The effect of holiday haemodialysis treatments on patient mood, adverse symptoms and subjective wellbeing using the Big Red Kidney Bus

BACKGROUND AND AIMS: People with end-stage kidney disease receiving haemodialysis are restricted to holidays where dialysis services are readily available. Holiday dialysis in regional, rural and remote areas is particularly challenging. The aims of this study were to (1) evaluate the wellbeing of those who received dialysis in a holiday haemodialysis bus, and (2) to measure patient wellbeing with that of a comparable cohort of haemodialysis patients. METHODS: A three machine haemodialysis bus, the Big Red Kidney Bus, was built to enable people, their families and carers to take holidays across a range of tourist destinations in Victoria, Australia. Measures included pre-post subjective wellbeing, dialysis symptoms and mood questionnaires complemented by post semi-structured telephone interviews. RESULTS: Participating holidaymakers were positive about the haemodialysis bus service and the standard of care experienced. They reported decreased dialysis side effects of fatigue, muscle cramp, and dry skin. The overall number of reported symptoms decreased and the perceived level of bother associated with symptoms also decreased. No changes in subjective wellbeing and mood were detected. Mean Personal Wellbeing Index scores were significantly higher than in a comparative haemodialysis sample. CONCLUSION: The Big Red Kidney Bus provided a safe and feasible holiday dialysis service. Holidaymakers' wellbeing was reflected by the decreased dialysis patient side effects.

C-reactive protein concentrations across the mood spectrum in bipolar disorder: a systematic review and meta-analysis

BACKGROUND: Inflammatory processes and neural-immune interactions have been implicated in the pathogenesis of psychiatric conditions, but studies in bipolar disorder are inconclusive so far. We aimed to investigate whether peripheral concentrations of C-reactive protein (CRP), an acute-phase response protein of inflammatory activity, are increased in bipolar disorder across the mood spectrum. METHODS: In this systematic review and meta-analysis, we searched MEDLINE, the Cochrane Library, Scopus, and Web of Knowledge from database inception to Aug 14, 2016, for studies that measured serum and plasma CRP concentrations in adult patients with bipolar disorder (as defined by DSM-IV-TR) and healthy controls. We extracted data from published reports. We did three between-group meta-analyses comparing CRP concentrations in patients in mania, depression, or euthymia, with those in healthy controls (cross-sectional studies), and two within-group meta-analyses comparing changes in CRP concentrations before and after treatment of an index manic or depressive episode (longitudinal studies). We used Hedges' adjusted g to calculate effect sizes and pooled results using random-effect models. We also did meta-regression analyses by mood state to investigate possible moderators of CRP concentrations. FINDINGS: We identified 27 studies representing 2161 patients with bipolar disorder and 81 932 healthy controls. Compared with healthy individuals, CRP concentrations were moderately increased in people with bipolar disorder during depression (g 0·67, 95% CI 0·23 to 1·11; p=0·003) and euthymia (0·65, 0·40 to 0·90; p<0·0001) and more substantially increased during mania (0·87, 0·58 to 1·15; p<0·0001). The extent of the increases in CRP concentrations in mania and depression was not related to symptom severity (p=0·256 for mania and p=0·626 for depression). CRP concentrations were moderately decreased after resolution of an index manic episode (-0·36, -0·66 to -0·05; p=0·022) and slightly decreased after resolution of an index depressive episode (-0·18, -0·30 to -0·07; p=0·002). INTERPRETATION: CRP concentrations are increased in bipolar disorder regardless of mood state, but are higher during mania than in depression and euthymia, suggesting an increased inflammatory burden in mania.

Gay men's estimates of the likelihood of HIV transmission in sexual behaviours

In 3 studies we recorded gay men's estimates of the likelihood that HIV would be transmitted in various sexual behaviours. In Study 1 (data collected 1993, n=92), the men were found to believe that transmissibility is very much greater than it actually is; that insertive unprotected anal intercourse (UAI) by an HIV-infected partner is made safer by withdrawal before ejaculation, and very much safer by withdrawal before either ejaculation or pre-ejaculation; that UAI is very much safer when an infected partner is receptive rather than insertive; that insertive oral sex by an infected partner is much less risky than even the safest variant of UAI; that HIV is less transmissible very early after infection than later on; and that risk accumulates over repeated acts of UAI less than it actually does. In Study 2 (data collected 1997/8, n=200), it was found that younger and older uninfected men generally gave similar estimates of transmissibility, but that infected men gave somewhat lower estimates than uninfected men; and that estimates were unaffected by asking the men to imagine that they themselves, rather than a hypothetical other gay man, were engaging in the behaviours. Comparison of the 1993 and 1997/8 results suggested that there had been some effect of an educational campaign warning of the dangers of withdrawal; however, there had been no effect either of a campaign warning of the dangers of receptive UAI by an infected partner, or of publicity given to the greater transmissibility of HIV shortly after infection. In Study 3 (data collected 1999, n=59), men induced into a positive mood were found to give lower estimates of transmissibility than either men induced into a neutral mood or men induced into a negative mood. It is argued that the results reveal the important contribution made to gay men's transmissibility estimates by cognitive strategies (such as the 'availability heuristic' and 'anchoring and adjustment') known to be general characteristics of human information-processing. Implications of the findings for AIDS education are discussed.

Quality of life and sense of coherence in people with arthritis

This study investigated the physical and psychological impact of arthritis on people's quality of life. A range of variables were examined in a sample of 375 participants who comprised three groups: people with arthritis receiving a support-based service from the Arthritis Foundation of Victoria, people with arthritis receiving standard treatment, and a group of people from the general population. The results revealed that the two arthritis groups reported a significantly higher level of functional impairment, pain, and negative affectivity, and lowered mood, positive affect, and Sense of Coherence, compared to the general population group. They also reported normal levels of importance, but lower levels of satisfaction on various life domains. After statistically controlling for pain however, group differences were eliminated on all variables except for functional impairment and for all satisfaction domains except health. These data are interpreted as evidence that the combination of low domain satisfaction coupled with high domain importance yields a negative psychological state. This, then suggests the possibility of a therapy based on reducing the perceived importance of health.

Managing the transition from school to university: a challenging or stressful experience?

Times of transition are stressful for most people. In this study, the aim was to investigate the stress reported by students as they commenced university, and to investigate whether stress levels, use of coping strategies, the availability of social support, and mood and anxiety differed among students who had moved house to commence university and those who had not. Results from 551 students indicate that 88% of them rated the level of commencing stress above the mid-point on a 5-pt Likert scale but there was no difference between students living at home and those not so, neither did these groups differ on their perceptions of available social support nor their use of coping strategies to deal with commencing university. There were however, gender differences on the use of appraisal of the stressor with females utilizing appraisal more so than males. Students who changed residence to study reported higher levels of depressive symptoms but not of anxiety symptoms. The strain of moving house and a deterioration in living conditions predicted scores on the stress of commencing university. These results are discussed in tenns of student welfare.

Emotional intelligence, attachment styles and couple relationship satisfaction

This study examined links between emotional intelligence (EI), attachment styles and gender as part of a larger study into the relationship between EI and relationship satisfaction. Two hundred and forty-six participants (age range 18-79, M=36.41, SD=13.78) were recruited via media advertisements. They completed measures of EI and attachment style in addition to providing demographic information. A significant main effect was found for attachment style across all aspects of EI. For gender, a significant main effect was found only for the empathy aspect of EI. Further, significant effects were found for the interaction of gender and attachment on both the mood and empathy factors of EI. These differences are discussed in the context of attachment style theory.

Reconstituting the invisible out of structure and repetition: a walk through diary V3.2.

This presentation will discuss the production of an interactive personal diary constructed in digital form as an interactive CD-Rom: Diary V 3.2. This diary was conceived as a digital version of the family photo album of the artist's nuclear family, which unfortunately disintegrated during 4 years of the diary's making. As a result Diary V 3.2 became more a documentation of the mood and state of mind of the maker than the family it began to focus on. It acted more as a trace or a remnant of mood, an artifact of loss. This was communicated not so much through narrative but ideas of loss and erasure. Another layer to this work concerns the migration of images, technique from the old analogue technology to the new digital technology which can act as a replay of the migrant experience.

Reducing latent deprivation during unemployment: the role of meaningful leisure activity

The aim of this study was to investigate the role of meaningful leisure activity in reducing latent deprivation during unemployment. Samples of unemployed (N=201) and employed (N=128) participants were asked to rate their levels of latent deprivation using the Access to Categories of Experience Scale. They were also asked to complete the Profile of Mood States depression subscale, Adult Self-Perception Profile, Meaningful Leisure Activities Questionnaire, and to rate the frequency with which they engaged in social and solitary leisure activities. Results indicate that unemployed participants engaged in social leisure activities less frequently than employed participants and solitary leisure activities more frequently; and they reported higher perceived latent deprivation, higher depressive affect and lower self-esteem. Overall, these findings suggest that participation in leisure activities that are meaningful, rather than simply frequent, may be a constructive and readily achievable coping response during unemployment.

Ego boundaries, shamanic-like techniques, and subjective experience : an experimental study

The subjective effects and therapeutic potential of the shamanic practice of journeying is well known. However, previous research has neglected to provide a comprehensive assessment of the subjective effects of shamanic-like journeying techniques on non-shamans. Shamanic-like techniques are those that demonstrate some similarity to shamanic practices and yet deviate from what may genuinely be considered shamanism. Furthermore, the personality traits that influence individual susceptibility to shamanic-like techniques are unclear. The aim of the present study was, thus, to investigate experimentally the effect of shamanic-like techniques and a personality trait referred to as "ego boundaries" on subjective experience including mood disturbance. Forty-three non-shamans were administered a composite questionnaire consisting of demographic items and a measure of ego boundaries (i.e., the Short Boundary Questionnaire; BQ-Sh). Participants were randomly assigned to one of three conditions: listening to monotonous drumming for 15 minutes coupled with one of two sets of journeying instructions; or sitting quietly with eyes closed for 15 minutes. Participants' subjective experience and mood disturbance were retrospectively assessed using the Phenomenology of Consciousness Inventory (PCI) and the Profile of Mood States-Short Form, respectively. The results indicated that there was a statistically significant difference between conditions with regard to the PCI major dimensions of visual imagery, attention and rationality, and minor dimensions of imagery amount and absorption. However, the shamanic-like conditions were not associated with a major reorganization of the pattern of subjective experience compared to the sitting quietly condition, suggesting that what is typically referred to as an altered state of consciousness effect was not evident. One shamanic-like condition and the BQ-Sh subscales need for order, childlikeness, and sensitivity were statistically significant predictors of total mood disturbance. Implications of the findings for the anthropology of consciousness are also considered.

Predicting female depression across puberty : a two-nation longitudinal study

Objective: To prospectively examine the relation between pubertal stage and the onset and course of depressive symptoms.

Method: The design was a three-wave longitudinal study of health and social development using statewide community samples in Washington, United States, and Victoria, Australia. Approximately 5,769 students initially ages 10 to 15 years were assessed for depressive symptoms with the Short Mood and Feelings Questionnaire. Pubertal status was assessed using a self-report version of the Pubertal Development Scale.

Results: Advancing pubertal stage carried higher risks for depressive symptoms in female subjects in all of the three study waves. The pubertal rise in female depressive symptoms was due to both higher risk for incident cases and an even greater effect on risks for persistence of depressive symptoms. Report of poor emotional control 12 months earlier carried a twofold higher risk for incident depressive symptoms and largely explained the pubertal rise in female incident cases. High family conflict and severity of bullying also predicted persistence of depressive symptoms. Preexisting depressive symptoms were not associated with later increases in the rate of pubertal transition.

Conclusions: Advancing pubertal stage carries risks for both the onset and persistence of depressive symptoms in females. Social adversity around puberty predicts the persistence of symptoms but does not account for a pubertal rise in female depression. A report of poor emotional control may be a useful marker of girls at risk for depressive symptoms and as a target for preventive intervention.

Professional carers' knowledge and response to depression among their aged-care clients : the care recipients' perspective

Depression is an under-diagnosed disorder among the elderly, even in those who are in receipt of aged-care services. One factor associated with this under diagnosis has been identified as a reluctance amongst the elderly to discuss their mood and emotions with their medical practitioners. The current study focused on why depression is not recognised and acted on by those providing residential or home-based care to older people. We interviewed 15 elderly people residing in high-level or low-level aged-care facilities, and three elderly people who were receiving personal care in their homes. All participants had been identified by their care agencies as depressed. Participants reported their perceptions of their personal carers' knowledge and practices in managing the residents' depression. Although the participants described their carers in positive terms, they were critical of their knowledge and skills in recognising depression, and indicated that the communication between personal carers and care recipients about depressive symptomatology was seriously flawed. Training for personal carers in these areas, and efforts to change organisational culture are recommended.

The role of the gift wrap stall at christmas

The pressure to wrap a gift can cause anxiety for the giver. At Christmas, many shopping centres have gift wrap stalls to assist their customers with the wrapping. In this paper we explore the purpose of a gift wrap stall and the role it plays in Christmas gift shopping. Data were collected through observation as it allowed insights into the phenomena that could not otherwise be obtained. Findings include the nature of a gift wrap stall, the mood surrounding the gift wrap stall, the types of gifts wrapped, the level of decision making involved, the role of the staff and issues relating to trust, the waiting times for gift wrapping, the giver’s gift wrap skills, and enquiries into the gift wrap service. This research makes an insightful contribution to a novel topic in the field of consumer behaviour as it allows us to better understand gift wrapping and its role in gift exchange.

Associations between the physical and social environment and depressive symptomology among Australian adolescents

Depression is a significant public health issue among Australian adolescents. A number of family, school and community level factors have been identified as important determinants of adolescent's health and well-being, including depression. This study examines associations between measures of the social and physical environment and adolescent mental health, specifically depressive symptomotology using data from the Healthy Neighbourhoods study, a large observational study carried out in 231 Australian schools stratified by socioeconomic quartiles and urban/non-urban geography, which focuses on adolescent health and well-being. Participants were 8256 year 6 and 8
students (48% male), aged 11-16 years (M = 11.6, SD = 0.8 years) from schools across Victoria,Queensland and Western Australia who completed a comprehensive on-line survey. Data collected included the Short Mood and Feeling Questionnaire (SMFQL a tool for assessing depressive symptomotology in adolescents. Results showed that the mean total depression score (possible range 0-26 with total scores;:: 8 used as the cutoff for depression symptomotology) was 6.4 (SD = 5.9), with scores for females (M = 6.8, SD = 6.3) higher than those for males (M = 5.9, SD = 5.5), and scores for year 8 students (M = 6.7,SD = 6.1) higher than those for year 6 students (M = 6.2, SD = 5.8) (p < .001). Greater access to sporting and play equipment, local parks, and more functional neighbourhoods for walking and jogging reduced the odds for depressive symptomotology (p < .05L while increased levels of abandoned homes, and higher levels of fighting within the neighbourhood, and fewer scout/guide clubs, local teams to play sport, and adults in the neighbourhood to talk with, as well as reduced neighbourhood safety increased the odds for depressive symptomotology (p < .05). These findings support the important role of physical and social environments in influencing adolescent health and well-being. Modifications to particular aspects of these environments at the community level may assist in providing adolescents some protection from depression.