associated with psychological well-being were particularly evident for individuals with low educational attainment. PMID:20954777

  12. Comparison of quadriceps strength and handgrip strength in their association with health outcomes in older adults in primary care.

    PubMed

    Chan, On Ying A; van Houwelingen, Anne H; Gussekloo, Jacobijn; Blom, Jeanet W; den Elzen, Wendy P J

    2014-01-01

    Sarcopenia is thought to play a major role in the functional impairment that occurs with old age. In clinical practice, sarcopenia is often determined by measuring handgrip strength. Here, we compared the lower limb quadriceps strength to the handgrip strength in their association with health outcomes in older adults in primary care. Our study population consisted of older adults (n = 764, 68.2% women, median age 83) that participated in the Integrated Systemic Care for Older People (ISCOPE) study. Participants were visited at baseline to measure quadriceps strength and handgrip strength. Data on health outcomes were obtained at baseline and after 12 months (including life satisfaction, disability in daily living, GP contact-time and hospitalization). Quadriceps strength and handgrip strength showed a weak association (β = 0.42 [95% CI 0.33-0.50]; R (2) = 0.17). Quadriceps strength and handgrip strength were independently associated with health outcomes at baseline, including quality of life, disability in daily living, GP contact-time, hospitalization, and gait speed. Combined weakness of the quadriceps and handgrip distinguished a most vulnerable subpopulation that presented with the poorest health outcomes. At follow-up, handgrip strength showed an association with quality of life (β = 0.05; P = 0.002) and disability in daily living (β = -0.5; P = 0.004). Quadriceps weakness did not further contribute to the prediction of the measured health outcomes. We conclude that quadriceps strength is only moderately associated with handgrip strength in an older population and that the combination of quadriceps strength and handgrip strength measurements may aid in the identification of older adults in primary care with the poorest health outcomes. In the prediction of poor health outcomes, quadriceps strength measurements do not show an added value to the handgrip strength.

  13. [Psychosocial stress and cardiology].

    PubMed

    Houppe, Jean-Pierre

    2013-06-01

    Psychosocial stress is a major independent risk and prognostic factor of cardiovascular events. It includes psychological, sociological and socioeconomic factors. Cardiovascular diseases are important providers of psychosocial stress. The knowledge of the cerebral development throughout the time allows to a better understanding of the relationship between psychosocial stress and cardiovascular risk. Psychosocial stress leads, on top of traditional cardiovascular risk factors, to the development or to the worsening of an endothelial dysfunction, of an inflammatory response and prothrombotic phenomenon. Anxiolytics and antidepressors are not very effective against psychosocial stress. Physical activity and psychotherapy are much more indicated, particularly cognitve-behavioral therapy. The ESC recommends an evaluation of psychosocial stress through a short questionnaire.

  14. Dealing with the Stress of College: A Model for Adult Students

    ERIC Educational Resources Information Center

    Kohler Giancola, Jennifer; Grawitch, Matthew J.; Borchert, Dana

    2009-01-01

    With an increase in nontraditional students attending college, there is a need to understand how work/school/life stress affects adult students. The purpose of this study is to test a comprehensive stress model that posits appraisal (cognitive evaluation) and coping as mediators between stressors/interrole conflict and psychosocial outcomes. The…

  15. Adopting Genetics: Motivations and Outcomes of Personal Genomic Testing in Adult Adoptees

    PubMed Central

    Baptista, Natalie M.; Christensen, Kurt D.; Carere, Deanna Alexis; Broadley, Simon A.; Roberts, J. Scott; Green, Robert C.

    2015-01-01

    Purpose American adult adoptees may possess limited amounts of information about their biological families and turn to direct-to-consumer personal genomic testing (PGT) for genealogical and medical information. We investigated the motivations and outcomes of adoptees undergoing PGT using data from the Impact of Personal Genomics (PGen) Study. Methods The PGen Study surveyed new 23andMe and Pathway Genomics customers prior to and 6 months after receiving PGT results. Exploratory analyses compared adoptees’ and non-adoptees’ PGT attitudes, expectations, and experiences. We evaluated the association of adoption status with motivations for testing and post-disclosure actions using logistic regression models. Results Of 1607 participants, 80 (5%) were adopted. As compared to non-adoptees, adoptees were more likely to cite limited family health history knowledge (OR = 10.1; 95% CI = 5.7–19.5) and the opportunity to learn genetic disease risks (OR = 2.7; 95% CI = 1.6–4.8) as strong motivations for PGT. Of 922 participants who completed 6-month follow-up, there was no significant association between adoption status and PGT-motivated healthcare utilization or health behavior change. Conclusion PGT allows adoptees to gain otherwise inaccessible information about their genetic disease risks and ancestry, helping them to fill the void of an incomplete family health history. PMID:26820063

  16. Management and outcomes of small bowel obstruction in older adult patients: a prospective cohort study

    PubMed Central

    Springer, Jeremy E.; Bailey, Jonathan G.; Davis, Philip J.B.; Johnson, Paul M.

    2014-01-01

    Background The purpose of this research was to examine the morbidity, mortality and rate of recurrent bowel obstruction associated with the treatment of small bowel obstruction (SBO) in older adults. Methods We prospectively enrolled all patients 70 years or older with an SBO who were admitted to a tertiary care teaching centre between Jul. 1, 2011, and Sept. 30, 2012. Data regarding presentation, investigations, treatment and outcomes were collected. Results Of the 104 patients admitted with an SBO, 49% were managed nonoperatively and 51% underwent surgery. Patients who underwent surgery experienced more complications (64% v. 27%, p = 0.002) and stayed in hospital longer (10 v. 3 d, p < 0.001) than patients managed nonoperatively. Nonoperative management was associated with a high rate of recurrent SBO: 31% after a median follow-up of 17 months. Of the patients managed operatively, 60% underwent immediate surgery and 40% underwent surgery after attempted nonoperative management. Patients in whom nonoperative management failed underwent surgery after a median of 2 days, and 89% underwent surgery within 5 days. The rate of bowel resection was high (29%) among those who underwent delayed surgery. Surgery after failed nonoperative management was associated with a mortality of 14% versus 3% for those who underwent immediate surgery; however, this difference was not significant. Conclusion These data suggest that some elderly patients with SBO may be waiting too long for surgery. PMID:25421079

  17. A Prognostic Model Predicting Autologous Transplantation Outcomes in Children, Adolescents and Young Adults with Hodgkin Lymphoma

    PubMed Central

    Satwani, Prakash; Ahn, Kwang Woo; Carreras, Jeanette; Abdel-Azim, Hisham; Cairo, Mitchell S.; Cashen, Amanda; Chen, Andy I.; Cohen, Jonathon B.; Costa, Luciano J.; Dandoy, Christopher; Fenske, Timothy S.; Freytes, César O.; Ganguly, Siddhartha; Gale, Robert Peter; Ghosh, Nilanjan; Hertzberg, Mark S.; Hayashi, Robert J.; Kamble, Rummurti T.; Kanate, Abraham S.; Keating, Armand; Kharfan-Dabaja, Mohamed A.; Lazarus, Hillard M.; Marks, David I.; Nishihori, Taiga; Olsson, Richard F.; Prestidge, Tim D.; Rolon, Juliana Martinez; Savani, Bipin N.; Vose, Julie M.; Wood, William A.; Inwards, David J.; Bachanova, Veronika; Smith, Sonali M.; Maloney, David G.; Sureda, Anna; Hamadani, Mehdi

    2015-01-01

    Autologous hematopoietic cell transplantation (AutoHCT) is a potentially curative treatment modality for relapsed/refractory Hodgkin lymphoma (HL). However, no large studies have evaluated pre-transplant factors predictive of outcomes of AutoHCT in children, adolescents and young adults (CAYA, age <30 years). In a retrospective study, we analyzed 606 CAYA patients (median age 23 years) with relapsed/refractory HL who underwent AutoHCT between 1995–2010. The probabilities of progression free survival (PFS) at 1, 5 and 10 years were 66% (95% CI: 62–70), 52% (95% CI: 48–57) and 47% (95% CI: 42–51), respectively. Multivariate analysis for PFS demonstrated that at the time of AutoHCT patients with Karnofsky/Lansky score ≥90, no extranodal involvement and chemosensitive disease had significantly improved PFS. Patients with time from diagnosis to first relapse of <1 year had a significantly inferior PFS. A prognostic model for PFS was developed that stratified patients into low, intermediate and high-risk groups, predicting for 5-year PFS probabilities of 72% (95% CI: 64–80), 53% (95% CI: 47–59) and 23% (95% CI: 9–36), respectively. This large study identifies a group of CAYA patients with relapsed/refractory HL who are at high risk for progression after AutoHCT. Such patients should be targeted for novel therapeutic and/or maintenance approaches post-AutoHCT. PMID:26237164

  18. Prognostic Significance of Depressive Symptoms on Weight Loss and Psychosocial Outcomes Following Gastric Bypass Surgery: A Prospective 24-month Follow-up Study

    PubMed Central

    White, Marney A.; Kalarchian, Melissa A.; Levine, Michele D.; Masheb, Robin M.; Marcus, Marsha D.; Grilo, Carlos M.

    2015-01-01

    Objective This study examined the prognostic significance of depressive symptoms in bariatric surgery patients over 24 months of follow-ups. Method Three hundred fifty-seven patients completed a battery of assessments before and at 6, 12, and 24 months following gastric bypass surgery. In addition to weight loss and depressive symptoms, the assessments targeted eating disorder psychopathology and quality of life. Results Clinically significant depressive symptoms, defined as a score of 15 or greater on the Beck Depression Inventory, characterized 45% of patients prior to surgery, and 12% at 6-month follow-up, 13% at 12-month follow-up, and 18% at 24-month follow-up. Preoperative depressive symptoms did not predict postoperative weight outcomes. In contrast, post-surgery depressive symptoms were predictive of weight loss outcomes. Higher post-surgery depressive symptoms at each time point predicted a greater degree of concurrent and subsequent eating disorder psychopathology and lower quality of life. Conclusions The frequency of elevated depressive symptoms decreases substantially following gastric bypass surgery but increases gradually over 24-months. Postoperative depressive symptoms are significantly associated with poorer weight outcomes at 6-months and 12-months following surgery but does not predict longer-term weight outcomes at 24-months. Post-operative depressive symptoms prospectively predict greater eating disorder psychopathology and poorer quality of life through 24-months. Elevated depressive symptoms, readily assessed by self-report, may signal a need for clinical attention after surgery. PMID:25720515

  19. Teaching for Social Capital Outcomes: The Case of Adult Literacy and Numeracy Courses

    ERIC Educational Resources Information Center

    Balatti, Jo; Black, Stephen; Falk, Ian

    2007-01-01

    There is strong evidence that participation in education and training can produce social capital outcomes. There is also strong evidence that such outcomes are useful outcomes; they can enhance the development of other outcomes often called human capital and they can contribute to the social-economic wellbeing of the learners and the communities…

  20. [The role of the pharmacist in dispensing medication in Adult Psychosocial Care Centers in the city of São Paulo, Capital of the State of São Paulo, Brazil].

    PubMed

    Zanella, Carolina Gomes; Aguiar, Patricia Melo; Storpirtis, Sílvia

    2015-02-01

    The objective of this study was to evaluate the role of the pharmacist in dispensing medication by conducting cross-sectional exploratory-descriptive research in eight Adult Psychosocial Care Centers (CAPS) in São Paulo. The pharmacists responsible for each of the dispensing units studied filled out a semi-structured questionnaire about the service provided. Two Adult CAPS units were selected from each of the North, South, Eastand West regions of São Paulo. The central region has no Adult CAPS, and was therefore not included in the study. Most of the respondents were aged between 35 and 40 years and were predominantly female. It was found that half of the respondents performed only 25% of dispensations and few conducted an analysis of all prescriptions before dispensing medication. All respondents contacted the prescriber if any medication-related problems a rose. However, few pharmaceutical interventions were commonly performed. Furthermore, one respondent indicated that all his/her functions in the pharmacy could be delegated to another professional. These findings reveal the pressing need for actions that ensure the ongoing training of pharmacists to enable them to be clinically prepared to deal with patients with mental disorders.

  1. Hemodialysis outcomes in a global sample of children and young adult hemodialysis patients: the PICCOLO MONDO cohort

    PubMed Central

    Ferris, Maria; Gibson, Keisha; Plattner, Brett; Gipson, Debbie S.; Kotanko, Peter; Marcelli, Daniele; Marelli, Cristina; Etter, Michael; Carioni, Paola; von Gersdorff, Gero; Xu, Xiaoqi; Kooman, Jeroen P.; Xiao, Qingqing; van der Sande, Frank M.; Power, Albert; Picoits-Filho, Roberto; Sylvestre, Lucimary; Westreich, Katherine; Usvyat, Len

    2016-01-01

    Background The aim of this study was to describe the experience of pediatric and young adult hemodialysis (HD) patients from a global cohort. Methods The Pediatric Investigation and Close Collaborative Consortium for Ongoing Life Outcomes for MONitoring Dialysis Outcomes (PICCOLO MONDO) study provided de-identified electronic information of 3244 patients, ages 0–30 years from 2000 to 2012 in four regions: Asia, Europe, North America and South America. The study sample was categorized into pediatric (≤18 years old) and young adult (19–30 years old) groups based on the age at dialysis initiation. Results For those with known end-stage renal disease etiology, glomerular disease was the most common diagnosis in children and young adults. Using Europe as a reference group, North America [odds ratio (OR) 2.69; CI 1.29, 5.63] and South America (OR 4.21; CI 2.32, 7.63) had the greatest mortality among young adults. North America also had higher rates of overweight, obesity, hypertension, cardiovascular disease, hospitalizations and secondary diabetes compared with all other regions. Initial catheter use was greater for North American (86.4% in pediatric patients and 75.2% in young adults) and South America (80.6% in pediatric patients and 75.9% in young adults). Catheter use at 1-year follow-up was most common in North American children (77.3%) and young adults (62.9%). Asia had the lowest rate of catheter use. For both age groups, dialysis adequacy (equilibrated Kt/V) ranged between 1.4 and 1.5. In Asia, patients in both age groups had significantly longer treatment times than in any other region. Conclusions The PICCOLO MONDO study has provided unique baseline and 1-year follow-up information on children and young adults receiving HD around the globe. This cohort has brought to light aspects of care in these age groups that warrant further investigation. PMID:26985383

  2. Comparing the effects of teen mentors to adult teachers on child lifestyle behaviors and health outcomes in Appalachia.

    PubMed

    Smith, Laureen H; Holloman, Christopher

    2013-10-01

    Childhood obesity prevalence rates in the United States are the highest in the rural Appalachian areas. Teens mentoring younger children to reverse obesity health risks are an understudied approach. This randomized-controlled trial compared the effects of two curriculum delivery methods and assessed the mediating effects of the number of sessions attended on the outcomes. The control group received the 8-week Just for Kids! curriculum via an adult teacher in a classroom and the experimental group received the same curriculum via individual teen mentoring. Data collected at baseline and postintervention were analyzed using multilevel linear models. Each of the outcomes (e.g., body mass index, blood pressure, current lifestyle behaviors) were modeled separately. Only the mentored children demonstrated improved current lifestyle behaviors (e.g., physical activity and dietary patterns) and health outcomes. Teen mentoring was an effective and efficacious approach to impact the lifestyle patterns and health outcomes of children in a school setting. PMID:23307890

  3. Comparing the effects of teen mentors to adult teachers on child lifestyle behaviors and health outcomes in Appalachia.

    PubMed

    Smith, Laureen H; Holloman, Christopher

    2013-10-01

    Childhood obesity prevalence rates in the United States are the highest in the rural Appalachian areas. Teens mentoring younger children to reverse obesity health risks are an understudied approach. This randomized-controlled trial compared the effects of two curriculum delivery methods and assessed the mediating effects of the number of sessions attended on the outcomes. The control group received the 8-week Just for Kids! curriculum via an adult teacher in a classroom and the experimental group received the same curriculum via individual teen mentoring. Data collected at baseline and postintervention were analyzed using multilevel linear models. Each of the outcomes (e.g., body mass index, blood pressure, current lifestyle behaviors) were modeled separately. Only the mentored children demonstrated improved current lifestyle behaviors (e.g., physical activity and dietary patterns) and health outcomes. Teen mentoring was an effective and efficacious approach to impact the lifestyle patterns and health outcomes of children in a school setting.

  4. Teaching the psychosocial aspects of pediatric surgery.

    PubMed

    Harris, Toi B; Sibley, Alexandra; Rodriguez, Carlos; Brandt, Mary L

    2013-08-01

    The optimal care of children with surgical diseases requires acquiring skills in the psychosocial assessment and therapy of children. Developing and implementing a curriculum to teach these concepts to pediatric surgery trainees should result in decreased perioperative stress for the child and improved patient outcomes and family satisfaction.

  5. Six Month Outcomes of a Peer-Enhanced Community Reinforcement Approach for Emerging Adults with Substance Misuse: A Preliminary Study.

    PubMed

    Smith, Douglas C; Davis, Jordan P; Ureche, Daniel J; Dumas, Tara M

    2016-02-01

    Little substance use disorder (SUD) treatment research with emerging adults ages 18-25 has been done in community settings, and it is well-known that peers influence emerging adult substance use. The purpose of this study was to develop and test the feasibility of a peer-enhanced behavioral treatment for emerging adults with substance use problems. Emerging adults (n=35) received a peer-enhanced version of the Community Reinforcement Approach (Peer-CRA), in which their peers (n=34) were trained to provide alcohol-specific social support. Both identified clients and peers were interviewed at treatment intake, and again three and six months later. Six month outcomes included days of abstinence adjusted for controlled environment days, social costs due to substance use, and binge drinking days in the past 90 days. Treatments were delivered with high fidelity, and a high proportion of participants were retained in treatment and follow-up assessments. Growth curve analyses revealed that emerging adults and their peers significantly increased their days of abstinence and reduced their binge drinking over time. Larger randomized trials should a) test whether peer-enhanced treatments are efficacious relative to treatment as usual, b) investigate whether secondary benefits exist for non-treatment seeking peers supporting another's treatment, and c) examine whether proposed mechanisms of change (i.e., peer support and peer reductions in substance use) account for any differences in outcomes.

  6. Psychosocial Outcomes Related to Subjective Threat from Armed Conflict Events (STACE): Findings from the Israeli-Palestinian Cross-Cultural HBSC Study

    ERIC Educational Resources Information Center

    Harel-Fisch, Yossi; Radwan, Qasrowi; Walsh, Sophie D.; Laufer, Avital; Amitai, Gabriel; Fogel-Grinvald, Haya; Abdeen, Ziad

    2010-01-01

    Objective: This study investigates the relationship between exposure to armed conflict and terror events, and an array of mental and behavioral outcomes within a large cross-cultural scientifically representative sample of 24,935 Palestinian (7,430 West Bank and 7,217 Gaza) and Israeli (5,255 Jewish and 6,033 Arab) 11-, 13-, and 15-year-old school…

  7. Do sugar-sweetened beverages cause adverse health outcomes in adults? A systematic review protocol

    PubMed Central

    2014-01-01

    Background Chronic diseases, such as cardiovascular disease and type 2 diabetes, impose significant burden to public health. Most chronic diseases are associated with underlying preventable risk factors, such as elevated blood pressure, blood glucose, and lipids, physical inactivity, excessive sedentary behaviours, overweight and obesity, and tobacco usage. Sugar-sweetened beverages are known to be significant sources of additional caloric intake, and given recent attention to their contribution in the development of chronic diseases, a systematic review is warranted. We will assess whether the consumption of sugar-sweetened beverages in adults is associated with adverse health outcomes and what the potential moderating factors are. Methods/Design Of interest are studies addressing sugar-sweetened beverage consumption, taking a broad perspective. Both direct consumption studies as well as those evaluating interventions that influence consumption (e.g. school policy, educational) will be relevant. Non-specific or multi-faceted behavioural, educational, or policy interventions may also be included subject to the level of evidence that exists for the other interventions/exposures. Comparisons of interest and endpoints of interest are pre-specified. We will include randomized controlled trials, controlled clinical trials, interrupted time series studies, controlled before-after studies, prospective and retrospective comparative cohort studies, case-control studies, and nested case-control designs. The MEDLINE®, Embase, The Cochrane Library, CINAHL, ERIC, and PsycINFO® databases and grey literature sources will be searched. The processes for selecting studies, abstracting data, and resolving conflicts are described. We will assess risk of bias using design-specific tools. To determine sets of confounding variables that should be adjusted for, we have developed causal directed acyclic graphs and will use those to inform our risk of bias assessments. Meta-analysis will

  8. Psychosocial aspects of abortion

    PubMed Central

    Illsley, Raymond; Hall, Marion H.

    1976-01-01

    The literature on psychosocial aspects of abortion is confusing. Individual publications must be interpreted in the context of cultural, religious, and legal constraints obtaining in a particular society at a given time, with due attention to the status and availability of alternatives to abortion that might be chosen by a woman with an “unwanted” pregnancy. A review of the literature shows that, where careful pre- and post-abortion assessments are made, the evidence is that psychological benefit commonly results, and serious adverse emotional sequelae are rare. The outcome of refused abortion seems less satisfactory, with regrets and distress frequently occurring. Research on the administration of abortion services suggests that counselling is often of value, that distress is frequently caused by delays in deciding upon and in carrying out abortions, and by unsympathetic attitudes of service providers. The phenomenon of repeated abortion seeking should be seen in the context of the availability and cost of contraception and sterilization. The place of sterilization with abortion requires careful study. A recommendation is made for observational descriptive research on populations of women with potentially unwanted pregnancies in different cultures, with comparisons of management systems and an evaluation of their impact on service users. PMID:1085671

  9. Direct Study of Parenting: A Serendipitous Outcome in a Course on Adult Development

    ERIC Educational Resources Information Center

    Williams, Robert B.

    2015-01-01

    This paper describes the activities of a course on adult development. The course intended to sensitize participants to the theories and reality of adulthood and aging by introducing them to selected literature on adult development and to the preparation of case records and mastery of activities that permit an analysis of the adult's world. The…

  10. Guideline 3: Psychosocial Treatment.

    ERIC Educational Resources Information Center

    American Journal on Mental Retardation, 2000

    2000-01-01

    The third in seven sets of guidelines based on the consensus of experts in the treatment of psychiatric and behavioral problems in mental retardation (MR) focuses on psychosocial treatment. Guidelines cover general principles, choosing among psychosocial treatments, severity of MR and psychiatric/behavior symptoms, diagnosable disorders, target…

  11. Psychosocial Communication and Computerization.

    ERIC Educational Resources Information Center

    Bradley, Gunilla; And Others

    1993-01-01

    Discusses the effect of computerization of the work environment on psychosocial communication. The RAM program, developed at Stockholm University to explore the effect of computers on the structure of organizations and the psychosocial work environment, is described; theoretical models are explained; and the future use of knowledge-based systems…

  12. Brief report: vocational outcomes for young adults with autism spectrum disorders at six months after virtual reality job interview training.

    PubMed

    Smith, Matthew J; Fleming, Michael F; Wright, Michael A; Losh, Molly; Humm, Laura Boteler; Olsen, Dale; Bell, Morris D

    2015-10-01

    Young adults with high-functioning autism spectrum disorder (ASD) have low employment rates and job interviewing presents a critical barrier to employment for them. Results from a prior randomized controlled efficacy trial suggested virtual reality job interview training (VR-JIT) improved interviewing skills among trainees with ASD, but not controls with ASD. We conducted a brief survey with 23 of 26 participants from this study to evaluate their vocational outcomes at 6-month follow-up with a focus on whether or not they attained a competitive position (employment or competitive volunteering). Logistic regression indicated VR-JIT trainees had greater odds of attaining a competitive position than controls (OR 7.82, p < 0.05). Initial evidence suggests VR-JIT is a promising intervention that enhances vocational outcomes among young adults with high-functioning ASD.

  13. Brief Report: Vocational Outcomes for Young Adults with Autism Spectrum Disorders at Six Months After Virtual Reality Job Interview Training

    PubMed Central

    Fleming, Michael F.; Wright, Michael A.; Losh, Molly; Boteler Humm, Laura; Olsen, Dale; Bell, Morris D.

    2016-01-01

    Young adults with high-functioning autism spectrum disorder (ASD) have low employment rates and job interviewing presents a critical barrier to employment for them. Results from a prior randomized controlled efficacy trial suggested virtual reality job interview training (VR-JIT) improved interviewing skills among trainees with ASD, but not controls with ASD. We conducted a brief survey with 23 of 26 participants from this study to evaluate their vocational outcomes at 6-month follow-up with a focus on whether or not they attained a competitive position (employment or competitive volunteering). Logistic regression indicated VR-JIT trainees had greater odds of attaining a competitive position than controls (OR 7.82, p < 0.05). Initial evidence suggests VR-JIT is a promising intervention that enhances vocational outcomes among young adults with high-functioning ASD. PMID:25986176

  14. Outcomes of adult medulloblastoma treated with a multimodality approach: A tertiary cancer center experience

    PubMed Central

    Mallick, Supriya; Gandhi, Ajeet Kumar; Benson, Rony; Sharma, Daya Nand; Haresh, Kunhi Parambath; Gupta, Subhash; Julka, Pramod Kumar; Rath, Goura Kisor

    2015-01-01

    Objectives: Adult medulloblastoma (AMB) is a rare central nervous system tumor. We aimed to analyze the treatment outcomes of AMB treated at our institute with surgery followed by craniospinal irradiation (CSI) and adjuvant chemotherapy. Methods: We retrospectively evaluated the treatment charts of 31 patients of AMB treated from 2003-2011. The patient demography, treatment details and survival data were collected in a predesigned proforma. Kaplan Meier method was used to analyze disease free survival (DFS) and the impact of prognostic factors was determined by univariate analysis (log rank test). Results: Male: Female ratio was 21:10. Cerebrospinal fluid dissemination was noted in 16% cases. CSI (36 Gray at 1.8 Gray/fraction to entire neuraxis and 20 Gray at 2 Gray/fraction boost to posterior fossa) was used in all cases. 26 patients received adjuvant chemotherapy (carboplatin plus etoposide). Median follows up was 26.85 months (9.47-119.73 months). The estimated 3 and 5 years DFS was found to be 84.9% and 50.7% respectively. On univariate analysis, tumor located laterally had a trend towards better DFS (HR 3.04; 95%CI 0.722 to 12.812; P = 0.07) compared to midline tumors. Other factors like adjuvant chemotherapy, age, gender, surgical extent had no statistically significant impact on survival. Conclusion: The results of our study (largest series from India) show that the regimen of surgery, adjuvant CSI and chemotherapy is feasible and confers descent survival. AMB patients should be treated with a multimodality approach in a tertiary care centre. PMID:26981508

  15. A systematic review of resilience and mental health outcomes of conflict-driven adult forced migrants

    PubMed Central

    2014-01-01

    Background The rising global burden of forced migration due to armed conflict is increasingly recognised as an important issue in global health. Forced migrants are at a greater risk of developing mental disorders. However, resilience, defined as the ability of a person to successfully adapt to or recover from stressful and traumatic experiences, has been highlighted as a key potential protective factor. This study aimed to review systematically the global literature on the impact of resilience on the mental health of adult conflict-driven forced migrants. Methodology Both quantitative and qualitative studies that reported resilience and mental health outcomes among forcibly displaced persons (aged 18+) by way of exploring associations, links, pathways and causative mechanisms were included. Fourteen bibliographic databases and seven humanitarian study databases/websites were searched and a four stage screening process was followed. Results Twenty three studies were included in the final review. Ten qualitative studies identified highlighted family and community cohesion, family and community support, individual personal qualities, collective identity, supportive primary relationships and religion. Thirteen quantitative studies were identified, but only two attempted to link resilience with mental disorders, and three used a specific resilience measure. Over-reliance on cross-sectional designs was noted. Resilience was generally shown to be associated with better mental health in displaced populations, but the evidence on this and underlying mechanisms was limited. Discussion The review highlights the need for more epidemiological and qualitative evidence on resilience in forcibly displaced persons as a potential avenue for intervention development, particularly in resource-poor settings. PMID:25177360

  16. Operative risk and outcome of surgery in adults with congenital valve disease.

    PubMed

    Luciani, Giovanni Battista; Viscardi, Francesca; Pilati, Mara; Barozzi, Luca; Faggian, Giuseppe; Mazzucco, Alessandro

    2008-01-01

    To define risk and outcome of surgery in adults with congenital valve disease (CVD), experience between 2002 and 2005 with 371 CVD operations (288 males, aged 56 +/- 9 years) was compared with 2102 for acquired valve disease (AVD) (69 +/- 22 years, p = 0.02). Diagnosis included: bicuspid aortic valve (BAV), 337, s/p ToF repair, 11; atrio-ventricular valve dysfunction, 10; other, 13. Associated lesions were present in 259 patients (70% vs. 17%, p = 0.001): ascending aorta, 205; right ventricular outflow tract obstruction, 40; coronary artery, 34; mitral/tricuspid valve, 27; septal defect, 17; subaortic stenosis, 4; aortic arch, 4; other, 3. Fifty-two patients (14% vs. 2.5% AVD, p = 0.001) had undergone 75 prior operations (1.4/patient) and 14 (3.8% vs. 1.9% AVD, p = 0.04) required urgent/emergent surgery (endocarditis, dissection). Valve repair was done in 36 (10% vs. 3% AVD, p = 0.02) and replacement in 335: stentless solution (native, autograft, xenograft) was offered to 101 (29%) patients. In BAV, partial root replacement was associated in 63, complete in 77 and ascending aorta in 92. Three (0.8%) hospital deaths occurred (vs. 1.9% AVD, p = 0.2) due to endocarditis. Twenty-six patients (7.0% vs. 10.8% AVD, p = 0.003) experienced complications (cardiac, 7; neurologic, 6; respiratory, 5; renal, 3; sepsis/multiple organ failure (MOF), 2; hemorrhage, 8). Urgent/emergent surgery predicted hospital mortality (p = 0.001). During 5-year follow-up (average 2.6 +/- 1.8 years), there was one late cardiac death and three reoperations (98% free). Despite higher prevalence of associated procedures, reoperation and emergent indication, operative risk in CVD is lower than in AVD, possibly because of younger age. Stentless valve surgery, allowing normal life-style (e.g., exercise, pregnancy), is increasingly preferred.

  17. Is the Complete Resection of Craniopharyngiomas in Adults Feasible Considering Both the Oncologic and Functional Outcomes?

    PubMed Central

    Lee, Eun Jung; Cho, Young Hyun; Hong, Seok Ho; Kim, Jeong Hoon

    2015-01-01

    Objective To assess the impact of the complete resection of craniopharyngioma (CP) in adults on oncologic and functional outcomes. Methods We retrospectively analyzed 82 patients with CP who were surgically treated by the same neurosurgeon at our institution between January 1994 and December 2012. Results Gross total resection (GTR) was achieved in 71 patients (86.6%), near total resection (NTR) in 7 patients (8.5%), and subtotal resection (STR) in 3 patients (3.7%). The disease-specific overall survival rate was 100% with the exclusion of 2 surgery-related mortalities. The overall recurrence rate was 12.2% (10 of 82 patients), however the recurrence rate according to extent of resection (EOR) was 9.9% (7 of 71 patients) after GTR, 14.3% (1 of 7 patients) after NTR, and 66.7% (2 of 3 patients) after STR. The overall recurrence-free survival (RFS) rates at 5 and 10 years were 87.0% and 76.8%, respectively. Postoperatively, most patients (86.3%) needed hormone replacement for at least 1 hypothalamic-pituitary axis. Vision improved in 56.4% of the patients with preoperative abnormal vision, but deteriorated in 27.4% of patients. Hypothalamic dysfunction developed in 32.9% of patients. There were no significant differences in the risks of pituitary dysfunction, visual deterioration, or hypothalamic dysfunction between the groups with complete vs. incomplete removal. The overall rate of postoperative complications was 22.0%, which did not differ between groups (p=0.053). Conclusion The complete removal of a CP at first surgery can provide a chance for a cure with acceptable morbidity and mortality risks. PMID:26713143

  18. Psychosocial environment: definitions, measures and associations with weight status--a systematic review.

    PubMed

    Glonti, K; Mackenbach, J D; Ng, J; Lakerveld, J; Oppert, J-M; Bárdos, H; McKee, M; Rutter, H

    2016-01-01

    Socio-ecological models suggest that many elements of the social environment act as upstream determinants of obesity. This systematic review examined definitions, measures and strength of associations between the psychosocial environment and adult weight status. Studies were included if they were conducted on adults, the outcome was weight status, carried out in any developed country and investigated at least one psychosocial environmental construct. Six databases for primary studies were searched: EMBASE, MEDLINE, PsycINFO, Scopus, Web of Science and the Cochrane Library. We restricted our search to studies published in English between January 1995 and February 2015. An adapted 'Quality Assessment Tool for Quantitative Studies' was used to evaluate risk of bias of included studies. Out of 14,784 screened records, 42 articles were assessed using full text. A total of 19 studies were included. The strongest associations with weight status were found for social capital and collective efficacy, although few studies found significant associations. There was heterogeneity in the definitions and metrics of psychosocial environmental constructs. There is limited evidence that greater social capital and collective efficacy are associated with healthier weight status. The research conducted to date has not robustly identified relations. We highlight challenges to undertaking research and establishing causality in this field and provide recommendations for further research.

  19. Variations in internet-related problems and psychosocial functioning in online sexual activities: implications for social and sexual development of young adults.

    PubMed

    Boies, Sylvain C; Cooper, Al; Osborne, Cynthia S

    2004-04-01

    This survey of 760 university students examined differences in Internet-related problems and psychosocial functioning between four patterns of participation in online sexual information and entertainment activities. Students who did not participate in either online sexual activity were more satisfied with their offline life and more connected to friends and family. Those who engaged in both online sexual activities were more dependent on the Internet and reported lower offline functioning. Students who only sought sexual information maintained strong offline affiliations. Those who only sought entertainment did not report lower offline functioning. Respondents most deficient in offline social support did not report compensatory online support. Despite students' common participation in online sexual activities (OSA) as a venue for social and sexual development, those relying on the Internet and the affiliations it provides appear at risk of decreased social integration. The authors discussed the finding's implications for social and sexual development. PMID:15140364

  20. Digging Deeper: Enriching Transition to Adult Life Outcome Research through Life-Histories

    ERIC Educational Resources Information Center

    Johnson, Jennifer

    2011-01-01

    Post-secondary outcomes for students with and without disabilities have been documented in transition research for over three decades. However, despite efforts to improve outcomes by the field of transition, former students with disabilities outcomes have remain lower than their non-disabled peers. Historically, the data, which has been collected…