Reproductive Health CHOICES for Young Adults with Sickle Cell Disease or Trait: Randomized Controlled Trial Outcomes over Two Years

Interventions to assist reproductive health decision-making in populations affected by sickle cell disease (SCD) or trait (SCT) lack proven efficacy over time. Our aim was to compare effects of CHOICES, a Web-based multimedia education program on implementing informed reproductive plans, and usual care education (e-Book) on reproductive knowledge, intention, and behavior over 24 months. We randomized 234 participants with SCD (n?=?138) or SCT (n?=?96) (age 18–35 years, 35 % male, 94 % African American) to CHOICES and e-Book groups. Participants completed a sickle cell-specific reproductive measure before and four times after the intervention (6, 12, 18 and 24 months). Compared to the e-Book group the CHOICES group had significantly more improvement in knowledge over time (p?=?.004) but not intention (p?=?.18) or behavior (p?=?.69). At baseline, 114 (48.7 %) participants reported having partners who would not put the couple at risk for their children inheriting SCD. Of the 116 (49.6 %) at-risk participants, a higher poroportion of those who were in the CHOICES group chose partners that reduced their risk by the last visit than the e-Book group (p?=?.04). Study findings provide important insights for designing a national trial of the CHOICES intervention focusing on subjects whose partner status puts them at risk for having a child with SCD.     

A Positive Psychology Intervention for Patients with an Acute Coronary Syndrome: Treatment Development and Proof-of-Concept Trial

Positive psychological constructs are associated with superior outcomes in cardiac patients, but there has been minimal study of positive psychology (PP) interventions in this population. Our objective was to describe the intervention development and pilot testing of an 8-week phone-based PP intervention for patients following an acute coronary syndrome (ACS). Initial intervention development and single-arm proof-of-concept trial, plus comparison of the PP intervention to a subsequently-recruited treatment as usual (TAU) cohort. PP development utilized existing literature, expert input, and qualitative interview data in ACS patients. In the proof-of-concept trial, the primary outcomes were feasibility and acceptability, measured by rates of exercise completion and participant ratings of exercise ease/utility. Secondary outcomes were pre-post changes in psychological outcomes and TAU comparisons, measured using effect sizes (Cohen’s d). The PP intervention and treatment manual were successfully created. In the proof-of-concept trial, 17/23 PP participants (74 %) completed at least 5 of 8 exercises. Participants rated the ease (M = 7.4/10; SD = 2.1) and utility (M = 8.1/10, SD = 1.6) of PP exercises highly. There were moderate pre-post improvements (ds = .46–.69) in positive affect, anxiety, and depression, but minimal effects on dispositional optimism (d = .08). Compared to TAU participants (n = 22), PP participants demonstrated greater improvements in positive affect, anxiety, and depression (ds = . 47–.71), but not optimism. A PP intervention was feasible, well-accepted, and associated with improvements in most psychological measures among cardiac patients. These results provide support for a larger trial focusing on behavioral outcomes.     

So hard to say goodbye? An investigation into the symbolic aspects of unintended disposition practices

Even though disposition is present in the consumer behavior research agenda, most of the studies focus mainly on intentional movements of products leaving the home. The present article describes a less conscious and co‐incidental journey of products into a liminal zone between use and disposal inside homes. A qualitative field study, based on the itinerary method, was undertaken with a group of 26 affluent women in Brazil. The findings show that consumers maintain purgatories – “forgotten” repositories of products no longer in use – as an in‐home disposition practice. The aspects and functioning of purgatory are also detailed, through a typology of purgatories and a discussion of specific strategies to deal with cluttering as a consequence of product accumulation inside homes. Finally, purgatories emerge as a contemporary consumer solution to deal not with individual products but with product collectivities' disposition. Copyright © 2016 John Wiley & Sons, Ltd.     

On Bourbaki’s axiomatic system for set theory

In this paper we study the axiomatic system proposed by Bourbaki for the Theory of Sets in the Éléments de Mathématique. We begin by examining the role played by the sign \(\uptau \) in the framework of its formal logical theory and then we show that the system of axioms for set theory is equivalent to Zermelo–Fraenkel system with the axiom of choice but without the axiom of foundation. Moreover, we study Grothendieck’s proposal of adding to Bourbaki’s system the axiom of universes for the purpose of considering the theory of categories. In this regard, we make some historical and epistemological remarks that could explain the conservative attitude of the Group.     

The type A behavior pattern, physical fitness, and psychophysiological reactivity

Joint effects of the Type A behavior pattern and aerobic fitness were examined with regard to heart rate (HR) and blood pressure (BP) changes elicited by laboratory challenges. Sixty-one college students were classified as Type A or B using the Structured Interview (SI), and as physically fit or sedentary using self-reports of activity level and estimated VO2max values obtained on a step test. Subjects were challenged with the SI, presentation of a snake, mental arithmetic, a cold pressor task, and two competitive card games. Significant A-B differences were found only on the SI and the card games. During the SI: As displayed significantly greater BP increases than Bs; sedentary subjects showed greater BP increases than fit subjects; and sedentary As revealed greater BP increases than either fit As, fit Bs, or sedentary Bs. In contrast, during the competitive games, physically fit As showed reliably greater BP increases than either sedentary As, sedentary Bs, or fit Bs. Since the physically fit subjects were almost exclusively varsity athletes and the sedentary subjects were college students who reported following a sedentary lifestyle, the differences between sedentary and fit groups may have been due to differences in aerobic fitness or to the improved ability of competitive athletes or those engaged in fitness training to match arousal level to task requirements.