Patterns of positivity: Positive affect trajectories among infants of mothers with a history of depression

This study examined positive affect (PA) trajectories over the first year of life among infants of mothers with a history of depression (N = 191) as well as predictors (i.e., maternal prenatal and postpartum depression symptoms, maternal parenting behaviors) of those trajectories. Infant PA was observed in play and feeding tasks during laboratory visits at 3, 6, and 12 months of age; parenting behaviors were observed at 3 months. Mothers completed questionnaires regarding their symptoms of depression throughout the prenatal period and during the first 3 months postpartum. Growth curve analyses indicated that infant PA increased across time, and this finding replicated across both the play and feeding tasks, though increases slowed over time. Neither maternal prenatal nor postpartum depression symptoms predicted infants' PA trajectories, but mothers' PA, positive parenting, and disengaged parenting were associated with infant PA during the play task. Our finding that infant PA increased over the first year postpartum suggests PA trajectories among infants of mothers with a history of depression may be indices of resilience, despite risks associated with their mothers' history of depression. Furthermore, this study highlights parenting behaviors that may be important targets of prevention and early intervention efforts to bolster infant PA.     

Nurses' working tasks and MSDs back symptoms: results from a national survey

Healthcare workers, namely registered nurses (RN), are frequently exposed to work-related musculoskeletal disorders (WRMSDs) risk factors. Identifying the symptoms of these disorders is one of the first epidemiological steps to managing them. This study aims to identify WRMSDs prevalence symptoms in Portuguese RN. During 8 months (2010-2011) the National Public Health School and the Portuguese Registered Nurses Board made a call to all RN to answer an online WRMSDs questionnaire. Respondents (n=2140) are mostly females (77.4%) and work mainly in hospitals (n=1396) and in primary healthcare centers (n=421). Results show high symptoms prevalence (last 12 months) in the lower back (60.6%), the upper back (44.5%), and the neck (48.6%). Nurses' activity, especially patient hygiene in bed, is a strong contributor (p>0.05) to pain in the upper back (OR=1.39 [1.09-1.80]) and lower back (OR=1.4 [1.08-1.84]). Patient holdup without mechanical support has the highest relationship (p>0.05) between work tasks and symptoms in the last 12 months in the upper back (OR=1.50 [1.19-1.90]). Prevalence rates of WRMSDs symptoms in Portuguese nurses are no different from other studies with Swedish, Italian and Greek nurses. Maybe changes in healthcare systems didn't change the way care is delivered and we must rethink how to prevent nurses WRMSDs.     

Actual versus perceived risk of cervical cancer among college women smokers

Cervical cancer is a well-established smoking-related illness, but many at-risk women are unaware of this link. OBJECTIVE: The authors designed this study to (1) investigate the relationship of smoking behavior with the history of abnormal Pap test results, sexual history, and perceived risk of cervical cancer and (2) determine whether self-classified smoking status (and hence perceived risk) corresponds with actual smoking behavior in a college student population. PARTICIPANTS AND METHOD SUMMARY: College women students (N = 135) completed a survey assessing smoking history, health history, sexual risk behavior, and risk awareness. RESULTS: Relative to those who had not smoked in the past month, current smokers (n = 36, or 27% of the total sample) perceived themselves to be at higher risk for developing cervical cancer, but did not demonstrate increased awareness of specific cervical cancer risk factors, including smoking. Twenty-eight percent (10 of 36) of past-month smokers did not define themselves as current smokers. CONCLUSION: The authors conclude that anti-smoking and health-related messages targeting smokers may misfire for individuals who do not define themselves as smokers but are nonetheless at risk for smoking-related consequences and escalating use.     

Process evaluation of the ‘Singapore Physical Activity and Nutrition Study’

IntroductionThe Singapore Physical Activity and Nutrition Study (SPANS) aimed to improve the physical activity (PA) and nutrition behaviours of Singaporean women aged 50 years and over. The SPANS program consisted of PA classes, nutrition workshops, telephone dietary counselling, health booklets, a health calendar and program ambassadors. This study aimed to assess and understand the implementation of the program strategies and gain insight into process evaluation components to inform future programs.MethodsThe evaluation was guided by a process evaluation framework and collected data via questionnaires (n = 209), program ambassador documentation and exit interviews with program completers (n = 13) and non-completers (n = 12).ResultsIn total, 295 participants completed the program (response rate = 84 %). Participants reported high levels of satisfaction with the overall program (99.5 %) and program activities (96.7 %), and also rated program ambassadors highly. Participation rates were highest for telephone dietary counselling sessions. The main reason for not attending program activities was having a ‘busy schedule’ (n = 158). Participants cited a need for improved recreational centre facilities and increased flexibility around program delivery.ConclusionsThe process evaluation showed that the program strategies were implemented as planned and were deemed suitable for supporting behaviour change among Singaporean women aged 50 years and over. The program reached and involved the majority of participants throughout the six months. The combination of practical educational resources and supportive program ambassadors were key strategies that facilitated positive PA and dietary behaviours. However, there needs to be some flexibility in the delivery of programs. The findings of this research may inform other programs in the region.     

Perceptions of participants and staff of implementing a physical activity program in rural primary care

Addressing the lack of physical activity (PA) in rural adults is vital because of the role it plays in the risk for many chronic diseases. The purpose of the study was to explore the feasibility of conducting a 12-week intervention utilizing a Fitbit to increase PA behavior in inactive rural adults recruited from a primary care clinic. Semi-structured interviews were conducted with study participants (n=10) and a focus group was held with nurses (n=7) from the primary care clinic. Data were analyzed using the process of immersion/crystallization. Participants and nurses both felt the program had a positive impact on PA and that the program was needed in the community. Study participants most often reported their favorite part of the study was being able to track their activity as well as the goal setting. However, study participants reported barriers to continued participation in PA related to a lack of time and ability to be active in cold weather. Further, nursing staff reported barriers in regard to a lack of resources (staffing and money) These barriers need to be examined further and addressed in order to implement a sustainable PA program that can be maintained through a primary care clinic.     

Evidence-based exposure criteria for work-related musculoskeletal disorders as a tool to assess physical job demands

Despite worldwide attention, musculoskeletal disorders (MSDs) remain a substantial concern at work. To support ergonomists to assess the work-related risk factors for MSDs, several instruments are available. Unfortunately, many of these instruments are not supported by evidence-based exposure criteria for particular MSDs. For effective prevention of MSDs, it is important to know to what extent work-related risk factors are present in the work situation. The Netherlands Center for Occupational Diseases (NCOD) develops evidence-based criteria documents for the assessment of work-related MSDs. The exposure criteria of these documents can be used on a group level to support ergonomists in their assessment of the physical job demands that are associated with work-related MSDs. At the moment the NCOD has exposure criteria for the assessment of 22 work-related MSDs, for instance on the work-relatedness of upper extremity disorders, non-specific low back pain or patellar tendinopathy. The use of these exposure criteria enables ergonomist to better assess the work-related risks of MSDs as a starting point for effective prevention.     

Reliability of the instrument DOA: dialogue about ability related to work

The aim of this study was to examine the reliability of the new instrument "DOA--a dialogue about ability related to work" [6]. DOA was developed using the Model of Human of Occupation as a theoretical base [12,13]. The instrument is divided into two sections; client self-assessment and professional assessment focusing on the individual's ability to perform work-related activities. Assessments are followed by a dialogue to distinguish goals for the return-to-work process based on the client's own preferences [6,14]. 34 outpatients' clients and 14 professionals from four clinics within psychiatric work rehabilitation in Sweden participated in the study. The Spearman Rank Correlation test generally showed acceptable significant correlations in test-retest (n=34). A greater part of items correlated "moderate to good" (r=0.51-0.75). In the raters' test (n=14) Percentage of agreement (PA) was good ranging between 93.1%-96.5%, which is above the acceptable criteria of 80%. There were no significance differences between the raters. The study has indicated that items in DOA work with generally good reliability to measure ability related to work. The instrument was demonstrated to be a reliable therapeutic tool in goal setting for return-to-work in a position outside of the clients' preferences.     

Prediction of future low levels of sickness absence among young persons sick listed with back, neck, or shoulder diagnoses

In recent years sickness absence has increased in most Western countries. Risk factors for sickness absence and disability pension have been emphasised in studies, while focus on factors predicting low sickness absence is very rare. This paper is an attempt to apply such a perspective in an 11-year prospective cohort study of young persons n = 213) who in 1985 were sick listed > or = 28 days with back, neck, or shoulder diagnoses. Having had no sick-leave spells > 14 days in 1992-1996 was used as the outcome measure. Sixty-nine persons (34%) had no such spells, with an unexpected similar proportion of men and women. Data on prior sick leave and demographic variables were analysed using univariate and multiple logistic regression. Factors that predicted low sickness absence were having prior low sickness absence, being a white-collar worker, and being married. We concluded that individuals with a history of low sickness absence have an increased odds for remaining in the work force after a single long sick-leave spell, and might need less attention in rehabilitation compared to persons with a history of high sickness absence. Focusing on low sickness absence led to different results than those discussed in previous studies on risk factors for disability pension.     

Risk of disability pension in relation to gender and age in a Swedish county; a 12-year population based, prospective cohort study

Residents of the county of Osterg?tland, Sweden, who were 16-64 years of age in December 1984 and not pensioned (n=229,864), were followed in a prospective, cohort, study of data collected between 1985 and 1996. Using survival methods as the method of analysis, the likelihood of being granted a disability pension was 14% for women, 11% for men, and increased with age. Women less than 54 years of age were at higher risk than men (P<0.001), 69% of disability pensions granted were full-time and 31% were part-time, more women received part-time pensions (P<0.001). Whether the differences observed are due to gender bias in social insurance practices, to disease patterns, to occupational and work-related factors, or to a cohort effect has yet to be determined.     

Work organization, well-being and health in geriatric care

The objective of the present study was to explore the connection between the organization of work in geriatric care and factors which have been connected to job stress and burnout, i.e. exhaustion, mental workload, job satisfaction and communication. We also analyzed how these factors were related to employee visits to doctors during the previous 12 months due to various medical conditions. The study was a cross-sectional questionnaire distributed to all employees within nursing homes and geriatric hospital wards with 10 employees or more throughout Iceland. The total response rate was 80%. The majority of respondents, or 96%, were women (n = 1432), and the results are based on their answers. Our data show that there is a high correlation between mental exhaustion and the unsatisfactory organization of work. Mental exhaustion upon completing work shifts was more closely connected to the health outcomes studied than were the other work-related factors studied. This is especially true for chronic fatigue, depression and sleeping disorders. It is important that employers and managers notice the mismatches between work and workers that this study manifests. Employers and managers must also consider the organizational factors that are influential.     

A comparative study of therapy duration for survivors of childhood sexual abuse

The goal of this study was to determine whether duration of group therapy affected outcomes for women with a history of childhood sexual abuse (CSA). The sample included women from 6-month therapy groups (n = 42) and the comparison group who completed 12 months of therapy (n = 114). When outcomes attained by the 6-month group were compared with those of the 12-month group, those in the 6-month group showed significantly greater gains in self-esteem, symptom change, and posttraumatic stress disorder symptoms. In addition, although participants in the 6-month group improved more in depression scores than those in the 12-month group, the difference was not statistically significant. The results of this study indicate that intensive 6-month group therapy for female survivors of CSA may be even more beneficial than less intensive 12-month groups.     

Resolution of depression among victims of intimate partner violence: is cessation of violence enough?

The objective of this article is to assess the effect of abuse cessation on depressive symptoms among women abused by a male intimate partner. This prospective cohort study of Seattle women with a history of intimate partner violence (IPV) who were classified by history of abuse and abuse status at 3 month, 9 month, and 2 year follow-up interviews. Relative risks (RR) were calculated using generalized estimating equations. Among subjects with a history of psychological abuse only, cessation of abuse was associated with a nonsignificant reduction in the likelihood of depression compared to subjects whose abuse continued (aRR = 0.88; 95%CI: 0.75,1.03). Among subjects with a history of physical/sexual abuse and psychological abuse, cessation of physical/sexual abuse only was associated with a 27% decline, and cessation of both types of abuse was associated with a 35% decline in the likelihood of depression (aRR = 0.73, 95%CI: 0.63,0.86; and aRR = 0.65; 95%CI: 0.55,0.76; respectively). Cessation of abuse among victims of IPV is associated with a decreased prevalence of depression.     

Actual Versus Perceived Risk of Cervical Cancer Among College Women Smokers

Cervical cancer is a well-established smoking-related illness, but many at-risk women are unaware of this link. Objective: The authors designed this study to (1) investigate the relationship of smoking behavior with the history of abnormal Pap test results, sexual history, and perceived risk of cervical cancer and (2) determine whether self-classified smoking status (and hence perceived risk) corresponds with actual smoking behavior in a college student population. Participants and Method Summary: College women students (N = 135) completed a survey assessing smoking history, health history, sexual risk behavior, and risk awareness. Results: Relative to those who had not smoked in the past month, current smokers (n = 36, or 27% of the total sample) perceived themselves to be at higher risk for developing cervical cancer, but did not demonstrate increased awareness of specific cervical cancer risk factors, including smoking. Twenty-eight percent (10 of 36) of past-month smokers did not define themselves as current smokers. Conclusion: The authors conclude that antismoking and health-related messages targeting smokers may misfire for individuals who do not define themselves as smokers but are nonetheless at risk for smoking-related consequences and escalating use.     

Cocaine use among the College Age Group: Historical Perspective—The Long and Colorful History of Erythoxylon Coca

Abstract

The rate of increase in the use of cocaine among college students has been greater even than the increase in the use of marijuana during the past ten years. Nationwide surveys indicate that 9 million Americans within the 18–25 age group, or 28.7%, have used cocaine. This compares with 2.9 million, or 9.1%, just a decade ago. The history of cocaine begins with the history of the coca plant. Even prior to the inca period the plant was used in South America; for centuries use of the plant remained restricted primarily to that continent. In 1859, an Austrian explorer brought home from Peru coca leaves that he sent to the University of Gottigen where Dr. Albert Niemann extracted and purified a crystalline compound he called cocaine. Several prominent physicians including Sigmund Freud and William Halsted, the father of modern surgery, experimented with cocaine on themselves and on their patients. Their published observations helped effect widespread use of cocaine in patent medicines, tonics, wines, and soft drinks. That earlier epidemic and the rest of the long and colorful history of cocaine brings into perspective the current epidemic of cocaine use.

“Mild Hypertension: When and How to Treat,” NORMAN H. KAPLAN. “Early and aggressive” drug therapy for mild hypertension, now widely prescribed in the United States, may be inappropriate for many of the 30 million patients with this condition. Although all of these patients are at greater risks of premature cardiovascular disease, the risks are manifested neither quickly nor uniformly. Drug therapy has not proved beneficial for patients with a diastolic (D) BP reading below 100 mm Hg, particularly those patients who are otherwise at low risk. Those antihypertensive drugs that are available now carry risks along with their benefits. Therefore, persons with mild hypertension who are at low risk should be encouraged to use nondrug therapies for at least six to 12 months. If their DBP remains below 100 mm Hg, they may be better off than if they were given drugs. The drug used in initial therapy has usually been a diuretic. For many patients, however, an adrenergic inhibitor may be a more appropriate choice. (Archives of Internal Medicine, 1983;143:255–259)

“Persistence of Normal BP After Withdrawal of Drug Treatment in Mild Hypertension,” PAUL D. LEVINSON, IBRAHIM M. KHATRI, EDWARD D. FREIS. Antihypertensive therapy was discontinued in 24 patients with mild hypertension whose BPs had been well controlled with diuretics alone. Eleven patients (46%) maintained normal diastolic BPs (≤ 90 mm Hg) for six months after stopping treatment and five patients (21%) for 12 months. All patients who remained normotensive for six to 12 months had mean diastolic BPs of 82 mm Hg or less during treatment. There was no signficant correlation between maintenance of normotension and any of the following: pretreatment BP, presence of target-organ damage, duration of known hypertension, family history of hypertension, heart size, body weight, weight gain after stopping diuretic therapy, 24-hour urinary sodium and potassium excretion, serum electrolyte values or renin profile. This study demonstrates that hypertension may be favorably modified, sometimes for many months, by effective antihypertensive treatment. (Archives of Internal Medicine 1982;142:2265–2268)     

Geographic variation in surgical treatment for work-related carpal tunnel syndrome: does improved return to work matter?

Medical treatment of compensated work-related conditions has two objectives--improve injured workers' health status and allow safe and sustained return to work (RTW). Theoretically, the choice of treatment method should be based primarily on these objectives. Surgical treatment of work-related carpal tunnel syndrome (CTS) provides an opportunity to evaluate whether this occurs. The traditional method of open release has been complemented by an endoscopic procedure, particularly useful in work-related cases due to the anticipated benefit of earlier RTW. The objective of this study was to investigate the differences in surgical treatment for work-related CTS across eight US workers' compensation (WC) jurisdictions, and the factors associated with these differences. From all WC claims reported to a single insurer during the 1995-1999 period, we identified individuals with a one or two surgical procedures for work-related CTS. Among selected individuals (n=4,421), about 20% were treated using the endoscopic procedure; this percentage had a ten-fold variation across the eight jurisdictions. However, utilization of endoscopic release did not increase during the study period, despite reports of better RTW outcomes. The highly jurisdictional nature of the US WC system, with significant differences in reimbursement levels for endoscopic procedures, and geographical differences in medical training were among the potential contributors to the observed variation in utilization.     

Development of Shyness: Relations With Children's Fearfulness,Sex, and Maternal Behavior

The relations of childhood fearfulness (observed and adult reported) and adult‐reported shyness at 18 (n = 256) and 30 (n = 230) months of age were assessed. Fear was positively related to shyness concurrently and longitudinally, but slightly more consistently at 18 months. The moderating roles of observed maternal sensitivity and children's sex in the relation between 18‐month fearfulness and 30‐month shyness, and between 18‐ and 30‐month shyness, were tested. The positive relation between mother‐reported fearfulness and shyness was strongest for sons of insensitive mothers but was not significant for daughters of sensitive, average, or insensitive mothers. The positive relation between mother‐reported 18‐ and 30‐month shyness was strongest for sons of insensitive mothers and for daughters of sensitive mothers. Moreover, when using scores of fear or shyness that were independent of each other, 18‐month mother‐reported fearfulness continued to interact with sex and sensitivity to predict 30‐month shyness; however, the positive relation between Time 1 and Time 2 shyness was consistent across sex and levels of sensitivity.     

Conservation of Resources theory in the context of multiple roles: an analysis of within- and cross-role mediational pathways

Based on the Conservation of Resources theory, we used data from the National Survey of Midlife Development in the United States (MIDUS I, 1995–1996; N=1779) to estimate by covariance structure analysis the direct and indirect effects of work and family demands, resources, and support on psychological distress. In a new application of the theory, we estimated six within-role mediational pathways linking work-related predictors to psychological distress through work interfering with family (WIF) and family-related predictors to psychological distress through family interfering with work (FIW). Finally, in a departure from previous work–family research, we estimated six cross-role mediational pathways linking work-related predictors to psychological distress through FIW and family-related predictors to psychological distress through WIF. Ten of the 12 hypothesized mediational effects were significant and another was marginally significant, supporting the mediational role of work–family conflict within Conservation of Resources theory.     

Greater Pupil Size in Response to Emotional Faces as an Early Marker of Social‐Communicative Difficulties in Infants at High Risk for Autism

When scanning faces, individuals with autism spectrum disorder (ASD) have shown reduced visual attention (e.g., less time on eyes) and atypical autonomic responses (e.g., heightened arousal). To understand how these differences might explain subclinical variability in social functioning, 9‐month‐olds, with or without a family history of ASD, viewed emotionally expressive faces, and gaze and pupil diameter (a measure of autonomic activation) were recorded using eye‐tracking. Infants at high risk for ASD with no subsequent clinical diagnosis (HRA‐) and low‐risk controls (LRC) showed similar face scanning and attention to eyes and mouth; attention was overall greater to eyes than mouth, but this varied as a function of the emotion presented. As a group, HRA‐ showed significantly larger pupil size than LRC. Correlations between scanning at 9 months, pupil size at 9 months, and 18‐month social‐communicative behavior, revealed positive associations between pupil size and attention to both face and eyes at 9 months in LRC, and a negative association between 9‐month pupil size and 18‐month social‐communicative behavior in HRA‐.The present findings point to heightened autonomic arousal in HRA‐. Further, with greater arousal relating to worse social‐communicative functioning at 18 months, this work points to a mechanism by which unaffected siblings might develop atypical social behavior.     

THE IMPACT OF PERCEIVED BACKGROUND RISK ON BEHAVIORAL HEALTH: EVIDENCE FROM HURRICANE KATRINA

I explore the hypothesis that Hurricane Katrina in August 2005 raised perceived background risks, which had spillover effects on behavioral health outcomes of mental health and substance use. I estimate the effect that Katrina had in the nondamaged storm surge region, in time intervals leading up to and after the hurricane, compared to areas impervious to hurricanes. I find causal evidence that Katrina increased poor mental health days by 18.8% for the first month after Katrina, and increased smoking among lifetime smokers until 2007. Effects were larger in counties with disproportionate risk to storm surge and for low‐educated individuals. (JEL D81, I12, Q54)     

Relationship Risks in Context: A Cumulative Risk Approach to Understanding Relationship Satisfaction

Risks associated with less satisfying intimate relationships often co‐occur within individuals, raising questions about approaches that consider only their independent impact. Utilizing the cumulative risk model, which acknowledges the natural covariation of risk factors, this study examined individuals in intimate relationships using the Florida Family Formation Survey (n = 2,876) and a replication sample (n = 1,048). Analyses confirmed that not only was relationship satisfaction lower among those with more risks, but the cumulative risk score was predictive above and beyond the individual risk factors. Furthermore, experiencing multiple risks exacerbated the negative associations between individual risks and relationship satisfaction, suggesting that the operation of a risk factor in a relationship is moderated by the presence or absence of other risks.