Psychological Response to HIV Positivity in Hemophilia

Objective. To compare the psychological and family adaptation of children and adolescents with hemophilia who were seropositive for human immunodeficiency virus type 1 (HIV-1) with an HIV-negative group of comparable age, demographic characteristics, and disease severity in a multi-site study. Design. Cross-sectional, controlled study. Setting. Thirty-three hemophilia treatment centers throughout the United States. Sample. Ninety-one children and adolescents with hemophilia who were seropositive for HIV and 92 children and adolescents with hemophilia who were seronegative and of comparable age, demographic characteristics, and disease severity. Results. HIV-seropositive children and adolescents reported less positive affect [(lower well being) (P < .05) ], and more frequent hemophilia-related school absences were identified among HIV-infected patients (P < .005). However, the two groups demonstrated surprisingly comparable levels of psychological, social, hemophilia-related adjustment, general family relations, and hemophilia-related family adaptation, as reported by patients and parents. However, mothers of HIV-seropositive children and adolescents reported higher levels of general psychological distress (P < .008) and higher levels of distress related to hemophilia (P < .0002) than parents of HIV-negative children. Conclusions. Seropositive children and adolescents with hemophilia demonstrate psychological resilience and levels of psychological adjustment that were comparable to seronegative counterparts. However, mothers of seropositive children were more distressed than mothers of HIV-negative children. Practitioners should ensure that stressed mothers obtain necessary psychological support.

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Sustainable Commuting: Results from a Social Approach and International Evidence on Carpooling

Sustainability ◽

10.3390/su12229587 ◽

2020 ◽

Vol 12 (22) ◽

pp. 9587

Author(s):

José Alberto Molina ◽

J. Ignacio Giménez-Nadal ◽

Jorge Velilla

Keyword(s):

Public Transport ◽

Well Being ◽

The United States ◽

Ordinary Least Squares ◽

Demographic Characteristics ◽

Household Composition ◽

Environmental Benefits ◽

Light Rail ◽

Social Approach ◽

Hov Lanes

Sustainable commuting (SC) usually refers to environmentally friendly travel modes, such as public transport (bus, tram, subway, light rail), walking, cycling, and carpooling. The double aim of the paper is to summarize relevant prior results in commuting from a social approach, and to provide new, international empirical evidence on carpooling as a specific mode of sustainable commuting. The literature shows that certain socio-demographic characteristics clearly affect the use of non-motorized alternatives, and compared to driving, well-being is greater for those using active travel or public transport. Additionally, this paper analyzes the behavior of carpooling for commuting, using ordinary least squares (OLS) models, which have been estimated from the Multinational Time Use Study (MTUS) for the following countries: Bulgaria, Canada, Spain, Finland, France, Hungary, Italy, South Korea, the United Kingdom, and the United States. Results indicate that carpooling for commuting is not habitual for workers, as less than 25% of the total time from/to work by car is done with others on board. With respect to the role of the socio-demographic characteristics of individuals, our evidence indicates that age, gender, education, being native, and household composition may have a cross-country, consistent relationship with carpooling participation. Given that socializing is the main reason for carpooling, in the current COVID-19 pandemic, carpooling may be decreasing and, consequently, initiatives have been launched to show that carpooling is a necessary way to avoid crowded modes of transport. Thus, the development of high-occupancy-vehicle (HOV) lanes by local authorities can increase carpooling, and draw attention to the economic and environmental benefits of carpooling for potential users.

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Meditation Effects on Anxiety and Resilience of Preadolescents and Adolescents: A Randomized Controlled Study

Children ◽

10.3390/children8080689 ◽

2021 ◽

Vol 8 (8) ◽

pp. 689

Author(s):

Alexandra Gomes ◽

Joana Vieira dos Santos ◽

Luís Sérgio Vieira

Keyword(s):

Children And Adolescents ◽

Externalizing Behavior ◽

Repeated Measures ◽

Positive Impact ◽

Well Being ◽

Controlled Study ◽

Control Group ◽

Quiet Time ◽

The Impact ◽

Experimental Group

Meditation has been described as having a positive impact on well-being while reducing anxiety and stress among those who practice, mainly working as a resource to cope with everyday difficulties. As a simple and easy to apply meditation technique, transcendental meditation (TM) has shown promising results in adults and in children, although more studies are needed to show the impact on psychological and behavioral dimensions in children and adolescents. This quasi-experimental, pre-test–post-test study, with a control group, aimed to evaluate the impact of TM on the stress and resilience of children and adolescents, with ages between 9 and 16 years old. Participants were selected within schools which implemented the Quiet Time Program (QT), from those who volunteered to participate. They were randomly assigned to an experimental group (immediate TM learning) and to a control group (delayed TM learning). A repeated measures ANOVA showed an interaction of time and group on externalizing behavior, from the strengths and difficulties measure. The experimental group decreased on externalizing less adjusted behaviors, while the control group increased in this aspect, after a twelve-week period. TM failed to reduce anxiety and to contribute to resilience in the TM experimental group. Both groups improved anxiety indicators. The results might suggest students were acting upon their expectation of improvement on practicing TM or solely modifying their behavior along the contextual factors, which affected both groups equally.

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152 Development of Deutetrabenazine as a Potential New Non-Antipsychotic Treatment for Tourette Syndrome in Children and Adolescents

CNS Spectrums ◽

10.1017/s1092852920000681 ◽

2020 ◽

Vol 25 (2) ◽

pp. 297-297

Author(s):

Joseph Jankovic ◽

Barbara Coffey ◽

Daniel O. Claassen ◽

David Stamler ◽

Barry J. Gertz ◽

...

Keyword(s):

Children And Adolescents ◽

Tourette Syndrome ◽

Neurodevelopmental Disorder ◽

The United States ◽

Fixed Dose ◽

Dose Titration ◽

Controlled Study ◽

Antipsychotic Treatment ◽

Open Label

Abstract:Background:Tourette syndrome (TS) is a neurodevelopmental disorder characterized by the hyperkinetic movements of motor and phonic tics manifested in young age. Currently approved treatments in the United States are antipsychotics: haloperidol, pimozide, and aripiprazole, which are associated with serious side effects, including tardive dyskinesia (TD). Deutetrabenazine, a vesicular monoamine transporter type 2 (VMAT2) inhibitor, was approved in 2017 by the US FDA for the treatment of chorea associated with Huntington’s disease and TD. Three ongoing studies (Alternatives for Reducing Tics in TS [ARTISTS]) are evaluating the efficacy, safety, and tolerability of deutetrabenazine in reducing tics in TS in children and adolescents (age 6-16 years).Methods:ARTISTS 1, a phase 2/3, response-driven, dose-titration, placebo-controlled study, randomizes patients (N=116) 1:1 to deutetrabenazine or placebo for 12 weeks. ARTISTS 2, a phase 3, fixed-dose study, randomizes patients (N=150) 1:1:1 to deutetrabenazine high or low dose, or placebo for 8 weeks. The primary efficacy outcome in these pivotal studies is change from baseline to end of treatment in the Total Tic Score (TTS) of the Yale Global Tic Severity Scale (YGTSS). Additional efficacy endpoints and safety/tolerability are also evaluated. ARTISTS is a 56-week, open-label, single-arm, long-term safety/tolerability study in patients who have successfully completed either ARTISTS 1 or ARTISTS 2.Results:Not available yet.Conclusion:TS can have potentially long-term life impact, and there remains unmet medical need for effective and well-tolerated treatments. Three ARTISTS studies will evaluate the efficacy, safety, and tolerability of deutetrabenazine in patients with tics in TS.Funding Acknowledgements:The studies are sponsored by Teva Pharmaceuticals and operationalized by Teva’s development partner, Nuvelution TS Pharma INC.

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A Novel Mobile Phone App Intervention With Phone Coaching to Reduce Symptoms of Depression in Survivors of Women’s Cancer: Pre-Post Pilot Study

JMIR Cancer ◽

10.2196/15750 ◽

2020 ◽

Vol 6 (1) ◽

pp. e15750 ◽

Cited By ~ 3

Author(s):

Philip I Chow ◽

Fabrizio Drago ◽

Erin M Kennedy ◽

Wendy F Cohn

Keyword(s):

Mental Health ◽

Pilot Study ◽

Mobile Phone ◽

Large Population ◽

Well Being ◽

The United States ◽

Controlled Study ◽

Sleep Disruption ◽

Intervention Period ◽

Symptoms Of Depression

Background Psychological distress is a major issue among survivors of women’s cancer who face numerous barriers to accessing in-person mental health treatments. Mobile phone app–based interventions are scalable and have the potential to increase access to mental health care among survivors of women’s cancer worldwide. Objective This study aimed to evaluate the acceptability and preliminary efficacy of a novel app-based intervention with phone coaching in a sample of survivors of women’s cancer. Methods In a single-group, pre-post, 6-week pilot study in the United States, 28 survivors of women’s cancer used iCanThrive, a novel app intervention that teaches skills for coping with stress and enhancing well-being, with added phone coaching. The primary outcome was self-reported symptoms of depression (Center for Epidemiologic Studies Depression Scale). Emotional self-efficacy and sleep disruption were also assessed at baseline, 6-week postintervention, and 4 weeks after the intervention period. Feedback obtained at the end of the study focused on user experience of the intervention. Results There were significant decreases in symptoms of depression and sleep disruption from baseline to postintervention. Sleep disruption remained significantly lower at 4-week postintervention compared with baseline. The iCanThrive app was launched a median of 20.5 times over the intervention period. The median length of use was 2.1 min. Of the individuals who initiated the intervention, 87% (20/23) completed the 6-week intervention. Conclusions This pilot study provides support for the acceptability and preliminary efficacy of the iCanThrive intervention. Future work should validate the intervention in a larger randomized controlled study. It is important to develop scalable interventions that meet the psychosocial needs of different cancer populations. The modular structure of the iCanThrive app and phone coaching could impact a large population of survivors of women’s cancer.

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Moderating Effect of Psychological Resilience on Functional Impairment in Relation to Subsequent Depression

Innovation in Aging ◽

10.1093/geroni/igaa057.1566 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 484-484

Author(s):

Shinae Choi ◽

Eun Ha Namkung

Keyword(s):

United States ◽

Older Adults ◽

Depressive Symptoms ◽

Functional Impairment ◽

Later Life ◽

Well Being ◽

The United States ◽

Ordinary Least Squares ◽

Psychological Resilience ◽

The Impact

Abstract The growing prevalence of functional impairment is a serious concern due to its relation to decreased quality of life in later life. Guided by the social convoy model and the stress process model, the present study investigated whether psychological resilience, particularly optimism and mastery moderated an association between functional impairment and subsequent depressive symptoms in later life. This study used data derived from two population-based national studies in the United States: 2012 and 2016 waves of the Health and Retirement Study (N = 5,035) and 2004 and 2013 waves of the Midlife in the United States (N = 2,476). Ordinary least squares regression was used to estimate the impact of optimism and mastery, respectively, on the associations between functional impairment (baseline measure at wave(t-1), changes over the study period from wave(t-1) to wave(t)) on subsequent changes in depressive symptoms. Across both studies, we found that having and developing functional impairment are related to increased number of depressive symptoms. Optimism independently predicted decreased depressive symptoms over the study periods and buffered the negative effects of functional impairment on depressive symptoms across the two studies. Specifically, the mitigating effects of optimism on depressive symptoms were greater for those with more numbers of functional limitations. The findings suggest that psychological resilience plays a key role in decreasing depressive symptoms, especially for midlife and older adults with functional impairment. The results also demonstrate the importance of examining both optimism and mastery when investigating psychological resilience and emotional well-being in older adults.

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Age Advantages in Emotional Experience Persist Even Under Threat From the COVID-19 Pandemic

Psychological Science ◽

10.1177/0956797620967261 ◽

2020 ◽

Vol 31 (11) ◽

pp. 1374-1385

Author(s):

Laura L. Carstensen ◽

Yochai Z. Shavit ◽

Jessica T. Barnes

Keyword(s):

United States ◽

Age Differences ◽

Perceived Risk ◽

Emotional Experience ◽

Well Being ◽

The United States ◽

Demographic Characteristics ◽

The Face ◽

Unavoidable Stress ◽

Prolonged Stress

The COVID-19 pandemic is creating unprecedented, sustained, and unavoidable stress for the entire population, and older people are facing particularly heightened risk of contracting the virus and suffering severe complications, including death. The present study was conducted when the pandemic was spreading exponentially in the United States. To address important theoretical questions about age differences in emotional experience in times of crisis, we surveyed a representative sample of 945 Americans between the ages of 18 and 76 years and assessed the frequency and intensity of a range of positive and negative emotions. We also assessed perceived risk of contagion and complications from the virus, as well as personality, health, and demographic characteristics. Age was associated with relatively greater emotional well-being both when analyses did and did not control for perceived risk and other covariates. The present findings extend previous research about age and emotion by demonstrating that older adults’ relatively better emotional well-being persists even in the face of prolonged stress.

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A Novel Mobile Phone App Intervention With Phone Coaching to Reduce Symptoms of Depression in Survivors of Women’s Cancer: Pre-Post Pilot Study (Preprint)

10.2196/preprints.15750 ◽

2019 ◽

Author(s):

Philip I Chow ◽

Fabrizio Drago ◽

Erin M Kennedy ◽

Wendy F Cohn

Keyword(s):

Mental Health ◽

Pilot Study ◽

Mobile Phone ◽

Large Population ◽

Well Being ◽

The United States ◽

Controlled Study ◽

Sleep Disruption ◽

Intervention Period ◽

Symptoms Of Depression

BACKGROUND Psychological distress is a major issue among survivors of women’s cancer who face numerous barriers to accessing in-person mental health treatments. Mobile phone app–based interventions are scalable and have the potential to increase access to mental health care among survivors of women’s cancer worldwide. OBJECTIVE This study aimed to evaluate the acceptability and preliminary efficacy of a novel app-based intervention with phone coaching in a sample of survivors of women’s cancer. METHODS In a single-group, pre-post, 6-week pilot study in the United States, 28 survivors of women’s cancer used iCanThrive, a novel app intervention that teaches skills for coping with stress and enhancing well-being, with added phone coaching. The primary outcome was self-reported symptoms of depression (Center for Epidemiologic Studies Depression Scale). Emotional self-efficacy and sleep disruption were also assessed at baseline, 6-week postintervention, and 4 weeks after the intervention period. Feedback obtained at the end of the study focused on user experience of the intervention. RESULTS There were significant decreases in symptoms of depression and sleep disruption from baseline to postintervention. Sleep disruption remained significantly lower at 4-week postintervention compared with baseline. The iCanThrive app was launched a median of 20.5 times over the intervention period. The median length of use was 2.1 min. Of the individuals who initiated the intervention, 87% (20/23) completed the 6-week intervention. CONCLUSIONS This pilot study provides support for the acceptability and preliminary efficacy of the iCanThrive intervention. Future work should validate the intervention in a larger randomized controlled study. It is important to develop scalable interventions that meet the psychosocial needs of different cancer populations. The modular structure of the iCanThrive app and phone coaching could impact a large population of survivors of women’s cancer.

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Assessing the Determinants of Quality of Life and the Impact on HIV Prevention Measures among HIV-Negative and Status-Unknown Young Men Who Have Sex with Men: A Study in Two U.S. Metropolitan Areas

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19020726 ◽

2022 ◽

Vol 19 (2) ◽

pp. 726

Author(s):

Yu Liu ◽

Savanah Russ ◽

Jason Mitchell ◽

Sarahmona Przybyla ◽

Chen Zhang

Keyword(s):

Quality Of Life ◽

Hiv Prevention ◽

Young Men ◽

Well Being ◽

The United States ◽

Prevention Measures ◽

Sex With Men ◽

The Impact ◽

Hiv Negative

Young men who have sex with men (YMSM) in the United States (U.S.) are disproportionally burdened by HIV and experience adverse social determinants of health. Minimal research has examined quality of life (QoL) and psychosocial/behavioral determinants among HIV-negative or status-unknown YMSM. We conducted a study with YMSM from two U.S. cities to assess their QoL scores, and whether specific QoL domains (e.g., physical, psychological, social, and environment) were associated with their demographics, psychosocial determinants, behavioral risk factors, and HIV prevention measures. Black YMSM, YMSM of low socioeconomic status (below high school education, income < $20,000, and lack of health insurance), and YMSM who did not disclose their sexual orientation had the lowest QoL scores across all domains. Substance use and unprotected anal intercourse were negatively associated with men’s physical/psychosocial health. Housing/food instability and perceived stress were among the strongest predictors of lower QoL in all domains. Higher physical/psychological and environment QoL scores were associated with a higher likelihood of HIV testing and PrEP use. The identification of YMSM within these demographic, behavioral, and psychosocial sub-groups is important for targeted intervention to enhance their well-being and engagement with HIV prevention.

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The Bioethical Dilemma of Gender-Affirming Therapy in Children and Adolescents

The Linacre Quarterly ◽

10.1177/0024363921989475 ◽

2021 ◽

pp. 002436392198947

Author(s):

Monique Robles

Keyword(s):

Gender Identity ◽

Children And Adolescents ◽

Ethical Decision Making ◽

Well Being ◽

The United States ◽

The Body ◽

Surgical Approaches ◽

Sex Reassignment Surgery ◽

Surgical Interventions ◽

Biological Sex

Since the establishment of the first transgender clinic in the United States in 2007, over sixty clinics associated with children’s hospitals have opened across the nation and are seeing very young children and adolescents with a diagnosis of gender dysphoria (GD). Once known as gender identity disorder, GD has been redefined by the latest version of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition ( DSM-5) not as a mental illness but as the distress experienced by individuals related to their biological sex. The widely accepted practice of gender-affirming therapy (GAT) to treat a vulnerable population despite the associated health risks, the lack of supportive scientific evidence for the pharmacological and surgical interventions, along with the unqualified claim that these interventions will decrease the rate of suicide in these individuals presents a significant bioethical dilemma. The growing trend of GD not only impacts the individuals diagnosed but also society, culture, and the integrity of the profession of medicine. This article utilizes the five-box method, an ethical decision-making framework, to address the implications of the proposed treatment. Once applied, it becomes clear that the hormonal and surgical approaches used are not scientifically or ethically justified. The patient’s autonomy and preferences should be respected, yet constrained, if there exists a considerable risk to the well-being of the individual without proven benefits. The quality of life of those receiving this treatment has not been shown to be significantly improved long term, and the mental, physical, and spiritual health of individuals with GD is not thoroughly addressed in these clinics. The important social and contextual factors, on both microcosmic and macrocosmic scales, are minimized in favor of promoting an ideology. Ultimately, Catholic moral teaching reveals that this widely recommended treatment violates the body–soul union, disregards the principle of totality and integrity, and debases the dignity of humanity. Summary: This article examines GAT, the paradigm used in treating individuals identifying as transgender, through the lens of an EDMF. Each stage of this widely proposed treatment - social affirmation, pubertal blockade, administration of cross-sex hormones, and sex reassignment surgery - poses harms and risks that are not fully disclosed to minors and families, creating a bioethical dilemma. Dialogue utilizing science and reasoning must be encouraged to assist individuals who experience a gender identity that rejects their biological sex. This approach would also contribute to the well-being of society.

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Physical activity in children and adolescents with Charcot-Marie-Tooth disease: A cross-sectional case-controlled study

10.1101/493908 ◽

2018 ◽

Author(s):

Rachel Kennedy ◽

Kate Carroll ◽

Kade L. Paterson ◽

Monique M. Ryan ◽

Joshua Burns ◽

...

Keyword(s):

Physical Activity ◽

Children And Adolescents ◽

Disease Severity ◽

Controlled Study ◽

Cross Sectional ◽

Related Function ◽

Charcot Marie Tooth ◽

Charcot Marie Tooth Disease ◽

Minute Walk ◽

Tooth Disease

Background Disability related to the progressive and degenerative neuropathies known as Charcot-Marie-Tooth disease (CMT) affects gait and function, increasing with age and influencing physical activity in adults with CMT. The relationship between disease, ambulatory function and physical activity in children and adolescents with CMT is unknown. Method A cross-sectional case-controlled study of 50 children with CMT and age- and gender-matched typically developing (TD) controls [mean age 12.5 (SD 3.9) years]. A 7-day recall questionnaire assessed physical activity; disease severity and gait-related function were measured to explore factors associated with physical activity. Results Children with CMT were less active than TD controls (estimated weekly moderate to vigorous physical activity CMT 283.6 (SD 211.6) mins, TD 318.0 (SD 202.5) mins; p < 0.001). The children with CMT had moderate disability [CMT Pediatric Scale mean score 20 (SD 8) /44] and reduced ambulatory capacity in a six-minute walk test [CMT 485.1 (SD 160.9) metres, TD 639.8 (83.1) metres; p < 0.001]. Physical activity correlated with greater disease severity (ρ = -0.52, p < 0.001) and six-minute walk distance (ρ = 0.71, p < 0.001). Conclusions Disease-related disability affects physical activity and gait-related function in children and adolescents with CMT compared to TD peers. Reduced physical activity adversely affects function across the timespan of childhood and adolescence into adulthood.

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