The impact of photosensitivity disorders on aspects of lifestyle

Background Photosensitivity disorders involve an abnormal skin reaction to sunlight exposure and affect a substantial percentage of the population. No previous studies have directly compared lifestyle attributes between photosensitive and healthy individuals. Objectives To assess the impact of photosensitivity on time spent outdoors in the U.K., holiday behaviour, use of sunscreens and vitamin D supplements, and employment status. Methods Questionnaires were completed by ambulant photosensitive and healthy adults aged 18–60 years residing in Greater Manchester. Results Forty‐five adults with moderate–severe photosensitivity and 124 healthy adults completed the questionnaire. This revealed that photosensitive subjects spent significantly less time outdoors in the U.K. on both summer weekdays (P < 0·01) and summer weekends (P < 0·0001) than healthy subjects, took fewer holidays per year (P < 0·05), and spent less time outdoors on a sunny holiday (P < 0·0001). They wore clothing that covered a wider skin area (P < 0·0001), and use of sunscreen was greater (both frequency of application and area covered) in the photosensitive group outside of holiday time (P < 0·0001), but not when on a sunny holiday, as healthy people increased their sunscreen use at this time. Despite the reduced sun exposure, photosensitive subjects were no more likely to take vitamin D supplements than healthy subjects were; they also exhibited a significantly higher rate of unemployment (P < 0·05). Conclusions Photosensitivity disorders negatively influence lifestyle including employment status; more attention is required to the socioeconomic impact of these conditions.     

A statistical assembled deformable model (SAMTUS) for vasculature reconstruction

Although many deformable models have been proposed in medical applications for segmenting isolated structures in the human anatomy, not much of such work had been done on tubular structures such as the vasculature. In this paper, we propose a statistical assembled model for tubular structures (SAMTUS) to segment entire tubular structure from three-dimensional (3D) volumetric data. To our knowledge, there is no literature about the statistical deformable model for entire tubular structures. Specifically, the statistical tubular model is composed of a statistical axis model (SAM) and a statistical surface model (SSM). Both of them are assembled from a set of branch segments through the control points. Instead of searching for fuzzy correspondence along tubular axes or surfaces, we build point matching between feature points along tubular segments, and train SAM and SSM independently to characterize, respectively, the axial and the cross-sectional variation of the entire structure. In this way, more accurate point correspondence can be established, and a larger number of deformation modes can be captured. Our SAMTUS-based segmentation process consists of three stages: initialization, model fitting and final refinement. The experimental results demonstrate that the algorithm obtains good quantifications on the morphology and volume of the vasculature of the zebrafish which is being used increasingly as a specimen for drug screening and genomic research.     

Quality of life for patients with schizophrenia living in the community in Greece

Several quality of life instruments were considered for use in a Greek mental health environment. Subjective Quality of Life Profile was chosen as it was easy to complete and covered the issues raised by patients with schizophrenia through interviews. Confirmatory factor analysis gave credence to the four-dimensional structure identified by the original authors. Patients with schizophrenia were generally satisfied with their quality of life, found the items in the instrument important and were optimistic about expectations for change. Age, gender, education, marital status and years of sickness were not statistically significant in a general linear model with quality of life as the outcome for the 27 core questions. There were some statistically significant results for the three disease-specific questions; positive expectation was correlated positively with education and negatively with years of sickness.     

Reconceptualizing the Domain and Boundaries of Family Life Education

Many scholars have defined family life education (FLE), and some have differentiated it from other family‐related fields. For example, Doherty (1995) provided a definition of the boundaries between FLE and family therapy; however, we believe those criteria can be improved. We explore the professions of family life education, family therapy, and family case management using the questions why, what, when, for whom, and how? After examining these questions for each role, we introduce the domains of family practice to differentiate among them. The approach defines FLE and encourages appropriate collaboration among the fields. Suggestions are made for using this model for career exploration, reviewing job requirements to assess role consistency and clarity, and for determining the need for and appropriateness of referral and collaboration.     

The importance of depression and alcohol use in coronary artery bypass graft surgery patients: risk factors for delirium and poorer quality of life

Objective To investigate whether depression, anxiety and stress increase the risk for delirium and poor quality of life (QOL) after coronary artery bypass (CABG) surgery. Methods A total of 180 CABG patients (mean age of 63.5 ± 10.1 years, 82.2% males) completed baseline and postoperative self-report questionnaires to assess distress and QOL. Incident delirium was diagnosed postoperatively with a structured clinical interview and patients were monitored every day post-operatively for confusion and disturbance in consciousness. Results Delirium developed in 63 persons (35% of sample). After adjustment for covariates, delirium was significantly associated with depression [odds ratio (OR): 1.08; 95% confidence interval (CI): 1.03–1.13, P = 0.003], anxiety (OR: 1.07; 95% CI: 1.02–1.13, P = 0.01) and stress (OR: 1.05; 95% CI: 1.00–1.09, P = 0.03). Preoperative depression scores were associated with poorer QOL including bodily pain (β = -0.39, P = 0.013), vitality (β=-0.32, P = 0.020), social functioning (β = -0.51, P ≤ 0.001), emotional role function (β = -0.44, P = 0.003) and general health (β = -0.33, P = 0.038). Among the covariates, harmful levels of alcohol use was consistently associated with poorer QOL. Conclusions Depression and harmful levels of alcohol use were consistently associated with poorer QOL whereas depression, anxiety and stress were associated with delirium risk. These findings point to further research examining depression and harmful levels of alcohol use in coronary heart disease populations undergoing coronary revascularization.     

The association of comorbid anxiety and depression with asthma-related quality of life and symptom perception in adults

Background and objective:   There are limited data on the association and interaction between anxiety and depression comorbidity and asthma-related quality of life (AQOL) and symptom perception. This study evaluated these associations in patients subsequent to an emergency department (ED) visit for asthma.
Methods:   This was a cross-sectional study of 110 (38 male) adult asthma patients (mean age 42 years), who had visited an ED in the previous 18 months. Participants completed the hospital anxiety and depression scale, measures of AQOL and the asthma symptom checklist.
Results:   Depression symptoms independently showed a significant negative association with AQOL after controlling for depression/anxiety, age, gender, smoking status and ED visits in the previous 12 months (ED-12). Overall, anxiety and depression symptoms accounted for 28.3% of the variance in AQOL. Greater anxiety was associated with increased perception of asthma-specific panic-fear and hyperventilation symptoms during an asthma attack, irrespective of depression status. Categorical analyses of groups of patients, differentiated by psychometric properties on the hospital anxiety and depression scale (anxiety vs normal, anxiety and depression vs normal depression) confirmed most results. However, for the anxiety group there was a significant association with the AQOL domains of emotional functioning and response to environmental stimuli, after controlling for depression symptoms.
Conclusions:   The negative association of depression symptom scores with AQOL and of anxiety with increased panic-fear and hyperventilation symptoms suggests a potential role for interventions addressing this psychological comorbidity, in order to improve AQOL.