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1.
Animals (Basel) ; 14(10)2024 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-38791719

RESUMO

Biological invasions are of special conservation concern in the Iberian Peninsula and other regions with high levels of endemism. Environmental variability, such as the seasonal fluctuations of Mediterranean streams, is a key factor that affects the spread of aquatic species in novel habitats. Fish parasites have a great potential to reflect such changes in the habitat features of freshwater ecosystems. The aim of this study consisted of seasonally analysing the health status and parasitological traits of non-native fish in Iberian waters. In particular, a strongly invasive population of Languedoc minnow Phoxinus septimaniae (leuciscid species native to south-east France) was assessed in Tordera Stream (north-eastern Iberian Peninsula, Mediterranean conditions). Fish were sampled in April, July, and October 2023 by electrofishing. Health status (external/internal organs) was significantly better in autumn (HAI = 28.8) than spring (HAI = 35.6). Life-cycle complexity was higher in spring (LCI = 1.98), whereas parasite abundance and Shannon diversity were significantly lower in autumn (TA = 19.6 and H' = 2.15, respectively). In October (more 'benign' environmental conditions in Iberian streams), minnows could display elevated foraging activity, with fish increasing their health condition and level of parasite resistance/tolerance. Overall results showed a particular seasonal profile of health and parasite infra-communities that allow this minnow species to thrive under highly fluctuating habitat conditions. This information could help environmental managers to control non-native fish in Mediterranean streams.

2.
J Vitreoretin Dis ; 8(3): 253-256, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38770069

RESUMO

Purpose: To evaluate the anatomic and visual outcomes of primary vitrectomy for rhegmatogenous retinal detachment (RRD) repair using no amount of postoperative prone positioning to clarify the role of face-down posturing for RRD reattachment. Methods: This retrospective consecutive interventional case series comprised patients who had primary vitrectomy for RRD repair. The surgical outcomes, single-surgery anatomic success rate, and postoperative best-corrected visual acuity (BCVA) were assessed. The primary objective was to evaluate the anatomic and visual outcomes of vitrectomy RRD reattachment using no postoperative prone positioning. Results: This study comprised 116 eyes of 116 patients. Single-surgery anatomic success was achieved in 112 (96.5%) of 116 eyes. The single-surgery anatomic success rate was 100% in phakic patients (n = 56) and 93% in pseudophakic patients (n = 60), with both groups having an improvement in the mean BCVA. Conclusions: Primary vitrectomy with no postoperative prone positioning is a successful surgical intervention for RRD repair. The anatomic closure rate in this study is one of the highest reported in the literature and involved a large number of macula-off RRDs, with minimal complications and a significant improvement in BCVA, primarily using 14% perfluoropropane for gas tamponade.

3.
BMC Psychiatry ; 24(1): 323, 2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38664716

RESUMO

BACKGROUND: In addition to having higher negative affect and lower positive affect overall, depressed individuals exhibit heightened affective reactivity to external stimuli than non-depressed individuals. Sleep may contribute to day-to-day fluctuations in depressed individuals, given that sleep disturbance is a common symptom of depression. Yet, little is known about changes in daily affect as a function of nightly sleep duration in depressed adults and non-depressed adults. The current study examined whether and how naturally-occurring sleep duration is associated with negative and positive affect, and how these associations differ between depressed vs. non-depressed adults. METHODS: Data were drawn from the second wave of the National Study of Daily Experiences (NSDE), a daily diary project of the Midlife in the United States (MIDUS) study. The sample of 2,012 adults (Mage=56.5; 57% female; 84% white) completed eight-day diary interviews via telephone on their daily experiences including nightly sleep duration and negative and positive affect. They also completed assessments of the Composite International Diagnostic Interview-Short form, and depressed status was determined based on DSM-III. Multilevel regression models with linear, quadratic, and cubic terms of sleep duration examined the nonlinear relationship between nightly sleep duration and daily affect. Interaction terms with depression status were added to examine differences between depressed and non-depressed adults. RESULTS: Depressed adults exhibited significant and greater fluctuations in daily affect as a function of nightly sleep duration than non-depressed adults. Specifically, the degree of decrease in positive affect and increase in negative affect was greater when depressed adults slept 2 or more hours less or longer than their usual sleep hours. Non-depressed adults exhibited relatively stable daily affect regardless of their nightly sleep hours. CONCLUSIONS: Sleep duration is nonlinearly associated with affect in daily lives of depressed adults, highlighting that both having too little sleep and excessive sleep are associated with adverse daily affective well-being. Implementing sleep interventions to promote an appropriate sleep duration may help improve daily affect among depressed adults.


Assuntos
Afeto , Depressão , Sono , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Afeto/fisiologia , Sono/fisiologia , Depressão/psicologia , Adulto , Idoso , Estados Unidos , Transtornos do Sono-Vigília/psicologia , Fatores de Tempo , Duração do Sono
4.
Health Psychol ; 2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38602830

RESUMO

OBJECTIVE: The current study examined how average daily loneliness (between-persons [BPs]), intraindividual variability in loneliness across days (within-persons [WPs]), and loneliness stability informed physical health symptomatology. METHOD: We utilized daily diary data from a national sample of 1,538 middle-aged adults (Mage = 51.02; 57.61% women) who completed eight end-of-day telephone interviews about daily experiences, including loneliness and physical health symptoms (e.g., headaches, nausea). Via multilevel modeling, we examined average daily loneliness (BPs), intraindividual variability in loneliness (WPs), stability in loneliness (individual mean-squared successive difference) in association with the number and average severity of daily physical health symptoms. RESULTS: When participants were less lonely on average, and on days when loneliness was lower than a person's average, they had fewer and less severe physical health symptoms. Additionally, participants who were more stable in loneliness across 8 days had less severe physical health symptoms. Further, there was a stronger association between instability in loneliness and more physical health symptoms for people who were lonelier on average. Finally, the increase in physical health symptom severity associated with WP loneliness was strongest for participants with low variability in loneliness. CONCLUSION: Loneliness is associated with physical health symptoms on a day-to-day basis, especially for people who are highly variable in loneliness. Considerations of multiple sources of variation in daily loneliness may be necessary to adequately address loneliness and promote health. Public health interventions addressing loneliness may be most effective if they support social connectedness in people's everyday lives in ways that promote stable, low levels of loneliness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

5.
Psychosom Med ; 86(4): 289-297, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38436651

RESUMO

OBJECTIVE: To identify distinct sleep health phenotypes in adults, examine transitions in sleep health phenotypes over time, and subsequently relate these to the risk of chronic conditions. METHODS: A national sample of adults from the Midlife in the United States study ( N = 3683) provided longitudinal data with two time points (T1: 2004-2006, T2: 2013-2017). Participants self-reported on sleep health (regularity, satisfaction, alertness, efficiency, duration) and the number and type of chronic conditions. Covariates included age, sex, race, education, education, partnered status, number of children, work status, smoking, alcohol, and physical activity. RESULTS: Latent transition analysis identified four sleep health phenotypes across both time points: good sleepers, insomnia sleepers, weekend catch-up sleepers, and nappers. Between T1 and T2, the majority (77%) maintained their phenotype, with the nappers and insomnia sleepers being the most stable. In fully adjusted models with good sleepers at both time points as the reference, being an insomnia sleeper at either time point was related to having an increased number of total chronic conditions by 28%-81% at T2, adjusting for T1 conditions. Insomnia sleepers at both time points were at 72%-188% higher risk for cardiovascular disease, diabetes, depression, and frailty. Being a napper at any time point related to increased risks for diabetes, cancer, and frailty. Being a weekend catch-up sleeper was not associated with chronic conditions. Those with lower education and unemployed were more likely to be insomnia sleepers; older adults and retirees were more likely to be nappers. CONCLUSION: Findings indicate a heightened risk of chronic conditions involved in suboptimal sleep health phenotypes, mainly insomnia sleepers.


Assuntos
Fenótipo , Distúrbios do Início e da Manutenção do Sono , Humanos , Masculino , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Feminino , Pessoa de Meia-Idade , Doença Crônica , Estudos Longitudinais , Idoso , Estados Unidos/epidemiologia , Adulto
6.
Artigo em Inglês | MEDLINE | ID: mdl-38334405

RESUMO

OBJECTIVES: Theoretical perspectives on aging suggest that when people experience declines in later life, they often selectively focus on maintaining aspects of their lives that are most meaningful and important to them. The social domain is one of these selected areas. The current study examines people's reports of control over their daily stressors over 10 years, predicting that the declines in control that are often observed in later life will not be observed for stressors involving interpersonal conflict and tensions with social partners. METHODS: Adults ranging from 35 to 86 years old at baseline (N = 1,940), from the National Study of Daily Experiences, reported control over interpersonal and noninterpersonal daily stressors across 8 consecutive days at 2 time points, about 10 years apart. RESULTS: Findings from multilevel models indicate that for noninterpersonal stressors, perceived control decreased over time. In contrast, perceived control over interpersonal conflicts and tensions remained robust over time. No cross-sectional baseline age differences were found for levels of interpersonal and noninterpersonal stressor control. DISCUSSION: Results are consistent with socioemotional selectivity and underscore the importance of interpersonal relationships in later adulthood. Understanding how people select and preserve certain aspects of control in their daily life can help guide efforts toward maximizing gains and minimizing losses in domains that matter most to people as they grow older.


Assuntos
Relações Interpessoais , Estresse Psicológico , Humanos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estresse Psicológico/psicologia , Envelhecimento/psicologia , Conflito Psicológico , Análise Multinível
7.
Int J Surg Case Rep ; 116: 109379, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38350372

RESUMO

INTRODUCTION: Gardner Syndrome (GS) is a variant of Familial Adenomatous Polyposis (FAP). FAP is characterized by several precancerous adenomatous intestinal polyps while GS has additional distinct extraintestinal features such as congenital hypertrophy of retinal epithelium (CHRPE), which we describe here. PRESENTATION OF CASE: 42-year-old male with GS presenting with flashes and floaters observed to have CHRPE-like lesions characteristic of GS. DISCUSSION: Subtle CHRPE findings differentiate pathological, described in the present case, from non-pathological etiologies and may guide further management. CONCLUSION: Here we present the signs and symptoms that raise suspicion for GS associated with CHRPE and how to approach management late in the disease presentation.

8.
Emotion ; 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38330327

RESUMO

Hormetic models of stress resilience describe nonlinear relations for exposure to adversity and health outcomes, where exposure induces salutary changes up to a threshold, with changes becoming deleterious afterward. Here we apply a hormetic model of stress to reactivity to daily stressors, examining whether mental and physical health benefits arise from low-to-moderate reactivity but then decrease at higher levels. Data are from the second wave of the National Study of Daily Experiences (NSDE). Adults (N = 2,022; Mage = 58.61, SD = 12.12, age range: 35-86; 57% female) completed telephone interviews detailing their stressors and affect on eight consecutive evenings. A series of multilevel structural equation models estimated within-person associations between daily stressors and negative affect (i.e., stress reactivity), and between-person linear and quadratic effects of stress reactivity on mental and physical health outcomes (i.e., life satisfaction, psychological distress, and number of chronic conditions). Findings reveal a significant quadratic effect for each outcome, indicating a U-shaped pattern (inverse U for positively valenced life satisfaction), such that low and high levels of stress reactivity were associated with poorer health and well-being, whereas moderate levels of daily stress reactivity predicted better health outcomes. These findings suggest that individuals who display either very low- or very high-stress reactivity may benefit from interventions that target their emotion regulation skills and coping resources. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

9.
J Pers ; 2024 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-38279657

RESUMO

OBJECTIVE: Examining the personality and well-being correlates of positive event diversity. BACKGROUND: Past research has highlighted that personality traits are linked to the frequency of daily positive events. This study is the first to examine positive event diversity, the extent to which positive events are spread across multiple types of positive life domains, as well as its personality and well-being correlates. METHOD: We conducted parallel analyses of three daily diary datasets (Ns = 1919, 744, and 1392) that included evening assessment of daily positive events and affective well-being. The Big Five personality traits were assessed in baseline surveys. RESULTS: Positive Event Diversity was related to higher person-mean daily positive affect but not negative affect. Higher Extraversion, Agreeableness, Openness, and lower Neuroticism were correlated with more positive event diversity. These associations became nonsignificant when controlling for positive event frequency. Positive event frequency moderated the link between positive event diversity and person-mean affect, such that higher positive event diversity was associated with higher negative and lower positive affect for people who experienced more frequent positive events. CONCLUSIONS: No consistent evidence was found for personality as a moderator of the positive event diversity-well-being link across the three studies. Further, the well-being implications of positive event diversity may be better understood when interpreting them alongside indexes of positive event frequency.

10.
Sci Total Environ ; 917: 170475, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38296092

RESUMO

Under the increasing threat to native ecosystems posed by non-native species invasions, there is an urgent need for decision support tools that can more effectively identify non-native species likely to become invasive. As part of the screening (first step) component in non-native species risk analysis, decision support tools have been developed for aquatic and terrestrial organisms. Amongst these tools is the Weed Risk Assessment (WRA) for screening non-native plants. The WRA has provided the foundations for developing the first-generation WRA-type Invasiveness Screening Kit (ISK) tools applicable to a range of aquatic species, and more recently for the second-generation ISK tools applicable to all aquatic organisms (including plants) and terrestrial animals. Given the most extensive usage of the latter toolkits, this study describes the development and application of the Terrestrial Plant Species Invasiveness Screening Kit (TPS-ISK). As a second-generation ISK tool, the TPS-ISK is a multilingual turnkey application that provides several advantages relative to the WRA: (i) compliance with the minimum standards against which a protocol should be evaluated for invasion process and management approaches; (ii) enhanced questionnaire comprehensiveness including a climate change component; (iii) provision of a level of confidence; (iv) error-free computation of risk scores; (v) multilingual support; (vi) possibility for across-study comparisons of screening outcomes; (vii) a powerful graphical user interface; (viii) seamless software deployment and accessibility with improved data exchange. The TPS-ISK successfully risk-ranked five representative sample species for the main taxonomic groups supported by the tool and ten angiosperms previously screened with the WRA for Turkey. The almost 20-year continuous development and evolution of the ISK tools, as opposed to the WRA, closely meet the increasing demand by scientists and decision-makers for a reliable, comprehensive, updatable and easily deployable decision support tool. For terrestrial plant screening, these requirements are therefore met by the newly developed TPS-ISK.


Assuntos
Ecossistema , Espécies Introduzidas , Animais , Plantas , Medição de Risco , Fatores de Risco
11.
Artigo em Inglês | MEDLINE | ID: mdl-37950462

RESUMO

BACKGROUND: Having multiple sleep problems is common in adulthood. Yet, most studies have assessed single sleep variables at one timepoint, potentially misinterpreting health consequences of co-occurring sleep problems that may change over time. We investigated the relationship between multidimensional sleep health across adulthood and mortality. METHODS: Participants from the Midlife in the United States Study reported sleep characteristics in 2004-2006 (MIDUS-2; M2) and in 2013-2014 (MIDUS-3; M3). We calculated a composite score of sleep health problems across 5 dimensions: Regularity, Satisfaction, Alertness, Efficiency, and Duration (higher = more problems). Two separate models for baseline sleep health (n = 5 140; median follow-up time = 15.3 years) and change in sleep health (n = 2 991; median follow-up time = 6.4 years) to mortality were conducted. Cox regression models controlled for sociodemographics and key health risk factors (body mass index, smoking, depressive symptoms, diabetes, and hypertension). RESULTS: On average, 88% of the sample reported having one or more sleep health problems at M2. Each additional sleep health problem at M2 was associated with 12% greater risk of all-cause mortality (hazard ratio [HR] = 1.12, 95% confidence interval [CI] = 1.04-1.21), but not heart disease-related mortality (HR = 1.14, 95% CI = 0.99-1.31). An increase in sleep health problems from M2 to M3 was associated with 27% greater risk of all-cause mortality (HR = 1.27, 95% CI = 1.005-1.59), and 153% greater risk of heart disease mortality (HR = 2.53, 95% CI = 1.37-4.68). CONCLUSIONS: More sleep health problems may increase the risk of early mortality. Sleep health in middle and older adulthood is a vital sign that can be assessed at medical checkups to identify those at greater risk.


Assuntos
Hipertensão , Transtornos do Sono-Vigília , Humanos , Estados Unidos/epidemiologia , Idoso , Sono , Fatores de Risco , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/epidemiologia
12.
Ann Behav Med ; 58(2): 131-143, 2024 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-37963585

RESUMO

BACKGROUND: Stress is a common part of college students' daily lives that may influence their physical activity (PA) and alcohol use. Understanding features of daily stress processes that predict health behaviors could help identify targets for just-in-time interventions. PURPOSE: This study used intensive longitudinal data to examine whether prior day stress processes predict current day PA or alcohol use. METHODS: Participants (N=58, Mage=20.5, 59% women, 70% White) were 18-to-25-year-old students who engaged in binge drinking at least twice monthly and used cannabis or tobacco in the past year. They wore activity (activPAL4) and alcohol (Secure Continuous Remote Alcohol Monitor) monitors for 11 days to assess daily PA (e.g., step counts) and alcohol use (e.g., drinking day), and completed daily surveys about yesterday's stress, including number of stressors (i.e., frequency), stressor intensity (i.e., severity), and frequency of affective states (e.g., guilt). Multilevel models examined prior day stress predicting current day PA or alcohol use. RESULTS: Participants had higher odds of current day drinking (odds ratio=1.21) and greater area under the curve (B=0.08) when they experienced greater than usual stress severity the prior day. Participants had higher current day peak transdermal alcohol concentration (B=0.12) and area under the curve (B=0.11) when they more frequently experienced guilt due to stressors the prior day. CONCLUSIONS: College students' unhealthy response of increasing alcohol use due to stress could adversely impact health outcomes. There is a critical need for interventions addressing students' ability to effectively manage and respond to the stress-inducing, daily demands of student life.


College students experience stress regularly, which may influence their physical activity (PA) and drinking behaviors. Understanding how daily stress predicts health behaviors could be useful for stress-reduction interventions. This study examined whether prior day stress predicted current day PA or alcohol use. Participants (N = 58) were 18- to 25-year-old college students who binge drank at least twice per month and used cannabis or tobacco in the past year. They wore PA and alcohol sensors for 11 days to assess daily PA and alcohol use, and completed daily surveys about yesterday's stress, including the number of stressors experienced (i.e., frequency), stressor intensity (i.e., severity), and mood responses related to stress (anger, anxiety, guilt, sadness). Participants were 21% more likely to drink and drank at higher intensity when they experienced greater than usual stress severity the prior day. Participants had higher current day alcohol use intensity when they more frequently experienced guilt due to stressors the prior day. College students' unhealthy response of increasing alcohol use due to stress could negatively impact short- and long-term health outcomes. There is a critical need for interventions addressing students' ability to effectively manage and respond to the stress-inducing, daily demands of student life.


Assuntos
Consumo de Álcool na Faculdade , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Masculino , Consumo de Álcool na Faculdade/psicologia , Estudantes/psicologia , Afeto , Ira , Culpa , Universidades , Consumo de Bebidas Alcoólicas/psicologia
13.
Gerontologist ; 64(5)2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-37944004

RESUMO

BACKGROUND AND OBJECTIVES: Sleep disorders often predict or co-occur with cognitive decline. Yet, little is known about how the relationship unfolds among older adults at risk for cognitive decline. To examine the associations of sleep disorders with cognitive decline in older adults with unimpaired cognition or impaired cognition (mild cognitive impairment and dementia). RESEARCH DESIGN AND METHODS: A total of 5,822 participants (Mage = 70) of the National Alzheimer's Coordinating Center database with unimpaired or impaired cognition were followed for 3 subsequent waves. Four types of clinician-diagnosed sleep disorders were reported: sleep apnea, hyposomnia/insomnia, REM sleep behavior disorder, or "other." Cognition over time was measured by the Montreal Cognitive Assessment (MoCA) or an estimate of general cognitive ability (GCA) derived from scores based on 12 neuropsychological tests. Growth curve models were estimated adjusting for covariates. RESULTS: In participants with impaired cognition, baseline sleep apnea was related to better baseline MoCA performance (b = 0.65, 95% confidence interval [95% CI] = [0.07, 1.23]) and less decline in GCA over time (b = 0.06, 95% CI = [0.001, 0.12]). Baseline insomnia was related to better baseline MoCA (b = 1.54, 95% CI = [0.88, 2.21]) and less decline in MoCA over time (b = 0.56, 95% CI = [0.20, 0.92]). Furthermore, having more sleep disorders (across the 4 types) at baseline predicted better baseline MoCA and GCA, and less decline in MoCA and GCA over time. These results were only found in those with impaired cognition and generally consistent when using self-reported symptoms of sleep apnea or insomnia. DISCUSSION AND IMPLICATIONS: Participants with sleep disorder diagnoses may have better access to healthcare, which may help maintain cognition through improved sleep.


Assuntos
Envelhecimento Cognitivo , Disfunção Cognitiva , Síndromes da Apneia do Sono , Distúrbios do Início e da Manutenção do Sono , Humanos , Idoso , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Disfunção Cognitiva/psicologia , Cognição , Testes Neuropsicológicos
14.
Dev Psychol ; 60(1): 45-58, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37917487

RESUMO

Perceived control is an important psychosocial resource for health and well-being across the lifespan. Global control (i.e., overall perceived control) decreases over time in studies following people every few years to upwards of 10 years. Changes across wider intervals of the lifespan, however, have yet to be examined. Further, how perceived control changes for specific aspects of daily life, such as stressors, remains comparatively less clear. Using data from the Midlife in the United States National Study of Daily Experiences (NSDE, N = 1,940, M = 56.25 years, SD = 12.20, 57% female), we examined longitudinal changes in global control across 20 years and daily stressor control across 10 years. Global control was assessed in the first wave of the NSDE (∼1996). In follow-up waves, conducted in ∼2008 and ∼2017, participants again not only reported their global control but also reported their perceived control over stressors they experience across 8 consecutive days. Longitudinal analyses revealed differential change trajectories for global control across 20 years and stressor control across 10 years (ps < .001). Global control declined for younger and older adults but stayed relatively stable for individuals in midlife. The rate of decline in daily stressor control was steeper than the decline in global control and did not vary by age at baseline. In addition, declines were amplified among individuals with higher global control at baseline. Results suggest that daily stressor control is a specific aspect of control beliefs that follows a different rate of change than global control. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Longevidade , Estresse Psicológico , Humanos , Feminino , Estados Unidos , Idoso , Masculino , Estresse Psicológico/psicologia
16.
Rev. bras. educ. méd ; 48(1): e026, 2024. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1535562

RESUMO

Resumo Introdução: O conhecimento das habilidades de comunicação clínica é primordial para o adequado exercício da medicina de família e comunidade (MFC), visto que um dos princípios da especialidade advém da relação médico-pessoa. A comunicação assertiva é uma competência clínica básica que deve ser aprendida, sobretudo, durante a residência médica. Não se trata de uma característica inata, perpassa um processo de conhecer, aplicar e dominar, necessitando, portanto, de avaliações. Objetivo: Este estudo teve como objetivo avaliar a percepção dos médicos residentes de MFC em relação às suas habilidades de comunicação. Método: Trata-se de um estudo quantitativo, descritivo e transversal. O cenário de estudo foi o conjunto de programas de residência de MFC do município de João Pessoa, na Paraíba. A coleta de dados foi feita a partir de um questionário on-line, disponível para preenchimento de setembro a novembro de 2022. Utilizamos para a construção do questionário o instrumento A Consulta em 7 Passos. Desenvolvemos escores denominados índice de desempenho geral (IDg), índice de desempenho por passo da consulta (IDp) e índice de desempenho por item (IDitem). Na análise estatística, utilizamos o teste t para amostras independentes. Resultado: O IDg médio foi de 72,0%. Os residentes tiveram o maior índice de IDp no passo 5 da consulta (81,7%), seguido pelos passos 2 (77,6%), 3 (76,1%) e 6 (75,9%). Os menores desempenhos foram nos passos 4 (68,9%), 7 (63,7%) e 1 (63,3%). Não houve significância estatística quanto ao desempenho quando se compararam sexo, ano de residência e programa. Conclusão: Os residentes de MFC avaliam positivamente suas habilidades de comunicação. Entretanto, ainda há o que aprimorar, como fomentar momentos crítico-reflexivos sobre os fenômenos subjetivos que ocorrem na consulta. Destarte, a utilização do instrumento A Consulta em 7 Passos se revelou, no presente estudo, como uma ferramenta importante no processo de formação e avaliação da comunicação clínica durante a residência.


Abstract Introduction: Knowledge of clinical communication skills is essential for the proper practice of Family Medicine, since one of the principles of the specialty treats the doctor-person relationship as fundamental. Good communication is a basic clinical competence and must be learned, above all, during medical residency. Communication is not an innate characteristic, but a process of self-knowledge, therefore requiring self-assessments. Objective: This study aimed to evaluate the perception of Family Medicine residents doctors in relation to their communication skills. Method: This is a quantitative, descriptive and cross-sectional study. The study setting was the set of Family Medicine Residency Programs in the city of João Pessoa, Paraíba. Data collection was performed using an online questionnaire, available to be completed from September to November 2022. We used the instrument A consulta em 7 passos (7-step consultation) to construct the questionnaire. We developed scores called overall performance index (IDg), query step performance index (IDp) and item performance index (IDitem). In the statistical analysis, we used the t test for independent samples. Result: The average overall performance index (IDg) was 72.0%. Residents had the highest IDp rate in step 5 of the consultation (81.7%), followed by step 2 (77.6%), step 3 (76.1%) and step 6 (75.9% ). While residents had the lowest performances in descending order in steps 4 (68.9%), 7 (63.7%) and 1 (63.3%). There was no statistical significance between sexes, year of residency and residency program. Conclusion: MFC residents positively evaluate their communication skills. However, there is still room forto improvement in how to encourage critical-reflective moments about the subjective phenomena that occur in the consultation. Furthermore, the use of a consulta em 7 passos is an important tool in the training and evaluation process in residency.

17.
Brain Behav Immun ; 115: 80-88, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37797778

RESUMO

Affective reactivity to stress is a person-level measurement of how well an individual copes with daily stressors. A common method of measuring affective reactivity entails the estimation of within-person differences of either positive or negative affect on days with and without stressors present. Individuals more reactive to common stressors, as evidenced by affective reactivity measurements, have been shown to have increased levels of circulating pro-inflammatory markers. While affective reactivity has previously been associated with inflammatory markers, the upstream mechanistic links underlying these associations are unknown. Using data from the Midlife in the United States (MIDUS) Refresher study (N = 195; 52% female; 84% white), we quantified daily stress processes over 10 days and determined individuals' positive and negative affective reactivities to stressors. We then examined affective reactivity association with peripheral blood mononuclear cell (PBMC) gene expression of the immune-related conserved transcriptional response to adversity. Results indicated that individuals with a greater decrease in positive affect to daily stressors exhibited heightened PBMC JUNB expression after Bonferroni corrections (p-adjusted < 0.05). JUNB encodes a protein that acts as a transcription factor which regulates many aspects of the immune response, including inflammation and cell proliferation. Due to its critical role in the activation of macrophages and maintenance of CD4+ T-cells during inflammation, JUNB may serve as a potential upstream mechanistic target for future studies of the connection between affective reactivity and inflammatory processes. Overall, our findings provide evidence that affective reactivity to stress is associated with levels of immune cell gene expression.


Assuntos
Leucócitos Mononucleares , Estresse Psicológico , Humanos , Feminino , Estados Unidos , Masculino , Estresse Psicológico/genética , Estresse Psicológico/psicologia , Inflamação/genética , Individualidade , Expressão Gênica/genética , Afeto/fisiologia
18.
Affect Sci ; 4(4): 757-769, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38156257

RESUMO

This study examined daily affective dynamic indices among individuals with a major depressive disorder (MDD) diagnosis in the past one year at the time of the interview, focusing on affective variability and change in affect in response to daily events (affective reactivity). Data were from the main survey and daily diary project of the Midlife in the United States (MIDUS) study. Participants (N = 1,970; nMDD = 202; nnon-MDD = 1,768) completed structured clinical interviews on mental health and telephone interviews about their daily experiences spanning eight consecutive days. Multilevel models revealed that the MDD group experienced greater positive (PA) and negative affect (NA) variability than the non-MDD group. On days that at least one stressful event was reported, the MDD group experienced a greater decrease in PA and a greater increase in NA. On days that at least one positive event was reported, the MDD group experienced a greater increase in PA and a greater decrease in NA. Changes in affect to daily events, particularly the mood brightening effect, may be indicators of depression and potential targets for intervention. Limitations of the study include a community sample, reliance on self-reported measures of daily stressors and positive events, inclusion of remitted and current MDD participants, and the DSM-III-R based criteria for MDD diagnosis.

19.
Psychosom Med ; 2023 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-37982543

RESUMO

OBJECTIVES: This analysis examined if financial hardship was associated with age-related decrements in kidney function using a material-psychosocial-behavioral framework. We also tested if this association was mediated by comorbidity of cardiometabolic risk factors (obesity, elevated blood pressure, and insulin resistance). METHODS: Data from 1,361 Non-Hispanic (NH) Black and white adults (ages 26-94; NH Black = 258) were obtained from the Wave 3 and Refresher phases of the Midlife in the United States (MIDUS) project. Kidney function was based on serum creatinine-based estimated glomerular filtration rate (CKD-EPI formula without race adjustment). Financial hardship was evaluated in three domains: material (income to poverty line ratio, health insurance coverage, and public/government financial assistance), psychological (perceived financial status, control over financial status, and perceived financial strains), and behavioral responses (financial adjustment/coping such as sold possessions and cutting back on spending). RESULTS: More severe financial hardship (overall score and in each domain) was associated with age-related decrements in eGFR, even after adjusting for sociodemographic, education, and health-related covariates. The association between financial hardship and age-related decrements in eGFR was conditional on sex but not race. Finally, cardiometabolic risk factors mediated the association between financial hardship and age-related decrements in eGFR. CONCLUSIONS: These findings affirm the negative effects of financial hardship on age-related decrements in renal clearance. In addition to incorporating traditionally used indicators of SES, such as education and income, future research on social hallmarks of aging should also consider the role of financial hardship on the aging process and age-related diseases.

20.
BMC Geriatr ; 23(1): 670, 2023 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-37848825

RESUMO

BACKGROUND: Everyday memory problems are believed to increase with age, leading many researchers to focus on older ages when examining reports of memory lapses. However, real world memory lapses are ubiquitous across the adult lifespan, though less is known about the types of problems and their impacts at younger ages. The current study examined occurrence and impacts of memory lapses using daily diaries in a broad age range and whether characteristics of lapses varied across age, gender, or education level. METHODS: Using an 8-day daily diary protocol, 2,018 individuals (ages 25-91) provided reports of their experiences of two types of daily memory lapses (retrospective and prospective) as well as the impact those lapses had on their emotional and functional well-being that day. Using multilevel modeling, we examined the likelihood of reporting memory lapses and their impacts on daily life and whether these depended on age, gender, or education level. RESULTS: Participants reported lapses on approximately 40% of days; retrospective memory lapses were significantly more likely than prospective lapses. Older ages and higher education level were related to greater likelihood of reporting retrospective lapses. Women (compared to men) were more likely to report prospective memory lapses. Women also tended to report greater impacts of their memory lapses. Lower education levels were related to greater impacts of memory lapses compared to higher education levels. Interestingly, age was not related to impacts of lapses. DISCUSSION: Our results indicate that memory lapses are common across the lifespan and that those individuals more likely to report lapses are not necessarily those that experience the greatest impacts of those lapses on daily life. Additional work is needed to understand the daily experience of memory lapses and how they differentially affect individuals regardless of age, gender, and education. CONCLUSIONS: Memory lapses are an important aspect of daily life across the lifespan and require measurement in an individual's real-world environments. Better measurement of these experiences will allow the development of more sensitive measures of changes in cognitive functioning that may impact an individual's ability to live independently.


Assuntos
Individualidade , Longevidade , Masculino , Humanos , Feminino , Estudos Retrospectivos , Transtornos da Memória/diagnóstico , Transtornos da Memória/epidemiologia , Transtornos da Memória/psicologia , Cognição
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