Κυριακή 8 Σεπτεμβρίου 2019

The Firearm Safety Among Children and Teens (FACTS) Consortium: defining the current state of the science on pediatric firearm injury prevention
The original version of the article unfortunately contained a typo in the last author name. The author name was incorrectly listed as Mark Zimmerman. The correct name should be Marc A. Zimmerman.

Reducing bedtime physiological arousal levels using immersive audio-visual respiratory bio-feedback: a pilot study in women with insomnia symptoms

Abstract

Hyperarousal is a critical component of insomnia, particularly at bedtime when individuals are trying to fall asleep. The current study evaluated the effect of a novel, acute behavioral experimental manipulation (combined immersive audio-visual relaxation and biofeedback) in reducing bedtime physiological hyperarousal in women with insomnia symptoms. After a clinical/adaptation polysomnographic (PSG) night, sixteen women with insomnia symptoms had two random-order PSG nights: immersive audio-visual respiratory bio-feedback across the falling asleep period (manipulation night), and no pre-sleep arousal manipulation (control night). While using immersive audio-visual respiratory bio-feedback, overall heart rate variability was increased and heart rate (HR) was reduced (by ~ 5 bpm; p < 0.01), reflecting downregulation of autonomic pre-sleep arousal, relative to no-manipulation. HR continued to be lower during sleep, and participants had fewer awakenings and sleep stage transitions on the manipulation night relative to the control night (p < 0.05). The manipulation did not affect sleep onset latency or other PSG parameters. Overall, this novel behavioral approach targeting the falling asleep process emphasizes the importance of pre-sleep hyperarousal as a potential target for improving sleep and nocturnal autonomic function during sleep in insomnia.

Depression and parenting in youth with type 1 diabetes: Are general and diabetes-specific parenting behaviors associated with depressive symptoms over a 2-year period?

Abstract

To examine cross-sectional and longitudinal associations of general parenting style and diabetes-specific parenting behaviors with depression in youth with type 1 diabetes. Participants (n = 390) completed self-report measures of depression at baseline and 2-year follow-up, general parenting style at baseline, and diabetes-specific parenting (conflict, task involvement, and collaborative involvement) at baseline and every 6 months. Logistic regression examined associations of parenting with depression at baseline and 2-year follow-up. A less authoritative parenting style, lower parent collaborative involvement, and greater diabetes-related conflict were associated with baseline depression in the model simultaneously including all parenting variables and covariates. Lower parent collaborative involvement and higher diabetes-related conflict were associated with depression at 2-year follow-up, adjusting for baseline depression and covariates. Parent task involvement was not associated with depression at either time. Findings suggest a protective role of parenting in reducing the risk of depression in youth with type 1 diabetes.

The role of sleep quality on the relationship between posttraumatic stress symptoms and pain in women

Abstract

Pain frequently co-occurs with elevated posttraumatic stress symptoms (PTSS); women are at elevated risk for their co-occurrence. PTSS and pain are associated with poor sleep quality; yet, little research has examined how sleep impacts their co-occurrence. The current study examines the indirect role of sleep on the relationship between PTSS and pain. A community sample of 182 women completed psychometrically-sound questionnaires assessing PTSS, sleep quality, pain characteristics, depression and anxiety symptoms, and anxiety sensitivity. We examined how sleep quality impacted associations among PTSS and pain intensity and pain interference, while controlling for key psychological factors. Greater PTSS was associated with worse pain interference, and poor sleep quality had a significant indirect effect on this relationship. Sleep may represent a modifiable behavioral mechanism that contributes to the mutual maintenance of PTSS and pain in women. Future research is needed to further clarify the role of sleep quality in their co-occurrence.

Temporal patterns of self-weighing behavior and weight changes assessed by consumer purchased scales in the Health eHeart Study

Abstract

Self-weighing may promote attainment and maintenance of healthy weight; however, the natural temporal patterns and factors associated with self-weighing behavior are unclear. The aims of this secondary analysis were to (1) identify distinct temporal patterns of self-weighing behaviors; (2) explore factors associated with temporal self-weighing patterns; and (3) examine differences in percent weight changes by patterns of self-weighing over time. We analyzed electronically collected self-weighing data from the Health eHeart Study, an ongoing longitudinal research study coordinated by the University of California, San Francisco. We selected participants with at least 12 months of data since the day of first use of a WiFi- or Bluetooth-enabled digital scale. The sample (N = 1041) was predominantly male (77.5%) and White (89.9%), with a mean age of 46.5 ± 12.3 years and a mean BMI of 28.3 ± 5.9 kg/m2 at entry. Using group-based trajectory modeling, six distinct temporal patterns of self-weighing were identified: non-users (n = 120, 11.5%), weekly users (n = 189, 18.2%), rapid decliners (n = 109, 10.5%), increasing users (n = 160, 15.4%), slow decliners (n = 182, 17.5%), and persistent daily users (n = 281, 27.0%). Individuals who were older, female, or self-weighed 6–7 days/week at week 1 were more likely to follow the self-weighing pattern of persistent daily users. Predicted self-weighing trajectory group membership was significantly associated with weight change over time (p < .001). In conclusion, we identified six distinct patterns of self-weighing behavior over the 12-month period. Persistent daily users lost more weight compared with groups with less frequent patterns of scale use.

Repetitive negative thinking, meaning in life, and serum cytokine levels in pregnant women: varying associations by socioeconomic status

Abstract

Elevated proinflammatory cytokines and decreased antiinflammatory cytokines are important in the context of perinatal health, and immune dysregulation has been found among perinatal women with low socioeconomic status (SES). Data examining psychological factors that may contribute to cytokines in pregnancy are lacking. Of importance, these associations may be most evident among women with low SES. This study examined the moderating role of SES on associations among presence of meaning in life and repetitive negative thinking with cytokine levels among 67 pregnant women. A cumulative SES index was calculated using income, education, perceived social class, and receipt of governmental support. Measures included the Perseverative Thinking Questionnaire, Meaning in Life Questionnaire, and serum interleukin (IL)-6 as well as IL-4. Using PROCESS, moderation analyses showed significant interactions between psychological factors and SES in predicting serum cytokines. In the context of high SES only, greater repetitive negative thinking was associated with higher levels of the proinflammatory cytokine IL-6 (p = 0.056) while greater meaning in life was associated with higher levels of the antiinflammatory cytokine IL-4 (p = 0.02). Findings from this study suggest that the benefits of these psychological factors on cytokine levels may be most readily observable among women with greater economic stability. Identifying psychological factors that positively contribute to biological functioning in women experiencing heightened economic distress will be crucial in addressing SES-related disparities in perinatal health.

Maintenance of affective wellbeing following acute pain in healthy older and younger adults

Abstract

Over 70% of older adults report chronic or acute pain, and pain threatens affective wellbeing. The strategies older adults use to maintain affective wellbeing following acute pain remain unknown. Specific strategies that can be used to manage pain include recalling, recognizing, and responding to positive stimuli and prioritizing close over knowledgeable social partners. The study tested whether older adults used positivity-enhancing strategies and maintained affective wellbeing following acute pain better than younger adults. Fifty older (ages 65–85) and 50 younger (ages 18–30) pain-free adults experienced a control and a pain condition and were given the chance to employ positivity-enhancing strategies. Older and younger adults similarly used positivity-enhancing strategies following pain. Younger adults demonstrated reduced preference for knowledgeable social partners after experiencing pain. Pain-related affective changes were similar between age groups. Older and younger adults may cope with acute pain similarly, highlighting future directions for exploring age differences in pain coping.

Factors affecting linkage to HIV care and ART initiation following referral for ART by a mobile health clinic in South Africa: evidence from a multimethod study

Abstract

Linkage to care from mobile clinics is often poor and inadequately understood. This multimethod study assessed linkage to care and antiretroviral therapy (ART) uptake following ART-referral by a mobile clinic in Cape Town (2015/2016). Clinic record data (N = 86) indicated that 67% linked to care (i.e., attended a clinic) and 42% initiated ART within 3 months. Linkage to care was positively associated with HIV-status disclosure intentions (aOR: 2.99, 95% CI 1.13–7.91), and treatment readiness (aOR: 2.97, 95% CI 1.05–8.34); and negatively with good health (aOR: 0.35, 95% CI 0.13–0.99), weekly alcohol consumption (aOR: 0.35, 95% CI 0.12–0.98), and internalised stigma (aOR: 0.32, 95% CI 0.11–0.91). Following linkage, perceived stigma negatively affected ART-initiation. In-depth interviews (N = 41) elucidated fears about ART side-effects, HIV-status denial, and food insecurity as barriers to ART initiation; while awareness of positive ART-effects, follow-up telephone counselling, familial responsibilities, and maintaining health to avoid involuntary disclosure were motivating factors. Results indicate that an array of interventions are required to encourage rapid ART-initiation following mobile clinic HIV-testing services.

Unique contribution of education to behavioral and psychosocial antecedents of health in a national sample of African Americans

Abstract

Education has demonstrated consistent links with many aspects of physical health and is theorized to relate to a variety of behavioral and psychosocial antecedents of health that may ultimately account for these associations. However, many of these associations and the extent to which they manifest specifically for African Americans have not been thoroughly tested. We examined associations of education—distinct from income—with established behavioral and psychosocial antecedents of health in a national sample of African Americans. Education favorably related to many behavioral (e.g., fruit/vegetable intake, lifetime smoking) and psychosocial (e.g., self-efficacy, personality traits, self-esteem, psychological well-being) antecedents of health, but not to all. Some evidence of stronger salutary relations of education for women was found. Results suggest that, for African Americans, education is generally favorably associated with an array of behavioral and psychosocial antecedents of physical health, partially explaining health disparities and providing a point of intervention moving forward.

Role of delay discounting in predicting change in HBA1c for individuals with prediabetes

Abstract

The majority of people with prediabetes transition to type 2 diabetes. Weight gain is a known predictor of increasing the risk of diabetes, but another reason may be a focus on immediate rewards and discounting of the future. Delay discounting (DD: devaluation of future consequences) is related to obesity and poor glycemic control in persons with type 2 diabetes. This study was designed to assess whether changes in DD are associated with HbA1c change beyond BMI change in individuals with prediabetes. Hierarchical regression showed changes in BMI (p = 0.008) and the $1000 DD task (p = 0.04) were associated with HbA1c change beyond demographic characteristics, with the full model accounting for 25.8% of the variance. Those with greater BMI increases and greater increases in discounting of the future showed the greatest increases in HbA1c. DD represents a novel target to prevent progression from prediabetes to type 2 diabetes.

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