Changes In Psychological Health Research Articles

Psychological Health in Late Effects of Poliomyelitis: Ten-Year Follow-Up.

Individuals with late effects of poliomyelitis (LEoP) cope with various physical and psychological symptoms throughout their entire life which become more severe as they are ageing. To perform a 10-year follow-up of the functional status and levels of psychological health of individuals with LEoP and to examine the associations of hope levels, work status, health perceptions, and life satisfaction with functional and psychological changes. A within-subject 10-year follow-up study. Eighty-two individuals with LEoP who participated in a previous study 10 years ago. Outcome measures included the functional status of individuals with LEoP assessed by the activities of daily living (ADL) questionnaire, emotional distress based on the Global Health Questionnaire (GHQ), hope based on the Hope Scale, life satisfaction as measured by the Satisfaction with Life Scale (SWLS), and subjective health perception. The McNemar test, paired t-test, Spearman's correlation coefficient, and linear regression were used for statistical analysis. The mean age was 66.9 ± 8.5 years with a male-female ratio of 0.52. A significant functional deterioration was noticed during the follow-up years. Yet, the functional deterioration was not associated with changes in psychological health. Psychological health was associated with elevated levels of hope and life satisfaction. Individuals with LEoP who continued to work demonstrated higher psychological health, higher levels of hope, and greater life satisfaction. Individuals with LEoP demonstrated significant psychological health, manifested in their ability to block emotional distress and maintain life satisfaction despite the deterioration in their functional status. Hope and psychological health were associated with increased life satisfaction. Work appeared to be a significant source of psychological health in this population.

Individual and Organizational Factors in Coping With COVID-19 in Soldier Students.

The COVID-19 pandemic has posed significant burden across different industrial sectors. Generally, an increase in psychological stress experiences has been reported, while the stress and coping responses of specific, potentially burdened populations have received less attention thus far. Thus, the present study investigated relations between individual (i.e., extraversion, neuroticism, conscientiousness) and organizational (i.e., organizational commitment and study satisfaction) factors, indicators of psychological health (i.e., loneliness, life satisfaction, COVID-19-related stress), and possible mediating effects of four broad coping dimensions (active coping, avoidant coping, social support, positive cognitive restructuring) in a specific sample of soldier students who engage in a double-role being military affiliates and students of non-military subjects. To this end, we assessed data of soldier students at two measurement points (N = 106 at t1 and N = 63 at t2) shortly after the second national lockdown in Germany (20. May 2021 to 11. July 2021) during the COVID-19 pandemic. Personality traits showed expected associations with indicators of psychological health, i.e., positive relations between neuroticism and social loneliness, between extraversion and COVID-19 stress, and negative relations between neuroticism and life satisfaction. Remarkably, organizational variables showed effects above and beyond personality traits on loneliness and life satisfaction. Neither individual, nor organizational factors could predict change in psychological health over time. We found evidence for mediation effects through active coping, avoidant coping, and the use of social support, but not through positive cognitive restructuring. Findings highlight the relative importance of organizational factors besides personality traits for psychological health in a military student sample, holding important implications for designing efficient support systems in the military.

SHORT TERM ANALYSIS OF SOCIAL DISTANCING ON MENTAL HEALTH AND PHYSICAL ACTIVITY DURING COVID-19

A societal “lockdown” began in early 2020 in response to the coronavirus disease (COVID-19) pandemic to slow the rate of transmission. Many states adopted social distancing and social isolation practices. Loneliness has been shown to be a significant burden on society during the COVID-19 pandemic and has been associated with poor mental health outcomes. Loneliness and poor mental health have been shown to increase behaviors that promote sedentary behavior and decrease physical activity. PURPOSE: To examine changes in psychological health and physical activity over 8 weeks during “lockdown” in response to COVID-19. METHODS: 90 individuals answered questions regarding their loneliness, depression, mood state, and physical activity over four time points each lasting two weeks. RESULTS: Time point (TP) 2, approximately 1 month into “lockdown”, showed the most significant effects on depression (26.33 ± 3.86) compared to TP 1 (17.31 ± 10.53, p < 0.001), TP 3 (16.11 ± 11.94, p < 0.001), and TP 4 (14.27 ± 10.86, p < 0.001), and TP 4 had the lowest total mood disturbance (35.92 ± 19.8) compared to TP 1 (41.05 ± 18.24, p < 0.05), TP 2 (43.26 ± 18.31, p < 0.01), and TP 3 (39.70 ± 19.71, p < 0.05). Self-reported symptoms of depression were seen in 100% of the sample population during TP 2. There were no significant changes in physical activity over 8 weeks (p > 0.05). Loneliness, depression, and mood state were negatively associated with participation in physical activity. Total mood disturbance was negatively associated with total physical activity at TP 1 (r = -0.24, p < 0.05), TP 2 (r = -0.28, p < 0.05) and TP 3 (r = -0.25, p < 0.05). Depression was negatively associated with total physical activity during TP 3 (r = -0.25, p < 0.05), TP 4 (r = -0.24, p < 0.05). CONCLUSION: Social isolation and social distancing practices had a negative effect on depression, and mood. Depressive symptoms were much higher than average compared to previous epidemiological data. Depression and total mood disturbance were highest during TP two possibly due to ambiguity and loneliness from social distancing. While physical activity was unchanged throughout the study, less people participated in the recommended physical activity guidelines. This study supports the connection between mental health and physical activity.

Effects of very low-carbohydrate vs. high-carbohydrate weight loss diets on psychological health in adults with obesity and type 2 diabetes: a 2-year randomized controlled trial.

Very low-carbohydrate (LC) diets are popular for type 2 diabetes (T2DM) management; however, long-term effects on psychological health remain largely unknown. This study reports the effects of a LC diet on mood and cognitive function after 2 years and explores the potential predictors of changes in psychological health. 115 adults (57% males; age: 58.5 ± 7.1years) with obesity and T2DM were randomized to consume an energy reduced (~ 500 to 1000kcal/day deficit), LC diet [14% energy as carbohydrate, 28% protein, 58% fat (< 10% saturated fat)] or an isocaloric high unrefined carbohydrate, low-fat diet [HC: 53% carbohydrate, 17% protein, 30% fat (< 10% saturated fat)] for 2 years. Both diets were combined with aerobic/resistance exercise (1h, 3days/week). Mood/well-being [Beck Depression Inventory (BDI), Spielberger State Anxiety Inventory (SAI), Profile of Mood States (POMS)], diabetes-related quality of life [Diabetes-39 (D-39)] and distress [Problem Areas in Diabetes (PAID) Questionnaire], and cognitive function were assessed during and post-intervention. 61 (LC: 33, HC: 28) participants completed the study. Weight loss was 9.1% after 12months and 6.7% after 2years with no difference between diet groups. There were no differences between the groups for the changes in any psychological health outcome (smallest p ≥ 0.19 for all time x diet interactions). Overtime, improvements in BDI, POMS [Total Mood Disturbance (TMD); four subscales], PAID, and D-39 (three subscales) scores occurred (p ≤ 0.05, time). Stepwise regression analysis showed improvements in BDI, POMS (TMD; two subscales), D-39, SAI, and PAID scores were significantly (p < 0.05) correlated with reductions in body weight and glycated hemoglobin. In adults with obesity and T2DM, energy-restricted LC and HC diets produced comparable long-term improvements on a comprehensive range of psychological health outcomes. The findings suggest both diets can be used as a diabetes management strategy as part of a holistic lifestyle modification program without concern of negative effects on mental well-being or cognition. ACTRN12612000369820, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=362168&isReview=true . Data described in the manuscript, code book, and analytic code will not be made available because approval has not been granted by participants.

Cardiac Rehabilitation Following Percutaneous Coronary Intervention Is Associated With Superior Psychological Health and Quality of Life in Males but Not in Females.

Cardiac rehabilitation (CR) improves psychological health and health-related quality of life (HR-QoL). Yet, available evidence suggests that their degree of improvements following CR may depend on patient sex and the mode of revascularization. We examined the interplay between sex and mode of revascularization on the psychological health and HR-QoL of patients completing CR. We analyzed the longitudinal records of patients who completed a 3-mo outpatient CR program following coronary revascularization. Levels of anxiety and depression were measured by the Hospital Anxiety and Depression Scale and HR-QoL was measured by the Medical Outcomes Study Short Form-36 before and after CR. A two-by-two analysis of covariance (females vs males by coronary artery bypass graft surgery [CABG] vs percutaneous coronary intervention [PCI]) was used to examine the sex-by-revascularization procedure interaction effect on changes in psychological health and HR-QoL. Of the 278 participants (age: 65 ± 9 yr) included in the analysis, 191 (69%) underwent PCI and 55 (20%) were females. Following CR, there was a significant sex-by-revascularization procedure interaction effect on anxiety (P = .033) and mental HR-QoL (mental component summary [MCS]; P = .040). Following CABG, females and males showed similar improvements in anxiety (-1.3 ± 3.4 vs -1.1 ± 3.6 points, P = .460) and MCS scores (5.4 ± 8.9 vs 4.5 ± 8.7 points, P = .887); following PCI, females experienced worse anxiety levels and mental component summary scores while males showed improvements (anxiety: +1.0 ± 3.8 vs -1.3 ± 3.8 points, P = .002; MCS: -1.6 ± 9.3 vs + 4.4 ± 8.9 points, P = .008, respectively). There was no interaction effect on depression. Continued efforts are required to improve anxiety and mental HR-QoL in females treated with PCI participating in CR.

Short-Term Analysis (8 Weeks) of Social Distancing and Isolation on Mental Health and Physical Activity Behavior During COVID-19.

Due to the COVID-19 pandemic, cities and states adopted social distancing, social isolation, or quarantine measurements to slow the transmission of the disease. Negative mental health outcomes including depression and anxiety have been associated with social distancing or social isolation. The purpose of the present study was to examine changes in psychological health and physical activity over an 8 week period under social distancing policies during the COVID-19 pandemic.Methods: Ninety (73.3% female; age 32.04 ± 11.33) individuals participated in this study. Qualifying participants answered questions using an online survey regarding their loneliness, depressive symptoms, anxiety symptoms, mood state, and physical activity over four time points each lasting two weeks.Results: Symptoms of depression and state anxiety were increased in the population when compared to nationwide statistics from before the COVID-19 pandemic. Time point 2, ~1 month into social isolation, showed the most significant effects on mental health. During this time point, 100% of the participants showed symptoms of depression. There were no significant changes in physical activity over the 8 weeks. Loneliness, depressive symptoms, fatigue, and mood state were negatively associated with participation in physical activity. Vigor and state anxiety were associated with participation in physical activity.Conclusion: Social isolation and social distancing practices have had a negative effect on depression, anxiety, and mood over time. It appeared that depressive symptoms and total mood disturbance was elevated during time point two. Depressive symptoms were much higher than average compared to previous epidemiological data. Physical activity amount did not change over time but was associated with poor mental health.

Psychological Health Benefits of Companion Animals Following a Social Loss.

In later life, the loss of a spouse due to divorce or widowhood is common and can lead to elevated depressive symptoms and loneliness. Research suggests that companion animal (CA) may be beneficial for psychological health, but limited research has explored whether CA can buffer negative consequences of social losses. This study uses data drawn from the Health and Retirement Study (HRS) to examine changes in depressive symptoms and loneliness in relation to a social loss among those with/without a CA. We used inverse-probability weighted regression to adjust for selection factors and isolate effects of CA ownership on changes in psychological health. Regardless of CA ownership, spousal loss was associated with psychological health consequences. Facing a social loss without a CA was related to statistically greater increases in depressive symptoms relative to those with a pet (2.580 vs. 1.207 symptoms, respectively). Similarly, experiencing a loss was associated with significantly greater increases in loneliness, with statistically greater increases in loneliness among those without a CA (p < .01). However, those with a CA did not experience greater increases in loneliness than those who did not experience a loss. In later life, CA ownership may buffer against the detrimental consequences of major social losses on psychological health. Future research on the therapeutic effects of CA ownership, as well as pet therapy, during other major life stage transitions is needed to help isolate potential mechanisms driving the benefits of human-animal interactions.

Psychological health of women who have conceived using assisted reproductive technology in Taiwan: findings from a longitudinal study

BackgroundDespite the increasing use of Assisted Reproductive Technology (ART) and the significant physical and emotional commitments that these treatments and procedures involve, only limited evidence exists regarding the psychological health of women who undergo ART. This study investigated the changes over time in the psychological health of women who have conceived using ART during the first, second, and third trimesters of pregnancy and during the postpartum period in Taiwan.MethodsA quantitative longitudinal study was conducted at a fertility centre in Taiwan. 158 pregnant women who had conceived using ART completed a web-based questionnaire that included the following instruments: State Anxiety Inventory, Edinburgh Postnatal Depression Scale, Modified Maternal Foetal Attachment Scale, Pregnancy Stress Rating Scale, Maternity Social Support Scale, Intimate Bond Measure, and Parenting Stress Index. The data were collected the first (9–12 weeks), second (19–22 weeks), third (28–31 weeks) trimesters of pregnancy and at 7–10 weeks postpartum.ResultsLevels of anxiety and depression, which are both key indicators of psychological health, were highest during the first trimester, with scores of 42.30 ± 11.11 and 8.43 ± 4.44, respectively. After the first trimester, anxiety scores decreased and remained stable through the remainder of pregnancy, with scores of 38.03 ± 10.58 in the second and 38.39 ± 10.36 in the third trimester, but increased at two-months postpartum, attaining a score of 41.18 ± 11.68. Further, depression scores showed a similar pattern, declining to a mean of 7.21 ± 4.23 in the second and 6.99 ± 4.11 in the third trimester and then increasing to 8.39 ± 5.25 at two-months postpartum. Pregnancy stress and social support were found to be the most important predictors of change in psychological health during pregnancy and the postpartum period.ConclusionPsychological health was found to be poorest during the first trimester and at two-months postpartum. Moreover, pregnancy stress and social support were identified as key predictors of change in psychological health. The findings indicate a need for increased sensitivity among healthcare professionals to the psychological vulnerability of women who have conceived using ART as well as a need to introduce tailored interventions to provide appropriate psychological support to these women.

Declining mental health among disadvantaged Americans

Although there is little dispute about the impact of the US opioid epidemic on recent mortality, there is less consensus about whether trends reflect increasing despair among American adults. The issue is complicated by the absence of established scales or definitions of despair as well as a paucity of studies examining changes in psychological health, especially well-being, since the 1990s. We contribute evidence using two cross-sectional waves of the Midlife in the United States (MIDUS) study to assess changes in measures of psychological distress and well-being. These measures capture negative emotions such as sadness, hopelessness, and worthlessness, and positive emotions such as happiness, fulfillment, and life satisfaction. Most of the measures reveal increasing distress and decreasing well-being across the age span for those of low relative socioeconomic position, in contrast to little decline or modest improvement for persons of high relative position.

Psychological Health in the Retirement Transition: Rationale and First Findings in the HEalth, Ageing and Retirement Transitions in Sweden (HEARTS) Study.

From an aging research and life-course perspective, the transition to retirement marks a significant life-event and provides a unique opportunity to study psychological health and coping during a period of substantial change in everyday life. The aim of the present paper is to: (a) outline the rationale of the HEalth, Ageing and Retirement Transitions in Sweden (HEARTS) study, (b) describe the study sample, and (c) to present some initial results from the two first waves regarding the association between retirement status and psychological health. The HEARTS study is designed to annually study psychological health in the years before and following retirement, and to examine change and stability patterns related to the retirement event. Among a representative Swedish population-based sample of 14,990 individuals aged 60–66 years, 5,913 completed the baseline questionnaire in 2015. The majority of the participants (69%) completed a web-based survey, and the rest (31%) completed a paper version. The baseline HEARTS sample represents the general population well in terms of gender and age, but is more highly educated. Cross-sectional findings from the first wave showed that retired individuals demonstrated better psychological health compared to those who were still working. Longitudinal results from the first and second waves showed that individuals who retired between waves showed more positive changes in psychological health compared with those still working or previously retired.

Changes in psychological health, subjective food intake ability and oral health-related quality of life during orthodontic treatment.

Assessing changes in patient's psychological health and oral health-related quality of life (OHRQoL) over time during orthodontic treatment may help clinicians to treat patients more carefully. To evaluate changes in mental health, self-reported masticatory ability and OHRQoL during orthodontic treatment in adults, this prospective study included 66 adults (30 men, 36 women; mean age, 24·2±5·2years). Each patient completed the Korean versions of the State-Trait Anxiety Inventory, Zung Self-Rating Depression Scale, Rosenberg self-esteem scale, key subjective food intake ability (KFIA) test for five key foods and Oral Health Impact Profile-14 (OHIP-14K) at baseline (T0), 12months after treatment initiation (T1) and debonding (T2). All variables changed with time. Self-esteem and the total OHIP-14K score significantly decreased and increased, respectively, at T1, with a particular increase in the psychological and social disabilities scores. There were no significant differences in anyquestionnaire scores before and after treatment. The total OHIP-14K score was positively correlated with trait anxiety and depression, and negatively correlated with self-esteem and KFIA at T0, regardless of the treatment duration. Older patients showed a significant increase in the total OHIP-14K score at T1 and T2. OHRQoL worsened with an increase in the treatment duration. Our results suggest that OHRQoL temporarily deteriorates, with the development of psychological and social disabilities, during orthodontic treatment. This is related to the baseline age, psychological health and self-reported masticatory function. However, patients recover once the treatment is complete.

Being present and enjoying it: Dispositional mindfulness and savoring the moment are distinct, interactive predictors of positive emotions and psychological health.

Mindfulness and savoring the moment both involve presently occurring experiences. However, these scientific constructs are distinct and may play complementary roles when predicting day-to-day positive emotions. Therefore, we examined the unique and interactive roles of dispositional mindfulness and perceived ability to savor the moment for predicting daily positive emotions as well as related psychological health benefits. Participants completed a nine-week longitudinal field study. At baseline, dispositional mindfulness and perceived ability to savor the moment were assessed, along with three indicators of psychological health: depressive symptoms, psychological well-being, and life satisfaction. Each day for the subsequent nine weeks, participants reported on their emotions. At the end of the study, participants again completed the three psychological health measures. Results showed that baseline dispositional mindfulness and perceived ability to savor the moment interacted to predict mean positive emotion levels over the reporting period and, in turn, residualized changes in psychological health. Specifically, the relation between perceived ability to savor the moment and positive emotions and, in turn, residualized change in psychological health indicators, was amplified at greater levels of mindfulness and fell to non-significance at lower levels of mindfulness. Dispositional mindfulness only predicted positive emotions and, in turn, residualized changes in psychological health, for those very high in perceived ability to savor the moment. This research provides preliminary evidence that dispositional mindfulness and perceived ability to savor the moment, though related constructs, may serve unique and synergistic roles in predicting benefits for and through positive emotions.

Functional Decline is Associated with Hopelessness in Amyotrophic Lateral Sclerosis (ALS).

To determine the relationships between hopelessness, depression, quality of life, and disease progression in ALS. Hopelessness and depression were assessed prospectively in a cohort of people with ALS using the Beck Hopelessness scale (BHS) and the ALS Depression Inventory (ADI-12), respectively. ALS Specific Quality of Life and measures of functional status (ALSFRS-R and forced vital capacity) were collected. Associations between changes in psychological health and functional scores were calculated using Spearman correlation coefficients. Twenty-five people with ALS had at least 2 visits and were followed for a mean of 11 (± 6) months. People with hopelessness and depression reported worse quality of life (p<0.01 for both associations). Decline in function between any two visits measured by ALSFRS-R (p<0.01) and FVC (p=0.02) correlated with increased hopelessness, but not depression. This study highlights the importance of monitoring hopelessness in ALS, particularly in patients with faster functional decline.

Changes in Psychological Health and Subjective Well-Being Among Incarcerated Individuals With Serious Mental Illness.

While improving the psychological health and well-being of individuals with serious mental illness can help reduce emotional distress and increase resilience, not enough is known about the well-being of incarcerated individuals with mental illness. Using the Schwartz Outcome Scale-10, the authors examined changes in subjective well-being and its association with other clinical symptoms and personality features in 43 mentally ill inmates in a large jail. All participants demonstrated significant improvement in general psychopathology and negative emotions. For well-being, however, different trajectories were associated with high versus low baseline ratings. Furthermore, those in the high well-being group were more likely to show features of aggression, dominance, hostility, mania, and more positive affect. These findings suggest that the level of well-being among inmates with serious mental illness may be an early indicator of personality features, clinical changes, and resilience, which is essential knowledge required when completing effective treatment planning.

Job Anxiety, Work‐Related Psychological Illness and Workplace Performance

AbstractThis article uses matched employee–employer data from the British Workplace Employment Relations Survey to examine the relationship between employee psychological health and workplace performance in 2004 and 2011. Using two measures of work‐related psychological health — namely employee‐reported job anxiety and manager‐reported workforce stress, depression and anxiety — we find a positive relationship between psychological ill‐health and absence, but not quits. The association between psychological ill‐health and labour productivity is less clear, with estimates sensitive to sector, time period and the measure of psychological health. The 2004–2011 panel is further used to explore the extent to which change in psychological health is related to change in performance.

PTU-059 “i can cope right now, because i know where i have come from”; a qualitative exploration of the lived experience of young adults with inflammatory bowel disease

<h3>Introduction</h3> Young people (YP) living with inflammatory bowel disease (IBD) are at risk of increased psychological morbidity, with increased rates of anxiety and depression at a life stage characterised by change, exploration, risk-taking and identity development whilst learning to manage and adjust to living with IBD as an adult. This is in the context of a globally rising incidence in paediatric Crohn’s disease (CD) with a peak onset in adolescence. However, despite this there remains little research exploring YPs perceptions and experiences of living with IBD. The aim of this first qualitative study was to explore the lived experiences of YP with IBD. <h3>Method</h3> YP aged 19–21 years with a diagnosis of ulcerative colitis (UC) or CD at a single large teaching centre were recruited for a qualitative face-to-face interview with a single investigator. Interviews were conducted following a semi-structured interview schedule regarding; receiving a diagnosis, impact on relationships, ways of coping, identity and the future. Interviews were audio-recorded, transcribed and subject to in-depth interpretative phenomenological analysis (IPA) used in clinical and health psychology. <h3>Results</h3> Seven patients were interviewed (4 CD, 3 UC), median age 20 years (range 19–21) with 43% (3/7) male. Through IPA the YPs accounts clustered around 4 super-ordinate themes with <i>contradiction</i>as an overarching theme, with several sub-themes illustrating experiences of living with IBD; 1) <i>coping with uncertainty and unpredictability</i>; included misdiagnosis, mislabelling, “everyone is different” and “takes years to make sense of it” 2) <i>living with invisibility and visibility</i>; included “losing myself”, embarrassment, disgust and use of humour. 3) <i>Lack of compassion for self</i>; included a contradiction of control and lack of control, being limited by yet not held back, stoic and hiding emotions. 4) <i>Resilience</i>; included positive impact on relationships and a positive outlook. <h3>Conclusion</h3> The findings of this first qualitative study to investigate the lived experience of YP with IBD highlights key areas for enabling other YP to make sense of a diagnosis of IBD. Furthermore, improving health care professionals (HCPs) understanding of the experiences of YP may improve relationships and encourage positive changes in psychological health, social interactions and capacity for self-management. This in turn may inform development of high quality, young-person friendly healthcare services, described as the ‘Cinderella’ of the NHS. <h3>Disclosure of interest</h3> None Declared.

Psychological health in the summer team of an Indian expedition to Antarctica

Context: Number of scientific personnel traveling to Antarctica for short summer stay far outnumbers winter personnel. Hence, psychological issues confronting such personnel need to be analyzed in detail. This study aims to study changes in psychological health, cognitive functioning, changes in motivation levels, and tobacco and alcohol consumption during a summer in Antarctica. Aims: To study changes in psychological health, cognitive functioning, changes in motivation levels and tobacco and alcohol consumption during a summer in Antarctica. Setting and Design: This cohort study was conducted on 33 summer team members of 27 th Indian Scientific Expedition to Antarctica. Subjects and Methods: Seven instruments were administered to assess general health, alcohol and tobacco dependence, memory and cognitive functioning of the team members. Statistical Analysis Used: The data were analyzed for statistical significance using nonparametric Wilcoxon Signed Rank Sum Test. Results: Scores on social dysfunction, depression, and somatic symptoms increased. Tobacco consumption also increased concomitantly. However, memory and cognitive function were not impaired. Alcohol consumption did not change. None of the subjects needed medication or evacuation for psychological difficulties. Conclusion: Psychological issues might manifest themselves even during a short stay in Antarctica during the summer season.

Efficacy and cost-effectiveness of an outcall program to reduce carer burden and depression among carers of cancer patients [PROTECT]: rationale and design of a randomized controlled trial

BackgroundCarers provide extended and often unrecognized support to people with cancer. The aim of this study is to test the hypothesis that excessive carer burden is modifiable through a telephone outcall intervention that includes supportive care, information and referral to appropriate psycho-social services. Secondary aims include estimation of changes in psychological health and quality of life. The study will determine whether the intervention reduces unmet needs among patient dyads. A formal economic program will also be conducted.Methods/DesignThis study is a single-blind, multi-centre, randomized controlled trial to determine the efficacy and cost-efficacy of a telephone outcall program among carers of newly diagnosed cancer patients. A total of 230 carer/patient dyads will be recruited into the study; following written consent, carers will be randomly allocated to either the outcall intervention program (n = 115) or to a minimal outcall / attention control service (n = 115). Carer assessments will occur at baseline, at one and six months post-intervention. The primary outcome is change in carer burden; the secondary outcomes are change in carer depression, quality of life, health literacy and unmet needs. The trial patients will be assessed at baseline and one month post-intervention to determine depression levels and unmet needs. The economic analysis will include perspectives of both the health care sector and broader society and comprise a cost-consequences analysis where all outcomes will be compared to costs.DiscussionThis study will contribute to our understanding on the potential impact of a telephone outcall program on carer burden and provide new evidence on an approach for improving the wellbeing of carers.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN: 12613000731796.

Shifting positivity ratios: emotions and psychological health in later life

Objective: A positivity ratio of approximately three positive emotions to one negative emotion has been found to distinguish between flourishing and languishing (optimal vs. poor psychological health). The current study assessed 2-year shifts (2008, 2010) in positivity ratios among 295 older adults and considered whether such shifts were associated with concurrent changes in psychological health (perceived stress, depressive symptoms, and perceived control).Method: Based on participants’ reported positive and negative emotions, we identified two positivity ratio groups who were characterized by ratios that did not change, either remaining persistently optimal (above 2.9) or persistently suboptimal, and two groups that depicted shifts in ratios that either became optimal or became suboptimal.Results: Most participants (67%) remained in their initial group, but shifts between categories did occur in both directions. Ratio groups and time (2008 vs. 2010) were predictor variables in 4 × 2 generalized estimating equations that were computed for each psychological health measure. The hypothesized positivity ratio group × time interaction emerged for each psychological health measure. Ratio shifts that ‘became optimal’ were associated with a significant concurrent decrease in stress and an increase in perceived control; ratio shifts that ‘became suboptimal’ were associated with a significant increase in depression.Conclusion: Although older adults who began with a suboptimal positivity ratio were unlikely to experience a shift to an optimal ratio, findings are more encouraging for those who began with an optimal positivity ratio. The majority of these older adults retained optimal positivity ratios over time and appeared to flourish.

Direct-to-consumer pharmacogenomic testing assessed in a US-based study.

SUMMARY Direct-to-consumer genetic testing has been around for approximately 20 years. Pharmacogenomic testing is a specialised form of this testing which informs the risk of developing particular toxicities or showing a lack of response when prescribed certain drugs. These tests were widely available in the US via companies such as 23andMe 1 but, somewhat controversially, public access has been recently restricted by the US Food and Drug Administration (FDA). 2 More limited, but similar, testing is also available in the UK, though consumers are expected to speak to a ‘genetics trained’ advisor first. Bloss and colleagues conducted a study on participants in the Scripps Genomic Health Initiative (SGHI) involving more than 3,000 individuals from academic institutes and technology companies in California. The participants were offered subsidised commercial pharmacogenomic testing. The current study compares certain outcomes between participants who had received the results of pharmacogenomic testing (approximately 35% of 1325 study participants) and those who were still awaiting their results (approximately 65%). The outcomes compared included concerns about privacy, whether results were shared with family members and doctors and whether the participants availed themselves of further free genetic counselling. The group that had received results were slightly more likely to have visited their primary care physician and significantly more likely to plan to share their results with their doctor than the group still awaiting the results. After receiving the results, participants were also more likely to decide to seek genetic counselling. The 475 participants who had already received their results were subdivided into those at high (41 participants) and low (434 participants) pharmacogenomic risk, based on data they provided about medicines taken currently or previously. These groups were compared on a number of outcomes such as visiting their primary care physician or another healthcare provider and level of distress after receiving their results. The main findings were that those in the high risk group were considerably more likely to have visited their primary care physician after receiving the results and were slightly more likely than the low risk group to share their results with their doctor. They were also twice as likely as the low risk group to seek genetic counselling. Levels of satisfaction with the process, including finding the test results useful, understanding them and sharing results with both their family and their doctor, were high for participants who had received results. In particular, the group with test results was significantly more likely to consider the results useful and understand them compared with the expectations of the group still awaiting the findings. There was no evidence for any changes in psychological health or increased distress following release of results.