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1.
Diabet Med ; 40(4): e15044, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36683387

RESUMO

BACKGROUND: No standardised questionnaires have been specifically developed to assess the considerable demands of managing type 1 diabetes (T1D) during pregnancy. AIMS: This study aimed to explore what domains of measurement are important to quality of life during pregnancy with TID and to assess if standardised questionnaires, used by previous researchers, adequately capture patients' reported experience of TID in pregnancy. METHODS: A qualitative inquiry was conducted using semi-structured focus groups with Canadian women who have experienced T1D in pregnancy. Participants were asked open-ended questions about experiences managing T1D during pregnancy and whether options on standardised tools captured their pregnancy experiences. Audio from focus groups was transcribed verbatim. Two researchers independently analysed the transcripts using inductive thematic analysis. Salient ideas, experiences and key words were coded iteratively and grouped into broader themes and subsequently reviewed by five participants. RESULTS: The sample included nine participants. Emergent themes included changes in day-to-day routines to manage T1D in pregnancy, fear of hyperglycaemia during pregnancy and of hypoglycaemia postpartum. Participants felt that existing options on standardised questionnaires did not adequately quantify diabetes interference in work, family time, planned activities and sleep, and did not address hyperglycaemia fear. CONCLUSIONS: Existing standardised questionnaires do not adequately capture patient-reported outcomes of greatest importance for those living with T1D in pregnancy. Future research assessing the impact of therapies on quality-of-life measures in TID pregnancies should quantify their influence on day-to-day activities, adjust measures of sleep quality and capture fear of hyperglycaemia in pregnancy and hypoglycaemia postpartum.


Assuntos
Diabetes Mellitus Tipo 1 , Hiperglicemia , Hipoglicemia , Gravidez , Humanos , Feminino , Qualidade de Vida , Canadá , Inquéritos e Questionários
2.
Br J Clin Psychol ; 62(3): 537-555, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37096744

RESUMO

OBJECTIVES: Disengagement from Early Intervention in Psychosis (EIP) services is pronounced in individuals from racially minoritized or diverse ethnic backgrounds, lesbian, gay, bisexual, transgender, and queer or questioning individuals, and individuals from some religious or spiritual backgrounds. The Early Youth Engagement in first episode psychosis study (EYE-2) is a cluster randomized controlled trial that tests a new engagement intervention. The current study aimed to (i) explore perspectives of service users from diverse backgrounds in relation to spirituality, ethnicity, culture and sexuality on engagement and the EYE-2 approach and (ii) use an evidence-based adaptation framework to incorporate their needs and perspectives into the EYE-2 resources and training. METHODS: This qualitative study used semi-structured interviews to explore service users' experiences and perspectives on EYE-2 approaches and resources. The study was conducted within EIP teams across three inner-city sites in England chosen to reflect diverse urban populations. Topic guides covered participant's identity, perceptions of EYE-2 resources, and experience of using mental health services. Transcribed interviews underwent thematic analysis. RESULTS: In this study, 21 service users aged 18 to 35 (M = 25.4; SD = 5.5) participated in semi-structured interviews. Seven key themes were identified across the four domains of the cultural adaptation framework: Differing cognitions and beliefs; multiple facets of culture; language as a barrier to engagement; stigma and discrimination; adaptations to EYE-2 resources; trust in therapeutic alliance; and individual differences in therapeutic preferences. CONCLUSIONS: The emergent themes highlighted a need to cater to various aspects of cultural diversity when developing EIP materials and services.


Assuntos
Serviços de Saúde Mental , Transtornos Psicóticos , Feminino , Humanos , Adolescente , Transtornos Psicóticos/terapia , Transtornos Psicóticos/psicologia , Inglaterra , Pesquisa Qualitativa
3.
Nature ; 527(7579): 508-11, 2015 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-26560029

RESUMO

Plant genomes, and eukaryotic genomes in general, are typically repetitive, polyploid and heterozygous, which complicates genome assembly. The short read lengths of early Sanger and current next-generation sequencing platforms hinder assembly through complex repeat regions, and many draft and reference genomes are fragmented, lacking skewed GC and repetitive intergenic sequences, which are gaining importance due to projects like the Encyclopedia of DNA Elements (ENCODE). Here we report the whole-genome sequencing and assembly of the desiccation-tolerant grass Oropetium thomaeum. Using only single-molecule real-time sequencing, which generates long (>16 kilobases) reads with random errors, we assembled 99% (244 megabases) of the Oropetium genome into 625 contigs with an N50 length of 2.4 megabases. Oropetium is an example of a 'near-complete' draft genome which includes gapless coverage over gene space as well as intergenic sequences such as centromeres, telomeres, transposable elements and rRNA clusters that are typically unassembled in draft genomes. Oropetium has 28,466 protein-coding genes and 43% repeat sequences, yet with 30% more compact euchromatic regions it is the smallest known grass genome. The Oropetium genome demonstrates the utility of single-molecule real-time sequencing for assembling high-quality plant and other eukaryotic genomes, and serves as a valuable resource for the plant comparative genomics community.


Assuntos
Genoma de Planta/genética , Poaceae/genética , Análise de Sequência de DNA/métodos , Aclimatação/genética , Mapeamento de Sequências Contíguas , Desidratação , Dessecação , Secas , Genes de Plantas/genética , Genômica , Dados de Sequência Molecular
4.
Depress Anxiety ; 37(12): 1168-1178, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32725848

RESUMO

BACKGROUND: Cognitive behavioral therapy (CBT) is an efficacious intervention for generalized anxiety disorder (GAD). Digital CBT may provide a scalable means of delivering CBT at a population level. We investigated the efficacy of a novel digital CBT program in those with GAD for outcomes of anxiety, worry, depressive symptoms, sleep difficulty, wellbeing, and participant-specific quality of life. METHODS: This online, two-arm parallel-group superiority randomized controlled trial compared digital CBT with waitlist control in 256 participants with moderate-to-severe symptoms of GAD. Digital CBT (Daylight), was delivered using participants' own smartphones. Online assessments took place at baseline (Week 0; immediately preceding randomization), mid-intervention (Week 3; from randomization), post-intervention (Week 6; primary endpoint), and follow-up (Week 10). RESULTS: Overall, 256 participants were randomized and intention-to-treat analysis found Daylight reduced symptoms of anxiety compared with waitlist control at post-intervention, reflecting a large effect size (adjusted difference [95% CI]: 3.22 [2.14, 4.31], d = 1.08). Significant improvements were found for measures of worry; depressive symptoms, sleep difficulty, wellbeing, and participant-specific quality of life. CONCLUSION: Digital CBT (Daylight) appears to be safe and efficacious for symptoms of anxiety, worry, and further measures of mental health compared with waitlist control in individuals with GAD.


Assuntos
Terapia Cognitivo-Comportamental , Qualidade de Vida , Ansiedade , Transtornos de Ansiedade/terapia , Humanos , Resultado do Tratamento
5.
J Neurosci ; 35(7): 3218-29, 2015 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-25698756

RESUMO

Autism spectrum disorder (ASD) is increasingly thought to result from low-level deficits in synaptic development and neural circuit formation that cascade into more complex cognitive symptoms. However, the link between synaptic dysfunction and behavior is not well understood. By comparing the effects of abnormal circuit formation and behavioral outcomes across different species, it should be possible to pinpoint the conserved fundamental processes that result in disease. Here we use a novel model for neurodevelopmental disorders in which we expose Xenopus laevis tadpoles to valproic acid (VPA) during a critical time point in brain development at which neurogenesis and neural circuit formation required for sensory processing are occurring. VPA is a commonly prescribed antiepileptic drug with known teratogenic effects. In utero exposure to VPA in humans or rodents results in a higher incidence of ASD or ASD-like behavior later in life. We find that tadpoles exposed to VPA have abnormal sensorimotor and schooling behavior that is accompanied by hyperconnected neural networks in the optic tectum, increased excitatory and inhibitory synaptic drive, elevated levels of spontaneous synaptic activity, and decreased neuronal intrinsic excitability. Consistent with these findings, VPA-treated tadpoles also have increased seizure susceptibility and decreased acoustic startle habituation. These findings indicate that the effects of VPA are remarkably conserved across vertebrate species and that changes in neural circuitry resulting from abnormal developmental pruning can cascade into higher-level behavioral deficits.


Assuntos
Anticonvulsivantes/efeitos adversos , Deficiências do Desenvolvimento/induzido quimicamente , Ácido Valproico/efeitos adversos , Animais , Animais Geneticamente Modificados , Aprendizagem da Esquiva/efeitos dos fármacos , Convulsivantes/toxicidade , Dendritos/efeitos dos fármacos , Dendritos/patologia , Deficiências do Desenvolvimento/fisiopatologia , Modelos Animais de Doenças , Reação de Fuga/efeitos dos fármacos , Agonistas de Aminoácidos Excitatórios/farmacologia , Habituação Psicofisiológica/efeitos dos fármacos , Potenciais Pós-Sinápticos Inibidores/efeitos dos fármacos , Potenciais Pós-Sinápticos Inibidores/fisiologia , Pentilenotetrazol/toxicidade , Reflexo de Sobressalto/efeitos dos fármacos , Células Ganglionares da Retina/patologia , Células Ganglionares da Retina/fisiologia , Convulsões/induzido quimicamente , Convulsões/tratamento farmacológico , Convulsões/patologia , Colículos Superiores/efeitos dos fármacos , Colículos Superiores/patologia , Transtornos da Visão/etiologia , Xenopus laevis
6.
Eur J Neurosci ; 40(6): 2948-62, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24995793

RESUMO

Information processing in the vertebrate brain is thought to be mediated through distributed neural networks, but it is still unclear how sensory stimuli are encoded and detected by these networks, and what role synaptic inhibition plays in this process. Here we used a collision avoidance behavior in Xenopus tadpoles as a model for stimulus discrimination and recognition. We showed that the visual system of the tadpole is selective for behaviorally relevant looming stimuli, and that the detection of these stimuli first occurs in the optic tectum. By comparing visually guided behavior, optic nerve recordings, excitatory and inhibitory synaptic currents, and the spike output of tectal neurons, we showed that collision detection in the tadpole relies on the emergent properties of distributed recurrent networks within the tectum. We found that synaptic inhibition was temporally correlated with excitation, and did not actively sculpt stimulus selectivity, but rather it regulated the amount of integration between direct inputs from the retina and recurrent inputs from the tectum. Both pharmacological suppression and enhancement of synaptic inhibition disrupted emergent selectivity for looming stimuli. Taken together these findings suggested that, by regulating the amount of network activity, inhibition plays a critical role in maintaining selective sensitivity to behaviorally-relevant visual stimuli.


Assuntos
Larva/fisiologia , Atividade Motora/fisiologia , Inibição Neural/fisiologia , Colículos Superiores/fisiologia , Percepção Visual/fisiologia , Xenopus laevis/fisiologia , Animais , Reação de Fuga/fisiologia , Ácido Glutâmico/metabolismo , Larva/efeitos dos fármacos , Modelos Neurológicos , Inibição Neural/efeitos dos fármacos , Neurônios/efeitos dos fármacos , Neurônios/fisiologia , Nervo Óptico/fisiologia , Técnicas de Patch-Clamp , Estimulação Luminosa , Colículos Superiores/efeitos dos fármacos , Sinapses/efeitos dos fármacos , Sinapses/fisiologia , Vias Visuais/efeitos dos fármacos , Vias Visuais/fisiologia , Percepção Visual/efeitos dos fármacos , Ácido gama-Aminobutírico/metabolismo
7.
Proc Natl Acad Sci U S A ; 108(48): 19276-81, 2011 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-22084086

RESUMO

Large-scale transcription profiling via direct cDNA sequencing provides important insights as to how foundation species cope with increasing climatic extremes predicted under global warming. Species distributed along a thermal cline, such as the ecologically important seagrass Zostera marina, provide an opportunity to assess temperature effects on gene expression as a function of their long-term adaptation to heat stress. We exposed a southern and northern European population of Zostera marina from contrasting thermal environments to a realistic heat wave in a common-stress garden. In a fully crossed experiment, eight cDNA libraries, each comprising ~125 000 reads, were obtained during and after a simulated heat wave, along with nonstressed control treatments. Although gene-expression patterns during stress were similar in both populations and were dominated by classical heat-shock proteins, transcription profiles diverged after the heat wave. Gene-expression patterns in southern genotypes returned to control values immediately, but genotypes from the northern site failed to recover and revealed the induction of genes involved in protein degradation, indicating failed metabolic compensation to high sea-surface temperature. We conclude that the return of gene-expression patterns during recovery provides critical information on thermal adaptation in aquatic habitats under climatic stress. As a unifying concept for ecological genomics, we propose transcriptomic resilience, analogous to ecological resilience, as an important measure to predict the tolerance of individuals and hence the fate of local populations in the face of global warming.


Assuntos
Adaptação Biológica/fisiologia , Perfilação da Expressão Gênica/métodos , Regulação da Expressão Gênica/fisiologia , Aquecimento Global , Zosteraceae/metabolismo , DNA Complementar/genética , Dinamarca , Ecologia/métodos , Etiquetas de Sequências Expressas , Genômica/métodos , Geografia , Proteínas de Choque Térmico/metabolismo , Itália , Mar Mediterrâneo , Análise Multivariada , Mar do Norte , Análise de Sequência de DNA , Temperatura , Zosteraceae/genética
8.
Nucleic Acids Res ; 39(14): 6029-43, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21470961

RESUMO

The discovery of regulatory motifs embedded in upstream regions of plants is a particularly challenging bioinformatics task. Previous studies have shown that motifs in plants are short compared with those found in vertebrates. Furthermore, plant genomes have undergone several diversification mechanisms such as genome duplication events which impact the evolution of regulatory motifs. In this article, a systematic phylogenomic comparison of upstream regions is conducted to further identify features of the plant regulatory genomes, the component of genomes regulating gene expression, to enable future de novo discoveries. The findings highlight differences in upstream region properties between major plant groups and the effects of divergence times and duplication events. First, clear differences in upstream region evolution can be detected between monocots and dicots, thus suggesting that a separation of these groups should be made when searching for novel regulatory motifs, particularly since universal motifs such as the TATA box are rare. Second, investigating the decay rate of significantly aligned regions suggests that a divergence time of ~100 mya sets a limit for reliable conserved non-coding sequence (CNS) detection. Insights presented here will set a framework to help identify embedded motifs of functional relevance by understanding the limits of bioinformatics detection for CNSs.


Assuntos
Evolução Molecular , Genoma de Planta , Sequências Reguladoras de Ácido Nucleico , Algoritmos , Sequência de Bases , Sequência Conservada , Elementos de DNA Transponíveis , Genômica/métodos , Filogenia , Plantas/classificação , Plantas/genética , Biossíntese de Proteínas , Alinhamento de Sequência , Software , Sítio de Iniciação de Transcrição
9.
Sci Diabetes Self Manag Care ; 49(6): 415-425, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37771237

RESUMO

PURPOSE: The purpose of the study was to explore various forms of diabetes self-management education (DSME), including group and individual sessions, for persons with lived experiences of homelessness (PWLEH) in Canada. METHODS: A qualitative descriptive study using open-ended interviews with health care and homeless sector service providers was utilized to serve those experiencing homelessness in 5 cities across Canada. NVivo qualitative data analysis software was used to facilitate thematic analysis, focusing on variations in DSME for PWLEH. RESULTS: We conducted interviews with 96 unique health and social care providers. Four themes were identified through focused coding of interviews. First, the use of a harm reduction approach during diabetes education tailored to PWLEH considered patients' access to food, medications, and supplies and other comorbidities, including mental health and substance use disorders. The second theme related to the unsuitability of the curriculum in mainstream diabetes education in a group setting for PWLEH. Third, the role of group education in community building is to create supportive relationships among members. The final theme was the importance of trust and confidentiality in DSME, which were most easily maintained during individual education, compared to group formats. CONCLUSIONS: Overall, PWLEH experience unique challenges in managing diabetes. DSME adapted to these individuals' unique needs may be more successful and could be delivered in both individual and group settings.


Assuntos
Diabetes Mellitus , Pessoas Mal Alojadas , Humanos , Problemas Sociais , Canadá/epidemiologia , Pesquisa Qualitativa , Diabetes Mellitus/epidemiologia
10.
BMC Evol Biol ; 11: 8, 2011 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-21226908

RESUMO

BACKGROUND: Seagrasses are a polyphyletic group of monocotyledonous angiosperms that have adapted to a completely submerged lifestyle in marine waters. Here, we exploit two collections of expressed sequence tags (ESTs) of two wide-spread and ecologically important seagrass species, the Mediterranean seagrass Posidonia oceanica (L.) Delile and the eelgrass Zostera marina L., which have independently evolved from aquatic ancestors. This replicated, yet independent evolutionary history facilitates the identification of traits that may have evolved in parallel and are possible instrumental candidates for adaptation to a marine habitat. RESULTS: In our study, we provide the first quantitative perspective on molecular adaptations in two seagrass species. By constructing orthologous gene clusters shared between two seagrasses (Z. marina and P. oceanica) and eight distantly related terrestrial angiosperm species, 51 genes could be identified with detection of positive selection along the seagrass branches of the phylogenetic tree. Characterization of these positively selected genes using KEGG pathways and the Gene Ontology uncovered that these genes are mostly involved in translation, metabolism, and photosynthesis. CONCLUSIONS: These results provide first insights into which seagrass genes have diverged from their terrestrial counterparts via an initial aquatic stage characteristic of the order and to the derived fully-marine stage characteristic of seagrasses. We discuss how adaptive changes in these processes may have contributed to the evolution towards an aquatic and marine existence.


Assuntos
Alismatales/genética , Organismos Aquáticos/genética , Evolução Molecular , Biologia Marinha , Proteínas de Plantas/genética , Alismatales/classificação , Organismos Aquáticos/classificação , Dados de Sequência Molecular , Oceanos e Mares , Filogenia
11.
Br J Haematol ; 153(5): 599-611, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21492126

RESUMO

Bcl-2 proteins represent a rheostat that controls cellular viability. Obatoclax, a BH3-mimetic, has been designed to specifically target and counteract anti-apoptotic Bcl-2 proteins. We evaluated the biological effects of obatoclax on the anti-tumour activity of rituximab and chemotherapy agents. Obatoclax induced cell death of rituximab/chemotherapy-sensitive (RSCL), -resistant cell lines (RRCL) and primary tumour-cells derived from patients with B-cell lymphomas (N=39). Obatoclax also enhanced the activity of rituximab and had synergistic activity when combined with chemotherapy agents. The ability of Obatoclax to induce PARP cleavage varied between patient samples and was not observed in some RRCL. Inhibition of caspase activity did not affect obatoclax activity, suggesting the existence of caspase-independent death pathways. Autophagy was detected by LC3 conversion and/or electron microscopy in RRCL and in patient-derived tumour cells. Moreover, obatoclax activity was inhibited by Beclin-1 knockdown. In summary, obatoclax is an active Bcl-2 inhibitor that potentiates the activity of chemotherapy agents and, to a lesser degree, rituximab. Defining the molecular events triggered by obatoclax is necessary to further its clinical development and identify potential biomarkers that are predictive of response.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Linfoma de Células B/patologia , Anticorpos Monoclonais Murinos/administração & dosagem , Anticorpos Monoclonais Murinos/farmacologia , Citotoxicidade Celular Dependente de Anticorpos/efeitos dos fármacos , Proteínas Reguladoras de Apoptose/biossíntese , Autofagia/efeitos dos fármacos , Caspases/fisiologia , Morte Celular/efeitos dos fármacos , Avaliação Pré-Clínica de Medicamentos/métodos , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Sinergismo Farmacológico , Humanos , Indóis , Linfoma de Células B/metabolismo , Linfoma Folicular/metabolismo , Linfoma Folicular/patologia , Linfoma Difuso de Grandes Células B/metabolismo , Linfoma Difuso de Grandes Células B/patologia , Proteínas de Neoplasias/biossíntese , Proteínas Proto-Oncogênicas/biossíntese , Proteínas Proto-Oncogênicas c-bcl-2/biossíntese , Pirróis/administração & dosagem , Pirróis/farmacologia , Rituximab , Células Tumorais Cultivadas , Regulação para Cima/efeitos dos fármacos , Proteína Killer-Antagonista Homóloga a bcl-2/análise , Proteína X Associada a bcl-2/análise
12.
Trials ; 22(1): 732, 2021 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-34688283

RESUMO

BACKGROUND: Early Intervention in Psychosis (EIP) services improve health outcomes for young people with psychosis in the medium-long term, but 25% of young people disengage in the first 12 months with costs to their mental health, families, society and health services. This study will evaluate the effectiveness of a team-based motivational engagement intervention, the Early Youth Engagement (EYE-2) intervention. METHODS AND DESIGN: The EYE-2 trial is a cluster randomised controlled trial comparing the EYE-2 intervention plus standardised EIP service to standardised EIP service alone, with randomisation at the clinical team (cluster) level. The study aimed to enrol 950 young people (aged 14-35 years) with first episode psychosis in 10 teams per arm. RESULTS: The primary outcome is time to disengagement: days from the date of allocation to care coordinator to date of the last contact following either refusal to engage with an EIP team or lack of response to EIP contact for 3 consecutive months which will be analysed using a shared frailty model. Secondary outcomes are Health of the Nation Outcome Scale (HoNOS), Process of Recovery Questionnaire (QPR), DIALOG (a service user-reported measure of quality of life and treatment satisfaction) and service use outcomes which will be analysed using mixed effects regression models. DISCUSSION: This paper is the detailed statistical analysis plan for the EYE-2 trial. Any changes to, or deviations from, this plan will be described and justified in the final trial report. TRIAL REGISTRATION: ISRCTN 51629746 . Prospectively registered on 7 May 2019. Date assigned 10 May 2019.


Assuntos
Transtornos Psicóticos , Qualidade de Vida , Adolescente , Análise Custo-Benefício , Humanos , Saúde Mental , Motivação , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/terapia
13.
Int J Clin Health Psychol ; 21(2): 100227, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33680001

RESUMO

Healthcare workers play a critical role in the health of a nation, yet rates of healthcare worker stress are disproportionately high. We evaluated whether mindfulness-based cognitive therapy for life (MBCT-L), could reduce stress in healthcare workers and target a range of secondary outcomes. Method: This is the first parallel randomised controlled trial of MBCT-L. Participants were NHS workers, who were randomly assigned (1:1) to receive either MBCT-L or wait-list. The primary outcome was self-reported stress at post-intervention. Secondary variables were well-being, depression, anxiety, and work-related outcomes. Mixed regressions were used. Mindfulness and self/other-compassion were explored as potential mechanisms of effects on stress and wellbeing. Results: We assigned 234 participants to MBCT-L (n = 115) or to wait-list (n = 119). 168 (72%) participants completed the primary outcome and of those who started the MBCT-L 73.40% (n = 69) attended the majority of the sessions. MBCT-L ameliorated stress compared with controls (B = 2.60, 95% CI = 1.63‒3.56; d = -0.72; p < .0001). Effects were also found for well-being, depression and anxiety, but not for work-related outcomes. Mindfulness and self-compassion mediated effects on stress and wellbeing. Conclusions: MBCT-L could be an effective and acceptable part of a wider healthcare workers well-being and mental health strategy.


Los trabajadores sanitarios juegan un papel fundamental en la salud de una nación, pero sus tasas de estrés son desproporcionadamente altas. Se evaluó si la terapia cognitiva basada en mindfulness para la vida (MBCT-L) podría reducir el estrés y otras variables secundarias en trabajadores sanitarios. Método: Primer ensayo controlado aleatorizado de MBCT-L. Los participantes fueron asignados aleatoriamente (1:1) a un grupo MBCT-L o a una lista de espera. La variable principal fue estrés percibido (post-intervención), y las variables secundarias bienestar, depresión, ansiedad, y otras relativas al trabajo. Se utilizaron regresiones mixtas. Mindfulness y autocompasión fueron explorados como potenciales mediadores del estrés y bienestar. Resultados: 234 participantes fueron asignados a MBCT-L (n = 115) o grupo control (n = 119) y 168 (72%) participantes completaron la variable principal. Un 74% (n = 69) de quienes empezaron MBCT-L atendieron la mayoría de las sesiones. MBCT-L mejoró el estrés comparado con lista de espera (B = 2,60; 95% CI = 1,63‒3,56; d =-0,57; p <  0,0001). También se encontraron efectos en bienestar, depresión y ansiedad, pero no en variables del trabajo. Mindfulness y autocompasión mediaron efectos sobre estrés y bienestar. Conclusiones: MBCT-L podría ser una pieza eficaz y aceptable dentro de una estrategia más amplia de bienestar y salud mental para trabajadores sanitarios.

14.
J Behav Ther Exp Psychiatry ; 70: 101609, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32950939

RESUMO

BACKGROUND AND OBJECTIVES: Cognitive behavioral therapy (CBT) is a first-line treatment for anxiety, but it is not widely available as clinical guidelines recommend. We examined the feasibility and efficacy of a novel smartphone-based fully automated digital CBT intervention, 'Daylight™', to improve symptoms of Generalized Anxiety Disorder (GAD). METHODS: In this multiple-baseline design, 21 adults (20 F; mean age 43yrs. range 19-65yrs.) with moderate-to-severe symptoms of GAD were randomized to one of three baseline durations (2-, 4-, or 6-weeks) and then received access to digital CBT. Participants completed daily ratings of anxiety and worry, weekly measures of anxiety, depressive symptoms, and sleep, and measures of anxiety, worry, wellbeing, quality of life, CBT skill acquisition, and work performance at initial assessment prior to baseline randomization, post-intervention, and follow-up. RESULTS: Digital CBT was found to be feasible in terms of engagement, satisfaction, and safety. For preliminary efficacy, improvements were detected in daily and weekly outcomes of anxiety for most participants. Despite individual differences, significant improvements occurred with the introduction of digital CBT and not during baseline. Overall, 70% of participants no longer had clinically significant symptoms of GAD, 61% no longer had significant depressive symptoms, and 40% no longer had significant sleep difficulty at post-intervention. LIMITATIONS: The study sample was recruited using the internet and was mostly female, limiting the generalizability of the findings. CONCLUSIONS: Findings support the feasibility and efficacy of Daylight. Further examination in randomized controlled trials is now warranted.


Assuntos
Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental , Smartphone , Adulto , Idoso , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Resultado do Tratamento , Adulto Jovem
15.
Trials ; 22(1): 272, 2021 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-33845856

RESUMO

BACKGROUND: Early Intervention in Psychosis (EIP) services improve health outcomes for young people with psychosis in the medium-long term, but 25% of young people disengage in the first 12 months with costs to their mental health, families, society and the NHS. This study will evaluate the effectiveness, cost-effectiveness and implementation of a team-based motivational Early Youth Engagement (EYE-2) intervention. METHOD: The study design is a cluster randomised controlled trial (RCT) with economic evaluation, comparing the EYE-2 intervention + standardised EIP service to standardised EIP service alone, with randomisation at the team level. A process evaluation will evaluate the delivery of the intervention qualitatively and quantitatively across contexts. The setting is 20 EIP teams in 5 sites: Manchester, South London, East Anglia, Thames Valley and Hampshire. Participants are young people (14-35 years) with first episode psychosis, and EIP staff. The intervention is the team-based motivational engagement (EYE-2) intervention, delivered alongside standardised EIP services, and supported by additional training, website, booklets and social groups. The comparator is the standardised EIP service. Both interventions are delivered by EIP clinicians. The primary outcome is time to disengagement (time in days from date of allocation to care coordinator to date of last contact following refusal to engage with EIP service, or lack of response to EIP contact for a consecutive 3-month period). Secondary outcomes include mental and physical health, deaths, social and occupational function, recovery, satisfaction and service use at 6, 12, 18 and 24 months. A 12-month within-trial economic evaluation will investigate cost-effectiveness from a societal perspective and from an NHS perspective. DISCUSSION: The trial will provide the first test of an engagement intervention in standardised care, with the potential for significant impact on the mental health and wellbeing of young people and their families, and economic benefits for services. The intervention will be highly scalable, supported by the toolkit including manuals, commissioning guide, training and resources, adapted to meet the needs of the diverse EIP population, and based on an in-depth process evaluation. TRIAL REGISTRATION: ISRCTN 51629746 prospectively registered 7th May 2019. Date assigned 10th May 2019.


Assuntos
Transtornos Psicóticos , Adolescente , Análise Custo-Benefício , Humanos , Londres , Saúde Mental , Motivação , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/terapia
16.
Mol Biol Evol ; 26(10): 2217-27, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19592668

RESUMO

Thermal adaptation of individual proteins is often achieved through modulating protein stability, with proteins that are adapted to extreme cold environments having increased conformational flexibility when brought to mesophilic conditions. Conversely, proteins adapted to higher temperatures appear less dynamic and are found to be much more stable against thermal denaturation than their mesophilic counterparts. According to the current paradigm, the adaptation of an organism for survival at higher or lower temperatures is facilitated by the adaptation of the component proteins. We note, however, that these observations have been carried out on relatively few proteins. The extent to which the conformational stabilities of all members of the proteome have been modulated for thermal adaptation remains unclear, with no direct experimental strategies to address this issue. Adapted extremophilies are likely to use a multitude of molecular and biophysical strategies for survival and, therefore, evolution of specific biophysical properties of proteins for optimal function may not be necessary for all proteins in the proteome. Using a sequence-based predictor of protein stability, eScape, an in silico examination of several extremophilic proteomes shows a correlation between the collective stability of the proteins and the thermal range of survival for the organism as expected. Unexpectedly, however, the analysis shows that protein thermostability is modified to different extents across the proteome and depends on the functional role for which the protein is involved. Identification of these differences provides unique opportunities to study interdependence within the proteome as well as the role that the proteome plays in the process of evolutionary thermal adaptation.


Assuntos
Adaptação Fisiológica , Proteoma/química , Análise de Sequência de Proteína/métodos , Temperatura , Algoritmos , Viabilidade Microbiana , Maleabilidade , Estabilidade Proteica , Estrutura Secundária de Proteína , Seleção Genética , Homologia de Sequência de Aminoácidos
17.
Mol Ecol ; 19(14): 2870-83, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20609077

RESUMO

Summer heat waves have already resulted in mortality of coastal communities, including ecologically important seagrass meadows. Gene expression studies from controlled experiments can provide important insight as to how species/genotypes react to extreme events that will increase under global warming. In a common stress garden, we exposed three populations of eelgrass, Zostera marina, to extreme sea surface temperatures, simulating the 2003-European heat wave. Populations came from locations widely differing in their thermal regime, two northern European locations [Ebeltoft (Kattegat), Doverodde (Limfjord, Baltic Sea)], and one southern population from Gabicce Mare (Adriatic Sea), allowing to test for population specificity in the response to a realistic heat stress event. Eelgrass survival and growth as well as the expression of 12 stress associated candidate genes were assessed during and after the heat wave. Contrary to expectations, all populations suffered equally from 3 weeks of heat stress in terms of shoot loss. In contrast, populations markedly differed in multivariate measures of gene expression. While the gene expression profiles converged to pre-stress values directly after the heat wave, stress correlated genes were upregulated again 4 weeks later, in line with the observed delay in shoot loss. Target genes had to be selected based on functional knowledge in terrestrial plants, nevertheless, 10/12 genes were induced relative to the control treatment at least once during the heat wave in the fully marine plant Z. marina. This study underlines the importance of realistic stress and recovery scenarios in studying the impact of predicted climate change.


Assuntos
Aquecimento Global , Resposta ao Choque Térmico , Zosteraceae/genética , Dinamarca , Ecossistema , Perfilação da Expressão Gênica , Regulação da Expressão Gênica de Plantas , Genótipo , Temperatura Alta , Itália , Fenótipo , RNA de Plantas/genética , Zosteraceae/fisiologia
18.
Structure ; 16(11): 1627-37, 2008 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-19000815

RESUMO

The abundance of dynamic and disordered regions in proteins suggests that structural determinants alone may not be sufficient to describe function. Instead, descriptors that account for the dynamic features of the energy landscape populated by the protein ensemble may be required. Here, we show that the thermodynamics of the dynamical complexity that imparts biological function can be largely reconstructed using sequence information alone, allowing thermodynamic characterization of entire proteomes without the need for structural analysis. We show that this tool can be used to analyze conserved energetic signatures within classes of proteins, as well as to compare the thermodynamic character of different proteomes.


Assuntos
Conformação Proteica , Proteínas/química , Proteoma/química , Algoritmos , Sequência de Aminoácidos , Aminoácidos/química , Cinética , Modelos Moleculares , Valor Preditivo dos Testes , Estabilidade Proteica , Proteínas/metabolismo , Reprodutibilidade dos Testes , Alinhamento de Sequência
19.
Assessment ; 27(1): 3-20, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31353931

RESUMO

Compassion has received increasing societal and scientific interest in recent years. The science of compassion requires a tool that can offer valid and reliable measurement of the construct to allow examination of its causes, correlates, and consequences. The current studies developed and examined the psychometric properties of new self-report measures of compassion for others and for the self, the 20-item Sussex-Oxford Compassion for Others Scale (SOCS-O) and 20-item Sussex-Oxford Compassion for the Self Scale (SOCS-S). These were based on the theoretically and empirically supported definition of compassion as comprising five dimensions: (a) recognizing suffering, (b) understanding the universality of suffering, (c) feeling for the person suffering, (d) tolerating uncomfortable feelings, and (e) motivation to act/acting to alleviate suffering. Findings support the five-factor structure for both the SOCS-O and SOCS-S. Scores on both scales showed adequate internal consistency, interpretability, floor/ceiling effects, and convergent and discriminant validity.


Assuntos
Empatia , Autorrelato/normas , Adulto , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
20.
Assessment ; 27(1): 149-163, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-28629232

RESUMO

Extending previous research, we applied latent profile analysis in a sample of adults with a history of recurrent depression to identify subgroups with distinct response profiles on the Five Facet Mindfulness Questionnaire and understand how these relate to psychological functioning. The sample was randomly divided into two subsamples to first examine the optimal number of latent profiles (test sample; n = 343) and then validate the identified solution (validation sample; n = 340). In both test and validation samples, a four-profile solution was revealed where two profiles mapped broadly onto those previously identified in nonclinical samples: "high mindfulness" and "nonjudgmentally aware." Two additional subgroups, "moderate mindfulness" and "very low mindfulness," were observed. "High mindfulness" was associated with the most adaptive psychological functioning and "very low mindfulness" with the least adaptive. In most people with recurrent depression, mindfulness skills are expressed evenly across different domains. However, in a small minority a meaningful and replicable uneven profile indicating nonjudgmental awareness is observable. Current findings require replication and future research should examine the extent to which profiles change from periods of wellness to illness in people with recurrent depression and how profiles are influenced by exposure to mindfulness-based intervention.


Assuntos
Depressão/psicologia , Transtorno Depressivo/psicologia , Atenção Plena , Testes Psicológicos/normas , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Recidiva , Inquéritos e Questionários , Reino Unido , Adulto Jovem
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