Anxiety and aggression in adolescents with autism spectrum disorders attending mainstream schools

This study investigated the link between anxiety and aggression in adolescents with autism spectrum disorders (ASDs) using self-report measures of anxiety and anger and teacher ratings of behaviour. Participants were 104 high school students aged 12–18: 52 students with ASDs, without intellectual disability, and their typically developing peers matched for age and gender. Students with ASDs who attend mainstream high schools reported higher levels of anxiety and reactive anger than their peers, were reported by their teachers to engage in more aggressive behaviours, and were at higher risk of being suspended from school. The results further suggested that social anxiety is a significant moderator of the relationship between autism and physical aggression. For ASD students, but not for the control students, there was a strong, positive relationship: higher levels of anxiety were associated with higher levels of physical aggression. However, ASD students with high anger control did not display physical aggression. Our results have implications for screening students for anxiety, the provision of interventions for managing anxiety and the development of anger management skills, and for the appropriateness of suspension as a mandatory response to incidents of physical aggression in schools.     

The effect of the emotional intelligence education programme on quality of life in haemodialysis patients

AimThis study investigated the effect of the emotional intelligence education programme on quality of life of haemodialysis patients.BackgroundNurses need knowledge development regarding the impact of educational strategies on patients' quality of life suffering from chronic diseases.MethodsA pragmatic quasi-randomized controlled trial was conducted with 47 haemodialysis patients attending a university hospital in an urban area of Iran. The patients were randomly assigned to intervention (n = 23) and control (n = 24) groups. A socio-demographic questionnaire, the Cyberia-Shrink Emotional Intelligence Questionnaire, and the Kidney Disease Quality of Life-Short Form were used to gather data. The intervention group attended an educational programme on emotional intelligence that consisted of six-group discussion sessions. To ensure the continuity of learning and to measure the subsequent expected behavioural changes, the patients filled out the data collection tools six and 12 weeks after the completion of the education programme.ResultsThe mean score of quality of life in the intervention group was 39.94 ± 15.88 in pre-test, 44.87 ± 16.04 six weeks and 52.47 ± 16.07 at the 12 weeks after the intervention (p = 0.032).ConclusionThe consideration of emotional intelligence educational strategies by nurses requires its incorporation into pre-qualifying nursing degrees and professional development programmes. Nurse managers need to lead nurses for applying emotional intelligence in daily practice with the aim of providing an holistic patient care.     

Association of sleep duration and incidence of diabetes modified by tea consumption: a report from the Shanghai men's health study

ObjectivesTo evaluate the association between sleep duration and the incidence of diabetes stratified by sleep-related factors among Chinese men.MethodsThis study included 34,825 men who provided information on sleep-related questions in the Shanghai Men's Health Study, a population-based cohort study conducted in Shanghai, China from 2002 to 2011. Participants were excluded who had a history of diabetes or who were diagnosed with diabetes within 2 years of recruitment. Cox regression was employed to evaluate the influence of sleep duration and its interaction with sleep-related factors on diabetes risk.ResultsA total of 1521 incident cases were documented during a median of 5.6 follow-up years. Adjusted hazard ratios and 95% confidence intervals were 1.0 (0.9–1.1) and 1.2 (1.0–1.3) for men who slept <7 and ≥8 h per day, respectively, compared with those who slept 7 h per day (p_trend = 0.01). Stratified analyses revealed that the association between sleep duration and risk of diabetes was only statistically significant among current smokers and regular drinkers, never tea drinkers, men with a high body mass index, hypertension or comorbidity, and men who did not work nightshift or who snored. A statistically significant interaction between tea drinking and sleep duration was observed (p_interaction = 0.01). The above association patterns remained when daytime nappers were excluded from the analyses.ConclusionsThe data suggested that longer sleep duration, particularly among individuals already exhibiting factors linked to poor quality of sleep, was associated with diabetes. The association between sleep duration and diabetes may be modified by tea drinking, especially in older men or men with more sleep-related factors.     

Insomnia and daytime neuropsychological test performance in older adults

Objectives/BackgroundThere is good documentation of the impact of insomnia on daytime cognitive function based on self-reports, but not on neuropsychological test performance. The study investigated the association of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA) complaints with daytime domain-specific neuropsychological performance in older adults.Participants/MethodsParticipants were 859 older adults (mean 71.9 years) in the Singapore Longitudinal Ageing Studies. They were interviewed and assessed at community-based eldercare activity centres and completed a sleep survey questionnaire and a battery of neuropsychological tests (Digit span, Rey Auditory Verbal Learning Test, Story memory, Brief Visuospatial Memory Test-Revised, Color Trails Test (1 and 2), Block design, and Verbal fluency).ResultsInsomnia complaints were present in 18.0% (n = 155) of participants. Controlling for the presence of other insomnia complaints, psychosocial and medical variables, and depression, EMA was independently and significantly associated with worse executive functioning (p = 0.031). DIS and DMS were not independently associated with poorer performance on any cognitive domain.ConclusionThe association of EMA among older adults with decreased executive functioning and underlying mechanistic factors should be further investigated.     

Older person behavioral and psychological symptoms (BPS) and functional limitations mediate the association between older person cognitive impairment and depressive symptoms in the caregiver

We assess for the mediation of the association between older person cognitive impairment and caregiver depressive symptoms through older person BPS and functional limitations, and whether the mediation varies by caregiver–older person relationship (spouse/adult child). Data for 1111 older person (aged 75+ with activity of daily living (ADL) limitation)–caregiver dyads from Singapore were used. The outcome variable was dichotomous (caregiver clinically significant depressive symptoms [CSDS]: yes/no) in the primary analysis and continuous (caregiver depressive symptoms score) in the sensitivity analysis. The causal steps approach assessed for the mediation of the association between older person cognitive impairment (yes/no) and the outcome variable through the two potential mediators. A bootstrapping approach calculated point estimates and confidence intervals (CIs) of the indirect (∼mediated) effects. Variation of the indirect effects by caregiver–older person relationship was also assessed. In the primary analysis, the causal steps approach supported older person BPS and functional limitations as mediators. The bootstrapping approach confirmed both as significant mediators, though BPS (indirect effect odds ratio (OR) 1.32 [95% bootstrap CI 1.19,1.48]; %mediation: 70.6%) was a stronger mediator than functional limitations (1.04 [1.01,1.11]; %mediation: 11.5%). Variation of the indirect effects by caregiver–older person relationship was not supported. Results of the sensitivity analysis confirmed these results. We conclude that while caring for an older person with cognitive impairment is detrimental for the caregiver's mood, management of associated BPS and functional limitations, especially the former, among such older persons may reduce depressive symptoms among their caregivers. Spouse as well as adult child caregivers benefit.     

Seasonal variation of salivary testosterone in men, normally cycling women, and women using hormonal contraceptives

Humans' endogenous testosterone concentrations vary over a number of temporal scales, with little known about variation longer than monthly cycles. Past studies of seasonal or circannual variation have principally used male participants and have produced inconsistent results. Thus, little is known about how testosterone concentrations fluctuate throughout the year, whether such variation differs between men and women, and whether there are influences of hormonal contraceptive use. The present study collected saliva samples from a large sample (N = 718) of men and women, each collected at one time point within a relatively uniform distribution over a full calendar year. Both men and normally-cycling women displayed seasonal variation in salivary testosterone concentrations, such that testosterone concentrations are maximal in the fall and minimal in the summer. Notably, normally-cycling women had testosterone concentrations that were over 100% greater at their maximum in fall compared to their minimum in summer. Women using hormonal contraceptives not only had consistently lower endogenous testosterone concentrations, but also showed a flatter seasonal testosterone profile. The implications for studies of psychology and human behavioral endocrinology are discussed.     

Neues zur organverteilung: das transplantationsgesetz und die folgen

The article describes and discusses changes in the practices of organ allocation which result from the implementation of the pertinent stipulations of the German Transplant Act from 1997. Both the levels of admission to a waiting list and of selection from such a list once a donor organ becomes available are covered. Since the law contains various rather odd clauses, the most important of which is the (logically and practically infeasible) requirement that organs be allocated exclusively according to medical criteria, it is not surprising that these oddities translate themselves into the respective policies as well. Several of them are laid bare. Finally, suggestions are made as to how they could be remedied.