Clinical outcome of a short-term psychotherapeutic intervention for the treatment of dental phobia

Objective: Anxiety before receiving dental treatment is widespread. The aim of this investigation was to evaluate the effect of a brief psychologic treatment on adherence to the dental treatment regimen in patients with dental phobia. Method and Materials: Dental phobic patients (n = 160) received 3 sessions of cognitive behavioral therapy that consisted of stress management training and exposure to phobic stimuli. The outcome was determined in terms of 3 subsequent dental visits. Results: Participating patients had not visited a dental clinician for an average of 6 years. Comparison of patients who completed the psychologic treatment with those who dropped out showed that 68% of the former but also 52% of the latter adhered to the subsequent dental treatment regimen. The number of psychologic treatment sessions correlated significantly and positively with anxiety level before treatment. Conclusion: Short-term psychologic therapy of 3 sessions results in a success rate of 70% to adherence to dental treatment among dental phobic patients. Duration of avoidance of anxiety before treatment was not related to success in completing the trial. Nevertheless, the more intense the patient's phobia, the more psychotherapeutic sessions were necessary. (Quintessence Int 2007;38; E589-E596).

Ein neues psychoendokrin-validiertes Verfahren zur Erfassung von Stressbewältigungsfertigkeiten (ISBF)

Background: We previously found good psychometric properties of the Inventory for assessment of stress management skills (German translation: Inventar zur Erfassung von Stressbewältigungsfertigkeiten), ISBF, a short questionnaire for combined assessment of different perceived stress management skills in the general population. Here, we investigate whether stress management skills as measured by ISBF relate to cortisol stress reactivity in two independent studies, a laboratory study (study 1) and a field study (study 2). Methods: 35 healthy non-smoking and medication-free men in study 1 (age mean±SEM:38.0±1.6) and 35 male and female employees in study 2 (age mean±SEM:32.9±1.2) underwent an acute standardized psychosocial stress task combining public speaking and mental arithmetic in front of an audience. We assessed stress management skills (ISBF) and measured salivary cortisol before and after stress and several times up to 60 min (study 2) and 120 min (study 1) thereafter. Potential confounders were controlled. Results:. General linear models controlling for potential confounders revealed that in both studies, higher stress management skills (ISBF total score) were independently associated with lower cortisol levels before and after stress (main effects ISBF: p’s<.055) and lower cortisol stress reactivity (interaction ISBF-by-stress: p’s<.029). Post-hoc-testing of ISBF subscales suggest lower cortisol stress reactivity with higher “relaxation abilities” (both studies) and higher scores in the scale “cognitive strategies and problem solving” (study 2). Conclusions: Our findings suggest blunted increases in cortisol following stress with increasing stress management skills as measured by ISBF. This suggests that the ISBF not only relates to subjective psychological but also objective physiological stress indicators which may further underscore the validity of the questionnaire.

Investigating short- and long-term transfer effects of a Taiji beginner course in participants’ daily life

OBJECTIVE: In recent years research investigating various health benefits of Taiji practice has markedly increased. Despite this growing scientific interest, essential questions such as to what extent a Taiji course may exert noticeable effects in participants’ everyday life, what these effects are, and how and where potential transfer effects occur, have hardly been considered. The aim of our study was to explore transfer effects from a Taiji course into participants’ daily lives. METHODS: We conducted a longitudinal observational study in 45 healthy participants at the end of their three-month Taiji beginner course (tp1) and at two months (tp2) as well as one year after course completion (tp3). Participants were asked to report their Taiji practice behavior at all time points, as well as to rate and describe perceived transfer effects of Taiji course contents on their daily life at tp1 and tp3. RESULTS: Transfer effects were reported by 91.1% of all respondents after course completion (tp1) and persisted in 73.3% at the one-year follow-up assessment (tp3), counting “increase of self-efficacy”, “improvement of stress management”, and “increase of body awareness” as the most frequently mentioned effects. Transfer effects predominantly occurred in participants’ work and social environments, as well as during everyday activities in public areas. While selfreliant Taiji practice frequency significantly decreased from 82.2% at tp1 to 55.6% at tp3 (P < 0.001), the magnitude of self-reported transfer effects did not (P = 0.35). As explorative analyses revealed, regular Taiji course attendance was highly correlated with stronger transfer effects at tp1 (r = 0.51; P < 0.001) and tp3 (r = 0.35; P = 0.020). Participants reporting high self-reliant Taiji practice frequency at tp2 were likely to maintain a regular practice routine at tp3 (r = 0.42; P < 0.004), whereas self-reliant practice frequency and transfer effects at tp1 were positively correlated with self-reliant practice frequency at tp3 on a trend level (r < 0.27; P > 0.08). CONCLUSION: Our data underline the importance of regular course participation for pronounced and long lasting transfer effects into participants’ everyday life. We discuss that several context and process-related aspects of a Taiji intervention are potentially relevant factors for enhancement of transfer effect.

Análisis multivariante del perfil psicológico de los deportistas universitarios : Aplicación del CPRD en México

El presente trabajo tiene como objetivo conocer el perfil psicológico de los deportistas universitarios colimenses y analizar si existen diferencias significativas entre practicantes de modalidades individuales y colectivas. Así mismo, se pretende encontrar los perfiles de riesgo para los deportistas. Se trata de un estudio transversal, basado en una muestra no probabilística de 122 alumnos de la Licenciatura en Educación Física y Deporte de la Universidad de Colima, en México. Utilizando como instrumento de medida el cuestionario "Características Psicológicas Relacionadas con el Rendimiento Deportivo" (CPRD), en la versión adaptada para deportistas mexicanos. El cuestionario mide control de estrés, motivación, cohesión de equipo, influencia de la evaluación del rendimiento y habilidad mental. Entre los principales hallazgos, se encontraron siete perfiles de riesgo, ordenados según un gradiente de necesidad de intervención por medio de la definición de puntos de corte, para todas y cada una de las subescalas. Se encontró que, casi un 40 de los deportistas se encuentran en algún perfil de riesgo, de los cuales 6,6 se encontraban en el perfil menor, y un 4,1 en el perfil de riesgo máximo.

Análisis multivariante del perfil psicológico de los deportistas universitarios : Aplicación del CPRD en México

El presente trabajo tiene como objetivo conocer el perfil psicológico de los deportistas universitarios colimenses y analizar si existen diferencias significativas entre practicantes de modalidades individuales y colectivas. Así mismo, se pretende encontrar los perfiles de riesgo para los deportistas. Se trata de un estudio transversal, basado en una muestra no probabilística de 122 alumnos de la Licenciatura en Educación Física y Deporte de la Universidad de Colima, en México. Utilizando como instrumento de medida el cuestionario "Características Psicológicas Relacionadas con el Rendimiento Deportivo" (CPRD), en la versión adaptada para deportistas mexicanos. El cuestionario mide control de estrés, motivación, cohesión de equipo, influencia de la evaluación del rendimiento y habilidad mental. Entre los principales hallazgos, se encontraron siete perfiles de riesgo, ordenados según un gradiente de necesidad de intervención por medio de la definición de puntos de corte, para todas y cada una de las subescalas. Se encontró que, casi un 40 de los deportistas se encuentran en algún perfil de riesgo, de los cuales 6,6 se encontraban en el perfil menor, y un 4,1 en el perfil de riesgo máximo.

Análisis multivariante del perfil psicológico de los deportistas universitarios : Aplicación del CPRD en México

El presente trabajo tiene como objetivo conocer el perfil psicológico de los deportistas universitarios colimenses y analizar si existen diferencias significativas entre practicantes de modalidades individuales y colectivas. Así mismo, se pretende encontrar los perfiles de riesgo para los deportistas. Se trata de un estudio transversal, basado en una muestra no probabilística de 122 alumnos de la Licenciatura en Educación Física y Deporte de la Universidad de Colima, en México. Utilizando como instrumento de medida el cuestionario "Características Psicológicas Relacionadas con el Rendimiento Deportivo" (CPRD), en la versión adaptada para deportistas mexicanos. El cuestionario mide control de estrés, motivación, cohesión de equipo, influencia de la evaluación del rendimiento y habilidad mental. Entre los principales hallazgos, se encontraron siete perfiles de riesgo, ordenados según un gradiente de necesidad de intervención por medio de la definición de puntos de corte, para todas y cada una de las subescalas. Se encontró que, casi un 40 de los deportistas se encuentran en algún perfil de riesgo, de los cuales 6,6 se encontraban en el perfil menor, y un 4,1 en el perfil de riesgo máximo.

Heat shock resistance traits in specimens of the seaweed Gracilaria vermiculophylla originating from native and non-native populations

We compared the responses of native and non-native populations of the seaweed Gracilaria vermiculophylla to heat shock in common garden-type experiments. Specimens from six native populations in East Asia and from eight non-native populations in Europe and on the Mexican Pacific coast were acclimated to two sets of identical conditions before their resistance to heat shock was examined. The experiments were carried out twice - one time in the native range in Qingdao, China and one time in the invaded range in Kiel, Germany - to rule out effects of specific local conditions. In both testing sites the non-native populations survived heat shock significantly better than the native populations, The data underlying this statement are presented in https://doi.pangaea.de/10.1594/PANGAEA.859335. After three hours of heat shock G. vermiculophylla exhibited increased levels of heat shock protein 70 (HSP70) and of a specific isoform of haloperoxidase, suggesting that both enzymes could be required for heat shock stress management. However, the elevated resistance toward heat shock of non-native populations only correlated with an increased constitutive expression of heat shock protein 70 (HSP70). The haloperoxidase isoform was more prominent in native populations, suggesting that not only increased HSP70 expression, but also reduced allocation into haloperoxidase expression after heat shock was selected during the invasion history. The data describing expression of HSP70 and three different isoforms of haloperoxidase are presented in https://doi.pangaea.de/10.1594/PANGAEA.859358.

Wetting and the physiological responses of grain-fed cattle in a heated environment

A controlled crossover experimental design was used to determine the effect of altered water sprinkling duration on heifers subjected to heat stress conditions. Heifers were subjected to 3 days of thermoneutral conditions followed by 3 days of hot conditions accompanied by water sprinkling between 1300 and 1500 h (HOT1-3). Then on the following 2 days (HOT4-5), environmental conditions remained similar, but 3 heifers were sprinkled between 1200 and 1600 h ( WET) and 3 were not sprinkled (NONWET). This was followed by a 1-day period (HOT6) in which environmental conditions and sprinkling regimen were similar to HOT1-3. Rectal temperature (RT) was collected hourly, and respiration rate (RR) was monitored every 2 h on HOT Days 2, 4, 5, and 6. Dry matter intake and rate of eating were also determined. Sprinkling reduced RR and RT (P < 0.01) of all heifers during HOT1-3. During HOT4-5, WET heifers had lower (P < 0.05) RT than NONWET from 1300 to 700 h and lower RR from 1400 to 2000 h. Dry matter intake of NONWET heifers was reduced by 30.6% (P < 0.05) during HOT4-5 and by 51.2% on HOT6. On HOT4-5 the dry matter intakes of WET heifers were similar to intakes under thermoneutral conditions. During HOT6, RT was again reduced following sprinkling in all heifers. Comparison of RT and RR of NONWET and WET heifers on HOT1-3 v. HOT6 revealed that under similar environmental conditions, NONWET heifers had increased RT, partially due to carry-over from HOT4-5. However, NONWET heifers had 40% lower feed intake but tended to have lower RR on HOT6 v. HOT1-3. Only RR of WET heifers was greater on HOT6, possibly a result of switching from a 4-h back to a 2-h sprinkling period, while maintaining a 62% greater intake (5.80 v. 3.58 kg/day) than NONWET heifers during this time. Results suggest that inconsistent cooling regimens may increase the susceptibility of cattle to heat stress and elicit different physiological and metabolic responses.

A systematic review of treatments for atopic dermatitis

Atopic dermatitis is a very common inflammatory skin disease, particularly in children. A systematic review of randomised controlled trials of treatments for atopic dermatitis (AD) was carried out to assess how many trials exist, what they cover, what they do not cover, the research gaps, provide a 'blue print' for future Cochrane Reviews and assist those making treatment recommendations by summarising the available RCT evidence, using descriptive statistics. The Cochrane Collaboration systematic review process formed the basis of the methodology, from which over 4000 studies were located via electronic database searches and hand searching of journals. A total of 292 trials were finally included covering 9 treatment groups and over 48 individual treatments. There are lots of trials covering lots of interventions but gaps are evident. However, there is evidence of a benefit in the treatment of atopic dermatitis with topical corticosteroids, psychological approaches, UV light, ascomycin derivatives, topical tacrolimus and oral cyclosporin. Treatments that show limited evidence of a benefit include non-sedatory antihistamines, topical doxepin, the oral antibiotic Cefadroxil on clinically infected AD, the topical antibacterial Mupirocin on clinically uninfected AD, Chinese herbs, hypnotherapy and biofeedback, massage therapy, dietary manipulation, house dust mite reduction, patient education, emollients, allergen antibody complexes of house dust mite and thymic extracts. Treatments that show no evidence of benefit include sedatory antihistamines, oral sodium cromoglycate, oral antibiotics on clinically uninfected AD, topical antibacterials, topical antifungals, aromatherapy essential oils, borage oil, fish oil, evening primrose oil, enzyme-free clothes detergent, cotton clothing, house dust mite hyposensitisation, salt baths, topical coal tar, topical cyclosporin and platelet-activating-factor antagonist. When interpreting the conclusions of this thesis it is important to understand that lack of evidence does not equal lack of efficacy, particularly considering the interventions that are commonly in use today to treat atopic dermatitis that have not been subjected to RCTs, such as occlusive dressings, water softening devices and stress management among many others.

The relationship of spirituality and the health promoting behaviors of diet and exercise of African -American women

Public health data show that African-Americans have not adopted health-promoting behaviors of diet and exercise. Spirituality, important in the lives of many African-American women, may be associated with health-promoting behaviors. This study was designed to determine how spirituality relates to health-promoting behaviors in African-American women. Burkhardt's theoretical framework for spirituality was adopted and measures were selected for the three elements of the framework: connectedness with self, others, and environment. ^ The study used a descriptive cross sectional correlational design to investigate the relationships of the independent variables of spirituality, sociodemographics, and BMI, to the dependent variables of diet and exercise, to answer the two primary questions: What is the role of spirituality in impacting the health-promoting behaviors of African-American women? Of the independent variables of spirituality, sociodemographics, and BMI, which are the best predictors of diet and exercise? ^ Central and South Floridian African-American women (n = 260) between 18 and 82 years of age completed several questionnaires: Rosenberg's Self-Esteem Scale, Health Promoting Lifestyle Profile II, Spiritual Perspective Scale, Brief Block Food Frequency, and socio-demographic information. ^ Hierarchical regression identified 40% of the variability of diet to be explained by socio-demographic (education) and spirituality variables (stress management and health responsibility) (p < .001). Twenty-nine percent of the variability of exercise was explained by socio-demographic (education) and spirituality variables (stress management) (p < .001). Canonical correlation analysis identified a significant pair of canonical variates which indicated individuals with good nutrition (.95), increased physical activity (.79), and healthy eating (.42) also had better stress management (.88), better health responsibility (.67), higher spiritual growth (.66), better interpersonal relations (.50), more education (.49), and higher self-esteem (.33). The set explained 57% of the variability (p < .001). ^ An understanding of the factors that influence these women's decision to utilize health-promoting strategies could provide health professionals with additional information to enable them to design culturally and spiritually related health messages for African-American women. The findings of this present study speak of the importance of focusing on stress management, health responsibility, spiritual growth, interpersonal relations and self-esteem along with diet and exercise; this will likely provide improvement in the health-promoting behaviors of African-American women. ^

Acceptance of relapse fears in breast cancer patients: effects of an act-based abridged intervention

Objective: Relapse fear is a common psychological scar in cancer survivors. The aim of this study is to assess the effects of an abridged version of Acceptance and Commitment Therapy (ACT) in breast cancer patients.Method: An open trial was developed with 12 non-metastatic breast cancer patients assigned to 2 conditions, ACT and waiting list. Interventions were applied in just one session and focused on the acceptance of relapse fears through a ‘defusion’ exercise. Interference and intensity of fear measured through subjective scales were collected after each intervention and again 3 months later. Distress, hypochondria and ‘anxious preocupation’ were also evaluated through standardized questionnaires.Results: The analysis revealed that ‘defusion’ contributed to decrease the interference of the fear of recurrence, and these changes were maintained three months after intervention in most subjects. 87% of participants showed clinically significant decreases in interference at follow-up sessions whereas no patient in the waiting list showed such changes. Statistical analysis revealed that the changes in interference were significant when comparing pre, post and follow-up treatment, and also when comparing ACT and waiting list groups. Changes in intensity of fear, distress, anxious preoccupation and hypochondria were also observed.Conclusions: Exposure through ‘defusion’ techniques might be considered a useful option for treatment of persistent fears in cancer patients. This study provides evidence for therapies focusing on psychological acceptance in cancer patients through short, simple and feasible therapeutic methods.

Determinantes das perturbações musculoesqueléticas nos trabalhadores de cuidados pessoais em residências de apoio ao idoso

Introdução: O enfermeiro especialista em reabilitação é o profissional com competências e conhecimentos para, após o diagnóstico, implementar e monitorizar os resultados dos programas de redução do risco das perturbações musculosqueléticas relacionadas com o trabalho (PME), junto dos trabalhadores de cuidados pessoais em residências de apoio ao idoso, avaliando e introduzindo no processo de prestação de cuidados os necessários ajustamentos, promovendo assim, práticas mais seguras e eficazes. Assim, o presente estudo centrou-se em identificar os determinantes das PME nestes trabalhadores e suas repercussões na saúde. Métodos: Estudo de natureza quantitativa, de tipologia transversal e descritivocorrelacional, com recurso a uma amostra não probabilística por conveniência, constituída por 120 indivíduos, na sua maioria do género feminino (95,8%) e com uma média de idades de 43,21 anos (Dp=10,812 anos). Como instrumento de colheita de dados utilizou-se o inquérito de saúde e trabalho (INSAT), aferido para este domínio de investigação. Resultados: Estes cuidadores formais manifestam défices de saúde com principal relevância para os relacionados com a mobilidade física e dor, quer pela existência de constrangimentos de natureza física e biomecânica, organizacional e psicossocial, bem como de natureza individual. Os problemas de saúde identificados por estes trabalhadores, resultantes das condições e características do trabalho foram: dores de costas (90,8%), dores musculares e articulares (82,5%), varizes (64,2%), dores de cabeça (49,2%) e ansiedade ou irritabilidade (47,5%). Ser do género feminino, ter idade entre os 49-58 anos, ser viúvo ou divorciado, ter doenças crónicas, tomar medicação e efetuar horário diurno, revelaram-se como determinantes percursores das PME assim como, a nível laboral, as características e os constrangimentos organizacionais e relacionais relacionados com o esforço físico, a intensidade e tempo de trabalho, as exigências emocionais, a insuficiência de autonomia e a má qualidade das relações sociais. Conclusão: Estes resultados apontam para a necessidade de desenvolvimento de estratégias preventivas das PME neste grupo profissional, onde é fundamental a intervenção do enfermeiro de reabilitação na implementação de programas de promoção da saúde, gestão do stresse e riscos psicossociais e formação profissional. Palavras-chave: Doenças musculosqueléticas; Enfermagem de Reabilitação; Saúde Ocupacional.

Nurse-led group consultation intervention reduces depressive symptoms in men with localised prostate cancer: a cluster randomised controlled trial

BACKGROUND: Radiotherapy for localised prostate cancer has many known and distressing side effects. The efficacy of group interventions for reducing psychological morbidity is lacking. This study investigated the relative benefits of a group nurse-led intervention on psychological morbidity, unmet needs, treatment-related concerns and prostate cancer-specific quality of life in men receiving curative intent radiotherapy for prostate cancer.

METHODS: This phase III, two-arm cluster randomised controlled trial included 331 men (consent rate: 72 %; attrition: 5 %) randomised to the intervention (n = 166) or usual care (n = 165). The intervention comprised four group and one individual consultation all delivered by specialist uro-oncology nurses. Primary outcomes were anxious and depressive symptoms as assessed by the Hospital Anxiety and Depression Scale. Unmet needs were assessed with the Supportive Care Needs Survey-SF34 Revised, treatment-related concerns with the Cancer Treatment Scale and quality of life with the Expanded Prostate Cancer Index -26. Assessments occurred before, at the end of and 6 months post-radiotherapy. Primary outcome analysis was by intention-to-treat and performed by fitting a linear mixed model to each outcome separately using all observed data.

RESULTS: Mixed models analysis indicated that group consultations had a significant beneficial effect on one of two primary endpoints, depressive symptoms (p = 0.009), and one of twelve secondary endpoints, procedural concerns related to cancer treatment (p = 0.049). Group consultations did not have a significant beneficial effect on generalised anxiety, unmet needs and prostate cancer-specific quality of life.

CONCLUSIONS: Compared with individual consultations offered as part of usual care, the intervention provides a means of delivering patient education and is associated with modest reductions in depressive symptoms and procedural concerns. Future work should seek to confirm the clinical feasibility and cost-effectiveness of group interventions.

Prevalencia y factores asociados al síndrome de agotamiento profesional en residentes de diferentes especialidades médicas : una revisión de la literatura de los últimos 15 años

El Síndrome de Agotamiento Profesional (SAP), es común en los trabajadores de la salud, particularmente en los expuestos a altos niveles de estrés en el trabajo e incluye el agotamiento emocional, despersonalización y baja realización personal. Se considera que los médicos residentes presentan una mayor prevalencia del síndrome que los médicos debido a que se encuentran en entrenamiento, período en el cual están sometidos a alta carga laboral debido a las largas horas de trabajo, horarios irregulares, privación de sueño, intensas demandas emocionales, así como la presión de dominar un gran conocimiento clínico. Objetivo. Determinar la prevalencia del Síndrome de Agotamiento Profesional o Burnout en la población de médicos residentes. Metodología. Se realizó una búsqueda de artículos en la base de datos electrónica Pubmed, seleccionando aquellos publicados entre los años 2001 al 2016, tanto en idioma inglés como en español, a texto completo y enfocados en estudios en médicos residentes. Resultados. Los hallazgos sugieren que el Síndrome de Agotamiento Profesional o Burnout es altamente prevalente, que varía de acuerdo a la residencia que se esté realizando, encontrando un promedio del 50% con un rango de 27% a 75% entre las diferentes especialidades de la población estudiada y, en consecuencia, puede constituir un problema de salud que amerita atención en cada Institución, esto a pesar de que la prevalencia pueda variar de un lugar a otro y en las diferentes especialidades. Conclusiones. El SAP o Burnout constituye un problema de salud entre la población de médicos residentes, lo que sugiere la conveniencia de diseñar medidas para su prevención como informar en la inducción al programa de residencia sobre el riesgo de la aparición del síndrome y sus síntomas, consultar tempranamente ante signos de alarma, adecuar el sistema de vigilancia epidemiológica para que incluya esta condición específica y ajustar o disminuir la carga laboral entre otras.