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1.
Arch Sex Behav ; 52(8): 3291-3299, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37626259

RESUMO

Reproduction in mammals includes two general categories of behaviors: mating and parenting. Historically and cross-culturally, men invest more than women in mating; women invest more than men in parenting. Sex differences in attention and attitude toward mating and parenting stimuli have rarely been assessed together despite theoretical interest. To evaluate these differences simultaneously in a naturalistic setting, 582 study participants (459 women, 123 men) were presented with sexual and infant images, online in the privacy of their home, at three time periods spanning several weeks for a more reliable result. Attention was measured by covertly recording viewing time of images using Qualtrics software, and attitude was measured via self-report after each viewing session. Men reported a more positive attitude than women toward the sexual images; women reported a more positive attitude than men toward the infant images. Women viewed the infant images marginally longer than did men, and the infant-to-sexual viewing ratio was larger for women. The sexual-to-infant viewing ratio was larger for men than for women. Unexpectedly, both genders viewed the sexual images longer than the infant images, with no significant gender difference in the sexual image viewing time. The results suggest that women and men may give equal attention to visual sexual stimuli despite self-reported sex differences in interest. The possibly underestimated valence of visual sexual stimuli for women is discussed.


Assuntos
Caracteres Sexuais , Comportamento Sexual , Humanos , Feminino , Masculino , Fatores Sexuais , Atitude , Autorrelato
2.
Proc Natl Acad Sci U S A ; 115(37): E8634-E8641, 2018 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-30139915

RESUMO

Insects use a diverse array of specialized terpene metabolites as pheromones in intraspecific interactions. In contrast to plants and microbes, which employ enzymes called terpene synthases (TPSs) to synthesize terpene metabolites, limited information from few species is available about the enzymatic mechanisms underlying terpene pheromone biosynthesis in insects. Several stink bugs (Hemiptera: Pentatomidae), among them severe agricultural pests, release 15-carbon sesquiterpenes with a bisabolene skeleton as sex or aggregation pheromones. The harlequin bug, Murgantia histrionica, a specialist pest of crucifers, uses two stereoisomers of 10,11-epoxy-1-bisabolen-3-ol as a male-released aggregation pheromone called murgantiol. We show that MhTPS (MhIDS-1), an enzyme unrelated to plant and microbial TPSs but with similarity to trans-isoprenyl diphosphate synthases (IDS) of the core terpene biosynthetic pathway, catalyzes the formation of (1S,6S,7R)-1,10-bisaboladien-1-ol (sesquipiperitol) as a terpene intermediate in murgantiol biosynthesis. Sesquipiperitol, a so-far-unknown compound in animals, also occurs in plants, indicating convergent evolution in the biosynthesis of this sesquiterpene. RNAi-mediated knockdown of MhTPS mRNA confirmed the role of MhTPS in murgantiol biosynthesis. MhTPS expression is highly specific to tissues lining the cuticle of the abdominal sternites of mature males. Phylogenetic analysis suggests that MhTPS is derived from a trans-IDS progenitor and diverged from bona fide trans-IDS proteins including MhIDS-2, which functions as an (E,E)-farnesyl diphosphate (FPP) synthase. Structure-guided mutagenesis revealed several residues critical to MhTPS and MhFPPS activity. The emergence of an IDS-like protein with TPS activity in M. histrionica demonstrates that de novo terpene biosynthesis evolved in the Hemiptera in an adaptation for intraspecific communication.


Assuntos
Alquil e Aril Transferases/metabolismo , Heterópteros/metabolismo , Proteínas de Insetos/metabolismo , Feromônios/metabolismo , Sesquiterpenos/metabolismo , Alquil e Aril Transferases/classificação , Alquil e Aril Transferases/genética , Animais , Vias Biossintéticas/genética , Heterópteros/enzimologia , Heterópteros/genética , Proteínas de Insetos/química , Proteínas de Insetos/genética , Masculino , Modelos Moleculares , Estrutura Molecular , Feromônios/química , Filogenia , Fosfatos de Poli-Isoprenil/metabolismo , Domínios Proteicos , Sesquiterpenos/química , Estereoisomerismo
3.
Toxicol Appl Pharmacol ; 304: 79-89, 2016 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-27221630

RESUMO

Geogenic dust from arid environments is a possible inhalation hazard for humans, especially when using off-road vehicles that generate significant dust. This study focused on immunotoxicological and neurotoxicological effects following subacute exposure to geogenic dust generated from sediments in the Nellis Dunes Recreation Area near Las Vegas, Nevada that are particularly high in arsenic; the naturally-occurring arsenic concentrations in these surficial sediments ranged from 4.8 to 346µg/g. Dust samples from sediments used in this study had a median diameter of 4.5µm and also were a complex mixture of naturally-occurring metals, including aluminum, vanadium, chromium, manganese, iron, cobalt, copper, zinc, strontium, cesium, lead, uranium, and arsenic. Adult female B6C3F1 mice exposed via oropharyngeal aspiration to 0.01 to 100mg dust/kg body weight, four times, a week apart, for 28days, were evaluated 24h after the last exposure. Peripheral eosinophils were increased at all concentrations, serum creatinine was dose responsively increased beginning at 1.0mg/kg/day, and blood urea nitrogen was decreased at 10 and 100mg/kg/day. Antigen-specific IgM responses and natural killer cell activity were dose-responsively suppressed at 0.1mg/kg/day and above. Splenic CD4+CD25+ T cells were decreased at 0.01, 0.1, 10, and 100mg/kg/day. Antibodies against MBP, NF-68, and GFAP were selectively reduced. A no observed adverse effect level of 0.01mg/kg/day and a lowest observed adverse effect level of 0.1mg/kg/day were determined from IgM responses and natural killer cell activity, indicating that exposure to this dust, under conditions similar to our design, could affect these responses.


Assuntos
Arsênio/toxicidade , Poeira/imunologia , Animais , Arsênio/análise , Nitrogênio da Ureia Sanguínea , Peso Corporal/efeitos dos fármacos , Misturas Complexas , Creatinina/sangue , Relação Dose-Resposta a Droga , Poeira/análise , Eosinófilos/efeitos dos fármacos , Feminino , Imunoglobulina M/efeitos dos fármacos , Imunofenotipagem , Células Matadoras Naturais/efeitos dos fármacos , Camundongos , Proteínas de Neurofilamentos/imunologia , Nevada , Tamanho do Órgão/efeitos dos fármacos , Tamanho da Partícula , Baço/patologia
4.
Proc Natl Acad Sci U S A ; 109(37): 14858-63, 2012 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-22927409

RESUMO

Insects use hydrocarbons as cuticular waterproofing agents and as contact pheromones. Although their biosynthesis from fatty acyl precursors is well established, the last step of hydrocarbon biosynthesis from long-chain fatty aldehydes has remained mysterious. We show here that insects use a P450 enzyme of the CYP4G family to oxidatively produce hydrocarbons from aldehydes. Oenocyte-directed RNAi knock-down of Drosophila CYP4G1 or NADPH-cytochrome P450 reductase results in flies deficient in cuticular hydrocarbons, highly susceptible to desiccation, and with reduced viability upon adult emergence. The heterologously expressed enzyme converts C(18)-trideuterated octadecanal to C(17)-trideuterated heptadecane, showing that the insect enzyme is an oxidative decarbonylase that catalyzes the cleavage of long-chain aldehydes to hydrocarbons with the release of carbon dioxide. This process is unlike cyanobacteria that use a nonheme diiron decarbonylase to make alkanes from aldehydes with the release of formate. The unique and highly conserved insect CYP4G enzymes are a key evolutionary innovation that allowed their colonization of land.


Assuntos
Exoesqueleto/química , Vias Biossintéticas/fisiologia , Sistema Enzimático do Citocromo P-450/metabolismo , Drosophila/enzimologia , Hidrocarbonetos/metabolismo , NADPH-Ferri-Hemoproteína Redutase/metabolismo , Aldeídos/metabolismo , Animais , Vias Biossintéticas/genética , Drosophila/química , Imuno-Histoquímica , Microscopia Confocal , Microssomos/metabolismo , Estrutura Molecular , Interferência de RNA
5.
Psychiatr Q ; 86(1): 123-36, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25294276

RESUMO

This is a 10 year longitudinal study of recovery progress within a residential program based upon therapeutic community principles and a Seven Domains Enhanced Recovery Model (Young and Ensing, 1999). A broad suite of measures associated with one of three definitions of recovery (symptom, function, and personal focused recovery) were administered along three longitudinal courses. Normalized mean rates of change and mean shared variances for these scales were examined for three subgroups based on length of stay. Measures associated with the same definition of recovery correlated moderately to strongly but measures did not correlate between facets, suggesting relative independence between definition facets. The results of this analysis suggest the existence of qualitatively distinct subgroups with different change dynamics. The aggregate means of these facets showed correlated change, while individual recovery pathways did not, suggesting significant heterogeneity in individual pathways of recovery. These findings support the conceptualization of recovery as a complex, heterogeneous and multi-faceted process. Practically, these findings emphasize the need for holistic, flexible and individualized recovery supports and that research into these constructs should include at least these facets over a longitudinal time frame.


Assuntos
Transtornos Mentais/terapia , Modelos Teóricos , Recuperação de Função Fisiológica/fisiologia , Comunidade Terapêutica , Resultado do Tratamento , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Fatores de Tempo
6.
Psychiatr Q ; 85(3): 329-43, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24615555

RESUMO

This study summarizes the results of a 10 year longitudinal study of individual recovery progress within a residential program based upon therapeutic community principles and a Seven Domains Enhanced Recovery Model that emerged from a grounded theory analysis of real life recovery experiences (Young and Ensing, Psychiatr Rehab J 22:219-231, 1999). The four primary hypotheses of the study predicted significant and moderately sized effect sizes on a holistic set of measures, corresponding to the Enhanced Recovery Model. Results indicate support for all hypotheses; statistically significant and moderate to large effects were found in all domain measures for the participants, most of whom had multiple unsuccessful previous treatment attempts. These results indicate that this theoretical structure and residential model is effective in supporting recovery for individuals with complex and persistent challenges across the broad range of recovery domains. Conceptually, this also adds quantitative support for the Seven Domains Enhanced Recovery Model, complementing previous qualitative studies.


Assuntos
Transtornos Mentais/psicologia , Transtornos Mentais/reabilitação , Tratamento Domiciliar/métodos , Comunidade Terapêutica , Resultado do Tratamento , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos
7.
Ecol Food Nutr ; 52(2): 93-115, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23445390

RESUMO

Maternal placentophagy, although widespread among mammals, is conspicuously absent among humans cross-culturally. Recently, however, advocates for the practice have claimed it provides human postpartum benefits. Despite increasing awareness about placentophagy, no systematic research has investigated the motivations or perceived effects of practitioners. We surveyed 189 females who had ingested their placenta and found the majority of these women reported perceived positive benefits and indicated they would engage in placentophagy again after subsequent births. Further research is necessary to determine if the described benefits extend beyond those of placebo effects, or are skewed by the nature of the studied sample.


Assuntos
Atitude Frente a Saúde , Ingestão de Alimentos , Motivação , Placenta , Período Pós-Parto , Adulto , Coleta de Dados , Feminino , Humanos , Cuidado Pós-Natal , Gravidez , Autorrelato
8.
Ecol Food Nutr ; 51(3): 198-217, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22632060

RESUMO

The absence of human placentophagy, the maternal consumption of the afterbirth, is puzzling given its ubiquity and probable adaptive value in other mammals. We propose that human fire use may have led to placentophagy avoidance in our species. In our environment of evolutionary adaptedness, gravid women would likely have been regularly exposed to smoke and ash, which is known to contain harmful substances. Because the placenta filters some toxicants which then accumulate there across pregnancy, maternal placentophagy may have had deleterious consequences for the overall fitness of mother, offspring, or both, leading to its elimination from our species' behavioral repertoire.


Assuntos
Poluentes Ambientais/efeitos adversos , Comportamento Alimentar/fisiologia , Incêndios , Placenta/química , Antropologia , Evolução Biológica , Feminino , Humanos , Gravidez
9.
Clin Breast Cancer ; 22(3): 212-222, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34756834

RESUMO

Supplemental screening with MRI or ultrasound increases cancer detection rate (CDR) in women with standard screening mammography. Whether it also reduces interval cancer rate (ICR) is unclear. This study reviewed the evidence evaluating the effect of supplemental imaging on ICR in women undergoing screening mammography. This systematic review included studies that reported both CDR and ICR in women undergoing screening mammography alone compared to those undergoing screening mammography with supplemental imaging. Five studies (3 randomized trials) were eligible. These reported on 142,153 women undergoing mammography screening alone or mammography with supplemental imaging (3 ultrasound and 2 MRI studies). Two studies included a general screening population and 3 included special populations (young, high genetic risk and/or dense breasts). The incremental CDR for supplemental MRI was 14.2 to 16.5/1000 screens and for ultrasound was 0 to 4.4/1000 screens. Effect on ICR was variable but evidence of a reduced ICR was more consistent for studies using supplemental MRI (ICR 0.3 to 0.8 per 1000 screens) than those using ultrasound (ICR 0.49 to 1.9 per 1000 screens). The higher CDR and lower ICR with supplemental screening were associated with higher recall and biopsy rates particularly with supplemental MRI (9.5%-15.9%, up to 69/1000 screens). Cancers detected with supplemental imaging modalities were generally smaller and earlier stage. Mammography with supplemental MRI or ultrasound increases detection of cancers (versus mammography only) in some sub-groups but also increases recall and biopsy rates and may have a relatively modest effect in reducing ICR.


Assuntos
Neoplasias da Mama , Mamografia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/epidemiologia , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Masculino , Mamografia/métodos , Programas de Rastreamento/métodos , Ultrassonografia
10.
JMIR Public Health Surveill ; 8(12): e37669, 2022 12 05.
Artigo em Inglês | MEDLINE | ID: mdl-36227157

RESUMO

BACKGROUND: In late 2020, the European Centre for Disease Prevention and Control and Epiconcept started implementing a surveillance system for severe acute respiratory infections (SARI) across Europe. OBJECTIVE: We sought to describe the process of digitizing and upgrading SARI surveillance in Malta, an island country with a centralized health system, during the COVID-19 pandemic from February to November 2021. We described the characteristics of people included in the surveillance system and compared different SARI case definitions, including their advantages and disadvantages. This study also discusses the process, output, and future for SARI and other public health surveillance opportunities. METHODS: Malta has one main public hospital where, on admission, patient data are entered into electronic records as free text. Symptoms and comorbidities are manually extracted from these records, whereas other data are collected from registers. Collected data are formatted to produce weekly and monthly reports to inform public health actions. From October 2020 to February 2021, we established an analogue incidence-based system for SARI surveillance. From February 2021 onward, we mapped key stakeholders and digitized most surveillance processes. RESULTS: By November 30, 2021, 903 SARI cases were reported, with 380 (42.1%) positive for SARS-CoV-2. Of all SARI hospitalizations, 69 (7.6%) were admitted to the intensive care unit, 769 (85.2%) were discharged, 27 (3%) are still being treated, and 107 (11.8%) died. Among the 107 patients who died, 96 (89.7%) had more than one underlying condition, the most common of which were hypertension (n=57, 53.3%) and chronic heart disease (n=49, 45.8%). CONCLUSIONS: The implementation of enhanced SARI surveillance in Malta was completed by the end of May 2021, allowing the monitoring of SARI incidence and patient characteristics. A future shift to register-based surveillance should improve SARI detection through automated processes.


Assuntos
COVID-19 , Influenza Humana , Humanos , Pandemias , SARS-CoV-2 , Influenza Humana/epidemiologia , COVID-19/epidemiologia , Malta/epidemiologia
11.
BMJ Open ; 11(5): e046685, 2021 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-33972342

RESUMO

OBJECTIVES: To assess an intervention for surgical antibiotic prophylaxis (SAP) improvement within surgical teams focused on addressing barriers and fostering enablers and ownership of guideline compliance. DESIGN: The Queensland Surgical Antibiotic Prophylaxis (QSAP) study was a multicentre, mixed methods study designed to address barriers and enablers to SAP compliance and facilitate engagement in self-directed audit/feedback and assess the efficacy of the intervention in improving compliance with SAP guidelines. The implementation was assessed using a 24-month interrupted time series design coupled with a qualitative evaluation. SETTING: The study was undertaken at three hospitals (one regional, two metropolitan) in Australia. PARTICIPANTS: SAP-prescribing decisions for 1757 patients undergoing general surgical procedures from three health services were included. Six bimonthly time points, pre-implementation and post implementation of the intervention, were measured. Qualitative interviews were performed with 29 clinical team members. SAP improvements varied across site and time periods. INTERVENTION: QSAP embedded ownership of quality improvement in SAP within surgical teams and used known social influences to address barriers to and enablers of optimal SAP prescribing. RESULTS: The site that reported senior surgeon engagement showed steady and consistent improvement in prescribing over 24 months (prestudy and poststudy). Multiple factors, including resource issues, influenced engagement and sites/time points where these were present had no improvement in guideline compliance. CONCLUSIONS: The barriers-enablers-ownership model shows promise in its ability to facilitate prescribing improvements and could be expanded into other areas of antimicrobial stewardship. Senior ownership was a predictor of success (or failure) of the intervention across sites and time periods. The key role of senior leaders in change leadership indicates the critical need to engage other specialties in the stewardship agenda. The influence of contextual factors in limiting engagement clearly identifies issues of resource distributions/inequalities within health systems as limiting antimicrobial optimisation potential.


Assuntos
Antibacterianos , Propriedade , Antibacterianos/uso terapêutico , Austrália , Fidelidade a Diretrizes , Hospitais , Humanos , Queensland
12.
BMC Genomics ; 11: 215, 2010 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-20353591

RESUMO

BACKGROUND: The mountain pine beetle (Dendroctonus ponderosae) is a significant coniferous forest pest in western North America. It relies on aggregation pheromones to colonize hosts. Its three major pheromone components, trans-verbenol, exo-brevicomin, and frontalin, are thought to arise via different metabolic pathways, but the enzymes involved have not been identified or characterized. We produced ESTs from male and female midguts and associated fat bodies and used custom oligonucleotide microarrays to study gene expression patterns and thereby made preliminary identification of pheromone-biosynthetic genes. RESULTS: Clones from two un-normalized cDNA libraries were directionally sequenced from the 5' end to yield 11,775 ESTs following sequence cleansing. The average read length was 550 nt. The ESTs clustered into 1,201 contigs and 2,833 singlets (4,034 tentative unique genes). The ESTs are broadly distributed among GO functional groups, suggesting they reflect a broad spectrum of the transcriptome. Among the most represented genes are representatives of sugar-digesting enzymes and members of an apparently Scolytid-specific gene family of unknown function. Custom NimbleGen 4-plex arrays representing the 4,034 tentative unique genes were queried with RNA from eleven different biological states representing larvae, pupae, and midguts and associated fat bodies of unfed or fed adults. Quantitative (Real-Time) RT-PCR (qRT-PCR) experiments confirmed that the microarray data accurately reflect expression levels in the different samples. Candidate genes encoding enzymes involved in terminal steps of biosynthetic pathways for exo-brevicomin and frontalin were tentatively identified. CONCLUSIONS: These EST and microarray data are the first publicly-available functional genomics resources for this devastating forestry pest.


Assuntos
Besouros/genética , Sequência de Aminoácidos , Animais , Besouros/química , Besouros/crescimento & desenvolvimento , Besouros/metabolismo , Etiquetas de Sequências Expressas , Corpo Adiposo/metabolismo , Feminino , Trato Gastrointestinal/metabolismo , Genoma de Inseto , Genômica , Proteínas de Insetos/química , Proteínas de Insetos/genética , Proteínas de Insetos/metabolismo , Masculino , Dados de Sequência Molecular , Família Multigênica , Feromônios/biossíntese , Alinhamento de Sequência
13.
Reprod Biomed Online ; 21(4): 537-51, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20729146

RESUMO

Mendelian disorders are individually rare but collectively common, forming a 'long tail' of genetic disease. A single highly accurate assay for this long tail would allow the scaling up of the Jewish community's successful campaign of population screening for Tay-Sachs disease to the general population, thereby improving millions of lives, greatly benefiting minority health and saving billions of dollars. This need has been addressed by designing a universal carrier test: a non-invasive, saliva-based assay for more than 100 Mendelian diseases across all major population groups. The test has been exhaustively validated with a median of 147 positive and 525 negative samples per variant, demonstrating a multiplex assay whose performance compares favourably with the previous standard of care, namely blood-based single-gene carrier tests. Because the test represents a dramatic reduction in the cost and complexity of large-scale population screening, an end to many preventable genetic diseases is now in sight. Moreover, given that the assay is inexpensive and requires only a saliva sample, it is now increasingly feasible to make carrier testing a routine part of preconception care.


Assuntos
Triagem de Portadores Genéticos/métodos , Doenças Genéticas Inatas/diagnóstico , Saliva/química , Sondas de DNA , Etnicidade , Aconselhamento Genético , Doenças Genéticas Inatas/etnologia , Testes Genéticos , Humanos , Mutação
14.
Ecol Food Nutr ; 49(6): 467-84, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-21888574

RESUMO

Maternal placentophagy, the consumption of the placenta or "afterbirth" by the mother following parturition, is an ubiquitous behavior among eutherian mammals, including non-human primates. Here we report on a cross-cultural survey of 179 human societies regarding the consumption, treatment, and disposal of human placenta, in addition to accompanying cultural beliefs and perceptions about the organ. The conspicuous absence of cultural traditions associated with maternal placentophagy in the cross-cultural ethnographic record raises interesting questions relative to its ubiquitous presence among nearly all other mammals, and the reasons for its absence (or extreme rarity) among prehistoric/historic and contemporary human cultures.


Assuntos
Antropologia Cultural , Cultura , Parto/etnologia , Placenta , Animais , Comparação Transcultural , Feminino , Humanos , Mamíferos , Gravidez
15.
Psychosom Med ; 71(1): 23-9, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19124615

RESUMO

OBJECTIVES: Mental stress can significantly affect ventricular repolarization, which could potentially trigger arrhythmias. We compared the effect of mental stress on repolarization indexed by the amplitude and area of the T wave in patients with coronary artery disease (CAD) and healthy subjects. METHODS: Fourteen healthy controls (11 M, mean age 42 years) and 14 patients with stable CAD (12 M, mean age 64) underwent a mental stress protocol consisting of mental arithmetic followed by a speech (5 minutes each), which was performed on two occasions following either nitroglycerine (NTG) or placebo. Multiple 12-lead electrocardiograms were acquired and repolarization was analyzed using automatically measured T wave amplitude (T(amp)) and area (T(area)). RESULTS: When preceded by placebo the overall effect of mental stress, whether induced by arithmetic or speech, was significantly different in CAD patients compared with controls, with a decrease in T(amp) and T(area) in controls and an increase in patients; e.g., change in T(amp) during arithmetic -20 +/- 3 microV in controls versus 4 +/- 2 microV in patients, p < .001, and during speech -9 +/- 3 microV in controls versus 7 +/- 1 microV in patients, p < .001. Following NTG, the effect of stress on repolarization was similar in the 2 groups, with a reversed effect, i.e., decrease instead of increase in T(amp) and T(area) in CAD patients. CONCLUSIONS: The effect of mental stress on ventricular repolarization is significantly different in CAD patients compared with healthy controls. These differences are considerably reduced by NTG.


Assuntos
Doença da Artéria Coronariana/fisiopatologia , Eletrocardiografia/efeitos dos fármacos , Ventrículos do Coração/efeitos dos fármacos , Nitroglicerina/farmacologia , Estresse Psicológico/fisiopatologia , Vasodilatadores/farmacologia , Adulto , Idoso , Doença da Artéria Coronariana/complicações , Feminino , Frequência Cardíaca/efeitos dos fármacos , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Matemática , Potenciais da Membrana/efeitos dos fármacos , Potenciais da Membrana/fisiologia , Pessoa de Meia-Idade , Projetos Piloto , Estudos de Amostragem , Fala , Estresse Psicológico/complicações
16.
Pain Med ; 10(2): 310-8, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19284486

RESUMO

OBJECTIVE: This study evaluated the relationship between psychological distress and disability associated with neck pain, analyzed the Neck Disability Index (NDI) for disability factors, and assessed the impact of psychological distress on those domains of disability. DESIGN: Prospective cross-sectional analytic survey. SETTING: Outpatient physical therapy clinic. PATIENTS: Sixty-one consecutive adult subjects with dominant neck pain participated. OUTCOME MEASURES: Each subject completed the NDI, psychometric measures for the Distress Risk Assessment Method, and a numeric pain rating scale. RESULTS: Measures of depression, somatization, and pain intensity explained 60% of the variance of disability due to neck pain. Factor analysis revealed two disability factors in the NDI dealing with physical activity/participation limitations and nonphysical activity-related impairments in bodily function. Psychological distress and pain intensity explained 25.6% of the variance of the factor dealing with activity/participation limitations, and 53.5% of the variance for the factor associated with impairments in bodily functions. CONCLUSION: Nondistressed adults reported significantly less disability due to neck pain than psychologically distressed subjects. The NDI was found to contain two factors that pertain to three domains of the disability. Five items relating to impairments in bodily function strongly correlated with depression and somatization. Presence of psychological distress has a confounding effect on NDI scores. An outcome measure containing items related only to activity limitations and participation restrictions might give a truer picture of disability associated with neck pain for patients with psychological distress.


Assuntos
Avaliação da Deficiência , Cervicalgia/psicologia , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Índice de Gravidade de Doença , Transtornos Somatoformes/epidemiologia , Transtornos Somatoformes/etiologia
17.
J Clin Transl Sci ; 3(1): 12-17, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31402986

RESUMO

Beyond medical schools' historical focus on pillar missions including clinical care, education, and research, several medical schools now include community engagement (CE) as a mission. However, most academic health systems (AHSs) lack the tools to provide metrics, evaluation, and standardization for quantifying progress and contributions of the CE mission. Several nationwide initiatives, such as that driven by the Institute of Medicine recommending advances in CE metrics at institutions receiving Clinical and Translational Science Awards, have encouraged the research and development of systematic metrics for CE, but more progress is needed. The CE components practical model provides a foundation for analyzing and evaluating different types of CE activities at AHSs through five components: research, education, community outreach and community service, policy and advocacy, and clinical care. At the Medical College of Wisconsin (MCW), an annual survey administered to faculty and staff assessed the types and number of CE activities from the prior year. Survey results were combined to create a CE report for departments across the institution and inform MCW leadership. Insights gathered from the survey have contributed to next steps in CE tracking and evaluation, including the development of a CE dashboard to track CE activities in real time. The dashboard provides resources for how individuals can advance the CE mission through their work and guide CE at the institutional level.

18.
J Midwifery Womens Health ; 64(4): 443-450, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30887687

RESUMO

INTRODUCTION: Clinical studies conducted in the early to mid-twentieth century, and recent self-reports by some maternal placentophagy practitioners, suggest that human maternal placentophagy improves breast milk quality and quantity, although little research has evaluated this claim. Some placentophagy providers and advocates suggest that increased prolactin levels after placenta ingestion could account for the purported lactation benefits. The current study was conducted to evaluate these claims by comparing plasma prolactin levels of women consuming steamed, dehydrated, and encapsulated placenta with those of women consuming a placebo. Neonatal weight gain was also compared between the 2 groups. METHODS: A randomized, double-blind, placebo-controlled pilot trial was conducted in which postpartum women (N = 27) were given a supplement containing their dehydrated placenta (n = 12) or placebo (n = 15). Plasma prolactin concentrations were measured 4 times across late pregnancy and early postpartum, and neonatal weights were recorded 3 times over the first 3 weeks postpartum. RESULTS: The results showed no statistically significant (P < .05) differences in either plasma prolactin levels or neonatal weight gain between groups. DISCUSSION: Maternal consumption of steamed, dehydrated, and encapsulated placenta postpartum does not appear to affect maternal postpartum prolactin or neonatal weight in the first 3 weeks postpartum. Further research is needed to investigate the possible effects of variation in placenta preparation methods or daily intake on human lactation.


Assuntos
Peso ao Nascer , Placenta , Período Pós-Parto , Prolactina/sangue , Aumento de Peso , Adulto , Cápsulas , Método Duplo-Cego , Feminino , Humanos , Recém-Nascido , Gravidez , Adulto Jovem
19.
Women Birth ; 31(4): e258-e271, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29174273

RESUMO

BACKGROUND: Human maternal placentophagy is gaining popularity among a growing number of women who believe it provides maternal benefits, including prevention of postpartum blues/depression, improved maternal bonding, and reduced fatigue. METHODS: We conducted a randomized, double-blind, placebo-controlled pilot study (N=27) in which participants consumed either their processed, encapsulated placenta (n=12), or similarly prepared placebo (n=15). Maternal mood, bonding, and fatigue were assessed via validated scales across four time points during late pregnancy and early postpartum. Psychometric data were analyzed for changes between and within both groups over time. RESULTS: No significant main effects related to maternal mood, bonding, or fatigue were evident between placenta and placebo group participants. However, examination of individual time points suggested that some measures had specific time-related differences between placenta and placebo groups that may warrant future exploration. Though statistical significance should not be interpreted in these cases, we did find some evidence of a decrease in depressive symptoms within the placenta group but not the placebo group, and reduced fatigue in placenta group participants at the end of the study compared to the placebo group. CONCLUSIONS: No robust differences in postpartum maternal mood, bonding, or fatigue were detected between the placenta and placebo groups. This finding may be especially important for women considering maternal placentophagy as a 'natural' (i.e., non-pharmacological) means of preventing or treating blues/depression. Given the study limitations, these findings should be interpreted as preliminary. Small, time-related improvements in maternal mood and lower fatigue post-supplementation among placenta group participants may warrant further research.


Assuntos
Afeto , Depressão , Ingestão de Alimentos , Mães/psicologia , Apego ao Objeto , Placenta , Período Pós-Parto , Adulto , Depressão Pós-Parto/prevenção & controle , Método Duplo-Cego , Fadiga , Feminino , Humanos , Comportamento Materno , Projetos Piloto , Gravidez , Escalas de Graduação Psiquiátrica
20.
Women Birth ; 31(4): e245-e257, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29174274

RESUMO

BACKGROUND: Recent studies show that human placenta, processed and encapsulated for postpartum consumption, contains a host of trace minerals and hormones that could conceivably affect maternal physiology. Our objective was to investigate whether salivary hormone concentrations of women ingesting their own encapsulated placenta during the early postpartum differed from those of women consuming a placebo. METHODS: Randomly assigned participants (N=27) were given a supplement containing either their dehydrated and homogenized placenta (n=12), or placebo (n=15). Saliva samples were collected during late pregnancy and early postpartum. Samples of participants' processed placenta, and the encapsulated placebo, were also collected. Hormone analyses were conducted on all samples utilizing liquid chromatography-tandem mass spectrometry. RESULTS: There were no significant differences in salivary hormone concentrations between the placenta and placebo groups post-supplementation that did not exist pre-supplementation. There were, however, significant dose-response relationships between the concentration of all 15 detected hormones in the placenta capsules and corresponding salivary hormone measures in placenta group participants not seen in the placebo group. The higher salivary concentrations of these hormones in the placenta group reflects the higher concentrations of these hormones in the placenta supplements, compared to the placebo. CONCLUSIONS: Some hormones in encapsulated placenta lead to small but significant differences in hormonal profiles of women taking placenta capsules compared to those taking a placebo, although these dose-response changes were not sufficient to result in significant hormonal differences between groups. Whether modest hormonal changes due to placenta supplementation are associated with therapeutic postpartum effects, however, awaits further investigation.


Assuntos
Ingestão de Alimentos , Hormônios/análise , Organoterapia , Placenta , Período Pós-Parto , Saliva/química , Adulto , Terapias Complementares , Feminino , Humanos , Organoterapia/efeitos adversos , Organoterapia/métodos , Organoterapia/psicologia , Projetos Piloto , Cuidado Pós-Natal , Gravidez , Adulto Jovem
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