901 resultados para Psychological factors
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OBJECTIVE: Psychological states relate to changes in circulating immune cells, but associations with immune cells in peripheral tissues such as macrophages have hardly been investigated. Here, we aimed to implement and validate a method for measuring the microbicidal potential of ex vivo isolated human monocyte-derived macrophages (HMDMs) as an indicator of macrophage activation. METHODS: The method was implemented and validated for two blood sampling procedures (short-term cannula insertion versus long-term catheter insertion) in 79 participants (34 women, 45 men) aged between 18 and 75 years. The method principle is based on the reduction of 2-(4-iodophenyl)-3-(4-nitrophenyl)-5-(2,4-dis-ulfophenyl)-2H-tetrazolium, monosodium salt (WST-1) by superoxide anions, the first in a series of pathogen-killing reactive oxygen species produced by phorbol myristate acetate-activated HMDM. Cytochrome c reduction and current generation were measured as reference methods for validation purposes. We further evaluated whether depressive symptom severity (Beck Depression Inventory) and chronic stress (Chronic Stress Screening Scale) were associated with macrophage microbicidal potential. RESULTS: The assay induced superoxide anion responses by HMDM in all participants. Assay results depended on blood sampling procedure (cannula versus catheter insertion). Interassay variability as a measure for assay reliability was 10.92% or less. WST-1 reduction scores correlated strongly with results obtained by reference methods (cytochrome c: r = 0.57, p = .026; current generation: r values ≥ 0.47, p values <.033) and with psychological factors (depressive symptom severity: r = 0.35 [cannula insertion] versus r = -0.54 [catheter insertion]; chronic stress: r = 0.36 [cannula insertion]; p values ≤ .047). CONCLUSIONS: Our findings suggest that the implemented in vitro method investigates microbicidal potential of HMDM in a manner that is valid and sensitive to psychological measures.
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BACKGROUND Psoriatic arthritis (PsA) and co-morbidities of psoriasis represent a significant clinical and economic burden for patients with moderate-to-severe psoriasis. Often these co-morbidities may go unrecognized or undertreated. While published data are available on the incidence and impact of some of them, practical guidance for dermatologists on detection and management of these co-morbidities is lacking. OBJECTIVE To prepare expert recommendations to improve the detection and management of common co-morbidities in patients with moderate-to-severe psoriasis. METHODS A systematic literature review was conducted on some common co-morbidities of psoriasis-cardiovascular (CV) diseases (including obesity, hypertension, hyperglycaemia and dyslipidaemia), psychological co-morbidities (including depression, alcohol abuse and smoking) and PsA-to establish the incidence and impact of each. Data gaps were identified and a Delphi survey was carried out to obtain consensus on the detection and management of each co-morbidity. The expert panel members for the Delphi survey comprised 10 dermatologists with substantial clinical expertise in managing moderate-to-severe psoriasis patients, as well as a cardiologist and a psychologist (see appendix) with an interest in dermatology. Agreement was defined using a Likert scale of 1-7. Consensus regarding agreement for each statement was defined as ≥75% of respondents scoring either 1 (strongly agree) or 2 (agree). RESULTS The expert panel members addressed several topics including screening, intervention, monitoring frequency, and the effects of anti-psoriatic treatment on each co-morbidity. Consensus was achieved on 12 statements out of 22 (3 relating to PsA, 4 relating to psychological factors, 5 relating to CV factors). The panel members felt that dermatologists have an important role in screening their psoriasis patients for PsA and in assessing them for psychological and CV co-morbidities. In most cases, however, patients should be referred for specialist management if other co-morbidities are detected. CONCLUSION This article provides useful and practical guidance for the detection and management of common co-morbidities in patients with moderate-to-severe psoriasis.
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There is growing evidence for the development of posttraumatic stress symptoms as a consequence of acute cardiac events. Acute coronary syndrome (ACS) patients experience a range of acute cardiac symptoms, and these may cluster together in specific patterns. The objectives of this study were to establish distinct symptom clusters in ACS patients, and to investigate whether the experience of different types of symptom clusters are associated with posttraumatic symptom intensity at six months. ACS patients were interviewed in hospital within 48 h of admission, 294 patients provided information on symptoms before hospitalisation, and cluster analysis was used to identify patterns. Posttraumatic stress symptoms were assessed in 156 patients at six months. Three symptom clusters were identified; pain symptoms, diffuse symptoms and symptoms of dyspnea. In multiple regression analyses, adjusting for sociodemographic, clinical and psychological factors, the pain symptoms cluster (β = .153, P = .044) emerged as a significant predictor of posttraumatic symptom severity at six months. A marginally significant association was observed between symptoms of dyspnea and reduced intrusive symptoms at six months (β = -.156, P = .061). Findings suggest acute ACS symptoms occur in distinct clusters, which may have distinctive effects on intensity of subsequent posttraumatic symptoms. Since posttraumatic stress is associated with adverse outcomes, identifying patients at risk based on their symptom experience during ACS may be useful in targeting interventions.
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Psychological and social factors have a deep impact on the treatment of HIV-infection, from the readiness to start antiretroviral therapy to treatment adherence over time. Among psychological factors, anxiety may affect HIV-infected persons in all stages of disease, from the disclosure of HIV diagnosis to the decision to start and maintain treatment. This is a lifelong challenge for both patients and doctors. Psychiatric comorbidities (depression, addiction) may enhance negative psychological effects of HIV. Among social factors, stigma and discrimination may occur in families and at work, leading to a loss of social support resulting in isolation and poverty. This may prevent HIV-positive individuals from seeking medical care. These aspects are particularly important in some groups of patients as injecting drug users and migrants. Acknowledgment and consideration of psychosocial factors are therefore essential for the long term success of antiretroviral therapy.
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Introduction According to Lent and Lopez’ (2002) tripartite view of efficacy beliefs, members of a team form beliefs about the efficacy of their team partners. This other-efficacy belief can influence individual performance as shown by Dunlop, Beatty, and Beauchamp (2011) in their experimental study using manipulated performance feedback to alter other-efficacy beliefs. Participants holding favorable other-efficacy beliefs outperformed those with lower other--‐efficacy beliefs. Antecedents of such other-efficacy beliefs are amongst others perceptions regarding motivation and psychological factors of the partner (Jackson, Knapp, & Beauchamp, 2008). Overt self-talk could be interpreted as the manifestation of such motivational or psychological factors. In line with this assumption, in an experimental study using dubbed videos of the same segment of a tennis match, Van Raalte, Brewer, Cornelius, and Petitpas (2006) found that players were perceived more favorably (e.g., more concentrated, and of higher ability levels) when shown with dubbed positive self-talk as compared to dubbed negative or no dubbed self--‐talk. Objectives The aim of the study was to examine the possible effects of a confederate’s overt self-talk on participants’ other-efficacy beliefs and performance in a team setting. Method In a laboratory experiment (between-subjects, pre-post-test design, matched by pretest performance) 89 undergraduate students (female = 35, M = 20.81 years, SD = 2.34) participated in a golf putting task together with a confederate (same gender groups). Depending on the experimental condition (positive, negative, or no self-talk), the confederate commented his or her putts according to a self-talk script. Bogus performance feedback assured that the performance of the confederate was held constant. Performance was measured as the distance to the center of the target, other-efficacy by a questionnaire. Results The data collection has just finished and the results of repeated measures analyses of variance will be presented and discussed at the congress. We expect to find higher other-efficacy beliefs and better individual performance in the positive self-talk condition. References Dunlop, W.L., Beatty, D.J., & Beauchamp, M.R. (2011). Examining the influence of other-efficacy and self-efficacy on personal performance. Journal of Sport & Exercise Psychology, 33, 586-593. Jackson, B., Knapp, P., & Beauchamp, M.R. (2008). Origins and consequences of tripartite efficacy beliefs within elite athlete dyads. Journal of Sport and Exercise Psychology, 30, 512-540. Lent, R.W., & Lopez, F.G. (2002). Cognitive ties that bind: A tripartite view of efficacy beliefs in growth--‐promoting relationships. Journal of Social and Clinical Psychology, 21, 256-286. Van Raalte, J.L., Brewer, B.W, Cornelius, A.E., & Petitpas, A.J. (2006). Self-presentational effects of self-talk on perceptions of tennis players. Hellenic Journal of Psychology, 3, 134-149.
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Cette contribution analyse les contraintes et opportunités issus de la transition entre l’école obligatoire et la formation professionnelle en Suisse. L’ambition est de montrer que des facteurs psychologiques et structuraux sont essentiels pour comprendre les inégalités observées lors de cette transition. Les résultats de différentes études empiriques montrent que des facteurs associés à la personnalité, au support social, et à l’engagement personnel dans la préparation au choix de carrière ont une incidence sur les différences interindividuelles en termes d’adaptabilité de carrière et de congruence du choix professionnel tel qu’observés avant la transition. Les implications pour la pratique dans le domaine du conseil en orientation seront présentées.
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So far, most research attempts to explain the mechanism of the action of acupuncture have focused mostly on mechanically-triggered active factors and have produced inconclusive findings. In this study, we investigate whether acupuncture might also involve nonmechanical, nonpsychological active factors originating in the therapist. In 30 individuals, an acupuncture needle was inserted in the acupoint PC6 using a special device without touching the needle. A second device was used to fix the needle rigidly in place, excluding any mechanical transmission of movement from the handle to the needle's tip. Each participant was exposed in random order to a control and a stimulation phase. During the stimulation phase, the free needle's end was held by the therapist to allow the transmission of Qi; during the control phase, it was left untouched. Participants' subjective sensations during the stimulation phase and the control phase were recorded using a questionnaire. Twenty-two of 28 (79%; p = 0.003) test participants believed that they had received stimulation when it had actually been performed, and 26 (93%; p < 0.001) sensed differences between the two experimental phases. Thus, participants were able to sense the transmission of therapeutic Qi in the absence of mechanical or psychological factors.
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This research investigated how an individual’s endorsements of mitigation and adaptation relate to each other, and how well each of these can be accounted for by relevant social psychological factors. Based on survey data from two European convenience samples (N = 616 / 309) we found that public endorsements of mitigation and adaptation are strongly associated: Someone who is willing to reduce greenhouse gas emissions (mitigation) is also willing to prepare for climate change impacts (adaptation). Moreover, people endorsed the two response strategies for similar reasons: People who believe that climate change is real and dangerous, who have positive attitudes about protecting the environment and the climate, and who perceive climate change as a risk, are willing to respond to climate change. Furthermore, distinguishing between (spatially) proximal and distant risk perceptions suggested that the idea of portraying climate change as a proximal (i.e., local) threat might indeed be effective in promoting personal actions. However, to gain endorsement of broader societal initiatives such as policy support, it seems advisable to turn to the distant risks of climate change. The notion that “localising” climate change might not be the panacea for engaging people in this domain is discussed in regard to previous theory and research.
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BACKGROUND Type D personality (Type D) is an independent psychosocial risk factor for poor cardiac prognosis and increased mortality in patients with cardiovascular disease (CVD), but the involved mechanisms are poorly understood. Macrophages play a pivotal role in atherosclerosis, the process underlying coronary artery disease (CAD). We investigated macrophage superoxide anion production in production in CAD patients with and without Type D. METHODS AND RESULTS We studied 20 male CAD patients with Type D (M:66.7±9.9years) and 20 age-matched male CAD patients without Type D (M:67.7±8.5years). Type D was measured using the DS14 questionnaire with the two subscales 'negative affectivity' and 'social inhibition'. We assessed macrophage superoxide anion production using the WST-1 assay. All analyses were controlled for potential confounders. CAD patients with Type D showed higher superoxide anion production compared to CAD patients without Type D (F(1,38)=15.57, p<0.001). Complementary analyses using the Type D subscales 'negative affectivity' and 'social inhibition', and their interaction as continuous measures, showed that both Type D subscales (negative affectivity: (ß=0.48, p=0.002, R(2)=0.227); social inhibition: (ß=0.46, p=0.003, R(2)=0.208)) and their interaction (ß=0.36, p=0.022, R(2)=0.130) were associated with higher WST-1 reduction scores. Results remained significant when controlling for classical CVD risk factors (i.e. body mass index, mean arterial blood pressure), atherosclerosis severity (i.e. intima media thickness, presence of carotid plaques), and psychological factors (depressive symptom severity, chronic stress). CONCLUSIONS Our results indicate higher macrophage superoxide anion production in CAD patients with Type D compared to those without Type D. This may suggest a mechanism contributing to increased morbidity and mortality in CAD patients with Type D.
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The number of breast cancer survivors increases every year, thanks to the development of new treatments and screening techniques. However, patients present with numerous side effects that may affect their quality of life. Exercise has been demostrated to reduce some of these side effects, but in spite of this, few breast cancer patientes know and follow the exercise recommendations needed to remain healthy. In this review, we describe the differente breast cancer treatments and the related side effects and implications of exercise in relation to these. We propose that exercise could be and integrative complementary intervention to improve physiological, physical and psychological factors that affect survival and quality of life of these patients. For that reason, the main objective of this review is to provide a general overview of exercise benefits in breast cancer patients and recommendations of how to design exercise interventions in patients with different side effects.
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La agricultura es uno de los sectores más afectados por el cambio climático. A pesar de haber demostrado a lo largo de la historia una gran capacidad para adaptarse a nuevas situaciones, hoy en día la agricultura se enfrenta a nuevos retos tales como satisfacer un elevado crecimiento en la demanda de alimentos, desarrollar una agricultura sostenible con el medio ambiente y reducir las emisiones de gases de efecto invernadero. El potencial de adaptación debe ser definido en un contexto que incluya el comportamiento humano, ya que éste juega un papel decisivo en la implementación final de las medidas. Por este motivo, y para desarrollar correctamente políticas que busquen influir en el comportamiento de los agricultores para fomentar la adaptación a estas nuevas condiciones, es necesario entender previamente los procesos de toma de decisiones a nivel individual o de explotación, así como los efectos de los factores que determinan las barreras o motivaciones de la implementación de medidas. Esta Tesis doctoral trata de profundizar en el análisis de factores que influyen en la toma de decisiones de los agricultores para adoptar estrategias de adaptación al cambio climático. Este trabajo revisa la literatura actual y desarrolla un marco metodológico a nivel local y regional. Dos casos de estudio a nivel local (Doñana, España y Makueni, Kenia) han sido llevados a cabo con el fin de explorar el comportamiento de los agricultores hacia la adaptación. Estos casos de estudio representan regiones con notables diferencias en climatología, impactos del cambio climático, barreras para la adaptación y niveles de desarrollo e influencia de las instituciones públicas y privadas en la agricultura. Mientras el caso de estudio de Doñana representa un ejemplo de problemas asociados al uso y escasez del agua donde se espera que se agraven en el futuro, el caso de estudio de Makueni ejemplifica una zona fuertemente amenazada por las predicciones de cambio climático, donde adicionalmente la falta de infraestructura y la tecnología juegan un papel crucial para la implementación de la adaptación. El caso de estudio a nivel regional trata de generalizar en África el comportamiento de los agricultores sobre la implementación de medidas. El marco metodológico que se ha seguido en este trabajo abarca una amplia gama de enfoques y métodos para la recolección y análisis de datos. Los métodos utilizados para la toma de datos incluyen la implementación de encuestas, entrevistas, talleres con grupos de interés, grupos focales de discusión, revisión de estudios previos y bases de datos públicas. Los métodos analíticos incluyen métodos estadísticos, análisis multi‐criterio para la toma de decisiones, modelos de optimización de uso del suelo y un índice compuesto calculado a través de indicadores. Los métodos estadísticos se han utilizado con el fin de evaluar la influencia de los factores socio‐económicos y psicológicos sobre la adopción de medidas de adaptación. Dentro de estos métodos se incluyen regresiones logísticas, análisis de componentes principales y modelos de ecuaciones estructurales. Mientras que el análisis multi‐criterio se ha utilizado con el fin de evaluar las opciones de adaptación de acuerdo a las opiniones de las diferentes partes interesadas, el modelo de optimización ha tenido como fin analizar la combinación óptima de medidas de adaptación. El índice compuesto se ha utilizado para evaluar a nivel regional la implementación de medidas de adaptación en África. En general, los resultados del estudio ponen de relieve la gran importancia de considerar diferentes escalas espaciales a la hora de evaluar la implementación de medidas de adaptación al cambio climático. El comportamiento de los agricultores es diferente entre lugares considerados a una escala local relativamente pequeña, por lo que la generalización de los patrones del comportamiento a escalas regionales o globales resulta relativamente compleja. Los resultados obtenidos han permitido identificar factores determinantes tanto socioeconómicos como psicológicos y calcular su efecto sobre la adopción de medidas de adaptación. Además han proporcionado una mejor comprensión del distinto papel que desempeñan los cinco tipos de capital (natural, físico, financiero, social y humano) en la implementación de estrategias de adaptación. Con este trabajo se proporciona información de gran interés en los procesos de desarrollo de políticas destinadas a mejorar el apoyo de la sociedad a tomar medidas contra el cambio climático. Por último, en el análisis a nivel regional se desarrolla un índice compuesto que muestra la probabilidad de adoptar medidas de adaptación en las regiones de África y se analizan las causas que determinan dicha probabilidad de adopción de medidas. ABSTRACT Agriculture is and will continue to be one of the sectors most affected by climate change. Despite having demonstrated throughout history a great ability to adapt, agriculture today faces new challenges such as meeting growing food demands, developing sustainable agriculture and reducing greenhouse gas emissions. Adaptation policies planned on global, regional or local scales are ultimately implemented in decision‐making processes at the farm or individual level so adaptation potentials have to be set within the context of individual behaviour and regional institutions. Policy instruments can play a formative role in the adoption of such policies by addressing incentives/disincentives that influence farmer’s behaviour. Hence understanding farm‐level decision‐making processes and the influence of determinants of adoption is crucial when designing policies aimed at fostering adoption. This thesis seeks to analyse the factors that influence decision‐making by farmers in relation to the uptake of adaptation options. This work reviews the current knowledge and develops a methodological framework at local and regional level. Whilst the case studies at the local level are conducted with the purpose of exploring farmer’s behaviour towards adaptation the case study at the regional level attempts to up‐scale and generalise theory on adoption of farmlevel adaptation options. The two case studies at the local level (Doñana, Spain and Makueni, Kenya) encompass areas with different; climates, impacts of climate change, adaptation constraints and limits, levels of development, institutional support for agriculture and influence from public and private institutions. Whilst the Doñana Case Study represents an area plagued with water‐usage issues, set to be aggravated further by climate change, Makueni Case study exemplifies an area decidedly threatened by climate change where a lack of infrastructure and technology plays a crucial role in the uptake of adaptation options. The proposed framework is based on a wide range of approaches for collecting and analysing data. The approaches used for data collection include the implementation of surveys, interviews, stakeholder workshops, focus group discussions, a review of previous case studies, and public databases. The analytical methods include statistical approaches, multi criteria analysis for decision‐making, land use optimisation models, and a composite index based on public databases. Statistical approaches are used to assess the influence of socio‐economic and psychological factors on the adoption or support for adaptation measures. The statistical approaches used are logistic regressions, principal component analysis and structural equation modelling. Whilst a multi criteria analysis approach is used to evaluate adaptation options according to the different perspectives of stakeholders, the optimisation model analyses the optimal combination of adaptation options. The composite index is developed to assess adoption of adaptation measures in Africa. Overall, the results of the study highlight the importance of considering various scales when assessing adoption of adaptation measures to climate change. As farmer’s behaviour varies at a local scale there is elevated complexity when generalising behavioural patterns for farmers at regional or global scales. The results identify and estimate the effect of most relevant socioeconomic and psychological factors that influence adoption of adaptation measures to climate change. They also provide a better understanding of the role of the five types of capital (natural, physical, financial, social, and human) on the uptake of farm‐level adaptation options. These assessments of determinants help to explain adoption of climate change measures and provide helpful information in order to design polices aimed at enhancing societal support for adaptation policies. Finally the analysis at the regional level develops a composite index which suggests the likelihood of the regions in Africa to adopt farm‐level adaptation measures and analyses the main causes of this likelihood of adoption.
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This paper will focus on Leon Tebbetts’ time in the United States Army Air Corps as an artist for Special Services. It will demonstrate how a combination of personal associations and psychological factors, including Hartley’s death, contributed to Tebbetts’ decision to abandon painting, with the result that this World War II muralist has been almost entirely forgotten.
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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014
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Some psychological variables of women seem to be in close relationship with the clinical course of pregnancy and delivery outcome. However, about risk factors for preterm birth, it is necessary to deepen the knowledge of the psychological risk area to enable more effective prevention. Aim: To relate the result of delivery, with regard to gestational age, mode of delivery and infant characteristics with psychological variables assessed during pregnancy, prenatal maternal attachment, psychopathological symptomatology and coping. Methodology: A prospective, descriptive correlational study; participants were 395 women at the second trimester of pregnancy and at postpartum, who attended antenatal clinics at the center of Portugal. The following instruments were used: Clinical Questionnaire about the Result of Delivery; Sociodemographic and Clinical Questionnaire in Pregnancy; Maternal Antenatal Attachment Scale; Brief Symptoms Inventory (BSI); Problems’ Resolution Inventory (PRI). Results: Gestational age and birth weight of the baby, on one side, and variables of prenatal attachment, BSI and PRI, on the other side, did not correlate significantly. The quality of prenatal maternal attachment was higher in women who came to have a delivery by forceps or vacuum extraction, compared with those that had caesarean birth (p = .05). The majority of women had a healthy pregnancy (75.7%). Coping strategies like Interpersonal Sensitivity and Help-seeking seem to influence the occurrence of obstetrical pathology. Women with higher scores on Total Prenatal Attachment and Intensity of Preocupation are more likely to have newborns with health problems. There is an association between clinical variables, the newborn´s health at birth and obstetric pathology of the II and III trimesters. Conclusion: Prenatal psychological factors such as prenatal attachment do not seem to influence the obstetric condition or the result of delivery but appear to play an important role about how pregnant women experience pregnancy and labor.
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In short, the European Union, as we know it, no longer exists. The very foundations on which it was built are eroding. Shared memories of the Second World War have faded away – half the 15- and 16-year-olds in German high schools do not know that Hitler was a dictator, while a third believe that he protected human rights. The collapse of the Soviet Union has stripped away the geopolitical rationale for European unity. The democratic welfare state that was at the heart of the post-war political consensus is under siege by, among other things, sheer demographics. And the prosperity that bolstered the European project’s political legitimacy is vanishing. More than six out of ten Europeans believe that the lives of today’s children will be more difficult than those of people from their own generation. Against this background, how unthinkable is the EU’s disintegration? Should Europeans make the mistake of taking the Union for granted? Should they assume that the Union would not collapse because it should not collapse? Here, Europe’s capacity to learn from the Soviet precedent could play a crucial part. For the very survival of the EU may depend on its leaders’ ability to manage a similar mix of political, economic and psychological factors that were in play in the process of the Soviet collapse. The game of disintegration is primarily a political one driven much more by the perceptions and misperceptions of the political actors than simply by the constellation of the structural factors – institutional and economic.