Symptom burden and its relationship to functional performance in patients with chronic obstructive pulmonary disease

The aim of this study was to explore symptom burden and its relationship to functional performance in patients with COPD. A descriptive, cross-sectional, correlational survey design was used and a sample of 214 patients with COPD. The sample was recruited from patients attending one of the major teaching hospitals in Dublin. Symptom burden was measured using the Memorial Symptom Assessment Scale (MSAS), and the functional performance was measured using the Functional Performance Inventory-Short Form (FPISF). Findings revealed that participants experienced a median of 13 symptoms. The most burdensome symptoms were shortness of breath, lack of energy, difficulty sleeping, worrying, dry mouth, feeling nervous, feeling irritable, and feeling sad. Participants with very severe COPD had the greatest symptom burden, followed by those with severe COPD, moderate COPD, and mild COPD. Symptom burden was higher for the psychological symptoms compared to the physical symptoms. Participants with mild COPD had the highest functional performance, followed by those with moderate COPD, very severe COPD, and severe COPD. Twenty symptoms were negatively correlated with overall functional performance, indicating that high symptom burden for those symptoms was associated with low overall functional performance. Moderate, negative, statistically significant correlations were found between the total symptom burden and overall functional performance, physical symptom burden and overall functional performance and psychological symptom burden and overall functional performance. A negative linear relationship was found between total symptom burden and overall functional performance among all stages of COPD except the mild group. No relationship was found between total symptom burden and overall functional performance for the moderate group. Healthcare professionals need to broaden the clinical and research assessment of physical and psychological symptoms in COPD; alleviating the burden of these symptoms may promote improved functional performance.

COPING STRATEGIES AND PSYCHOLOGICAL WELL-BEING AMONG BHUTANESE REFUGEES RESETTLED IN OTTAWA, CANADA

Since 2008, more than 6000 Bhutanese refugees have been resettled in over 21 communities across Canada, with nearly 300 individuals residing in Ottawa. This resettling process is associated with physical and psychological stress, as individuals acclimatize to a new country. A lack of understanding of the impact of this transition exists. This study assessed the relationship between coping strategies and psychological well-being of Bhutanese refugees resettled in Ottawa. A cross sectional survey of a representative sample of Bhutanese adults (n = 110) was conducted between November and December 2015. Coping strategies and psychological well-being were measured using the Brief COPE and General Well-being (GWB) scales. The total GWB mean score of 69.04 ± 12.09 suggests that respondents were in moderate distress. GWB did not significantly differ by sex, marital status, religion, employment, part time or full time job, or length of stay in Canada. Using multiple linear regression, significant independent variables from univariate analysis with GWB (age, education, positive reframing, self-blame and venting) were modeled to determine the best predictors of general well-being (GWB, F (11, 96) = 3.61, p < .001, R² = 21.2%). Higher levels of education and positive reframing were associated with greater GWB scores while self-blame and ages 41-50 were inversely associated with general well-being. It was found that above 66% of the unemployed participants were from age groups 41 and above. This finding suggests that career guidance services and vocational training to address unemployment may benefit this community. Nurses can provide support and counselling to assist refugees to minimize the use of negative coping strategies like self-blame and venting and promote positive coping strategies. Further, collaboration between nurses, other interdisciplinary professionals and community organizations is necessary to address social determinants of health and enhance refugee psychological well-being.

Moral Insanity and psychological disorder: the hybrid roots of Psychiatry

This paper traces the significance of the diagnosis of ‘moral insanity’ (and the related the diagnoses of ‘monomania’ and ‘manie sans delire’) to the development of psychiatry as a profession in the 19th century. The pioneers of psychiatric thought were motivated to explore such diagnoses because they promised public recognition in the high status surroundings of the criminal court. Some success was achieved in presenting a form of expertise that centred on the ability of the experts to detect quite subtle, ‘psychological’ forms of dangerous madness within the minds of offenders in France and more extensively in England. Significant backlash in the press against these new ideas pushed the profession away from such psychological exploration and back towards its medical roots that located criminal insanity simply within the organic constitution of its sufferers.

Lifestyles of higher education students: the influence of self- esteem and psychological well-being

Background The transition to higher education can affect lifestyle-related factors. Objectives: To identify lifestyles of higher education students and analyse the influence of self-esteem and psychological well-being. Methods Correlational cross-sectional study. A total of 4,314 students partici- pated in the study. Online questionnaires were used: Estilo de Vida Fantástico (Fantastic Lifestyle Assessment) [1]; Questionário de Bem- estar Psicológico (Psychological General Well-Being Questionnaire) [2], and Escala de auto-estima de Rosenberg (Rosenberg Self-Esteem Scale [3]. Results Most students (85.3 %) have a healthy lifestyle. Lifestyle is strongly correlated with self-esteem and psychological well-being (p < 0.001). While analysing the association between self-esteem and psycho- logical well-being and the various lifestyle domains according to gen- der, a positive and significant correlation (p < 0.001) was found among female students, except for the Smoking domain (p = 0.393); in relation to psychological well-being, positive correlations were found in all domains. Among male students, positive and significant correlations (p < 0.001) were found in most lifestyle domains and self-esteem, except for the Smoking (p = 0.992), Alcohol and other drugs (p = 0.181) and Other behaviours (p = 0.442) domains; in rela- tion to psychological well-being, positive and significant correlations (p < 0.001) were found in most lifestyle domains, except for the Smoking (p = 0.458) and Other behaviours (p = 0.128) domains. Conclusions Based on the results, higher education institutions should support intervention projects to maintain high levels of psychological well- being and self-esteem, promoting healthy lifestyles.

Do psychological factors play a crucial role in sport performance?: research on personality and psychological variables of athletes in Hungary

Contemporary research aims to investigate background factors that contribute to successful sport performance. Of these factors the psychological well-being and mental health status should be underlined that have gained a significant role, particularly in the frames of sport psychological counseling. The aim of the present study is to seek for interrelations of psychological variables and sport performance of young athletes, and to reveal what advantages might be utilized in younger ages to strengthen sport performance. No gender differences were found in sport performance; while age showed significant difference. The findings indicated differences of the investigated psychological variables by age and gender. Regression analyses were employed to test how psychological factors predict successful sport performance. The analyses strengthened the role of age and gender specific factors that should be considered during sport psychological counseling. The benefits should be highlighted in young age in order to ensure more successful performance in adulthood.

Women's disengagement from legal proceedings for intimate partner violence: sociodemographic and psychological variables

The aim of this study is to shed light on what makes women decide whether or not to continue with legal proceedings for intimate partner violence once they have commenced. Legal professionals, members of the police force, and women in Spain were interviewed to help draft a questionnaire that was applied to a sample of 345 women who had undertaken legal proceedings against their (ex)partners. Socio-demographic, emotional, and psychological variables were considered as possible predictor variables and included in a logistic regression analysis. Results show that the best equation for predicting disengagement from legal procedures includes the level of support received by the victim, contact with the aggressor, thoughts about going back with the aggressor, and a feeling of guilt. The essential role of the psychological support during the legal process is emphasized in conclusions.

Caffeine Intake and its Association with Disease Progression, Sleep Quality and Anxiety Symptoms and Nutritional Alterations in People Living with HIV in the Miami Adult Studies on HIV Cohort

Miami-Dade County has approximately 27,000 people living with HIV (PLWH), and the highest HIV incidence in the nation. PLWH have reported several types of sleep disturbances. Caffeine is an anorexic and lipolytic stimulant that may adversely affect sleep patterns, dietary intakes and body composition. High caffeine consumption (>250 mg. per day or the equivalent of >4 cups of brewed coffee) may also affect general functionality, adherence to antiretroviral treatment (ART) and HIV care. This study assess the relationship of high caffeine intake with markers of disease progression, sleep quality, insomnia, anxiety, nutritional intakes and body composition. A convenience sample of 130 PLWH on stable ART were recruited from the Miami Adult Studies on HIV (MASH) cohort, and followed for three months. After consenting, questionnaires on Modified Caffeine Consumption (MCCQ), Pittsburg Insomnia Rating Scale (PIRS), Pittsburg Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), socio-demographics, drug and medication use were completed. CD4 count, HIV viral load, anthropometries, and body composition measures were obtained. Mean age was 47.89±6.37 years, 60.8% were male and 75.4% were African-Americans. Mean caffeine intake at baseline was 337.63 ± 304.97 mg/day (Range: 0-1498 mg/day) and did not change significantly at 3 months. In linear regression, high caffeine consumption was associated with higher CD4 cell count (β=1.532, P=0.049), lower HIV viral load (β=-1.067, P=0.048), higher global PIRS (β=1.776, P=0.046), global PSQI (β=2.587, P=0.038), and GAD-7 scores (β=1.674, P=0.027), and with lower fat mass (β=-0.994, P=0.042), energy intakes (β=-1.643, P=0.042) and fat consumption (β=-1.902, P=0.044), adjusting for relevant socioeconomic and disease progression variables. Over three months, these associations remained significant. The association of high caffeine with lower BMI weakened when excluding users of other anorexic and stimulant drugs such as cocaine and methamphetamine, suggesting that caffeine in combination, but not alone, may worsen their action. In summary, high caffeine consumption was associated with better measures of disease progression; but was also detrimental on sleep quality, nutritional intakes, BMI and body composition and associated with insomnia and anxiety. Large scale studies for longer time are needed to elucidate the contribution of caffeine to the well-being of PLWH.

Successful aging at 100 years: the relevance of subjectivity and psychological resources

Very old individuals seem to present an admirable capacity to overcome adversities and adapt to the challenges of advanced age. However, studies focusing successful pattern of centenarians found that they may easily fail to be categorized as successful agers when objective criteria are applied. The present study examines if centenarians can be considered successful agers. Following Rowe and Kahn's successful aging model, the primary goal was to clarify whether centenarians are able to be successful agers according to objective and subjective criteria of no major disease and disability, high cognitive and physical functioning and engagement with life. The second goal was to investigate whether socio-demographic factors, psychological, social, and economic resources are related to objective and subjective successful aging profiles.

Behavioural and neurochemical consequences of chronic gut microbiota depletion during adulthood in the rat

Gut microbiota colonization is a key event for host physiology that occurs early in life. Disruption of this process leads to altered brain development which ultimately manifests as changes in brain function and behaviour in adulthood. Studies using germ-free mice highlight the extreme impact on brain health that results from life without commensal microbes, however the impact of microbiota disturbances occurring in adulthood is less studied. To this end, we depleted the gut microbiota of 10-week-old male Sprague Dawley rats via chronic antibiotic treatment. Following this marked, sustained depletion of the gut bacteria, we investigated behavioural and molecular hallmarks of gut-brain communication. Our results reveal that depletion of the gut microbiota during adulthood results in deficits in spatial memory as tested by Morris water maze, increased visceral sensitivity and a greater display of depressive-like behaviours in the forced swim test. In tandem with these clear behavioural alterations we found change in altered CNS serotonin concentration along with changes in the mRNA levels of corticotrophin releasing hormone receptor 1 and glucocorticoid receptor. Additionally, we found changes in the expression of BDNF, a hallmark of altered microbiota-gut-brain axis signaling. In summary, this model of antibiotic-induced depletion of the gut microbiota can be used for future studies interested in the impact of the gut microbiota on host health without the confounding developmental influence of early-life microbial alterations.

Patterns of psychotropic prescribing and polypharmacy in older hospitalized patients in Ireland: the influence of dementia on prescribing

Neuropsychiatric Symptoms (NPS) are ubiquitous in dementia and are often treated pharmacologically. The objectives of this study were to describe the use of psychotropic, anti-cholinergic, and deliriogenic medications and to identify the prevalence of polypharmacy and psychotropic polypharmacy, among older hospitalized patients in Ireland, with and without dementia. All older patients (≥ 70 years old) that had elective or emergency admissions to six Irish study hospitals were eligible for inclusion in a longitudinal observational study. Of 676 eligible patients, 598 patients were recruited and diagnosed as having dementia, or not, by medical experts. These 598 patients were assessed for delirium, medication use, co-morbidity, functional ability, and nutritional status. We conducted a retrospective cross-sectional analysis of medication data on admission for 583/598 patients with complete medication data, and controlled for age, sex, and co-morbidity. Of 149 patients diagnosed with dementia, only 53 had a previous diagnosis. At hospital admission, 458/583 patients experienced polypharmacy (≥ 5 medications). People with dementia (PwD) were significantly more likely to be prescribed at least one psychotropic medication than patients without dementia (99/147 vs. 182/436; p < 0.001). PwD were also more likely to experience psychotropic polypharmacy (≥ two psychotropics) than those without dementia (54/147 vs. 61/436; p < 0.001). There were no significant differences in the prescribing patterns of anti-cholinergics (23/147 vs. 42/436; p = 0.18) or deliriogenics (79/147 vs. 235/436; p = 0.62). Polypharmacy and psychotropic drug use is highly prevalent in older Irish hospitalized patients, especially in PwD. Hospital admission presents an ideal time for medication reviews in PwD.

Relationship between blood pressure and psychological features of experience and behaviour among teachers

Purpose: Relationships between psychic features and psychophysical parameters, such as blood pressure, have a high relevance in research on coping with stress. We want to investigate the correlation between blood pressure and this psychic features. Methods: We investigated 79 teachers from high schools and secondary schools in and around Leipzig, Germany. Using the systolic blood pressure as an indicator, we built three groups: hypotonics, normotonics, and hypertonics. We assessed several health psychologically dependent variables and looked for differences between these groups (Chi-Square-Test). Results: Hypotonics experienced more stress and less planning and goal behaviour. Furthermore, they more often use physical exercises in order to increase their social well-being. Hypertonics, on the other hand, were driven by fear of loss of control and show a higher sense of feeling threatened. Conclusions: We could find for each group different relationships that are highly relevant to health. This results shows how psychological features and physiological regulation mechanisms are linked.

[climacteric Syndrome In A Northeastern Brazilian City: A Household Survey].

To assess the prevalence of Climacteric Syndrome (CS) in women from a municipality of Northeastern Brazil which is less developed socioeconomically. A prospective household survey was performed in São Luís, Maranhão, Brazil with 1,210 climacteric women aged 45 to 60 years. Interviews were applied using previously tested standard questionnaires from April to July 2008. The severity of climacteric symptoms was analyzed by circulatory and psychological indexes and the latter were associated with menopausal status. Multiple correspondence analysis was used to assess the relation among climacteric symptoms. Most patients were 55 to 60 years old (35.3%), mulatto (37.9%), with 9-11 years of schooling (39.8%), with a partner (56%), Catholic (73.9%) and belonged to the socioeconomic class C (51.1%). The prevalence of CS was 85.9%, and hot flashes (56.4%) and sweating (50.4%) were the most prevalent symptoms. The most frequent psychological symptoms were nervousness (45%) and emotional liability (44.8%). The severity of vasomotor and psychological symptoms was significantly higher during the peri and postmenopausal period (p<0.05). Vaginal dryness (62.7%) was the most prevalent urogenital complaint. The prevalence of CS was high among women from São Luís, Maranhão, Brazil.