Background and Purpose-Social problem-solving therapy shows promise as an intervention to improve the well-being of family caregivers. There is some evidence that training in problem solving may be effectively delivered by telephone. The purpose of this study was to quantify the impact of social problem-solving telephone partnerships on primary family caregiver outcomes after stroke survivors are discharged home from a rehabilitation facility. Methods-Using a randomized 3-group repeated-measures experimental design, 74 stroke survivors with an admitting diagnosis of ischemic stroke and their primary family caregivers were entered into the study. The intervention consisted of an initial 3-hour home visit between a trained nurse and the family caregiver within 1 week after discharge to begin problem-solving skill training. This initial session was followed by weekly (the first month) and biweekly (the second and third month) telephone contacts. Results-Compared with the sham intervention and control groups, family caregivers who participated in the social problem-solving telephone partnership intervention group had better problem-solving skills; greater caregiver preparedness; less depression; and significant improvement in measures of vitality, social functioning, mental health, and role limitations related to emotional problems. There were no significant differences among the groups in caregiver burden. Satisfaction with healthcare services decreased over time in the control group while remaining comparable in the intervention and sham intervention groups. Conclusion-These results indicate that problem-solving training may be useful for family caregivers of stroke survivors after discharge from rehabilitative facilities.

The use and quality of longitudinal research designs has increased over the past two decades, and new approaches for analyzing longitudinal data, including multi-level modeling (MLM) and latent growth modeling (LGM), have been developed. The purpose of this paper is to demonstrate the use of MLM and its advantages in analyzing longitudinal data. Data from a sample of individuals with intra-articular fractures of the lower extremity from the University of Alabama at Birmingham's Injury Control Research Center is analyzed using both SAS PROC MIXED and SPSS MIXED. We start our presentation with a discussion of data preparation for MLM analyses. We then provide example analyses of different growth models, including a simple linear growth model and a model with a time-invariant covariate, with interpretation for all the parameters in the models. More complicated growth models with different between-and within-individual covariance structures and nonlinear models are discussed. Finally, information related to MLM analysis such as online resources is provided at the end of the paper. Publisher's Disclaimer:The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at http://www.apa.org/journals/rep NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptLongitudinal designs have recently received more attention in a variety of different disciplines of psychology including clinical, developmental, personality and health psychology . In some areas, such as developmental psychology and personality psychology, a substantial number of recently published studies have been longitudinal Khoo, West, Wu, & Kwok, 2006). For example, Khoo et al. (2006) found that slightly more than one third of articles published in Developmental Psychology in 2002 included at least one longitudinal study, defined as having at least two measurement occasions. This proportion is double the proportion of longitudinal studies published in the same journal in 1990. Furthermore, more than 70% of the longitudinal studies published in Developmental Psychology in 2002 included three or more measurement waves.In this paper, we will focus on the analyses of multiwave longitudinal data, where multiwave is defined as more than two waves.With the growing use of longitudinal research, a number of methodological and statistical sources on the analysis of multiwave longitudinal data have appeared in the past decade (e.g., Bollen & Curran, 2006;Collins & Sayer, 2001; Singer & Willet, 2003), including discussions of traditional approaches such as repeated-measures Univariate Analysis ...

Ulcerative colitis (UC) is a common form of inflammatory bowel disease with a complex aetiology. As part of the Wellcome Trust Case Control Consortium 2, we performed a genomewide association scan for UC in 2361 cases and 5417 controls. Loci showing evidence of association at P < 1 × 10 −5 were followed up by genotyping in an independent set of 2321 cases and 4818 controls. We find genome-wide significant evidence of association at three new loci, each containing at least one biologically relevant candidate gene, on chromosomes 20q13 (HNF4A; P = 3.2 × 10 −17 ), 16q22 (CDH1 and CDH3; P = 2.8 × 10 −8 ) and 7q31 (LAMB1; 3.0 × 10 −8 ). Of note, CDH1 has recently been associated with susceptibility to colorectal cancer, which is an established complication of longstanding UC. The new associations suggest that changes in the integrity of the intestinal epithelial barrier may contribute to the pathogenesis of UC.

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Objective-To test the hypothesis that a problem-solving training program would lower depression, health complaints, and burden, and increase well-being reported by community-residing family caregivers of persons with traumatic brain injuries (TBIs). Design-Randomized controlled trial. Setting-General community.Participants-Of the 180 people who expressed interest in the study, 113 did not meet eligibility criteria. A consenting sample of family caregivers were randomized into a problem-solving training group (4 men, 29 women; average age, 51.3y) or an education-only control group (34 women; average age, 50.8y). Care recipients included 26 men and 7 women in the intervention group (average age, 36.5y) and 24 men and 10 women in the control group (average age, 37.2y).Intervention-Problem-solving training based on the D'Zurilla and Nezu social problem-solving model was provided to caregivers in the intervention group in 4 in-home sessions and 8 telephone follow-up calls over the course of their year-long participation. Control group participants received written educational materials and telephone calls at set intervals throughout their 12 months of participation.Main Outcome Measures-Caregiver depression, health complaints, well-being, and social problem-solving abilities.Results-Hierarchical linear models revealed caregivers receiving problem-solving training reported significant decreases in depression, health complaints, and in dysfunctional problem-solving styles over time. No effects were observed on caregiver well-being, burden, or constructive problemsolving styles.Conclusions-Problem-solving training provided in the home appears to be effective in alleviating distress and in decreasing dysfunctional problem-solving styles among family caregivers of persons Reprint requests to Patricia A. Rivera, PhD, Birmingham VAMC, 700 19th St S, Birmingham, AL 35233, No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated. NIH Public Access KeywordsBrain injuries; Caregivers; Problem-solving; Randomized controlled trials; RehabilitationEvidence accumulating from decades of empirical research substantiates that many family caregivers of persons with traumatic brain injury (TBI) experience considerable distress and compromised quality of life, generally, in the wake of the neurobehavioral changes imposed by TBI. 1 To a great extent, this research has been content to describe the various demographic, social, and psychologic correlates of distress, depression, and burden reported by caregivers. Despite this evidence, a recent critical review identified only 4 published studies to date of interventions to alleviate caregiver distress, and it concluded that there is currently no evidence supporting the usefulness of any single psychosocial intervention for family caregivers of persons with TBI. 2Much of the available research on caregiver distress after TBI...

OFG mainly presents in young adults with lip and buccal involvement. Abnormalities in inflammatory markers, hematology and oral features of ulceration, and buccal-sulcal involvement are factors more commonly associated with CD. Initial presentation of OFG does not necessarily predict development of CD, although this is more likely in childhood.

Fuller Theological Seminary The utility of different reality negotiation strategies among 57 persons who had traumatically acquired severe physical disabilities was examined. It was predicted that a sense of goal-directed determination ("agency"; Snyder, 1989) would predict lower depression and psychosocial impairment scores soon after injury. To meet the demands of rehabilitation and social integration, however, it was hypothesized that a sense of ability to find ways to meet goals ("pathways") would predict lower depression and psychosocial impairment among persons who had been disabled for a longer period. The expected interaction was significant in the prediction of psychosocial impairment but not of depression. The sense of pathways was predictive of impairment and depression regardless of the time since injury. Results suggest that in the reality negotiation process the different components of hope as denned by Snyder have salient effects on perceptions of ability to function in social capacities.

The purpose of this study was to identify the major problems and associated feelings experienced by family caregivers of stroke survivors during the first month after returning home. Safety, difficulty in managing activities of daily living, and cognitive, behavioral and emotional changes of stroke survivors (for example, mood swings, lack of motivation, forgetfulness and memory loss, depression and calling the caregiver often) were the three most common problems experienced by caregivers during the first month. Other problems were loss of caregiver independence, confinement, tiredness and inadequate time to do caregiving tasks as well as managing stroke survivor physical symptoms, for example, pain, not eating and skin problems. The first month of caregiving is very dynamic and distressful for caregivers of stroke survivors and telephone contacts appear to be beneficial in assisting caregivers to cope with the caregiving process.