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1.
BJOG ; 127(3): 364-375, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31507061

RESUMO

OBJECTIVE: Unselected population-based BRCA testing provides the opportunity to apply genomics on a population-scale to maximise primary prevention for breast-and-ovarian cancer. We compare long-term outcomes of population-based and family-history (FH)/clinical-criteria-based BRCA testing on psychological health and quality of life. DESIGN: Randomised controlled trial (RCT) (ISRCTN73338115) GCaPPS, with two-arms: (i) population-screening (PS); (ii) FH/clinical-criteria-based testing. SETTING: North London Ashkenazi-Jewish (AJ) population. POPULATION/SAMPLE: AJ women/men. METHODS: Population-based RCT (1:1). Participants were recruited through self-referral, following pre-test genetic counselling from the North London AJ population. INCLUSION CRITERIA: AJ women/men >18 years old; exclusion-criteria: prior BRCA testing or first-degree relatives of BRCA-carriers. INTERVENTIONS: Genetic testing for three Jewish BRCA founder-mutations: 185delAG (c.68_69delAG), 5382insC (c.5266dupC) and 6174delT (c.5946delT), for (i) all participants in PS arm; (ii) those fulfilling FH/clinical criteria in FH arm. Linear mixed models and appropriate contrast tests were used to analyse the impact of BRCA testing on psychological and quality-of-life outcomes over 3 years. MAIN OUTCOME MEASURES: Validated questionnaires (HADS/MICRA/HAI/SF12) used to analyse psychological wellbeing/quality-of-life outcomes at baseline/1-year/2-year/3-year follow up. RESULTS: In all, 1034 individuals (691 women, 343 men) were randomised to PS (n = 530) or FH (n = 504) arms. There was a statistically significant decrease in anxiety (P = 0.046) and total anxiety-&-depression scores (P = 0.0.012) in the PS arm compared with the FH arm over 3 years. No significant difference was observed between the FH and PS arms for depression, health-anxiety, distress, uncertainty, quality-of-life or experience scores associated with BRCA testing. Contrast tests showed a decrease in anxiety (P = 0.018), health-anxiety (P < 0.0005) and quality-of-life (P = 0.004) scores in both PS and FH groups over time. Eighteen of 30 (60%) BRCA carriers identified did not fulfil clinical criteria for BRCA testing. Total BRCA prevalence was 2.9% (95% CI 1.97-4.12%), BRCA1 prevalence was 1.55% (95% CI 0.89-2.5%) and BRCA2 prevalence was 1.35% (95% CI 0.74-2.26%). CONCLUSION: Population-based AJ BRCA testing does not adversely affect long-term psychological wellbeing or quality-of-life, decreases anxiety and could identify up to 150% additional BRCA carriers. TWEETABLE ABSTRACT: Population BRCA testing in Ashkenazi Jews reduces anxiety and does not adversely affect psychological health or quality of life.


Assuntos
Ansiedade , Detecção Precoce de Câncer , Genes BRCA1 , Genes BRCA2 , Síndrome Hereditária de Câncer de Mama e Ovário , Qualidade de Vida , Adulto , Ansiedade/fisiopatologia , Ansiedade/prevenção & controle , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/psicologia , Feminino , Predisposição Genética para Doença/psicologia , Testes Genéticos/métodos , Testes Genéticos/estatística & dados numéricos , Síndrome Hereditária de Câncer de Mama e Ovário/diagnóstico , Síndrome Hereditária de Câncer de Mama e Ovário/etnologia , Síndrome Hereditária de Câncer de Mama e Ovário/genética , Síndrome Hereditária de Câncer de Mama e Ovário/psicologia , Humanos , Judeus/genética , Judeus/estatística & dados numéricos , Londres/epidemiologia , Masculino , Anamnese/estatística & dados numéricos , Incerteza
2.
Medicine (Baltimore) ; 98(51): e18188, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860965

RESUMO

AIM: We compared the effects of 50% N2O and N2O titration in burn management to alleviate pain and anxiety associated with burn dressing. METHODS: In this single-blind prospective randomized controlled trial, 70 stable adult burn patients were randomized to 2 groups during May 2015 to January 2016. The experimental group was titrated with N2O ranging from 30% to the ideal sedation concentration before dressing change until the end. The control group was treated with 50% N2O 2 minutes before dressing change until the end. Pain, anxiety, vital signs, and the highest concentrations of N2O inhaled were recorded at 1 minute before N2O inhalation (T0), dismantling of outer (T1), inner dressings (T2), debridement (T3), drug-smearing (T4), bandaging (T5), and 10 minutes after completion of the procedure (T6). RESULTS: The pain and anxiety scores in the experimental group performed significantly less than the control group during T2-T6. The systolic blood pressure in T2 and the heart rate at T2 and T3 varied significantly between the 2 groups. The highest N2O concentrations of the experimental group were mainly 60% to 70% at T2 (87.9%), T3 (87.9%), and T4 (81.8%). CONCLUSION: N2O titration significantly reduced pain and anxiety in burn patients, with minimal side effects.


Assuntos
Analgésicos não Entorpecentes/uso terapêutico , Ansiolíticos/uso terapêutico , Queimaduras/terapia , Óxido Nitroso/uso terapêutico , Administração por Inalação , Adolescente , Adulto , Idoso , Analgésicos não Entorpecentes/administração & dosagem , Ansiolíticos/administração & dosagem , Ansiedade/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Óxido Nitroso/administração & dosagem , Manejo da Dor , Método Simples-Cego , Adulto Jovem
3.
Medicine (Baltimore) ; 98(51): e18471, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31861026

RESUMO

This study aimed to compare the Hamilton anxiety rating/Hamilton depression rating (HAMA/HAMD) scale scores and blood pressure (BP) goal achievement associated with the use of valsartan-amlodipine single-pill combinations (SPCs) versus valsartan and amlodipine combination in adult hypertensive patients.A total of 476 hypertensive patients were randomly assigned into the SPC (valsartan-amlodipine) and control (valsartan and amlodipine combination) groups. All patients had an uncontrolled BP (160-179/100-109 mm Hg). BP goal was <140/90 mm Hg. Cox proportional hazards regression analysis was used to analyze the likelihood of HAMA/HAMD scales, SPCs, control group, and daily dosage number. Kaplan-Meier analysis was used to estimate the rates of BP goal achievement over time among the 2 groups.A total of 476 patients were included in the study, and 439 patients completed the follow-up and received the index drug therapy. There was a significant difference in BP between the 2 groups on days 28, 42, and 56. Patients who received SPCs had a significantly higher rate of BP goal achievement over time (P = .000). The average HAMD scores in the SPC and control groups were 5.54 and 5.49 and 6.06 and 6.21 on days 28 and 56, respectively. The average HAMA scores in the SPC and control groups were 7.41 and 7.13 and 7.90 and 8.01 on days 28 and 56, respectively. The means of HAMD and HAMA scores were 5.826 and 7.614, respectively. The higher the HAMA/HAMD scores, the lower was the BP goal achievement. The number of drugs taken by the patients was associated with the HAMA and HAMD scores. There was no significant difference between HAMA scores of patients taking 1 tablet daily (7.22 ±â€Š1.885) and those taking two-tablets daily (7.38 ±â€Š1.953) (P = .408). However, when these scores were compared to those of patients taking 4 tablets daily (8.08 ±â€Š2.285), a significant difference was observed (P = .000, P = .000).Hypertensive patients treated with valsartan-amlodipine SPCs were significantly more likely to achieve BP goal and have lesser HAMA/HAMD scores compared to patients treated with valsartan and amlodipine combination.


Assuntos
Combinação Anlodipino e Valsartana/uso terapêutico , Anti-Hipertensivos/administração & dosagem , Ansiedade/prevenção & controle , Depressão/prevenção & controle , Hipertensão/tratamento farmacológico , Combinação Anlodipino e Valsartana/farmacologia , Pressão Sanguínea/efeitos dos fármacos , Feminino , Humanos , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
4.
Nurs Res ; 68(6): 494-500, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31693556

RESUMO

BACKGROUND: Recognizing the effects of acculturation on quality of life and emotional health, especially during pregnancy, we developed an intervention that would target these factors in order to improve maternal well-being during the prenatal period and potentially improve infant outcomes, particularly preterm birth for Mexican-American women (Latinas). OBJECTIVE: The purpose of these pilot studies was to test the acceptability, feasibility, and preliminary efficacy of the mastery lifestyle intervention (MLI) to decrease depressive and anxiety symptoms and improve coping as implemented in prenatal clinics with culturally homogenous groups of Latinas. METHODS: The MLI was tested in three small pilot studies (n = 15), one in El Paso, Texas (an urban area), and two in Bastrop, Texas (a rural area outside Austin), for acceptability and feasibility. A pretest/posttest, quasi-experimental design was used with pregnant self-identified Mexican-American Latinas at 14-20 weeks' gestation. Measures of anxiety, depressive symptoms, and positive and negative coping were used. RESULTS: Feasibility was a success in terms of implementation of the MLI in an active prenatal clinic setting and the use of electronic tablets for data collection and entry of data into REDcap. Satisfaction was high, with the location of the MLI being at their primary OB/GYN clinic. Participants reported that six intervention sessions appear to be ideal as was the class length of 1.5 to 2 hours. On Cohen's d, there were medium to large effect size decreases in depressive and anxiety symptoms and small to medium effect size decreases in the use of negative coping strategies and small effect sizes for increases in positive coping strategies. DISCUSSION: Pilot testing of the MLI indicated that it was well accepted from the participants and feasible as a culturally tailored behavioral therapy administered in a group setting by nurse practitioners. Our initial pilot results also suggest preliminary efficacy as indicated by moderate to large Cohen's d effect sizes for depression and anxiety.


Assuntos
Ansiedade/prevenção & controle , Depressão/prevenção & controle , Estilo de Vida/etnologia , Americanos Mexicanos/psicologia , Complicações na Gravidez/prevenção & controle , Cuidado Pré-Natal , Aculturação , Adaptação Psicológica , Adulto , Ansiedade/etnologia , Depressão/etnologia , Estudos de Viabilidade , Feminino , Humanos , Projetos Piloto , Gravidez , Complicações na Gravidez/etnologia , Qualidade de Vida , Texas
5.
Lancet Psychiatry ; 6(12): 1011-1020, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31734106

RESUMO

BACKGROUND: Rates of anxiety and depression are increasing among children and young people. Recent policies have focused on primary prevention of mental disorders in children and young people, with schools at the forefront of implementation. There is limited information for the comparative effectiveness of the multiple interventions available. METHODS: We did a systematic review and network meta-analysis, searching MEDLINE, Embase, PsycINFO, and Cochrane Central Register of Controlled trials for published and unpublished, passive and active-controlled randomised and quasi-randomised trials. We included educational setting-based, universal, or targeted interventions in which the primary aim was the prevention of anxiety and depression in children and young people aged 4-18 years. Primary outcomes were post-intervention self-report anxiety and depression, wellbeing, suicidal ideation, or self-harm. We assessed risk of bias following the Cochrane Handbook for Systematic Reviews of Interventions. We estimated standardised mean differences (SMD) using random effects network meta-analysis in a Bayesian framework. The study is registered with PROPSERO, number CRD42016048184. FINDINGS: 1512 full-text articles were independently screened for inclusion by two reviewers, from which 137 studies of 56 620 participants were included. 20 studies were assessed as being at low risk of bias for both random sequence generation and allocation concealment. There was weak evidence to suggest that cognitive behavioural interventions might reduce anxiety in primary and secondary settings. In universal secondary settings, mindfulness and relaxation-based interventions showed a reduction in anxiety symptoms relative to usual curriculum (SMD -0·65, 95% credible interval -1·14 to -0·19). There was a lack of evidence to support any one type of intervention being effective to prevent depression in universal or targeted primary or secondary settings. Comparison-adjusted funnel plots suggest the presence of small-study effects for the universal secondary anxiety analysis. Network meta-analysis was not feasible for wellbeing or suicidal ideation or self-harm outcomes, and results are reported narratively. INTERPRETATION: Considering unclear risk of bias and probable small study effects for anxiety, we conclude there is little evidence that educational setting-based interventions focused solely on the prevention of depression or anxiety are effective. Future research could consider multilevel, systems-based interventions as an alternative to the downstream interventions considered here. FUNDING: UK National Institute for Health Research.


Assuntos
Ansiedade/prevenção & controle , Depressão/prevenção & controle , Meta-Análise em Rede , Serviços de Saúde Escolar , Adolescente , Ansiedade/terapia , Criança , Pré-Escolar , Terapia Cognitivo-Comportamental , Depressão/terapia , Humanos , Ideação Suicida
6.
Nurs Educ Perspect ; 40(6): 367-369, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31644456

RESUMO

Various causes exist for nursing student anxiety in the clinical setting. There is a need for further intervention research that may be effective to reduce student anxiety related to clinical. The purpose of this pilot research study was to measure and manage anxiety for nursing students in the clinical area with the assistance of a smartphone app. The usefulness of the app was evaluated by means of a focus group.


Assuntos
Ansiedade/diagnóstico , Ansiedade/prevenção & controle , Aplicativos Móveis , Smartphone , Estudantes de Enfermagem/psicologia , Bacharelado em Enfermagem , Grupos Focais , Humanos , Projetos Piloto
7.
Medicine (Baltimore) ; 98(39): e17307, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574859

RESUMO

To investigate the cognitive and psychological outcomes of pediatric allogeneic HSCT survivors in China.A total of 135 3 to 18 years old children and adolescents who underwent allo-HSCT and survived at least 3 months post-HSCT were recruited and completed the assessments. Cognitive and psychological functions were assessed via age-appropriate standardized measures. Clinical information was extracted from the medical records.Forty one 3 to 6 years old children completed Psychological Questionnaires for 3 to 6 years Children. The scores of 21(51.2%) children in cognitive development dimension, 18(43.9%) in motor development dimension, 16(39.0%) in language development and social development dimension, 15(36.6%) in emotion and will dimension and 14(34.1%) in living habits dimension were less than the standard. Fifty six 8 to 16 years old children and adolescents completed the Depression Self-rating Scale for Children and 9 (16.1%) of these met the criteria of depression. Sixty nine 7 to 16 years old children and adolescents completed the screening for Child Anxiety Related Disorders and 7 (10.1%) of these met the criteria of anxiety, especially social phobia and school phobia. Eighty nine 6 to 18 years old children and adolescents completed the Symptom Checklist-90 and 43.8% to 77.5% of these experienced mild symptoms like obsession-compulsion (77.5%), hostility (64%), and interpersonal sensitivity (60.7%). Children treated with total body irradiation (TBI) showed more cognitive impairments like motor deficits than those without TBI. Also older children and adolescents had more symptoms like psychoticism.These findings demonstrated cognitive and psychological late effects of pediatric allo-HSCT survivors in a single center in China and highlighted that the survivors conditioned with TBI had more cognitive impairments and older children and adolescents had more symptoms. Early intervention in these children and adolescents might minimize the cognitive losses and psychological effects.


Assuntos
Ansiedade , Disfunção Cognitiva , Depressão , Transplante de Células-Tronco Hematopoéticas , Complicações Pós-Operatórias , Qualidade de Vida , Adolescente , Ansiedade/diagnóstico , Ansiedade/etiologia , Ansiedade/prevenção & controle , Criança , Pré-Escolar , China/epidemiologia , Cognição , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/prevenção & controle , Depressão/diagnóstico , Depressão/etiologia , Depressão/prevenção & controle , Intervenção Médica Precoce/métodos , Feminino , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Masculino , Destreza Motora , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/prevenção & controle , Técnicas Psicológicas , Sobreviventes/psicologia
8.
Eur J Oncol Nurs ; 42: 153-161, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31557665

RESUMO

PURPOSE: Caring for cancer patients can be highly stressful for both family caregivers and oncology professionals. These high levels of stress can lead to poorer patient outcomes and increased risk of health problems for the caregivers themselves. Art therapy may help these caregivers as art-making can be a relaxing and enjoyable form of self-expression and art therapists can support individuals in expressing and processing challenging emotions. Research on art-making or art therapy with caregivers of cancer patients has shown some positive results, but its interpretation is limited by the use of multifaceted interventions. METHOD: In this mixed-methods study we compared two brief arts-based approaches for both professional and informal caregivers: single sessions of coloring or open-studio art therapy, with a 45-minute session each. Assessments imcluded self-reports of affect, stress, self-efficacy, anxiety, burnout arnd creative agency alongside salivary biomarkers before and after the session. Open-ended questions, field notes and observations formed the qualitative part of the study. RESULTS: Thirty-four professional (n=25) and informal (n=9) caregivers participated. Participants in both conditions showed increases in positive affect, creative agency, and self-efficacy and decreases in negative affect, anxiety, perceived stress, and burnout. Participants in both conditions expressed enjoyment, relaxation, appreciation of time away from stressors, creative problem solving, a sense of flow, and personal and existential insight. The two approaches also elicited distinct experiences with participants reporting that they found improved focus in coloring and appreciated the support and freedom of expression in open studio art therapy. CONCLUSIONS: These findings suggest that even brief art-making interventions can be beneficial for stressed caregivers of cancer patients. As experience with art-making increased the impact, repeated sessions may be even more useful. We recommend that oncology units have dedicated studio spaces with therapeutic support and different forms of art-making available to meet individual caregiver needs.


Assuntos
Terapia pela Arte , Cuidadores/psicologia , Neoplasias/psicologia , Neoplasias/terapia , Radioterapia (Especialidade) , Adulto , Ansiedade/prevenção & controle , Esgotamento Profissional/prevenção & controle , Emoções , Empatia , Existencialismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto
10.
Braz J Med Biol Res ; 52(9): e8533, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31483000

RESUMO

This study aimed to evaluate the effect of a newly designed intensive caregiver education program (ICEP) on reducing cognitive impairment, anxiety, and depression in acute ischemic stroke (AIS) patients. One hundred and ninety-six AIS patients were divided into ICEP group and Control group in a 1:1 ratio using blocked randomization method. In the ICEP group, the caregivers received ICEP, while in the Control group caregivers received usual education and guidance. All patients received conventional rehabilitation treatment. Cognitive impairment (assessed by Mini Mental State Examination (MMSE) score and Montreal Cognitive Assessment (MoCA) score), anxiety (assessed by Hospital Anxiety and Depression Scale (HADS)-A score and Self-rating Anxiety Scale (SAS) score), and depression (assessed by HADS-D score and Self-rating Depression Scale (SDS) score) were assessed at baseline (M0), 3 months (M3), 6 months (M6), and 12 months (M12). Cognitive impairment score at M12 and cognitive impairment score change (M12-M0) were increased, while cognitive impairment rate at M12 was reduced in the ICEP group compared with the Control group. Anxiety score change (M12-M0), anxiety score at M12, and anxiety rate at M12 were decreased in the ICEP group compared with the Control group. Depression score change (M12-M0), depression score at M12, and depression rate at M12 were lower in the ICEP group compared with the Control group. Further subgroup analysis based on baseline features also provided similar results. In conclusion, ICEP effectively reduced cognitive impairment, anxiety, and depression in AIS patients.


Assuntos
Transtornos de Ansiedade/prevenção & controle , Ansiedade/prevenção & controle , Cuidadores , Disfunção Cognitiva/prevenção & controle , Transtorno Depressivo/prevenção & controle , Educação em Saúde/métodos , Acidente Vascular Cerebral/enfermagem , Adulto , Ansiedade/etiologia , Transtornos de Ansiedade/etiologia , Estudos de Casos e Controles , Disfunção Cognitiva/etiologia , Transtorno Depressivo/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/psicologia , Reabilitação do Acidente Vascular Cerebral
11.
Psychiatr Danub ; 31(Suppl 3): 386-389, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488757

RESUMO

BACKGROUND: Nowadays, anxiety disorders are becoming more and more important in our population. And if there is one category of people more vulnerable to this problem, it is the teenagers. In addition, more and more children and teenagers are diagnosed with an IQ greater than 130, causing all the stress and questions that it generates. In this project, we are comparing two groups of adolescents, one with an IQ over 130, the other with an IQ less than 130. We are wondering if there is any difference between these groups, in terms of phobia and other psychopathologies. SUBJECTS AND METHODS: A sample of 35 teenagers, from 12 to 16 years old, separated in two groups (IQ over 130 and IQ below 130), fulfilled the following questionnaires: the School Rehabilitation Assessment Scale-Revised (SARS-R), the "Family Adaptability and Cohesiveness Evaluation Scale III" (FACES III), and the "Kiddie- SADS-lifetime" (K-SADS-PL), and a social data collection questionnaire. RESULTS: At the end of this study, we can retain the following relevant elements: adolescents with IQs greater than 130 are statistically more likely to be the eldest siblings (Cochran Test F=9.159, p=0.010). They do not develop more phobias, but are more shy (t=4.375, p=0.036) than the control population. These high-potential and shy teenagers have a whole list of commonalities, such as being easily irritable, being easily distracted, ect... They have fewer friends in real life (t=2.255, p=0.033), fewer virtual friends (t=4.346, p=0.000) and fewer virtual relationships (t=2.431, p=0.021). Their families are very cohesive (Test t=0.004). There is no significant role of the socio-professional class of parents playing in the value of the IQ of their children (t=4.667, p=0.323). CONCLUSION: To conclude, being a teenager and having an IQ greater than 130 is not always a pleasure. Our results showed us that the majority of these young people consider themselves as shy, unsure of themselves and claim to have many fears. This is evidence of an increased anxiety component compared to the control sample. It seems important to insist on the need to be able and to know how to identify these young people as soon as possible, in order to propose appropriate therapeutic management.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Ansiedade/epidemiologia , Ansiedade/psicologia , Testes de Inteligência/estatística & dados numéricos , Inteligência , Psicopatologia , Timidez , Adolescente , Ansiedade/prevenção & controle , Transtornos de Ansiedade/prevenção & controle , Estudos de Casos e Controles , Criança , Medo , Amigos/psicologia , Humanos , Fatores Socioeconômicos , Inquéritos e Questionários
12.
Psychiatr Danub ; 31(Suppl 3): 452-454, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488771

RESUMO

"Before convincing the intellectual part of the mind it is necessary to touch and prepare the heart", an aphorism by Blaise Pascal (Vozza 1995), refers to one of the most important functions of strategic training, not only being successful in making communicative messages correctly and rationally understood, but also involving its addressee, above all by making one enter into emotional syntony with the communicative content. To understand the precious wealth of knowledge that has over time brought the necessary skills to do strategic training, it is necessary to find its roots by taking a step back in time. It is necessary to go as far as the fifth century BC, with Protagoras and its persuasive efficacy, with a rapid historical excursus passing by Aristotle and his Sophistic communication techniques to arrive at about 2000 years later, passing through social psychology, up to the Palo Alto strategic school. Among its various activities, the Genius Academy Centre for Research and Psychological Studies has decided to push two strategic training projects aiming to increase the level of well-being perceived by the addressee and encouraging the desired change. One of the two strategic training projects, A "Journey" in a journey, conceived by the writer, started in 2013. The educational and therapeutic value are amplified by optimizing the suggestions and stimuli of the journey. Another strategic training project for future aeronautical professionals, which gives a great contribution to the traditional technical training, is an innovative psychological programme specifically designed to prepare, not only for technical operational challenges, but also for numerous psychological challenges deriving from working in a particular environment such as the airport. It is specifically designed to study and improve the travel experience of people in airport transit and aims to raise the level of traveller's well-being, through a series of highly innovative interventions in specifically provided areas with the use of digital reality in coping and helping with anxiety and fear of flying.


Assuntos
Adaptação Psicológica , Transtornos de Ansiedade/prevenção & controle , Transtornos de Ansiedade/psicologia , Ansiedade/prevenção & controle , Ansiedade/psicologia , Comunicação Persuasiva , Viagem/psicologia , Ansiedade/terapia , Transtornos de Ansiedade/terapia , História do Século XXI , História Antiga , Humanos
13.
Biol Pharm Bull ; 42(9): 1471-1481, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31474708

RESUMO

Sutaehwan (STH) has been used in Korean medicine for the treatment of abortus habitualis such as fetal restlessness in the uterus. Previously, we reported that a modified formulation of STH, Sutaehwan-Gami, has phytoestrogen-like properties in an ovariectomized menopausal rat model. However, the therapeutic effects of STH and the precise mechanisms by which STH affects various menopausal symptoms remain poorly understood. The current study was designed to explore the effects of a modified form of STH on menopausal anxiety, depression and heart hypertrophy and its mechanisms in 4-vinylcyclohexene diepoxide (VCD)-induced menopausal mouse models. VCD-induced menopausal model mice were fed a modified form of STH, which contained water extract of 3 herbs (called STH_KP17001) at a dose of 100 or 300 mg/kg/d or as a positive control, estradiol at a dose of 0.2 mg/kg/d with standard mouse pellets for 13 weeks. The results show that STH_KP17001 significantly restored the VCD-induced weight reduction of uterine and ovary through the phosphorylation of extracellular signal-regulated kinase (ERK) and protein kinase B (AKT) in the uterus and ovary. Moreover, STH_KP17001 showed slight proliferative effects and estrogen receptor α phosphorylation in MCF-7 cells. Treatment with STH_KP17001 reversed VCD-induced anxiety and depression through AMP-activated protein kinase (AMPK) activation and brain-derived neurotrophic factor (BDNF) expression in the cerebral cortex, while improving heart hypertrophy through inactivation of inhibitor of kappaB α (IκBα) in the heart. The results indicate that STH_KP17001 improves menopause-induced anxiety, depression and heart hypertrophy, implying its protective role for the management of menopausal symptoms.


Assuntos
Ansiedade/prevenção & controle , Cardiomegalia/prevenção & controle , Depressão/prevenção & controle , Menopausa/psicologia , Extratos Vegetais/farmacologia , Animais , Cicloexenos , Modelos Animais de Doenças , Feminino , Humanos , Células MCF-7 , Medicina Tradicional Coreana , Camundongos Endogâmicos C57BL , Extratos Vegetais/isolamento & purificação , Compostos de Vinila
14.
Soins Psychiatr ; 40(323): 29-34, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31402037

RESUMO

Art is used as a form of mediation in care units. In addition to its benefit as an occupational activity, it is rooted in the tangible which can help combat apragmatism and anxiety.While this practice helps patients give meaning to their existence, the group approach and the help of a therapist form part of personalised care projects. Work around the self-portrait is an illustration of this practice, between the occupational and the therapeutic.


Assuntos
Terapia pela Arte/métodos , Transtornos Mentais/terapia , Psicoterapia de Grupo , Autoavaliação , Ansiedade/prevenção & controle , Humanos , Transtornos Mentais/psicologia
15.
Mayo Clin Proc ; 94(9): 1852-1864, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31451292

RESUMO

Physical inactivity and psychosocial stress are prevalent in residents of the United States. The purpose of this article is to review the interaction between these 2 conditions and examine the effects of exercise on stress and cardiovascular (CV) health. A query of scientific references between 1974 to 2018 was performed using the PubMed search engine accessing the MEDLINE database using the search terms psychosocial stress, CV disease (CVD), physical activity, exercise, cardiac rehabilitation, and team sports. Psychosocial stress is a strong independent risk factor for adverse CV events. Conversely, people who experience CV events subsequently have drastically elevated rates of new-onset mental health disorders, including depression and anxiety. Psychosocial stress and CVD often trigger self-reinforcing feedback loops that can worsen mental health and cardiac prognosis. Exercise predictably improves CV health and prognosis and also is effective at lowering levels of psychosocial stress. Group exercise in particular seems to provide social support while at the same time boosting fitness levels and, thus, may be the single most important intervention for patients with concomitant CVD and emotional stress. Collaborative physical activity, such as group exercise, team sports, interactive physical play, and cardiac rehabilitation programs, have the potential to improve mental health and CV prognosis.


Assuntos
Cardiotoxicidade/etiologia , Transtorno Depressivo/prevenção & controle , Exercício/fisiologia , Aptidão Física/fisiologia , Comportamento Sedentário , Estresse Psicológico/complicações , Ansiedade/etiologia , Ansiedade/prevenção & controle , Cardiotoxicidade/fisiopatologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Transtorno Depressivo/etiologia , Feminino , Humanos , Estilo de Vida , Masculino
16.
Psicothema (Oviedo) ; 31(3): 298-304, ago. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-185357

RESUMO

Background: Super Skills for Life (SSL) is a transdiagnostic prevention program designed for children with anxiety and depressive symptoms based on cognitive-behavioral therapy. This study is a trial of the efficacy of the SSL program to reduce anxiety and depression symptoms in a representative sample of Spanish children aged 6 to 8. Method: This cluster randomized controlled trial involved 123 Spanish-speaking children recruited from 10 schools. Schools were the unit of randomization, and were randomly assigned to one of two experimental conditions: intervention group (SSL) and waiting list control (WLC) group. Assessments were conducted before and after the 8-week intervention. Results: Generalized estimating equations showed that, compared with WLC, the intervention significantly reduced emotional symptoms of anxiety and depression. Significant improvements were also found in specific symptoms of anxiety disorders, and in the interference of anxiety in the child´s life. Conclusions: The findings of this study provide initial support for the immediate effects of SSL, suggesting that it is a valuable resource for the early reduction of anxiety and depressive symptoms in young Spanish-speaking children


Antecedentes: Super Skills for Life (SSL) es un programa de prevención transdiagnóstico diseñado para niños con síntomas de ansiedad y depresión basado en la terapia cognitivo-conductual. Se presenta un ensayo sobre la eficacia del programa SSL en la reducción de los síntomas de ansiedad y depresión en una muestra representativa de niños españoles de 6 a 8 años de edad. Método: este ensayo controlado aleatorio grupal incluyó a 123 niños hispanohablantes reclutados en 10 colegios. Los colegios fueron la unidad de aleatorización, siendo asignados aleatoriamente a una de dos condiciones experimentales: grupo de intervención (SSL) y grupo control (GC). Las evaluaciones se realizaron antes y después de la intervención de 8 semanas. Resultados: las ecuaciones de estimación generalizadas mostraron que, en comparación con el GC, la intervención redujo significativamente los síntomas emocionales de ansiedad y depresión. También se encontraron mejorías significativas en síntomas de trastornos de ansiedad específicos y en la interferencia de la ansiedad en la vida del niño. Conclusiones: los resultados de este estudio proporcionan apoyo inicial a los efectos inmediatos de SSL, sugiriendo que es un recurso valioso para la reducción temprana de los síntomas de ansiedad y depresión en niños pequeños hispanohablantes


Assuntos
Humanos , Masculino , Feminino , Criança , Ansiedade/prevenção & controle , Terapia Cognitivo-Comportamental/métodos , Depressão/prevenção & controle , Avaliação de Programas e Projetos de Saúde , Qualidade de Vida , Transtornos de Ansiedade/prevenção & controle , Transtorno Depressivo/prevenção & controle , Pais , Instituições Acadêmicas , Autorrelato , Espanha , Listas de Espera
17.
Cancer Control ; 26(1): 1073274819864641, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31327239

RESUMO

Anxiety, a condition which is commonly found in patients with cancer, has negative impacts on their quality of life and treatment outcome. This study aimed to determine the level of anxiety in patients with cancer and explore sociodemographic, disease-related, and hospital-related factors associated with anxiety in those patients. A cross-sectional study was conducted on 510 inpatients with cancer at Thanh Hoa Oncology Hospital, Vietnam. Data were collected from self-administered questionnaire forms on hospital depression anxiety-A, interviews with patients, and patient medical records. The univariate and multivariate linear regression analyses were performed using STATA ver. 14.0. Our finding that the patients' mean anxiety score (standard deviation) was 7.22 (3.8); 27.6% of the patients had an anxiety score between 8 and 10 points, and 15.5% had an anxiety score of ≥11 points. In the multivariate model, in more advanced stages of cancer, and patients with metastasis were more likely to have higher levels of anxiety than those who presented no sign of metastasis. The longer the patients had cancer, the less anxious they became. Lower levels of anxiety were observed in patients who stated that hospital facilities were adequate or had trust in health workers. Patients with cancer need to be provided with psychological support in the early stage of cancer detection and when metastases form. A strong patient-health-care provider relationship after diagnosis may help reduce distress among patients with cancer with higher levels of medical mistrust.


Assuntos
Ansiedade/diagnóstico , Pacientes Internados/psicologia , Neoplasias/psicologia , Relações Médico-Paciente , Qualidade de Vida , Adulto , Idoso , Ansiedade/prevenção & controle , Ansiedade/psicologia , Institutos de Câncer , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/terapia , Questionário de Saúde do Paciente/estatística & dados numéricos , Vietnã
18.
J Youth Adolesc ; 48(9): 1668-1685, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31346924

RESUMO

Given the recent rise in adolescent mental health issues, many researchers have turned to school-based mental health programs as a way to reduce stress, anxiety, and depressive symptoms among large groups of adolescents. The purpose of the current systematic review and meta-analysis is to identify and evaluate the efficacy of school-based programming aimed at reducing internalizing mental health problems of adolescents. A total of 42 articles, including a total of 7310 adolescents, ages 11-18, met inclusion for the meta-analyses. Meta-analyses were completed for each of the three mental health outcomes (stress, depression, and anxiety) and meta-regression was used to determine the influence of type of program, program dose, sex, race, and age on program effectiveness. Overall, stress interventions did not reduce stress symptoms, although targeted interventions showed greater reductions in stress than universal programs. Overall, anxiety interventions significantly reduced anxiety symptoms, however higher doses may be necessary for universal programs. Lastly, depression interventions significantly reduced depressive symptoms, but this reduction was moderated by a combination of program type, dose, race, and age group. Although, school-based programs aimed at decreasing anxiety and depression were effective, these effects are not long-lasting. Interventions aimed at reducing stress were not effective, however very few programs targeted or included stress as an outcome variable. Implications for practice, policy and research are discussed.


Assuntos
Ansiedade/psicologia , Depressão/prevenção & controle , Prevenção Primária/organização & administração , Serviços de Saúde Escolar/organização & administração , Estresse Psicológico/prevenção & controle , Estudantes/psicologia , Adolescente , Ansiedade/prevenção & controle , Criança , Depressão/psicologia , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Estresse Psicológico/psicologia
19.
Rom J Ophthalmol ; 63(2): 146-152, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31334393

RESUMO

Purpose: Preoperative anxiety over cataract surgery affects a large number of patients. This study aims to evaluate the effect of slow-stroke back massage on the anxiety of candidates for cataract surgery. Design: Quasi-experimental study. Methods: This study was a quasi-experimental study, which involved 60 candidates for cataract surgery referred to Amiralmomenin Hospital, Zabol in Iran between August 1, 2015, and March 30, 2016. These patients were randomly divided into two groups of slow-stroke back massage group (n=30) and control group (n=30). After obtaining an informed consent, the anxiety levels were measured by the Spielberger state trait anxiety questionnaire in the slow-stroke back massage group and the control group on the morning of the surgery before and immediately after the massage. SPSS software version 22 was used for data analysis. Independent t-test and chi-square test were used to compare the data. Findings: According to the results, there was a significant difference between the anxiety levels of the patients in the intervention group before and after the massage (p < 0.001). Conclusions: Based on the results of this study, Slow-stroke-back massage, which is a low-cost and safe method, significantly reduces anxiety in patients who are candidates for cataract surgery.


Assuntos
Ansiedade/prevenção & controle , Extração de Catarata/psicologia , Massagem/métodos , Cuidados Pré-Operatórios/métodos , Adulto , Ansiedade/epidemiologia , Ansiedade/etiologia , Dorso , Feminino , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento
20.
Chem Biol Interact ; 311: 108758, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31348919

RESUMO

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder in children. It is diagnosed by two main behavioral phenotypes i.e. social-communication impairments and repetitive behavior. ASD is complex disorder with unsolved etiology due to multiple genes involvement, epigenetic mechanism and environmental factors. The clinical and preclinical studies have been indicating the association of propionic acid with autism spectrum disorder. Numerous studies suggest the potential therapeutic effects of peroxisome proliferator-activated receptor-gamma (PPAR-γ) in different brain disorders. This research evaluates the utility of selective agonist of PPAR-γ, pioglitazone in postnatal propionic acid induced ASD related symptomatology in male Wistar rats. PPA (250 mg/kg, p.o.) was administered to male offspring for three consecutive days from postnatal 21st day to 23rd day. PPA induced social impairment, repetitive behavior, hyperlocomotion, anxiety and low exploratory activity in rats. Also, postnatal propionic acid-treated rats showed higher levels of oxidative stress (increased in thiobarbituric acid reactive species and decreased in reduced glutathione) as well as inflammation (increased in interleukin-6, tumor necrosis factor-alpha and decreased in interleukin-10) in the cerebellum, brainstem and prefrontal cortex. The rats were treated daily with pioglitazone (10 mg/kg and 20 mg/kg, p.o.) from postnatal 24th day to end of the study. Treatment with pioglitazone, significantly attenuated the postnatal propionic acid-induced social impairment, repetitive behavior, hyperactivity, anxiety and low exploratory activity. Furthermore, pioglitazone also reduced the postnatal propionic acid-induced oxidative stress and neuroinflammation in aforementioned brain regions. Hence, pioglitazone improved the propionic acid-induced neurobehavioral and biochemical impairments in rats.


Assuntos
Transtorno do Espectro Autista/patologia , Estresse Oxidativo/efeitos dos fármacos , PPAR gama/agonistas , Pioglitazona/farmacologia , Animais , Ansiedade/prevenção & controle , Transtorno do Espectro Autista/induzido quimicamente , Transtorno do Espectro Autista/metabolismo , Comportamento Animal/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Modelos Animais de Doenças , Comportamento Exploratório/efeitos dos fármacos , Glutationa/metabolismo , Inflamação/prevenção & controle , Interleucina-10/metabolismo , Interleucina-6/metabolismo , Locomoção/efeitos dos fármacos , Masculino , PPAR gama/metabolismo , Fenótipo , Pioglitazona/uso terapêutico , Propionatos/toxicidade , Ratos , Ratos Wistar
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