Behavioral Medicine

To evaluate the impact of a Mindfulness Based Stress Reduction (MBSR) program in patients with chronic bothersome tinnitus on the (1) severity of symptoms of tinnitus and (2) functional connectivity in neural attention networks. Open-label interventional pilot study. Outpatient academic medical center. A total of 13 adult participants with a median age of 55 years, suffering from bothersome tinnitus. An 8-week MBSR program was conducted by a trained MBSR instructor. The primary outcome measure was the difference in patient-reported tinnitus symptoms using the Tinnitus Handicap Index (THI) and Tinnitus Functional Index (TFI) between pre-intervention, post-MBSR, and 4-week post-MBSR assessments. Secondary outcomes included change in measurements of depression, anxiety, mindfulness, and cognitive abilities. Functional connectivity magnetic resonance imaging (MRI) was performed at pre- and post-MBSR intervention time points to serve as a neuroimaging biomarker of critical cortical netwo...

This research examined the contributions of active and passive coping for health problems, and meaning-based coping, to positive psychosocial functioning in a sample of 100 individuals in residential care with a mean age of 83.11 years old. Study participants resided in skilled care, intermediate care, or assisted living facilities. Based on interview data collected on site in participants' residential settings, hierarchical multiple regression analyses revealed that active and passive coping and meaning-based coping had separate influences on measures of positive psychosocial functioning. Active coping was correlated with higher positive affect, whereas passive coping was associated with higher negative affect and self-acceptance. Positive reappraisal, a meaning-based coping strategy, was uniquely associated with higher positive affect, positive social relations, and self-acceptance. Positive religious coping was not independently associated with positive psychosocial function...

This report examines hygiene behaviour and associated factors among 13-15 year old in-school adolescents in nine African countries. The total sample included 25,760 school children aged 13-15 years from nationally representative samples from nine African countries. We examined the prevalence of and relationship between tooth brushing, hand washing before eating, hand washing after toileting, hand washing with soap and a range of psychosocial factors such as socio-demographic characteristics, health behaviour, mental health or well-being and protective factors. Overall, sub-optimal hygiene behaviour was reported, the proportions of school children reporting optimal (>once a day) tooth brushing (77.3%) was higher than the proportions reported for washing their hands regularly before meals (62.2%), after toileting (58.4%) and washing their hands with soap (35.0%). In multivariate analysis higher education, health-enhancing behaviours such as daily fruits or vegetable consumption, and protective factors such as caregiver supervision were associated with tooth brushing, hand washing before meals, hand washing after toileting and washing of hands with soap. The cross-national data on hygiene behaviour from nine African countries found sub-optimal hygiene behaviour. Various determinants of optimal hygiene behaviour were identified that can guide programmes to improve hygiene behaviour of this adolescent population.

The rationale for the development of effective programs for parents with serious mental illness and their children is compelling. Using qualitative methods and a grounded theory approach with data obtained in site visits, seven existing programs for parents with mental illness and their children in the United States are described and compared across core components: target population, theory and assumptions, funding, community and agency contexts, essential services and intervention strategies, moderators, and outcomes. The diversity across programs is strongly complemented by shared characteristics, the identification of which provides the foundation for future testing and the development of an evidence base. Challenges in program implementation and sustainability are identified. Qualitative methods are useful, particularly when studying existing programs, in taking steps toward building the evidence base for effective programs for parents with serious mental illness and their chil...

This study aimed to assess weight bias among professionals who specialize in treating eating disorders and identify to what extent their weight biases are associated with attitudes about treating obese patients. Participants were 329 professionals treating eating disorders, recruited through professional organizations that specialize in eating disorders. Participants completed anonymous, online self-report questionnaires, assessing their explicit weight bias, perceived causes of obesity, attitudes toward treating obese patients, perceptions of treatment compliance and success of obese patients, and perceptions of weight bias among other practitioners. Negative weight stereotypes were present among some professionals treating eating disorders. Although professionals felt confident (289; 88%) and prepared (276; 84%) to provide treatment to obese patients, the majority (184; 56%) had observed other professionals in their field making negative comments about obese patients, 42% (138) be...

Th is study of the relationship bet ween den tal anxiety and psych ological and behavioral variables suggests that the most important factor in explaining the variance in children's perceived dental anxiety is their level of general ...

Sickle cell disease (SCD) is the most common genetic disorder of the blood. The disease produces significantly abnormal hemoglobin (Hgb) molecules in red blood cells (RBCs). The sickling of RBCs occurs when partially or totally deoxygenated Hgb molecules distort their normal disk shape, producing stiff, sticky, sickle-shaped cells that obstruct small blood vessels and produce vasoocclusion as well as the disruption of oxygen to body tissues. Because tissue damage can occur at multiple foci, patients with SCD are at risk for other medical complications including, but not limited to, delayed growth and sexual maturation; acute and chronic pulmonary dysfunction; stroke; aseptic necrosis of the hip, shoulders, or both; sickle cell retinopathy; dermal ulcers; and severe chronic pain. The chronicity of the illness combined with frequent hospitalizations for pain and other medical management can contribute significantly to impaired psychosocial functioning, altered intra- and interpersonal relationships, and reduced quality of life. Unlike previous qualitative reviews of SCD, this article describes the relevant clinical and research data on the relation between psychosocial functioning and SCD in adult and child populations. The authors discuss the significant role of psychosocial issues in the trajectory and management of the disease and conclude that understanding the pathophysiology of SCD without thoroughly understanding the equally important psychosocial influences is misunderstanding SCD.

Background: Vancomycin is the antibiotic of choice for the treatment of serious infections such as methicillin-resistant Staphylococcus aureus (MRSA). Inappropriate prescribing of vancomycin can lead to therapeutic failure, antibiotic resistance, and drug toxicity.

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The nature of individual coping responses to stressful life events was explored in a representative adult community sample. Two approaches to the classification of coping strategies were operationalized. Using these measures, small but significant gender and contextual differences in coping were identified. Mood and symptom levels were related to coping responses and to quantitative and qualitative measures of social resources. Measures of coping and social resources attenuated the relationship between undesirable life events and personal functioning.