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Verma, Rahul, Yasna Mehdian, Neel Sheth, Kathy Netten, Jean Vinette, Ashley Edwards, Joanna Polyviou, Julia Orkin, and Reshma Amin. "101 Screening for Psychosocial Risk in Families of Children with Medical Complexity (CMC)." Paediatrics & Child Health 25, Supplement_2 (August 2020): e42-e42. http://dx.doi.org/10.1093/pch/pxaa068.100.
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Abstract Background Children with medical complexity (CMC) are defined by their medical fragility, dependence on assistive technology and substantial care needs. Family caregivers of CMC have unique challenges, such as prolonged hospitalizations and poor care coordination, which result in extensive caregiver stress. There is a great need to quantify the level of psychosocial stress and resilience in these caregivers to allow for appropriate allocation of health care resources. The Psychosocial Assessment Tool (PAT) is a brief parent-reported screening tool for measuring psychosocial risk in caregivers of pediatric populations. This is the first study to use the PAT in children with medical complexity. Objectives To quantify psychosocial risk in family caregivers of children diagnosed with medical complexity. To identify predictors of caregiver distress based on their sociodemographic factors. It was hypothesized that the extensive health demands of CMC will result in high amounts of chronic, ongoing caregiver distress relative to the previously studied pediatric populations. Design/Methods This cross-sectional study was conducted at The Hospital for Sick Children, Toronto, Canada. Family caregivers of children with medical complexity completed the PAT questionnaires during regularly scheduled Long-Term Ventilation and Complex Care clinic visits. Based on the overall PAT scores, caregivers were stratified as “Universal” low risk (<1.0), “Targeted” intermediate risk (1.0 to 1.9), or “Clinical” high risk (≥2.0). Multiple linear regression analysis was performed to examine the effect of sociodemographic variables and illness severity on total PAT scores. Comparisons with previous pediatric studies were made using T-test statistics. Results 136 [103 females (76%)] family caregivers completed the study. Mean PAT score was 1.17 (SD = 0.740). 61 (44.85%) caregivers were classified as Universal risk, 60 (44.12%) as Targeted risk, and 15 (11.03%) as Clinical risk. Compared to previously studied pediatric populations, our CMC have the second-highest overall PAT scores, which are also substantially weighted towards the higher risk categories (Table 1). Multiple linear regression analysis demonstrated that subjective report of financial hardship by caregivers is a significant predictor of total PAT scores (p < 0.05). Conclusion Family caregivers of children with medical complexity report PAT scores amongst the highest of all pediatric populations. These caregivers experience significant psychosocial distress, demonstrated by larger proportions of caregivers in the Targeted and Clinical risk categories. Therefore, psychosocial interventions including financial assistance are urgently needed in this population.
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Boska, Gabriella de Andrade, Rogério da Silva Ferreira, Heloisa Garcia Claro, Priscilla Oliveira Luz, and Márcia Aparecida Ferreira de Oliveira. "Homelessness, crack use, and length of stay as predictors of planned discharge from night care in a Psychosocial Care Center." REVISTA CIÊNCIAS EM SAÚDE 11, no. 2 (June 23, 2021): 66–72. http://dx.doi.org/10.21876/rcshci.v11i2.1113.
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Objective: identify predictors of planned discharge to night care embracement in a Psychosocial Care Center Alcohol and Drugs (CAPS AD III). Methods: Quantitative, retrospective, and documentary study of 560 medical records of people with problems resulting from the use of alcohol and other drugs who were admitted to the hospital at night in a CAPS AD III in São Paulo, over five years. As a dependent variable, the type of discharge was used (planned or not). As independent variables, the profile of the subjects related to substance use and time in hospital. Results: 1,097 admissions were identified with 50.4% of unplanned discharge associated with homelessness (p = 0.007), problematic use crack (p = 0.015), length of reception proposed by the team (p = 0.029) and length of stay of the user (p < 0.001). Conclusion: Being homeless, problematic use of crack, and lack of user participation on the decisions regarding length of stay in CAPS AD III were associated with unplanned discharge.
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Cunningham, Schuyler C., Jeasmine Aizvera, Paul Wakim, and Lisa Felber. "Use of a self-reported psychosocial distress screening tool as a predictor of need for psychosocial intervention in a general medical setting." Social Work in Health Care 57, no. 5 (February 20, 2018): 315–31. http://dx.doi.org/10.1080/00981389.2018.1437499.
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van Lier, Lisanne I., Henriëtte G. van der Roest, Babette SH Oosten, Vjenka Garms-Homolová, Graziano Onder, Harriet Finne-Soveri, Pálmi V Jónsson, et al. "Predictors of Societal Costs of Older Care-Dependent Adults Living in the Community in 11 European Countries." Health Services Insights 12 (January 2019): 117863291882094. http://dx.doi.org/10.1177/1178632918820947.
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Background: The objective was to identify predictors of societal costs covering formal and informal care utilization by older home care clients in 11 European countries. Methods: Societal costs of 1907 older clients receiving home care for 12 months from the Aged in Home care (AdHoc) study were estimated using the InterRAI Minimum Data Set for Home Care’s (MDS-HC) resource use items. Predictors (medical, functional, and psychosocial domains) of societal costs were identified by performing univariate and multivariate generalized linear model analyses. Results: Mean societal costs per participant were €36 442, ranging from €14 865 in Denmark to €78 836 in the United Kingdom. In the final multivariate model, country, being married, activities of daily living (ADL) dependency, cognitive impairment, limitations of going out, oral conditions, number of medications, arthritis, and cerebro vascular accident (CVA) were significantly associated with societal costs. Conclusions: Of the predictors, ADL dependency and limitations of going out may be modifiable. Developing interventions targeted at improving these conditions may create opportunities to curtail societal costs.
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Enlow, Paul T., Keri J. Brown Kirschman, Janelle Mentrikoski, Margo M. Szabo, Catherine Butz, Ariel M. Aballay, and Christina L. Duncan. "The Role of Youth Coping Strategies and Caregiver Psychopathology in Predicting Posttraumatic Stress Symptoms in Pediatric Burn Survivors." Journal of Burn Care & Research 40, no. 5 (April 29, 2019): 620–26. http://dx.doi.org/10.1093/jbcr/irz067.
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Abstract Caregiver psychosocial functioning is repeatedly linked with postburn adjustment in pediatric burn survivors. However, few studies have examined youth characteristics as predictors, such as coping strategies. Furthermore, research has not explored how caregiver psychopathology and youth coping strategies interact to predict youth postburn adjustment. The aim of this study was to examine how youth coping strategies and caregiver anxiety and depression predict youth posttraumatic stress symptoms (PTSS). Forty-six youth between 7 and 17 years old (M = 12.5, SD = 2.65) and their caregivers were recruited from two U.S. burn centers. Youth and parents completed questionnaires that assessed demographics, caregiver anxiety, and depression, youth self-reports of coping strategies, and youth PTSS. Burn injury data (e.g. TBSA, time since injury) was obtained from medical record reviews. Hierarchical regressions were conducted with caregiver psychopathology (depression, anxiety), youth coping strategies (active, avoidant, distraction, social support), and the interaction between caregiver psychopathology and youth coping strategies as predictors and youth PTSS as the outcome variable. Higher levels of caregiver anxiety (βs = .36 to .42) and avoidance coping (βs = .38 to .43) were associated with more PTSS. Caregiver anxiety and depression moderated the association between youth use of distraction coping and youth PTSS. These findings reinforce the importance of assessing psychosocial functioning in pediatric burn survivors and their caregivers, and providing interventions to promote better psychosocial outcomes. Coping strategies may help reduce PTSS and buffer against the harmful influence of caregiver psychopathology. Future research may wish to pilot interventions that promote healthy coping.
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Talal, Andrew H., Phyllis Andrews, Anthony Mcleod, Yang Chen, Clewert Sylvester, Marianthi Markatou, and Lawrence S. Brown. "Integrated, Co-located, Telemedicine-based Treatment Approaches for Hepatitis C Virus Management in Opioid Use Disorder Patients on Methadone." Clinical Infectious Diseases 69, no. 2 (October 17, 2018): 323–31. http://dx.doi.org/10.1093/cid/ciy899.
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Abstract Background Despite high hepatitis C virus (HCV) prevalence, opioid use disorder (OUD) patients on methadone rarely engage in HCV treatment. We investigated the effectiveness of HCV management via telemedicine in an opioid substitution therapy (OST) program. Methods OUD patients on methadone underwent biweekly telemedicine sessions between a hepatologist and physician assistant during the entire HCV treatment course. All pretreatment labs (HCV RNA, genotype, and noninvasive fibrosis assessments) were obtained onsite and direct-acting antivirals were coadministered with methadone using modified directly observed therapy. We used multiple correspondence analysis, least absolute shrinkage and selection operator, and logistic regression to identify variables associated with pursuit of HCV care. Results Sixty-two HCV RNA–positive patients (24% human immunodeficiency virus [HIV] infected, 61% male, 61% African American, 25.8% Hispanic) were evaluated. All patients were stabilized on methadone and all except 4 were HCV genotype 1 infected. Advanced fibrosis/cirrhosis was present in 34.5% of patients. Of the 45 treated patients, 42 (93.3%) achieved viral eradication. Of 17 evaluated patients who were not treated, 5 were discontinued from the drug treatment program or did not follow up after the evaluation, 2 had HIV adherence issues, and 10 had insurance authorization issues. Marriage and a mental health diagnosis other than depression were the strongest positive predictors of treatment pursuit, whereas being divorced, separated, or widowed was the strongest negative predictor. Conclusions HCV management via telemedicine integrated into an OST program is a feasible model with excellent virologic effectiveness. Psychosocial and demographic variables can assist in identification of subgroups with a propensity or aversion to pursue HCV treatment.
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Bovina, I. B. "Problem of suicide risk diagnostics and possibility to use implicit association test." Psychological-Educational Studies 6, no. 1 (2014): 146–54. http://dx.doi.org/10.17759/psyedu.2014060117.
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If we make a search for the term suicide in the database PsycARTICLES, we will find 1732 articles published from 1898 till 2013. The dynamics of the scientific interest towards the problem is following: 127 articles were published from 1981 till 1991, 596 articles were published from 1992 till 2002; finally, 830 articles were published from 2003 till 2013. The rise of the research interest is obvious. The more detailed analysis of the articles showed that there are different models explaining suicide (for example: medical, philosophical, psychological and sociological). The different interacting predictors of suicide were revealed in the numerous studies: sociocultural, psychosocial, and biological ones. The preventive measures are already worked out and the new ones are in the process of validation. Having such a rich and complex scientific knowledge and practical tools to handle the problem the statistics say that the number of suicides continues to grow. The brief literature review is focused on the problem of the diagnostics of suicide risk. The potential of the implicit associations test for the diagnostics of suicide risk is discussed in this paper.
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Gil-Lacruz, Marta, and Ana Isabel Gil-Lacruz. "Health Attributions and Health Care Behavior Interactions in a Community Sample." Social Behavior and Personality: an international journal 38, no. 6 (July 1, 2010): 845–58. http://dx.doi.org/10.2224/sbp.2010.38.6.845.
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In this article we examine the influence of a number of psychosocial variables on health attributions and the use of the health care system. The study sample consisted of 1,032 participants, who were representative of a stratified suburban community in Spain. Home-based interviews were conducted to identify participants' main health improvement resources. Most answers were related to health attitudes concerning behavior, the health services available to participants, or other external agents. Qualitative and quantitative strategies were employed and results showed that age and health perception were the most reliable predictors of these attitudes. Social variables were found to play an important role in the explanation of participants' beliefs and medical consultation behaviors.
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Madalinska, Joanna B., Marc van Beurden, Eveline M. A. Bleiker, Heiddis B. Valdimarsdottir, Lottie Lubsen-Brandsma, Leon F. Massuger, Marian J. E. Mourits, et al. "Predictors of Prophylactic Bilateral Salpingo-Oophorectomy Compared With Gynecologic Screening Use in BRCA1/2 Mutation Carriers." Journal of Clinical Oncology 25, no. 3 (January 20, 2007): 301–7. http://dx.doi.org/10.1200/jco.2006.07.4922.
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Purpose Women with BRCA1/2 gene mutations who have completed their childbearing are strong candidates for risk-reducing prophylactic bilateral salpingo-oophorectomy (PBSO). The aim of the current study was to identify baseline predictors of PBSO versus gynecologic screening (GS) in this group of high-risk women. Patients and Methods Baseline questionnaires were available from 160 BRCA1/2 carriers who participated in a nationwide, longitudinal, observational study of the psychosocial consequences of prophylactic surgery versus periodic screening. Topics addressed by the questionnaire included generic quality of life, cancer-specific distress, risk perception, knowledge of ovarian cancer, and perceived pros and cons of surgery versus screening. PBSO use during the 12-month period after the first gynecologic consultation was determined on the basis of medical record data. Results During the 12-month follow-up period, 74% of women had undergone PBSO, and 26% opted for screening. Statistically significant multivariate predictors of PBSO included education, general health perceptions, perceived incurability of ovarian cancer, and perceived benefits of surgery. Conclusion Women with lower educational levels, with poorer general health perceptions, who view ovarian cancer as an incurable disease, and who believe more strongly in the benefits of surgery are more likely to undergo PBSO. Clinicians should ensure that high-risk women are well informed about the low predictive value of GS techniques and about the lethal threat posed by ovarian cancer because of its limited curability.
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Xiao, Qianyi, Xin Liu, Ruru Wang, Yimeng Mao, Hao Chen, Xiaomei Li, Xiaoxi Liu, et al. "Predictors of Willingness to Receive the COVID-19 Vaccine after Emergency Use Authorization: The Role of Coping Appraisal." Vaccines 9, no. 9 (August 29, 2021): 967. http://dx.doi.org/10.3390/vaccines9090967.
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The current study aims to identify psychosocial factors based on protection motivation theory (PMT) influencing Chinese adults’ willingness to receive the COVID-19 vaccine after the emergency use authorization of the New Coronavirus Inactivated Vaccine in China. A cross-sectional online survey was conducted among Chinese residents aged 18–59 years, and 2528 respondents from 31 provinces and autonomous regions were included in the current study. Based on PMT, threat appraisals and coping appraisals were measured. Hierarchical multiple regressions and multivariate logistic regressions were used to identify the relationships between the PMT constructs and vaccination willingness after other covariates were controlled for. A total of 1411 (55.8%) respondents reported being willing to receive the COVID-19 vaccine. The PMT model explained 26.6% (p < 0.001) of the variance in the vaccine willingness. The coping appraisals, including response efficacy, self-efficacy, and response costs, were significantly correlated with the willingness to receive the COVID-19 vaccine, and response efficacy was the strongest influencing factor (adjusted OR = 2.93, 95% CI: 2.42–3.54). In conclusion, the coping appraisals for vaccination, instead of threat appraisals regarding the pandemic itself, mainly influenced people’s willingness to get vaccinated after the emergency use authorization of the COVID-19 vaccine in China. These findings are helpful for developing education and interventions to promote vaccination willingness and enhance public health outcomes during a pandemic.
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Straiton, Nicholas. "The Relevance of Childhood Developmental Factors to the Efficacy of Acupuncture on the Affective Component of Back Pain." Acupuncture in Medicine 27, no. 4 (December 2009): 180–82. http://dx.doi.org/10.1136/aim.2009.001024.
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There is substantial evidence to support the use of acupuncture in the treatment of low back pain. The main predictors of chronic low back pain are non-medical and psychosocial. The understanding of how acupuncture can modulate the pain experience has recently been enhanced by the elucidation of the role of C fibre afferents on the limbic system. C fibre deactivation of the limbic system can only occur in the presence of intact corticosubcortical neuronal pathways. The normal development of these pathways is determined by social factors in the early years of life. The effect of acupuncture treatment for low back pain may be determined by successful relationships between the mother and child in the first 18 months of life.
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Bower, Kelly M., Deborah Gross, Margaret Ensminger, Jana Goins, and Phyllis Sharps. "2358." Journal of Clinical and Translational Science 1, S1 (September 2017): 27. http://dx.doi.org/10.1017/cts.2017.104.
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OBJECTIVES/SPECIFIC AIMS: The purpose of this study is to understand factors that are associated with identifying which eligible pregnant women in Baltimore City accept a referral for HV services. Taking into account demographic and obstetrical variables, we will examine the extent to which 13 medical and 14 psychosocial risk factors differentiate pregnant women who (1) accepted a HV referral, (2) could not be located, or (3) refused a HV referral. METHODS/STUDY POPULATION: In this observational study, we will use secondary data on 8172 pregnant women collected by Health Care Access Maryland (HCAM) between 2014 and 2016. HCAM is the single point of entry for all pregnant women in Baltimore City into HV. HV eligibility includes being a pregnant woman, residing in Baltimore City, being uninsured or receiving Medicaid, and being identified by a prenatal care provider who completed an assessment profile of the woman’s medical and psychosocial risk (prenatal risk assessment). The outcome variable, HV engagement status (ie, accepted referral, could not be located, refused referral), will be based on HCAM discharge codes. Medical risk factors include BMI, hypertension, anemia, asthma, sickle cell, diabetes, vaginal bleeding, genetic risk, sexually transmitted disease, last dental visit >1 year ago, and taking prescription medications. Psychosocial risk factors include current pregnancy unintended; <1 year since last delivery; late entry to prenatal care (>20 wk gestation); mental, physical, or developmental disability; history of abuse or violence within past 6 months; tobacco use; alcohol use; illegal substance use within the past 6 months; resides in home built before 1978; homelessness; lack of social/emotional support; exposure to long-term stress; lack of transportation; and history of depression or mental illness. All risk factor variables are categorical (yes/no). Control variables will include demographics (eg, age, race, ethnicity, marital status, educational level) and OB history (eg, history of preterm labor, history of fetal or infant death). We will conduct descriptive statistics to characterize the sample and look for interrelatedness among the risk factors. Where there is a high level of inter-relatedness we will consider combining or omitting variables to reduce redundancy. We will use multinomial regression to examine which medical and psychological factors are associated with referral category. RESULTS/ANTICIPATED RESULTS: We hypothesize that (a) women with more medical risk factors will be more likely to accept a referral for HV services, (b) women with more psychosocial risk factors will be more likely to refuse HV or not be located, and (c) certain risk factors, such as depression/mental illness, history of abuse/violence, illegal substance use, homelessness, and exposure to long-term stress will be the strongest predictors of not accepting HV referral and/or not being located. DISCUSSION/SIGNIFICANCE OF IMPACT: The translation of effective randomized control trials (RCTs) to successful implementation in community-based programs can be challenging. Community-based programs serving low-income communities typically lack the same resources available to recruit and retain participants in RCTs. And, exclusion criteria applied in RCTs are often not applied in real world implementation which can open program to participants with more complex social and medical characteristics. Findings from this study will inform the translation of evidence-based HV programs into real world settings through an enhanced understanding of the characteristics of women who are not engaged by HV programs. This will inform development of improved outreach methods that may more effectively engage at-risk women for prenatal HV services.
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Taffa, N., K. I. Klepp, J. Sundby, and G. Bjune. "Psychosocial determinants of sexual activity and condom use intention among youth in Addis Ababa, Ethiopia." International Journal of STD & AIDS 13, no. 10 (October 1, 2002): 714–19. http://dx.doi.org/10.1258/095646202760326480.
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Determinants of sexual activity and intentions for condom use were examined guided by the Attitude, Social influences, and Self-efficacy (ASE) model as a theoretical framework. A total of 561 in and out-of-school youth (15–24 years) in Addis Ababa completed a self-administered questionnaire. A third of them reported sexual intercourse in the past and half of the sexually active used condoms during recent intercourse. Being out-of-school, male, aged 20–24 years, alcohol use and khat (amphetamine-like substance) consumption predicted the likelihood of engagement in sexual activity. Of these variables, however, male sex was more associated with reported condom use during recent sexual intercourse. Self-efficacy, skills, and barriers predicted 23% of the variance in intentions to use condoms. Self-efficacy was also associated with past condom use. Psychosocial constructs predicted more variations in condom use intention for males than for females. In general, self-efficacy was found to be the strongest predictor of the constructs, whereas attitude and social influences were the weakest. The study implies that HIV/AIDS prevention programmes for young people in Ethiopia need to emphasize building assertive communication skills in sexual negotiations and condom use. Minimizing the gender gap in sexual relationships forms the cornerstone for such educational strategies.
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Castaldelli-Maia, João Mauricio, Aline Rodrigues Loreto, Bruna Beatriz Sales Guimarães-Pereira, Carlos Felipe Cavalcanti Carvalho, Felipe Gil, Fernanda Piotto Frallonardo, Flávia Ismael, et al. "Smoking cessation treatment outcomes among people with and without mental and substance use disorders: An observational real-world study." European Psychiatry 52 (August 2018): 22–28. http://dx.doi.org/10.1016/j.eurpsy.2018.02.005.
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AbstractBackground:There is a lack of studies evaluating smoking cessation treatment protocols which include people with and without mental and substance use disorders (MSUD), and which allows for individuals with MSUD undergoing their psychiatric treatment.Methods:We compared treatment success between participants with (n = 277) and without (n = 419) MSUD among patients in a 6-week treatment provided by a Brazilian Psychosocial Care Center (CAPS) from 2007 to 2013. Sociodemographic, medical and tobacco use characteristics were assessed at baseline. Tobacco treatment consisted of 1) group cognitive behavior therapy, which included people with and without MSUD in the same groups, and 2) pharmacotherapy, which could include either nicotine patches, nicotine gum, bupropion or nortriptyline. For participants with MSUD, tobacco treatment was integrated into their ongoing mental health treatment. The main outcome was 30-day point prevalence abstinence, measured at last day of treatment.Results:Abstinence rates did not differ significantly between participants with and without MSUD (31.1% and 34.4%, respectively). Variables that were significantly associated with treatment success included years smoking, the Heaviness of Smoking Index, and use of nicotine patch or bupropion.Conclusions:The inclusion of individuals with and without MSUD in the same protocol, allowing for individuals with MSUD undergoing their psychiatric treatment, generates at least comparable success rates between the groups. Predictors of treatment success were similar to those found in the general population. Facilities that treat patients with MSUD should treat tobacco use in order to reduce the disparities in morbidity and mortality experienced by this population.
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Powelson, Elisabeth B., Brianna Mills, William Henderson-Drager, Millie Boyd, Monica S. Vavilala, and Michele Curatolo. "Predicting chronic pain after major traumatic injury." Scandinavian Journal of Pain 19, no. 3 (July 26, 2019): 453–64. http://dx.doi.org/10.1515/sjpain-2019-0040.
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Abstract Background and aims Chronic pain after traumatic injury and surgery is highly prevalent, and associated with substantial psychosocial co-morbidities and prolonged opioid use. It is currently unclear whether predicting chronic post-injury pain is possible. If so, it is unclear if predicting chronic post-injury pain requires a comprehensive set of variables or can be achieved only with data available from the electronic medical records. In this prospective study, we examined models to predict pain at the site of injury 3–6 months after hospital discharge among adult patients after major traumatic injury requiring surgery. Two models were developed: one with a comprehensive set of predictors and one based only on variables available in the electronic medical records. Methods We examined pre-injury and post-injury clinical variables, and clinical management of pain. Patients were interviewed to assess chronic pain, defined as the presence of pain at the site of injury. Prediction models were developed using forward stepwise regression, using follow-up surveys at 3–6 months. Potential predictors identified a priori were: age; sex; presence of pre-existing chronic pain; intensity of post-operative pain at 6 h; in-hospital opioid consumption; injury severity score (ISS); location of trauma, defined as body region; use of regional analgesia intra- and/or post-operatively; pre-trauma PROMIS Depression, Physical Function, and Anxiety scores; in-hospital Widespread Pain Index and Symptom Severity Score; and number of post-operative non-opioid medications. After the final model was developed, a reduced model, based only on variables available in the electronic medical record was run to understand the “value add” of variables taken from study-specific instruments. Results Of 173 patients who completed the baseline interview, 112 completed the follow-up within 3–6 months. The prevalence of chronic pain was 66%. Opioid use increased from 16% pre-injury to 28% at 3–6 months. The final model included six variables, from an initial set of 24 potential predictors. The apparent area under the ROC curve (AUROC) of 0.78 for predicting pain 3–6 months was optimism-corrected to 0.73. The reduced final model, using only data available from the electronic health records, included post-surgical pain score at 6 h, presence of a head injury, use of regional analgesia, and the number of post-operative non-opioid medications used for pain relief. This reduced model had an apparent AUROC of 0.76, optimism-corrected to 0.72. Conclusions Pain 3–6 months after trauma and surgery is highly prevalent and associated with an increase in opioid use. Chronic pain at the site of injury at 3–6 months after trauma and surgery may be predicted during hospitalization by using routinely collected clinical data. Implications If our model is validated in other populations, it would provide a tool that can be easily implemented by any provider with access to medical records. Patients at risk of developing chronic pain could be selected for studies on preventive strategies, thereby concentrating the interventions to patients who are most likely to transition to chronic pain.
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Dai, Ying, and Jianghong Liu. "612 Early Protective Factors of Child Sleep Quality Trajectory: Results from the Healthy Brain and Behavior Study." Sleep 44, Supplement_2 (May 1, 2021): A240—A241. http://dx.doi.org/10.1093/sleep/zsab072.610.
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Abstract Introduction Poor sleep quality is associated with many adverse health outcomes for children and adolescents. Recently, increasing knowledge has been gained for understanding risk factors for poor sleep, but there is little knowledge about early protective factors for sleep quality in young people. The purpose of this study was to investigate whether prenatal obstetric and psychosocial factors, and happiness during childhood would predict child sleep quality across time. Methods A total of 290/454 children aged 11–12 years in the Healthy Brain and Behavior Study were included in analysis. Prenatal obstetric and psychosocial factors were recalled by mothers through structured interviews. Childhood happiness and child sleep quality across 1, 3, 5, 11, and 12 years of age were reported by mothers through questionnaires. Two-level linear mixed-effects modeling was conducted. Results Overall, children’s average sleep quality increased from 1 to 5 years, followed by a decrease during 5 to 12 years. Prenatal care (β = 0.376, SE = 0.169, p = 0.027), better maternal psychosocial support during pregnancy (β = 0.045, SE = 0.016, p = 0.007), and higher childhood happiness (β = 1.333, SE = 0.274, p < 0.001) were associated with better sleep quality across childhood. Childhood happiness during previous developmental age predicts better sleep quality at later age (β = 1.526, SE = 0.350, p < 0.001). Other prenatal factors including prenatal gestation and parturition history, substance use during pregnancy, maternal labor and delivery complications, and neonatal conditions were not associated with child sleep quality trajectory. Conclusion Prenatal care, prenatal psychosocial support, and childhood happiness are protective factors of child sleep quality across 1–12 years of age. Future prospective longitudinal studies are needed to understand the causal relationship between early protective factors and sleep quality in childhood and adolescence. Support (if any) This study is supported by the Pennsylvania Department of Health (SAP# 4100043366), the Clinical & Translational Research Center, Perelman School of Medicine, University of Pennsylvania (grant number UL1-RR-024134).
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Mahajan, Satish M., Paul Heidenreich, Bruce Abbott, Ana Newton, and Deborah Ward. "Predictive models for identifying risk of readmission after index hospitalization for heart failure: A systematic review." European Journal of Cardiovascular Nursing 17, no. 8 (September 7, 2018): 675–89. http://dx.doi.org/10.1177/1474515118799059.
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Aims: Readmission rates for patients with heart failure have consistently remained high over the past two decades. As more electronic data, computing power, and newer statistical techniques become available, data-driven care could be achieved by creating predictive models for adverse outcomes such as readmissions. We therefore aimed to review models for predicting risk of readmission for patients admitted for heart failure. We also aimed to analyze and possibly group the predictors used across the models. Methods: Major electronic databases were searched to identify studies that examined correlation between readmission for heart failure and risk factors using multivariate models. We rigorously followed the review process using PRISMA methodology and other established criteria for quality assessment of the studies. Results: We did a detailed review of 334 papers and found 25 multivariate predictive models built using data from either health system or trials. A majority of models was built using multiple logistic regression followed by Cox proportional hazards regression. Some newer studies ventured into non-parametric and machine learning methods. Overall predictive accuracy with C-statistics ranged from 0.59 to 0.84. We examined significant predictors across the studies using clinical, administrative, and psychosocial groups. Conclusions: Complex disease management and correspondingly increasing costs for heart failure are driving innovations in building risk prediction models for readmission. Large volumes of diverse electronic data and new statistical methods have improved the predictive power of the models over the past two decades. More work is needed for calibration, external validation, and deployment of such models for clinical use.
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Gritz, Ellen R., Cindy L. Carmack, Carl de Moor, Anne Coscarelli, Christopher W. Schacherer, Eric G. Meyers, and Elliot Abemayor. "First Year After Head and Neck Cancer: Quality of Life." Journal of Clinical Oncology 17, no. 1 (January 1999): 352. http://dx.doi.org/10.1200/jco.1999.17.1.352.
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PURPOSE: Treatment regimens for head and neck cancer patients profoundly affect several quality-of-life domains. Rehabilitative needs have been identified through cross-sectional analyses; however, few studies have prospectively assessed quality of life, included assessment of psychosocial variables, and identified predictors of long-term follow-up. PARTICIPANTS AND METHODS: The present study addresses these limitations through a prospective assessment of 105 patients with a newly diagnosed first primary squamous cell carcinoma of the oral cavity, pharynx, or larynx. Participants were enrolled onto a larger randomized controlled trial comparing a provider-delivered smoking cessation intervention with a usual-care-advice control condition. Participants completed a battery of self-report measures after diagnosis and before treatment and additional quality-of-life instruments at 1 and 12 months after initial smoking cessation advice. RESULTS: Participants displayed improvements at 12 months in functional status (P = .006) and in the areas of eating, diet, and speech; however, the latter three represent areas of continued dysfunction, and the changes were not statistically significant. Despite these improvements, patients reported a decline in certain quality-of-life domains, including marital (P = .002) and sexual functioning (P = .017), as well as an increase in alcohol use (P < .001). Predictors of quality of life at 12 months included treatment type, the Vigor subscale of the Profile of Mood States instrument, and quality-of-life scores obtained 1 month after initial smoking cessation advice. CONCLUSION: Results reinforce the need for rehabilitation management through the integration of psychologic and behavioral interventions in medical follow-up.
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Abdel-Salam, Doaa M., Ibrahim A. Albahlol, Reem B. Almusayyab, Nouf F. Alruwaili, Manar Y. Aljared, Maram S. Alruwaili, and Renad M. Alnasser. "Prevalence, Correlates, and Barriers of Contraceptive Use among Women Attending Primary Health Centers in Aljouf Region, Saudi Arabia." International Journal of Environmental Research and Public Health 17, no. 10 (May 19, 2020): 3552. http://dx.doi.org/10.3390/ijerph17103552.
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(1) Backgrounds and Objectives: with the rapid alteration in the socio-demographic pattern of the Saudi community, particularly the changes concerned with women’s education and work force, contraceptive use must be a fundamental aspect in the life of women in reproductive age. The present study aimed to identify the prevalence and correlates of contraceptive use among women attending primary health centers in Aljouf region, Saudi Arabia, and to determine the perceived barriers of stopping or not using contraceptive methods in this population. (2) Methods: a primary health center-based cross-sectional study was conducted among 369 women of reproductive age. Data collection was done by using structured questionnaires distributed during face to face interviews with the participants. Data were analyzed using the SPSS program, version 24. (3) Results: most of the participants (n = 166; 45%) were current contraceptive users and 32.2% (n = 119) reported previous use of contraceptive methods. Pills were the most frequently used method (n = 203; 71.2%) and intrauterine devices (IUDs) came next (n = 67; 23.5%) while surgery was the least common method among the respondents (n = 3; 1.1%). Logistic regression analysis showed that the significant predictors of contraceptive use were: age > 35 years (odds ratio (OR): 4.52; confidence interval (CI): 1.56–15.42), Children number ≥ 4 (odds ratio (OR): 1.41; confidence interval (CI): 1.06–1.92) and monthly income ≥ 5000 Saudi Riyal (RS) (odds ratio (OR): 2.29; confidence interval (CI): 1.24–8.27). The most perceived barriers towards contraceptive utilization were cultural, demographic, medical, administrative, and barriers related to the method itself. The least reported barriers were psychosocial and physical. (4) Conclusions: the present study showed a high prevalence of contraceptive use among Saudi women in Aljouf region, Saudi Arabia. The study recommended sustained efforts to increase population awareness of the importance of family planning. Policymakers should discover the barriers that prevent contraceptive utilization by women.
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Ekramzadeh, Sahra, Ali Javadpour, Brian Draper, Arash Mani, Adrienne Withall, and Ali Sahraian. "Prevalence and correlates of suicidal thought and self-destructive behavior among an elderly hospital population in Iran." International Psychogeriatrics 24, no. 9 (March 14, 2012): 1402–8. http://dx.doi.org/10.1017/s1041610212000245.
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ABSTRACTBackground: Few studies have examined suicidal ideation and behavior in hospitalized physically ill elderly patients, a group potentially at high risk. Our aim was to investigate the prevalence and risk factors for suicide ideation, and direct and indirect self-destructive behaviors among a sample of elderly inpatients.Methods: A cross-sectional study was conducted in 2009; 650 inpatients aged 60 years and over were screened from various medical services in teaching hospitals affiliated to Shiraz University of Medical Sciences in Iran. Suicidal ideation and behavior were measured with the Beck Scale for Suicidal Ideation (BSSI) and the Harmful Behavior Scale (HBS). Depression was measured with the Geriatric Depression Scale (GDS), medical burden with the geriatric version of the Cumulative Illness Rating Scale (CIRS-G), life events with the Paykel Life Event Scale, and social support with the Perceived Social Support Scale.Result: Of the 650 patients screened with a mean age of 70.5 years (SD ± 7.5), 570 met inclusion criteria and of these 123 (21.6%) reported suicidal ideation on the BSSI and 80 (14.4%) had at least one self-destructive behavior included in the HBS. There was a significant correlation between suicide ideation and harmful behaviors (r = 0.503, p = 0.001). In a regression analysis, depressive symptoms, increased burden of medical conditions, marital status, history of substance use, history of traumatic life events, lack of perceived social support, and poor education were associated with both suicide ideation and harmful behavior. From demographic variables, living without a spouse and unemployment were predictors of suicidal ideation and behavior.Conclusion: Hospitalized, physically ill elderly patients have high rates of suicidal ideation and self-destructive behavior and these vary according to psychosocial and clinical factors. The general hospital is therefore a potential site for the recognition of suicidal individuals and implementation of proximal suicide prevention strategies.
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Berg, Michael B., and Linda Lin. "Prevalence and predictors of early COVID-19 behavioral intentions in the United States." Translational Behavioral Medicine 10, no. 4 (August 2020): 843–49. http://dx.doi.org/10.1093/tbm/ibaa085.
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Abstract Despite early warnings and calls for action, COVID-19 infection rates continue to climb in many areas of the United States. The current study examined participants’ reported likelihood of engaging in eight behaviors designated by the Centers for Disease Control and Prevention as critical for the prevention of COVID-19 at the outset of the epidemic. Self-efficacy, perceived threat, and internal and external health locus of control were explored as potential predictors of those behaviors. In addition, demographic and contextual factors, such as age, gender, political identity, and whether or not participants were currently living under a quarantine advisory, were recorded for analysis. Overall, participants reported high engagement with the prevention behaviors. Higher levels of self-efficacy, perceived severity of the illness, and external locus of control in regard to medical professionals were all positively associated with plans to take the recommended precautions. Based on the results, it appears that messaging regarding COVID-19 prevention may be particularly effective when it focuses on the high risk of the illness, the ease with which the prevention behaviors can be taken, and a reassurance that the medical establishment has individuals’ best health in mind when it makes its specific recommendations. While numerous countries have succeeded in reducing the spread of COVID-19, the number of new cases in the United States remains high, even relative to other populations also heavily impacted by the disease [1]. Although it would be difficult to pinpoint a single cause or explanation for the epidemic’s course in the USA, at the heart of its spread, like the spread of all infectious diseases, is noncompliance with preventative measures. The current research served as a preliminary exploration of the prevalence and predictors of eight COVID-19 prevention behaviors. A brief survey was sent out at the end of March 2020 to 350 U.S. residents in order to assess the likelihood of their engaging in various prevention behaviors recommended at that time and several related psychosocial factors. The psychological factors assessed included health locus of control (HLOC) beliefs, self-efficacy, and perceived threat. In addition, a handful of demographic and contextual factors, such as age, gender, political identity, and whether or not they were working outside the home or were currently living under a quarantine advisory, were recorded for examination.
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Cassista, Julianne, Julie Payne-Gagnon, Brigitte Martel, and Marie-Pierre Gagnon. "Applying Theory to Understand and Modify Nurse Intention to Adhere to Recommendations regarding the Use of Filter Needles: An Intervention Mapping Approach." Nursing Research and Practice 2014 (2014): 1–8. http://dx.doi.org/10.1155/2014/356153.
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The manipulation of glass ampoules involves risk of particle contamination of parenteral medication, and the use of filter needles has often been recommended in order to reduce the number of particles in these solutions. This study aims to develop a theory-based intervention to increase nurse intention to use filter needles according to clinical guideline recommendations produced by a large university medical centre in Quebec (Canada). Using the Intervention Mapping framework, we first identified the psychosocial determinants of nurse intention to use filter needles according to these recommendations. Second, we developed and implemented an intervention targeting nurses from five care units in order to increase their intention to adhere to recommendations on the use of filter needles. We also assessed nurse satisfaction with the intervention. In total, 270 nurses received the intervention and 169 completed the posttest questionnaire. The two determinants of intention, that is, attitude and perceived behavioral control, were significantly higher after the intervention, but only perceived behavioral control remained a predictor of intention. In general, nurses were highly satisfied with the intervention. This study provides support for the use of Intervention Mapping to develop, implement, and evaluate theory-based interventions in order to improve healthcare professional adherence to clinical recommendations.
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Lyon, Aaron R., Michael D. Pullmann, Jedediah Jacobson, Katie Osterhage, Morhaf Al Achkar, Brenna N. Renn, Sean A. Munson, and Patricia A. Areán. "Assessing the usability of complex psychosocial interventions: The Intervention Usability Scale." Implementation Research and Practice 2 (January 2021): 263348952098782. http://dx.doi.org/10.1177/2633489520987828.
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Background: Usability—the extent to which an intervention can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction—may be a key determinant of implementation success. However, few instruments have been developed to measure the design quality of complex health interventions (i.e., those with several interacting components). This study evaluated the structural validity of the Intervention Usability Scale (IUS), an adapted version of the well-established System Usability Scale (SUS) for digital technologies, to measure the usability of a leading complex psychosocial intervention, Motivational Interviewing (MI), for behavioral health service delivery in primary care. Prior SUS studies have found both one- and two-factor solutions, both of which were examined in this study of the IUS. Method: A survey administered to 136 medical professionals from 11 primary-care sites collected demographic information and IUS ratings for MI, the evidence-based psychosocial intervention that primary-care providers reported using most often for behavioral health service delivery. Factor analyses replicated procedures used in prior research on the SUS. Results: Analyses indicated that a two-factor solution (with “usable” and “learnable” subscales) best fit the data, accounting for 54.1% of the variance. Inter-item reliabilities for the total score, usable subscale, and learnable subscale were α = .83, α = .84, and α = .67, respectively. Conclusion: This study provides evidence for a two-factor IUS structure consistent with some prior research, as well as acceptable reliability. Implications for implementation research evaluating the usability of complex health interventions are discussed, including the potential for future comparisons across multiple interventions and provider types, as well as the use of the IUS to evaluate the relationship between usability and implementation outcomes such as feasibility. Plain language abstract: The ease with which evidence-based psychosocial interventions (EBPIs) can be readily adopted and used by service providers is a key predictor of implementation success, but very little implementation research has attended to intervention usability. No quantitative instruments exist to evaluate the usability of complex health interventions, such as the EBPIs that are commonly used to integrate mental and behavioral health services into primary care. This article describes the evaluation of the first quantitative instrument for assessing the usability of complex health interventions and found that its factor structure replicated some research with the original version of the instrument, a scale developed to assess the usability of digital systems.
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Kafle, B., Y. Bagale, and M. Dhungana. "Sociodemographic profile and Psychiatric diagnosis in attempted suicide." Journal of Psychiatrists' Association of Nepal 5, no. 1 (September 29, 2017): 22–25. http://dx.doi.org/10.3126/jpan.v5i1.18327.
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Introduction: The presence of a mental disorder is an important risk factor for suicide. Attempted suicide is one of the major emergencies in psychiatry. Suicide attempts are considered to be the best predictors of an eventual completed suicide. Data of patients presenting with attempted suicide is scanty in Nepal.Objective: The aim of the study was to explore the socio-demographic and psychiatric diagnosis of the patients with suicidal attemptMethod: The study population included those patients who were admitted and being managed for attempted suicide and brought for psychiatric evaluation during the period of one year (1st July 2015- 30 June 2016) at Devdaha Medical College and research institute, Nepal. Each patient underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Details including socio-demographic data, psychiatric diagnosis, was tabulated and analyzed using SPSS-16.Result: Among the total patients (N=75), 68% were in the age group 20-39 years. Majority of the cases were female (78.7%). 53.3% cases were married and majority were from Hindu religion. Most common method of attempted suicide was by poisoning and was by intake of Organophosphorous. Adjustment disorder(44%) and Depression(24%) were the most common psychiatric diagnosis. Marital dispute (22.7%) and family dispute (17.3%) and were the most common psychosocial precipitant.Conclusion: Attempted suicide is widely prevalent on younger age group. It is usually by poisoning and the use of Organophosphorus compound is most common in our setting and is commonly associated with adjustment disorder. Hence, psychiatric care is essential for these patients.
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Spittal, M. J., S. Forsyth, R. Borschmann, J. T. Young, and S. A. Kinner. "Modifiable risk factors for external cause mortality after release from prison: a nested case–control study." Epidemiology and Psychiatric Sciences 28, no. 2 (September 25, 2017): 224–33. http://dx.doi.org/10.1017/s2045796017000506.
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Aim.People released from prison are at higher risk of mortality from potentially preventable causes than their peers in the general population. Because most studies of this phenomenon are reliant on registry data, there is little health and behavioural information available on those at risk, hampering the development of targeted, evidence-based preventive responses. Our aim was to identify modifiable risk and protective factors for external cause and cause-specific mortality after release from prison.Methods.We undertook a nested case–control study using data from a larger retrospective cohort study of mortality after release from prison in Queensland, Australia between 1994 and 2007. Cases were 286 individuals who had died from external causes (drug overdose, suicide, transport accidents, or violence) matched with 286 controls on sex, Indigenous status, and release date. We extracted data from detention, case-management, and prison medical records.Results.Factors associated with increased risk of external cause mortality included use of heroin and other opioids in the community [odds ratio (OR) = 2.20, 95% CI 1.41–3.43,p< 0.001], a prescription for antidepressants during the current prison sentence (OR = 1.94, 95% CI 1.02–3.67,p= 0.042), a history of problematic alcohol use in the community (OR = 1.54, 95% CI 1.05–2.26,p= 0.028), and having ever served two or more custodial sentences (OR = 1.51, 95% CI 1.01–2.25,p= 0.045). Being married (OR = 0.45, 95% CI 0.29–0.70,p< 0.001) was protective. Fewer predictors were associated with cause-specific mortality.Conclusions.We identified several behavioural, psychosocial, and clinical markers associated with mortality from preventable causes in people released from prison. Emerging evidence points to interventions that could be targeted at those at increased risk of external cause mortality. These include treatment and harm reduction programmes (for substance use), improving transitional support programmes and continuity of care (for mental health), diversion and drug reform (for repeat incarceration) and nurturing stable relationships during incarceration. The period of imprisonment and shortly after release provides a unique opportunity to improve the long-term health of ex-prisoners and overcome the disadvantage associated with imprisonment.
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Kobe, Elizabeth A., Mathew J. Crowley, Amy Jeffreys, William S. Yancy, Jennifer Zervakis, David E. Edelman, and Cynthia J. Coffman. "44499 Heterogeneity of treatment effect among patients with type 2 diabetes and body mass index >=27kg/m^2 in the Jump Start Study." Journal of Clinical and Translational Science 5, s1 (March 2021): 47. http://dx.doi.org/10.1017/cts.2021.525.
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ABSTRACT IMPACT: This is the first study to use QUINT analyses to examine heterogeneity of treatment effect for group medical visits among individuals with type 2 diabetes. QUINT is a data driven method that assumes no a priori assumptions regarding effect moderators - an important step in the path towards personalized medicine. OBJECTIVES/GOALS: To examine heterogeneity of treatment effect (HTE) in Jump Start, a trial that compared the effectiveness of group medical visits (GMVs) focused on medication management only versus the addition of intensive weight management (WM) on glycemic control for patients with type 2 diabetes and body mass index >=27kg/m^2. METHODS/STUDY POPULATION: Jump Start patients (n=263) were randomized to a GMV-based medication management plus low carbohydrate diet-focused WM program (WM/GMV; n = 127) or GMV-based medication management only (GMV; n = 136) for diabetes control. We used QUalitative INteraction Trees (QUINT), a tree-based clustering method, to determine if there were subgroups of patients who derived greater benefit from either WM/GMV or GMV. Subgroup predictors included 32 baseline demographic, clinical, and psychosocial factors. Outcome was hemoglobin A1c (HbA1c). We conducted internal validation via bootstrap resampling to estimate bias in the range of mean outcome differences among arms. RESULTS/ANTICIPATED RESULTS: QUINT analyses indicated that for patients who had not previously attempted weight loss, WM/GMV resulted in better glycemic control than GMV alone (mean difference in HbA1c improvement = 1.48%). For patients who had previously attempted weight loss and had lower cholesterol and blood urea nitrogen levels, GMV alone was better than WM/GMV (mean difference in HbA1c improvement = 1.51%). Internal validation resulted in moderate corrections in the mean HbA1c differences between arms; however, differences remained in the clinically significant range. DISCUSSION/SIGNIFICANCE OF FINDINGS: Among patients with diabetes and BMI>=27kg/m^2, a low-carbohydrate, weight loss focus may better improve HbA1c in those who have never attempted weight loss. A medication management focus may be better in those who have attempted weight loss and have lower cholesterol and blood urea nitrogen.
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Ghose, Bishwajit, and Sanni Yaya. "Experience of Intimate Partner Violence and Help-Seeking Behaviour among Women in Uganda." Psych 1, no. 1 (May 7, 2019): 182–92. http://dx.doi.org/10.3390/psych1010013.
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Intimate partner violence (IPV) is recognised as a fundamental violation of women’s human rights and a widespread phenomenon in Africa. Women’s low socioeconomic empowerment, cultural acceptability, and lack of social support exacerbate the health and psychosocial outcomes of IPV among African women. To date, there is no systematic research on IPV and its association with healthcare use among adult women in Uganda. Therefore, we conducted the present study on IPV among Ugandan women of childbearing age (15–49 years). Cross-sectional data on 7536 women were collected from the Uganda Demographic and Health Survey (UDHS—Uganda Demographic and Health Survey 2016). The objectives were to assess the predictors of IPV as well as help-seeking behaviour for victims of IPV. IPV was assessed by women’s experience of physical, emotional and sexual violence and healthcare use was assessed by self-reported medical visits during the last 12 months. Logistic regression methods were used to analyse the data. According to descriptive findings, which showed that more than half of the women reported experiencing any IPV (55.3%, 95%CI = 53.6, 57.0), emotional IPV (41.2%, 95%CI = 39.6, 42.8) was the most prevalent of all three categories, followed by physical (39.3%, 95%CI = 37.7, 40.9) and sexual IPV (22.0%, 95%CI = 20.7, 23.3). In the multivariate analysis, higher age, rural residence, religious background (non-Christian), ethnicity (Banyankore and Itseo), secondary/higher education and husband’s alcohol drinking habit were positively associated with women’s experience of IPV. Husband’s alcohol drinking was found to be a significant barrier to seeking help among those who experienced IPV. In conclusion, our findings suggest a noticeably high prevalence of IPV among Ugandan women. There are important sociodemographic and cultural patterns in the occurrence of IPV that need to be taken into account when designing intervention policies. Special attention should be given to women living with husbands/partners who drink alcohol, as this might increase their odds of experiencing IPV, as well as reduce the likelihood of seeking help.
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Сигида, Евгений, YEvgyeniy Sigida, Наталья Баклагина, Natalya Baklagina, Инна Лукьянова, Inna Lukyanova, Зоя Киреенкова, and Zoya Kireenkova. "Disability as a predictor of special needs for tourist services." Servis Plus 9, no. 2 (June 15, 2015): 64–72. http://dx.doi.org/10.12737/11313.
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In modern society, tourism is of great socio-cultural importance of forming new behavior algorithms of various categories of the population. The flow of tourists increases, more people appear with disabilities who remain limited mobility due to the presence of numerous social barriers that need to be adaptive conditions of consumption of tourist services in the framework of tourism, accessible to all. Involvement of disabled people in the tourism industry remains an unsolved problem. Persons with special needs in tourist services are among the switched off from society. Issues related to the provision of tourist services are resolved not to the full extent without the conditions for such activities. Information about opportunities for persons with disabilities in Russian is very limited. Use of tourism in the system of social protection remains the least affordable and little studied. At the same time, tourists with special needs in the travel services are potential customers for businesses, they can participate in the economic development, to make a profit. We believe that to a certain degree this is connected with insufficient development of theoretical and conceptual issues of adaptive tourism, which affects in particular the question of society´s attitude to such concepts as "human health" and "disability". Considering tourism as a complex adaptive relationship, social, psychological, medical, sports and recreation and other measures which are included in the content of tourism activities in providing tourism services for persons with special needs, the priority is allocated in a specific form of psychosocial work at all levels of the tourism industry. Adaptive tourism is focused on the study and implementation of subject-subject relationship that accompany the promotion tour. And it´s not only the elimination of barriers to the movement of the mechanical traveling. The question is about a particular way of working with people with special needs in tourist services. lack of attention to categories of people requiring special conditions in tourism, underdevelopment of appropriate infrastructure reduce the motivation for learning by those who in their professional activities would like to have specific tourist services to persons with disabilities. Adaptive tourism is based, on the one hand, on the general theory and methodology of social work, and on the other- on the technology of the organization of tourist activity and the concept of adaptive physical training (adaptive physical education, adaptive sports, adaptive motor recreation). Our research has allowed developing the scientific and theoretical basis of the concept of model-specific tourism activities and offers a training profile for psychosocial workers capable of organizational and managerial activities with persons with special needs in tourist services.
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Ereshefsky, Sabrina, Vanessa Zarubin, Valerie Tryon, Tyler Lesh, Cameron Carter, and Tara Niendam. "T76. RETROSPECTIVE ADHD SYMPTOMS IN EARLY PSYCHOSIS: RELATION TO CURRENT CLINICAL SYMPTOMS AND PSYCHOSOCIAL FUNCTIONING." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S260—S261. http://dx.doi.org/10.1093/schbul/sbaa029.636.
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Abstract Background Individuals with psychosis have a 2–5 times higher prevalence of ADHD than the general population. Individuals with early psychosis (EP) with an ADHD history have poorer premorbid social and role functioning, a more challenging symptom course, and poorer long-term psychosocial outcomes. The high degree of overlap in cognitive profiles for both psychosis and ADHD highlights a need for additional research. This project sought to assess the relation between historical report of childhood ADHD symptoms, current psychosis symptoms, and psychosocial functioning in individuals with EP. It is hypothesized that ADHD symptoms will significantly predict functioning. Methods Individuals, aged 12–30, who experienced the onset of psychotic symptoms in the past 2 years and presented for care at UC Davis EP clinics, were consented and enrolled. Individuals provided retrospective self-report ratings of childhood (between ages 5–12) symptoms of ‘inattention’ and ‘hyperactivity/impulsivity’ on the Barkley ADHD Rating Scale. Raters coded current psychosocial (Global Social/Role Functioning [GSF/GRF]) and clinical functioning ([Brief Psychiatric Rating Scale [BPRS], Scale for Assessment of Positive [SAPS] and Negative [SANS] Symptoms) at presentation. BPRS, SAPS, and SANS ratings were combined into ‘reality distortion,’ ‘poverty,’ and ‘disorganization’ domains. Medical chart review will be conducted to identify historical report of ADHD diagnosis. Multiple linear regression was used to examine relative contribution of demographic variables, clinical symptoms, and self-reported childhood ADHD symptoms to current social and role functioning. Results Ninety-eight participants (20.22 years ± 3.95; 39% female; 37% non-Hispanic White; 27% Hispanic; 2% missing demographics) provided complete data. Childhood inattention, poverty, and disorganized symptoms predicted current GSF (R-squared = .39, F[5, 92] = 11.92, p < .001). When assessing demographic differences on outcomes, GSF was rated significantly higher in non-Hispanic White (M = 7.03, SD = 1.80) compared to other non-White participants (M = 6.28, SD = 1.64; t[94] = -2.08, p = .04). With the inclusion of race as a predictor, only poverty and disorganization predicted GSF (R-squared = .40, F[6, 89] = 10.04, p < .001). Poverty symptoms predicted current GRF, while childhood ADHD and other psychosis symptoms did not predict GRF (R-squared = .31, F[5, 92] = 8.09, p < .001). Age significantly correlated with GRF (r = -.31, p = .002). Poverty remained a significant predictor of GRF after including age (R-squared = .37, F[6, 89] = 8.84, p < .001). Additional cognitive correlates, collateral report of childhood ADHD symptoms, prior diagnoses, date of psychosis illness onset, and medication history will also be examined. Discussion Social functioning was predicted by childhood self-rated inattention and current negative and disorganized symptoms; however, the relation with childhood inattention did not remain after controlling for race/ethnicity. Additional analyses will be conducted to assess if race is presenting as a proxy for other social determinants, including insurance designation, in this sample. Individuals with ADHD experience more difficulty in social settings compared to typically developing peers, possibly due to increased need to use environmental cues; for individuals who go on to develop psychosis, these childhood events are possibly perceived as more stressful, adding to risk for psychosis. However, it is unclear if self-report childhood inattention – captured here as a putative symptom of ADHD – may be better accounted for by premorbid cognitive impairment associated with risk for psychosis. Additional research is required to establish this connection.
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Dunkel Schetter, Christine, Andrea N. Niles, Christine M. Guardino, Mona Khaled, and Michael S. Kramer. "Demographic, Medical, and Psychosocial Predictors of Pregnancy Anxiety." Paediatric and Perinatal Epidemiology 30, no. 5 (May 25, 2016): 421–29. http://dx.doi.org/10.1111/ppe.12300.
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Wilson, D., and S. Lavelle. "Psychosocial predictors of intended condom use among Zimbabwean adolescents." Health Education Research 7, no. 1 (1992): 55–68. http://dx.doi.org/10.1093/her/7.1.55.
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McDowell, Michelle E., Stefano Occhipinti, Megan Ferguson, and Suzanne K. Chambers. "Prospective predictors of psychosocial support service use after cancer." Psycho-Oncology 20, no. 7 (June 7, 2010): 788–91. http://dx.doi.org/10.1002/pon.1774.
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Hong, Song Hee, and Marvin D. Shepherd. "Psychosocial and demographic predictors of pediatric psychotropic medication use." American Journal of Health-System Pharmacy 53, no. 16 (August 15, 1996): 1934–39. http://dx.doi.org/10.1093/ajhp/53.16.1934.
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Hüsler, Gebhard, Bernard Plancherel, and Egon Werlen. "Psychosocial Predictors of Cannabis Use in Adolescents at Risk." Prevention Science 6, no. 3 (July 27, 2005): 237–44. http://dx.doi.org/10.1007/s11121-005-0009-y.
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Gau, Susan S. F., Mian-Yoon Chong, Pincheng Yang, Cheng-Fang Yen, Kung-Yee Liang, and Andrew T. A. Cheng. "Psychiatric and psychosocial predictors of substance use disorders among adolescents." British Journal of Psychiatry 190, no. 1 (January 2007): 42–48. http://dx.doi.org/10.1192/bjp.bp.106.022871.
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BackgroundFew studies have prospectively examined psychosocial and psychiatric predictors of adolescent substance use disorders simultaneously.AimsTo identify psychosocial and psychiatric predictors of substance use disorders in adolescence.MethodSchool children aged 12 years (s. d. =0. 3) free from any substance use disorder at grade7(n=428) were assessed in three consecutive years, using a standardised psychiatric interview. Their baseline psychosocial information was also collected. The outcome was the onset age of a substance use disorder. The Cox regression model was used for data analysis.ResultsThe most significant predictive factors for adolescent substance use disorder included male gender, attention-deficit hyperactivity disorder, conduct disorder and sibling use of tobacco. Three protective factors against such morbidity included living in a household with two parents, a good academic grade at grade 7 and objection to the use of substances.ConclusionsEarly intervention for disruptive behaviour disorders and specific psychosocial risk factors might prevent substance use disorders in early adolescence.
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Cardoso, G., A. Antunes, A. Loureiro, P. Santana, J. Caldas-de-Almeida, and M. Silva. "Predictors of the use of Psychosocial Interventions in Portugal: Results from the SMAILE Project." European Psychiatry 41, S1 (April 2017): S156. http://dx.doi.org/10.1016/j.eurpsy.2017.01.2022.
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IntroductionThe treatment of psychiatric disorders depends on a combination of different types of care, such as psychiatric treatment and psychosocial interventions. However, there is little research on the factors that determine access to care, particularly to psychosocial interventions.ObjectivesTo characterize the use of psychosocial interventions (psychotherapy, day hospital, and psychosocial rehabilitation) in users of outpatient psychiatric services in Portugal.AimsThis retrospective study analyses all outpatient psychiatric visits in four Portuguese departments of psychiatry in the metropolitan areas of Lisbon and Porto, and aims to evaluate the socio-demographic and clinical determinants of psychosocial interventions.MethodsSocio-demographic and clinical variables were obtained from clinical charts of outpatients’ visits in 2002, 2007 and 2012 (n = 2621). All patients were characterized regarding the use of any psychosocial intervention beyond psychiatric consultations. Logistic regression analysis was performed to evaluate the predictors of psychosocial interventions use.ResultsBeing followed in 2012, being single, having no professional activity, and having a diagnosis of psychosis or common mental disorder were significantly associated (P < 0.05) with higher odds of accessing psychosocial interventions. On the other hand, a lower level of education was associated with less use of this type of care.ConclusionsSocio-demographic and clinical characteristics of psychiatric services, outpatients are determinants of the use of psychosocial interventions. Evidence suggests that social inequalities may influence the access to psychosocial interventions in Portugal.FundingFundação para a Ciência e Tecnologia (FCT), Portugal.
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Tsochas, Kyriakos, Lambros Lazuras, and Vassilis Barkoukis. "Psychosocial predictors of nutritional supplement use among leisure time exercisers." Performance Enhancement & Health 2, no. 1 (March 2013): 17–23. http://dx.doi.org/10.1016/j.peh.2013.02.001.
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Moser, Debra K., Philip J. Clements, Mary-Lynn Brecht, and Steven R. Weiner. "Predictors of psychosocial adjustment in systemic sclerosis." Arthritis & Rheumatism 36, no. 10 (October 1993): 1398–405. http://dx.doi.org/10.1002/art.1780361012.
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Mackay, Mark T., and Maja Steinlin. "Recent developments and new frontiers in childhood arterial ischemic stroke." International Journal of Stroke 14, no. 1 (August 6, 2018): 32–43. http://dx.doi.org/10.1177/1747493018790064.
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This review will discuss important developments in childhood arterial ischemic stroke over the past decade, focusing on improved understanding of the causes, consequences, and targets for intervention. Risk factors for childhood arterial ischemic stroke are different to adults. Infections, particularly herpes group viruses, are important precipitants for stroke. Non-atherosclerotic arteriopathies are the most common cause of childhood arterial ischemic stroke and an important predictor of recurrent events. Recent advances include the identification of serum biomarkers for inflammation and endothelial injury, and imaging biomarkers to monitor for vascular progression. Multicenter trials of immunotherapies in focal cerebral arteriopathies are currently in development. Recognition of clinical and radiological phenotypic patterns has facilitated the discovery of multisystem disorders associated with arterial ischemic stroke including ACTA2 arteriopathy and adenosine deaminase 2 deficiency. Identification of these Mendelian disorders provide insights into genetic mechanisms of disease and have implications for medical and surgical management. In contrast to adults, there are long diagnostic delays in childhood arterial ischemic stroke. Refinement of pediatric Code Stroke protocols and clinical decision support tools are essential to improve diagnostic certainty and improve access to reperfusion therapies. Children do not recover better than adults following arterial ischemic stroke, with more than half of survivors having long-term impairments. The physical, cognitive, and behavioral consequences of childhood arterial ischemic stroke are increasingly reported but further research is required to understand their impact on participation, quality of life, psychosocial, and family functioning. Longitudinal studies and the use of advanced imaging techniques, to understand neurobiological correlates of functional reorganization, are essential to developing targeted intervention strategies to facilitate recovery.
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Featherstone, Harvey J., and Bernard D. Beitman. "“Daily” Common Migraine: Psychosocial Predictors of Outcomes of Medical Therapy." Headache: The Journal of Head and Face Pain 23, no. 3 (June 22, 2005): 110–12. http://dx.doi.org/10.1111/j.1526-4610.1983.hed2303110.x.
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Kelly, A., and J. FW Deakin. "PSYCHOSOCIAL & BIOLOGICAL PREDICTORS OF EARLY POSTNATAL DEPRESSION." Clinical Neuropharmacology 15 (1992): 184B. http://dx.doi.org/10.1097/00002826-199202001-00352.
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Schlenz, Alyssa M., Jeffrey Schatz, and Carla W. Roberts. "Caregiver Psychological Functioning in Relation to Pain and Health Care Utilization in Pediatric Sickle Cell Disease." Blood 124, no. 21 (December 6, 2014): 4844. http://dx.doi.org/10.1182/blood.v124.21.4844.4844.
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Abstract Introduction Biopsychosocial models of illness suggest that a combination of disease-related and psychosocial factors influence outcomes for patients. In pediatric sickle cell disease (SCD), caregivers play a significant role in helping children to manage pain, including during home-based management of episodes as well as during the decision-making process for seeking health care services for severe episodes. Few previous studies have examined the extent to which caregiver psychological functioning is related to health outcomes for pediatric patients with SCD. The purpose of the present study was to determine how two specific aspects of psychological functioning (caregiver coping style and mood) impact pain outcomes for this population. Methods Caregivers (N = 70) and their children with SCD (N = 76) were recruited at routine hematological visits to participate in a study of pain in pediatric SCD. Caregivers completed ratings of coping style (active versus passive coping) using the Coping Strategies Questionnaire, Revised. Caregivers also completed ratings of positive and negative mood using the Positive and Negative Affect Scale, Revised. Information on recent pain history was collected using the Structured Pain Interview for SCD. Both caregivers and children completed the interviews and their ratings were averaged to produce final pain ratings. Information was collected on pain frequency (total over the past 12 months) and pain intensity and duration (average over the past 12 months). Medical record review was used to collect information on health care utilization for pain over the past 24 months, including total number of emergency room visits, hospitalizations, and outpatient contacts for pain. A structured coding method was used to examine medical records and a second rater independently verified the information. The medical record was also used to confirm the child’s SCD subtype. Multiple hierarchical regressions were used to determine the effects of caregiver coping style and mood on pain and health care utilization. All models controlled for child age, gender, and disease subtype (high versus low risk). Results Multiple hierarchical regression analysis suggested that caregiver psychological functioning was associated with pain duration and health care utilization. Specifically, caregiver negative mood contributed a significant amount of variance to the model for pain duration (F (1, 65) = 8.01, p = .006, R2 = .11). In addition, caregiver active and passive coping contributed a significant amount of variance to the model for health care utilization (F (2, 64) = 3.91, p = .025, R2 = .10) and passive coping was a significant individual predictor of utilization (p = .041). Caregiver psychological variables were not significantly related to pain frequency or intensity. Conclusion Caregivers of children with SCD play an important role in helping children to manage pain. The present study suggests that improving caregiver psychological functioning may help to improve pain outcomes for children with SCD. In particular, negative mood and passive coping were most related to poorer pain outcomes in terms of duration and health care utilization. Negative mood tends to be associated with poorer psychological functioning, including higher ratings of anxiety and depression, whereas passive coping tends to reflect negative beliefs about pain and less reliance on active approaches to pain management. Clinicians working with caregivers may benefit from focusing on the aspects of pain that are more controllable for families, such as preventative approaches to pain episodes or adherence with existing home-based protocols. Referrals for additional psychosocial supports may also be beneficial for caregivers presenting with poorer psychological functioning. Limitations of the present study include the cross-sectional design and the use of retrospective pain ratings. Understanding the temporal precedence of pain and caregiver psychological functioning would be beneficial in future studies. Disclosures No relevant conflicts of interest to declare.
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Friedman, Lois, John Webb, and Trent Everett. "Psychosocial and Medical Predictors of Colorectal Cancer Screening Among Low-Income Medical Outpatients." Journal of Cancer Education 19, no. 3 (September 1, 2004): 180–86. http://dx.doi.org/10.1207/s15430154jce1903_14.
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Moss, Nathan D., Erin L. O’Connor, and Katherine M. White. "Psychosocial predictors of the use of enhanced podcasting in student learning." Computers in Human Behavior 26, no. 3 (May 2010): 302–9. http://dx.doi.org/10.1016/j.chb.2009.10.012.
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Mirzaei-Alavijeh, Mehdi, Hassan Gharibnavaz, and Farzad Jalilian. "Skin Cancer Prevention: Psychosocial Predictors of Sunscreen Use in University Students." Journal of Cancer Education 35, no. 1 (July 23, 2019): 187–92. http://dx.doi.org/10.1007/s13187-019-01579-2.
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Hojat, M., M. Robeson, I. Damjanov, J. J. Veloski, K. Glaser, and J. S. Gonnella. "Studentsʼ psychosocial characteristics as predictors of academic performance in medical school." Academic Medicine 68, no. 8 (August 1993): 635–7. http://dx.doi.org/10.1097/00001888-199308000-00015.
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Williams, R. B., T. L. Haney, R. A. McKinnis, F. E. Harrell, K. L. Lee, D. B. Pryor, R. Califf, Y. H. Kong, R. A. Rosati, and J. A. Blumenthal. "Psychosocial and physical predictors of anginal pain relief with medical management." Psychosomatic Medicine 48, no. 3 (March 1986): 200–210. http://dx.doi.org/10.1097/00006842-198603000-00005.
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Scherer, Marcia J., Caren Sax, Alan Vanbiervliet, Laura A. Cushman, and John V. Scherer. "Predictors of assistive technology use: The importance of personal and psychosocial factors." Disability and Rehabilitation 27, no. 21 (January 2005): 1321–31. http://dx.doi.org/10.1080/09638280500164800.
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Bountress, Kaitlin, Carla Kmett Danielson, Vernell Williamson, Vladimir Vladmirov, Joel Gelernter, Kenneth Ruggiero, and Ananda Amstadter. "Genetic and psychosocial predictors of alcohol use trajectories among disaster-exposed adolescents." American Journal on Addictions 26, no. 6 (June 8, 2017): 623–31. http://dx.doi.org/10.1111/ajad.12575.
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Moos, Rudolf H. "Iatrogenic effects of psychosocial interventions for substance use disorders: prevalence, predictors, prevention." Addiction 100, no. 5 (May 2005): 595–604. http://dx.doi.org/10.1111/j.1360-0443.2005.01073.x.
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