Metacognitions mediate HIV stigma & depression/anxiety in men who have sex with men living with HIV

The study examined whether the relationships between HIV stigma and depression and anxiety would be mediated by metacognitive beliefs and thought control strategies among men who have sex with men whom are living with HIV. Participants completed an online survey that measured 30-item Metacognitions Questionnaire, thought control strategies (Thought Control Questionnaire), and symptoms of depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7). The relationships between internalised and anticipated HIV stigma with depressive symptoms were mediated by negative metacognitive beliefs and the use of worry and social thought control strategies. Negative Metacognitive beliefs mediated the association between internalised HIV stigma and anxiety symptoms

The OnTrack Diabetes Group Therapy Project: Feasibility Trial of a Web-based CBT Program with Conjunctive Group Therapy

Context. Type 2 diabetes is a global public health concern due to its wide-spread impacts on mortality, morbidity and quality of life, which are largely preventable through adequate self-management. However, emotional and psychological barriers to effective self-management remain a challenge for health systems to address. Interventions targeting diabetes self-management, emotional and psychological issues can lead to improvements in patients’ physical and mental health outcomes. Furthermore, there is a significant, positive relationship between social support and psychological wellbeing in people with diabetes and cognitive behavioural therapy (CBT) has demonstrated efficacy in reducing symptoms of depression and anxiety in this population. Intervention. This paper presents on the feasibility trial of an intervention that includes social support in the form of CBT-based group therapy delivered in conjunction with a web-based CBT type 2 diabetes self-management and mood intervention. Methods. Aims of this study include: (i) to evaluate user uptake, engagement, perceived usefulness and acceptability of the intervention; and (ii) to evaluate the implementation fidelity of both intervention components, as well as group cohesion and group-facilitator alliance, and their relationship to participant engagement in the group therapy program. A sample of 30 adults with type 2 diabetes is recruited to take part in the trial at three locations, including metropolitan Victoria and regional areas of Victoria and Queensland. Results. Results will indicate the feasibility of delivering a face-to-face group therapy program with web-based support and will inform the future roll-out of the program as a complete web-based intervention. Conclusions. Implications for the future implementation of the program based on feasibility trial findings will be discussed

Depression mediates HIV stigma and medication adherence in men who have sex with men (living with HIV)

The study examined whether the relationship between HIV stigma and medication adherence would be mediated by depression and anxiety among men who have sex with men (MSM) whom are living with HIV (PLWH). Participants completed an online survey that measured HIV stigma, medication adherence (using the ARMS) and symptoms of depression (Patient Health Questionnaire-9) and anxiety (Generalised Anxiety Disorder-7). Results indicated depression mediated the association between HIV stigma and medication adherence more strongly than anxiety

Comparison of government and non-government alcohol and other drug (AOD) treatment service delivery for the lesbian, gay, bisexual, and transgender (LGBT) community

Background: Lesbian, gay, bisexual, and transgender (LGBT) populations are more likely to misuse alcohol and other drugs (AOD), compared to the general population. However, LGBT engagement with AOD treatment is often precluded by insensitivity and misunderstanding of LGBT issues. These treatment barriers may be a consequence of either worker attitudes, organizational factors or a combination of both. Few studies have compared service context as an impediment to AOD treatment. Objectives: This pilot study sought to examine and compare staff attitudes, knowledge and awareness of LGBT issues in two state-wide AOD services within Australia. One organization was a government service, whilst the other was faith based. Methods: A cross-sectional study of a convenience sample (N = 130) of workers employed in a state-wide government AOD service (n = 65), and a state-wide non-government service (n = 65) was conducted. Participants self-completed a questionnaire comprising tools previously used to assess staff attitudes, knowledge and awareness of LGBT issues. Results: Few significant differences in attitudes and awareness of LGBT issues between government and non-government respondents were found. Nearly all respondents were supportive of LGBT persons irrespective of organizational context, with a small number of negative views. Although most respondents demonstrated awareness of organizational policies and practices relating to LGBT clients, many were “unsure” or “neutral” of what these might be. Conclusion: It is confirming that the majority of staff report supportive attitudes towards LGBT clients. Findings suggest that organizations need to continue to take leadership to strengthen organizational training and capacity to deliver LGBT friendly AOD treatment practices

Modelling the effects of past and future climate on the risk of bluetongue emergence in Europe

Vector-borne diseases are among those most sensitive to climate because the ecology of vectors and the development rate of pathogens within them are highly dependent on environmental conditions. Bluetongue (BT), a recently emerged arboviral disease of ruminants in Europe, is often cited as an illustration of climate's impact on disease emergence, although no study has yet tested this association. Here, we develop a framework to quantitatively evaluate the effects of climate on BT's emergence in Europe by integrating high-resolution climate observations and model simulations within a mechanistic model of BT transmission risk. We demonstrate that a climate-driven model explains, in both space and time, many aspects of BT's recent emergence and spread, including the 2006 BT outbreak in northwest Europe which occurred in the year of highest projected risk since at least 1960. Furthermore, the model provides mechanistic insight into BT's emergence, suggesting that the drivers of emergence across Europe differ between the South and the North. Driven by simulated future climate from an ensemble of 11 regional climate models, the model projects increase in the future risk of BT emergence across most of Europe with uncertainty in rate but not in trend. The framework described here is adaptable and applicable to other diseases, where the link between climate and disease transmission risk can be quantified, permitting the evaluation of scale and uncertainty in climate change's impact on the future of such diseases

Utilisation of novel methodologies to engage 'hard to reach' clients in health promotion and screening, in rural and regional areas

This following provides a detailed summary regarding the case of HIV screening and health promotion within a regional/rural community in Queensland, with higher self-reported rates of stigma and discrimination. Information is provided regarding the community engagement and communication strategies employed to promote this novel screening initiative; use of community-based online technologies to promote participant recruitment, and use of respondent-driven sampling to increase engagement with hard to reach and socially isolated members of the target group. Use of peer-health promotion officers, a discrete screening environment, bringing the mobile service to the key target groups and geographical regions; onward linking and integration with mainstream health services and models of care; and direct collaborative partnering with key community organisations will be further discussed and are pivotal to the feasibility and acceptability of these types of initiatives. Broader applications to other health areas will also be discussed

Tricuspid annuloplasty concomitant with mitral valve surgery: Effects on right ventricular remodeling

ObjectivesTricuspid valve annuloplasty (TVP) has been advocated concomitantly with left-sided cardiac surgery in case of more than moderate tricuspid regurgitation (TR) or tricuspid annular dilation (TAD) (diameter >40 mm or 21 mm/m²) even in the absence of significant TR. Data on postoperative right ventricular (RV) remodeling are lacking in such patients.MethodsPreoperative and postoperative echocardiography data from 45 consecutive TVP procedures, performed in mitral valve surgery in a single tertiary center, were retrospectively analyzed and compared with a propensity-matched control group of 33 procedures without concomitant TVP. RV function and geometry was analyzed by measuring RV size, fractional area change, and end-diastolic sphericity index (RVSI = long-axis length/short-axis width) and compared at baseline versus follow-up.ResultsAt a mean follow-up of 5 months, a favorable change in RV geometry was observed in TVP patients (RVSI increased from 1.99 ± 0.33 to 2.21 ± 0.42; P = .001), whereas the opposite was observed in the control group (RVSI decreased from 2.34 ± 0.52 to 2.17 ± 0.13; P = .05). Only in control patients, indexed RV end-diastolic area increased significantly (P = .003). In TVP patients, when comparing patients with baseline more than moderate TR (n = 13) to patients with isolated TAD (n = 32), there was a significant decrease in RV end-diastolic area only in the group with more than moderate TR (from 12.9 ± 3.5 cm2/m2 to 10.3 ± 1.9 cm2/m2; P = .009).ConclusionsAdding TVP to mitral valve surgery in patients with more than moderate TR or TAD leads to favorable changes in RV geometry and prevents postoperative RV dilation. This is most pronounced in patients with more than moderate TR at baseline

Mothers of Soldiers in Wartime: A National News Narrative

National news media represent mothers of US combat soldiers in the Iraq War as archetypal good mothers, that is, mothers who continue their maternal work even after their children are deployed. However, not all mothers are depicted as the archetypal patriotic mother, i.e., a good mother who is also stoic and silent about the war and her child\u27s role in it. Mothers of soldiers are portrayed as good mothers who sometimes also voice their attitudes about the war effort. The maternal attitudes ranged from complete support for the war to opposition to the war but support for the soldiers. The findings suggest a picture of wartime motherhood that is more nuanced than the historical image of the patriotic mother suggests

Dietary habits, physical activity, and sedentary behaviour of children of employed mothers: a systematic review

Since approximately 40% of the global workforce are women, a comprehensive understanding of association of maternal employment with child dietary patterns, physical activity and sedentary behaviour needs more focus. This systematic review aims to identify the association between maternal employment and dietary patterns (DP), physical activity (PA) and sedentary behaviour (SB) of children and adolescents (6 to 18 years). Searches were performed using electronic databases and manual searches. Peer reviewed journal articles, conference papers, theses at masters/doctoral levels in English were included. A total 42 studies met selection criteria, which indicated associations between maternal employment and at least one of the domains of interest: DP, PA and/or SB. Using individual samples of analysis, it was found that, 9 samples of DP, 11 samples of PA and 12 samples of SB were positively correlated with maternal employment, whereas 25 samples of DP, 5 samples of PA and 5 samples of SB showed an opposite association. Results suggest that PA and SB were positively related with maternal employment, whereas DP had an inverse relationship. Findings from this review provide evidence that children of employed mothers had poorer DP and greater prevalence of SB, however, their children are more physically active. Future interventions need to create a positive environment at the workplace and for families to support employed mothers and improve children’s dietary patterns and decrease sedentary behaviours. Future studies should prioritise the domains of DP, PA and SB that have been studied inadequately and have inconsistent results

Towards a resource-based habitat approach for spatial modelling of vector-borne disease risks

Given the veterinary and public health impact of vector-borne diseases, there is a clear need to assess the suitability of landscapes for the emergence and spread of these diseases. Current approaches for predicting disease risks neglect key features of the landscape as components of the functional habitat of vectors or hosts, and hence of the pathogen. Empirical–statistical methods do not explicitly incorporate biological mechanisms, whereas current mechanistic models are rarely spatially explicit; both methods ignore the way animals use the landscape (i.e. movement ecology). We argue that applying a functional concept for habitat, i.e. the resource-based habitat concept (RBHC), can solve these issues. The RBHC offers a framework to identify systematically the different ecological resources that are necessary for the completion of the transmission cycle and to relate these resources to (combinations of) landscape features and other environmental factors. The potential of the RBHC as a framework for identifying suitable habitats for vector-borne pathogens is explored and illustrated with the case of bluetongue virus, a midge-transmitted virus affecting ruminants. The concept facilitates the study of functional habitats of the interacting species (vectors as well as hosts) and provides new insight into spatial and temporal variation in transmission opportunities and exposure that ultimately determine disease risks. It may help to identify knowledge gaps and control options arising from changes in the spatial configuration of key resources across the landscape. The RBHC framework may act as a bridge between existing mechanistic and statistical modelling approaches