The Role of Psychological Well-Being in Weight Loss: New Insights from a Comprehensive Lifestyle Intervention

Background/Objective: Although the literature suggested that impaired psychological well-being (PWB) is associated with obesity, evidence on the role of PWB in weight outcomes is limited and inconclusive. This research aimed to investigate the joint role of PWB in achieving clinically significant weight loss (CWL; loss of 5% of the initial weight) through a comprehensive lifestyle intervention for obesity using a broad-based evaluation. Method: This study is a prospective cohort of 96 patients with obesity attending a comprehensive lifestyle intervention for weight loss. Data on weight, lifestyle, PWB, and distress, were collected before and after the intervention. Results: 30.5% of the participants achieved CWL at the end of treatment. A more pronounced increase in autonomy (odds ratio = 0.80 [95% CI: 0.68, 0.93], p ≤.01) and somatization (odds ratio = 0.83 [95% CI: 0.70, 0.98], p ≤.05) from pre- to post-treatment were independently associated with a lower probability of CWL. Conclusions: Unbalanced dimensions of PWB, in particular exceedingly high autonomy, may contribute to a poor weight loss outcome. This study paves the way for the addition of psychotherapeutic strategies geared to euthymia in comprehensive lifestyle intervention

Needs of multimorbid heart failure patients and their carers: a qualitative interview study and the creation of personas as a basis for a blended collaborative care intervention

IntroductionInvolving patients and carers in the development of blended collaborative care (BCC) interventions for multimorbid heart failure (HF) patients is recommended but rarely practised, and research on the patient perspective is scarce. The aim of this study is to investigate patients’ and carers' care-related needs and preferences to better customize a novel international BCC intervention.MethodsA qualitative study design using framework analysis was employed. The study was performed in accordance with the EQUATOR standards for reporting qualitative research (SRQR). Patients aged at least 65 years with HF and at least two other physical diseases as well as their carers completed semistructured interviews in Germany, Italy, and Denmark. Based on these interviews, personas (prototype profiles of patients and carers) were created.ResultsData from interviews with 25 patients and 17 carers were analysed. Initially, seven country-specific personas were identified, which were iteratively narrowed down to a final set of 3 personas: (a) the one who needs and wants support, (b) the one who has accepted their situation with HF and reaches out when necessary, and (c) the one who feels neglected by the health care system. Carers identifying with the last persona showed high levels of psychological stress and a high need for support.DiscussionThis is the first international qualitative study on patients' and carers' needs regarding a BCC intervention using the creation of personas. Across three European countries, data from interviews were used to develop three contrasting personas. Instead of providing “one size fits all” interventions, the results indicate that BCC interventions should offer different approaches based on the needs of individual patients and carers. The personas will serve as a basis for the development of a novel BCC intervention as part of the EU project ESCAPE (Evaluation of a patient-centred biopSychosocial blended collaborative CAre Pathway for the treatment of multimorbid Elderly patients)

Unambiguous detection of nitrated explosive vapours by fluorescence quenching of dendrimer films

Unambiguous and selective standoff (non-contact) infield detection of nitro-containingexplosives and taggants is an important goal but difficult to achieve with standard analyticaltechniques. Oxidative fluorescence quenching is emerging as a high sensitivity method fordetecting such materials but is prone to false positives—everyday items such as perfumeselicit similar responses. Here we report thin films of light-emitting dendrimers that detectvapours of explosives and taggants selectively—fluorescence quenching is not observed for arange of common interferents. Using a combination of neutron reflectometry, quartz crystalmicrobalance and photophysical measurements we show that the origin of the selectivity isprimarily electronic and not the diffusion kinetics of the analyte or its distribution in the film.The results are a major advance in the development of sensing materials for the standoffdetection of nitro-based explosive vapours, and deliver significant insights into the physicalprocesses that govern the sensing efficacy

The antecedents and outcomes of creative cognition

This chapter summarises the antecedents and outcomes that are associated with creative potential and creative achievement, as well as the outcomes of creative practice and engagement with the arts. It provides a concise overview of the relationships between creativity and individual or dispositional factors such as intelligence, personality and executive functions, while also exploring the effects of environmental or situational factors, such as reward and evaluation, on creativity and motivation with an especial focus on two important outcomes of creative cognition, academic achievement and wellbeing. The consequences associated with engagement in creative practice and arts-integrated teaching are also discussed

Psychological correlates of unexplained syncope: preliminary findings.

Background and Aims. 5-37% of the cases of syncope remain unexplained after a thorough medical evaluation. A psychogenic etiology is seldom investigated and a well-defined relationship between syncope and psychological distress has not yet been established. We aimed to assess psychological profile in patients with medically unexplained syncope. Methods. A consecutive series of 63 patients (mean age=47.9\ub117.8 years) with syncope of unknown origin underwent to head-up tilt test: 40 subjects presented vasovagal syncope-VVS, 23 unexplained syncope-US. The sample was evaluated by both observer-rated (DSM and DCPR) and self-rated (Symptom Questionnaire-SQ, Psychosocial Index-PSI, Illness Attitude Scale-IAS and Fear Questionnaire-FQ) methods. Differences on diagnoses and questionnaires\u2019 mean scores between VVS and US subjects were analyzed using \u3c72-test and analysis of variance. Results. Of the 63 patients, 60 had at least one DSM or DCPR diagnosis, such as specific phobia (47.6%), illness denial (22.2%) and demoralization (19%). We found no statistical differences on diagnoses\u2019 distribution between VVS and US patients. However, US group had significantly higher scores on SQ anxiety, depression and hostility (p<.01); worse outcomes on PSI stress (p<.01), well-being (p<.01) and psychological distress (p<.05); lower level of IAS health anxiety (p<.05), higher of nosophobia (p<.05). At the FQ, VVS were more blood (p=.007) and social phobic (p=.003), while US patients had more associated anxiety/depression (p=.039). Conclusion. Despite similar psychopathology, US patients reported higher psychological distress than VVS patients. These findings underline the need to include the evaluation of self-perceived distress in screening patients with US and consider it for effective treatment

Agent-based modeling of the El Farol Bar modeling

No abstract available

Stati depressivi, personalit&#224; di tipo D e comportamento di tipo A in pazienti cardiopatici.

Scopo dello studio \ue8 stato quello di indagare la frequenza e la comorbilit\ue0 tra diagnosi DSM dell\u2019area depressiva (depressione maggiore/minore e distimia), specifiche diagnosi DCPR (demoralizzazione e comportamento di tipo A) e personalit\ue0 di tipo D, in pazienti cardiopatici. Il campione \ue8 composto da una serie consecutiva di 161 pazienti afferenti ad un programma di cardiologia riabilitativa in seguito ad un intervento di cardiochirurgia (principalmente bypass, sostituzione/plastica valvolare e angioplastica). L\u2019assessment psicologico si \ue8 avvalso degli adattamenti italiani della SCID-I (moduli A e D), dell\u2019intervista sui DCPR (moduli riguardanti demoralizzazione e comportamento di tipo A) e del questionario DS-14 (per la diagnosi di personalit\ue0 di tipo D). All\u2019interno del campione le diagnosi DSM considerate ricorrono nel 34.8% dei casi, le diagnosi DCPR nel 31.7% e la personalit\ue0 di tipo D nel 16%. Per quanto riguarda la valutazione delle comorbilit\ue0, \ue8 emerso come i 26 soggetti con personalit\ue0 di tipo D presentino tutti una comorbilit\ue0 con o una diagnosi di demoralizzazione o di comportamento di tipo A. \uc8 emersa inoltre una comorbilit\ue0 significativa tra Depressione Maggiore e diagnosi di comportamento di tipo A e demoralizzazione. I risultati suggeriscono la necessit\ue0 di considerare, nell\u2019assessment di pazienti cardiopatici, sia gli stati depressivi e le sindromi psicosomatiche che la presenza di personalit\ue0 di tipo D, prestando particolare attenzione alle comorbilit\ue0 fra queste diagnosi. In Cardiologia Riabilitativa l\u2019assessment delle diagnosi depressive e delle sindromi psicosomatiche potrebbe condurre alla strutturazione di interventi specifici maggiormente mirati alla riduzione della sintomatologia

Type d personality in cardiovascular psychosomatics: association with type a behavior, demoralization and depression.

Introduction: Some authors pointed out that there is the need to include personality assessment in the early identification of patients at greater risk for distress-related cardiac events. Furthermore, despite the well-known role of depression in the clinical course of cardiovascular diseases, an increasing body of literature highlights that also sub-clinical depression should be considered. Objectives of this study were: 1) to assess specific configuration of personalities (type A/D) and clinical and subclinical depression (major/minor depression, dysthymia and demoralization) among patients in cardiac rehabilitation (CR); 2) to detect overlaps among syndromes. Methods: 246 patients (72.8% males), most of whom undergone angioplasty (38.6%) or valve surgery (30.9%), were enrolled in the study. Assessment included Structured Clinical Interview for DSM\u2013IV (SCID), Interview for the Diagnostic Criteria for Psychosomatic Research (DCPR) and 14-item Type D scale (DS14). Results: Within the sample, DSM diagnoses occurred in 33.3% of cases, DCPR in 41.5% (demoralization=24.8%, type A=28%), and type D personality in 17.9%. Among type D patients, only 18.2% did not show other comorbid diagnoses: 63.6% also presented demoralization, 45.5% type A behavior and 50% DSM depression. On the contrary, 45.9% of demoralized, 29% of type A and 27.2% of depressed patients showed type D traits. Discussion/conclusion: The use of psychosomatic and personality assessments may contribute to a better understanding of patients\u2019 psychological distress than traditional psychiatric nosography. Moreover, it may help to identify early specific subgroups of patients who might be at greater risk for further psychological and cardiac problems