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3.
Front Psychol ; 14: 1179320, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37275728

RESUMO

Cancer-related financial hardship (i.e., financial toxicity) has been associated with anxiety and depression, greater pain and symptom burden, treatment nonadherence, and mortality. Out-of-pocket healthcare costs and lost income are primary drivers of financial toxicity, however, income loss is a pronounced risk factor for cancer patients with low incomes. There has been little progress in developing an income intervention to alleviate financial toxicity cancer patients with low incomes. Unconditional cash transfers (UCT), or guaranteed income, have produced positive health effects in experiments with general low-income populations, but have not yet been evaluated in people with cancer. The Guaranteed Income and Financial Treatment (GIFT) Trial will use a two-arm randomized controlled trial to compare the efficacy of a 12-month UCT intervention providing $1000/month to treatment as usual on financial toxicity, health-related quality of life and treatment adherence in people with cancer who have low-incomes. The study will recruit 250 Medicaid beneficiaries with advanced cancer from two comprehensive cancer centers in Philadelphia, obtain informed consent, and randomize patients to one of two conditions: (1) $1,000/month UCT or (2) treatment as usual. Both arms will receive information on financial toxicity and the contact information for their hospital social worker or financial advocate upon enrollment. Participants will complete online surveys at baseline, 3, 6, 9, and 12 months from enrollment to collect patient-reported data on primary (i.e., financial toxicity, health-related quality of life, and treatment adherence) and secondary outcomes (i.e., anxiety, depression, food insecurity, housing stability). Social security records will be used to explore the effect on mortality at 2, 3, and 5 years post-enrollment. Linear mixed-models will be used to analyze all primary and secondary continuous outcomes over time and general estimating equations with a logit link and binary distribution for all binary outcomes over time. Differences between treatment and control groups and treatment effects will be determined using models that control for age, gender, race, baseline food security, baseline housing stability, and baseline ECOG. Findings from this study will have significant implications for the development and implementation of programs and policies that address the financial burden of cancer and other serious illnesses.

4.
J Urban Health ; 100(2): 227-244, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-37037977

RESUMO

The purpose of this experiment was to test the effects of a $500 per month guaranteed income for 2 years on health and financial outcomes. A mixed-methods randomized controlled trial in Stockton, CA, USA enrolled 131 individuals to the treatment condition and 200 to control to receive a guaranteed income from February 2019 to January 2021. Quantitative data collection began 3 months prior to allocation at 6-month intervals concluding 6 months after withdrawal of the intervention. Qualitative data collection included 105 interviews across 3 stages. The primary outcomes were income volatility, physical and mental health, agency, and financial wellbeing. The treatment condition reported lower rates of income volatility than control, lower mental distress, better energy and physical functioning, greater agency to explore new opportunities related to employment and caregiving, and better ability to weather pandemic-related financial volatility. Thus, this study provides causal evidence of positive health and financial outcomes for recipients of guaranteed income. As income volatility is related to poor health outcomes, provision of a guaranteed income is a potentially powerful public health intervention.


Assuntos
Renda , Transtornos Mentais , Humanos , Saúde Mental , Transtornos Mentais/terapia , Emprego , Saúde Pública
5.
Dev Psychol ; 54(9): 1606-1620, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30148390

RESUMO

In contrast to a large body of work concerning the effects of physiological stress reactivity on children's socioemotional functioning, far less attention has been devoted to understanding the effects of such reactivity on cognitive, including mnemonic, functioning. How well children learn and remember information under stress has implications for a range of educational, clinical, and legal outcomes. We evaluated 8-14 year olds' (N = 94, 50 female) memory for negative, neutral, and positive images. Youth had seen the images a week previously as a part of a laboratory stress task. At encoding and retrieval, and in between, youth provided saliva samples that were later assayed for cortisol, salivary α amylase (sAA), testosterone, and dehydroepiandrosterone (DHEA). Overall, higher cortisol reactivity to the lab task predicted enhanced memory for emotional but not neutral images. However, cortisol further interacted with pubertal hormones (testosterone and DHEA) to predict memory. Among girls with lower pubertal hormone levels, greater cortisol reactivity was associated with enhanced memory for negative information, whereas among boys with higher pubertal hormone levels, cortisol reactivity was associated with enhanced memory for positive information. sAA, was unrelated to memory. Overall, our findings reveal that individual differences in hormone levels associated with pubertal development have implications for our understanding of how stress-responsive biological systems directly and interactively influence cognitive outcomes. (PsycINFO Database Record


Assuntos
Emoções/fisiologia , Hormônios/metabolismo , Memória/fisiologia , Puberdade/fisiologia , Puberdade/psicologia , Estresse Psicológico/metabolismo , Adolescente , Nível de Alerta/fisiologia , Criança , Feminino , Humanos , Masculino , Psicologia do Adolescente , Psicologia da Criança , Fatores Sexuais , alfa-Amilases/metabolismo
6.
J Child Custody ; 15(4): 286-301, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-32038112

RESUMO

Statements made by children in a range of legal settings can irrevocably impact their family structure, relationships, and living environment. Because these statements can fundamentally alter children's futures, efforts have been made to identify methods to enhance children's reports by increasing comprehensiveness, completeness, and accuracy. Interviewer support has broadly been considered a method of interest, but variations in what constitutes "support" have highlighted the need for greater specificity in documenting how different facets of supportive behaviors relate to children's reporting tendencies. In this review, we describe work focused on the effects of interviewer support, on children's memory completeness and accuracy. We then describe to a subset of interviewer behaviors that encourage elaboration in dyadic interactions: back-channeling and vocatives. We present preliminary evidence suggesting that these utterances, referred to as implicit encouragement, can increase the amount of detail provided without compromising accuracy. Implications for custody evaluations are discussed.

7.
Biochem Biophys Res Commun ; 353(1): 11-7, 2007 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-17161379

RESUMO

Abrupt discontinuation of 3-hydroxy-3-methylglutaryl-coenzyme-A-reductase inhibitors (statins) is associated with increased cardiovascular risk. To investigate the molecular mechanisms determining the increased cardiovascular risk after statin withdrawal, we studied the effects of statin treatment and withdrawal on angiotensin II (AII) actions in rat aortic vascular smooth muscle cells (VSMC) in culture. In VSMC, AII stimulated the phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2), and of p38 mitogen-activated protein kinase (p38 MAPK), with an EC50% of 0.86 and 3 nM, respectively. Maximal stimulation was observed after 5-10 min of exposure to AII. Pretreatment with 1-3 microM simvastatin for 24h inhibited AII-mediated stimulation of ERK1/2 and p38 MAPK phosphorylation; without affecting the levels on non-phosphorylated MAPK. Washout of simvastatin produced a rebound increase above control levels of AII-mediated phosphorylation of ERK1/2 and p38 MAPK. As previously reported for other agonists, the rebound increase of AII effects was observed from 1 to 3h after statin withdrawal, and was lost at later times. The basal levels of phosphorylation and the amount of non-phosphorylated kinases were unaffected by statin withdrawal. Similar effects were observed with lovastatin. Our results suggest that statins modulate AII effects in VSMC, and that transient increases in AII effects mediated via the MAPK pathway may play a role in the vascular dysfunction associated with statin withdrawal.


Assuntos
Angiotensina II/administração & dosagem , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Proteína Quinase 1 Ativada por Mitógeno/metabolismo , Músculo Liso Vascular/metabolismo , Miócitos de Músculo Liso/metabolismo , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , Animais , Células Cultivadas , Relação Dose-Resposta a Droga , Combinação de Medicamentos , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Sistema de Sinalização das MAP Quinases/fisiologia , Masculino , Músculo Liso Vascular/citologia , Músculo Liso Vascular/efeitos dos fármacos , Miócitos de Músculo Liso/citologia , Miócitos de Músculo Liso/efeitos dos fármacos , Fosforilação/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley
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