Predictors of depressed mood 12 months after injury. Contribution of self-efficacy and social support

Abstract Purpose: There is evidence that depressed mood and perception of pain are related in patients with chronic illness. However, how individual resources such as self-efficacy and social support play a role in this association remains unclear. The aim of this study was to investigate the influence of both variables as either moderator or mediator. Method: In a longitudinal study, 274 injured workers (M = 43.24 years) were investigated. Data were collected on sociodemographics, depressed mood, pain, social support, and self-efficacy at three months post-injury, and depressed mood one year post-injury. Results: Hierarchical multiple linear regression analyses revealed that pain (β = 0.14; p < 0.01) and social support (β = -0.18; p < 0.001) were significant predictors of depressed mood. Self-efficacy moderated the relationship of pain (β = -0.12; p < 0.05) and depressed mood after one year. Lower self-efficacy in combination with pain had a stronger impact than higher self-efficacy and pain on depressed mood. Social support did not moderate the association. Conclusions: Self-efficacy for managing pain is important in the development of depressed mood. According to the results of this study, we suggest that the detection of low social support and low self-efficacy might be important in long-term rehabilitation process. Implications for Rehabilitation Risk for depressed mood one year after an accident is high: One in five workers report depressed mood. Protective factors for depressed mood in injured workers needs to be considered in the rehabilitation. Focusing on resources like social support and self-efficacy could be protective against depressed mood. The early detection of low social support and low self-efficacy might be important in long-term rehabilitation processes

Monitoring Programmes, Multiple Stress Analysis and Decision Support for River Basin Management

The identification of plausible causes for water body status deterioration will be much easier if it can build on available, reliable, extensive and comprehensive biogeochemical monitoring data (preferably aggregated in a database). A plausible identification of such causes is a prerequisite for well-informed decisions on which mitigation or remediation measures to take. In this chapter, first a rationale for an extended monitoring programme is provided; it is then compared to the one required by the Water Framework Directive (WFD). This proposal includes a list of relevant parameters that are needed for an integrated, a priori status assessment. Secondly, a few sophisticated statistical tools are described that subsequently allow for the estiation of the magnitude of impairment as well as the likely relative importance of different stressors in a multiple stressed environment. The advantages and restrictions of these rather complicated analytical methods are discussed. Finally, the use of Decision Support Systems (DSS) is advocated with regard to the specific WFD implementation requirements.

Treatment with tumor necrosis factor inhibitors in axial spondyloarthritis: comparison between private rheumatology practices and academic centers in a large observational cohort

OBJECTIVE To evaluate the initiation of and response to tumor necrosis factor (TNF) inhibitors for axial spondyloarthritis (axSpA) in private rheumatology practices versus academic centers. METHODS We compared newly initiated TNF inhibition for axSpA in 363 patients enrolled in private practices with 100 patients recruited in 6 university hospitals within the Swiss Clinical Quality Management (SCQM) cohort. RESULTS All patients had been treated with ≥ 1 nonsteroidal antiinflammatory drug and > 70% of patients had a baseline Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥ 4 before anti-TNF agent initiation. The proportion of patients with nonradiographic axSpA (nr-axSpA) treated with TNF inhibitors was higher in hospitals versus private practices (30.4% vs 18.7%, p = 0.02). The burden of disease as assessed by patient-reported outcomes at baseline was slightly higher in the hospital setting. Mean levels (± SD) of the Ankylosing Spondylitis Disease Activity Score were, however, virtually identical in private practices and academic centers (3.4 ± 1.0 vs 3.4 ± 0.9, p = 0.68). An Assessment of SpondyloArthritis international Society (ASAS40) response at 1 year was reached for ankylosing spondylitis in 51.7% in private practices and 52.9% in university hospitals (p = 1.0) and for nr-axSpA in 27.5% versus 25.0%, respectively (p = 1.0). CONCLUSION With the exception of a lower proportion of patients with nr-axSpA newly treated with anti-TNF agents in private practices in comparison to academic centers, adherence to ASAS treatment recommendations for TNF inhibition was equally high, and similar response rates to TNF blockers were achieved in both clinical settings.

Ethnically-based rejection sensitivity and academic achievement: The danger of retracting into one’s heritage culture

This study examined the relation between ethnically based rejection sensitivity and academic achievement in a sample of 936 immigrant students in Germany and Switzerland. The theory of race-based rejection sensitivity that originated in North America was extended to immigrant students in Europe. The rough political climate against immigrants in Europe makes it probable that immigrant youth face particular difficulties and are affected by ethnically based rejection sensitivity, at least as much as—or even more than—minority youth in the United States. Using a standardized literacy performance test and multilevel analyses, we found that ethnically based rejection sensitivity was negatively related to academic achievement for immigrant students. This relation was partially mediated by a strong contingency of the students' self-worth on the heritage culture, as well as by a low number of native German or Swiss majority-group friends. We interpret these processes as immigrant students' efforts to cope with ethnically based rejection sensitivity by retracting into their heritage culture and avoiding majority-group contact, which unfortunately, however, at the same time also results in lower academic achievement. Copyright © 2014 John Wiley & Sons, Ltd.

The sacred musical compositions of the late Israel Lazarus Mombach : containing the services for Sabbaths and festivals, New Year and Day of Atonement, consecration hymns, psalms and choral wedding service

ed. by M. Keizer

HIV disclosure decisions and social support among African-American women in Houston, Texas

African Americans make up 12.3% of the population but account for over half of the new HIV cases and 39% of the AIDS cases in 2003 (Centers for Disease Control and Prevention [CDC], 2003). African American women in particular accounted for 64% of these cases of HIV and 60% of the AIDS cases (Leigh & Huff, 2003). This study contributed to the knowledge about the disclosure process of women living with HIV/AIDS by documenting the relationship between social support and the disclosure process in the African American HIV/AIDS population.^ The study aims were to: (1) discuss the participants' self concept of support; (2) describe the common characteristics of the disclosure process; and (3) evaluate the common characteristics of support sought in a potential disclosure source. The ethnographic qualitative methodology was utilized to elicit participant narratives of HIV disclosure and social support. The researcher utilized a key informant interview methodology building on existing social and organizational relationships (Krueger, 1994) to gain access to the population. ^ Semi-structured interviews are a widely used and accepted qualitative research method for use with hard to reach populations and sensitive topics. Ten participants completed a 45 to 60 minute, one on one semi-structured interview covering social support and disclosure variables. Inclusion and exclusion criteria included: (1) self identified as a person living with HIV/AIDS; (2) African American); (3) female; (4) age 18-64 years old, (5) residence in Houston or surrounding counties.^ Themes generated from the interviews were (1) nondisclosure, (2) experiences with disclosure, (3) timing, (4) disclosure sources, and (5) coping. The themes suggest African American women living with HIV/AIDS come from different lifestyles but share similar experiences. Women utilize different strategies such as deciphering whom to trust and determining how much information to divulge in order to protect themselves or others.^ Although the sample group was small for this study, the results inform us about the various experiences each woman goes through as it relates to social support and disclosure and that each woman has to customize her response to the type of support she is receiving and her personal attitude about her disease.^

Whence a healthy mind: Correlation of physical fitness and academic performance among schoolchildren

Background. Public schools are a key forum in the fight for child health because of the opportunities they present for physical activity and fitness surveillance. However, because schools are evaluated and funded on the basis of standardized academic performance rather than physical activity, empirical research evaluating the connections between fitness and academic performance is needed to justify curriculum allocations to physical activity. ^ Methods. Analyses were based on a convenience sample of 315,092 individually-matched standardized academic (TAKS™) and fitness (FITNESSGRAM®) test records collected by 13 Texas school districts under state mandates. We categorized each fitness result in quintiles by age and gender and used a mixed effects regression model to compare the academic performance of the top and bottom fitness groups for each fitness test and grade level combination. ^ Results. All fitness variables except BMI showed significant, positive associations with academic performance after sociodemographic covariate adjustments, with effect sizes ranging from 0.07 (95% CI: 0.05,0.08) in girls trunklift-TAKS reading to 0.34 (0.32,0.35) in boys cardiovascular-TAKS math. Cardiovascular fitness showed the largest inter-quintile difference in TAKS score (32-75 points), followed by curl-ups. After an additional adjustment for BMI and curl-ups, cardiovascular associations peaked in 8th-9 th grades (maximum inter-quintile difference 142 TAKS points; effect size 0.75 (0.69,0.82) for 8th grade girls math) and showed dose-response characteristics across quintiles (p<0.001 for both genders and outcomes). BMI analysis demonstrated limited, non-linear association with academic performance after adjustment for sociodemographic, cardiovascular fitness and curl-up variables. Low-BMI Hispanic high school boys showed significantly lower TAKS scores than the moderate (but not high) BMI group. High-BMI non-Hispanic white high school girls showed significantly lower scores than the moderate (but not low) BMI group. ^ Conclusions. In this study, fitness was strongly and significantly related to academic performance. Cardiovascular fitness showed a distinct dose-response association with academic performance independent of other sociodemographic and fitness variables. The association peaked in late middle to early high school. The independent association of BMI to academic performance was only found in two sub-groups and was non-linear, with both low and high BMI posing risk relative to moderate BMI but not to each other. In light of our findings, we recommend that policymakers consider PE mandates in middle-high school and require linkage of academic and fitness records to facilitate longitudinal surveillance. School administrators should consider increasing PE time in pursuit of higher academic test scores, and PE practitioners should emphasize cardiovascular fitness over BMI reduction.^

Posttraumatic stress disorder among veterans of the Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) wars: Psychological comorbidities, postdeployment social support and unit support

Much attention has been given to treating Operation Iraqi Freedom/Operation Enduring (OIF/OEF) Veterans with posttraumatic stress disorder (PTSD). However, little attention is given to those Veterans who do not meet diagnostic criteria for PTSD but who may still benefit from intervention. Research is needed to investigate the impact of how different racial/ethnic backgrounds, different levels of social support and comorbid mental health disorders impact OIF/OEF Veterans with varying levels of PTSD. The purpose of this dissertation is to examine the association of comorbid Axis I disorders, race/ethnicity, different levels of postdeployment social support and unit support on OIF/OEF Veterans with varying levels of PTSD. Data for this dissertation were from postdeployment screenings of OIF/OEF Veterans from a large Veterans Affairs hospital in southeast Texas. To examine the study hypotheses, we conducted multinomial logistic regressions of the clinician reported data. ^ The first article examined the prevalence of subthreshold and full levels of PTSD and compared Axis I and alcohol use comorbidity rates among 1,362 OIF/OEF Veterans with varying levels of PTSD. Results suggest that OIF/OEF Veterans with subthreshold PTSD experience similar levels of psychological distress as those with full PTSD and highlight the need to provide timely and appropriate mental health services to individuals who may not meet the diagnostic criteria for full PTSD. ^ These results suggest that OIF/OEF Veterans of all race/ethnicities can benefit from strong social support systems. Postdeployment social support was found to be a protective factor against the development of PTSD among White, Black and Hispanic veterans while deployment unit support was a protective factor only among Black Veterans. The second article investigated the association between postdeployment social support and unit support with varying levels of PTSD by race/ethnicity among 1,115 OIF/OEF Veterans. ^ The results of this study can help to formulate treatment and interventions for OIF/OEF Veterans with varying levels of PTSD and social support systems.^

The Children’s Bureau’s Role in Promoting Parent Engagement and Family Support: A Brief History and Current Efforts

Over the years, federal child welfare policy has supported parent engagement and family support strategies through various Children’s Bureau funded state formula grant programs, research and demonstration discretionary grants, and technical assistance. This article highlights programs funded by two federal laws, Promoting Safe and Stable Families and the Child Abuse Prevention and Treatment Act, and Children’s Bureau’s efforts to test innovations and disseminate knowledge about promising and evidence-based practices regarding parent engagement and family support. The article begins with a brief legislative history and then describes several grant programs that are supported by the legislation. The article concludes with lessons learned and a discussion of the new opportunities for system changes through the Title IV-E Waiver Demonstration projects.

Baseline evaluation of environmental physical activity and nutrition support of Texas Medical Center hospital worksites

Background: Obesity is a major health problem in the United States that has reached epidemic proportions. With most U.S adults spending the majority of their waking hours at work, the influence of the workplace environment on obesity is gaining in importance. Recent research implicates worksites as providing an 'obesogenic' environment as they encourage overeating and reduce the opportunity for physical activity. Objective: The aim of this study is to describe the nutrition and physical activity environment of Texas Medical Center (TMC) hospitals participating in the Shape Up Houston evaluation study to develop a scoring system to quantify the environmental data collected using the Environmental Assessment Tool (EAT) survey and to assess the inter-observer reliability of using the EAT survey. Methods: A survey instrument that was adapted from the Environmental Assessment Tool (EAT) developed by Dejoy DM et al in 2008 to measure the hospital environmental support for nutrition and physical activity was used for this study. The inter-observer reliability of using the EAT survey was measured and total percent agreement scores were computed. Most responses on the EAT survey are dichotomous (Yes and No) and these responses were coded with a '0' for a 'no' response and a '1' for a 'yes' response. A summative scoring system was developed to quantify these responses. Each hospital was given a score for each scale and subscale on the EAT survey in addition to a total score. All analyses were conducted using Stata 11 software. Results: High inter-observer reliability is observed using EAT. The percentage agreement scores ranged from 94.4%–100%. Only 2 of the 5 hospitals had a fitness facility onsite and scores for exercise programs and outdoor facilities available for hospital employees ranged from 0–62% and 0–37.5%, respectively. The healthy eating percentage for hospital cafeterias range from 42%–92% across the different hospitals while the healthy vending scores were 0%–40%. The total TMC 'healthy hospital' score was 49%. Conclusion: The EAT survey is a reliable instrument for measuring the physical activity and nutrition support environment of hospital worksites. The study results showed a large variability among the TMC hospitals in the existing physical activity and nutrition support environment. This study proposes cost effective policy changes that can increase environmental support to healthy eating and active living among TMC hospital employees.^

Flexibility and Academic Credits within Higher Education trends

La globalización en la Educación Superior y el nuevo marco de mercado dentro del sistema universitario ha introducido el concepto de flexibilidad. Uno de Ios instrumentos principales en el desarrollo de este proceso ha sido el Sistema de Crédito Académico (el Marco de Crédito), que es un modo de reestructurar el currículum hacia la Flexibilidad de Suministros. Muchos países en el mundo entero han introducido este modelo, después del Sistema de Crédito americano. Este trabajo explorará conceptualmente los eslabones entre las tendencias principales en la enseñanza superior y este nuevo concepto.