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1.
Psychotherapy (Chic) ; 61(2): 151-160, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38497724

RESUMO

The tripartite model of the therapy relationship, which includes the working alliance, real relationship, and transference-countertransference configuration, has been a useful way to conceptualize the complexity of the connection between a therapist and a client. However, little research has focused on the interrelationships between these three components over time. This study sought to replicate the findings of Bhatia and Gelso (2018) by examining the between-person relationships among each of the three elements averaged across all sessions. Additionally, we extended earlier work by examining the within-person relationship between the working alliance, the real relationship, and transference-countertransference with themselves as well as with each of the other elements across sessions. Using 5,931 sessions across 142 clients and 36 therapists, we examined time-ordered associations among the cocreated working alliance, cocreated real relationship, and the therapist-rated transference-countertransference configuration using latent variable dynamic structural equation modeling. Results replicated the findings of Bhatia and Gelso (2018), demonstrating that in one session, the working alliance and the real relationship were positively related, and both the working alliance and the real relationship were negatively related to the transference-countertransference configuration. Regarding the interrelations over time, the findings revealed that the working alliance in the previous session had a significant and positive relationship with real relationship in the current session, and the real relationship in the previous session was related to reduced transference-countertransference in the current session. These findings provide support for complex interrelations among the components over time. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Contratransferência , Relações Profissional-Paciente , Psicoterapia , Transferência Psicológica , Humanos , Feminino , Adulto , Masculino , Psicoterapia/métodos , Aliança Terapêutica , Modelos Psicológicos , Pessoa de Meia-Idade , Adulto Jovem
2.
Subst Use Misuse ; 59(3): 439-449, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38066682

RESUMO

Objective: "Wine-mom" culture, which promotes the idea that women should use alcohol to cope with the stressors of parenting, is pervasive in modern society, yet remains an under-researched variable in the context of women's alcohol use. The present investigation was a descriptive study and cross-cultural exploration (United States vs. United Kingdom) of the association between wine-mom culture (perceptions of wine-mom culture and related behaviors) and various alcohol-related outcomes, parenting experiences, and drinking motives. Methods: This study included 233 American and 233 British mothers recruited through Prolific. Participants completed the study questions/questionnaires in Qualtrics; they completed nine items measuring their perceptions of and engagement with wine-mom culture, the Alcohol Use Disorders Identification Test, the Parental Stress Scale, and the Drinking Motives Questionnaire-Revised, along with questions about their alcohol use and parenting experiences. Results: Our results indicated that although American mothers were more familiar with wine-mom culture than British mothers, the correlations observed were similar for both groups. Some of the wine-mom culture variables were associated with problematic alcohol use and parenting stress. Additionally, wine-mom culture-related behaviors had moderate to strong positive correlations with drinking to cope motives. Conclusion: Our findings suggest that future research should examine the role of wine-mom culture in the perception that alcohol can-or should-be used as a form of self-medication. Other future directions and considerations for this area of study are discussed.


Assuntos
Alcoolismo , Vinho , Humanos , Feminino , Estados Unidos , Consumo de Bebidas Alcoólicas , Comparação Transcultural , Motivação , Etanol , Adaptação Psicológica
3.
Alcohol ; 113: 49-56, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37558014

RESUMO

OBJECTIVE: In recent years, women have significantly closed the alcohol use gender gap-and they are drinking more heavily now than in previous decades (Keyes et al., 2019). Furthermore, "wine-mom" culture (which promotes the use of alcohol to cope with the stressors of parenthood) has become increasingly prevalent in society and may be a factor in mothers' alcohol use. In the present study, we examined wine-mom-consistent drinking (whether one's alcohol use corresponds to that promoted by wine-mom culture) as a moderator in the relationship between psychosocial predictors (stress, body dissatisfaction) and alcohol-related outcomes (problematic alcohol use, food and alcohol disturbance-FAD). METHODS: Participants were mothers (Mage = 40.18, SD = 8.28) recruited through Prolific from both the United States and the United Kingdom (n = 466; 50 % from the US and UK each); they completed the study via a Qualtrics survey. RESULTS: In the models tested, stress interacted with wine-mom-consistent drinking in predicting FAD (alcohol effects and restriction dimensions), and body dissatisfaction interacted with wine-mom-consistent drinking in predicting the FAD restriction dimension. Compared to those who did not endorse wine-mom-consistent drinking, the relationship between the predictors and the FAD dimensions was stronger among participants who endorsed wine-mom-consistent drinking. Body dissatisfaction and wine-mom-consistent drinking also emerged as significant independent predictors in some of the models. CONCLUSION: Wine-mom-consistent drinking is associated with problematic alcohol use and FAD among mothers. Further research is needed to better understand wine-mom culture and related psychosocial factors in mothers' drinking motives and behaviors.


Assuntos
Insatisfação Corporal , Vinho , Humanos , Feminino , Estados Unidos , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Mães , Motivação
4.
J Am Coll Health ; : 1-9, 2023 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-37167584

RESUMO

Objective: The aim of the present study was to examine the role of health locus of control (HLOC; internal, chance, powerful others) in antibiotic resistance perceptions and antibiotic use behaviors among college students. Participants: Participants were 366 students recruited from the introductory psychology pool at a university in the northeastern United States. Methods: Participants completed the study via Qualtrics in 2015 (October-December). They completed the Multidimensional Health Locus of Control Scale (measuring internal, chance, powerful others HLOC) and questions about their antibiotic use and antibiotic resistance perceptions. Results: Linear regression analyses were employed to examine the role of the HLOC in antibiotic use behaviors and antibiotic resistance perceptions. With the exception of the regression with antibiotic resistance concern as an outcome, powerful others HLOC was the strongest predictor across all models. Conclusions: Antibiotic misuse was prevalent in our sample and powerful others HLOC was associated with problematic antibiotic use.

5.
Chronic Illn ; 18(2): 426-438, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-33377395

RESUMO

OBJECTIVE: The aim of the present study was to examine illness perceptions and coping in relation to the health-related quality of life (HRQOL) among individuals experiencing chronic Lyme disease (CLD). METHODS: Participants were 82 individuals who had a confirmed diagnosis of Lyme disease and had been experiencing symptoms for 6 months or more. They were recruited through various online mechanisms (e.g., social media, online support groups), and they completed the consent form and questionnaires via Qualtrics. Participants completed questions about their demographics and health status as well as the Illness Perception Questionnaire-Revised (Moss-Morris et al., 2002), the Brief COPE (Carver, 1997), and the 36-item Short Form Health Survey (SF-36; Ware & Sherbourne, 1992). RESULTS: Illness perceptions and coping explained a significant amount of variance in HRQOL. Among the illness perceptions, the consequences and identity dimensions were most strongly associated with HRQOL. Behavioral disengagement and substance use were the coping strategies most strongly associated with the emotional health outcomes. DISCUSSION: Illness perceptions and coping are related to HRQOL among individuals with CLD. Given the increase in Lyme disease incidence and the chronicity of symptoms in some cases, it is critical to continue to examine the psychosocial factors associated with HRQOL in this population.


Assuntos
Síndrome Pós-Lyme , Qualidade de Vida , Adaptação Psicológica , Nível de Saúde , Humanos , Percepção , Qualidade de Vida/psicologia , Inquéritos e Questionários
6.
Addict Behav ; 124: 107107, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34530208

RESUMO

Drunkorexia is a behavior pattern marked by calorie restriction and/or compensation in relation to alcohol consumption. The aim of the present study was to examine the role of social norms (descriptive, injunctive) and social comparison orientation (SCO; global, alcohol-specific, eating disorder-related) in drunkorexia engagement. Specifically, our research aimed to examine a possible interaction between norms and SCO; we hypothesized that the relationship between social norms and drunkorexia would be moderated by SCO in that the relationship would be stronger among those elevated on SCO. Data were collected from an undergraduate sample (n = 501); participants completed the consent form and questions/questionnaires via Qualtrics. The results indicated that the predictor variables examined were correlated with overall drunkorexia engagement. In the regression models, in terms of main effects, eating disorder-related SCO emerged as the strongest predictor of the drunkorexia dimensions as well as overall drunkorexia engagement. Descriptive norms emerged as the second strongest predictor in the models. Only one interaction was identified; eating disorder-related SCO moderated the relationship between descriptive norms and the bulimia drunkorexia dimension. The simple slopes analysis indicated that descriptive norms was positively predictive of the bulimia drunkorexia dimension only among individuals with average or elevated eating disorder-related SCO. Social comparisons made regarding one's body, eating, or exercise (eating disorder-related) and social norms are potentially important targets for drunkorexia prevention and/or intervention programs. Further research is needed to better understand risk factors for drunkorexia engagement in the college population.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Normas Sociais , Consumo de Bebidas Alcoólicas , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Humanos , Comparação Social , Estudantes , Universidades
7.
J Clin Psychol Med Settings ; 29(1): 195-205, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34114151

RESUMO

The aim of the present study was to examine the role of self-perceived burden, social support seeking, and social network diversity in loneliness and psychological distress among women with ovarian cancer. A cross-sectional design was employed whereby 130 women diagnosed with ovarian cancer, recruited through various online sources (e.g., social media), completed the study via Qualtrics. Participants completed questionnaires that assessed self-perceived burden, social support seeking, social network diversity, loneliness, and psychological distress (anxiety, depressive symptoms). The models examined indicated that there were indirect effects of self-perceived burden and social network diversity on psychological distress via loneliness. Social support seeking was not significant in the models. Loneliness, self-perceived burden, and social network diversity should be of clinical concern among those working to support women with ovarian cancer. Future studies on longitudinal patterns or examining other factors associated with loneliness are needed to better understand the mental health of women with ovarian cancer.


Assuntos
Neoplasias Ovarianas , Angústia Psicológica , Estudos Transversais , Feminino , Humanos , Solidão/psicologia , Masculino , Neoplasias Ovarianas/complicações , Neoplasias Ovarianas/psicologia , Rede Social , Apoio Social
8.
Mol Biol Rep ; 49(1): 839-845, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34739689

RESUMO

BACKGROUND: The establishment of non-native populations of threatened and legally protected species can have many implications for the areas where these species have been introduced. Non-native populations of threatened species have the potential to be exploited and therefore the subject of legal protection, while conversely, if they have become invasive in their introduced range, there is the likelihood that population control will be carried out to reduce abundance and negative impacts associated with introduced species. From both a legal and invasive species monitoring standpoint, it is important to know how many individuals are present. METHODS AND RESULTS: Short tandem repeats (STRs) were developed for the hog deer, an endangered species that was introduced following European settlement to Victoria, Australia using Illumina MiSeq sequencing technology. These markers were combined with previous STRs characterised for hog deer to create a 29-plex identification system. A total of 224 samples were genotyped across the population in Victoria, and further analyses of null allele frequencies, deviation from Hardy-Weinberg equilibrium, and the removal of monomorphic or low amplifying markers resulted in a final marker panel of 15 loci. Despite low values for number of alleles at each locus (2-4), probability of identity showed sufficient discrimination power, with an average probability of identity at 2.94 × 10-6, and a probability of sibling identity of 8.9 × 10-4 across all sites. CONCLUSIONS: It is feasible to create an informative DNA profiling system that can distinguish between individuals for applications in both wildlife forensic and population control research.


Assuntos
Impressões Digitais de DNA/métodos , Cervos/genética , Espécies em Perigo de Extinção , Genética Populacional/métodos , Repetições de Microssatélites/genética , Polimorfismo de Nucleotídeo Único , Alelos , Animais , Austrália , Feminino , Frequência do Gene , Loci Gênicos , Genótipo , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Masculino , Reação em Cadeia da Polimerase/métodos , Análise de Sequência de DNA/métodos
10.
J Psychosoc Oncol ; 39(3): 399-415, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33559539

RESUMO

PURPOSE: Our research aimed to examine the role of intolerance of uncertainty (IU) in psychological distress (PD) among women with ovarian cancer. Fear of COVID-19 (FCOV) was examined as a mediator, and participant health status and the reopening status of their geographic region were examined as moderators. DESIGN: A cross-sectional quantitative design was employed. PARTICIPANTS: Participants (n = 100) were recruited through various online sources and completed the study via Qualtrics. METHODS: Moderated mediation models and post-hoc linear regression analyses were used to determine the role of predictor variables in PD. RESULTS: No significant moderators or mediators were found. Despite a strong correlation between FCOV and IU, both variables explained unique variance in the anxiety and stress models, while FCOV was not significant in the depressive symptoms model. IMPLICATIONS FOR PROVIDERS: Both IU and FCOV should be considered in helping women with ovarian cancer manage their PD during the COVID-19 pandemic.


Assuntos
COVID-19 , Controle de Doenças Transmissíveis , Medo/psicologia , Nível de Saúde , Neoplasias Ovarianas/psicologia , Angústia Psicológica , Incerteza , Adulto , Idoso , Estudos Transversais , Autoavaliação Diagnóstica , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem
11.
Eat Behav ; 41: 101480, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33631489

RESUMO

The aim of the present study was to examine the relationship between fit ideal internalization and drunkorexia engagement in women. Specifically, in line with the Tripartite Influence Model, we examined the indirect effect of fit ideal internalization on drunkorexia through eating disorder-related social comparison orientation and body dissatisfaction. Data were collected from two samples of women-college undergraduate students (n = 198) and women recruited through Amazon Mechanical Turk (n = 324)-in order to test the model across the two groups. All participants completed the consent forms and then questionnaires via Qualtrics between March and June 2020. The results suggest that fit ideal internalization, body dissatisfaction, and eating disorder-related social comparison orientation are linked to drunkorexia. More specifically, multigroup path analyses indicated that there was an indirect effect of fit ideal internalization on drunkorexia via eating disorder-related social comparison orientation but not through body dissatisfaction. In examining the role of different types of eating disorder-related social comparison orientation (body, eating, exercise) in the model, more nuanced patterns emerged across the samples. Future research examining potential mediators and moderators of the relationship between eating disorder-related social comparison orientation and drunkorexia would be beneficial in expanding this area of study.


Assuntos
Insatisfação Corporal , Transtornos da Alimentação e da Ingestão de Alimentos , Imagem Corporal , Feminino , Humanos , Comparação Social , Estudantes , Inquéritos e Questionários
12.
Artigo em Inglês | MEDLINE | ID: mdl-32968488

RESUMO

BACKGROUND: The fungal pathogen Zymoseptoria tritici is a significant constraint to wheat production in temperate cropping regions around the world. Despite its agronomic impacts, the mechanisms allowing the pathogen to asymptomatically invade and grow in the apoplast of wheat leaves before causing extensive host cell death remain elusive. Given recent evidence of extracellular vesicles (EVs)-secreted, membrane-bound nanoparticles containing molecular cargo-being implicated in extracellular communication between plants and fungal pathogen, we have initiated an in vitro investigation of EVs from this apoplastic fungal wheat pathogen. We aimed to isolate EVs from Z. tritici broth cultures and examine their protein composition in relation to the soluble protein in the culture filtrate and to existing fungal EV proteomes. RESULTS: Zymoseptoria tritici EVs were isolated from broth culture filtrates using differential ultracentrifugation (DUC) and examined with transmission electron microscopy (TEM) and nanoparticle tracking analysis (NTA). Z. tritici EVs were observed as a heterogeneous population of particles, with most between 50 and 250 nm. These particles were found in abundance in the culture filtrates of viable Z. tritici cultures, but not heat-killed cultures incubated for an equivalent time and of comparable biomass. Bottom-up proteomic analysis using LC-MS/MS, followed by stringent filtering revealed 240 Z. tritici EV proteins. These proteins were distinct from soluble proteins identified in Z. tritici culture filtrates, but were similar to proteins identified in EVs from other fungi, based on sequence similarity analyses. Notably, a putative marker protein recently identified in Candida albicans EVs was also consistently detected in Z. tritici EVs. CONCLUSION: We have shown EVs can be isolated from the devastating fungal wheat pathogen Z. tritici and are similar to protein composition to previously characterised fungal EVs. EVs from human pathogenic fungi are implicated in virulence, but the role of EVs in the interaction of phytopathogenic fungi and their hosts is unknown. These in vitro analyses provide a basis for expanding investigations of Z. tritici EVs in planta, to examine their involvement in the infection process of this apoplastic wheat pathogen and more broadly, advance understanding of noncanonical secretion in filamentous plant pathogens.

13.
Eat Weight Disord ; 25(6): 1507-1513, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31587177

RESUMO

PURPOSE: The purpose of the present study was to examine the role of body esteem (BE), sensation seeking (SS), and their interaction in drunkorexia, a behavior pattern marked by calorie restriction/compensation in the context of alcohol consumption. While previous research on drunkorexia has focused on a range of variables, the present study examined two novel variables and their potential interaction: body esteem (weight, appearance) and sensation seeking. METHODS: A sample of college students (n =488) completed the Body Esteem Scale for Adolescents and Adults, the Brief Sensation Seeking Scale, and the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale, which measures overall drunkorexia engagement as well as four dimensions: alcohol effects, bulimia, dietary restraint and exercise, and restriction. RESULTS: Moderated linear regression analyses indicated that SS and BE (weight, appearance) did not interact in predicting drunkorexia. Rather, only main effects were observed; SS, weight esteem (WE), and appearance esteem (AE) were significant in predicting overall drunkorexia engagement. In terms of the drunkorexia dimensions, AE was a significant predictor in the alcohol effects, dietary restraint and exercise, and restriction models. WE was significant in the dietary restraint and exercise model as well as the restriction model. SS was a significant predictor across all drunkorexia dimensions. CONCLUSIONS: Our findings suggest that both elevated SS and lowered BE are associated with drunkorexia engagement. Implications for practice are discussed. Drunkorexia is a complex and multifaceted behavior pattern; therefore, further research is needed in this area of study. LEVEL OF EVIDENCE: Level V (descriptive study).


Assuntos
Consumo de Bebidas Alcoólicas , Estudantes , Adolescente , Adulto , Restrição Calórica , Exercício Físico , Humanos , Sensação
14.
Ecol Evol ; 9(18): 10828-10842, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31624584

RESUMO

In Australia, many species have been introduced that have since undergone drastic declines in their native range. One species of note is the hog deer (Axis porcinus) which was introduced in the 1860s to Victoria, Australia, and has since become endangered in its native range throughout South-East Asia. There is increased interest in using non-native populations as a source for genetic rescue; however, considerations need to be made of the genetic suitability of the non-native population. Three mitochondrial markers and two nuclear markers were sequenced to assess the genetic variation of the Victorian population of hog deer, which identified that the Victorian population has hybrid origins with the closely related chital (Axis axis), a species that is no longer present in the wild in Victoria. In addition, the mitochondrial D-loop region within the Victorian hog deer is monomorphic, demonstrating that mitochondrial genetic diversity is very low within this population. This study is the first to report of long-term persistence of hog deer and chital hybrids in a wild setting, and the continual survival of this population suggests that hybrids of these two species are fertile. Despite the newly discovered hybrid status in Victorian hog deer, this population may still be beneficial for future translocations within the native range. However, more in-depth analysis of genetic diversity within the Victorian hog deer population and investigation of hybridization rates within the native range are necessary before translocations are attempted.

15.
mBio ; 10(5)2019 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-31506307

RESUMO

Most known examples of horizontal gene transfer (HGT) between eukaryotes are ancient. These events are identified primarily using phylogenetic methods on coding regions alone. Only rarely are there examples of HGT where noncoding DNA is also reported. The gene encoding the wheat virulence protein ToxA and the surrounding 14 kb is one of these rare examples. ToxA has been horizontally transferred between three fungal wheat pathogens (Parastagonospora nodorum, Pyrenophora tritici-repentis, and Bipolaris sorokiniana) as part of a conserved ∼14 kb element which contains coding and noncoding regions. Here we used long-read sequencing to define the extent of HGT between these three fungal species. Construction of near-chromosomal-level assemblies enabled identification of terminal inverted repeats on either end of the 14 kb region, typical of a type II DNA transposon. This is the first description of ToxA with complete transposon features, which we call ToxhAT. In all three species, ToxhAT resides in a large (140-to-250 kb) transposon-rich genomic island which is absent in isolates that do not carry the gene (annotated here as toxa- ). We demonstrate that the horizontal transfer of ToxhAT between P. tritici-repentis and P. nodorum occurred as part of a large (∼80 kb) HGT which is now undergoing extensive decay. In B. sorokiniana, in contrast, ToxhAT and its resident genomic island are mobile within the genome. Together, these data provide insight into the noncoding regions that facilitate HGT between eukaryotes and into the genomic processes which mask the extent of HGT between these species.IMPORTANCE This work dissects the tripartite horizontal transfer of ToxA, a gene that has a direct negative impact on global wheat yields. Defining the extent of horizontally transferred DNA is important because it can provide clues to the mechanisms that facilitate HGT. Our analysis of ToxA and its surrounding 14 kb suggests that this gene was horizontally transferred in two independent events, with one event likely facilitated by a type II DNA transposon. These horizontal transfer events are now in various processes of decay in each species due to the repeated insertion of new transposons and subsequent rounds of targeted mutation by a fungal genome defense mechanism known as repeat induced point mutation. This work highlights the role that HGT plays in the evolution of host adaptation in eukaryotic pathogens. It also increases the growing body of evidence indicating that transposons facilitate adaptive HGT events between fungi present in similar environments and hosts.


Assuntos
Ascomicetos/genética , Elementos de DNA Transponíveis/genética , Proteínas Fúngicas/genética , Transferência Genética Horizontal , Micotoxinas/genética , Doenças das Plantas/microbiologia , Triticum/microbiologia , Sequência de Bases , Evolução Molecular , Interações Hospedeiro-Patógeno/genética , Alinhamento de Sequência , Virulência/genética
16.
J Psychopathol Behav Assess ; 41(1): 144-159, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31289422

RESUMO

Deficits in a range of skill domains (including executive functioning, emotion regulation, social cognition and language/communication) are associated with disrupted youth behavior and functioning across mental health diagnoses. The identification of skill deficits are important for effective treatment planning, particularly for personalized interventions. While there are multiple ways to assess these skills, parent/caregiver reports represent an important information source. To date, no single, brief measure has been developed that gathers parent/caregiver ratings across this range of constructs. We have developed a short caregiver-report questionnaire (the Thinking Skills Inventory; TSI), to screen for skill deficits. Here, we examine the reliability and validity of this rating scale in 384 youth who were consecutively referred for neuropsychiatric evaluation. A primary caregiver completed the TSI as well as other established measures. Exploratory and confirmatory factor analyses support five subscales on the TSI: Attention and Working Memory, Language and Communication, Emotion Regulation, Cognitive Flexibility, and Social Thinking Skills. The subscales showed moderate to high internal consistency (Cronbach's alphas range from 0.84 to 0.91). Correlations with established caregiver-report measures confirm their convergent and discriminant validity, and associations with multiple clinical diagnoses and cross-diagnostic aggressive behavior further support the utility of the scale for our intended purpose. In sum, this free, brief measure is a valid and reliable way to identify variation in skill domains relevant to a range of psychopathology. The TSI may be useful in youth mental health settings to assist with treatment planning and to inform referral for further evaluation.

17.
J Fam Psychol ; 33(6): 629-639, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31169392

RESUMO

The present study investigated relations among various aspects of economic adversity and cortisol levels for young children facing economic hardship. Specifically, the study examined relations to cortisol for variables representing family income, material hardship, financial strain, economic instability, and household chaos. Participants were 374 children, ages 3-5 years, who attended a Head Start preschool, as well as their primary caregivers. Nearly all children lived in households classified as poor or low-income, defined as less than two times the federal poverty threshold. Caregivers completed interviews about family demographics and economic adversity at the beginning of the school year. Child salivary cortisol was sampled in duplicate on two weekday mornings at the end of the school year. We hypothesized that economic instability would show direct statistical effects on child cortisol as well as indirect effects via household chaos. A structural equation model that corresponded to this hypothesis showed adequate fit for the sample data and revealed a statistically significant indirect effect of economic adversity on child cortisol via economic instability and household chaos, as well as statistically significant direct effects of economic instability and chaos on child cortisol, and a significant indirect effect of economic instability on cortisol via household chaos. Implications concern understanding mechanisms of poverty risk, including the impact of instability and chaos on stress physiology, and promoting physiological regulation for children facing economic hardship. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Hidrocortisona/metabolismo , Pobreza/psicologia , Meio Social , Adulto , Cuidadores , Pré-Escolar , Família , Características da Família , Feminino , Humanos , Entrevistas como Assunto , Masculino , Philadelphia , Pobreza/estatística & dados numéricos
18.
J Oncol Pract ; 15(7): e628-e635, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31162998

RESUMO

PURPOSE: The cost of cancer care is escalating dramatically, in part because of the rising expense of systemic cancer therapy. This creates financial dilemmas for patients and insurers and potential economic disruption for institutions attempting to provide cancer care to the underserved. Our institution initiated a drug recovery and copay assistance program (DRCAP) to mitigate the impact of the rising cost of parenteral medications. METHODS: We performed a 3-year review of our strategies to mitigate financial burden of parenteral therapeutics and supportive care medicines. Financial metrics were established and analyzed before and after implementing DRCAP. Medication encounters and associated costs were stratified by adolescents and young adults (15 to 39 years of age), and adults 40 years of age and older and were annualized from 2016 to 2018. RESULTS: The DRCAP resulted in a total of nearly $3.5 million worth of drugs replaced or copay assistance yearly in 2017 and 2018. This accounted for approximately 10% of our pharmacy budget for parenteral medications in each of these years. The vast majority was received in the form of drug replacement. The DRCAP resulted in assistance to 173 and 256 patients in 2017 and 2018, respectively. CONCLUSION: A DRCAP increased availability of otherwise unaffordable parenteral oncolytics and resulted in cost savings for our institution. Adolescents and young adults were disproportionately represented because of inadequate or no insurance. Despite the salutary benefits, such programs likely inflate the overall cost of cancer care. Cancer care providers participating in a DRCAP will remain in this conundrum until market forces can affect the cost of oncology therapeutics.


Assuntos
Antineoplásicos/economia , Custos de Medicamentos , Neoplasias/economia , Institutos de Câncer/economia , Redução de Custos , Humanos , Infusões Parenterais , Assistência Médica , Neoplasias/tratamento farmacológico , South Carolina
19.
Psychooncology ; 28(3): 553-560, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30614141

RESUMO

OBJECTIVE: Intolerance of uncertainty (IU) is a trait variable that captures an individual's lack of tolerance for unknown outcomes and events. Positive correlations between IU and mental health symptoms have been observed in various populations, while social variables (social support and decreased loneliness) seem to serve as protective factors against psychological distress among individuals with cancer. The present study examined the moderation effect of social support and loneliness in the relationship between IU and mental health symptoms among women diagnosed with ovarian cancer. METHODS: This study was a cross-sectional design involving 131 women diagnosed with ovarian cancer recruited through social media and other online sources. Participants completed questionnaires that assessed their IU (prospective and inhibitory), anxiety symptoms, depressive symptoms, social support, and loneliness. Moderated regression analyses were applied to test the hypothesis that low social support and high loneliness would exacerbate the relationship between IU and symptoms of anxiety and depression. RESULTS: The hypothesized moderation effects (social support × IU, loneliness × IU) were not supported in the anxiety and depressive symptoms models. Post hoc linear regression analyses indicated that IU and loneliness were predictive of depressive and anxiety symptoms. Loneliness was the strongest predictor in both the anxiety and depressive symptoms models, followed by IU. CONCLUSIONS: The findings indicate that loneliness and IU-particularly inhibitory IU-are important considerations in understanding mental health symptoms among women diagnosed with ovarian cancer. Addressing both loneliness and IU may be an important avenue in clinical settings.


Assuntos
Ansiedade/psicologia , Depressão/psicologia , Solidão/psicologia , Neoplasias Ovarianas/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Relações Interpessoais , Masculino , Saúde Mental , Pessoa de Meia-Idade , Estudos Prospectivos , Apoio Social , Inquéritos e Questionários , Incerteza
20.
Med Sci Educ ; 29(2): 475-487, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34457504

RESUMO

OBJECTIVE: This study compares data from two medical student cohorts early in their training from New Zealand and Hong Kong and then makes further comparisons with a non-medical group. METHODS: Questionnaires obtained information regarding educational site (universities situated in New Zealand, Hong Kong, and USA), gender, age, motivational beliefs, quality of life, and competitiveness. The study was split into two phases. The first phase focused on measuring and comparing the learning and wellbeing variables of two medical student cohorts. The second phase focussed on making further comparisons with non-medical student groups. RESULTS: Responses were elicited from 353 students in medically oriented courses and 688 students with a non-medical orientation. For phase 1, the results indicated differences between the two medical student groups on measures of self-efficacy, intrinsic value, enjoyment of competition, and physical quality of life. For phase 2, differences between the medical and non-medical student groups were noted for self-efficacy, intrinsic value, enjoyment of competition, contentiousness, and physical and social quality of life. CONCLUSIONS: The results provide insights into medical and non-medical students' learning and wellbeing experiences from multi-national, multi-discipline perspectives. The results suggest that wellbeing issues of students are likely context-specific and moderated by region, curriculum, gender, and culture.

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