Differential Effects of Reward Drive and Rash Impulsivity on the Consumption of a Range of Hedonic Stimuli

Background and aims Impulsivity has consistently been associated with over-consumption and addiction. Recent research has reconceptualized impulsivity as a two-dimensional construct (Dawe, Gullo, & Loxton, 2004). This study explores the relationship of the two components of impulsivity, reward drive (RD) and rash impulsivity (RI), on a broad group of 23 hedonic consumption behaviors (e.g., gambling, substance use, eating, and media use). We tentatively grouped the behaviors into three descriptive classes: entertainment, foodstuffs, and illicit activities and substances. Results RD and RI positively predicted elevated levels of consumption in a community sample (N=5,391; 51% female), for the vast majority of the behaviors considered. However, the effect sizes for RD and RI varied significantly depending on the behavior; a pattern that appeared to be at least partially attributable to the class of consumption. Results support the view that RD is related more strongly to the consumption of products that provide social engagement or a sense of increased status; whereas RI better reflects an approach toward illicit or restricted products that are intensely rewarding with clear negative consequences. Discussion and conclusion Results support the utility of the two-factor model of impulsivity in explaining individual differences in patterns of hedonic consumption in the general population. We discuss findings in terms of strengthening current conceptualizations of RI and RD as having distinct implications with respect to health-related behaviors

Implementation Strategies for Interventions Aiming to Increase Participation in Mail-Out Bowel Cancer Screening Programmes: A Realist Review

Background Bowel cancer is the third most commonly diagnosed cancer and the third most common cause of cancer-related death with 1,849,518 new cases of bowel diagnosed, and 880,792 deaths reported globally in 2018 alone. Survival can be improved through early detection via national mail-out bowel cancer screening programs; however, participation remains low in many countries. Behavior change is therefore required to increase participation. This realist review aims to (a) identify the behavior change techniques (BCTs) used in each intervention, (b) understand the mechanisms of action responsible for the BCTs effectiveness, and (c) apply a behavior change model to inform how behavior change techniques and mechanisms of action (MoA) can be combined to increase screening participation. Methods We systematically reviewed the literature for interventions aiming to increase participation in mail-out bowel cancer screening. We used a four-stage realist synthesis approach whereby; (1) interventions were extracted from each study; (2) BCTs applied in each intervention were identified and coded using the BCT taxonomy-v1; (3) the Theory and Techniques tool was used to link BCT to their mechanisms of action; and (4) BCT and MoA were categorized according to their effectiveness and what Health Action Process Approach (HAPA) stage of change they would affect. Results We identified 68 intervention trials using 26 unique BCTs and 13 MoA to increase participation. Sixteen BCTs and 10 MoA were identified within the interventions that successfully increased participation rates. Interventions targeting both stages of the HAPA model had a higher success rate (80%) than those targeting one stage of change (51%). When targeting only one stage, interventions targeting the volitional stage had a higher success rate (71%) than interventions only targeting the motivational stage of change (26%). Conclusion Importantly, this review identified a suite of BCTs and MoA that are effective for increasing participation in mail-out bowel cancer screening programs. With increased participation in bowel cancer screening leading to improved survival, our findings are key to informing the improvement of policy and interventions that aim to increase screening using specific strategies at key stages of health decision-making

A health action process approach for developing invitee endorsed interventions to increase mail-out bowel cancer screening

Theory-based, user-informed interventions are needed to increase the low participation rates of population-based faecal occult blood test (FOBT) bowel cancer screening. This study investigated the theoretical fit of the health action process approach (HAPA) for home FOBT screening and measured screening invitees' attitudes towards different intervention strategies. A cross-sectional sample (n = 377), aged 50–74 years, participated in this study. Two scales were created for this study. The process approach to mail-out screening (PAMS) scale measured HAPA constructs, and the user ratings of mail-out screening interventions (UR-MSI) scale measured attitudes towards different intervention strategies. Structural equation modelling was used to assess the fit of PAMS scale responses to the HAPA model, and descriptive statistics were calculated for UR-MSI responses. PAMS results showed acceptable model fit, CFI = .968, RMSEA = .050 and explained 49.9% of the variation in FOBT screening participation. Positive ratings of interventions ranged from 20.47%, an intervention prompting planning to complete the FOBT kit, to 72.25%, an intervention promoting the positive health outcome associated with FOBT screening. Intervention strategies should be combined such that they target all factors specified within the HAPA model. User-informed intervention design should be used to effectively facilitate FOBT uptake in the community

Support-seeking by cancer caregivers living in rural Australia

Objective: Rural cancer caregivers report poor wellbeing and high unmet needs for support. This study investigates sources of support sought by cancer caregivers living in rural Australia, and factors associated with support-seeking. Methods: Informal caregivers of people with cancer completed a questionnaire assessing sociodemographic characteristics, caregiver factors and support-seeking. Descriptive statistics, bivariate analyses and logistic regression were used to identify common sources of support and factors associated with support-seeking. Alluvial and radar plots were used to identify and describe support-seeking profiles. Findings: Of 244 rural caregivers, 64 % reported seeking support for themselves, 72 % for the cancer patient, and 22 % did not seek any support. The most common sources of support were general practitioners and online. Higher caregiver burden, higher income, caring for someone with anxiety/depression or caring for someone who has difficulty completing their usual activities were associated with seeking support from a greater number of sources. The ‘No support-seekers’ profile had the highest proportions of caregivers who were male, caring for someone \u3c 12 months post-diagnosis and lower income earners. Conclusions: Many rural caregivers seek support for themselves and the cancer patient, commonly from medical and online sources. Implications for public health: Further work may be needed to reduce caregiver burden and support caregivers who are male, caring for someone recently diagnosed, and those with lower incomes

The quality of life of regional and remote cancer caregivers in Australia

Objective: This study compares the well-being of rural caregivers with that of the general population and explores the potential drivers of poorer outcomes. Method: Patient–caregiver dyads (n = 241) residing in regional or remote Queensland, Australia, reported on QoL, chronic illness, caregiver burden, depression, anxiety and stress. Caregiver outcomes were compared with population norms and patient outcomes. Multiple regressions were conducted to identify factors associated with poorer caregiver outcomes. Results: Caregivers reported lower mental health-related QoL (M = 0.436, 95% CI = 0.410–0.462) in comparison with age-matched population norms (M = 0.556, 95% CI = 0.532–0.580). No differences existed between caregiver and population norms for anxiety, stress and depression. Caregiver chronic illness and higher burden were associated with poorer mental and physical QoL, depression, anxiety and stress (η2s ranging from 0.03 to 0.30). These associations were slightly stronger for male caregivers when compared with female caregivers (η2s ranging from 0.03 to 0.08). Conclusion: It is vital that efforts are made to improve rural caregivers\u27 mental and emotional well-being. Interventions that support caregivers with chronic conditions reduce caregiver burden and take into consideration the unique experience of male caregivers will go some way to addressing this. Future research is needed to identify other drivers of health outcomes in this group

Identifying modifiable features of home bowel cancer screening kits to facilitate use: Consumer perspectives

Objectives: Despite the widely publicised health benefits of participation in bowel cancer screening, only 43.5% of recipients participate in the Australian National Bowel Cancer Screening Program (NBCSP). Through consultation with kit recipients, this study aimed to identify features of home bowel screening kits that could be modified to increase their use. Method: Participants (n = 25) were presented with nine different bowel cancer screening kits and asked to identify features of each kit that might prevent or promote their use. Responses were coded using content analysis, and a narrative synthesis is presented summarising preferences relating to each element of the kit. Results: Six modifiable elements were identified: collection tool, collection sheet, specimen container, instruction, packaging and processes. Participant preferences were for collection devices that limited the users’ proximity to faecal matter, smaller packaging, simpler processes and step-by-step pictorial instructions. Responses regarding aesthetics, the amount of information included and receiving immediate results were mixed. Conclusions: Findings provide several consumer-driven recommendations, which are to be tested in future research aimed at improving the acceptability and usability of kits distributed in population bowel cancer screening programs

Socio-demographic factors drive regional differences in participation in the National Bowel Cancer Screening Program – An ecological analysis

Objective: To examine if geographic variations in the participation rates in the National Bowel Cancer Screening Program (NBCSP) are related to population-level socio-demographic characteristics. Methods: Data reflecting participation in the NBCSP for 504 Local Government Areas (LGAs) between July 2011 and June 2013 were extracted from the Social Health Atlas of Australia. Logistic regression models were used to examine independent associations (odds ratios [ORs]) between participation, Remoteness Area (RA) and selected socio-demographic variables. Results: Compared to the participation rate for major cities (33.4%), participation was significantly higher in inner regional areas (36.5%, OR=1.15), but was much lower in remote (27.9%, OR=0.77) or very remote areas (25.0%, OR=0.65). When controlling for study period, gender, proportion of persons aged 65 years and older, Indigenous status, cultural background and socioeconomic status, significantly higher rates were observed in all non-metropolitan areas than in major cities. Indigenous status was strongly related to the poorer participation in remote areas. Conclusions: Socio-demographic characteristics, particularly Indigenous status, cultural background and population ageing, seem to be more important drivers of regional disparities in NBCSP participation than geographic remoteness. Implications for public health: This study provides important evidence to understand the regional disparities in participating in the national screening program

Health literacy and the health status of men with prostate cancer

OBJECTIVE: To test the Health Literacy Questionnaire (HLQ) in a sample of men with prostate cancer and examine the components of health literacy that are most strongly associated with mental and physical health‐related quality of life in men with prostate cancer. METHOD: Members (N = 565) of a state‐wide prostate cancer support network in Queensland, Australia (Mage = 71.14, SD = 8.68) completed the HLQ along with the Medical Outcomes Study, 36‐item short‐form health survey (SF‐36). Confirmatory factor analysis was employed to assess the internal structure of the HLQ. The effects (bs) of each of the nine health literacy factors on mental and physical health status were graphed and compared using Fishers exact test for comparing parameter estimates. RESULTS: Fit indices including RMSEA (0.069, CI = 0.066‐0.072), CFI (.853), and TLI (.839), alongside item loadings and internal consistency (Cronbach alphas >0.80) for the nine‐factor model, supported the robustness of the HLQ for use in this prostate cancer sample. Health literacy factors reflecting social and health provider support, navigating health systems, finding and understanding health information, and active engagement with providers shared small to moderate associations with mental health status and little to no association with physical health status. CONCLUSION: Findings provide support for the use of the HLQ as a valid and reliable measure of health literacy in men with prostate cancer. Although further research is required to establish causality, interventions that aim to improve skills in connecting and effectively communicating with health care services and providers might lead to better mental health related quality of life for men with prostate cancer

Kaposi's sarcoma-associated herpesvirus ORF57 protein: exploiting all stages of viral mRNA processing

Nuclear mRNA export is a highly complex and regulated process in cells. Cellular transcripts must undergo successful maturation processes, including splicing, 5'-, and 3'-end processing, which are essential for assembly of an export competent ribonucleoprotein particle. Many viruses replicate in the nucleus of the host cell and require cellular mRNA export factors to efficiently export viral transcripts. However, some viral mRNAs undergo aberrant mRNA processing, thus prompting the viruses to express their own specific mRNA export proteins to facilitate efficient export of viral transcripts and allowing translation in the cytoplasm. This review will focus on the Kaposi’s sarcoma-associated herpesvirus ORF57 protein, a multifunctional protein involved in all stages of viral mRNA processing and that is essential for virus replication. Using the example of ORF57, we will describe cellular bulk mRNA export pathways and highlight their distinct features, before exploring how the virus has evolved to exploit these mechanisms

Support-seeking by cancer caregivers living in rural Australia

Objective: Rural cancer caregivers report poor wellbeing and high unmet needs for support. This study investigates sources of support sought by cancer caregivers living in rural Australia, and factors associated with support-seeking. Methods: Informal caregivers of people with cancer completed a questionnaire assessing sociodemographic characteristics, caregiver factors and support-seeking. Descriptive statistics, bivariate analyses and logistic regression were used to identify common sources of support and factors associated with support-seeking. Alluvial and radar plots were used to identify and describe support-seeking profiles. Findings: Of 244 rural caregivers, 64% reported seeking support for themselves, 72% for the cancer patient, and 22% did not seek any support. The most common sources of support were general practitioners and online. Higher caregiver burden, higher income, caring for someone with anxiety/depression or caring for someone who has difficulty completing their usual activities were associated with seeking support from a greater number of sources. The ‘No support-seekers’ profile had the highest proportions of caregivers who were male, caring for someone <12 months post-diagnosis and lower income earners. Conclusions: Many rural caregivers seek support for themselves and the cancer patient, commonly from medical and online sources. Implications for public health: Further work may be needed to reduce caregiver burden and support caregivers who are male, caring for someone recently diagnosed, and those with lower incomes