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Feola M.,Cardiovascular Rehabilitation Heart Failure Unit | Garnero S.,Cardiovascular Rehabilitation Heart Failure Unit | Vallauri P.,Psychology Service | Salvatico L.,Psychology Service | And 3 more authors.
Open Cardiovascular Medicine Journal | Year: 2013

Cognitive impairment, anxiety and depression have been described in patients with congestive heart failure (CHF). We analyzed in-hospital CHF patients before discharge with neuropsychological tests attempting to correlate with prognostic parameters. Methods: All subjects underwent a mini mental state examination (MMSE), geriatric depression scale (GDS), anxiety and depression scale test (HADS). We evaluated NYHA class, brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF) and non-invasive cardiac output (CO). Results: Three-hundred and three CHF patients (age 71.6 ys) were analysed. The mean NYHA class was 2.9±0.8, LVEF was 43.4±15.8%; BNP plasma level and CO were calculated as 579.8±688.4 pg/ml and 3.9±1.1 l/min, respectively. In 9.6% a pathological MMSE score emerged; a depression of mood in 18.2% and anxiety in 23.4% of patients were observed. A significant correlation between MMSE and age (r=0.11 p=0.001), BNP (r=0.64 p=0.03) but not between MMSE and NYHA class and LVEF was observed. GDS and HADS were inversely correlated with NYHA class (r=0.38 p=0.04) and six-minute walking test (r=0.18 p=0.01) without an association with objective parameters in CHF (BNP, LVEF and cardiac output). At multivariate analysis only MMSE and BNP are inversely correlated significantly (p=0.019 OR=-0.64, CI=-042-0.86). Conclusions: in-hospital CHF patients may manifest a reduction of MMSE and important anxiety/depression disorders. The results of the study suggest that the presence of cognitive impairment in older CHF patients with higher BNP plasma level should be considered. In admitted CHF patients anxiety and depression of mood are commonly reported and influenced the perception of the severity of illness. © Feola et al.


Dzierzewski J.M.,University of Florida | Williams J.M.,University of Florida | Roditi D.,University of Florida | Marsiske M.,University of Florida | And 6 more authors.
Journal of the American Geriatrics Society | Year: 2010

OBJECTIVES: To examine the relationship between objectively measured nocturnal sleep and subjective report of morning pain in older adults with insomnia; to examine not only the difference between persons in the association between sleep and pain (mean level over 14 days), but also the within-person, day-to-day association. DESIGN: Cross-sectional. SETTING: North-central Florida. PARTICIPANTS: Fifty community-dwelling older adults (mean age±standard deviation 69.1±7.0, range 60-90) with insomnia. MEASUREMENTS: Daily home-based assessment using nightly actigraphic measurement of sleep and daily self-report of pain over 14 consecutive days. RESULTS: Between persons, average sleep over 14 days was not associated with average levels of rated pain, but after a night in which an older adult with insomnia experienced above-average total sleep time he or she subsequently reported below-average pain ratings. The model explained approximately 24% of the within-person and 8% of the between-person variance in pain ratings. CONCLUSIONS: Sleep and pain show day-to-day associations (i.e., covary over time) in older adults with insomnia. Such associations may suggest that common physiological systems underlie the experience of insomnia and pain. Future research should examine the crossover effects of sleep treatment on pain and of pain treatment on sleep. © 2010, Copyright the Authors. Journal compilation © 2010, The American Geriatrics Society.


Doran N.,University of California at San Diego | Schweizer C.A.,San Diego State University | Myers M.G.,Psychology Service
Psychology of Addictive Behaviors | Year: 2011

Expectancies are important predictors of smoking behavior. Recent research suggests that expectancies are not stable and vary across internal and external states and levels of cigarette consumption. Expectancies may also vary between individuals as a function of temperamental characteristics such as behavioral undercontrol (BU). Although pre-initiation expectancies have been linked to subsequent smoking behaviors, no study has assessed the effect of smoking initiation on expectancies. The present study was designed to test the hypotheses that both positive (PRE) and negative (NRE) reinforcement expectancies would increase following initiation, and that these changes would be moderated by BU. College students were interviewed 12-15 months apart. Those who initiated smoking between assessments (n = 69) were included in the present study. Linear mixed models showed a significant increase in PRE but not NRE from pre- to postinitiation. The relationship between NRE and time was moderated by BU, such that higher BU was associated with significantly larger post-initiation increases in NRE. Findings suggest that PRE and NRE change significantly following experience with smoking. Furthermore, undercontrolled, impulsive individuals may be particularly vulnerable to smoking with the intention of alleviating aversive states. © 2010 American Psychological Association.


PubMed | Federal University of Rio Grande do Sul, Bioethics Research Laboratory, Oncology Service, Pediatric Oncology Service and 5 more.
Type: Journal Article | Journal: Revista da Associacao Medica Brasileira (1992) | Year: 2015

cancer is the second leading cause of death in children between the ages of 0 and 14 years, corresponding to approximately 3% of all cases diagnosed in Brazil. A significant percentage (5-10%) of pediatric cancers are associated with hereditary cancer syndromes, including Li-Fraumeni/Li-Fraumeni-like syndromes (LFS/LFL), both of which are caused by TP53 germline mutations. Recent studies have shown that a specific TP53 mutation, known as p.R337H, is present in 1 in 300 newborns in Southern and Southeast Brazil. In addition, a significant percentage of children with LFS/LFL spectrum tumors in the region have a family history compatible with LFS/LFL.to review clinical relevant aspects of LFS/LFL by our multidisciplinary team with focus on pediatric cancer.the NCBI (PubMed) and SciELO databases were consulted using the keywords Li-Fraumeni syndrome, Li-Fraumeni-like syndrome and pediatric cancer; and all manuscripts published between 1990 and 2014 using these keywords were retrieved and reviewed.although LFS/LFL is considered a rare disease, it appears to be substantially more common in certain geographic regions. Recognition of population- specific risks for the syndrome is important for adequate management of hereditary cancer patients and families. In Southern and Southeastern Brazil, LFS/ LFL should be considered in the differential diagnosis of children with cancer, especially if within the spectrum of the syndrome. Due to the complexities of these syndromes, a multidisciplinary approach should be sought for the counseling, diagnosis and management of patients and families affected by these disorders. Pediatricians and pediatric oncologists in areas with high prevalence of hereditary cancer syndromes have a central role in the recognition and proper referral of patients and families to genetic cancer risk evaluation and management programs.


PubMed | University of Louisville, The Community Consortium., Mental Health Service, Psychology Service and Northeast Ohio Medical University
Type: Journal Article | Journal: The American journal of orthopsychiatry | Year: 2016

State licensing boards have obligations to protect the public from impaired professionals and to protect the rights of professionals applying for licensure. Competently functioning professionals who have or have had a mental health diagnosis or are being treated for a mental health condition should not be screened out, according to the Americans with Disabilities Act (ADA). A review of case law shows applicable precedents from discrimination among physicians and lawyers but not, to date, among psychologists. An examination of psychology licensure application materials from all 50 states and the District of Columbia revealed that some states, particularly Alaska, Arkansas, Colorado, Florida, Georgia, Kentucky, Missouri, Montana, and New Hampshire, include language that might screen out professionals with lived experience who are currently functioning competently. For comparison, we review a sample of licensure applications for physicians and lawyers and find a similar pattern. Five of the present authors offer ourselves and other published authors as examples of competent licensed psychologists who have lived with mental illnesses. We conclude with recommendations for more inclusive language and protection of confidentiality. (PsycINFO Database Record


Drebing C.E.,Psychology Service | Bell M.,Yale University | Campinell E.A.,Veterans Health Administration | Fraser R.,University of Washington | And 3 more authors.
Journal of Rehabilitation Research and Development | Year: 2012

As the field of vocational services (VS) research matures, it is necessary to review its progress and identify any important gaps in measurement and methodology that may hamper future efforts. To encourage progress, we have identified (1) ways to increase consistency in measuring employment outcomes, (2) emerging patterns and lingering gaps in the range of variables and measures commonly used in VS research, (3) broader methodological patterns and needs in the area of study design and sampling, (4) interventions that warrant additional study, and (5) broad strategies to increase the overall amount and quality of VS research. The goal of this article is to assist the field in achieving clearer coherence in shared expectations and standards for research so that the field can consolidate its gains as it helps people successfully return to rewarding jobs in the community.


Groark C.,Sussex Partnership NHS Trust | Sclare I.,Guys Hospital | Raval H.,Psychology Service
Clinical Child Psychology and Psychiatry | Year: 2011

For adolescents who flee to the UK seeking asylum, the experience of leaving their home country puts them at risk of developing mental health problems. Although there is a research base exploring the mental health of asylum-seeking children and adolescents who arrive with their families, there is in contrast very little focusing on the mental health needs of children and adolescents who arrive in the UK alone. There has been ongoing debate about whether current theoretical models for understanding reactions to trauma and loss are helpful in supporting unaccompanied asylum-seeking children and adolescents with complex psychological and social issues as a result of fleeing their home countries. This article draws on young people's own understanding of their experiences of seeking asylum in the UK using a qualitative semi-structured interview. It attempts to develop a more contextually relevant understanding of their emotional reactions to adversity and to consider the sorts of support required. Interpretative Phenomenological Analysis was used to provide an in-depth understanding of six young asylum seekers' experiences, exploring themes of loss, negotiating a new life, psychological distress and the process of adjustment. Psychological interventions and future service provision for this group are discussed. © The Author(s) 2010.


Houri L.F.,Psychology Service
Transplantation proceedings | Year: 2012

Considering the challenges faced by members of the Intrahospital Committee of Organ and Tissue Donation for Transplantation (CIHDOTT) of a Brazilian hospital complex in Santa Casa of Belo Horizonte in the execution of multiple donations of organs and tissues, this study aimed to investigate the issues involved in the intention to donate within this population. This research sought to promote the work of CIHDOTT by planning strategies for conducting of family interviews to best meet the needs of this population, thereby contributing to reduce the wait-list for transplantations in this state hospital of Minas Gerais. The survey was performed by applying a standard questionnaire to 602 respondents comprising patients and families/caregivers. The analysis of the collected data was developed from studies of contingency tables based on chi- square and Fisher exact tests. The analysis revealed that 94% of the population to be favorable to donation. It also showed a significant influence of the following factors to determining the likelihood of organ donation: knowledge of religion (35%), spouse's opinion (17%), as well as belief in the possibility of interference or delay of the funeral as a result of donation (6%). Although the population expressed a willingness to donate, there were significant contravening factors that may be addressed by professional training and informational activities. Copyright © 2012 Elsevier Inc. All rights reserved.


Harper S.,Psychology Service | O'Rourke A.,Psychology Service
Irish Journal of Psychological Medicine | Year: 2015

Objective. The purpose of this pilot study was to evaluate a 12-session group-based motivational intervention for substance misusers in a prison setting. The intervention aimed to increase both participants awareness of problem substance use and motivation to change their substance use behaviour. Method. Participants were recruited for the intervention through active outreach in the prison. Participants of the intervention group completed a structured interview before the group commencing and standardised pre- and post-outcome measures. The results of the intervention group (n = 31) were compared with a waiting list control group (n = 11). Results. Non-parametric analysis showed retention rates on this programme at 2, 4 and 6 weeks were 88%, 79% and 76%, respectively. Outcome data were consistent with the predicted direction for the treatment group compared with the waitlist control with significant between-group differences found on ambivalence and taking steps scores. Conclusion. This group-based intervention demonstrated positive levels of client engagement and retention. The intervention was also successful in reducing participant ambivalence about their drug use. Implications for service provision are discussed and design limitations of the present study are considered. Overall, findings indicate the potential utility of a group-based motivational intervention for substance misusers in forensic settings. © College of Psychiatrists of Ireland 2015.


Fortier C.B.,Translational Research Center for and Stress Disorders and Geriatric Research | Fortier C.B.,Harvard University | Amick M.M.,Translational Research Center for and Stress Disorders and Geriatric Research | Amick M.M.,Boston University | And 11 more authors.
Journal of Head Trauma Rehabilitation | Year: 2014

OBJECTIVE: Report the prevalence of lifetime and military-related traumatic brain injuries (TBIs) in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) veterans and validate the Boston Assessment of TBI-Lifetime (BAT-L). SETTING: The BAT-L is the first validated, postcombat, semistructured clinical interview to characterize head injuries and diagnose TBIs throughout the life span. PARTICIPANTS: Community-dwelling convenience sample of 131 OEF/OIF veterans. DESIGN: TBI criteria (alteration of mental status, posttraumatic amnesia, and loss of consciousness) were evaluated for all possible TBIs, including a novel evaluation of blast exposure. MAIN MEASURES: BAT-L, Ohio State University TBI Identification Method (OSU-TBI-ID). RESULTS: About 67% of veterans incurred a TBI in their lifetime. Almost 35% of veterans experienced at least 1 military-related TBI; all were mild in severity, 40% of them were due to blast, 50% were due to some other (ie, blunt) mechanism, and 10% were due to both types of injuries. Predeployment TBIs were frequent (45% of veterans). There was strong correspondence between the BAT-L and the OSU-TBI-ID (Cohen κ = 0.89; Kendall τ-b = 0.95). Interrater reliability of the BAT-L was strong (κs >0.80). CONCLUSIONS: The BAT-L is a valid instrument with which to assess TBI across a service members lifetime and captures the varied and complex nature of brain injuries across OEF/OIF veterans life span. Copyright © 2014 Wolters Kluwer Health | Lippincott Williams and Wilkins.

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