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Objective: The aims of this paper were to report on the global psychosocial functioning of 5-year-old DHH children and examine the risk and protective factors that predict outcomes. Design: A cross-sectional analysis of data collected from a prospective, population-based longitudinal study. Study sample: Parents/caregivers of 356 children completed questionnaires on psychosocial development (CDI, SDQ), functional communication (PEACH) and demographic information. Children completed standardized assessments of non-verbal cognitive ability (WNV) and language (PLS-4). Results: On average, global psychosocial functioning was within the range of typically developing children; however, variability was high and 12% of children had scores that were more than 2 SDs below the norm. Non-verbal cognitive ability, presence of additional disabilities, language and functional communication significantly predicted outcomes. In contrast, type of hearing device, severity of hearing loss and age at intervention did not. Conclusion: The global psychosocial functioning of this cohort of 5-year-old DHH children fell within the range of typically developing children. The findings suggest that spoken language ability and functional communication skills are vital for healthy psychosocial development. [ABSTRACT FROM AUTHOR]

Women living with HIV are at increased risk for psychosocial distress, especially among social and economically disadvantaged women living in rural areas. Little is known about how social support and wealth impacts the mental health of women caring for young children in low- and middle-income countries. The purpose of this paper was to assess demographic, socio-economic, and social support correlates of depression and anxiety in HIV-infected+ female caregivers living in rural Uganda. Depression and anxiety were assessed using the Hopkins Symptom Checklist (HSCL-25), two-domains of social support (family and community) were measured with the adapted Multidimensional Scale for Perceived Social Support, and wealth was measured using a checklist of material possessions and housing quality among 288 women. Multivariable linear regression models assessed the association of depression and anxiety with demographic and social predictors. Sixty-one percent of women reported clinically significant symptoms of depression or anxiety using the standard HSCL-25 cut-off of >1.75. Lower wealth (p = .01) and family support (p = .01) were significantly associated with more depressive symptoms, with greater family support being more protective of depression in the highest wealth group (top 20%) compared to the lowest. More anxiety symptoms were associated with lower wealth (p = .001), lower family support (p = .02), and higher community support (p = .003). Economic and social support factors are important predictors of caregiver mental health in the face of HIV disease in rural Uganda. Findings suggest that interventions should consider ways to increase economic opportunities and strengthen family support for HIV+ caregivers. [ABSTRACT FROM PUBLISHER]

Purpose: This paper studies the relationship between computed tomography (CT) scan on admission, according to Marshall’s tomographic classification, and quality-of-life (QoL) after 1 year in patients admitted to the Intensive Care Unit (ICU) with traumatic brain injury (TBI). Methods: This study used validated scales including the Glasgow Outcome Scale and the PAECC (Project for the Epidemiologic Analysis of Critical Care Patients) QoL questionnaire. Results: We enrolled 531 patients. After 1 year, 171 patients (32.2%) had died (missing data = 6.6%). Good recovery was seen in 22.7% of the patients, while 20% presented moderate disability. The PAECC score after 1 year was 9.43 ± 8.72 points (high deterioration). Patients with diffuse injury I had a mean of 5.08 points vs 7.82 in those with diffuse injury II, 11.76 in those with diffuse injury III and 19.29 in those with diffuse injury IV (p< 0.001). Multivariate analysis found that QoL after 1 year was associated with CT Marshall classification, depth of coma, age, length of stay, spinal injury and tracheostomy. Conclusions: Patients with TBI had a high mortality rate 1 year after admission, deterioration in QoL and significant impairment of functional status, although more than 40% were normal or self-sufficient. QoL after 1 year was strongly related to cranial CT findings on admission. [ABSTRACT FROM PUBLISHER]

In this study, researchers aimed to investigate whether a relationship exists between maternal-fetal attachment (MFA) and antenatal mind-mindedness in a sample of Australian pregnant women (n = 43). Participants completed the Maternal Fetal Attachment Scale (MFAS) in their second and third trimester, and a modified 'describe your baby' interview with the inclusion of general prompts as a measure of antenatal mind-mindedness in their third trimester. Positive correlations were observed between mental comments, but not total predictions, made by women during the modified antenatal mind-mindedness task and MFAS scores at the second and third trimesters. An average of 6.07 total predictions and 1.30 mental predictions were made before prompts, increasing to 17.65 total comments and 6.58 mental comments after prompts. Prompts within the mind-mindedness task resulted in 42 participants making at least one mental prediction (M = 6.58). Our findings provide the first evidence for a relationship between MFA and antenatal mind-mindedness, and highlight the importance of considering mind-mindedness during pregnancy in the developing bond from mother to baby. [ABSTRACT FROM AUTHOR]

Many young people are potentially at risk of noise-induced hearing loss due to unsafe use of personal listening devices. The aim of this cross-sectional study was to examine the association of sociodemographic factors and risk behavior with unsafe use of personal listening devices in adolescents to identify a target group for prevention. A smartphone application was developed to objectively measure music listening habits among 314 adolescents with a mean age of 13 years and 7 months (SD ±5 months). Listening habits were characterized as safe or unsafe based on the weekly noise dose. Data on sociodemographic factors and traditional health risk behaviors were obtained by questionnaires. Within the study group, 10.5% of the participants exceeded the 50%, and 4.8% the 100% recommended weekly noise dose. Adolescents with a lower socioeconomic status were more likely to engage in unsafe listening habits as compared to adolescents with a higher socioeconomic status. Additionally, risk behavior was associated with higher odds of having unsafe listening habits as compared to no risk behavior. Age, sex and educational levels were not significantly associated with unsafe listening habits. The findings of the present study indicate that interventions to promote safe listening habits should target adolescents with a lower socioeconomic status and higher risk behavior. Future research is needed to investigate how these adolescents can be motivated to adopt safe listening habits. [ABSTRACT FROM AUTHOR]

Follow-up care (FU-care) and self-management are recognized as important to ensure prolonged effects of rehabilitation. Objectives of this study were to explore current FU-care and self-management after specialized rehabilitation for patients with rheumatic and musculoskeletal diseases. This multicentre cohort study included 523 patients who self-reported need and plans for FU-care and plans for self-management activities (SMAs) at rehabilitation discharge. The FU-care received and adherence to SMA were self-reported after 4-, 8-, and 12-months. Predictors for received FU-care and adherence to SMA were explored in multiple logistic regression models. Plans for FU-care were significantly associated with received FU-care. Younger age, better coping skills, and performing regular social activities and hobbies were significant predictors for received FU-care. Throughout the follow-up year, 221 (51%) participants had adherence to their SMA plans. Older age, regular physical activity, more severe pain, and performing regular social activities and hobbies were significant predictors for adherence to SMA. Participants with SMA adherence more often reported planned FU-care, and more frequently received the FU-care they needed. Planning FU-care should be integrated in specialized rehabilitation. Patients with poor coping skills and sedentary lifestyle may need more support over longer time to implement behavioral changes for healthy self-management. Planning follow-up should be integrated in specialized rehabilitation as it supports self-management and receiving follow-up at home. Patients with sedentary lifestyle, poor coping skills, and depression may need more support over longer time to implement healthy self-management. Structure and routines in daily life enhance self-management. [ABSTRACT FROM AUTHOR]

This study investigated the association of resilience on caregiver burden and quality of life in informal caregivers of patients with severe traumatic musculoskeletal injuries. A prospective cohort study of eligible caregivers and acutely injured trauma patients was conducted during 2018 in South East Queensland, with follow-up 3 months after patient discharge. Resilience was examined using the 10-item Connor Davidson Resilience Scale. The primary outcomes, caregiver burden and quality of life were measured respectively, using the Caregiver Strain Index and the Short Form Version 12 Health Survey. Baseline measures were completed with fifty-three (77%) patient/carer dyads. Thirty-eight (28%) were available for follow up at 3 months. Significant reductions from baseline were found at follow up, for levels of resilience, mental health, physical exercise and community support. In multiple regression models, caregiver resilience at follow-up independently predicted lower caregiver burden (β = −0.74, p = 0.008) and higher levels of patient physical health and function (β = −0.69, p = 0.003). Upon commencing informal care, caregivers' resilience, mental health and support systems are adversely affected. Higher levels of caregiver resilience appear to be protective against caregiver burden and declines in patient physical function. Early evaluation of caregivers' resilience, their physical and mental health and socio-ecological networks could improve carer and patient health outcomes. After 3 months of providing informal care to severely injured musculoskeletal trauma patients, there are apparent declines in their mental health, resilience, community support and physical activity levels. However, those with higher levels of resilience compared to lower levels could be protected against caregiver burden. Higher caregiver resilience could also prevent declines in patients' physical function. The rehabilitation of severe trauma patients should additionally include routine assessment and management of informal caregivers with the aim to prevent caregiver burden. Early clinical assessment of caregiver resilience using a valid resilience measurement tool could identify caregivers at risk of caregiver burden and flag vulnerable caregivers for ongoing support in the community. Early assessment of caregivers' physical and mental health and health related behaviours could flag the need for health promotion interventions aimed at supporting caregivers' physical and mental health. [ABSTRACT FROM AUTHOR]

This study describes physical activity levels and factors associated with physical activity at the end of stroke rehabilitation. Primary stroke survivors were assessed at completion of physical rehabilitation. Outcomes included physical activity (e.g. step count, moderate-vigorous physical activity duration) and sedentary time measured with the Sensewear Armband, gait speed, and cognition. The number of participants meeting physical activity recommendations was calculated. Differences in physical activity were examined between household ambulators (gait speed <0.4 m/s), limited community ambulators (0.4–0.8 m/s), and unlimited community ambulators (>0.8 m/s). The influence of age, cognition, and gait speed on physical activity was determined by multiple regression. Seventy-nine stroke survivors participated. Twenty-one participants achieved 30 min/day of moderate-vigorous physical activity accumulated in 10 min bouts. Unlimited community ambulators took more steps/day (median 4975 vs. 469 limited, 355 household, p < 0.001), had higher moderate-vigorous physical activity (median 74 min/day vs. 22 limited, 31 household, p < 0.001) and lower sedentary time (mean 1105 vs. 1239 limited, 1232 household minutes/day, p < 0.001). Age, gait speed, and cognition predicted 21.3% of the variance in moderate-vigorous physical activity (p = 0.001); adding employment status to the model predicted 57.3% of the variance in step count (p < 0.001). Physical activity is low following stroke and should be a target for treatment, particularly in those with gait speeds ≤0.8 m/s. Seventy-three percent of stroke survivors performed ≥30 minutes of moderate to vigorous physical activity throughout the day. Twenty-seven percent of stroke survivors accumulated ≥30 minutes of moderate to vigorous physical activity in 10 minute bouts. Despite relatively good physical ability, daily step count was low in this sample. Those with gait speeds ≤0.8 m/s had lower physical activity levels and higher sedentary time. [ABSTRACT FROM AUTHOR]

Enhancing children's daily participation is the optimal goal of early childhood intervention. This study aimed to identify child and family predictors of participation for toddlers with global developmental delay. Fifty-nine toddlers with global developmental delay (aged 24–43 months) and their mothers participated in a 6-month longitudinal study. Predictors for participation were child factors [age, gender, delay severity, mastery motivation (perceived persistence and task persistence), and withdrawal behavior], and family factors (socioeconomic status, family income, maternal education, stress, and maternal teaching behavior). Dependent variables were participation diversity and intensity of four activity types measured 6-month later using the Assessment of Preschool Children's Participation (Chinese version). Correlation and hierarchical regression statistical methods were used. Older children with higher persistence had higher overall participation. Different factors predicted different participation dimensions and different activity types. Older age, higher perceived persistence, and being less withdrawn predicted higher diversity and intensity for play participation. For skill development participation, older age, less severity, higher mastery motivation, and better maternal teaching behaviors predicted higher diversity; and age, mastery motivation and maternal teaching predicted intensity. Different factors predict participation attendance differently. Supporting parents to enhance toddlers' mastery motivation may optimize children's participation in daily activities. Based on the child and their caregiver preferences, applicability and/or engagement for different activity types, interventionists could collaborate further with caregivers to find strategies to increase children's participation attendance in daily life. Interventionists could consult with caregivers: (a) to observe the persistence and positive affect (mastery motivation) of children during different activities, (b) to figure out the possible barriers to participation in those activities, and (c) to demonstrate appropriate caregiver-child interactions. Interventionists are encouraged to support children's mastery motivation and quality of maternal teaching behaviors to enhance participation in daily activities. [ABSTRACT FROM AUTHOR]

Describe the course of exercise capacity in pediatric burn patients during the initial 6 months after hospital discharge, and examine whether its recovery can be predicted from burn characteristics, sociodemographic characteristics, and/or prior assessment. Exercise capacity was assessed at discharge, and 6 weeks, 3 months, and 6 months after discharge using the Steep Ramp Test (SRT). Twenty-four pediatric patients with burns affecting 0.1–34% of total body surface area were included. At group level, exercise capacity was low at discharge and did not reach healthy reference values within 6 months, despite significant improvement over time. At individual level, the course of exercise capacity varied widely. Six months after discharge, 48% of participants scored more than one standard deviation below healthy age- and sex-specific reference values. SRT outcomes at 6 weeks and 3 months were the best predictors of exercise capacity 6 months after discharge, explaining, respectively, 76% and 93% of variance. Forty-eight percent of participants did not achieve healthy reference values of exercise capacity and were therefore considered "at risk" for diminished functioning. Our preliminary conclusion that early assessment of exercise capacity with the SRT can timely identify those patients, needs to be strengthened by further research. Pediatric burns can be considered as a chronic medical condition because of the lifelong consequences. Exercise capacity is reduced following- even minor -pediatric burns. Recovery patterns vary widely: some pediatric burn patients achieve healthy levels of exercise capacity without specific intervention, while others do not. The Steep Ramp Test can be used to assess exercise capacity, identifying those "at risk" for adverse outcomes at an early stage. Patients "at risk" should be encouraged to play sports and adopt an active lifestyle. [ABSTRACT FROM AUTHOR]

Purpose: Purpose in life and capabilities are two significant individual elements that enhance quality of life among older people. Capabilities refers to the extent to which older people are free to make choices that are important to them. At present, it is not known how purpose in life interacts with capabilities to influence quality of life for those living with a disability. This study examined the extent to which purpose in life and capabilities interacts with health status to affect quality of life, particularly for older people with a disability. Methods: Self-report data from participants in a longitudinal cohort study of older New Zealanders were analyzed. Responses from 452 older people with a disability were compared with 3299 age- and gender-matched older people without a disability on indicators related to health and aging. The associations were tested using hierarchical regression. Mediational impact of purpose in life and capabilities were tested via path analysis. Results: Mental health, physical health, purpose in life, and capabilities accounted for a significant amount of variance in quality of life for older people with a disability. Purpose in life and capabilities were significant unique mediators for older people with a disability. Conclusions: Purpose in life may help older people with a disability to deal with early onset stressors or changes in mental and physical health to maintain overall quality of life. The role of capabilities suggests that the social environment and access to resources and choices are important in ensuring that older people aging with or into a disability achieve quality of life in a socially just environment. Purpose in life and capability are unique mediators of the relationship between health status and quality of life. Purpose in life may act as an effective buffering mechanism to deal with disability in later life while capability can empower older people with a disability to achieve quality of life in a just environment. The notion of successful aging with disability should be re-defined as using psychological, social support, and healthcare resources to live a life consistent with personal values in the context of disability Rather than emphasizing structural factors and physical functioning in activity participation, older people with disability should be supported to decide and pursue their own preferences. Rehabilitation professionals can work flexibly with older people with disability to maximize their resilience, dignity, autonomy and choice, and positive connection to others. [ABSTRACT FROM AUTHOR]

Objective: Individuals' beliefs about the causes of multifactorial health conditions (causal attributions) shape how they conceptualize and respond to health threats and are therefore important for health promotion. Studies of racial/ethnic and cultural variation in obesity causal beliefs, however, are scarce. To address this gap, this study described beliefs about the underlying causes of obesity (genetic inheritance, diet, and physical activity) in Hispanic and non-Hispanic White women participating in a longitudinal cohort study in South King County, Washington State (n = 1,002). Design: Analysis of baseline survey data. Self-reported obesity causal beliefs were compared by race/ethnicity and acculturation indicators (survey language and nativity) using marginal effect estimates generated from multinomial logistic regression models. Results: Hispanic women had a higher probability of not believing 'at all' in inheritance and physical activity as causes of obesity – an absolute increase of 33% and 5% over non-Hispanic White women, respectively. Both acculturation indicators were also associated with a higher probability of not believing 'at all' in inheritance as a cause of obesity, though Hispanic women who completed the survey in English and were born in the United States had genetic causal beliefs similar to non-Hispanic White women. Behavioral attributions did not vary by acculturation indicators in Hispanic women. Conclusions: Differences in obesity casual beliefs, particularly genetic attributions, exist and may be important for developing and delivering effective obesity-related health promotion interventions. Identifying the determinants and public health consequences of cultural variation in obesity attributions should be the focus of future research. [ABSTRACT FROM AUTHOR]

Objective: We investigated the factors influencing speech perception in babble for 5-year-old children with hearing loss who were using hearing aids (HAs) or cochlear implants (CIs). Design: Speech reception thresholds (SRTs) for 50% correct identification were measured in two conditions - speech collocated with babble, and speech with spatially separated babble. The difference in SRTs between the two conditions give a measure of binaural unmasking, commonly known as spatial release from masking (SRM). Multiple linear regression analyses were conducted to examine the influence of a range of demographic factors on outcomes. Study sample: Participants were 252 children enrolled in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. Results: Children using HAs or CIs required a better signal-to-noise ratio to achieve the same level of performance as their normal-hearing peers but demonstrated SRM of a similar magnitude. For children using HAs, speech perception was significantly influenced by cognitive and language abilities. For children using CIs, age at CI activation and language ability were significant predictors of speech perception outcomes. Conclusions: Speech perception in children with hearing loss can be enhanced by improving their language abilities. Early age at cochlear implantation was also associated with better outcomes. [ABSTRACT FROM AUTHOR]

Objective: This study examined language and speech outcomes in young children with hearing loss and additional disabilities. Design: Receptive and expressive language skills and speech output accuracy were evaluated using direct assessment and caregiver report. Results were analysed first for the entire participant cohort, and then to compare results for children with hearing aids (HAs) versus cochlear implants (CIs). Study sample: A population-based cohort of 146 five-year-old children with hearing loss and additional disabilities took part. Results: Across all participants, multiple regressions showed that better language outcomes were associated with milder hearing loss, use of oral communication, higher levels of cognitive ability and maternal education, and earlier device fitting. Speech output accuracy was associated with use of oral communication only. Average outcomes were similar for children with HAs versus CIs, but their associations with demographic variables differed. For HA users, results resembled those for the whole cohort. For CI users, only use of oral communication and higher cognitive ability levels were significantly associated with better language outcomes. Conclusions: The results underscore the importance of early device fitting for children with additional disabilities. Strong conclusions cannot be drawn for CI users given the small number of participants with complete data. [ABSTRACT FROM AUTHOR]

Background: Alcohol and substance use is prevalent in trauma patients admitted to hospital. Aim: Investigate the association between hospital admission and substance use for three different injury types among trauma patients according to age and gender. Method: Prospective cross-sectional emergency department study. The patients were divided into injury groups and compared with respect to gender, age, hospital admission, substance use, and blood alcohol level. Results: The study included 998 trauma patients, of whom 39% screened positive for substance use. Patients with head injury had a higher prevalence of alcohol use (29%). Patients with head injury and hazardous drug or alcohol use were less likely to stay in hospital for more than 24 hours (adjusted OR: 0.61, 95% CI: 0.41–0.93,p = .02), whereas patients with injuries to neck/thorax/abdomen and hazardous use had the highest risk of staying in hospital more than 24 hours (adjusted OR: 5.22, 95% CI: 1.47–18.76,p = .01). Injuries to pelvis/extremities were more common among women with medicine use. Conclusion: Patients with head injury and hazardous use were less likely to be admitted to hospital, whereas patients with injuries to the neck/thorax/abdomen and hazardous use were more likely to be admitted. [ABSTRACT FROM PUBLISHER]

Objective: The purpose of this study was to describe the clinical characteristics of children with unilateral hearing loss (UHL), examine deterioration in hearing, and explore amplification decisions.Design: Population-based data were collected prospectively from time of diagnosis. Serial audiograms and amplification details were retrospectively extracted from clinical charts to document the trajectory and management of hearing loss.Sample: The study included all children identified with UHL in one region of Canada over a 13-year period (2003–2015) after implementation of universal newborn hearing screening.Results: Of 537 children with permanent hearing loss, 20.1% (108) presented with UHL at diagnosis. They were identified at a median age of 13.9 months (IQR: 2.8, 49.0). Children with congenital loss were identified at 2.8 months (IQR: 2.0, 3.6) and made up 47.2% (n = 51), reflecting that a substantial portion had late-onset, acquired or late-identified loss. A total of 42.4% (n = 39) showed deterioration in hearing, including 16 (17.4%) who developed bilateral loss. By study end, 73.1% (79/108) of children had received amplification recommendations.Conclusions: Up to 20% of children with permanent HL are first diagnosed with UHL. About 40% are at risk for deterioration in hearing either in the impaired ear and/or in the normal hearing ear. [ABSTRACT FROM AUTHOR]

Objective: Guided by the theory of planned behaviour (TPB) and health literacy concepts, SIPsmartER is a six-month multicomponent intervention effective at improving SSB behaviours. Using SIPsmartER data, this study explores prediction of SSB behavioural intention (BI) and behaviour from TPB constructs using: (1) cross-sectional and prospective models and (2) 11 single-item assessments from interactive voice response (IVR) technology. Design: Quasi-experimental design, including pre- and post-outcome data and repeated-measures process data of 155 intervention participants. Main Outcome Measures: Validated multi-item TPB measures, single-item TPB measures, and self-reported SSB behaviours. Hypothesised relationships were investigated using correlation and multiple regression models. Results: TPB constructs explained 32% of the variance cross sectionally and 20% prospectively in BI; and explained 13–20% of variance cross sectionally and 6% prospectively. Single-item scale models were significant, yet explained less variance. All IVR models predicting BI (average 21%, range 6–38%) and behaviour (average 30%, range 6–55%) were significant. Conclusion: Findings are interpreted in the context of other cross-sectional, prospective and experimental TPB health and dietary studies. Findings advance experimental application of the TPB, including understanding constructs at outcome and process time points and applying theory in all intervention development, implementation and evaluation phases. [ABSTRACT FROM AUTHOR]

Objectives: To prospectively investigate the impact of transitions in informal caregiving on emotional well-being over two years in a large population study of older people. Methods: Information on provision of unpaid care in 2004/2005 and 2006/2007 was available for 6571 participants in the English Longitudinal Study of Ageing. Three well-being domains were also assessed on each occasion: life satisfaction (measured with the Satisfaction with Life Scale); quality of life (assessed with the CASP-19 scale); and depression symptoms (measured using the Centers for Epidemiologic Studies Depression Scale). Multivariable analyses of the impact on well-being of two-year caregiving transitions (caregiving entry and caregiving exit, or continued caring) were conducted separately for spousal/child carers and carers of other family/non-relatives. Results: Compared to non-caregiving, entry into spousal/child caregiving was associated with decline in quality of life (B = −1.60, p <.01) whereas entry into caregiving involving other kin relations increased life satisfaction (B = 1.02, p <.01) and lowered depression symptoms (B = −0.26, p <.05). Contrary to expectations, caregiving exit was related to increased depression in both spousal/child (B = 0.44, p <.01) and non-spousal/child (B = 0.25, p <.05) carers. Continued spousal/child caregiving was also related to decline in quality of life (B = −1.24, p <.05). Other associations were suggestive but non-significant. Conclusion: The emotional impact of different caregiving transitions in later life differs across kin relationships; notably, spousal and child carers' well-being was consistently compromised at every stage of their caregiving career over the two-year study period. [ABSTRACT FROM AUTHOR]

Primary objective: To define the prognostic value of head computed tomography (CT) in patients suffering from SICH after 3 years of follow-up. Research design and methods: Between January 2011 and May 2012, consecutive patients with SICH who underwent brain CT scans within the first 12 hours of presentation were prospectively included. Independent predictors of 30-day mortality and unfavourable functional outcome (modified Rankin Scale = 4–6 and Barthel Index ≤ 60) at 36 months were identified by univariable and multivariable regression analysis. Main outcomes and results: A total of 228 participants were identified. According to multivariable analysis, independent CT-related predictors for 30-day mortality were intraventricular haemorrhage [IVH] (OR = 2.42;p= 0.009), haematoma volume ≥ 30 cm3(OR = 3.32;p= 0.006), the presence of midline shift (OR = 3.77;p= 0.004) and hydrocephalus (OR = 5.22;p= 0.001). Further, IVH (OR = 3.72, 95% CI = 1.16–11.8,p= 0.026), volume of haemorrhage ≥ 30 cm3(OR = 3.96; 95% CI = 1.65–5.84;p= 0.015) and midline shift (OR = 6.58; 95% CI = 1.33–32.4;p= 0.021) had significant associations with an mRS ≥ 4 at 36 months. Conclusions: A favourable long-term functional outcome at 36 months and short-term survival were less likely in patients with greater volume of haematoma, presence of IVH and midline displacement. [ABSTRACT FROM PUBLISHER]

Objective: This study compared cortical and sub-cortical volumes between patients with complicated (i.e. presence of intracranial abnormality on the day-of-injury CT) and uncomplicated (i.e. absence of intracranial abnormality) mild traumatic brain injury (MTBI) 4 weeks post-injury. The study hypothesized regionally decreased brain volumes and reduced cortical thickness in patients with complicated MTBIs compared with uncomplicated MTBI. Methods: This study was part of a larger 2 years cohort study on MTBI. Baseline clinical and magnetic resonance imaging (MRI) data were compared for those with complicated and uncomplicated MTBI. It identified 168 patients with MTBI (90 uncomplicated and 78 complicated), aged 16–65 years. 3T MRI-system (Signa HDxt, GE Medical Systems, Milwaukee, WI) and cortical reconstruction and volumetric segmentation by FreeSurfer software have been used. Results: No significant differences between uncomplicated and complicated MTBIs were found in neuroanatomic volumes and cortical thickness after controlling for age, gender and education. The complicated MTBI group showed larger ventricles compared with the uncomplicated group, but this effect diluted when adjusting for potential confounders. Conclusion: The study findings suggest that the classification of complicated and uncomplicated MTBI may be too broad to differentiate volumetric and morphometric effects of injury in the early post-injury phase. [ABSTRACT FROM PUBLISHER]

Objectives: Increased symptom endorsement on the short form of the Centre for Epidemiologic Studies Depression (CESD) Scale has been previously associated with lower everyday problem-solving (EPS) ability in older adults. However, given the multifactorial and complex nature of depressive symptoms, it remains unclear whether certain symptoms/aspects of depression account for this relationship. We examined established factor scores on the full version of the CES-D to assess their utility as predictors of EPS in an older adult cohort. Methods: Community-dwelling older adults (n = 103; age: 51-91) were administered the CES-D along with a measure of EPS ability assessing both social and practical EPS. Regression analyses were used to determine the relationships between variables. Results: Analyses revealed that increased CES-D scores predicted worse EPS ability in older adults (β = -.17, p < .05) beyond the effects of age, gender, and education. Regression analyses examining each CES-D factor score revealed that decreased positive affect (loss of hope/enjoyment in life; β = -.21, p < .01) remained the only significant predictor of decreased overall EPS scores beyond demographic variables, while depressed affect, interpersonal, and somatic factors were not significant predictors. Positive affect predicted both practical, as well as social EPS scores. Conclusions: Current results extend previous findings by showing that the relationship between increased depressive symptoms and decreased EPS ability in older age may be primarily driven by anhedonia as opposed to other depressive symptoms. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine if a potential relationship among physical activity (PA), fundamental movement skills and weight status exists amongst early adolescent youth. Participants were a sample of 85 students; 54 boys (mean age = 12.94 ± 0.33 years) and 31 girls (mean age = 12.75 ± 0.43 years). Data gathered during physical education class included PA (accelerometry), fundamental movement skills and anthropometric measurements. Standard multiple regression revealed that PA and total fundamental movement skill proficiency scores explained 16.5% (P < 0.001) of the variance in the prediction of body mass index. Chi-square tests for independence further indicated that compared with overweight or obese adolescents, a significantly higher proportion of adolescents classified as normal weight achieved mastery/near-mastery in fundamental movement skills. Results from the current investigation indicate that weight status is an important correlate of fundamental movement skill proficiency during adolescence. Aligned with most recent research, school- and community-based programmes that include developmentally structured learning experiences delivered by specialists can significantly improve fundamental movement skill proficiency in youth. [ABSTRACT FROM AUTHOR]

Objective: Obesity is a heritable condition with well-established risk-reducing behaviours. Studies have shown that beliefs about the causes of obesity are associated with diet and exercise behaviour. Identifying mechanisms linking causal beliefs and behaviours is important for obesity prevention and control. Design: Cross-sectional multi-level regression analyses of self-efficacy for weight control as a possible mediator of obesity attributions (diet, physical activity, genetic) and preventive behaviours in 487 non-Hispanic White women from South King County, Washington. Main Outcome Measures: Self-reported daily fruit and vegetable intake and weekly leisure-time physical activity. Results: Diet causal beliefs were positively associated with fruit and vegetable intake, with self-efficacy for weight control partially accounting for this association. Self-efficacy for weight control also indirectly linked physical activity attributions and physical activity behaviour. Relationships between genetic causal beliefs, self-efficacy for weight control, and obesity-related behaviours differed by obesity status. Self-efficacy for weight control contributed to negative associations between genetic causal attributions and obesity-related behaviours in non-obese, but not obese, women. Conclusion: Self-efficacy is an important construct to include in studies of genetic causal beliefs and behavioural self-regulation. Theoretical and longitudinal work is needed to clarify the causal nature of these relationships and other mediating and moderating factors. [ABSTRACT FROM AUTHOR]

Objectives:To investigate the roles of reasons for living (RFL) and meaning in life (MIL) in potentially promoting mental health and well-being and protecting against suicide ideation among community-residing older adults and to investigate the psychometric properties of the Reasons for Living Scale-Older Adult version (RFL-OA). Method:Of 173 older adults initially recruited into a longitudinal study on late-life suicide ideation, 109 completed the RFL-OA and measures of cognitive and physical functioning and positive and negative psychological factors at a two-year follow-up assessment. We tested a model in which RFL and MIL protect against suicide ideation, controlling for demographic and clinical factors. We also assessed the psychometric properties of the RFL-OA in community-residing older adults, investigating its internal consistency and its convergent (MIL, perceived social support, and life satisfaction), divergent (loneliness, depressive symptom severity, and suicide ideation), and discriminant validity (cognitive and physical functioning). Results:RFL-OA scores explained significant variance in suicide ideation, controlling for age, sex, depressive symptom severity, and loneliness. MIL explained significant unique variance in suicide ideation, controlling for these factors and RFL, and MIL significantly mediated the association between RFL and suicide ideation. Psychometric analyses indicated strong internal consistency (α = .94), convergent, divergent, and discriminant validity for the RFL-OA relative to positive and negative psychological factors and cognitive and physical functioning. Conclusion:These findings add to a growing body of literature suggesting merit in investigating positive psychological factors together with negative factors when assessing suicide risk and planning psychological services for older adults. [ABSTRACT FROM AUTHOR]

Background:The incidence of diabetes in Latinos is 12.8% compared to 9.3% of the general population. Latinos suffer from a higher prevalence of diabetic complications and mortality than whites yet receive less monitoring tests and education.Purpose:(1) Identify changes in clinical indicators among subjects with type 2 diabetes participating in the Emory Latino Diabetes Education Program (ELDEP), (2) identify changes in risk reduction examinations, and (3) describe the independent contribution of sociodemographic characteristics and biomedical indicators as predictors of class return.Methods:A quasi-experimental study was conducted over 5 years in Latinos with type 2 diabetes mellitus. One hundred forty-two patients receiving culturally appropriate diabetes self-management education and support (DSME/S) were included from 7 primary care clinics in Georgia. Questionnaires and biomedical markers were collected at baseline and 3-month follow-up.Results:Results from this study show that A1C was lowered from 9.1% at baseline to 7.8% at follow-up (P<  .001), blood pressure decreased from 135/85 to 128/79 mmHg (P<  .001), and home blood glucose monitoring increased from 63% to 85% (P<  .001). Risk-reduction examinations increased significantly from baseline to follow-up. Predictors of attendance for DSME/S classes were income, physical activity, and previous class attendance (P<  .05).Discussion:ELDEP was effective in providing DSME/S, decreasing biomedical markers, and increasing risk reduction examinations.Translation to Health Education Practice:Exploring culturally appropriate, community-based interventions to foster engagement in follow-up care may be useful in improving diabetes self-management in Latinos. [ABSTRACT FROM PUBLISHER]

Objective: The aim of this study was to prospectively investigate predictors of global functioning and employment 10 years following traumatic brain injury (TBI) compared with orthopaedic trauma. Research design: Prospective cohort. Methods: Ninety-seven individuals with complicated mild-to-severe TBI and 91 with traumatic orthopaedic injury were followed-up at 10 years post-injury. Global functioning (GOS-E) and employment status were recorded. Results: Groups did not differ on global functioning or employment status. Post-TBI, shorter PTA and less severe orthopaedic injuries were associated with better global functioning; and shorter PTA and younger age were associated with employment. Following traumatic orthopaedic injury, younger age was associated with employment, but not after excluding individuals no longer in the labour force. Conclusions: In this sample, demographic factors and injury severity contribute to long-term outcomes following TBI, but not orthopaedic trauma. PTA continues to influence outcomes 10 years following TBI. There is ongoing detrimental influence of orthopaedic injuries on global functioning for individuals with TBI, suggesting a potential benefit in greater clinical attention to these injuries. Further understanding of the complex interplay between these predictors and other personal and environmental factors will contribute to improving individualized rehabilitation. [ABSTRACT FROM PUBLISHER]

Background: Although most people who inject drugs (PWID) in Tijuana, Mexico, primarily inject heroin, injection and non-injection use of methamphetamine and cocaine is common. We examined patterns of polydrug use among heroin injectors to inform prevention and treatment of drug use and its health and social consequences. Methods: Participants were PWID residing in Tijuana, aged ≥18 years who reported heroin injection in the past six months and were recruited through respondent-driven sampling (n = 1,025). Latent class analysis was conducted to assign individuals to classes on a probabilistic basis, using four indicators of past six-month polydrug and polyroute use: cocaine injecting, cocaine smoking or snorting, methamphetamine injecting, and methamphetamine smoking or snorting. Latent class membership was regressed onto covariates in a multinomial logistic regression. Results: Latent class analyses testing 1, 2, 3, and 4 classes were fit, with the 3-class solution fitting best. Class 1 was defined by predominantly heroin use (50.2%, n = 515); class 2 by methamphetamine and heroin use (43.7%, n = 448), and class 3 by methamphetamine, cocaine, and heroin use (6.0%, n = 62). Bivariate and multivariate analyses indicated a group of methamphetamine and cocaine users that exhibited higher-risk sexual practices and lower heroin injecting frequency, and a group of methamphetamine users who were younger and more likely to be female. Conclusions: Discrete subtypes of heroin PWID were identified based on methamphetamine and cocaine use patterns. These findings have identified subtypes of heroin injectors who require more tailored interventions to reduce the health and social harms of injecting drug use. [ABSTRACT FROM AUTHOR]

The study investigates illicit drug use in the night-time economy and its association with intoxication, harm and violence experienced by licensed venue patrons. Five-minute structured interviews measuring event-level data were conducted over a 15-month period (March 2010-June 2011) between 9 pm and 1 am. A total of 3949 patrons were interviewed in Newcastle and Geelong, Australian regional cities close to capital cities. Mean age was 24.3 years old (SD=5.8) and 54.4% were male. Six percent of the sample self-reported consuming illicit substances at the time of interview; 7.3% at nightclub venues, 11.8% in the street, 5.5% in pubs and 2.8% in bars. Amphetamines, methamphetamines and ecstasy accounted for two-thirds of substance use. Patrons who reported consuming illicit drugs were 1.90 times as likely to be involved in a prior violent incident (OR 1.35-2.70 95% CI, p < 0.001). Participants who reported illicit drug use at the time of interview were likely to be 0.89 ( p < 0.001) points higher on self-reported intoxication scale (0-10), and were more likely to have engaged in high risk alcohol consumption χ2 (1, n = 3396) = 9.63, p < 0.01) than those who did not report using drugs. Illicit drug use contributes significantly to the burden of harm and intoxication in night-time environments, despite being a minority behavior. [ABSTRACT FROM AUTHOR]

The aim of the current study was to examine different aspects of procedural memory in young adults who varied with regard to their language abilities. We selected a sample of procedural memory tasks, each of which represented a unique type of procedural learning, and has been linked, at least partially, to the functionality of the corticostriatal system. The findings showed that variance in language abilities is associated with performance on different domains of procedural memory, including the motor domain (as shown in the pursuit rotor task), the cognitive domain (as shown in the weather prediction task), and the linguistic domain (as shown in the nonword repetition priming task). These results implicate the corticostriatal system in individual differences in language. [ABSTRACT FROM PUBLISHER]

Primary objective: To characterize an acute stress reaction (ASR) following an improvised explosive device (IED) blast-related mild traumatic brain injury (mTBI). Research design: Participants were male, US military personnel treated in Afghanistan within 4 days following an IED-related mTBI event ( n = 239). Methods and procedures: Demographics, diagnosis of ASR, injury history and self-reported mTBIs, blast exposures and psychological health histories were recorded. Main outcomes and results: In total, 12.5% of patients met ASR criteria. Patients with ASR were significantly younger and junior in rank ( p < 0.05). Patients with ASR were more likely to experience the IED-blast while dismounted, report a loss of consciousness (LOC) and higher pain levels ( p < 0.05). Adjusting for age and rank, multivariate logistic regression showed an association between mTBI history and ASR (AOR = 1.405; 95% CI = 1.105-1.786, p < 0.01). Adjusting for mechanism of injury (dismounted vs. mounted), LOC and pain, multivariate logistic regression showed an association between mTBI history and ASR (AOR = 1.453; 95% CI = 1.132-1.864, p < 0.01). Prior blast exposure and past psychological health issues were not associated with ASR. Conclusions: A history of multiple mTBIs is associated with increased risk of ASR. Future research is warranted. [ABSTRACT FROM AUTHOR]

Purpose: Personality disorders (PDs) are associated with significant distress, disability, and cause great difficulties in life. PDs have been suggested to influence adaptation after major burns, but the potential relationship has not been fully elucidated. This study aimed to describe the prevalence of PDs in 107 patients with major burn injury, and to identify the impact of PDs on perceived patient outcome assessed as health-related quality of life (HRQoL) one year after burn. Methods: One burn-specific instrument (Burn Specific Health Scale-Brief (BSHS-B)) and two generic instruments (EuroQol Five Dimensions and Short Form 36 Health Survey) were used, and Psychiatric Axis I and II disorders were assessed one year post burn. Results: This study identified an above normal prevalence of PDs among individuals afflicted by burn, and participants with PD had a significantly larger lifetime burden of Axis I disorders compared to participants without PD. Participants with PDs scored significantly lower than those without PD in the BSHS-B domain Skin involvement, and the effect of having a PD was related to the subscale Treatment regimens. There was no relationship between the presence of PD and generic HRQoL. Conclusions: An implication of these observations is that special rehabilitation efforts including more tailored interventions must be offered to these patients to ensure that the obstacles they perceive to caring for themselves in this respect are eliminated. [ABSTRACT FROM AUTHOR]

BackgroundParents exert a significant effect on children's eating behaviors and physical activity levels, so it is imperative to find successful obesity prevention programs that target whole families in underserved communities. PurposeTo investigate the effects of a Coordinated School Health Program (CSHP) on parents in the program over a 2-year period. MethodsParents of kindergarteners (n = 277) in 7 schools participating in a CSHP that served an underserved, predominantly minority community were surveyed at 3 time points regarding their nutrition and physical activity knowledge, attitudes, and behaviors (KABs). Results after years 1 and 2 were compared with pre-intervention results using t tests. Effects of socioeconomic variables were investigated using multivariate linear regression. ResultsReported unhealthy behaviors were lower at the end of both year 1 (P = .03) and year 2 (P = .04). Numerous factors were associated with changes in KABs in the parents, including parental gender. DiscussionA CSHP may have lasting effects on parental behaviors in an underserved, predominantly minority community. Translation to Health Education PracticeFuture studies should assess the effects of CSHPs in other populations and which factors most significantly affect parental attitude and behavioral changes so that program content may be tailored accordingly. [ABSTRACT FROM AUTHOR]

We examined the association between a general construct of wellness beliefs, sense of coherence, and a specific measure of tobacco-related beliefs, tobacco use myths, as predictors of two smoking-related outcome measures-next year smoking expectation and last 30-day smoking. Self-report questionnaires were administered to 710 adolescents attending California continuation high schools at baseline and at 1-year follow-up between 2006 and 2008. Cross-sectionally, predictor and outcome measures were correlated. However, in longitudinal analyses, only tobacco use myths predicted change in outcome measures. We speculate that future smoking interventions among adolescents would achieve relatively efficacious outcomes by targeting specific health beliefs instead of global health beliefs. The study's limitations are noted. [ABSTRACT FROM AUTHOR]

We examined the association between the allocation of time to regular physical activity (PA) and achievement in mathematics and language in Chilean adolescents after controlling for confounders. In a random sample of 620 ninth graders (15.6 ± 0.7 years old), we measured regular PA, including physical education and sports extracurricular activities, and academic performance, using national standardised tests. Bivariate and multivariate regression analyses modelled the relation between academic and health-related behaviours. Sufficiency and proficiency in mathematics and language were used as outcome variables. Only 18% of adolescents had >4 h·week–1of regular PA. Devoting >4 h · week–1to regular PA significantly increased the odds of sufficiency and proficiency in both domains. After full adjustment, the odds of sufficiency and proficiency in mathematics increased by 1.9 (95% CI: 1.1–3.5) and 2.7 (95% CI: 1.7–4.3), respectively. Similarly, the odds of sufficiency and proficiency in language increased by 3.3 (95% CI: 1.7–9.7) and 2.6 (95% CI: 1.6–4.1), respectively. Adolescents with the highest allocation of time to regular PA performed much better in mathematics and language than inactive students. The academic benefits associated with PA can help to promote sustained behaviour changes regarding lifestyles. They can be more easily perceived as gains than health benefits alone. [ABSTRACT FROM AUTHOR]

Objective: Patients’ role in treatment decision-making can influence psychosocial and health-related outcomes (i.e. satisfaction, felt respect, adherence). We examined decisional control in a surgical context, identifying correlates of patients’ preferences and experiences. Design: 380 patients and 7 surgeons were surveyed during initial surgical consultation visits in a low-income outpatient clinic. Measures: Patients reported preferences for (pre-consultation) and experiences of (post-consultation) decisional control, demographics, satisfaction with care, and adherence to treatment recommendations. Surgeons rated patients’ health status. Results: Preferences for and experiences of decisional control were unrelated, suggesting significant preference–experience misalignment. However, this misalignment did not appear to be consequential for patient outcomes. Rather, more decisional control, regardless of patients’ preferences, predicted greater satisfaction with care and greater self-reported adherence as assessed at a post-surgical appointment. Conclusions: Decisional control predicts better outcomes for patients, regardless of their preferences for control over treatment decisions. These findings suggest that interventions should aim to increase patients’ degree of decisional control when feasible and appropriate. [ABSTRACT FROM PUBLISHER]

Sleep deprivation is an often hidden problem in working adults. In this study, we evaluated self-regulation processes contributing to poor sleep patterns of full-time office employees. We investigated whether work-related demands and prioritizing sleep (in relation to other activities) predicted sleep behaviours over an 11-day period. Seventy-three adults in New Zealand completed online measures, including the Copenhagen Psychosocial Questionnaire, a measure of sleep prioritization, and the Pittsburgh Sleep Quality Index. Mixed-model analyses of daily data revealed that higher sleep prioritization and positive work-related emotions during a workday predicted better sleep quality that night. Cognitive demands on a workday predicted a later bedtime that night, whereas emotional demands predicted an earlier bedtime (but also an earlier waking time). Regression analyses revealed that when controlling for baseline levels of each dependent measure, pre-sleep arousal predicted fewer hours of sleep and greater sleep difficulty whereas sleep prioritization predicted a faster time getting to sleep, longer sleep and less sleep difficulty. High priority for sleep and positive emotions at work may promote sleep quality, whereas cognitive and emotional demands, or pre-sleep arousal may disrupt sleep patterns. These findings point to sleep prioritization and cognitive-emotional self-regulation skills as potential targets for work-based interventions aimed at promoting sleep. [ABSTRACT FROM PUBLISHER]

Our objective was to determine whether serial HIV testing during pregnancy and the postpartum period as well as male partner testing are acceptable and feasible in Tororo, Uganda. This was a prospective study of pregnant women at the Tororo District Hospital (TDH) Antenatal Clinic. Patients presenting for routine antenatal care were asked to participate in a serial HIV testing integrated into standard antenatal and postpartum/child immunization visits, and to invite their male partners for HIV testing. Serial testing was defined as ≥2 tests during pregnancy and ≥2 tests within 24 weeks postpartum. Of the 214 enrolled women, 80 (37%) completed serial testing, 176 (82%) had ≥2 tests, and 147 (69%) had ≥3 tests during the study period. One hundred eighty-two women (85%) accepted male partner testing, but only 19 men (10%) participated. One woman seroconverted during the study, for a cumulative HIV incidence of 0.5% (1/214). In multivariable logistic regression analysis, longer distance between home and clinic (aOR 0.87 [95% CI 0.79–0.97]) and not knowing household income (aOR 0.30 [95% CI 0.11–0.84]) were predictive of not completing serial testing. Higher level of education was associated with completing serial testing (linear trendpvalue = 0.05). In conclusion, partial serial HIV testing was highly acceptable and feasible, but completion of serial testing and male partner testing had poor uptake. [ABSTRACT FROM PUBLISHER]

Objectives:The purpose of the study was to explore whether and how loneliness in adults was influenced by life events and experiences in early and later stages in life. Applying a life-course and gender perspective, the current study investigates statuses and transitions that influence self-reported loneliness among men and women in middle age (age 40–59) and when older (age 60–80). Method:The panel data are from two waves of the Norwegian study of the life course, ageing and generations. Our sample consists of 3750 people aged 40–80 at baseline who were surveyed in 2002–2003 (T1) and 2007–2008 (T2). Multivariate analyses were used to investigate personal characteristics and life events associated with loneliness at baseline and life events predicting the incidence of loneliness during the five-year period. Results:Adverse childhood events were associated with loneliness by both men and women. In the older group, men's loneliness was related to having been bullied, and conflicts between parents. Women's loneliness was related to economic problems in their childhood family. Regarding the incidence of loneliness – becoming lonely between T1 and T2 – among those aged 40–59, divorce predicted women becoming lonely, but not men. Among those aged 60–80, the partner's death was a stronger predictor of the incidence of loneliness among men than among women. Conclusion:The results demonstrate that loneliness is influenced by events and experiences from early childhood to later life, and that some events and experiences influence loneliness in men and women differently. [ABSTRACT FROM PUBLISHER]

This study aimed to examine the associations among prenatal nicotine exposure, oxidative stress, and postpartum visceral fat among women exposed to secondhand smoke (SHS). The study was conducted in Kelantan, Malaysia, from April 2010 to December 2012. Blood samples were collected in the second and third trimesters from 135 healthy pregnant women who were followed-up at delivery, 2 months, 6 months and 12 months postpartum. Maternal hair nicotine and oxidative stress markers during pregnancy were measured. Visceral fat was assessed by bioelectrical impedance. Multiple linear regression analysis revealed that maternal hair nicotine concentration was associated with increased DNA damage (tail moment:β = 0.580,p= 0.001) and decreased glutathione peroxidase (β = –12.100;p= 0.009) in the second trimester of pregnancy. Increased DNA damage, protein oxidation and total antioxidant capacity in the second trimester were associated with 2, 6, and 12 months postpartum visceral fat. No direct association was found between prenatal hair nicotine level and postpartum visceral fat; however, these results suggest that any relation of SHS to visceral adiposity may be indirect, mediated via enhanced oxidative stress. [ABSTRACT FROM AUTHOR]

Primary objective: To determine whether sleep disturbance in the acute post-traumatic brain injury (TBI) period predicts symptoms of depression, anxiety or apathy measured 6 and 12 months after TBI. Research design: Longitudinal, observational study. Methods and procedures: First time closed-head injury patients ( n = 101) were recruited and evaluated within 3 months of injury and followed longitudinally, with psychiatric evaluations at 6 and 12 months post-injury. Pre- and post-injury sleep disturbances were measured via the Medical Outcome Scale (MOS) for Sleep. Subjects were also assessed for anxiety, depression, apathy, medical comorbidity and severity of TBI. Main outcomes and results: Sleep disturbance in the acute TBI period was associated with increased symptoms of depression, anxiety and apathy 12 months post-injury. Conclusions: Sleep disturbances experienced soon after trauma (i.e. <3 months after injury) predicted neuropsychiatric symptoms 1 year after injury, raising two important clinical questions: (1) Is sleep disturbance soon after trauma a prognostic marker of subsequent neuropsychiatric symptoms? and (2) Can early treatment of sleep disturbance during the post-TBI period reduce subsequent development of neuropsychiatric symptoms? Future studies with larger sample sizes and appropriate control groups could help to answer these questions, using evidence-based methods for evaluating and treating sleep disturbances. [ABSTRACT FROM AUTHOR]

Studies have shown more erectile dysfunction (ED) in men living with HIV (MLHIV), relative to age matched HIV-negative men. Erection enhancing medication (EEM) is more frequently used by HIV-positive men than in the general male population. Increased sexually transmitted infection has been described in HIV-positive men with ED using EEM. This study investigated the use of EEM and party drugs (methyleendioxymethamfetamine (XTC), gammahydroxybutyrate (GHB) “fluid XTC” and alkyl nitrites “poppers”) among MLHIV. Self-administered questionnaires were distributed consecutively to all patients attending 17 European HIV treatment centers. The sample included 1118 HIV-positive men, among whom 74.5% men having sex with men (MSM). The use of EEM was more frequent in MSM than in heterosexual men (odds ratio (OR) 3.33,p<0.001) and was associated with increased sexual risk behavior (OR 3.27,p<0.001). Nonmedically indicated use of EEM was linked to increased use of party drugs (OR 2.30,p=0.01). Physicians taking care of MLHIV need to be aware of the high prevalence of (nonmedical) use of EEM and party drugs. Medical provision of EEM should be combined with a discussion on safer sex behavior and the risk related to concomitant use of party drugs and illegal EEM. [ABSTRACT FROM AUTHOR]

Background: Post-traumatic depression (PTD) may be a result of several factors like secondary injury chemical cascades as well as psycho-social factors following traumatic brain injury (TBI). While the role of serotonin in the pathology and treatment of idiopathic major depression may be somewhat controversial, it is unclear what role serotonin may play in PTD following a TBI. Objective: To assess serotonergic function and genetic risk for PTD development over 1 year following TBI. Research design: Examination of variation in the serotonin transporter gene [ SLC6A4 (5-HTTLPR, rs25331, and a variable number of tandem repeats variant in Intron 2)] in 109 subjects with moderate-severe injury. Depression was assessed using the Patient Health Questionnaire (PHQ-9) at 6 and/or 12 months post-injury. Main outcomes and results: At 6 months post-injury, subjects with a history of pre-morbid mood disorders and 5-HTTLPR L-homozygotes were at greater risk for PTD. Contrary to major depression, subjects without pre-morbid mood disorders ( n = 80) and S-carriers were 2.803-times less likely to be depressed compared to L-homozygotes. At 12 months post-injury, LG-carriers were also less likely to experience PTD. Temporal analysis also showed 5-HTTLPR associations in PTD development across recovery. Conclusions: This study suggests a unique injury- and temporally-specific interaction between TBI and genetic risk for depression. [ABSTRACT FROM AUTHOR]

Purpose: To study the association between self-reported general tension and muscle tension, and clinically tested relaxation ability. Methods: Self-reports on muscle tension habits and on general tension, and the covariates neck and shoulder pain, perceived stress level, perceived mastery of work, quantitative work demands, and leisure time physical activity, were collected on a questionnaire (52 males, 81 females, mean age 23 years). A clinical test on relaxation ability was performed by a trained physiotherapist on a subsample (38 males, 39 females). Results: Perceived general tension showed a highly significant ( p < 0.001) correlation with the muscle tension habit score (0.58), and the muscle tension factor (0.54). None of the self-reported tension measures correlated with the relaxation ability score. The self-reported tension measures, but not the clinical tension score, showed an association with neck and shoulder pain and perceived stress level. Conclusions: The self-reported measures of general tension and of muscle tension correlated and probably represented similar phenomenon. However, the subjects' perceived stress level was to a higher degree reflected in the measure of general tension. The score of the clinical test on relaxation ability did not show an association with the self-reported tension measures. [ABSTRACT FROM AUTHOR]

Problem Behaviour Theory suggests that young people's problem behaviours tend to cluster. This study examined the relationship between traditional bullying, cyberbullying and engagement in problem behaviours using longitudinal data from approximately 1500 students. Levels of traditional victimisation and perpetration at the beginning of secondary school (grade 8, age 12) predicted levels of engagement in problem behaviours at the end of grade 9 (age 14). Levels of victimisation and perpetration were found to moderate each other's associations with engagement in problem behaviours. Cyberbullying did not represent an independent risk factor over and above levels of traditional victimisation and perpetration for higher levels of engagement in problem behaviours. The findings suggest that to reduce the clustering of cyberbullying behaviours with other problem behaviours, it may be necessary to focus interventions on traditional bullying, specifically direct bullying. [ABSTRACT FROM AUTHOR]

Smoking, drinking, and illicit drug use are leading causes of morbidity and mortality, both during adolescence as well as later in life. The determination of how well national and local policy and intervention efforts address teen substance use depends largely on the collection of valid and accurate data. Assessments of substance use rely heavily on retrospective self-report measures, but the reliability and validity, however, may be limited by various sources of measurement error. This study utilizes four waves of data from the National Longitudinal Survey of Youth spanning eight years. Results from multiple linear regression analyses showed that the single most consistent variable associated with telescoping was the number of years since the substance was first reported. Time since first report was the single consistent variable and was strongly associated with telescoping in each wave-to-wave comparison for all three substances under study. Implications for policy and research are discussed. [ABSTRACT FROM AUTHOR]

Objective: To investigate associations between disability and employment 1 year after traumatic brain injury (TBI) using the International Classification of Functioning, Disability and Health (ICF) as a conceptual model. Design and methods: A prospective study including 93 patients with moderate-to-severe TBI (aged 16-55 year). Disability components of the ICF model (impairments, activity limitations and participation restrictions) and personal factors (age, gender, pre-injury employment status) were used as independent variables. The outcome measure was employment at 1 year post-injury categorized into unemployed and employed groups. Results: Personal factors, impairments (brain injury severity, overall trauma severity and number of impaired body functions) and activity limitations (motor and cognitive abilities) accounted for 57%% of the variance in employment outcome. Multivariate analyses showed that the probabilities of being employed 1 year post-injury were 95%% lower for patients who were unemployed pre-injury (OR == 0.05), 74%% lower for those with more severe brain injury (OR == 0.26) and 82%% lower for those with more cognitive limitations (OR == 0.18). Conclusion: Rehabilitation professionals should take into account the importance of the ICF model when planning vocational rehabilitation interventions for individuals with TBI and focus on targeting modifiable aspects related to employment outcome, such as the individual's cognitive ability. [ABSTRACT FROM AUTHOR]