This study examines the effects of TYSABRI on the health-related quality of life (HrQoL) outcomes, disease status and symptomatology, treatment satisfaction, productivity outcomes and healthcare utilization for patients with Crohn’s Disease (CD). A total of 241 patients consented to participate in the study, out of which 61 patients qualified for the baseline survey. After three-months of TYSABRI therapy, the follow-up survey was completed by 24 patients. Changes in outcome scores from baseline to the three-month follow-up were evaluated. The 24 patients with the three-month follow-up were, on average 41 years old and 62.5% percent were female. For those with follow-up, a significantly lower proportion of patients (41.7 percent) identified their CD severity as moderate to severe compared to 83.3 percent at baseline (p=0.001). The patients also reported experiencing a significantly lower mean number of CD relapses at follow-up (4.0) compared to baseline (6.8) (p=0.004). Improved median well-being scores (2.0 vs. 1.0; p<0.001) and improved median abdominal pain scores (2.0 vs. 1.0; p=0.001) were also reported at follow-up. The patient global assessment of HrQoL over the last 2 weeks was significantly improved at follow-up (2.0 vs. 3.0; p=0.006). Similar improved results were observed regarding their assessment of the impact of CD on HrQoL (7.0 vs. 5.0; p<0.001). A significant change of 32.0 points on the total Inflammatory Bowel Disease Questionnaire (IBDQ) scale (p<0.001) and significant improvements in each of the four component scales were also seen at follow-up (p≤0.05). Significant improvement was noted on the SF-36 PCS scale (mean change 7.0; p=0.001) and MCS scale (mean change 6.0; p=0.05). Significant improvements were observed in the scores for each of the four scales of the treatment satisfaction questionnaire at follow-up: effectiveness scale (28.6 vs. 63.0; p<0.001); side-effects scale (61.6 vs. 82.2; p=0.01); convenience scale (63.8 vs. 70.8; p=0.05); and global satisfaction scale (41.3 vs. 67.0; p<0.001). A significant decrease in the number of CD-related emergency room (ER) visits was observed between baseline and follow-up (1.3 vs. 0.7; p=0.03). For the productivity outcomes, the percent of planned household work lost due to absenteeism was significantly reduced (73.1 percent vs. 43.9 percent; p=0.02) and the total percent of planned hours lost was also reduced (87.3 percent vs. 64.4 percent; p=0.037). These results indicate that TYSABRI is associated with significant improvement in HrQoL outcomes, CD disease severity, treatment satisfaction, ER visits and productivity outcomes. / text

Two decades of research suggest that a non-specific style of autobiographical memory retrieval–known as overgeneral memory–may be a cognitive style that increases depression vulnerability. Recent theorizing and empirical evidence suggest the mechanisms underlying overgeneral memory include rumination and avoidance. This study provided a preliminary investigation of the effectiveness of an expressive writing intervention, which has been found to reduce rumination and avoidance, in reducing overgeneral memory, with the ultimate goal of preventing future depressive symptoms among non-depressed college students. Two hundred and seven non-depressed college students completed the expressive writing intervention, in addition to a one-month and six month follow-up assessment. Participants were randomized one of three writing conditions: traditional expressive writing, specific expressive writing, or control writing. Participants in the traditional and specific expressive writing conditions were instructed to write about their deepest thoughts and feelings about an emotional event; the specific expressive writing condition contained the additional instruction that participants describe the events in a vivid and detailed manner. Participants in the control condition were instructed to write about a neutral topic (i.e., time management). All groups wrote for 20 minutes on three consecutive days. Study results showed that compared to participants in the control writing condition, participants in the traditional and specific expressive writing conditions demonstrated significantly greater autobiographical memory specificity at the six-month follow-up, but not at the one-month follow-up. Furthermore, the observed increase in autobiographical memory specificity for the expressive writing conditions could not be attributed to change in depressive symptoms over the same time interval. Results revealed that the effect of the traditional expressive writing intervention on increased autobiographical memory specificity was partially mediated by a reduction in avoidance assessed at the one-month follow-up. The hypothesis that rumination would partially mediate the effect of the expressive writing intervention on increased autobiographical memory specificity was not supported. Despite preliminary evidence that an expressive writing intervention compared to a control wiring condition is effective in increasing autobiographical memory specificity over a six-month period for initially non-depressed college students, it remains to be seen if increased autobiographical memory specificity decreases vulnerability to future depressive symptoms. / text

Objective: To examine reasons why Multiple Sclerosis (MS) patients may not be adherent to disease-modifying therapies (DMTs). Also, to determine patient perceptions of MS as a disease and DMTs as a source of treatment, and compare these between patients with prior DMT experience and those who were DMT-naïve. Finally, to assess the level of MS symptoms reported in patients taking DMTs, and compare these between DMT users and non-users. Methods: Patients with MS who were affiliated with a regional health plan at any point between January 2005 and December 2010 were asked to fill out a survey, the Multiple Sclerosis Medication Questionnaire (MSMQ). For study purposes, non-adherence was defined as missing any doses in the previous 28 days by the patient. In addition, the MSMQ examined reasons why MS patients do not initiate or discontinue DMT use. For statistical analyses, chi-square tests were performed to detect differences and t-tests and Mann-Whitney U tests to confirm the results. Results: A total of 197 surveys were returned, of which 105 (53.3%) patients were currently on a DMT. Thirty-two (30.5%) of the DMT users were considered non-adherent. Of the non-adherent respondents, the most frequent reason for non-adherence that was at least moderately important was being "too busy" (n=13/29, 44.8%). Amongst patients who were not using a DMT, the most common barrier to DMT use was related to possible side effects of treatment (n=46/79, 58.2%). Analyzing the statements regarding barriers to DMTs revealed significant differences in the proportion of agreement regarding physician's lack of advocacy for DMT use between DMT-naïve patients and those who discontinued DMT use (44.7% vs. 17.1%, respectively, p[less than]0.01), as well as for dislike for using needles (24.3% vs. 46.3%, respectively, p=0.043). In terms of MS symptoms, patients using a DMT generally reported the symptoms posed less of a problem, although significant differences were not seen in chi-square analyses. Conclusion: The injectable nature of most DMTs seems to cause varying degrees of discomfort in MS patients, which may contribute to non-adherence. Reasons given by MS patients for DMT non-adherence in the MSMQ mirror the literature regarding this topic. MS patients who are not currently on DMT may not seek or remain on treatment for various reasons. It appears certain perceptions regarding MS and DMTs are associated with potential DMT use. / text

The purpose of the study is to examine the influence of parental contributions to perfectionism on depressive symptoms for Asian American adolescents and whether perceived parental support and/or social support may buffer/moderate the relationship. Perceived support from parents and peers may serve as protective factors from experiencing distress associated with the high pressures experienced by Asian Americans to succeed academically and be perfect in school. Asian American adolescents will fill out self-report measures for dimensions of perfectionism, depressive symptoms, and perceived parental and social support. Multiple regressions will be used to test the hypothesis of this study. Implications for the proposed study suggested the development of an intervention to help cultivate coping skills related to parent-driven stress for Asian American adolescents. / text

In breast cancer patients, symptoms of depression decrease quality of life and may have other serious consequences, such as increasing mortality. Few studies have focused on psychosocial issues and their relation to breast cancer in African-American women. Thus, only limited information has been published on the breast cancer experience of African American women. A grounded theory approach was used to explicate the social psychological and social structural processes of African American women with breast cancer experiencing depressive symptoms. The sample included nine African American women with breast cancer who experienced depressive symptoms. Unstructured interviews were conducted with each participant.Data were analyzed using the constant comparison method. The data indicated that African American women used the basic social process of Transcending the now to manage the basic social problem of having breast cancer and experiencing depressive symptoms. The five phases of the basic social psychological (BSP) process Transcending the Now that emerged during data analysis were Relying on Faith, Being Strong, Seeking Support, Dealing with Life Too, and Enduring Breast Cancer. The findings of this study provide nurses with new knowledge regarding the experience of depressive symptoms in African American women with breast cancer and provide a theory of transcending that can be used in building a research-based practice.

Purpose: To describe the gender impact on the situation of women at the onset of myocardial infarction and describe why women wait to contact medical caregivers when showing symptoms of myocardial infarction. Method: Literature review with a descriptive design. Articles was retrieved from PudMed and Cinahl. Findings: Women are affected more than men of the so-called atypical symptoms of a heart attack. This means that they can not always relate the symptoms to a heart attack. In some cases, female patients have had an ongoing heart attack without knowing it. In addition to the diffuse symptom picture can also gender, women's social role and status have a major impact on the decision to seek care. The fear of disturbing, denial and not to be taken seriously, plays a major role. Women find it difficult to put their own needs first. Conclusion: The authors of this study believe that more information is needed to reach out to the public continuously for women to recognize atypical symptoms of heart attack. Keywords: Atypical Symptoms, Literature review, women / Syfte: Syftet med studien var att beskriva genus inverkan på kvinnors situation vid insjuknande av hjärtinfarkt och beskriva varför kvinnor väntar med att söka sjukvård vid symtom på hjärtinfarkt. Metod: Litteraturstudie i beskrivande design. Artiklarna söktes fram i databasarna Pubmed och Cinahl. Resultat: Kvinnor drabbas oftare än män av så kallade atypiska symtom vid en hjärtinfarkt. Detta gör att de inte alltid kan relatera symtomen till en hjärtinfarkt. I vissa fall så har kvinnliga patienter haft en pågående hjärtinfarkt utan att veta om det. Förutom den diffusa symtombildens så kan även genus, kvinnans sociala roll och status ha en stor inverkan på beslutet att söka vård. Rädslan för att störa, förnekelse och att inte bli tagen på allvar spelar stor roll. Kvinnor har svårt att sätta sina egna behov förts utan tänker i första hand på hemmet och familjen. Slutsats: Författarna till denna studie anser att mer information behövs nå ut till allmänheten kontinuerligt för att kvinnor ska känna igen atypiska symtom på hjärtinfarkt. Nyckelord: Atypiska symtom, Litteraturstudie, kvinnor

There is an increasing awareness in the food industry about the role that proper nutrition plays in maintaining health and preventing disease. Women especially have always been interested in nutrition and its impact on their well-being. This awareness has placed more pressure on the food industry to provide a greater variety of nutritious and wholesome products which has led to the development of a new field in the food industry, called functional foods. These are food products that apart from the micro- and macronutrients that it already provides have additional important physiologically active functions that enhance health. These active components, called phytochemicals (from plant sources) and zoochemicals (from animal sources) have changed the role of diet in health. Functional foods can, by nature or design, bridge the traditional gap between food and medicine and thereby provide consumers with the opportunity to become involved in their own health care. One of these functional foods that have been receiving increased attention and research is soy. Apart from other health benefits of soy, such as cholesterol reduction and bone strengthening, scientific evidence has shown that soy can be used as an alternative for hormone replacement therapy (HRT). The increased interest in the latter can be ascribed to the changed attitude of women, as well as evidence of the side effects of conventional hormone replacement therapies. Consumer research in the nutraceutical area is, however, still in its infancy stage. Objective: The main objective of this study was thus to assess South African consumers' opinion of the potential health benefits of soy and soy products as an alternative for HRT. To attain this main objective, the following specific objectives were stated: To determine, by means of a consumer questionnaire, the percentage of South African consumers who are aware of soy. To determine, by means of an attitude scale, the attitudinal disposition of South African consumers towards the potential health benefits of soy and soy products as an alternative for HRT. To determine South African consumers' opinions regarding the menopausal related health benefits of soy. To determine whether there is a relation between respondents who Eat/drink soy and their opinion of the potential health benefits of soy. To determine whether there is a relation between respondents who never use soy and their opinion of the bone strengthening benefit of soy. To determine whether there is a relation between respondents' opinion of the health benefits of soy and their opinions of soy as an alternative for HRT and reliever of menopausal symptoms, respectively. Methods: In this study, consumers' opinion regarding the health benefits of soy was evaluated using a questionnaire. Respondents were randomly selected from nine metropolitan, as well as rural areas in South Africa, representing the four main race groups, namely whites, blacks, coloureds and Indians. The total sample size of the metropolitan and rural subjects was 3001. A sub-dataset was created which included female respondents that have heard of soy before and were premenopausal (35-44 years) and post-menopausal (50-59 years) of age. Thus, the total number of respondents used for further statistical analyses was 825. The respondents expressed their opinions of the health benefits of soy on a five-point hedonic (Likert) scale which was adapted to a three-point scale for easier interpretation of the tables. Results: 1. Of the 3 001 respondents, 2 437 (80%) were aware of soy. 2. A mean attitudinal disposition score of 2.47 on a three-point scale indicated a neutral to positive attitudinal disposition of the South African consumer population towards the potential health benefits of soy and soy products as alternative for HRT. No practically significant differences were found between the mean values of each statement, which indicated that no specifically strong opinions were expressed between different races or between different age groups. 3. Of all the consumers surveyed and those who did express a specific opinion, 72% agreed that soy has many health benefits compared to only 7% who disagreed. Although 34% of South Africans expressed a positive opinion when asked if soy can be used as alternative for HRT, the majority (46%) of the population had a neutral opinion. Forty-two percent of the consumers who held an opinion regarding soy as reliever of menopausal symptoms were positive, 35% had a neutral opinion and 23% of South Africans did not agree that soy can relieve menopausal symptoms. 4. A relation, although not of practical significance, was found between respondents who eat/drink soy and their opinion of the health benefits of soy. Of the respondents who indicated that they eat/drink soy, the majority agreed that soy has many health benefits. The respondents who disagreed when asked if they eat/drink soy, still expressed an overall positive opinion when asked whether soy has many health benefits. 5. A relation, although not of practical significance, was found between respondents who never use soy and their opinion of the bone strengthening benefit of soy. Of those who indicated that they use soy, the majority agreed that soy has a bone strengthening benefit. On the contrary, only 43% of those who agreed that they never use soy were positive about the bone strengthening benefit of soy, whereas 37% held a neutral opinion and 20% expressed a negative opinion. 6. The relation between respondents' opinion of the overall health benefits of soy and their opinion of soy as alternative for HRT and reliever of menopausal symptoms was of practical significance. Of the respondents who did not agree that soy has many health benefits, the majority expressed a negative opinion of soy as an alternative for HRT. Of those who agreed that soy has many health benefits, 45% expressed a neutral opinion and 44% a positive opinion of soy as alternative for HRT. Almost half (47%) of the respondents who agreed that soy does have many health benefits, expressed a neutral opinion when asked if soy can relieve menopausal symptoms, whereas only 30% had a positive opinion in this regard. The majority (86%) of the respondents who disagreed that soy has many health benefits, also expressed a negative opinion of soy as reliever for menopausal symptoms Conclusion: The results of this study indicate that 80% of the South African consumer population are aware of soy and that South African consumers have a neutral to positive attitudinal disposition towards the potential health benefits of soy. Respondents did not express a particularly strong opinion regarding several health benefits of soy. It may be hypothesized that they are not informed well enough on the health benefits of soy as to take a stand and to form a definite opinion. Neither different race groups, nor pre- or post-menopausal women differ significantly in the frequency of their opinions, indicating that in this study, race and age did not have a practical significant influence on opinion of the health benefits of soy. Of all those surveyed and who did express a specific opinion, 72% agreed that soy has many health benefits, which is almost the same percentage (74%) as American consumers who perceive soy products as healthy as according to the United Soybean Board (USB) National Report (2003-2004:4). A survey by Adams (2001:433) reported that 71% of American consumers believed that plant-derived HRT have fewer risks and can thus be used as a safe alterative for conventional HRT. According to the results of the present study only 34% of South African consumers expressed a positive opinion when asked if soy can be used as an alternative for HRT. Insufficient evidence on the safety and efficacy of the potential health benefits of soy, as well as a lack of consumer education in South Africa, could be the reason for this uncertainty among XIV South African consumers. While only 26% of American consumers are aware that soy might relieve menopausal symptoms (USB National Report, 2003- 2004:4), results of the current study found that 42% of South Africans were of opinion that soy can relieve menopausal symptoms. A relation, although not of practical significance, was found between respondents who eat/drink soy and their opinion of the health benefits of soy. This can be an indication that whether or not the South African consumer population consume soy doesn't have an influence on their opinion of soy's health benefits in practice. The relation found between respondents who never use soy and their opinion of the bone strengthening benefit of soy were not of practical significance. This can be an indication that whether or not South Africans use soy does not influence their opinion of the bone strengthening benefit of soy in practice. Furthermore, a practically significant relation was found between respondents' opinion of the overall health benefits of soy and their opinion of soy as alternative for HRT and reliever of menopausal symptoms, respectively. Interestingly, respondents who expressed a positive opinion regarding the health benefits of soy did not have a convincingly positive opinion of soy as alternative for HRT and as reliever of menopausal symptoms. They expressed a more neutral opinion. As expected, consumers that were not of opinion that soy has certain health benefits, also disagreed when asked if soy can be used as an alternative for HRT or as reliever of menopausal symptoms. Although the causes for the respondents' opinion or uncertainty were not determined in this study, it can be hypothesised that it may be due to lack of standardisation of evidence on the safety and efficacy of alternative hormone replacement therapies. Further studies are still needed to determine the contributing factors which influence consumers' opinion or lack of opinion on soy. If consumers are not educated about the benefits and disadvantages of soy as alternative for HRT, they cannot make intelligent decisions and choices as to whether or not to use soy as alternative for HRT. / Thesis (M. Consumer Science)--North-West University, Potchefstroom Campus, 2004.

There is a growing interest in the impact of waiting for surgery, a common experience for many Canadians. Pain and psychological symptoms prior to surgical management are frequently problems for women with gynaecological conditions, however minimal research was found to investigate pain and psychological symptoms in these women prior to surgery. Also pain is recognized to increase healthcare utilization, but this has not been previously examined in this population. The objectives of this research project were to examine levels of pain, psychological factors associated with pain and frequency of healthcare utilization due to pain in a population of women waiting for gynaecological surgery, predominantly undergoing hysterectomies. Four hundred and twenty nine women in a tertiary care centre in southeastern Ontario were included in the study. Anxiety was measured using the State Trait Anxiety Inventory (STAI), depression with the Centre for Epidemiologic Studies Depression Scale (CES-D), somatization using the Seven Symptom Screening Test (SSST) and catastrophizing was measured using an abbreviated coping strategies questionnaire (CSQ). Pain was assessed using the Brief Pain Inventory (BPI). Women also reported on their healthcare utilization for pain over the past 12 months. The length of wait was obtained from hospital waiting data. Results showed a moderate to severe pain intensity score occurred in 30.5% of women and a moderate to severe interference score in 31.5%. Being younger, married, employed and with high trait anxiety were factors associated with higher rates of healthcare utilization. High levels of depression, somatization and catastrophizing were associated with higher pain intensity and interference scores. This study supports the need for preoperative assessment of physical and psychological symptoms in women waiting for gynaecological surgery. Improving patients’ health prior to surgery will potentially reduce their healthcare demands on a financially constrained healthcare service. / Thesis (Master, Nursing) -- Queen's University, 2009-09-25 12:31:28.298

Tree-planters are likely to suffer from musculoskeletal injuries during their short work season. The objective of this research is to identify the biomechanical mechanisms that contribute to these injuries with an overall goal of reducing injury frequency and severity. Pre- and post-season discomfort questionnaires were administered to workers in two tree-planting camps to identify areas of the body most prone to injury. Musculoskeletal pain and discomfort were significantly higher post season. Greatest pain and discomfort were reported in the feet, wrists and back, while the highest frequency of pain was reported in the back. Upper body and trunk postures were recorded during the tree-planting task in the field using digital video and inclinometers. Results indicated that deep trunk flexion occurred over 2600 times per day and workers spent at least half of their workday in trunk flexion greater than 45 degrees. Although results provide useful insight into injury mechanisms, postural data were two dimensional. Inertial motion sensors were used in a second field study the following season to examine differences in three-dimensional upper limb and trunk relative joint angles during commonly used tree seedling unloading methods. Results showed trunk rotation up to 50 degrees combined with deep trunk flexion during parts of the task. Trunk flexion and rotation were significantly less when the tree seedling load was distributed asymmetrically as compared to symmetrically. Joint reaction forces in the lower body and trunk during the same unloading methods was examined during a simulated planting task in a lab environment. Greatest joint reaction forces and non-neutral postures occurred when the tree was inserted into the ground. Right-loaded planting bags resulted in more substantial differences in posture and joint reaction forces than either left-loaded or even-loaded bags. Axial forces were greater in the right leg than the left throughout the task, regardless of loading condition. In conclusion, underlying biomechanical mechanisms for injury during tree-planting seem to be a combination of awkward postures (particularly the trunk), repetitive motions, and carrying of heavy loads. Different seedling unloading strategies did not result in substantial overall differences in posture or joint reaction forces. / Thesis (Ph.D, Kinesiology & Health Studies) -- Queen's University, 2010-04-14 10:02:32.385

Depression is the most common mental illness worldwide, and although aspects of the social environment, including social capital and neighbourhood disadvantage, have been linked to depression, the underlying mechanisms are not well understood. Debates within the social capital and neighbourhood disadvantage literatures have yielded mixed findings in studies of depression and an understanding of how social capital may differentially relate to symptomatology in men and women must be solidified. In the first manuscript of this thesis, I assess whether (1) network and psychosocial measures of individual social capital are each associated with depressive symptoms, and (2) the association varies according to whether the capital lies outside or inside an individual’s neighbourhood. The second manuscript investigates whether: (1) neighbourhood disadvantage has a stronger association with depression in women compared to men and (2) if specific social capital factors mediate the association between neighbourhood disadvantage and depression. Data came from the Montreal Neighbourhood Networks and Healthy Aging Study conducted in 2008. Data included telephone interview responses from 2624 adults from 300 census tracts in the Montreal metropolitan area. The CESD-10 instrument was used to assess depressive symptoms. Name and position generator instruments and self-reported questions were used to assess psychosocial and network components of social capital. Multilevel logistic regressions adjusted for a range of socio-demographic and economic characteristics. Manuscript 1 results indicated that core tie diversity as well as the psychosocial measures of generalized trust, trust in neighbours, and perceptions of neighbourhood cohesion may be beneficial to those suffering from depressive symptoms. Manuscript 2 results, stratified by gender, indicated that neighbourhood disadvantage was associated with depressive symptoms in women only and that perceived neighbourhood cohesion mediated this association. Core tie diversity, generalized trust and trust in neighbours were associated with depression in women but did not act as mediating variables. It is suggested that network and psychosocial, as well as general- and neighbourhood specific measures of social capital be included in studies of depressive symptoms. Health promotion initiatives meant to combat depression may wish to consider the gender differences in the design and implementation of neighbourhood or peer-based programs. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2012-09-21 09:32:28.57