Depression among unaccompanied minor refugees: the relative contribution of general and acculturation-specific daily hassles

Objectives. This study is designed to provide an empirical conceptualization of daily hassles among unaccompanied refugees, and whether they might affect mental health of young refugees after resettlement. First, we examined the underlying structure of daily hassles conceptualized as measuring general and acculturation-specific hassles. Second, we examined whether these two distinct categories of daily hassles significantly contribute to depression above and beyond the impact of premigration trauma.

Design. The study was based on self-report questionnaire data collected from 895 unaccompanied refugees who had been granted residence in Norway.

Results. Using structural equation modeling, the results confirmed the grouping of hassles in two general categories, which explained 43% of the variance in depression.

Conclusion. The findings underscore the importance of current life conditions for unaccompanied refugees' mental health.     

Cancer patterns in Inuit populations

Inuit people inhabit the circumpolar region, with most living in Alaska, northwest Canada, and Greenland. Although malignant diseases were believed to be almost non-existent in Inuit populations during the beginning of the 20th century, the increasing life expectancy within these populations showed a distinct pattern, characterised by a high risk of Epstein-Barr virus-associated carcinomas of the nasopharynx and salivary glands, and a low risk of tumours common in white populations, including cancer of the prostate, testis, and haemopoietic system. Both genetic and environmental factors seem to be responsible for this pattern. During the second half of the 20th century, Inuit societies underwent major changes in lifestyle and living conditions, and the risk of lifestyle-associated tumours, especially cancers of the lung, colon, and breast, increased considerably after changes in smoking, diet, and reproductive factors. This Review will briefly summarise the current knowledge on cancer epidemiology in Inuit populations, with emphasis on the characteristic Inuit types of cancer.     

Incense use and respiratory tract carcinomas: a prospective cohort study

BACKGROUND.

Incense use is an integral part of daily life in large parts of Asia. The burning of incense is a powerful producer of particulate matter and the smoke contains a multitude of well‐characterized carcinogens. However, to the authors' knowledge, no convincing association has been reported between exposure to incense smoke and the development of cancer. Therefore, the relation between incense use and the risk of respiratory tract carcinomas was analyzed in a prospective cohort study.

METHODS.

Between 1993 and 1998, a population‐based cohort of 61,320 Singapore Chinese who were free of cancer and ages 45 to 74 years completed a comprehensive interview regarding living conditions and dietary and lifestyle factors. Through linkage to population‐based registries, the cohort was followed through 2005 and cancer occurrence determined. The relative risk for these cancers associated with incense use was estimated using a Cox proportional hazards model.

RESULTS.

A total of 325 upper respiratory tract (UPT) carcinomas and 821 lung carcinomas were observed during follow‐up. Incense use was associated with a significantly increased risk of UPT carcinomas other than nasopharyngeal, whereas no overall effect was observed on lung cancer. The duration and intensity of incense use were associated with an increased risk of squamous cell carcinomas in the entire respiratory tract (P for trend = .004), whereas there was no significant association noted between incense use and nonsquamous cell carcinomas. The relative risk of squamous cell carcinomas among long‐term incense users was 1.8 (95% confidence interval [95% CI], 1.2‐2.6; P = .004) in the entire respiratory tract.

CONCLUSIONS.

The results of the current study indicate that long‐term use of incense is associated with an increased risk of squamous cell carcinoma of the respiratory tract. Cancer 2008. © 2008 American Cancer Society.     

Resilience predicting psychiatric symptoms: a prospective study of protective factors and their role in adjustment to stressful life events

Objective. The purpose of this prospective study was to explore the Resilience Scale for Adults (RSA) as a predictor for developing psychiatric symptoms when exposed to stressful life events. Methods. A healthy sample (N = 159) completed the RSA, the Hopkins Symptom Checklist‐25 (HSCL‐25) and the occurrence of Stressful Life Events (SLE) twice, with a three‐month interval. Results. The results indicated that the RSA measures important protective factors that buffer the development of psychiatric symptoms when individuals encounter stressful life events. Two of the RSA factors, in particular, contributed to buffering the development of psychiatric symptoms. Conclusion. The findings suggest that the RSA is a significant predictor of mental health and a useful tool for further research examining individual differences in stress tolerance. Copyright © 2006 John Wiley & Sons, Ltd.     

Prevalence of micro- and macrovascular diabetes complications at time of type 2 diabetes diagnosis and associated clinical characteristics: A cross-sectional baseline study of 6958 patients in the Danish DD2 cohort

Aims

To examine the prevalence of micro- and macrovascular complications and their associated clinical characteristics at time of type 2 diabetes (T2D) diagnosis.

Predictors of Response to Web-Based Cognitive Behavioral Therapy With High-Intensity Face-to-Face Therapist Guidance for Depression: A Bayesian Analysis

Background

Several studies have demonstrated the effect of guided Internet-based cognitive behavioral therapy (ICBT) for depression. However, ICBT is not suitable for all depressed patients and there is a considerable level of nonresponse. Research on predictors and moderators of outcome in ICBT is inconclusive.

Objective

This paper explored predictors of response to an intervention combining the Web-based program MoodGYM and face-to-face therapist guidance in a sample of primary care patients with mild to moderate depressive symptoms.

Methods

Participants (N=106) aged between 18 and 65 years were recruited from primary care and randomly allocated to a treatment condition or to a delayed treatment condition. The intervention included the Norwegian version of the MoodGYM program, face-to-face guidance from a psychologist, and reminder emails. In this paper, data from the treatment phase of the 2 groups was merged to increase the sample size (n=82). Outcome was improvement in depressive symptoms during treatment as assessed with the Beck Depression Inventory-II (BDI-II). Predictors included demographic variables, severity variables (eg, number of depressive episodes and pretreatment depression and anxiety severity), cognitive variables (eg, dysfunctional thinking), module completion, and treatment expectancy and motivation. Using Bayesian analysis, predictors of response were explored with a latent-class approach and by analyzing whether predictors affected the slope of response.

Results

A 2-class model distinguished well between responders (74%, 61/82) and nonresponders (26%, 21/82). Our results indicate that having had more depressive episodes, being married or cohabiting, and scoring higher on a measure of life satisfaction had high odds for positively affecting the probability of response. Higher levels of dysfunctional thinking had high odds for a negative effect on the probability of responding. Prediction of the slope of response yielded largely similar results. Bayes factors indicated substantial evidence that being married or cohabiting predicted a more positive treatment response. The effects of life satisfaction and number of depressive episodes were more uncertain. There was substantial evidence that several variables were unrelated to treatment response, including gender, age, and pretreatment symptoms of depression and anxiety.

Conclusions

Treatment response to ICBT with face-to-face guidance may be comparable across varying levels of depressive severity and irrespective of the presence and severity of comorbid anxiety. Being married or cohabiting, reporting higher life satisfaction, and having had more depressive episodes may predict a more favorable response, whereas higher levels of dysfunctional thinking may be a predictor of poorer response. More studies exploring predictors and moderators of Internet-based treatments are needed to inform for whom this treatment is most effective.

Trial Registration

Australian New Zealand Clinical Trials Registry number: ACTRN12610000257066; https://www.anzctr.org.au/trial_view.aspx?id=335255 (Archived by WebCite at http://www.webcitation.org/6GR48iZH4).     

Resilience in relation to personality and intelligence

Resilience is a construct of increasing interest, but validated scales measuring resilience factors among adults are scarce. Here, a scale named the Resilience Scale for Adults (RSA) was crossvalidated and compared with measures of personality (Big Five/5PFs), cognitive abilities (Raven's Advanced Matrices, Vocabulary, Number series), and social intelligence (TSIS). All measures were given to 482 applicants for the military college. Confirmatory factor analyses confirmed the fit of the five-factor model, measuring 'personal strength', 'social competence', 'structured style', 'family cohesion' and 'social resources'. Using Big Five to discriminate between well adjusted and more vulnerable personality profiles, all resilience factors were positively correlated with the well adjusted personality profile. RSA-personal strength was most associated with 5PFs-emotional stability, RSA-social competence with 5PFs-extroversion and 5PFs-agreeableness, as well as TSIS-social skills, RSA-structured style with 5PFs-conscientiousness. Unexpectedly but interestingly, measures of RSA-family cohesion and RSA-social resources were also related to personality. Furthermore, the RSA was unrelated to cognitive abilities. This study supported the convergent and discriminative validity of the scale, and thus the inference that individuals scoring high on this scale are psychologically healthier, better adjusted, and thus more resilient.