Search

Abstract: The associations between social support and stress with internalizing symptoms (depressive symptoms and hopelessness) and hazardous drinking were tested in an inpatient sample of suicidal military personnel. Baseline data from a randomized clinical trial were analyzed. Different sources of support and stressors in the social context of military personnel were differentially linked to internalizing symptoms and hazardous drinking. In the full sample ( n = 192), family and nonfamily support were both inversely associated with internalizing symptoms but not hazardous drinking. Family stress was positively associated with internalizing symptoms. In a subsample of service members who had a history of deployment ( n = 98), postdeployment social support was protective against internalizing symptoms, whereas deployment harassment was associated with increased odds of hazardous drinking. Results underscore the need for assessment of various dimensions of social support and stress to guide case formulation and optimize strategies to support patients' mental well-being and adaptive coping., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: To further elucidate the nature of illness in veterans of the 1990 to 1991 Gulf War (GW) by examining the GW Illness (GWI) definition advanced by the Centers for Disease Control and Prevention, which specified caseness as having at least one symptom from two of the three factors: fatigue, mood-cognition, and musculoskeletal., Methods: A total of 311 male and female GW veterans drawn from across the nation were assessed in a survey-based study approximately 10 years after deployment., Results: A total of 33.8% of the probability-weighted sample met GWI criteria. Multiple symptom profiles were found, with more than half of GWI cases endorsing a symptom on all the three factors, and almost all cases endorsing at least one mood-cognition symptom., Conclusion: Although the Centers for Disease Control and Prevention definition has some limitations that should be considered, it remains a useful tool for assessing the presence of illness in GW veterans.

Objective: Veterans can present at nongovernment (Department of Defense, Department of Veterans Affairs) mental health agencies with complex symptom constellations that frequently include posttraumatic stress disorder, depression, and generalized anxiety. To date, no veteran study has validated these measures on a treatment-seeking sample of veterans outside the DoD and VA., Methods: We used a treatment-seeking sample of veterans ( N = 493) to validate measures that assess these constructs (PTSD Checklist 5, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7)., Results: The seven-factor posttraumatic stress disorder hybrid configuration was the best fit. The best fitting model of the depression measure was a two-factor structure, cognitive-affective, and somatic depression. The measure of generalized anxiety was a unidimensional model., Limitations: Follow-up studies should validate these measures on nontreatment-seeking discharged veterans., Conclusions: We interpret these findings within the veteran scholarship and explore clinical implications for providers., Competing Interests: Conflict of interest: None declared., (Copyright © 2023 American College of Occupational and Environmental Medicine.)

Abstract: The present study was developed to evaluate the effects of mindfulness-based stress reduction (MBSR) on the level of emotional flexibility and ambivalence related to emotional expression of divorced women. A general community sample of 30 divorced women was recruited and randomly assigned to experimental and control groups. The experimental group received MBSR for 8 weeks, and the control group was placed on a waiting list. The Emotional Flexibility Questionnaire (EFQ) and the Ambivalence Over the Expression of Emotion Questionnaire (AEQ) were administered to both groups before (pre) and after (post) the treatment. Data were analyzed using two-way mixed repeated-measures analyses of variance. The results showed that women in the treatment group had a significant increase in the total score of the EFQ and its components. In addition, the MBSR group had a significant decrease in the total score of the AEQ and its components. MBSR intervention shows potential for use with divorced women to help with emotion regulation and subsequent better adjustment to separation., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

We have constructed recombinant baculoviruses containing cDNAs encoding either the alpha 1- or the beta 1-subunit of the bovine GABAA receptor. In Spodoptera frugiperda (IPLB-Sf-21) cells infected with recombinant virus expressing either the alpha 1- or beta 1-subunit, or in cells co-infected with both viruses, functional GABAA receptors were detected by whole-cell electrophysiological recordings. The threshold for the responses mediated by the homo-oligomeric channels (alpha- or beta-) was 2-3 x 10(-6) M GABA, and for the co-infected cells was 8 x 10(-8) M GABA, suggesting that hetero-oligomeric channels formed in these cells. All GABA-induced currents were found to be inhibited by bicuculline and picrotoxin, potentiated by pentobarbital but were insensitive to benzodiazepines.

Eleven women with Stages III and IV epithelial ovarian carcinomas were entered into a protocol consisting of concurrent whole abdominal radiotherapy and intraperitoneal cisplatin followed by additional intraperitoneal cisplatin. The entire abdomen received 20 Gy in 20 fractions with no renal or hepatic shielding. Intraperitoneal cisplatin dosage was 20 mg/m2 weekly during radiation and 90 mg/m2 monthly thereafter for an additional three courses. Patients with Stages IIIC and IV had a median survival of 18 months and a two-year actuarial survival of 32%. Primary failure sites were the abdomen, pleura, and lymph nodes. Acute toxicity during radiotherapy was comparable to patients treated with radiation alone. No chronic renal, hepatic, or enteric complications were observed. Although the protocol did not have substantial efficacy in advanced disease, its toxicity was moderate enough to consider its use in less advanced cancers with peritoneal metastases. In particular, the protocol can be considered for women with ovarian cancer with no gross residuum and for women with papillary serous carcinoma of the uterine corpus.

Abstract: The purpose of the current study was to examine the latent structure and cross-cultural measurement validity of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) posttraumatic stress disorder (PTSD) symptoms assessed by the PTSD Checklist for DSM-5. Participants comprised trauma-exposed Chinese and Pakistani undergraduate students (N = 495 and N = 186, respectively). Confirmatory factor analysis (CFA) indicated that a seven-factor hybrid model involving intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal factors provided good fit in both samples. This model fit significantly better than three alternative models including the DSM-5 four-factor model and six-factor anhedonia and externalizing behaviors models. The subsequent multigroup CFA showed that the best-fitting hybrid model demonstrated cross-cultural measurement invariance. Our findings provide further empirical support for the seven-factor PTSD hybrid model and its cross-cultural invariance, and have implications for understanding and application of DSM-5's PTSD symptoms., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Most patients with advanced cancer receive treatment for related pain. Opioid accessibility, however, is a risk factor for misuse, which can present care challenges and quality-of-life concerns. There is a lack of consistent universal screening prior to initiation of opioid prescribing. One crucial issue in treating this population is adequately identifying and mitigating risk factors driving opioid misuse. Drawing on theory and research from addiction science, psychology, palliative care, and oncology, the presented conceptual framework suggests that risk factors for opioid misuse during cancer care can be stratified into historical, current, malleable, and unmalleable factors. The framework identifies necessary factors to address in order to mitigate risk for opioid misuse during cancer care, and offers key directions for future research. [ABSTRACT FROM AUTHOR]

Avoidant/restrictive food intake disorder (ARFID) is an uncommon but complex eating disorder characterized by extreme picky eating without poor body image or fear of weight gain. Intake is limited by volume or variety of food, driven by fear of adverse consequences associated with ingestion, sensory sensitivities to food properties, or a lack of interest in eating. Avoidance or restriction of food intake can lead to low body weight or failure to thrive, nutritional deficiencies, reliance on enteral feeding, and psychosocial impairment. The presentation of ARFID varies depending on severity, variety, and volume of diet; therefore, medical evaluation should be comprehensive, should be tailored to patient needs, and should include screening for commonly co-occurring psychiatric conditions. Cognitive behavioral therapy and/or family-based therapy, in conjunction with pharmacotherapy and/or hospital refeeding, have demonstrated therapeutic benefit. Available literature is sparse and largely limited to children and adolescents. Additional studies are needed to evaluate therapeutic interventions, medical follow-up, and prognosis. [ABSTRACT FROM AUTHOR]

Abstract: Meaning in life (MiL) is regarded as a valuable indicator of positive functioning in terms of an understanding of one's purpose in life, well-being, and professional commitment. As such, it is important to improve MiL for the stability of nursing staff. General self-efficacy is a significant predictor of both MiL and nursing professional commitment. Nursing professional commitment is key for both the stability of nursing staff and the provision of excellent health care. Few scholars have investigated the relationship between general self-efficacy and nursing professional commitment. In particular, a possible mediating effect of MiL has not been fully explored in nursing students.We aimed to examine the association between general self-efficacy and MiL among nursing students and to determine whether MiL mediates the relationship between general self-efficacy and nursing professional commitment for Chinese nursing students.A cross-sectional descriptive design was used. Between June and September 2019, 710 Chinese nursing students from 2 colleges completed the Meaning in Life Scale (MiLS), General Self-Efficacy Scale (GSES), and Nursing Professional Commitment Scale (NPCS). Data were analyzed using structural equation modeling (SEM) and SPSS (version 23.0, IBM Corp, Armonk, NY).The mean MiL score was above the moderate level (M = 52.55, SD = 9.79). However, the mean scores of self-efficacy and nursing professional commitment were relatively low. Self-efficacy was positively related to MiL (B = 0.46, P < .01), and MiL was positively related to nursing professional commitment (B = 0.37, P < .01). However, self-efficacy was not related to nursing professional commitment (B = 0.12, P = .01). We therefore suggest that MiL has a complete mediating role between self-efficacy and nursing professional commitment among Chinese nursing students.In this study, we confirmed the complete mediation of nursing professional commitment by MiL in nursing students, thus providing scientific evidence that could be beneficial for the development of interventions to increase nursing professional commitment., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

The purpose of this investigation was to evaluate sex differences in health and fitness outcomes among United States Military Academy (USMA) graduates (class years 1980-2011). Subjects (n = 701 men, 641 women, age: 45.7 ± 9.3 years) were surveyed as a part of a larger investigation on risk and resiliency factors among USMA graduates. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) short form and calculation of weekly metabolic equivalents (METs). Overweight and obesity status were assessed by body mass index (BMI). Significance for the study was set at p ≤ 0.05. Obesity rates for men (30.1%) were significantly higher than for women (16.6%). Men reported significantly higher (p = 0.01) vigorous METs·wk-1 (1,214.6 ± 1,171.6) than women (1,046.8 ± 1,133.2) despite significantly higher (p = 0.00) BMI values (28.75 ± 4.53 kg·m-2) than women (25.90 ± 5.48 kg·m-2). Women were 89% more likely to have ever been on a diet and reported higher (15.2%) Army Body Composition Program enrollment rates than men (6.3%). Obesity rates among men reflect trends seen in the broader military, Veteran, and U.S. adult populations, whereas obesity rates among women were lower. Men may be at a greater risk for obesity later in life despite higher self-reported physical activity; however, lean body mass and self-report bias should be considered. Because lifetime obesity may be influenced by factors other than physical activity, health initiatives should use a comprehensive approach early in the career of military officers. [ABSTRACT FROM AUTHOR]

Over a 42-month period, 210 patients had a lower midline incision, usually extending around the umbilicus, that was closed with a continuous, running number 2 polypropylene suture. Patients in this study had various predisposing factors for wound disruption. Over 60% were operated upon because of gynecologic cancer. Additional high-risk factors included obesity in 56%, diabetes in 28%, previous irradiation or chemotherapy in 17%, and ascites in 8%. The operative procedures performed ranged from hysterectomies with node sampling to bowel resections and exenterations; wound complications were noted in seven patients. One patient had an incisional hernia. No eviscerations occurred. The closure is safe, expedient, and cost-efficient, and distributes tension equally over a continuous line.

Two sisters with multiple congenital anomalies are described. They are felt to represent the third affected sibship with the rare syndrome of genital, renal, and middle ear anomalies. A term pregnancy is also reported in the younger of the affected sisters.

Patients with locally advanced vulvovaginal carcinomas with pubic bone encroachment or fixation pose a treatment dilemma. The purpose of this study was to evaluate the outcome in 12 patients who have undergone pubic bone resection at the University of Minnesota as part of treatment of locally extensive primary, recurrent, or metastatic vulvovaginal carcinomas. Six patients with primary vulvar carcinomas and six patients with recurrent or metastatic vulvovaginal carcinomas underwent bone resection as part of their surgical therapy. Survival in the primary treatment group was 50%, with no local recurrences. Survival in the recurrent/metastatic disease group was 83%, with a follow-up time of 9 months to 15 years. One vulvar and one groin recurrence have occurred in the recurrent/metastatic group. Pubic bone resection added little to surgical morbidity and gave good functional results. Pubic bone resection, in combination with radical extirpative procedures, is an option for treatment of patients with locally extensive vulvovaginal carcinomas, particularly those with previous radiation therapy.

Balance is affected in numerous neurologic disorders, like stroke, multiple sclerosis and Parkinson's disease contributing to falls, and diminishing quality of life and functionality. The mini-BESTest is one of the most recommended scales to detect balance disorders in people with Parkinson's disease, which has solid psychometric properties. Unfortunately, this scale has not been validated in Chile and there are no other validated scales that can determine balance disorders in patients with Parkinson's disease to date. The study objective was to validate the mini-BESTest scale in Chilean Parkinson's disease patients. The translation and adaptation to Chilean Spanish of the mini-BESTest scale were made following a cross-cultural adaptation process, to then obtain face and content validity by an expert committee. Afterwards, the demographic data and psychometric properties of internal consistency and ceiling and floor effects were measured with a sample of 50 subjects with Parkinson's disease. Furthermore, 10 subjects of the sample were evaluated with the purpose of measuring inter rater reliability. The scale presented a good internal consistency (Cronbach's alpha = 0.845), and an excellent inter rater reliability (intraclass correlation coefficient = 0.97), no ceiling or floor effects were found. The results of the face and content validity and psychometric properties are adequate, achieving the validation of the mini-BESTest scale for balance in Chilean people with Parkinson's disease.

Posttraumatic stress disorder (PTSD) treatments primarily address traumatic memories, despite PTSD's association with both traumatic and positive memory difficulties. Addressing this gap, we explored the perspectives of trauma-exposed individuals with mental health treatment experience on therapeutically addressing positive memories. A treatment-seeking sample from a community mental health center (n1 = 60) and a community sample from Amazon's Mechanical Turk (n2 = 123) were queried on the acceptability, feasibility, and delivery/components of a pilot positive memory technique. Results indicated interest or willingness in therapeutically discussing positive memories; most endorsed benefits were improved mood, positive thoughts, and self-esteem. Few barriers were identified (e.g., lack of evidence) compared with feasibility factors (ease/usefulness, improved satisfaction/tolerability, and engagement in PTSD treatment). Preferred treatment components included identifying/discussing positive memories, eliciting associated positive affect, and writing about the positive memory as homework. Results provide formative support for the development and integration of a positive memory technique into PTSD treatments.