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1.
Int Arch Occup Environ Health ; 95(3): 559-571, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35220487

RESUMO

OBJECTIVE: Estimate the effort-reward imbalance prevalence (ERI) among physicians. METHODS: A systematic review was conducted from 2005 to 2019 using PRISMA guidelines on the PubMed and EBSCOhost search engines. Data were classified according to the ERI definition used by the authors. A meta-analysis was performed on effort and reward scores and on ERI prevalence rates. RESULTS: Out of 3787 results, we selected 41 studies. The physicians' ERI prevalence rate ranged from 3.50 to 96.9%. The standardized pooled effort mean score was 58.5 for effort and 48.9 for a reward out of 100, respectively. The overall combined ERI rate (when the ratio between effort and reward scores was above 1) was 40.2% among 21,939 practitioners (31.7% in the working European population). ERI rate was 70.2% using a four-point Likert scale and 21.1% using a five-point Likert scale. The highest rate (96.9%) was observed among German rural general practitioners and the lowest rate (3.50%) among Swiss hospital practitioners. The low percentage of variability (I2 = 27%) attributed to effort scores heterogeneity between studies suggested that this dimension is not discriminant in the physician ERI assessment. The high heterogeneity in reward scores (I2 = 83%) indicated that this dimension is sensible in ERI assessment among physicians. The number of items used did not appear as a significant source of heterogeneity. CONCLUSION: Physician job ERI appeared to be higher than in the working population. Studying each dimension and item indicators could help improve psychosocial risk prevention.


Assuntos
Satisfação no Emprego , Médicos , Humanos , Médicos/psicologia , Prevalência , Recompensa , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Carga de Trabalho/psicologia
2.
J Neurotrauma ; 39(1-2): 86-92, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-33626946

RESUMO

This case-control study using baseline data from the population cohort Adolescent Brain Cognitive Development (ABCD) Study® compared lifetime history of concussion between children with and without attention-deficit/hyperactivity disorder (ADHD). We hypothesized that children with ADHD would have a greater lifetime history of concussion than children without ADHD. Children were recruited from schools across the United States, sampled to provide strong generalizability to the US population. The current sample included 10,585 children (age: mean = 9.9; standard deviation = 0.6; range 9-10 years; 48.9% girls; 64.6% White), including 1085 with ADHD and 9500 without ADHD. The prevalence of prior concussion among children with ADHD was 7.2% (95% CI: 6.6-7.8%) compared with 3.2% (3.1-3.3%) among children without ADHD, meaning current ADHD status was associated with twice the odds of experiencing a prior concussion [χ2 = 44.54; p < 0.001; odds ratio = 2.34 (1.81-3.03)]. No significant differences were observed in proportion of boys and girls with ADHD who had a prior concussion history. The number of current ADHD symptoms were not meaningfully associated with prior concussion history. Lower socioeconomic status was associated with lower rates of reported concussion, but not differentially in association with ADHD. ADHD is associated with twice the lifetime prevalence of prior concussion before age 11 among children from the general U.S. population. Boys and girls with ADHD did not differ in proportions with prior concussion and concussion history was not related to the number of ADHD symptoms reported by parents.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Concussão Encefálica , Adolescente , Atletas/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Concussão Encefálica/psicologia , Estudos de Casos e Controles , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Estados Unidos/epidemiologia
3.
Eur J Neurol ; 29(4): 1017-1024, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34951095

RESUMO

BACKGROUND AND PURPOSE: Variants in the glucocerebrosidase (GBA) gene are recognized as a common and important genetic risk factor for Parkinson disease (PD). However, the impact of variant severity on the clinical phenotype of PD in the Chinese population remains unclear. Thus, the present study aimed to determine the frequency of GBA-related PD (GBA-PD) and the relationship of GBA variant severity with clinical characteristics in a large Chinese cohort. METHODS: Long-range polymerase chain reaction and next generation sequencing were performed for the entire GBA gene. GBA variant severity was classified into five classes: mild, severe, risk, complex, and unknown. RESULTS: Among the total 737 PD patients, 47 GBA variants were detected in 79 (10.72%) patients, and the most common GBA variants were R163Q, L444P, and R120W. Complete demographic and clinical data were obtained for 673 patients, which revealed that 18.50% of early onset PD patients had GBA variants. Compared with patients without GBA variants, GBA-PD patients experienced PD onset an average of 4 years earlier and had more severe motor and nonmotor symptoms. Patients carrying severe and complex variants had a higher burden of nonmotor symptoms, especially depression, and more mood/cognitive and gastrointestinal symptoms than patients carrying mild variants. CONCLUSIONS: GBA-PD is highly prevalent in the Chinese population. The severity of GBA variants underlies distinct phenotypic spectrums, with PD patients carrying severe and complex variants seeming to have similar phenotypes. PD patient stratification by GBA variant severity should become a prerequisite for selecting specific treatments.


Assuntos
Glucosilceramidase , Doença de Parkinson , China/epidemiologia , Estudos de Associação Genética , Predisposição Genética para Doença , Glucosilceramidase/genética , Humanos , Mutação/genética , Doença de Parkinson/epidemiologia , Doença de Parkinson/genética , Doença de Parkinson/psicologia , Prevalência
4.
AIDS Care ; 34(2): 227-231, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-33625933

RESUMO

HIV-associated functional impairment may cause cognitive impairment secondary to the viral infection, hence, associations between cognitive impairment and functional impairment in youth living with HIV are important to assess. We sought to determine whether cognitive impairment is associated with functional impairment and if it carries higher risk for also having functional impairment. We collected parent-rated information regarding youth functional impairment on four different measures and administered a cognitive battery to youth to determine cognitive impairment, 203 HIV-infected youth and 44 HIV-uninfected controls. Degree of cognitive impairment correlated strongly with decreased function: CBCL, r = -.17, p = .01; VABS2, r = -.28, p < .001; repeated-grades, r = .26, p < .001. Presence of cognitive impairment was associated with increased risk of functional impairment: 3.47 (CIS); 1.71 (CBCL); 2.17 (VABS2); 2.97 (repeated-grades). Repeated-grades strongly associated with cognitive impairment and functional impairment. We found strong associations between HIV-infected youth functional impairment on CBCL, VABS2 and repeated-grades with degree of cognitive impairment; and that when cognitive impairment was present youth had higher risk of experiencing functional impairment as well. Asking whether youth have repeated a grade at school could be a helpful screening question for assessing potential functional impairment and provide clinicians with an indication as to whether a further in-depth assessment is required.


Assuntos
Disfunção Cognitiva , Infecções por HIV , Adolescente , Disfunção Cognitiva/complicações , Infecções por HIV/psicologia , Humanos , Programas de Rastreamento
5.
Psychooncology ; 31(1): 107-115, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34425036

RESUMO

OBJECTIVE: CanCope is an internet-delivered, cognitive-behavioural intervention adapted from the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders to improve emotion regulation and support the mental health of cancer survivors. Four separate pilot studies evaluated each of CanCope's modules for (1) feasibility and participant satisfaction, and changes in (2) module-specific outcomes, and (3) global measures of emotion dysregulation and anxiety and depressive symptoms, from pre-to-post module delivery. METHODS: Eligible cancer survivors self-selected into one two-week online module designed to improve a specific aspect of emotion regulation ([1] understanding emotions, [2] mindfulness of emotions, [3] cognitive reappraisals, [4] challenging emotion-driven behaviours). RESULTS: Across modules, post-intervention surveys were completed by 17-19 participants, (58.1%-90.5% completion rate for participants who received the intervention). Each module was feasible and participants reported high satisfaction. Moderate-to-large pre-to-post effect sizes in mean differences were observed in module-specific target outcomes (p's < 0.05). Emotion dysregulation significantly decreased across modules 1 to 3 (p's < 0.05) with a non-significant decrease for module 4 (p = 0.13). Anxiety symptoms significantly decreased across all modules (p's < 0.05). Depressive symptoms significantly decreased across modules 1 and 3 (p's < 0.05), with non-significant decreases across modules 2 (p = 0.08) and 4 (p = 0.06). CONCLUSIONS: Each CanCope module demonstrated promise in targeting emotion regulation skills and supporting the mental health of cancer survivors. Randomised controlled trials are required to test the efficacy of CanCope as an intervention in its entirety.


Assuntos
Sobreviventes de Câncer , Terapia Cognitivo-Comportamental , Intervenção Baseada em Internet , Neoplasias , Transtornos de Ansiedade/terapia , Sobreviventes de Câncer/psicologia , Terapia Cognitivo-Comportamental/métodos , Humanos , Saúde Mental , Neoplasias/terapia
6.
J Assoc Nurses AIDS Care ; 33(3): 259-269, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35500057

RESUMO

ABSTRACT: Women living with HIV have a higher burden of non-AIDS comorbidities and prevalence of chronic conditions. The Adaptive Leadership Framework for Chronic Illness clarifies living with complex health challenges by delineating the technical work of health care providers as well as the adaptive work and leadership behaviors of patients and their providers. We conducted a descriptive, qualitative study of women residing in the Southern United States who were participating in the Women's Interagency HIV Study in North Carolina. Twenty-two participants (mean age = 52.2 years; 90.9% self-identifying as Black or African American) completed semi-structured qualitative interviews. We identified adaptive challenges (e.g., affective and disclosure challenges) and adaptive work and leadership behaviors. Women learned skills to care for their health and support their families and to work with their providers to manage their care. Findings support the importance of identifying leadership behaviors for the purpose of developing person-centered interventions.


Assuntos
Infecções por HIV , Liderança , Afro-Americanos/psicologia , Doença Crônica , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , North Carolina/epidemiologia , Pesquisa Qualitativa , Estados Unidos/epidemiologia
7.
Value Health ; 25(5): 824-834, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35500951

RESUMO

OBJECTIVES: The Patient-Reported Outcome Measurement Information System (PROMIS) Preference score (PROPr) can be used to assess health state utility (HSU) and estimate quality-adjusted life-years in cost-effectiveness analyses. It is based on item response theory and promises to overcome limitations of existing HSU scores such as ceiling effects. The PROPr contains 7 PROMIS domains: cognitive abilities, depression, fatigue, pain, physical function, sleep disturbance, and ability to participate in social roles and activities. We aimed to compare the PROPr with the 5-level EQ-5D (EQ-5D-5L) in terms of psychometric properties using data from 3 countries. METHODS: We collected PROMIS-29 profile and EQ-5D-5L data from 3 general population samples (United Kingdom = 1509, France = 1501, Germany = 1502). Given that cognition is not assessed by the PROMIS-29, it was predicted by the recommended linear regression model. We compared the convergent validity, known-groups construct validity, and ceiling and floor effects of the PROPr and EQ-5D-5L. RESULTS: The mean PROPr (0.48, 0.53, 0.48; P<.01) and EQ-5D-5L scores (0.82, 0.85, 0.83; P<.01) showed significant differences of similar magnitudes (d = 0.34; d = 0.32; d = 0.35; P<.01) across all samples. The differences were invariant to sex, income, occupation, education, and most conditions but not for age. The Pearson correlation coefficients between both scores were r = 0.74, r = 0.69, and r = 0.72. PROPr's ceiling and floor effects both were minor to moderate. The EQ-5D-5L's ceiling (floor) effects were major (negligible). CONCLUSIONS: Both the EQ-5D-5L and the PROPr assessed by the PROMIS-29 show high validity. The PROPr yields considerably lower HSU values than the EQ-5D-5L. Consequences for quality-adjusted life-year measurements should be investigated in future research.


Assuntos
Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Fadiga , Alemanha , Humanos , Psicometria , Qualidade de Vida/psicologia
8.
J Bodyw Mov Ther ; 30: 203-209, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35500972

RESUMO

BACKGROUND: Participating in yoga may be ideal for college students to increase physical activity and improve mental health. PURPOSE: To investigate the feasibility and impact of an 8-week yoga intervention within a university setting on mental and physiologic heath. METHODS: This 8-week yoga intervention included twelve yoga-naïve adults, (23.8 ± 4.6 years; 71% female). Participants attended two 60-min yoga classes/week in addition to baseline, mid- and post-lab visits. RESULTS: 83% of participants attended ≥75% of yoga classes. Stress and depression symptoms decreased by 11% and 25%, respectively and erythrocyte sedimentation rate (ESR) reduced by 28%. Participants who did not meet physical activity recommendations observed greater improvements in stress, depression symptoms, ESR, and C-reactive protein compared to participants who met recommendations. CONCLUSION: The majority of participants attended ≥12 of 16 yoga classes. Exploratory analyses provide preliminary support for the impact of yoga on reducing stress, symptoms of depression, and ESR. Participants who were not meeting physical activity guidelines prior to starting the intervention received greater benefits.


Assuntos
Meditação , Ioga , Adulto , Exercício Físico , Feminino , Humanos , Masculino , Projetos Piloto , Estudantes , Ioga/psicologia
9.
Semin Vasc Surg ; 35(1): 60-68, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35501042

RESUMO

Pregnancy-associated aortic dissection (AD) is a rare event, with an incidence of 0.0004% per pregnancy. The work of the Aortic Dissection Collaborative identified pregnancy-associated AD as a high-priority topic, despite its rarity. The Pregnancy Working Group, which included physicians and patient stakeholders, performed a systematic literature review of pregnancy-associated AD from 1960 to 2021 and identified 6,333 articles through PubMed, OVID MEDLINE, Cochrane, Embase, CINAHL and Web of Science. The inclusion criterion was AD in pregnant populations and exclusion criteria were case reports, conference abstracts, and languages other than English. Assessment of full-text articles for eligibility after removal of duplicates from all databases yielded 68 articles to be included in the final review. Topics included were timing of AD in pregnancy, type of AD, and management considerations of pregnancy-associated AD. The Pregnancy Working Group identified gaps in knowledge and future areas of research for pregnancy-associated AD, including clinical management, mental health outcomes post AD, reproductive and genetic counseling, and contraception after AD. Future collaborative projects could be a multicenter, international registry for all pregnancy-associated AD to refine the risk factors, best practice and management of AD in pregnancy. In addition, future mixed methodology studies may be useful to explore social, mental, and emotional factors related to pregnancy-associated AD and to determine support groups' effect on anxiety and depression related to these events in the pregnancy and postpartum period.


Assuntos
Aneurisma Dissecante , Período Pós-Parto , Aneurisma Dissecante/epidemiologia , Aneurisma Dissecante/terapia , Feminino , Humanos , Estudos Multicêntricos como Assunto , Período Pós-Parto/psicologia , Gravidez , Fatores de Risco
10.
Facial Plast Surg Clin North Am ; 30(2): 255-269, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35501063

RESUMO

Facial transplantation is a vascularized composite allotransplantation, which may be considered in patients with extensive and challenging facial defects for which conventional reconstructive approaches fail to provide satisfactory functional and esthetic outcomes. Facial transplantation has the advantage of replacing defective or absent structures with anatomically identical tissues. Facial transplantation may provide functional, esthetic, and psychosocial benefits, but must be weighed against risks such as lifelong immunosuppression. Success is reliant on patient understanding, motivation, consent and compliance, and a multidisciplinary approach with careful team planning and organization. This review highlights the achievements, challenges, and future directions of this rapidly evolving field.


Assuntos
Transplante de Face , Procedimentos Cirúrgicos Reconstrutivos , Estética , Face/cirurgia , Transplante de Face/psicologia , Previsões , Humanos
11.
Am J Health Behav ; 46(2): 164-176, 2022 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-35501957

RESUMO

Objectives: Our aim was to overcome the low evaluation accuracy of traditional random sampling methods for college students' mental health, and to use the values of big data of college students' social network behaviors in the prediction and evaluation of their mental health. Methods: We monitored and evaluated college students' mental health through big data analysis. After generating the samples of college students' social network behaviors, a mental health monitoring and evaluation model was established based on a support vector machine (SVM) and decision tree (DT). Then, the DT model was pruned, and input data of the model were optimized by genetic algorithm (GA). Results: The optimal parameter combination was derived for our model. The maximum number of iterations was 60; the smallest number of samples needed for reclassifying internal nodes was 6; the number of samples with the fewest leaf nodes was 30. The mental health scores of most students fell in the interval [0, 6] for unobvious symptoms of mental crisis. The binary classification results of several models were as follows. On anxiety, all models surpassed the accuracy of 60%, except the traditional SVM. The optimal model, ie, Model 5, achieved an accuracy of 86.7%. On depression, all models exceeded the accuracy of 60%, and the GA-optimized DT 5 realized an accuracy as high as 83.1%. On drooping spirit, the optimal model, ie, GA-optimized DT 5, reached an accuracy of 89.5%, which is comparable to that of the GA-optimized SVM 4. Conclusions: The characteristic dimensions extracted by GA are representative. The primary mental states of college students can be estimated quickly and accurately by our model with a low cost of data storage, through the feature analysis of social network behaviors.


Assuntos
Big Data , Saúde Mental , Ansiedade , Análise de Dados , Humanos , Estudantes/psicologia
12.
Am J Health Behav ; 46(2): 177-185, 2022 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-35501958

RESUMO

Background: The COVID-19 has led public health researchers to try to improve mental health among older adults with diabetes. Leisure-time physical activity (LTPA) has emerged as a means of coping with mental health difficulties in the pandemic. Methods: We extracted 301 respondents from the Health and Retirement Study (HRS) based on the following criteria: over 50 years old and the onset of diabetes. We used multiple questionnaire items to assess mental health (ie, loneliness, happiness, and positive and negative affect) for older adults with diabetes. We used multivariate analysis of variance to investigate the relationships between the fixed variable (ie, LTPA) and outcome variables (ie, mental health). We categorized LTPA participation into 3 groups (ie, low, mid, and high) and examined mental health following various levels of LTPA participation. Results: LTPA participation showed a significant group mean differences for loneliness, happiness, and positive affect, but not for negative affect. High-LTPA respondents presented lower loneliness and higher happiness than low-LTPA respondents. High-LTPA and mid-LTPA respondents indicated higher positive affect than low-LTPA respondents. Conclusions: This study provides evidence of the benefits of LTPA on mental health for older adults with diabetes and suggests that high-LPTA involvement can be effective in promoting mental health among older adults with diabetes in the COVID-19 era.


Assuntos
COVID-19 , Diabetes Mellitus , Adaptação Psicológica , Idoso , Estudos Transversais , Diabetes Mellitus/epidemiologia , Exercício Físico , Humanos , Atividades de Lazer/psicologia , Saúde Mental , Pessoa de Meia-Idade , Pandemias
13.
Am J Health Behav ; 46(2): 186-196, 2022 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-35501960

RESUMO

Background: In this study, we explored the factors that motivate food choice, and evaluated the psychometric properties and demographic correlates of the Eating Motivation (EATMOT) questionnaire in adults in the United States (US). Methods: This cross-sectional survey involved 905 adults in 6 sites across the US. The EATMOT questionnaire measures participants' self-reported motivations for food selection, demographic, and anthropometric data. Analyses included exploratory and confirmatory factor analyses, correlations, Welch's t-tests, and logistic regressions. Results: We established a 3-factor model (health-related, emotional, and environmental/political motivations) as the best fit to the data (CFI = .983, RMSEA = .049, SRMR = .054). Gender differences were found within the 3 factors, as well as in the intercorrelations between factors. Higher levels of health-related motivations (B = .10, SE = .04, OR = 1.11 (95% CI: 1.03, 1.19), p = .006) were associated with increased reports of weight loss dieting, whereas higher levels of environmental/political motivations (B = -.09, SE = .04, OR = 0.91, p = .02) were associated with fewer reports of weight-loss dieting. Conclusion: An abbreviated version of the EATMOT scale is appropriate for use in a US sample and identifies 3 categories of factors that impact dietary choices. These factors may be important in building interventions to improve diets.


Assuntos
Preferências Alimentares , Motivação , Adulto , Estudos Transversais , Dieta/psicologia , Preferências Alimentares/psicologia , Humanos , Inquéritos e Questionários , Estados Unidos
14.
Am J Health Behav ; 46(2): 197-208, 2022 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-35501965

RESUMO

Objectives: In this paper, we explore the relationship between the psychological capital, sport anxiety, and sport performance of collegiate judo athletes. Methods: The research object is the collegiate first-division judo athletes in Taiwan. Convenience sampling was used to conduct an online survey. A total of 106 questionnaires were issued, 102 valid questionnaires were returned, and the effective response rate was 96.23%. The data were analyzed by using confirmatory factor analysis (CFA) and structural equation modeling (SEM). Results: The psychological capital of collegiate judo athletes has a significant positive impact on sport performance; moreover, the sport anxiety of collegiate judo athletes has a significant negative impact on psychological capital. Through psychological capital, sport performance can be improved. Therefore, psychological capital has an intermediary effect. Conclusion: This study shows the higher the level of mental capital of collegiate judo athletes, the better the positive impact on sport performance; in addition, the higher the sport anxiety, the lower the psychological capital. However, sport anxiety can improve sport performance through psychological capital; therefore, we recommend that the training plan of collegiate judo athletes focus on strengthening the athletes' mental skills to improve their sport performance.


Assuntos
Artes Marciais , Ansiedade , Transtornos de Ansiedade , Atletas/psicologia , Humanos , Artes Marciais/fisiologia , Inquéritos e Questionários
15.
Ned Tijdschr Geneeskd ; 1662022 04 12.
Artigo em Holandês | MEDLINE | ID: mdl-35499674

RESUMO

Delusional misidentification syndrome is a less common neuropsychiatric symptom and can occur in different diseases as dementia and psychiatric diseases or as part of a somatic disease. It can be difficult to recognise and can give a high burden for the formal caregiver. In this article we describe three cases, the pathophysiology and the possible treatment of a delusional misidentification syndrome.


Assuntos
Síndrome de Capgras , Síndrome de Capgras/diagnóstico , Síndrome de Capgras/psicologia , Delusões/diagnóstico , Delusões/etiologia , Delusões/psicologia , Humanos
16.
Pediatrics ; 149(Suppl 5)2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35503309

RESUMO

Advances in developmental psychology, child psychiatry, and allied disciplines have pointed to events and experiences in the early years as the origin of many adult mental health challenges. Yet, children's mental health services still largely lack a developmental or prevention-focused orientation, with most referrals to mental health professionals occurring late, once problems are well established. An early childhood mental health system rooted in the principles of life-course health development would take a very different approach to designing, testing, and implementing prevention and intervention strategies directed toward early child mental health. Priorities for such a system include supporting healthy family environments, parent-child and family relationships, parents' emotional/behavioral health, and family routines as a means of providing the best possible neurobiological foundation for mental health across the life span. The system would include proactive, trauma-informed, multidisciplinary care, with integrated mental health and social services support embedded in pediatric primary care settings. Novel intervention approaches in need of further research include 2-generational dyadic interventions designed to improve the mental health of parents and children, mental health-oriented telemedicine, and contingency management (CM) strategies. Integral to this Life Course Health Development reformulation is a commitment by all organizations supporting children to primordial and primary prevention strategies to reduce racial and socioeconomic disparities in all settings. We contend that it is the family, not the individual child, that ought to be the identified target of these redesigned approaches, delivered through a transformed pediatric system with anticipated benefits for multiple health outcomes across the life course.


Assuntos
Saúde Mental , Pais , Adulto , Criança , Pré-Escolar , Família , Relações Familiares , Humanos , Pais/psicologia
17.
Pediatrics ; 149(Suppl 5)2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35503323

RESUMO

Advances in obstetrics and neonatal medicine have resulted in improved survival rates for preterm infants. Remarkably, >75% extremely (<28 weeks) preterm infants who leave the NICU do not experience major neurodevelopmental disabilities, although >50% experience more minor challenges in communication, perception, cognition, attention, regulatory, and executive function that can adversely impact educational and social function resulting in physical, behavioral, and social health issues in adulthood. Even late premature (32-36 weeks) infants have more neurodevelopmental challenges than term infants. Although early intervention and educational programs can mitigate risks of prematurity for children's developmental trajectories, restrictive eligibility requirement and limitations on frequency and intensity mean that many premature infants must "fail first" to trigger services. Social challenges, including lack of family resources, unsafe neighborhoods, structural racism, and parental substance use, may compound biological vulnerabilities, yet existing services are ill-equipped to respond. An intervention system for premature infants designed according to Life Course Health Development principles would instead focus on health optimization from the start; support emerging developmental capabilities such as self-regulation and formation of reciprocal secure early relationships; be tailored to each child's unique neurodevelopmental profile and social circumstances; and be vertically, horizontally, and longitudinally integrated across levels (individual, family, community), domains (health, education), and time. Recognizing the increased demands placed on parents, it would include parental mental health supports and provision of trauma-informed care. This developmental scaffolding would incorporate parenting, health, and developmental interventions, with the aim of improved health trajectories across the whole of the life course.


Assuntos
Doenças do Prematuro , Poder Familiar , Adulto , Criança , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Acontecimentos que Mudam a Vida , Pais/psicologia
19.
Eur Rev Med Pharmacol Sci ; 26(8): 2721-2726, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35503617

RESUMO

OBJECTIVE: Essential tremor (ET) is among the most common central nervous system disorders. It is characterised by symmetrical and bilateral postural tremor, usually affecting the hands. Alongside such motor symptoms, psychiatric symptoms, such as anxiety and depression, often occur. This study aimed to investigate how anxiety, depression and childhood trauma influence ET patients' tremor frequency and severity. PATIENTS AND METHODS: The participants comprised 85 patients and 70 control volunteers. Participating patients have been admitted to our clinic for hand tremor complaints and diagnosed with ET, according to the Washington Heights Inwood Genetic Study of Essential Tremor (WHIGET) diagnosis criteria, and they returned for follow-up for at least one year after their initial treatment. Patients with thyroid dysfunction, Parkinson's disease, central nervous system pathology, a history of smoking or alcohol use or a history of drug use that may cause tremor were excluded from the study. Patients' demographic data, such as their age and gender, age at disease onset, disease duration, family history and tremor severity were recorded. The Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Childhood Trauma Questionnaire (CTQ) were applied to all patients. RESULTS: Statistically significant differences were found in BDI score averages and BAI score averages between the patient and control groups (p = 0.002; p = 0.001) and physical abuse, emotional neglect and sexual abuse scores on the CTQ scale (p = 0.001, p = 0.007 and p = 0.001, respectively). CONCLUSIONS: Childhood mental trauma and emotional mood disorders are more common among ET patients. However, these disorders do not appear to affect ET severity.


Assuntos
Experiências Adversas da Infância , Tremor Essencial , Ansiedade/psicologia , Depressão/psicologia , Emoções , Tremor Essencial/diagnóstico , Humanos , Tremor/diagnóstico
20.
Sci Rep ; 12(1): 7138, 2022 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-35504954

RESUMO

Neuroinflammation contributes to epileptogenesis and ictogenesis. Various signals of neuroinflammation lead to neuronal hyper-excitability. Since an interplay between epilepsy, psychiatric comorbidities and neuroinflammation has been suggested, we explored psychiatric symptoms in epilepsy patients, and the relationship with neuroinflammation. We screened epilepsy patients who were admitted for video-EEG monitoring between July 2019 and December 2020. Enrolled patients were asked to respond to neuropsychiatric questionnaires (Hospital Anxiety and Depression Scale (HADS) and Neuropsychiatric Inventory-Questionnaire (NPI-Q)) on admission. Serum cytokines (IL-1ß, IL-2, IL-6, IFN-γ, CCL2, and CCL5) were measured by ELISA on admission, and within 6 h after a seizure. We enrolled 134 patients, and 32 patients (23.9%) had seizures during monitoring. Cytokine levels did not change after seizures, but IL-2 and IL-6 increased in cases of generalized tonic-clonic seizures. The HADS-A score was lower in Q4 of CCL5 (p-value = 0.016) and anxiety was also less common in Q4 of CCL5 (p-value = 0.042). NPI-Q question 4 (depression) severity was higher in CCL2 (p-value = 0.024). This suggested that psychiatric symptoms may also be related to inflammatory processes in epilepsy patients. Further large, standardized studies are necessary to underpin the inflammatory mechanisms in epilepsy and psychiatric symptoms.


Assuntos
Citocinas , Epilepsia , Epilepsia/psicologia , Humanos , Interleucina-2 , Interleucina-6 , Convulsões
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