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1.
Pediatr Res ; 2024 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-39294239

RESUMEN

BACKGROUND: Limited evidence exists on the preferred feeding method when breastfeeding is not possible in late and moderate preterm (LMPT) infants. This RCT evaluates growth, safety, and tolerance of a concept infant formula (IF) with large, milk phospholipid-coated lipid droplets enriched in dairy lipids in LMPT infants with primary objective to demonstrate non-inferiority of daily weight gain from randomization to 3 months corrected age compared to a standard IF. METHODS: LMPT infants were randomized before or around term equivalent age to either the concept (n = 21) or standard IF (n = 20). Forty-one breastfed (BF) infants served as reference. RESULTS: Due to unintended low recruitment, non-inferiority in daily weight gain could not be demonstrated for the Concept compared to the Control group, but was compared to the BF group. Other outcomes were similar between the formula groups, except for an apparent larger head circumference gain in the Concept group. No apparent differences in growth and body composition outcomes were observed between the Concept and BF reference groups. CONCLUSION: This small-scale study suggests the concept IF is a safe alternative for parents who choose IF to feed their LMPT infant. Larger trials are needed to better determine impacts on head growth or body composition. IMPACT: In a small group of late and moderate preterm infants, growth from randomization until 3 months corrected age of infants fed with a concept infant formula with large, milk phospholipid-coated lipid droplets was not -significantly different from infants fed a standard infant formula. Infants in the Concept group had non-significant larger gain in head circumference compared to the Control group; larger trials are needed to confirm this finding. Both formulas were well-tolerated, with no differences in adverse events. The concept formula is potentially a safe alternative for parents of moderate to late preterm infants who choose to use formula milk.

2.
Am J Bioeth ; 24(10): 37-40, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39283400
3.
Mil Med ; 189(Supplement_3): 142-148, 2024 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-39160826

RESUMEN

INTRODUCTION: Positive and negative affect influence an individual's ability to utilize available physical, psychological, and social resources to maximize responses to life events. Little research has examined the factors that influence the development of positive affect or reduction of negative affective responses among deployed military personnel. The present study aimed to investigate the relationship between deployment-related stressors and symptoms of behavioral health concerns with affectivity among deployed U.S. service members. MATERIALS AND METHODS: Participants were 1148 U.S. Air Force medical personnel deployed to Balad, Iraq, between 2004 and 2011. All participants completed self-report measures of PTSD symptoms, general military and combat exposure, stress, and affectivity. The Institutional Review Board at Wilford Hall Medical Center, the Air Force Personnel Survey Program, and the U.S. Army's Joint Combat Casualty Research Team reviewed and approved the study. RESULTS: Most respondents (89%, 1,018/1,139) reported a positive military experience, but many respondents reported exposure to a potentially traumatic event during deployment. For example, seeing dead or seriously injured Americans (47%, 523/1,123) was the most common exposure reported by participants. A large portion of personnel (21%, 232/1,089) reported clinical levels of PTSD symptoms (score of 33 or higher on the Posttraumatic Stress Disorder Checklist-Military version). Risk factors, including PTSD symptoms, combat exposure, and stress, explained 39% of the variance in negative affect, R2 = 0.39, F(1046) = 224.96, P < .001. Conversely, these risk and resilience factors, including PTSD symptoms, combat exposure, stress, and general military experiences, explained 28% of the variance in positive affect, R2 = 0.28, F(1050) = 103.79, P < .001. No significant gender differences were found between models predicting positive and negative affect. CONCLUSIONS: Negative mood states may be partly an epiphenomenon of PTSD, which has been shown to be safely and effectively treated in the deployed environment. Social support during deployments is uniquely associated with a positive mood. These findings extend beyond the military and into any high-stress occupation wherein leaders could interpret these findings as a need to build or reinforce efforts to provide opportunities to sustain healthy relationships in personnel. These critical indigenous resources support mission readiness and enable the maintenance of positive psychological health.


Asunto(s)
Afecto , Personal Militar , Trastornos por Estrés Postraumático , Humanos , Masculino , Femenino , Adulto , Personal Militar/psicología , Personal Militar/estadística & datos numéricos , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/epidemiología , Estados Unidos/epidemiología , Encuestas y Cuestionarios , Despliegue Militar/psicología , Despliegue Militar/estadística & datos numéricos , Guerra de Irak 2003-2011 , Estrés Psicológico/psicología , Estrés Psicológico/etiología , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Persona de Mediana Edad , Autoinforme/estadística & datos numéricos
4.
Clin Psychol Eur ; 6(Spec Issue): e12067, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-39118647

RESUMEN

The purpose of this article is to provide a brief overview of how clinical psychology evolved in the United States as a prelude to discussing the emergence of psychological clinical science in the closing years of the 20th century. Despite the growth of clinical psychology, mental disorders remain highly prevalent, compelling us to envision new ways to deliver services in an effective but efficient manner. Topics include the dissemination gap, the affordable access gap, and the Psychological Clinical Science Accreditation System (PCSAS). Examples of novel methods for addressing the problem of public mental health in the 21st century are discussed. Finally, I close by considering the potential relevance of our experience in America for European clinical psychology.

5.
Artículo en Inglés | MEDLINE | ID: mdl-39150515

RESUMEN

A fire in one of the Windscale nuclear reactors at Sellafield (Cumbria, England) in October 1957 released 1,800 TBq of 131I (half-life, 8 days) to atmosphere. Measurements of 131I activity in thyroids of exposed children showed typical thyroid doses of tens of milligray, but with some exceeding 100 mGy. Radiation exposure in childhood is known to increase the risk of thyroid cancer. Consequently, an investigation was conducted into whether raised numbers of thyroid cancer cases occurred in those exposed to 131I as young children in Cumbria. A database of Cumbrian births from 1950 onwards allowed cohorts of 56,086 births during 1950-1958 and 137,444 births during 1959-1980 to be constructed, periods including children potentially exposed and unexposed, respectively, to 131I. Three areas of Cumbria with different 131I contamination levels were identified from monitoring data, and births assigned to these three areas for the two periods of birth. Members of these six sub-cohorts were linked to incident thyroid cancer cases in Great Britain during 1981-2020 using national cancer registration databases, providing thyroid cancer incidence rates. Incidence rate ratios (IRRs), with the lowest contamination area as a reference, were computed. No IRR differed discernibly from unity. For births during 1950-1958, the IRR for the combined highest and intermediate 131I contamination areas was 0.68 (95% confidence interval: 0.24, 1.56), and no case of thyroid cancer was found in the small cohort born in the highest contamination area. In conclusion, no increased risk of thyroid cancer in those exposed to 131I as young children in Cumbria in 1957 was detected. This study adds to the evidence on the long-term risk of thyroid cancer following childhood exposure to low and moderate levels of 131I, such as occurred following the Fukushima nuclear accident in 2011.

6.
J Anxiety Disord ; 106: 102896, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39018679

RESUMEN

PTSD has been associated with negative long-term consequences, including social and occupational impairments. Yet, a nuanced understanding of the interplay between PTSD symptoms and distinct domains of impairments on a short-term basis (weeks/ months) at the within-person level remains underexplored. In a large sample (nwave 1 = 1096, nwave 7 = 304) of UK healthcare workers assessed across seven assessment waves during the COVID-19 pandemic (spaced 6 weeks apart), we employed exploratory graphical vector autoregression models (GVAR) models to discern within-person temporal (across time) and contemporaneous (within same time window) dynamics between PTSD symptoms and functional impairment domains. The contemporaneous network highlighted strong co-occurrences between different symptoms and impairments. The temporal network revealed a mutually reinforcing cycle between intrusion and avoidance symptoms. Intrusion symptoms showed the highest out-strength (i.e., most predictive symptom), predicting avoidance symptoms, elevated sense of current threat, and various functional impairments. Avoidance symptoms, elevated after increased levels of intrusions, predicted work impairments that in turn were associated with difficulties in fulfilling other obligations. Our findings underscore the dynamics between perceived threat and intrusions, and the role intrusions may play in predicting a cascade of adverse effects. Targeted interventions aimed at mitigating intrusions may disrupt this negative cycle.


Asunto(s)
COVID-19 , Personal de Salud , Trastornos por Estrés Postraumático , Humanos , Trastornos por Estrés Postraumático/psicología , Masculino , COVID-19/psicología , Reino Unido , Femenino , Estudios Longitudinales , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Adulto , Persona de Mediana Edad , SARS-CoV-2
7.
Viruses ; 16(6)2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38932112

RESUMEN

HIV-associated neurocognitive disorders (HAND) are highly prevalent in those ageing with HIV. High-income country data suggest that vascular risk factors (VRFs) may be stronger predictors of HAND than HIV-disease severity, but data from sub-Saharan Africa are lacking. We evaluated relationships of VRFs, vascular end-organ damage and HAND in individuals aged ≥ 50 in Tanzania. c-ART-treated individuals were assessed for HAND using consensus criteria. The prevalence of VRFs and end organ damage markers were measured. The independent associations of VRFs, end organ damage and HAND were examined using multivariable logistic regression. Data were available for 153 individuals (median age 56, 67.3% female). HAND was highly prevalent (66.7%, 25.5% symptomatic) despite well-managed HIV (70.5% virally suppressed). Vascular risk factors included hypertension (34%), obesity (10.5%), hypercholesterolemia (33.3%), diabetes (5.3%) and current smoking (4.6%). End organ damage prevalence ranged from 1.3% (prior myocardial infarction) to 12.5% (left ventricular hypertrophy). Measured VRFs and end organ damage were not independently associated with HAND. The only significant association was lower diastolic BP (p 0.030, OR 0.969 (0.943-0.997). Our results suggest that vascular risk factors are not major drivers of HAND in this setting. Further studies should explore alternative aetiologies such as chronic inflammation.


Asunto(s)
Infecciones por VIH , Humanos , Femenino , Masculino , Tanzanía/epidemiología , Persona de Mediana Edad , Factores de Riesgo , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Anciano , Prevalencia , Complejo SIDA Demencia/epidemiología , Fármacos Anti-VIH/uso terapéutico , Terapia Antirretroviral Altamente Activa , Trastornos Neurocognitivos/epidemiología , Trastornos Neurocognitivos/etiología
8.
BMJ Qual Saf ; 2024 Jun 26.
Artículo en Inglés | MEDLINE | ID: mdl-38925929

RESUMEN

OBJECTIVE: To estimate and quantify the cost implications and health impacts of improving the performance of English endoscopy services to the optimum quality as defined by postcolonoscopy colorectal cancer (PCCRC) rates. DESIGN: A semi-Markov state-transition model was constructed, following the logical treatment pathway of individuals who could potentially undergo a diagnostic colonoscopy. The model consisted of three identical arms, each representing a high, middle or low-performing trust's endoscopy service, defined by PCCRC rates. A cohort of 40-year-old individuals was simulated in each arm of the model. The model's time horizon was when the cohort reached 90 years of age and the total costs and quality-adjusted life-years (QALYs) were calculated for all trusts. Scenario and sensitivity analyses were also conducted. RESULTS: A 40-year-old individual gains 0.0006 QALYs and savings of £6.75 over the model lifetime by attending a high-performing trust compared with attending a middle-performing trust and gains 0.0012 QALYs and savings of £14.64 compared with attending a low-performing trust. For the population of England aged between 40 and 86, if all low and middle-performing trusts were improved to the level of a high-performing trust, QALY gains of 14 044 and cost savings of £249 311 295 are possible. Higher quality trusts dominated lower quality trusts; any improvement in the PCCRC rate was cost-effective. CONCLUSION: Improving the quality of endoscopy services would lead to QALY gains among the population, in addition to cost savings to the healthcare provider. If all middle and low-performing trusts were improved to the level of a high-performing trust, our results estimate that the English National Health Service would save approximately £5 million per year.

9.
Clin Gastroenterol Hepatol ; 22(9): 1926-1936, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38759827

RESUMEN

BACKGROUND & AIMS: Postcolonoscopy colorectal cancer incidence and mortality rates are higher for endoscopists with low polyp detection rates. Using the UK's National Endoscopy Database (NED), which automatically captures real-time data, we assessed if providing feedback of case-mix-adjusted mean number of polyps (aMNP), as a key performance indicator, improved endoscopists' performance. Feedback was delivered via a theory-informed, evidence-based audit and feedback intervention. METHODS: This multicenter, prospective, NED Automated Performance Reports to Improve Quality Outcomes Trial randomized National Health Service endoscopy centers to intervention or control. Intervention-arm endoscopists were e-mailed tailored monthly reports automatically generated within NED, informed by qualitative interviews and behavior change theory. The primary outcome was endoscopists' aMNP during the 9-month intervention. RESULTS: From November 2020 to July 2021, 541 endoscopists across 36 centers (19 intervention; 17 control) performed 54,770 procedures during the intervention, and 15,960 procedures during the 3-month postintervention period. Comparing the intervention arm with the control arm, endoscopists during the intervention period: aMNP was nonsignificantly higher (7%; 95% CI, -1% to 14%; P = .08). The unadjusted MNP (10%; 95% CI, 1%-20%) and polyp detection rate (10%; 95% CI, 4%-16%) were significantly higher. Differences were not maintained in the postintervention period. In the intervention arm, endoscopists accessing NED Automated Performance Reports to Improve Quality Outcomes Trial webpages had a higher aMNP than those who did not (aMNP, 118 vs 102; P = .03). CONCLUSIONS: Although our automated feedback intervention did not increase aMNP significantly in the intervention period, MNP and polyp detection rate did improve significantly. Engaged endoscopists benefited most and improvements were not maintained postintervention; future work should address engagement in feedback and consider the effectiveness of continuous feedback. CLINICAL TRIALS REGISTRY:  www.isrctn.org ISRCTN11126923 .


Asunto(s)
Pólipos del Colon , Colonoscopía , Humanos , Colonoscopía/métodos , Pólipos del Colon/diagnóstico , Masculino , Femenino , Persona de Mediana Edad , Reino Unido , Estudios Prospectivos , Anciano , Neoplasias Colorrectales/diagnóstico , Retroalimentación , Mejoramiento de la Calidad
10.
Transcult Psychiatry ; : 13634615241245872, 2024 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-38766870

RESUMEN

In the United States, Asian Americans express greater stigma toward those with mental disorders and report lower rates of seeking mental health treatment than do White Americans. However, research on these topics in Filipino cultural groups, especially Filipinos living in the Philippines (i.e., Filipino nationals), is sparse. To support the design of interventions to decrease stigma and improve rates of seeking treatment, we assessed attitudes toward mental disorders and help-seeking in Filipinos. U.S. national (i.e., American) and Filipino national participants completed an online survey containing the Mental Illness Stigma Scale, a Theory of Planned Behavior questionnaire measuring attitudes toward seeking treatment, and queries regarding demographic and psychosocial factors. Filipinos expressed significantly more stigma regarding relationship disruption, interpersonal anxiety, and poor hygiene, alongside increased perceived subjective norms opposing seeking treatment and decreased perceived behavioral control over getting treatment if necessary. We ran a linear mixed effects regression on each nationality separately to identify relationships between stigma and psychosocial factors. For Filipinos, increased parental education predicted decreased perceived relationship disruption and interpersonal anxiety; urbanization was associated with greater trust in mental health professionals, and having a close relative with a disorder led to decreased belief in patient recoverability. For Americans, increased participant education predicted decreased interpersonal anxiety, increased perceived recoverability, and improved perceived behavioral control over getting treatment if necessary, and having a close relative with a disorder predicted improved perceived treatability. The results guide programs for decreasing stigma and increasing treatment-seeking behavior. Limitations, future research directions, and possible interventions are discussed.

11.
Psychol Methods ; 2024 Apr 11.
Artículo en Inglés | MEDLINE | ID: mdl-38602781

RESUMEN

The comparison of idiographic network structures to determine the presence of heterogeneity is a challenging endeavor in many applied settings. Previously, researchers eyeballed idiographic networks, computed correlations, and used techniques that make use of the multilevel structure of the data (e.g., group iterative multiple model estimation and multilevel vector autoregressive) to investigate individual differences. However, these methods do not allow for testing the (in)equality of idiographic network structures directly. In this article, we propose the Individual Network Invariance Test (INIT), which we implemented in the R package INIT. INIT extends common model comparison practices in structural equation modeling to idiographic network structures to test for (in)equality between idiographic networks. In a simulation study, we evaluated the performance of INIT on both saturated and pruned idiographic network structures by inspecting the rejection rate of the χ² difference test and model selection criteria, such as the Akaike information criterion (AIC) and Bayesian information criterion (BIC). Results show INIT performs adequately when t = 100 per individual. When applying INIT on saturated networks, the AIC performed best as a model selection criterion, while the BIC showed better results when applying INIT on pruned networks. In an empirical example, we highlight the possibilities of this new technique, illustrating how INIT provides researchers with a means of testing for (in)equality between idiographic network structures and within idiographic network structures over time. To conclude, recommendations for empirical researchers are provided. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

12.
BMC Psychiatry ; 24(1): 318, 2024 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-38658915

RESUMEN

BACKGROUND: Studies conducted in Western societies have identified variables associated with chronic pain, but few have done so across cultures. Our study aimed to clarify the relationship between specific mental health markers (i.e., depression, anxiety, posttraumatic stress disorder [PTSD], perceived stress) as well as specific protective factors (i.e., social support and self-efficacy) related to physical pain among university students across non-WEIRD and WEIRD samples. METHOD: A total of 188 university students (131 women and 57 men) were included in the study. We used network analysis to ascertain mental health markers especially central to the experience of physical pain. RESULTS: No statistically significant difference was found between mental health markers (i.e., depression, anxiety, perceived stress, and PTSD) and protective factors (i.e., social support and self-efficacy) associated with physical pain symptoms for Swiss students versus Indian students (M = 0.325, p = .11). In addition, networks for Swiss versus Indian students did not differ in global strength (S = 0.29, p = .803). Anxiety was the most central mental health marker, and social support was the most important protective factor related to physical pain in both countries. However, for Swiss students, perceived stress, and for Indian students, PTSD symptoms were central mental health markers related to physical pain. CONCLUSION: Our results identify factors that may serve as important treatment targets for pain interventions among students of both countries before it becomes chronic.


Asunto(s)
Ansiedad , Depresión , Factores Protectores , Autoeficacia , Apoyo Social , Trastornos por Estrés Postraumático , Estudiantes , Humanos , Masculino , Femenino , Estudiantes/psicología , Adulto Joven , Adulto , Trastornos por Estrés Postraumático/psicología , Ansiedad/psicología , Depresión/psicología , Suiza , India , Universidades , Estrés Psicológico/psicología , Dolor Crónico/psicología , Adolescente , Salud Mental , Dolor/psicología
13.
Clin Psychol Rev ; 110: 102417, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38688158

RESUMEN

Although psychological treatments are broadly recognized as evidence-based interventions for various mental disorders, challenges remain. For example, a substantial proportion of patients receiving such treatments do not fully recover, and many obstacles hinder the dissemination, implementation, and training of psychological treatments. These problems require those in our field to rethink some of our basic models of mental disorders and their treatments, and question how research and practice in clinical psychology should progress. To answer these questions, a group of experts of clinical psychology convened at a Think-Tank in Marburg, Germany, in August 2022 to review the evidence and analyze barriers for current and future developments. After this event, an overview of the current state-of-the-art was drafted and suggestions for improvements and specific recommendations for research and practice were integrated. Recommendations arising from our meeting cover further improving psychological interventions through translational approaches, improving clinical research methodology, bridging the gap between more nomothetic (group-oriented) studies and idiographic (person-centered) decisions, using network approaches in addition to selecting single mechanisms to embrace the complexity of clinical reality, making use of scalable digital options for assessments and interventions, improving the training and education of future psychotherapists, and accepting the societal responsibilities that clinical psychology has in improving national and global health care. The objective of the Marburg Declaration is to stimulate a significant change regarding our understanding of mental disorders and their treatments, with the aim to trigger a new era of evidence-based psychological interventions.


Asunto(s)
Trastornos Mentales , Psicoterapia , Humanos , Trastornos Mentales/terapia , Psicoterapia/métodos , Psicoterapia/tendencias , Intervención Psicosocial/métodos , Psicología Clínica/tendencias
14.
Clin Endocrinol (Oxf) ; 100(6): 558-564, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38652736

RESUMEN

CONTEXT: Epidemiological studies involving patients with acromegaly have yielded conflicting results regarding cancer incidence and causes of mortality in relation to control of growth hormone (GH) excess. OBJECTIVE: The objective of this retrospective cohort study is to clarify these questions and identify goals for treatment and monitoring patients. METHODS: We studied 1845 subjects from the UK Acromegaly Register (1970-2016), obtaining cancer standardised incidence rates (SIR) and all causes standardised mortality rates (SMR) from UK Office for National Statistics, to determine the relationship between causes of mortality-age at diagnosis, duration of disease, post-treatment and mean GH levels. RESULTS: We found an increased incidence of all cancers (SIR, 1.38; 95% CI: 1.06-1.33, p < .001), but no increase in incidence of female breast, thyroid, colon cancer or any measure of cancer mortality. All-cause mortality rates were increased (SMR, 1.35; 95% CI: 1.24-1.46, p < .001), as were those due to vascular and respiratory diseases. All-cause, all cancer and cardiovascular deaths were highest in the first 5 years following diagnosis. We found a positive association between post-treatment and mean treatment GH levels and all-cause mortality (p < .001 and p < .001), which normalised with posttreatment GH levels of <1.0 µg/L or meantreatment GH levels of <2.5 µg/L. CONCLUSION: Acromegaly is associated with increased incidence of all cancers but not thyroid or colon cancer and no increase in cancer mortality. Excess mortality is due to vascular and respiratory disease. The risk is highest in the first 5 years following diagnosis and is mitigated by normalising GH levels.


Asunto(s)
Acromegalia , Hormona de Crecimiento Humana , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Acromegalia/sangre , Acromegalia/complicaciones , Acromegalia/terapia , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/complicaciones , Hormona de Crecimiento Humana/sangre , Hormona de Crecimiento Humana/metabolismo , Incidencia , Neoplasias/complicaciones , Sistema de Registros , Enfermedades Respiratorias/complicaciones , Estudios Retrospectivos , Reino Unido , Enfermedades Vasculares/complicaciones
15.
Front Oncol ; 14: 1304633, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38420017

RESUMEN

Background: A heterogeneous geographic distribution of childhood acute lymphoblastic leukemia (ALL) cases has been described, possibly, related to the presence of different environmental factors. The aim of the present study was to explore the geographical distribution of childhood ALL cases in Greater Mexico City (GMC). Methods: A population-based case-control study was conducted. Children <18 years old, newly diagnosed with ALL and residents of GMC were included. Controls were patients without leukemia recruited from second-level public hospitals, frequency-matched by sex, age, and health institution with the cases. The residence address where the patients lived during the last year before diagnosis (cases) or the interview (controls) was used for geolocation. Kulldorff's spatial scan statistic was used to detect spatial clusters (SCs). Relative risks (RR), associated p-value and number of cases included for each cluster were obtained. Results: A total of 1054 cases with ALL were analyzed. Of these, 408 (38.7%) were distributed across eight SCs detected. A relative risk of 1.61 (p<0.0001) was observed for the main cluster. Similar results were noted for the remaining seven ones. Additionally, a proximity between SCs, electrical installations and petrochemical facilities was observed. Conclusions: The identification of SCs in certain regions of GMC suggest the possible role of environmental factors in the etiology of childhood ALL.

16.
J Am Coll Health ; : 1-8, 2024 Jan 16.
Artículo en Inglés | MEDLINE | ID: mdl-38227928

RESUMEN

Objective: This manuscript describes an evidence-based, student-led, single-session group intervention to support emotional wellbeing among graduate students. The present objective is to provide a roadmap for other universities. Participants: Key participants include clinical psychology graduate students (leader and workshop facilitators), faculty supervisor, representatives from receiving departments or schools, and institutional advocates. Methods: The two-hour workshop was based on four core transdiagnostic cognitive behavioral skills, including psychoeducation about emotions, mindful emotional awareness, cognitive flexibility, and behavior change. The workshop was designed and continues to be led by trained graduate students. Results: Key steps and lessons learned are presented for the exploration, preparation, implementation, and sustainment phases. Conclusions: This program has the potential to be flexibly replicated at other universities to assist with graduate student mental health. It provides unique supports for recipients and unique training opportunities for student facilitators.

17.
Thorax ; 79(1): 43-49, 2023 12 15.
Artículo en Inglés | MEDLINE | ID: mdl-37940200

RESUMEN

BACKGROUND: Previous studies found exposure to air pollution leads to exacerbations of asthma in paediatric and adult patients and increases asthma-related emergency hospital admissions (AREHA). METHODS: AREHAs and levels of air pollutants (PM10, PM2.5 and NO2) were obtained from Mexico City for the period 2017-2019. A time-series approach was used to explore the relationship between air pollutants and AREHA. Relative risks of AREHA were estimated using a negative binomial regression in young children (less than 5 years) and adults (greater than 18 years). RESULTS: There was a positive association between AREHA and PM10, PM2.5 and NO2 in adults, which remained after mutual adjustment for these pollutants. The relative risk (RR) of admission in adults increased by 3% (95% CI 1% to 4%) for a 10 µg/m3 increase in PM10, 1% (0.03% to 3%) for a 5 µg/m3 increase in PM2.5 and by 1% (0.06% to 2%) for a 5 µg/m3 increase in NO2. In contrast, in young children, AREHAs were negatively associated with PM10 after adjustment for NO2 (RR 0.97 (0.95 to 0.99) for a 10 µg/m3 and with NO2 after adjustment for PM10 and PM2.5 (RR 0.98 (0.96 to 0.99) and 0.97 (0.96 to 0.99), respectively, for a 5 µg/m3 increase in NO2). AREHAs in children were not associated with PM2.5 after adjustment for NO2. CONCLUSIONS: Ambient air pollution, within the previous week, was associated with emergency hospital admissions for asthma to public hospitals in adults in Mexico City. The relationship in children was less consistent. Further work is needed to explore why differences between adults and children exist to inform appropriate interventions to benefit public health.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Asma , Adulto , Humanos , Niño , Preescolar , México/epidemiología , Dióxido de Nitrógeno/efectos adversos , Dióxido de Nitrógeno/análisis , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Asma/epidemiología , Asma/etiología , Material Particulado/efectos adversos , Material Particulado/análisis , Hospitales , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/análisis
19.
Psychol Trauma ; 2023 Oct 16.
Artículo en Inglés | MEDLINE | ID: mdl-37843525

RESUMEN

OBJECTIVE: Network analysis aims to identify links between symptoms that may serve to maintain one other; the current study uses network analysis to identify relationships between posttraumatic stress disorder (PTSD) symptoms as they unfold over time within individuals. We also examine whether positive affect (PA) may buffer subsequent PTSD symptoms in daily life and compare single individual networks to the average within-person effects. METHOD: Fifty-two individuals (76.9% female; 84.6% white) who had experienced a Criterion A trauma participated in the 2-week study and reported their PA and PTSD symptom levels five times a day at 2-hr intervals (M surveys completed = 60.4). Multilevel and regularized individual-only network models were generated using vector autoregression. RESULTS: Feeling distant from others was the PTSD symptom most closely connected to lower PA; it was also the most connected to other PTSD symptoms. PA items did not predict lower PTSD at the next time point, except for one bidirectional relationship. Feeling on edge was the symptom with the largest magnitude of relationships to other symptoms in the multilevel network, but this was only reflected in 38.5% of the individual networks. Three example individual networks are described and discussed for clinical implications. CONCLUSIONS: We did not find evidence to support the hypothesis that PA buffers PTSD symptom severity on the time scale assessed (2 hr). Feeling distant from others was a bridge between lower PA and PTSD symptoms and may indicate social support as an important factor in treating trauma survivors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

20.
J Pers ; 2023 Sep 19.
Artículo en Inglés | MEDLINE | ID: mdl-37724779

RESUMEN

OBJECTIVE: Solitude is a common experience that can elicit both positive (e.g., relaxation) and negative (e.g., loneliness) emotions. But can changing the way we think about solitude improve its emotional effects? In a previous study, our team found that positively reframing solitude buffers against a reduction in positive affect when alone. Yet, it is unknown whether people who are lonely-and thus more likely to experience solitude negatively-benefit from modifying their beliefs about being alone. METHOD: Here, we test whether reframing solitude as a beneficial experience or de-stigmatizing loneliness helps people experiencing moderate-to-severe loneliness (N = 224) feel more positive emotion and less negative emotion during solitude. We randomly assigned participants to read about either the benefits of solitude, the high prevalence of loneliness, or a control topic. Then, participants spent 10 min alone in the laboratory. State affect was assessed before and after the solitude period. RESULTS: Across conditions, the solitude period reduced high-arousal positive (e.g., excited) and high-arousal negative (e.g., anxious) affect. Notably, people who read about the benefits of solitude experienced a significantly larger increase in low-arousal positive affect compared with the control condition. CONCLUSION: Our findings indicate that lonely individuals can more readily reap the emotional benefits of solitude when they reframe solitude as an experience that can enhance their well-being.

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