801 research outputs found
Medication treatment perceptions, concerns and expectations among depressed individuals with Type I Bipolar Disorder
BACKGROUND: Subjective experience of illness affects outcomes among populations with bipolar disorder (BD). This cross-sectional study combined qualitative and quantitative approaches to evaluate perceived treatment effects, concerns and expectations among 90 individuals with BD. METHODS: Adults with type I BD, mean age 36.6 years, 51% women, completed a semi-structured interview that was audio taped, transcribed, coded and analyzed along emergent themes. Quantitative scales measured depressive symptoms (Hamilton Depression Scale/HAMD), psychopathology (Clinical Global Impression/CGI), and insight and treatment attitudes (Insight and Treatment Attitudes Questionnaire/ITAQ). RESULTS: Individuals had moderate depression and psychopathology with good insight into need for treatment. Drug treatment was perceived as beneficial, by âstabilizingâ or âbalancingâ mood (42%, N=38), decreasing anxiety/depressive symptoms (19%, N=17) and improving sleep (10%, N=9). While 39%, (N=35) of individuals denied medication concerns, nearly 29%, (N=26) feared possible long-term effects, particularly diabetes or liver/kidney damage. Media stories and advertisements contributed to medication fears. Hopes and expectations for treatment ranged from those that were symptom or functional status-based, such as desiring mood stabilization and elimination of specific symptoms (23%, N=21), to more global hopes such as âbeing normalâ (20%, N=18) or âcuredâ (18%, N=16). LIMITATIONS: Limitations include relatively small sample, lack of a comparator, inclusion of only depressed individuals and those willing to discuss their illness experience. CONCLUSIONS: While individuals with BD appreciate the effects of medications, concerns regarding adverse effects and discrepancy between actual and hoped-for outcomes can be substantial. Subjective experience with medications using qualitative and quantitative methods should be explored in order to optimize treatment collaboration and outcomes
Female reproductive strategy predicts preferences for sexual dimorphism in male faces
The aim of the current studies was to test an assumption that variation in female preferences for sexually dimorphic male facial characteristics reflects strategic optimisation of investment in offspring. A negative relationship was predicted between ideal number of children and preferences for masculine male face shapes, as the benefits of securing paternal investment should outweigh the benefits of securing good genes as the costs of raising offspring increase. In Study 1 desired number of children and preferences for masculine face shapes were compared in a sample of female students. In study 2, the prediction was tested in a sample with a wider age profile while controlling for relationship status. Preferences for explicit partner characteristics were also assessed. The prediction was supported: women who desired a higher number of children preferred more feminine male face shapes and ranked cues to investment of parental care over cues to immunocompetence in a partner more highly than those who desired fewer children. Results indicate that female mate preferences vary with reproductive strategy and support assumptions that preferences for feminine male faces reflect preferences for âgood dadsâ
Are workplace health promotion programs effective at improving presenteeism in workers? a systematic review and best evidence synthesis of the literature
<p>Abstract</p> <p>Background</p> <p><it>Presenteeism </it>is highly prevalent and costly to employers. It is defined as being present at work, but limited in some aspect of job performance by a health problem.</p> <p>Workplace health promotion (WHP) is a common strategy used to enhance on-the-job productivity. The primary objective is to determine if WHP programs are effective in improving presenteeism. The secondary objectives are to identify characteristics of successful programs and potential risk factors for presenteeism.</p> <p>Methods</p> <p>The Cochrane Library, Medline, and other electronic databases were searched from 1990 to 2010. Reference lists were examined, key journals were hand-searched and experts were contacted. Included studies were original research that contained data on at least 20 participants (â„ 18 years of age), and examined the impacts of WHP programs implemented at the workplace. The <it>Effective Public Health Practice Project Tool for Quantitative Studies </it>was used to rate studies. 'Strong' and 'moderate' studies were abstracted into evidence tables, and a best evidence synthesis was performed. Interventions were deemed successful if they improved the outcome of interest. Their program components were identified, as were possible risk factors contributing to presenteeism.</p> <p>Results</p> <p>After 2,032 titles and abstracts were screened, 47 articles were reviewed, and 14 were accepted (4 strong and 10 moderate studies). These studies contained preliminary evidence for a positive effect of some WHP programs. Successful programs offered organizational leadership, health risk screening, individually tailored programs, and a supportive workplace culture. Potential risk factors contributing to presenteeism included being overweight, a poor diet, a lack of exercise, high stress, and poor relations with co-workers and management. Limitations: This review is limited to English publications. A large number of reviewed studies (70%) were inadmissible due to issues of bias, thus limiting the amount of primary evidence. The uncertainties surrounding presenteeism measurement is of significant concern as a source of bias.</p> <p>Conclusions</p> <p>The presenteeism literature is young and heterogeneous. There is preliminary evidence that some WHP programs can positively affect presenteeism and that certain risk factors are of importance. Future research would benefit from standard presenteeism metrics and studies conducted across a broad range of workplace settings.</p
Current definitions of âtransdiagnosticâ in treatment development: A search for consensus
Research in psychopathology has identified psychological processes that are relevant across a range of Diagnostic and Statistical Manual (DSM) mental disorders, and these efforts have begun to produce treatment principles and protocols that can be applied transdiagnostically. However, review of recent work suggests that there has been great variability in conceptions of the term âtransdiagnosticâ in the treatment development literature. We believe that there is value in arriving at a common understanding of the term âtransdiagnostic.â The purpose of the current manuscript is to outline three principal ways in which the term âtransdiagnosticâ is currently used, to delineate treatment approaches that fall into these three categories, and to consider potential advantages and disadvantages of each approachFirst author draf
The influence of diet and physical activity on bone density of children aged 5-7 years: The Belfast HAPO family study
ObjectiveOsteoporosis is a global health issue, and modifiable behavioural factors need to be identified in childhood to reduce the risk of osteoporosis in later life. The aim of this study was to investigate the influence of diet and physical activity on bone density of children aged 5â7 years participating in the Belfast Hyperglycaemia and Adverse Pregnancy Outcome (HAPO) Family study.Design and methodsPregnant women were recruited to the Belfast centre of the HAPO study at 24â32 weeks gestation. Offspring were followed up at 5â7 years as part of the Belfast HAPO Family Study. Heel bone mineral density (BMD) and bone mineral apparent density (BMAD) were measured and calculated, respectively. Physical activity in the offspring was measured by accelerometery and dietary intakes were measured using a 4-day food diary.ResultsResults from 793 offspring were analysed. Mean age of the offspring ± standard deviation was 6.4 ± 0.5 years. A mean of 48.3 ± 22.4 min each day was spent in moderate to vigorous physical activity (MVPA). Median (interquartile range) dietary calcium and vitamin D intakes were 844 (662â1073) mg/day and 1.7 (1.1â2.5) ÎŒg/day, respectively. Neither dietary vitamin D nor calcium intakes were significantly associated with offspring heel BMD or BMAD in multiple regression. However, controlling for confounders, a 30-min greater MVPA was associated with significantly larger heel BMD (0.018 g/cm2 in boys and 0.010 g/cm2 in girls) and BMAD (0.005 g/cm3 in boys and 0.003 g/cm3 in girls).ConclusionPhysical activity was associated with better BMD and BMAD in 5â7-year-old children. Dietary calcium and vitamin D were not predictive of BMD and BMAD
Anthocyanins do not influence long-chain n-3 fatty acid status:Studies in cells, rodents and humans
Increased tissue status of the long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFA), eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) is associated with cardiovascular and cognitive benefits. Limited epidemiological and animal data suggest that flavonoids, and specifically anthocyanins, may increase EPA and DHA levels, potentially by increasing their synthesis from the shorter-chain n-3 PUFA, α-linolenic acid. Using complimentary cell, rodent and human studies we investigated the impact of anthocyanins and anthocyanin-rich foods/extracts on plasma and tissue EPA and DHA levels and on the expression of fatty acid desaturase 2 (FADS2), which represents the rate limiting enzymes in EPA and DHA synthesis. In experiment 1, rats were fed a standard diet containing either palm oil or rapeseed oil supplemented with pure anthocyanins for 8 weeks. Retrospective fatty acid analysis was conducted on plasma samples collected from a human randomized controlled trial where participants consumed an elderberry extract for 12 weeks (experiment 2). HepG2 cells were cultured with α-linolenic acid with or without select anthocyanins and their in vivo metabolites for 24 h and 48 h (experiment 3). The fatty acid composition of the cell membranes, plasma and liver tissues were analyzed by gas chromatography. Anthocyanins and anthocyanin-rich food intake had no significant impact on EPA or DHA status or FADS2 gene expression in any model system. These data indicate little impact of dietary anthocyanins on n-3 PUFA distribution and suggest that the increasingly recognized benefits of anthocyanins are unlikely to be the result of a beneficial impact on tissue fatty acid status
Comparison of Inappropriate Shocks and Other Health Outcomes Between Single- and Dual-Chamber Implantable Cardioverter-Defibrillators for Primary Prevention of Sudden Cardiac Death: Results from the Cardiovascular Research Network Longitudinal Study of Implantable Cardioverter-Defibrillators
Background In US clinical practice, many patients who undergo placement of an implantable cardioverterâdefibrillator (ICD) for primary prevention of sudden cardiac death receive dualâchamber devices. The superiority of dualâchamber over singleâchamber devices in reducing the risk of inappropriate ICD shocks in clinical practice has not been established. The objective of this study was to compare risk of adverse outcomes, including inappropriate shocks, between singleâ and dualâchamber ICDs for primary prevention. Methods and Results We identified patients receiving a singleâ or dualâchamber ICD for primary prevention who did not have an indication for pacing from 15 hospitals within 7 integrated health delivery systems in the Longitudinal Study of Implantable CardioverterâDefibrillators from 2006 to 2009. The primary outcome was time to first inappropriate shock. ICD shocks were adjudicated for appropriateness. Other outcomes included allâcause hospitalization, heart failure hospitalization, and death. Patient, clinician, and hospitalâlevel factors were accounted for using propensity score weighting methods. Among 1042 patients without pacing indications, 54.0% (n=563) received a singleâchamber device and 46.0% (n=479) received a dualâchamber device. In a propensityâweighted analysis, device type was not significantly associated with inappropriate shock (hazard ratio, 0.91; 95% confidence interval, 0.59â1.38 [P=0.65]), allâcause hospitalization (hazard ratio, 1.03; 95% confidence interval, 0.87â1.21 [P=0.76]), heart failure hospitalization (hazard ratio, 0.93; 95% confidence interval, 0.72â1.21 [P=0.59]), or death (hazard ratio, 1.19; 95% confidence interval, 0.93â1.53 [P=0.17]). Conclusions Among patients who received an ICD for primary prevention without indications for pacing, dualâchamber devices were not associated with lower risk of inappropriate shock or differences in hospitalization or death compared with singleâchamber devices. This study does not justify the use of dualâchamber devices to minimize inappropriate shocks
- âŠ