Kooperativer Bibliotheksverbund

Berlin Brandenburg


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  • Wiley (CrossRef)  (13)
Type of Medium
  • 1
    In: British Journal of Health Psychology, September 2017, Vol.22(3), pp.609-626
    Description: Byline: Margaret R. Bauer, Joshua F. Wiley, Karen L. Weihs, Annette L. Stanton Keywords: avoidance; intrusive thoughts; coping; cognitive processing; cancer Objectives Theories and research regarding cognitive and emotional processing during the experience of profound stressors suggest that the presence of intrusive thoughts and feelings predicts greater use of avoidance and that the use of avoidance paradoxically predicts more intrusions. However, empirical investigations of their purported bidirectional relationship are limited. Design This study presents a longitudinal investigation of the reciprocal relationship between intrusions and avoidance coping over a 6-month period in the year following breast cancer diagnosis. Methods Breast cancer patients (N = 460) completed measures of cancer-related intrusions and avoidance at study entry, 3 months, and 6 months later (i.e., an average of 2, 5, and 8 months after diagnosis, respectively). Results Cross-lagged panel analyses revealed that intrusive thoughts, feelings, and images at study entry predicted greater avoidance 3 months later, and avoidance coping at study entry predicted intrusions 3 months later, controlling for the stability of intrusions and avoidance as well as time since diagnosis. Findings were not statistically significant for avoidance predicting intrusions, or vice versa, between the 3-month and the 6-month assessment period, during which they declined. Conclusions These findings provide empirical support for the theoretical contention that avoidance and intrusive thoughts and emotions reciprocally influence one another following stressful events. Additionally, in the months shortly after breast cancer diagnosis, intrusions and avoidance are positively related. However, the relationships attenuate over time, which could indicate resolved cognitive and emotional processing of the cancer experience. Statement of contribution What is already known on this subject? Following stressful life events, individuals often experience intrusive thoughts and feelings related to the event and they report avoidance of such reminders. Many studies demonstrate that greater intrusions predict more subsequent use of avoidance coping, and other studies show that greater use of avoidance predicts more intrusions. Their reciprocal relation has not been examined, however. What does this study add? This is the first examination of the concurrent, reciprocal influence of intrusions and avoidance. Findings suggest that accounting for the bidirectional influence of avoidance and intrusions best estimates hypothesized models. Higher intrusions and avoidance predicted each other for the first 3 months after study entry, but the relationship diminished 6 months after study entry, perhaps due to productive mental processing of the stress of breast cancer diagnosis and treatment.
    Keywords: Avoidance ; Intrusive Thoughts ; Coping ; Cognitive Processing ; Cancer
    ISSN: 1359-107X
    E-ISSN: 2044-8287
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  • 2
    Language: English
    In: Journal of Traumatic Stress, December 2010, Vol.23(6), pp.775-784
    Description: Studies have assessed relationships between posttraumatic stress disorder (PTSD) symptoms and physiological reactivity concurrently; fewer have assessed these relationships longitudinally. This study tests concurrent and prospective relationships between physiological reactivity (heart rate and skin conductance) to a monologue procedure and PTSD symptoms in female assault survivors, tested within 1 and 3 months posttrauma. After controlling for initial PTSD and peritraumatic dissociation, 3 measures of increased physiological reactivity to the trauma monologue at 1 month predicted 3‐month PTSD reexperiencing severity. Additionally, increased heart rate following trauma and neutral monologues at 1 month was predictive of 3‐month numbing symptoms. Implications for the prospective relationship between physiological reactivity to trauma cues and PTSD over time are discussed.
    Keywords: Interview, Psychological -- Methods ; Stress Disorders, Post-Traumatic -- Physiopathology ; Survivors -- Psychology;
    ISSN: 0894-9867
    E-ISSN: 1573-6598
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  • 3
    In: Journal of School Health, April 1957, Vol.27(4), pp.107-114
    ISSN: 0022-4391
    E-ISSN: 1746-1561
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  • 4
    In: Health & Social Care in the Community, March 2017, Vol.25(2), pp.780-789
    Description: Solutions to support older people to live independently and reduce the cost of an ageing population are high on the political agenda of most developed countries. Help‐at‐home schemes offer a mix of community support with the aim to address a range of well‐being needs. However, not much is currently known about the costs, outcomes and economic consequences of such schemes. Understanding their impact on individuals’ well‐being and the economic consequences for local and central government can contribute to decisions about sustainable long‐term care financing. This article presents results from a mixed‐methods study of a voluntary sector‐provided help‐at‐home scheme in England for people of 55 years and older. The study followed a participatory approach, which involved staff and volunteers. Data were collected during 2012 and 2013. Social care‐related quality of life was measured with the Adult Social Care Outcomes Toolkit for 24 service users (59% response rate) when they started using the scheme and 4–6 months later. A customised questionnaire that captured resource use and well‐being information was sent to 1064 service users (63% response rate). The same tool was used in assessment with service users who started using the scheme between November 2012 and April 2013 (100% response rate). Costs of the scheme were established from local budget and activity data. The scheme was likely to achieve a mean net benefit of £1568 per person from a local government and National Health Service (NHS) perspective and £3766 from the perspective of the individual. An expenditure of £2851 per person accrued to central government for the additional redistribution of benefit payments to older people. This article highlights the potential contribution of voluntary sector‐run help‐at‐home schemes to an affordable welfare system for ageing societies.
    Keywords: Costs ; Economic ; Home ; Independent Living ; Older People ; Third Sector
    ISSN: 0966-0410
    E-ISSN: 1365-2524
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  • 5
    Language: English
    In: Pharmacoepidemiology and drug safety, January 2011, Vol.20(1), pp.57-65
    Description: To determine guideline conformity of initiation of oral hypoglycemic (OH) treatment for type 2 diabetes in Austria; to study patient and prescriber correlates of recommended initiation with metformin monotherapy. We used claims from 11 sickness funds that covered 7.5 million individuals, representing 〉90% of the Austrian population. First-time OH use was defined as a first filled prescription after one year without any OH drug or insulin. Among these incident users, we described the OH drug class used and defined correlates of initiation with metformin monotherapy. From 1/2007 to 6/2008, we identified 42,882 incident users of an OH drug: 70.8% used metformin, 24.7% used a sulfonylurea, and 4.5% initiated treatment with another class. We estimated the incidence of OH-dependent type 2 diabetes at 3.8-4.4 per 1000 patient-years. We conducted multivariate analyses among 39 077 patients with available prescriber information. Independent correlates of initiation with metformin were younger age, female gender, waived co-payment, more recent initiation, fewer hospital days and more therapeutic classes received in the year prior to first OH therapy (all p 〈 0.001). Prescriber specialty and age (p 〈 0.001), but not gender, were also associated with metformin initiation. Approximately 20% of metformin initiators had a second OH drug added within 〈18 months. While we were unable to ascertain specific contraindications to metformin (renal insufficiency, hepatic failure), 〈10% of the general population are expected to have these conditions. Seventy per cent of new initiators of OH treatment in Austria received metformin as recommended by international guidelines. At least 20% did not, taking into account possible contraindications, which provides an opportunity for intervention.
    Keywords: Guideline Adherence ; Diabetes Mellitus, Type 2 -- Drug Therapy ; Hypoglycemic Agents -- Therapeutic Use ; Metformin -- Therapeutic Use
    ISSN: 10538569
    E-ISSN: 1099-1557
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  • 6
    In: Annals of the New York Academy of Sciences, May 1977, Vol.284(1), pp.254-263
    ISSN: 0077-8923
    E-ISSN: 1749-6632
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  • 7
    In: Journal of Continuing Education in the Health Professions, 1998, Vol.18(4), pp.235-243
    Description: : Increased regulation of professional practice imposes obligations upon practitioners to keep abreast of professional developments. One mandate of a professional association is to offer opportunities for professional growth in clinical practice, education, and research to its members. But are there others who should be involved? Rapid societal change has dictated new constraints in the practices of health care practitioners, some legislated and others imposed by institutional and economic considerations. At the same time, research and advances in technology challenge health care practitioners to expand their knowledge and change their practices in ways that go well beyond mere technical competence. A philosophical analysis of professionalism places the responsibility for continuing education with the professional practitioners, individually and in collaboration with their colleagues. The purpose of such collaboration is to further professional goals and to ensure that professional competence is maintained. Different organizations typically represent these interests on behalf of their members. Professional ideals extend beyond the local workplace and clinical competence to researching new initiatives that may more accurately reflect the complex needs of individual clients. Professional constraints insist on standards of practice that are evidence based and effective for the majority of clients with similar needs. A systems approach to these issues suggests a framework that delineates organizational responsibilities and relationships; it recognizes the different roles and expertise of each of the players and acts as a catalyst for ongoing discussion and collaboration in the marketplace of continuing professional education.
    Keywords: Professional Competence ; Professional Development ; Professionalism;
    ISSN: 0894-1912
    E-ISSN: 1554558X
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  • 8
    Language: English
    In: International Journal of Cancer, 03/12/1993, Vol.53(5), pp.804-811
    Description: HL-60-R, a multi-drug-resistant (MDR) subclone of the human leukemia cell line HL-60, was selected in continuous culture in doxorubicin (DOX) in the absence of mutagenic agents. When compared to the parent line HL-60, HL-60-R showed greater relative resistance to vinblastine than to etoposide, or to the selecting agent DOX. Co-exposure to verapamil, a known modulator of MDR, partially increased its sensitivity to DOX and vinblastine. The HL-60-R cell line stained positively with the P-glycoprotein-specific monoclonal antibody (MAb), C219, whereas the HL-60 parent was negative. Southern analysis showed 32-fold amplification of the mdrI gene in HL-60-R, whereas slot-blot analysis demonstrated 70-fold over-expression of the specific mdrI message in HL-60-R compared to HL-60. Northern blot analysis revealed the presence of 2 species of messenger RNA of sizes 5.1 kb and 4.5 kb. No transcripts were detectable in the parent. Flow cytometric analysis showed significantly reduced cellular retention of DOX as well as rapid efflux from the drug-resistant cell line. HL-60-R proved to be nearly 4 times more resistant to hydrogen peroxide than its parent, and 1,000 times more resistant to inhibition of cellular glutathione synthesis by D,L-buthionine sulfoximine (BSO). Verapamil modulated DOX resistance in HL-60-R incompletely but, in the presence of glutathione depletion, nearly completely reversed DOX resistance. Elevated levels of glutathione and glutathione-peroxidase activity were demonstrated, thereby implicating enhanced activity of the glutathione/glutathione-peroxidase cycle as an additional basis for its resistance to DOX. These findings suggest that an enhanced capacity for detoxifying oxyradicals may contribute to anthracycline resistance in acute leukemia.
    Keywords: Doxorubicin -- Metabolism ; Glutathione -- Metabolism ; Glutathione Peroxidase -- Metabolism ; Leukemia, Myeloid, Acute -- Metabolism;
    ISSN: 00207136
    E-ISSN: 10970215
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  • 9
    Language: English
    In: Journal of Obstetric, Gynecologic & Neonatal Nursing, January 1987, Vol.16(1), pp.48-55
    Description: A series of descriptive studies was carried out to 1) characterize maternal respiration, type of bearing-down efforts, vocalization, and behavior; 2) describe the obstetric conditions and intrauterine pressure associated with the bearing-down reflex; and 3) describe the duration of second stage, fetal heart rate, and neonatal outcomes when women bear down spontaneously. Thirty-one healthy nulliparous women who had received no formal childbirth education were neither directed nor instructed to bear down with contractions. The women were supported in their involuntary bearing-down efforts throughout the second stage of their labors while the above features of their labor were recorded. The findings suggest that labor progress is adequate and fetal outcome is good when the management of the expulsion phase of labor encourages maternal pushing that is complementary with the involuntary bearing-down reflex rather than sustained breath-holding. These findings support the necessity for further research regarding the bearing-down techniques used during labor.
    Keywords: Medicine ; Nursing
    ISSN: 0884-2175
    E-ISSN: 1552-6909
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  • 10
    Language: English
    In: Arthritis & Rheumatism, March 1995, Vol.38(3), pp.351-360
    Description: To develop guidelines for therapeutic trials designed to improve the overall course of systemic sclerosis (SSc), that is, to reduce the development of significant organ damage or death. A committee developed general guidelines for patient inclusion and exclusion criteria, randomization, blinding of patients and physicians, controls, duration of the trial, investigator training, responses, samples size, study dropouts, statistical analyses, data management, and safety monitoring. Delphi and nominal group techniques were used. Briefly, patients with diffuse cutaneous SSc of less than 24 months' duration should be included because they are at greatest risk for the development of severe organ damage and death. Patients should be excluded if they have other connective tissue diseases, SSc‐like illnesses related to exposures or ingestions, severe existing internal organ damage, an unacceptable risk of side effects, or concurrent therapies that might independently influence the outcome. Randomized, double‐blind, placebo‐controlled trials are preferred. The treatment and followup period must be long enough to permit observation of any disease modification, which is likely to require 18–36 months, unless an extraordinarily effective therapy is identified. Responses selected should be quantitative, consistently and accurately reflect activity of SSc in major target organs (not solely the skin), be sensitive to change, and be standardized, with limited variability. An example of a set of responses is given. Surrogate responses are desirable, but none have been validated as correlating with organ damage. Guidelines have been established for trials of disease‐modifying interventions in SSc. These guidelines will need to be altered as additional information becomes available. Any given protocol will be individualized based on the nature of the intervention and objectives of the study. Nonetheless, each study team should develop a protocol that meets the spirit of these guidelines.
    Keywords: Medicine;
    ISSN: 0004-3591
    E-ISSN: 1529-0131
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