The psychological impact of screening for preeclampsia : a qualitative study

Background: The screening test, to establish risk status for pre-term preeclampsia (PE), is a relatively recent medical advancement. Although the psychological impact of screening for various maternal conditions is well established, it is currently unknown as to the impact of screening for pre-term PE. PE is a condition which can affect not only the mother’s health but also the health of her unborn child. Aims: The primary aim of this thesis was to explore the psychological impact of screening for pre-term PE risk status, comparing the illness representations of women identified as high-risk with those identified as low-risk. The studies in this thesis also address how women reflect on their experiences of screening for pre-term PE, the factors that influenced them to take part, and how they would feel about participating in pre-term PE risk screening in the future. Finally, the studies in this thesis ran in conjunction with a medicated RCT, investigating the effects of aspirin versus a placebo in reducing pre-term PE incidence. This thesis also sought to establish the factors that influence participation or non-participation in the RCT. Methods: This is a qualitative thesis; semi-structured interviews were conducted with high- and low-risk women, after they had been screened and found out their risk status. The interview template was informed by the Common-Sense Model of illness representations and transcripts were analysed using Template Analysis. Results: The women who participated in these studies did not report experiencing any adverse psychological effects as a result of the screening process or finding out their risk status for pre-term PE. Women held positive views towards prenatal screening in general and also screening for pre-term PE risk. Low-risk women felt reassured as results provided comfort. High-risk women were encouraged that they would receive appropriate medical care and be more aware themselves of signs or symptoms of PE. For those high-risk women invited to participate in a medicated RCT, women demonstrated good knowledge of the trial suggesting they made fully informed decisions. The main factor that influenced non-participation in the trial was negative attitudes towards taking medication during pregnancy and worries around potential side effects. Participants of the trial reported that their main reason for taking part was the close medical attention they would receive. They believed the extra medical awareness from the trial, and extra scan appointments, would be beneficial and reassuring, regardless of whether they were included in the active or placebo arm of the RCT. Conclusions: The current research indicates that women did not, generally, experience adverse psychological effects from being screened or receiving their result for pre-term PE. This contributes and supports the previous research suggesting screening for pre-term PE risk should be recommended. This study also suggests that in order to increase uptake, in both medicated pregnancy RCTs and with aspirin for the prevention of pre-term PE, women would benefit from receiving more knowledge and understanding around the safety of taking such medications during pregnancy, from medical staff

Behavioural inhibition and early neural processing of happy and angry faces interact to predict anxiety: a longitudinal ERP study

Limited prospective research has examined whether attention biases to emotion moderate associations between Behavioural Inhibition (BI) and anxiety in preschool-aged children. Furthermore, there has been an over-reliance on behavioral measures in previous studies. Accordingly, we assessed anxiety in a sample of preschool-aged children (3–4 years) at baseline, and again approximately 6 and 11 months later, after they started school. At baseline, children completed an assessment of BI and an EEG task where they were presented with angry, happy, and neutral faces. EEG analyses focused on ERPs (P1, P2, N2) associated with specific stages of attention allocation. Interactions between BI and emotion bias (ERP amplitude for emotional versus neutral faces) were found for N2 and P1. For N2, BI was significantly associated with higher overall anxiety when an angry bias was present. Interestingly for P1, BI was associated with higher overall anxiety when a happy bias was absent. Finally, interactions were found between linear time and happy and angry bias for P1, with a greater linear decrease in anxiety over time when biases were high. These results suggest that attention to emotional stimuli moderates the BI-anxiety relationship across early development

Uncertain world: How children’s curiosity and intolerance of uncertainty relate to their behaviour and emotion under uncertainty

Curiosity and intolerance of uncertainty (IU) are both thought to drive information seeking but may have different affective profiles; curiosity is often associated with positive affective responses to uncertainty and improved learning outcomes, whereas IU is associated with negative affective responses and anxiety. Curiosity and IU have not previously been examined together in children but may both play an important role in understanding how children respond to uncertainty. Our research aimed to examine how individual differences in parent-reported curiosity and IU were associated with behavioural and emotional responses to uncertainty. Children aged 8 to 12 (n = 133) completed a game in which they were presented with an array of buttons on the screen that, when clicked, played neutral or aversive sounds. Children pressed buttons (information seeking) and rated their emotions and worry under conditions of high and low uncertainty. Facial expressions were also monitored for affective responses. Analyses revealed that children sought more information under high uncertainty than low uncertainty trials and that more curious children reported feeling happier. Contrary to expectations, IU and curiosity were not related to the number of buttons children pressed, nor to their self-reported emotion or worry. However, exploratory analyses suggest that children who are high in IU may engage in more information seeking that reflects checking or safety-seeking than those who are low in IU. In addition, our findings suggest that there may be age-related change in the effects of IU on worry, with IU more strongly related to worry in uncertain situations for older children than younger children

Uncertain world: How children’s curiosity and intolerance of uncertainty relate to their behaviour and emotion under uncertainty

Curiosity and intolerance of uncertainty (IU) are both thought to drive information seeking but may have different affective profiles; curiosity is often associated with positive affective responses to uncertainty and improved learning outcomes, whereas IU is associated with negative affective responses and anxiety. Curiosity and IU have not previously been examined together in children but may both play an important role in understanding how children respond to uncertainty. Our research aimed to examine how individual differences in parent-reported curiosity and IU were associated with behavioural and emotional responses to uncertainty. Children aged 8 to 12 (n = 133) completed a game in which they were presented with an array of buttons on the screen that, when clicked, played neutral or aversive sounds. Children pressed buttons (information seeking) and rated their emotions and worry under conditions of high and low uncertainty. Facial expressions were also monitored for affective responses. Analyses revealed that children sought more information under high uncertainty than low uncertainty trials and that more curious children reported feeling happier. Contrary to expectations, IU and curiosity were not related to the number of buttons children pressed, nor to their self-reported emotion or worry. However, exploratory analyses suggest that children who are high in IU may engage in more information seeking that reflects checking or safety-seeking than those who are low in IU. In addition, our findings suggest that there may be age-related change in the effects of IU on worry, with IU more strongly related to worry in uncertain situations for older children than younger children

Trajectories of anxiety when children start school: the role of behavioural inhibition and attention bias to angry and happy faces

Extensive research has examined attention bias to threat in the context of anxiety in adults, but little is understood about this association in young children and there is a dearth of longitudinal research examining whether attention bias to threat predicts anxiety over time in childhood. In the current study, a sample of 180 children participated in a longitudinal study, first as preschoolers and again as they transitioned to formal schooling. At baseline, children aged 3-4 years completed a free-viewing eyetracking task with angry-neutral and happy-neutral face pairs and an assessment of behavioural inhibition (BI). At follow-up, parents provided daily reports of their child’s state anxiety over a 2-week period as their child started school and completed a measure of their child’s anxiety symptoms. Results indicated that, on average, preschool-aged children exhibit a bias for emotional faces that is stronger for angry than happy faces. There was little evidence that this bias was associated with anxiety symptoms. However, BI interacted with dwell bias for angry faces to predict trajectories of anxiety over the transition to school. An unexpected interaction between BI and dwell bias for happy faces was also found, with dwell for happy faces associated with lower anxiety for children higher in BI. The findings are consistent with recent developmental models of the BI-anxiety relationship and indicate that attention bias modification may not be suitable for young children, for whom attention bias to threat may be normative

HIV and adolescents: focus on young key populations

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138345/1/jia20076.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138345/2/jia20076-sup-0001.pd

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

A systematic review of the barriers and facilitators impacting patient enrolment in clinical trials for lung cancer

Purpose. Clinical research trials are needed to enhance the medical care and treatment for lung cancer, which remains the leading cause of cancer-related deaths worldwide. While clinical trials allow for the development of novel therapies to treat cancer, the recruitment of lung cancer patients to trials is low. This review aimed to identify and synthesise the available literature concerning barriers and facilitators affecting lung cancer patients’ decisions to enrol in clinical trials to guide future cancer research efforts. Methods. Four databases were systematically searched: Academic Search Complete, CINHAL, PubMed, and PsycINFO in August 2023. A supplemental grey literature search was also conducted alongside this. Articles were quality appraised using CASP and JMI checklists, and results were narratively synthesised. Results. Eighteen articles of varied design met the inclusion criteria, and results were mapped onto the Capability, Opportunity, and Motivation Behaviour (COM-B) Model to help structure and conceptualise review findings. Evidence suggests that the decision to enrol in a trial is multifaceted and informed by: when and how study information is presented, travel and trial eligibility, and altruistic hopes and fears. Conclusions. There is need to address the many different concerns that lung cancer patients have about participating in a clinical trial through the supply of accessible and timely trial information, and via the reduction of travel, expansion of study eligibility criteria, and recognition of a person's altruistic wishes, hopes, fears, and family-oriented concerns. Future research should aim to work alongside lung cancer patients, clinicians, and other stakeholders to increase research accessibility