Evaluating emotional distress and health-related quality of life in patients with heart failure and their family caregivers:Testing dyadic dynamics using the Actor-Partner Interdependence Model

Purpose: 1) To compare levels of emotional symptoms and health-related quality of life between patients with heart failure and their family caregivers; and 2) to examine whether patients’ and caregivers’ emotional symptoms were associated with their own, as well as their partner’s health-related quality of life. Method: In this cross-sectional study, 41 patients-caregiver dyads (78% male patients, aged 68.6 years; and 83% female caregivers, aged 65.8 years) completed all nine dimensions of the Brief Symptom Inventory and the Minnesota Living with Heart failure Questionnaire. Dyadic data were analysed for 6 sub-scales of the Brief Symptom Inventory, using the Actor–Partner Interdependence Model. Results: There were no statistically significant differences in emotional symptoms and health-related quality of life between patients with heart failure and their caregivers. Patients’ and caregivers’ emotional symptoms were associated with their own health-related quality of life. Caregivers’ anxiety, phobic anxiety, obsession-compulsion, depression and hostility negatively influenced their partner’s (i.e. the patient’s) health-related quality of life. There were no partner effects of patients’ emotional symptoms on the health-related quality of life of caregivers. Conclusions: The results of this study suggest that patients may be particularly vulnerable to the emotional distress, i.e. thoughts, impulses and actions of their caregivers. It may be possible to improve patients’ health-related quality of life by targeting specific detrimental emotional symptoms of caregivers

Addressing Inequality: Framing Social Protection in National Development Strategies

It is important to address different inequalities and one way to achieve this is through social protection as a mechanism for redistribution. Achieving social justice and a reduction in inequalities through social protection will also require other policies to be in place. This article suggests that social protection will be most effective at reducing inequalities if it is integrated in a coherent national development strategy (NDS), which provides a framework for policy formulation and linkages, and if policies are rooted in solid analysis to enable them to target specific inequalities. It also argues that NDSs need to be formulated so that they are based on alternative visions of development that give voice to various groups, notably the excluded. ActionAid's NDS project is provided as an example of how to reduce inequalities and advance redistributive and transformative social protection

Integrated family support project outcome evaluation

The Integrated Family Support Project (IFSP) was established in late 2007 as a three year pilot project to develop a model for collaboration between government and nongovernment agencies and families in the Australian Capital Territory (ACT) who needed coordinated support. Framed by a strengths perspective, the program sought to work with families early in the life of the child and life of the problem, before the problems necessitated statutory child protection intervention, or in the early stages of statutory involvement. The IFSP was jointly funded for three years by the Commonwealth Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) and the ACT Department of Disability, Housing and Community Services (DHCS). It built upon a previous 12 month trial project, and ceased in November 2010 at the conclusion of funding. DHCS commissioned the Institute of Child Protection Studies (ICPS) at the Australian Catholic University (ACU) to develop an evaluation framework for the IFSP, provide sixmonthly progress reports after progress workshops, implement a medium-term process evaluation in 2009 and an outcome evaluation in 2010. This document reports the outcome evaluation

Evaluating perceptions of self-efficacy and quality of life in patients having coronary artery bypass grafting and their family caregivers

Background Self-efficacy is a critical factor for quality of life in patients who undergo coronary artery bypass grafting, as well as for their family caregivers. However, there is lack of knowledge about whether patients' self-efficacy and caregivers' perceptions of patient self-efficacy are associated with quality of life in patient and caregiver dyads. Objectives The aims of this study were to compare self-efficacy and quality of life between patients and family caregivers and to examine whether patients' and caregivers' perceptions of patient self-efficacy were associated with their own and their partner's quality of life in patient and caregiver dyads who were waiting for patients' coronary artery bypass grafting. Methods In this cross-sectional study, 84 dyads (85% male patients and 87% female caregivers) completed the Cardiac Self-efficacy Scale, which consists of self-efficacy for controlling symptoms and self-efficacy for maintaining function subscales, and the Short-Form 12 Health Survey for quality of life. Data were analyzed using the Actor-Partner Interdependence Model. Results Caregivers rated patient self-efficacy for maintaining function higher than did patients themselves and caregivers' perceptions were positively correlated with patients' physical health. Patients' self-efficacy for maintaining function exhibited an actor effect on their own mental health. There were no other actor or partner effects of self-efficacy on quality of life. Conclusions Differences between patients' and caregivers' perceptions of patient self-efficacy for maintaining function should be addressed before surgery to reduce discordance. Patients' self-efficacy for maintaining function was associated with their own quality of life. There was no partner (relationship) effect of self-efficacy on quality of life. More research is needed in this area

Macrophage migratory inhibitory factor (MIF) profiles are associated with indicators of physical and psychosocial stress in professional rugby league players

Introduction: MIF is an inflammatory cytokine which has a remarkable array of functions, including immune, metabolic and angiogenic effects. There is substantial evidence linking MIF to hypothalamic-pituitary-adrenal (HPA) axis functions, with MIF hypothesised to counter-regulate the anti-inflammatory actions of glucocorticoids (GC) at least partially by reducing the GC-sensitivity of immune cells. There is also evidence that changes in MIF are part of the well-established bi-directional links between psychological stress factors and dysregulation of inflammatory systems and HPA function. In professional athletes there is a unique combination of both physical and psychosocial stress which has been hypothesised to include immune dysfunction. The current study examined the association between indicators of physical and psychosocial stress on changes in MIF across a competitive season in professional rugby league players. Methods: Players (n=29) from a Sydney National Rugby League club participated in the study from February – August 2012. MIF was analysed in resting blood samples taken at least 24 hrs after the most recent exercise bout on six occasions approximately 1 month apart, with the first (baseline) sample taken prior to season start. From the same time points, data from standardised wellness questions was extracted from player diaries. Results: A significant effect of Time was observed in MIF levels (p\u3c.001), with a nadir at time 4 (May), and no difference between baseline and final samples (Feb-Aug). To determine salient associations, change in MIF from baseline to time 4 was calculated, and found to be negatively associated with the change over the same time period in stress/mood, sleep and muscle soreness, such that better mood, sleep quality and less muscle soreness were associated with lower levels of MIF. Conclusion: The current findings provide evidence that in a highly physically fit cohort, inflammatory markers are associated with indicators of both physical and psychosocial stress. MIF appears to be a reactive marker associated with stress and deserves further attention. Further, it may be important for athlete preparation to determine sleep and psychosocial stress influences on the homeostasis of inflammatory stress through GC function

Unpacking cohort social ties: the appropriateness of perceived social capital to graduate early career performance in construction project teams

Construction project teams require social capital. When present in appropriate forms, it creates the social cohesion through which individuals accept project goals as their own. It lets team members share knowledge when present and reveal when it is missing. In education, social learning helps students appreciate the need for social capital appropriate to team performance. In practice, social capital enables the project team learning that overcomes project-specific challenges. Despite this importance, little is known about how students perceive social capital or the compatibility of that understanding with construction project needs. To characterise this aspect of ‘graduateness’, collective understanding of social capital was elicited from construction students in a Scottish university by free recall. Analysis was structured around four dimensions of social capital: cohesion, legitimacy & authenticity, sharing, and safety. Notions of friendship were found to dominate student understanding of the social capital even though this understanding derived from settings where the need for capital to support team performance is emphasised. The potential for misalignment between the capital that graduating students bring into practice with that required by project teams was apparent. The case for further investigation of this influence on early career development was established

When signalling goes wrong:pathogenic variants in structural and signalling proteins causing cardiomyopathies

Cardiomyopathies are a diverse group of cardiac disorders with distinct phenotypes, depending on the proteins and pathways affected. A substantial proportion of cardiomyopathies are inherited and those will be the focus of this review article. With the wide application of high-throughput sequencing in the practice of clinical genetics, the roles of novel genes in cardiomyopathies are recognised. Here, we focus on a subgroup of cardiomyopathy genes [TTN, FHL1, CSRP3, FLNC and PLN, coding for Titin, Four and a Half LIM domain 1, Muscle LIM Protein, Filamin C and Phospholamban, respectively], which, despite their diverse biological functions, all have important signalling functions in the heart, suggesting that disturbances in signalling networks can contribute to cardiomyopathies