Can Psychology Research Inform Health Information Data Collection?

Conclusions drawn from electronic medical records (EMRs) are only as accurate as the data provided. Recent findings by psychologists and health researchers may help streamline health information data collection and subsequent data analysis. Specifically, four areas will be discussed: (1) Standardization of terms between the patient and the health professionals, (2) Impact of patient inattention and fatigue when responding to health measures, (3) Importance of source labeling within the medical record (e.g., self-administered questionnaire, responded via phone, etc.), (4) Cognitive load on patients when using mobile health technology (e.g., apps, tablets, online patient portal, etc.). Research suggests consideration of these potential biases could provide the patient with a better health care experience, assist the health care provider in diagnosis and treatment, conserve time and resources, and aid researchers as they consider health outcomes

Sexuality and intimacy among people living with serious mental illnesses: Factors contributing to sexual activity

OBJECTIVE: Limited research has focused on sexuality for those diagnosed with a severe mental illness. We aimed to extend existing work by exploring relationships between mastery (perception of control of one's life and future), sexual self-esteem (perceptions of one's capacity to engage in healthy sexual behavior), sexual attitudes (permissive ideas about sexuality), and perceived importance of relationships/sexuality and number of sexual partners. METHOD: A secondary analysis of survey data from adult participants living with a severe mental illness (N = 401) in the Indiana Mental Health Services and HIV-Risk Study (Perry & Wright, 2006) was conducted. Analysis of covariance (controlling for marital status) compared those with 0 partners, 1 partner, or multiple partners over the past 3 months on the dependent variables of mastery, sexual self-esteem, sexual attitudes, and perceived importance. RESULTS: Participants with more permissive attitudes, greater perceived importance, and higher mastery were more likely to be sexually active with multiple partners. Self-esteem did not differentiate groups. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Given the key role of sexual satisfaction in quality of life and the high rates of sexual risk behavior in this population, it is important that clinicians systematically assess mastery, perceived importance, and attitudes about sexuality when working with consumers diagnosed with a severe mental illness. Individually tailoring existing interventions on the basis of consumers' levels of mastery, related to self-efficacy for implementing changes in life, could improve long-term outcomes for these programs. Future research should examine other constructs that may account for more variance in sexual activity, such as perceptions of risk, intentions for sexual safety, or romantic relationship functioning

'Swimmability' : a key element for communities to safely engage with Australian urban rivers

Australia’s largest cities are growing, and this is placing increasing pressure on urban waterways. There is a growing awareness that the quality of life in Australian urban communities is enhanced through the engagement of people with healthy urban rivers. Swimming, boating, and fishing in many Australian urban waterways are popular recreational activities. Swimming and other activities associated with waterways contributes to quality of life in urban communities. Swimming in urban rivers can be risky. Hazards include dangerous currents, aquatic plants, submerged hazards, algal blooms, and unsuitable water quality. In Sydney, Australia’s largest City, swimming is popular in the Hawkesbury-Nepean River. Data from showed that E. coli levels in the river occasionally exceeded safe recreational guidelines for human health. The results are not reported to the public. We believe that it is more important than ever that government, industry and scientific bodies work to protect and improve the water quality of Australian urban rivers as our cities grow. Sharing this information with the community needs to consider education programs, public forums, and timely communication of the current state of local Australian urban rivers regarding their ‘swimmability’

Estimating adolescent sleep patterns: parent reports versus adolescent self-report surveys, sleep diaries, and actigraphy

In research and clinical contexts, parent reports are often used to gain information about the sleep patterns of their adolescents; however, the degree of concordance between parent reports and adolescent-derived measures is unclear. The present study compares parent estimates of adolescent sleep patterns with adolescent self-reports from surveys and sleep diaries, together with actigraphy. Methods: A total of 308 adolescents (59% male) aged 13–17 years completed a school sleep habits survey during class time at school, followed by a 7-day sleep diary and wrist actigraphy. Parents completed the Sleep, Medical, Education and Family History Survey. Results: Parents reported an idealized version of their adolescent’s sleep, estimating significantly earlier bedtimes on both school nights and weekends, significantly later wake times on weekends, and significantly more sleep than either the adolescent self-reported survey, sleep diary, or actigraphic estimates. Conclusion: Parent reports indicate that the adolescent averages a near-optimal amount of sleep on school nights and a more than optimal amount of sleep on weekends. However, adolescent-derived averages indicate patterns of greater sleep restriction. These results illustrate the importance of using adolescent-derived estimates of sleep patterns in this age group and the importance of sleep education for both adolescents and their parents

Factor structure of the autonomy preference index in people with severe mental illness

People vary in the amount of control they want to exercise over decisions about their healthcare. Given the importance of patient-centered care, accurate measurement of these autonomy preferences is critical. This study aimed to assess the factor structure of the Autonomy Preference Index (API), used widely in general healthcare, in individuals with severe mental illness. Data came from two studies of people with severe mental illness (N=293) who were receiving mental health and/or primary care/integrated care services. Autonomy preferences were assessed with the API regarding both psychiatric and primary care services. Confirmatory factor analysis was used to evaluate fit of the hypothesized two-factor structure of the API (decision-making autonomy and information-seeking autonomy). Results indicated the hypothesized structure for the API did not adequately fit the data for either psychiatric or primary care services. Three problematic items were dropped, resulting in adequate fit for both types of treatment. These results suggest that with relatively minor modifications the API has an acceptable factor structure when asking people with severe mental illness about their preferences to be involved in decision-making. The modified API has clinical and research utility for this population in the burgeoning field of autonomy in patient-centered healthcare

Unemployment in Iraqi Refugees: The Interaction of Pre and Post-Displacement Trauma

Previous refugee research has been unable to link pre-displacement trauma with unemployment in the host country. The current study assessed the role of pre-displacement trauma, post-displacement trauma, and the interaction of both trauma types to prospectively examine unemployment in a random sample of newly-arrived Iraqi refugees. Participants (N = 286) were interviewed three times over the first two years post-arrival. Refugees were assessed for pre-displacement trauma exposure, post-displacement trauma exposure, a history of unemployment in the country of origin and host country, and symptoms of posttraumatic stress disorder (PTSD) and depression. Analyses found that neither pre-displacement nor post-displacement trauma independently predicted unemployment 2 years post-arrival; however, the interaction of pre and post-displacement trauma predicted 2-year unemployment. Refugees with high levels of both pre and post-displacement trauma had a 91% predicted probability of unemployment, whereas those with low levels of both traumas had a 20% predicted probability. This interaction remained significant after controlling for sociodemographic variables and mental health upon arrival to the US. Resettlement agencies and community organizations should consider the interactive effect of encountering additional trauma after escaping the hardships of the refugee\u27s country of origin

Respiratory Sinus Arrhythmia as an Index of Vagal Activity during Stress in Infants: Respiratory Influences and Their Control

Respiratory sinus arrhythmia (RSA) is related to cardiac vagal outflow and the respiratory pattern. Prior infant studies have not systematically examined respiration rate and tidal volume influences on infant RSA or the extent to which infants' breathing is too fast to extract a valid RSA. We therefore monitored cardiac activity, respiration, and physical activity in 23 six-month old infants during a standardized laboratory stressor protocol. On average, 12.6% (range 0–58.2%) of analyzed breaths were too short for RSA extraction. Higher respiration rate was associated with lower RSA amplitude in most infants, and lower tidal volume was associated with lower RSA amplitude in some infants. RSA amplitude corrected for respiration rate and tidal volume influences showed theoretically expected strong reductions during stress, whereas performance of uncorrected RSA was less consistent. We conclude that stress-induced changes of peak-valley RSA and effects of variations in breathing patterns on RSA can be determined for a representative percentage of infant breaths. As expected, breathing substantially affects infant RSA and needs to be considered in studies of infant psychophysiology

Effects of Prenatal Social Stress and Maternal Dietary Fatty Acid Ratio on Infant Temperament: Does Race Matter?

Background: Infant temperament predicts a range of developmental and behavioral outcomes throughout childhood. Both maternal fatty acid intake and psychosocial stress exposures during pregnancy may influence infant temperament. Furthermore, maternal race may modify prenatal diet and stress effects. The goals of this study are to examine the joint effects of prenatal diet and stress and the modifying effects of race on infant behavior. Methods: Analyses included N=255 mother-infant dyads, primarily minorities (21% Blacks; 42% Hispanics), enrolled in an urban pregnancy cohort. Maternal prenatal stress was indexed by a negative life events (NLEs) score on the Crisis in Family Systems-Revised survey. Prenatal total daily intakes of polyunsaturated fatty acids (PUFAs) (n3, n6) were estimated from a food frequency questionnaire; n3:n6 ratios were calculated. Mothers completed the Infant Behavior Questionnaire-Revised (IBQ-R), a measure of infant temperament, when the children were 6 months old. Three commonly used dimensions were derived: Orienting & Regulation, Extraversion, and Negative Affectivity. Associations among prenatal stress, maternal n3:n6 ratio, and race/ethnicity on infant temperament, controlling for maternal education and age and child sex, were examined. Results: Among Blacks, prenatal stress effects on infant Orienting & Regulation scores were modified by maternal n3:n6 ratios (p=0.03): As NLEs increased, lower n3:n6 ratios predicted lower infant Orienting & Regulation scores, whereas higher n3:n6 ratios attenuated the effect of prenatal stress. There were no main or interaction effects predicting Extraversion or Negative Affectivity. Conclusions: An optimal PUFA ratio may protect the fetus from stress effects on infant behavior, particularly among Blacks. These findings may have implications for later neurodevelopment and social functioning predicted by early temperamental characteristics

Elevated sodium concentrations in Australian drinking water supplies

Salt in the drinking water of many Australian water supplies could be adversely contributing to the ill-health of many people. Health care professionals often recommend low-sodium diets for patients with kidney disease, heart disease and cardiovascular disease. It is recommended that people on a low-sodium diet drink water with less than 20 mg/L of sodium. The sodium concentration of water supplies in many regional and remote regions of Australia often had water with elevated sodium (more than 20 mg/L) in their water supplies. In NSW 17 of the 21 regional water supplies tested had higher than 20 mg/L sodium. The issue of elevated sodium in many Australian drinking water supplies needs to be recognised more prominently. Sodium needs to be sampled more frequently and the results shared openly with consumers and health professionals. All water authorities that provide drinking water with sodium concentrations higher than 20 mg/L should be advising their customers of this fact as a high priority. People on low-sodium diets that have >20 mg/L sodium in their water supply should consider options to obtain low-sodium water