Immunity and health after bereavement in relation to coping

Coping was examined as an intervening variable between the stressor of bereavement and its effects on subjective health and immunity in thirty-nine recently bereaved Norwegian women. Coping was defined as: "positive response outcome expectancies". Data were collected approximately one month after the death of the husband, and twelve months thereafter. Data collected were: expected coping success (self-scoring), subjective health (UHI), anxiety and depression (GWB), and immunoglobulins (IgA, IgM, IgG) with components (C3, C4). Statistics were: frequencies, paired t -test, ANOVA, and MANOVA. Permissions and confidentiality were in accordance with the Helsinki-declaration. Coping was found to be related strongly to health and to health changes. Few relations were found between immunity and health. Coping, health, and anxiety and depression formed a triangle of interrelations. It was concluded that coping defined as "positive response outcome expectancies" may be a predictor of the adaptational outcome after a crisis.     

The extra credit effect in interpersonal attraction

An experiment was conducted in which three levels of personal evaluation (positive, mixed, or negative) were crossed with two levels of dependence of the evaluator (high or low) and two levels of accuracy of the evaluation (high or low). Liking for the evaluator was expected to increase linearly with the favorableness of the evaluation, with two possible exceptions: When a positive evaluation from a dependent evaluator was inaccurate, and when a negative evaluation from a dependent evaluator was accurate. In the former case, the obvious inaccuracy of the positive evaluation in the face of the temptation to ingratiate was expected to elicit a decrement in liking (an “ingratiation effect”) by the person being evaluated. In the latter case, the honesty of the evaluator in the face of the temptation to ingratiate was expected to elicit an increment of linking (an “extra credit effect”) by the person being evaluated. Only the second of these two possibilities was supported.     

A Test of Contextual Theory: The Relationship Among Relational Ethics,Marital Satisfaction,Health Problems,and Depression

Few studies have examined the theoretical underpinning of contextual theory. Using structural equation modeling, the relationship among relational ethics (recognized as the most important aspect of contextual theory), marital satisfaction, depression, and illness was examined. Data came from a national sample of 632 mid-life, married individuals. Results supported Nagy’s contextual theory. The total score of the Relational Ethics Scale was a significant predictor of marital satisfaction, and marital satisfaction was significantly associated with depression and health problems. Vertical and horizontal subscales of relational ethics also were significant predictors of depression and health problems through the mediating variable of marital satisfaction.     

Stresses reported by UK trainee counselling psychologists

This study examined stressors and psychological distress in 109 UK counselling psychology trainees. The research focus was two-fold. What is the profile of stressors that counselling psychology trainees report about the components of training? What relationship is there between this profile, and other characteristics of trainees, including their level of current psychological distress? Data from a stress survey and from the General Health Questionnaire were examined. High stress scores were found on three aspects of the stress survey (‘academic’, ‘placements’, ‘personal and professional development’), but not–surprisingly–on the aspect, ‘lack of support systems’. Significant stress differences were reported for gender and age of participants, and highly significant positive relationships were found between General Health Questionnaire and stress scores. Overall, the results suggest actions to be taken. Further research is needed to clarify unavoidable and avoidable stressors in training, and the reduction of trainees’ experience of training stress to the necessary minimum needs to be adopted as an active target by programmes.     

Can organisational safety climate and occupational stress predict work-related driver fatigue?

Road crashes are a significant cause of work-related injury and death. Driver fatigue is thought to cause 20–30% of fatal crashes. The current study utilised a survey to examine the relationship between safety climate, occupational stress and work-related driver fatigue. Drivers (n = 219) from two government organisations responded to items from the job-related tension scale [Kahn, R. L., Wolfe, D. M., Quinn, R. P., & Snoek, J. D. (1964). Organisational stress: Studies in role conflict and ambiguity. Malabar, FL: Krieger Publishing], safety climate questionnaire [Glendon, A., & Litherland, D. (2001). Safety climate factors, group differences and safety behaviour in road construction. Safety Science, 39, 157–188] and purpose-designed items on fatigue-related behaviour. Outcome measures were current self-reported, fatigue-related behaviour and self-reported ‘near (crash) misses’ during the previous 6 months. Together, occupational stress and safety climate predicted fatigue-related behaviour, accounting for 29% of the variance over and above that explained by control variables. Further, logistic regression revealed occupational stress and safety climate to be significant predictors of fatigue-related near misses. Safety climate emerged as a stronger predictor of both fatigue-related behaviour and near misses than occupational stress. Results suggest that organisations can play a part in improving the safety-related behaviours of their workforce through attention to safety climate and occupational stress.     

Infant feeding and HIV in Sub-Saharan Africa: what lies beneath the dilemma?

The debate over how to best guide HIV-infected mothers in resource-poor settings on infant feeding is more than two decades old. Globally, breastfeeding is responsible for approximately 300,000 HIV infections per year, while at the same time, UNICEF estimates that not breastfeeding (formula feeding with contaminated water) is responsible for 1.5 million child deaths per year. The largest burden of these infections and deaths occur in Sub-Saharan Africa. Using this region as an example of the burden faced more generally in other resource-poor settings, we contrast the evolution of the clinical standard of care for infant feeding with HIV-infected mothers in high-income countries to the current international clinical guidelines for HIV-infected mothers and infant feeding in resource-poor settings. While the international guidelines of exclusive breastfeeding for a 6-month period seem to offer the least-worst strategy for reducing mother-to-child transmission of HIV during infancy while conferring some immunity through breastfeeding post-6 months, we argue that the impact of the policy on mothers and healthcare workers on the ground is not well understood. The harm reduction approach on the level of health policy translates into a complicated, painful moral dilemma for HIV-positive mothers and those offering them guidance on infant feeding. We argue that the underlying socio-economic disparities that continue to fuel the need for a harm reduction policy on infant feeding and the harm to women and children justify: (1) that higher priority be given to solving the infant feeding dilemma with improved data on safe feeding alternatives, and (2) support of innovative, community-driven solutions that address the particular economic and cultural challenges that continue to result in HIV-transmission to children within these communities.

Consenting to uncertainty: challenges for informed consent to disease screening—a case study

This paper uses chronic beryllium disease as a case study to explore some of the challenges for decision-making and some of the problems for obtaining meaningful informed consent when the interpretation of screening results is complicated by their probabilistic nature and is clouded by empirical uncertainty. Although avoidance of further beryllium exposure might seem prudent for any individual whose test results suggest heightened disease risk, we will argue that such a clinical precautionary approach is likely to be a mistake. Instead, advice on the interpretation of screening results must focus not on risk per se, but on avoidable risk, and must be carefully tailored to the individual. These points are of importance for individual decision-making, for informed consent, and for occupational health.

Health-Related Quality of Life in a National Sample of Caregivers: Findings from the Behavioral Risk Factor Surveillance System

Purpose Recent national public health agendas, such as Healthy People 2010, call for improved public health surveillance and health promotion programs for people with disabilities and their caregivers. The goal of this study was to understand the public health impact of caregiving on health-related quality of life (HRQoL) using population-level data. Design & Methods A cross-sectional study design was used. 184,450 adults surveyed during the 2000 national Behavioral Risk Factor Surveillance System survey formed the sample. Binary logistic regression models ascertained differences between caregivers and non-caregivers in reporting reduced (“fair” or “poor”) health. Ordinary least squares regression (OLS) and multinomial logistic regression models examined the influence of caregiving status on HRQoL, measured as categories of healthy days reported in the last 30 days and the number of days reported as physical and mental health not good in the last 30 days. Results Sixteen percent (16%) of the survey respondents were caregivers. There was an interaction effect between caregiving status and age of the caregiver. In the fully adjusted models, caregivers <55 years old had a 35% increased risk of having fair or poor health (odds ratio [OR] = 1.35, 95% confidence interval [CI] 1.28, 1.43) as compared to non-caregivers in that age group, while caregivers 55 years and older had a 3% decreased risk in having fair or poor health (OR = 0.97, 95% confidence interval [CI] 0.92, 1.03) compared to non-caregivers of the same age. In the adjusted models that examined the association of caregiving and healthy days, younger caregivers similarly showed larger deficits in both mental and physical HRQoL compared to older caregivers. For example combining mental and physical days, caregivers <55 had 1.44 fewer healthy days (β = −1.44, standard error (SE) = 0.07), while caregivers 55+ had 0.55 fewer days *β = −0.55, standard error (SE) = 0.13 (compared to non-caregivers in their respective age groups). Implications With increasing population age and the projected increase in caregivers, it is important that we understand the social and public health burden of caregiving and begin to identify interventions to sustain the HRQoL of caregivers. We found that caregivers have a slight to modest decline in HRQoL compared to non-caregivers, and that caregiving affects the HRQoL of younger adults more than older adults. Further research at the population level as to the type and level of burden of caregiving is needed.     

Genetics Education for Health Professionals: A Context

Education of health professionals about genetics is essential to the integration of genetics into mainstream health care, but there are a number of associated challenges. By virtue of their training, genetic counselors are well suited to address many of those challenges and to assume a variety of roles related to genetics education for health professionals. This paper provides a brief overview of the status of genetics education for non-genetics health professionals and reviews the context in which educational efforts are likely to occur.