Medical, psychological and socio-economic implications of chronic hand eczema: a cross-sectional study.

BACKGROUND Hand eczema (HE) is a common skin disease with major medical psychological and socio-economic implications. Onset and prognosis of HE are determined by individual as well as environmental factors. So far, most epidemiological data on HE have been reported from Scandinavian and recently German studies. OBJECTIVE To investigate the characteristics and medical care of patients with chronic HE (CHE) in Switzerland, and identify risk factors. METHODS In this cross-sectional study, data from patients with chronic HE were obtained by means of medical history, dermatological examination and patient questionnaires. Multiple logistic regression analysis was applied to identify risk factors for high severity and dermatology life quality index (DLQI). RESULTS In seven dermatology departments, 199 patients (mean age 40.4 years, 50.8% female) with CHE (mean duration 6.6 years) were enrolled. Moderate to severe HE was reported by 70.9% of patients, and was associated with age <30 or >50 years, localization of lesions and pruritus. Because of the CHE, 37.3% of patients were on sick leave over the past 12 months, 14.8% had changed or lost their job. Practically all patients applied topical therapy, 21% were treated with alitretinoin, and 21% with psoralen plus UVA light (PUVA). The effects on the health-related quality of life was moderate to large in 33.7% and 39.4% of CHE patients, respectively. Factors associated with a high impact on DLQI (mean 9.7 ± 5.8) were female sex, lesions on back of the hands and pruritus as well as mechanical skin irritation and wearing gloves. CONCLUSION In agreement with recent studies, the Swiss data demonstrate the high impact of CHE on medical well-being, patient quality of life and work ability. As it is associated with an intense use of health care services, high rate of sick leave, job loss and change, CHE may cause a high socio-economic burden.

Long-term impact of treated congenital toxoplasmosis on quality of life and visual performance

Background: Long-term evolution of congenital toxoplasmosis is not documented. We assessed the outcome of treated congenital toxoplasmosis in a cohort of adult individuals who had undergone ante- and postnatal treatment to provide information for pediatricians and parents on the evolution of the disease. Methods: We conducted a questionnaire study on 126 adults with congenital toxoplasmosis (mean age: 22.2 years; age range: 18–31 years) monitored regularly until the time of inclusion. The main outcome measures were quality of life (Psychological General Well-Being Index) and visual function (VF14 questionnaire), and the outcomes were correlated with disease-specific factors. Results: Of the 102 patients (80.9%) who were finally included in the study, 12 (11.8%) presented neurologic effects and 60 (58.8%) manifested ocular lesions; in the latter category, 13 individuals (12.7%) had reduced visual function. The overall global quality-of-life score (74.7 ± 14.2) was close to the expected normal range for the general population (73.7 ± 15.3). Overall, visual function was only slightly impaired (M = 97.3; 95% confidence interval, 95.8–98.8). Although disease-independent critical life circumstances were associated with a reduced Psychological General Well-Being Index, this index was not influenced by any of the clinical characteristics of congenital toxoplasmosis. Neurologic pathologies, reduced visual acuity, foveal location of the retinal lesion, and squinting contributed to decreased visual function at follow-up. Conclusions: Our data reveal that treated congenital toxoplasmosis has little effect on the quality of life and visual function of the affected individuals. These encouraging findings may help to alleviate the anxiety of affected individuals and their parents.

Tracking the implicit self using event-related potentials

Negative biases in implicit self-evaluation are thought to be detrimental to subjective well-being and have been linked to various psychological disorders, including depression. An understanding of the neural processes underlying implicit self-evaluation in healthy subjects could provide a basis for the investigation of negative biases in depressed patients, the development of differential psychotherapeutic interventions, and the estimation of relapse risk in remitted patients. We thus studied the brain processes linked to implicit self-evaluation in 25 healthy subjects using event-related potential (ERP) recording during a self-relevant Implicit Association Test (sIAT). Consistent with a positive implicit self-evaluation in healthy subjects, they responded significantly faster to the congruent (self-positive mapping) than to the incongruent sIAT condition (self-negative mapping). Our main finding was a topographical ERP difference in a time window between 600 and 700 ms, whereas no significant differences between congruent and incongruent conditions were observed in earlier time windows. This suggests that biases in implicit self-evaluation are reflected only indirectly, in the additional recruitment of control processes needed to override the positive implicit self-evaluation of healthy subjects in the incongruent sIAT condition. Brain activations linked to these control processes can thus serve as an indirect measure for estimating biases in implicit self-evaluation. The sIAT paradigm, combined with ERP, could therefore permit the tracking of the neural processes underlying implicit self-evaluation in depressed patients during psychotherapy.

[Ongoing breastfeeding with breast abscess]

Mastitis puerperalis can frequently be complicated by a breast abscess. Immediate diagnosis and treatment are crucial if breastfeeding is to be continued and for the prevention of further complications. Somatic and psychological interventions are of importance for recovery. Specialised nurses and midwives have an important impact on the promotion of well-being of affected mothers.

Links between body mass index, total body fat, cholesterol, high-density lipoprotein, and insulin sensitivity in patients with obesity related to depression, anger, and anxiety

OBJECTIVE: Define links between psychosocial parameters and metabolic variables in obese females before and after a low-calorie diet. METHOD: Nine female obese patients (age 36.1 +/- 7.1 years, body mass index [BMI] > 30 kg/m2) were investigated before and after a 6-week low-calorie diet accompanied by behavior therapy. Blood lipids, insulin sensitivity (Bergman protocol), fat distribution (by dual-energy X-ray absorptiometry [DEXA]), as well as psychological parameters such as depression, anger, anxiety, symptom load, and well-being, were assessed before and after the dieting period. RESULTS: The females lost 9.6 +/- 2.8 kg (p < .0001) of body weight, their BMI was reduced by 3.5 +/- 0.3 kg/m2 (p < .0001), and insulin sensitivity increased from 3.0 +/- 1.8 to 4.3 +/- 1.5 mg/kg (p = .05). Their abdominal fat content decreased from 22.3 +/- 5.5 to 18.9 +/- 4.5 kg (p < .0001). In parallel, psychological parameters such as irritability (p < .05) and cognitive control (p < .0001) increased, whereas feelings of hunger (p < .05), externality (p < .05), interpersonal sensitivity (p < .01), paranoid ideation (p < .05), psychoticism (p < .01), and global severity index (p < .01) decreased. Prospectively, differences in body fat (percent) were correlated to nervousness (p < .05). Waist-to-hip ratio (WHR) differences were significantly correlated to sociability (p < .05) and inversely to emotional instability (p < .05), whereas emotional instability was inversely correlated to differences in insulin sensitivity (p < .01). DISCUSSION: Weight reduction may lead to better somatic risk factor control. Women with more nervousness and better sociability at the beginning of a diet period may lose more weight than others.

The Struggle of Giving Up Personal Goals – Affective, Physiological, and Cognitive Consequences of an Action Crisis.

A critical phase in goal striving occurs when setbacks accumulate and goal disengagement becomes an issue. This critical phase is conceptualized as an action crisis and assumed to be characterized by an intrapsychic conflict in which the individual becomes torn between further goal pursuit and goal disengagement. Our theorizing converges with Klinger’s conceptualization of goal disengagement as a process, rather than a discrete event. Two longitudinal field studies tested and found support for the hypothesis that an action crisis not only compromises an individual’s psychological and physiological well-being, but also dampens the cognitive evaluation of the respective goal. In Study 3, marathon runners experiencing an action crisis in their goal of running marathons showed a stronger cortisol secretion and a lower performance in the race 2 weeks later. Results are interpreted in terms of action-phase–specific mindsets with a focus on self-regulatory processes in goal disengagement.

Acute effects of stochastic resonance whole body vibration

AIM: To investigate the acute effects of stochastic resonance whole body vibration (SR-WBV) training to identify possible explanations for preventive effects against musculoskeletal disorders. METHODS: Twenty-three healthy, female students participated in this quasi-experimental pilot study. Acute physiological and psychological effects of SR-WBV training were examined using electromyography of descending trapezius (TD) muscle, heart rate variability (HRV), different skin parameters (temperature, redness and blood flow) and self-report questionnaires. All subjects conducted a sham SR-WBV training at a low intensity (2 Hz with noise level 0) and a verum SR-WBV training at a higher intensity (6 Hz with noise level 4). They were tested before, during and after the training. Conclusions were drawn on the basis of analysis of variance. RESULTS: Twenty-three healthy, female students participated in this study (age = 22.4 ± 2.1 years; body mass index = 21.6 ± 2.2 kg/m2). Muscular activity of the TD and energy expenditure rose during verum SR-WBV compared to baseline and sham SR-WBV (all P < 0.05). Muscular relaxation after verum SR-WBV was higher than at baseline and after sham SR-WBV (all P < 0.05). During verum SR-WBV the levels of HRV were similar to those observed during sham SR-WBV. The same applies for most of the skin characteristics, while microcirculation of the skin of the middle back was higher during verum compared to sham SR-WBV (P < 0.001). Skin redness showed significant changes over the three measurement points only in the middle back area (P = 0.022). There was a significant rise from baseline to verum SR-WBV (0.86 ± 0.25 perfusion units; P = 0.008). The self-reported chronic pain grade indicators of pain, stiffness, well-being, and muscle relaxation showed a mixed pattern across conditions. Muscle and joint stiffness (P = 0.018) and muscular relaxation did significantly change from baseline to different conditions of SR-WBV (P < 0.001). Moreover, muscle relaxation after verum SR-WBV was higher than after sham SR-WBV (P < 0.05). CONCLUSION: Verum SR-WBV stimulated musculoskeletal activity in young healthy individuals while cardiovascular activation was low. Training of musculoskeletal capacity and immediate increase in musculoskeletal relaxation are potential mediators of pain reduction in preventive trials.

High self-esteem prospectively predicts better work conditions and outcomes

We examined the reciprocal prospective relations between self-esteem and work conditions and outcomes, including justice at work, support at work, work stressors, job satisfaction, job success, and counterproductive work behavior. Data came from two independent longitudinal studies, including five assessments over an 8-month period (N = 663, age 16–62 years) and three assessments over a 2-year period (N = 600, age 22–51 years), respectively. Across both studies, high self-esteem prospectively predicted better work conditions and outcomes, whereas nearly all of the reverse effects (i.e., work conditions and outcomes predicting self-esteem) were nonsignificant. The results held for both male and female participants. If future research supports the causality of the self-esteem effects, interventions aimed at improving self-esteem might be useful in increasing an individual’s well-being and success at work, which consequently might be beneficial for employers.

Wellbeing

Well-being is an important component of physical and psychological health and an important source for individual development. The article aims to give an overview of different research traditions and definitions of well-being and to outline the basic ideas of research into well-being. It also examines well-being in school, the sources and predictors of well-being, as well as the function of well-being in educational settings. Both student and teacher well-being are considered.

The development of self-esteem

In this article, we review new insights gained from recent longitudinal studies examining the development of self-esteem and its influence on important life outcomes. The evidence supports the following three conclusions. First, self-esteem increases from adolescence to middle adulthood, peaks at about age 50 to 60 years, and then decreases at an accelerating pace into old age; moreover, there are no cohort differences in the self-esteem trajectory from adolescence to old age. Second, self-esteem is a relatively stable, but by no means immutable, trait; individuals with relatively high (or low) self-esteem at one stage of life are likely to have relatively high (or low) self-esteem decades later. Third, high self-esteem prospectively predicts success and well-being in life domains such as relationships, work, and health. Given the increasing evidence that self-esteem has important real-world consequences, the topic of self-esteem development is of considerable societal significance.

Implicit motives and basic need satisfaction in extreme endurance sports.

Previous research has shown that the effects of basic psychological needs on the flow experience in sports are moderated by implicit motives. However, so far, only leisure and health-oriented sports have been analyzed. In a pilot study and a main study (N = 29, 93), we tested whether the implicit achievement and affiliation motives interact with the need for competence and the need for social relatedness satisfaction, respectively, to predict flow experience and well-being in extreme endurance athletes. Results showed that highly achievement-motivated individuals benefited more from the need for competence satisfaction in terms of flow than individuals with a low achievement motive did. In addition, highly affiliation-motivated individuals whose need for social relatedness is satisfied reported higher positive affect and lower exercise addiction scores than athletes with a low motive. We discuss the differential effects of the interplay between the achievement and affiliation motives and basic needs on different outcome variables.

Cohort and Gender Differences in Psychosocial Adjustment to Later-Life Widowhood

Objectives. Despite the large body of literature on bereavement, little is known about the impact of sociohistorical context on individual reactions to spousal loss. This study examines the effect of marital status, time period and gender on physical and mental health, and whether reported difficulties following spousal loss differ at 2 distinctive time periods. Method. Two cohorts of older bereaved persons (n = 753) in Switzerland, surveyed in 1979 and 2011, were compared regarding their reports of difficulties related to marital loss. The bereaved spouses were also compared with a group of married contemporaries (n = 1,517) regarding subjective health and depressive symptoms. Results. Marital status and gender each have independent effects on subjective health and depressive symptoms. The effects of widowhood on subjective health differed significantly at both time points. Widowed individuals in 2011, especially women, reported fewer social and financial difficulties than their counterparts in 1979. However, the effect of widowhood on depressive symptoms and psychological difficulties did not differ significantly across time points. Discussion. Social changes in the late 20th century may be protective for older adults’ physical, social, and financial well-being in the face of spousal loss, yet these changes do not alleviate widow(er)s’ psychological distress.

Examining Gender Differences in Received, Provided and Invisible Social Control: An Application of the Dual-Effects-Model

The dual-effects model of social control not only assumes that social control leads to better health practices but also arouses psychological distress. However, findings are inconsistent. The present study advances the current literature by examining social control from a dyadic perspective in the context of smoking. In addition, the study examines whether control, continuous smoking abstinence, and affect are differentially related for men and women. Before and three weeks after a self-set quit attempt, we examined 106 smokers (77 men, mean age: 40.67, average number of cigarettes smoked per day: 16.59 [SD=8.52, range=1-40] at baseline and 5.27 [SD=6.97, range=0-40] at follow-up) and their nonsmoking heterosexual partners, assessing received and provided control, continuous abstinence, and affect. With regard to smoker's affective reactions, partner's provided control was related to an increase in positive and to a decrease in negative affect, but only for female smokers. Moreover, the greater the discrepancy between smoker received and partner's provided control was the more positive affect increased and the more negative affect decreased, but again only for female smokers. These findings demonstrate that female smokers' well-being was raised over time if they were not aware of the control attempts of their nonsmoking partners, indicating positive effects of invisible social control. This study's results emphasize the importance of applying a dyadic perspective and taking gender differences in the dual-effects model of social control into account.

Seelsorge, Psychologie und Medizin im Gespräch mit Spiritual Care (Psychologische Perspektive)

Spirituality is a travelling concept among different disciplines. As for psychology, spirituality has long been a neglected topic – especially in the academic context. However, during the last dec-ade there has been an increase of theoretical and empirical work, mainly emerging from positive and life-span developmental psychology. This research focuses spirituality either as an element of well-being or as predictor of well-being and health (e.g. as a coping strategy), or finally as an outcome after dealing with critical life events (i.e. spiritual growth). This knowledge has an impact on spiritual care – and vice-versa spiritual care – as a growing inter- and transdisciplinary field – has an impact on clinical psychological practice.

Gesundheitsbewertung vs. Arbeitszufriedenheit: Der Zusammenhang von Indikatoren des subjektiven Wohlbefindens mit selbstberichteten Fehlzeiten

In der vorliegenden Studie wird ausgehend von der Annahme, dass Personen bestrebt sind, für sich Wohlbefinden zu erzielen bzw. aufrechtzuerhalten, Fehlen als ein Mittel zu diesem Ziel hin konzeptualisiert. Es wird der Frage nachgegangen, welcher der beiden Indikatoren des subjektiven Wohlbefindens - allgemeine Gesundheitsbewertung vs. Arbeitszufriedenheit - für die Erklärung von Fehlzeiten von höherer Relevanz ist. Es wird erwartet, dass der kontextungebundene Indikator psychischen und körperlichen Wohlbefindens stark mit Fehlzeiten zusammenhängt, während der arbeitspezifische Indikator in keiner Beziehung zu den selbstberichteten Fehlzeiten steht. 1 410 Beschäftigte einer Telekommunikationsfirma wurden befragt. Die Ergebnisse hierarchischer Regressionsanalysen bestätigen die vermuteten Zusammenhänge und geben korrelative Hinweise für den postulierten Mechanismus.