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1.
bioRxiv ; 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38915588

RESUMO

ECHS1 Deficiency (ECHS1D) is a rare and devastating pediatric disease that currently has no defined treatments. This disorder results from missense loss-of-function mutations in the ECHS1 gene that result in severe developmental delays, encephalopathy, hypotonia, and early death. ECHS1 enzymatic activity is necessary for the beta-oxidation of fatty acids and the oxidation of branched-chain amino acids within the inner mitochondrial matrix. The pathogenesis of disease remains unknown, however it is hypothesized that disease is driven by an accumulation of toxic metabolites from impaired valine oxidation. To expand our knowledge on disease mechanisms, a novel mouse model of ECHS1D was generated that possesses a disease-associated knock-in (KI) allele and a knock-out (KO) allele. To investigate the behavioral phenotype, a battery of testing was performed at multiple time points, which included assessments of learning, motor function, endurance, sensory responses, and anxiety. Neurological abnormalities were assessed using wireless telemetry EEG recordings, pentylenetetrazol (PTZ) seizure induction, and immunohistochemistry. Metabolic perturbations were measured within the liver, serum, and brain using mass spectrometry and magnetic resonance spectroscopy. To test disease mechanisms, mice were subjected to disease pathway stressors and then survival, body weight gain, and epilepsy were assessed. Mice containing KI/KI or KI/KO alleles were viable with normal development and survival, and the presence of KI and KO alleles resulted in a significant reduction in ECHS1 protein. ECHS1D mice displayed reduced exercise capacity and pain sensation. EEG analysis revealed increased slow wave power that was associated with perturbations in sleep. ECHS1D mice had significantly increased epileptiform EEG discharges, and were sensitive to seizure induction, which resulted in death of 60% of ECHS1D mice. Under basal conditions, brain structure was grossly normal, although histological analysis revealed increased microglial activation in aged ECHS1D mice. Increased dietary valine only affected ECHS1D mice, which significantly exacerbated seizure susceptibility and resulted in death. Lastly, acute inflammatory challenge drove regression and early lethality in ECHS1D mice. In conclusion, we developed a novel model of ECHS1D that may be used to further knowledge on disease mechanisms and to develop therapeutics. Our data suggests altered metabolic signaling and inflammation may contribute to epilepsy in ECHS1D, and these alterations may be attributed to impaired valine metabolism.

2.
Am J Perinatol ; 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38810899

RESUMO

This study aimed to investigate and present a review of the literature on long-term neurodevelopmental outcomes in children with gastroschisis. Gastroschisis is the most common abdominal wall defect. Children with gastroschisis are at high risk for premature birth, intestinal failure, sepsis, and repeated anesthesia exposure, which collectively increase the risk for adverse long-term neurodevelopmental outcomes. The existing literature on neurodevelopmental outcomes is limited in number, quality, and generalizability, creating a gap in clinical knowledge and care. Five internet databases were searched by a professional research librarian: Ovid MEDLINE, Scopus, Web of Science, PsycINFO, and Cochrane Library. Included articles were (1) published in English, (2) included postneonatal hospital discharge neurodevelopmental outcomes of children with gastroschisis, and (3) included patients under the age of 18 years. No date parameters were applied. The paucity of literature on long-term neurodevelopmental outcomes in gastroschisis children has left large gaps in the body of knowledge on post-hospital care of such children. In this review, 37 articles were found evaluating neurodevelopmental outcomes in gastroschisis and, while conclusions were contradictory, the literature broadly indicated the potential for neurodevelopmental deficits in the gastroschisis pediatric population. A significant limitation of this review was the heterogeneous samples included in available literature, which confounded the ability to determine cognitive risk of gastroschisis independent of other abdominal wall defects. Findings of this review demonstrate potential risk for neurodevelopmental deficits in the pediatric gastroschisis population exist, yet additional research is needed to definitively predict the significance, type, onset, and trajectory of neurodevelopmental impairment in this population. The significant gaps in long-term outcomes data have elucidated the need for prospective, longitudinal investigation of various cognitive domains in homogenous gastroschisis populations to properly evaluate prevalence of neurodevelopmental deficits and guide recommendations for long-term clinical care. KEY POINTS: · Limited literature exists regarding long-term neurodevelopmental outcomes in gastroschisis.. · There is some evidence to suggest worse cognitive behavioral outcomes in gastroschisis over time.. · Developmental surveillance, screening, and evaluation may be beneficial for gastroschisis patients..

3.
Personal Ment Health ; 18(2): 93-106, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38504144

RESUMO

Personality disorders are a highly prevalent mental health condition. Historically, clinician attitudes have been negative, and only a small number have specialised training. This study evaluated clinician attitudes and confidence in working with people with personality disorder following the combination of training and implementation of a stepped care whole-of-service approach. A total of 102 multidisciplinary mental health clinicians were trained to implement the stepped care approach, and completed surveys prior to implementation and at 12 months follow up. Clinicians delivered manualised structured psychological therapy as part of the model. Measures assessed changes in attitudes and confidence, and impact of the service changes and therapy approach. Qualitative responses elucidated core themes. Evaluation at 12 months post training and service redesign showed improvements in clinician skills, confidence, theoretical knowledge and attitudes. Qualitative thematic analysis found core themes of improved understanding, clinical skills and improvements in the accessibility and timeliness of treatment. Implementing a whole-of-service model featuring stepped care therapies enhanced clinician attitudes, confidence, skills and knowledge in working with people with personality disorders. Clinicians identified that the whole-of-service model also improved accessibility to treatment, and quality of clinical care to the consumer and their carers.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica , Transtornos da Personalidade , Humanos , Transtornos da Personalidade/terapia , Feminino , Masculino , Adulto , Serviços de Saúde Mental , Psicoterapia/educação , Pessoa de Meia-Idade , Conhecimentos, Atitudes e Prática em Saúde
4.
N Engl J Med ; 390(12): 1092-1104, 2024 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-38507752

RESUMO

BACKGROUND: Giant axonal neuropathy is a rare, autosomal recessive, pediatric, polysymptomatic, neurodegenerative disorder caused by biallelic loss-of-function variants in GAN, the gene encoding gigaxonin. METHODS: We conducted an intrathecal dose-escalation study of scAAV9/JeT-GAN (a self-complementary adeno-associated virus-based gene therapy containing the GAN transgene) in children with giant axonal neuropathy. Safety was the primary end point. The key secondary clinical end point was at least a 95% posterior probability of slowing the rate of change (i.e., slope) in the 32-item Motor Function Measure total percent score at 1 year after treatment, as compared with the pretreatment slope. RESULTS: One of four intrathecal doses of scAAV9/JeT-GAN was administered to 14 participants - 3.5×1013 total vector genomes (vg) (in 2 participants), 1.2×1014 vg (in 4), 1.8×1014 vg (in 5), and 3.5×1014 vg (in 3). During a median observation period of 68.7 months (range, 8.6 to 90.5), of 48 serious adverse events that had occurred, 1 (fever) was possibly related to treatment; 129 of 682 adverse events were possibly related to treatment. The mean pretreatment slope in the total cohort was -7.17 percentage points per year (95% credible interval, -8.36 to -5.97). At 1 year after treatment, posterior mean changes in slope were -0.54 percentage points (95% credible interval, -7.48 to 6.28) with the 3.5×1013-vg dose, 3.23 percentage points (95% credible interval, -1.27 to 7.65) with the 1.2×1014-vg dose, 5.32 percentage points (95% credible interval, 1.07 to 9.57) with the 1.8×1014-vg dose, and 3.43 percentage points (95% credible interval, -1.89 to 8.82) with the 3.5×1014-vg dose. The corresponding posterior probabilities for slowing the slope were 44% (95% credible interval, 43 to 44); 92% (95% credible interval, 92 to 93); 99% (95% credible interval, 99 to 99), which was above the efficacy threshold; and 90% (95% credible interval, 89 to 90). Between 6 and 24 months after gene transfer, sensory-nerve action potential amplitudes increased, stopped declining, or became recordable after being absent in 6 participants but remained absent in 8. CONCLUSIONS: Intrathecal gene transfer with scAAV9/JeT-GAN for giant axonal neuropathy was associated with adverse events and resulted in a possible benefit in motor function scores and other measures at some vector doses over a year. Further studies are warranted to determine the safety and efficacy of intrathecal AAV-mediated gene therapy in this disorder. (Funded by the National Institute of Neurological Disorders and Stroke and others; ClinicalTrials.gov number, NCT02362438.).


Assuntos
Técnicas de Transferência de Genes , Terapia Genética , Neuropatia Axonal Gigante , Criança , Humanos , Proteínas do Citoesqueleto/genética , Terapia Genética/efeitos adversos , Terapia Genética/métodos , Neuropatia Axonal Gigante/genética , Neuropatia Axonal Gigante/terapia , Transgenes , Injeções Espinhais
5.
HERD ; 17(1): 112-126, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37904529

RESUMO

OBJECTIVE: This study examines the impact of ambulatory waiting room characteristics on patients' emotional states and investigates whether these states are universally experienced or influenced by social and cultural factors among women aged 18-35 from the three largest demographic groups in the United States: Black, Hispanic/Latina, and White. BACKGROUND: Patients typically spend more time waiting for routine medical appointments than receiving care, and evidence suggests that waiting can reinforces power dynamics that benefit privileged groups, leading to different experiences for minority women seeking preventative care. Still, literature addressing the impact of waiting areas is largely limited to universal measures, and little is known about how different ethnic/race groups respond to waiting spaces. METHODS: This inquiry used a questionnaire assessing 15 waiting room characteristics and testing four variables (furniture arrangement, room-scale, color saturation, and quantity of positive distractions) in a 2 × 3 quasiexperiment using a fractional randomized block design with 24 waiting room images. FINDINGS: Responses from 1,114 participants revealed mutual preferences for sociopetal seating, positive distractions, neutral colors, and welcoming and calming environments. Yet, Black participants indicated significantly greater importance in seeing ethnically/racially similar patients and healthcare providers and strategies that promote transparency, including image-based provider directories and views into the clinic. CONCLUSION: By investigating the impact of the waiting room environment on patient affect and comparing perceptions across three demographic groups of women, this study offers insights into potential strategies for improving access to preventative care services by creating more welcoming ambulatory care waiting environments.


Assuntos
Afeto , Comparação Transcultural , Salas de Espera , Feminino , Humanos , Instituições de Assistência Ambulatorial , Grupos Minoritários , Estados Unidos , Adolescente , Adulto Jovem , Adulto
6.
Australas Psychiatry ; 32(2): 125-134, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38103036

RESUMO

OBJECTIVE: There are few studies on the efficacy and acceptability of psychotherapy conducted via telehealth technology for people with personality disorder. This study aims to examine clinician perspectives on virtual psychotherapy. METHOD: Twenty multidisciplinary mental health clinicians (85% female, average age 42 years) with at least 2 years of experience in telehealth psychotherapy contributed quantitative and qualitative ratings of acceptability and efficacy of this modality. RESULTS: Likert scale ratings (1 = not, 5 = very) demonstrated high client acceptability (mean = 4.0), effectiveness (4.0) and high clinician acceptability (4.2) and sustainability (4.2). Three recommendations emerged from qualitative analysis: prioritising frame establishment, ensuring client safety online and maximising alliance-enhancing strategies. CONCLUSIONS: This study, which collected quantitative and qualitative ratings of virtual psychotherapy, found that telehealth psychotherapy can be effective and acceptable for people with personality disorder. Strategies associated with success included strong governance, secure technology and careful attending to relationship management.


Assuntos
Psicoterapia , Telemedicina , Humanos , Feminino , Adulto , Masculino , Transtornos da Personalidade/terapia , Saúde Mental
7.
Artigo em Inglês | MEDLINE | ID: mdl-37917479

RESUMO

OBJECTIVE: This research investigates how watching videos of police violence and experiences with police contributes to health disparities in well-being that disproportionately negatively affect Black Americans. METHOD: A large-scale survey of Americans (n = 1,240; nBlack American = 286, nWhite American = 954) examined the impact of negative experiences with police and watching violent policing videos as distal (i.e., external) stressors that contribute to symptoms of trauma. The proximal (i.e., internal) stressor of worrying about being stereotyped as criminal by police was also examined. RESULTS: Those who identified as Black were more likely to report negative experiences with police, exposure to violent policing videos, and greater worry about being stereotyped as criminal by police than those who identified as White. The three stressors were, in turn, associated with experiencing trauma symptoms. CONCLUSIONS: Exposure to violent policing videos is disproportionately associated with well-being for Black Americans, even when accounting for direct experiences with police. These findings demonstrate the importance of considering vicarious trauma in therapeutic settings and have implications for dissemination of these videos through media channels. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

9.
Knee Surg Sports Traumatol Arthrosc ; 31(12): 5463-5476, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37804345

RESUMO

PURPOSE: Research regarding revision anterior cruciate ligament reconstruction (RACLR) with quadriceps tendon (QT) autografts is lacking. The purpose of this study was to perform a systematic review and meta-analysis of RACLR with QT and compare its patient outcomes to RACLR with hamstring tendon (HT) and bone-patellar tendon-bone (BTB) autografts. METHODS: Adhering to PRISMA guidelines, a search for studies using QT in RACLR was performed within PubMed, Scopus, and CINAHL from database date of inception through December 26, 2022. Primary outcomes sought included: failure rate, Lysholm scores, International Knee Documentation Committee (IKDC) scores, IKDC grades, arthrometric knee side-to-side differences (STSD), pivot shift grade, donor site morbidity, return to sport, visual analog scale (VAS) pain scores. RESULTS: Nine studies were included consisting of 606 RACLR: 349 QT, 169 HT, and 88 BTB. Overall failure rates were 7.6% QT, 13.3% HT, and 8.7% BTB. Mean weighted Lysholm scores were 85.8 ± 3.8 QT, 82.5 ± 3.8 HT and 86.6 ± 4.5 BTB. IKDC average scores were 82.3 ± 1.6 QT, 80.1 ± 1.7 HT, and 81.7 ± 5.5BTB. Combined rates of IKDC A/B grades were 88.4% and 80.0% for QT and HT, respectively. VAS average scores were 0.9 ± 1.1 QT, 1.4 ± 0.2 HT, and 0.7 ± 0.8 for BTB. Side-to-side difference was reported for QT and HT with average values of 1.7 ± 0.6 mm and 2.1 ± 0.5 mm, respectively. Grade 0 or 1 pivot shifts were reported in 96.2% of QT patients and 91.3% of HT. Donor site morbidity, only reported for QT and HT, was 14.6 ± 9.7% and 23.6 ± 14.1%, respectively. QT resulted in a mean Tegner score of 5.9 ± 1.5 versus HT 5.7 ± 1.5. Rate of return to pivoting sports was 38.0% QT, 48.6% HT, and 76.9% BTB. Across all outcomes, there was no significant difference when comparing QT to HT, QT to BTB, and QT compared to HT and BTB combined. CONCLUSIONS: RACLR with QT yields satisfactory patient reported outcomes, satisfactory improvement in knee laxity, expected return to sport rates, and has an overall 7.6% failure rate. Outcomes are comparative to those of HT and BTB making it an acceptable graft choice for RACLR. Surgeons should consider using QT autograft for RACLR, especially when other autografts are unavailable. LEVEL OF EVIDENCE: IV.


Assuntos
Lesões do Ligamento Cruzado Anterior , Tendões dos Músculos Isquiotibiais , Ligamento Patelar , Humanos , Tendões dos Músculos Isquiotibiais/transplante , Autoenxertos/cirurgia , Ligamento Patelar/cirurgia , Lesões do Ligamento Cruzado Anterior/cirurgia , Tendões/transplante , Transplante Autólogo , Enxerto Osso-Tendão Patelar-Osso
10.
Physiol Behav ; 266: 114205, 2023 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-37100220

RESUMO

Individuals who report perceived stress often eat more unhealthy foods and more calories than those with lower stress levels, though individual differences and contexts are important. This study investigated how visual food cues on fast-food menus may increase calorie consumption intentions due to their potential motivational influences. A 2 (presence or absence of visual cues) x 4 (exemplar fast-food restaurant menu) fractionated experiment administered online (N = 325) indicated that when participants viewed menus with visual cues, they selected a greater number of calories to consume. Additionally, data showed an interaction effect of perceived stress and visual cues revealing that visual elements incentivized participants reporting higher stress to select more calories whereas visual cues did not have this effect for people reporting lower levels of perceived stress. Though important limitations exist, a key takeaway is that food cue exposure is another important factor to consider when predicting how stress may affect eating decisions.


Assuntos
Comportamento de Escolha , Sinais (Psicologia) , Humanos , Preferências Alimentares , Ingestão de Energia , Estresse Psicológico
11.
Artigo em Inglês | MEDLINE | ID: mdl-36447216

RESUMO

OBJECTIVE: We developed and piloted a novel art-based online skills program led by a peer mental health professional with lived experience of complex mental health, including Borderline Personality Disorder (BPD). Key challenges of living with BPD and emotion dysregulation were addressed through artmaking informed by a dialectical framework and skills, to evaluate acceptability and efficacy. METHOD: A structured, manualised 2-hour weekly arts-based skills program was piloted for people with BPD over 18 weeks. Evaluation included both quantitative and qualitative measures at commencement and completion. RESULTS: Thirty-eight participants enrolled in the program (89.5% identified she/her pronouns, average age 33.6 years), and 31 completed (82% retention). Multilevel modelling analysis of the primary outcome variable Difficulties in Emotion Regulation Scale (DERS) demonstrated a large improvement over time (effect size Cohen's d = 1.77). Qualitative thematic analysis found participants had improved capacity to regulate emotions and tolerate distress, improved connection with others, enhanced understanding of the self, and higher hope for living well. We found that artmaking facilitated processes and helped the expression of difficult emotions, symbolise challenging relationships, and facilitate greater self-understanding. Participants reported high levels of satisfaction, and 77.4% reported that the program had increased wellbeing. CONCLUSION: This novel artmaking program for emotion dysregulation and BPD was acceptable and potentially effective. Peer facilitation using arts-based skills is a modality of therapy for further investigation.

12.
Front Psychol ; 13: 923808, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36081718

RESUMO

This study examined whether the stability of highly relevant animate and inanimate information predicted encoding. Participants (N = 149 young adults) viewed audiovisual media and completed a change detection task of screenshots taken from the viewing session. The screenshots were either left as originally viewed or a factor was altered. The factors were all motivationally (relevant to biological imperatives) and story (relevant to the ongoing narrative) relevant. Half were part of an animal and half were part of other environmental information. This was crossed with whether the information was stable or fleeting in the scene (e.g., a person's clothing vs. their gestures). Changes to animals were more recognized than inanimate information. Changes to fleeting inanimate information were better recognized than changes to stable inanimate information. These findings indicate potential for relevant change in environmental threat and opportunity is adaptively significant and likely to increase attention and encoding across animate and inanimate categories of information.

13.
Genes (Basel) ; 13(9)2022 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-36140822

RESUMO

Epileptic encephalopathies may arise from single gene variants. In recent years, next-generation sequencing technologies have enabled an explosion of gene identification in monogenic epilepsies. One such example is the epileptic encephalopathy SLC13A5 deficiency disorder, which is caused by loss of function pathogenic variants to the gene SLC13A5 that results in deficiency of the sodium/citrate cotransporter. Patients typically experience seizure onset within the first week of life and have developmental delay and intellectual disability. Current antiseizure medications may reduce seizure frequency, yet more targeted treatments are needed to address the epileptic and non-epileptic features of SLC13A5 deficiency disorder. Gene therapy may offer hope to these patients and better clinical outcomes than current available treatments. Here, we discuss SLC13A5 genetics, natural history, available treatments, potential outcomes and assessments, and considerations for translational medical research for an AAV9-based gene replacement therapy.


Assuntos
Epilepsia , Simportadores , Citratos , Epilepsia/genética , Epilepsia/terapia , Terapia Genética , Humanos , Mutação , Convulsões/genética , Convulsões/terapia , Sódio , Espasmos Infantis , Simportadores/genética
14.
Front Public Health ; 10: 966374, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36033819

RESUMO

Coffee production workers are exposed to complex mixtures of gases, dust, and vapors, including the known respiratory toxins, diacetyl, and 2,3-pentanedione, which occur naturally during coffee roasting and are also present in flavorings used to flavor coffee. This study evaluated the associations of these two α-diketones with lung function measures in coffee production workers. Workers completed questionnaires, and their lung function was assessed by spirometry and impulse oscillometry (IOS). Personal exposures to diacetyl, 2,3-pentanedione, and their sum (SumDA+PD) were assigned to participants, and metrics of the highest 95th percentile (P95), cumulative, and average exposure were calculated. Linear and logistic regression models for continuous and binary/polytomous outcomes, respectively, were used to explore exposure-response relationships adjusting for age, body mass index, tenure, height, sex, smoking status, race, or allergic status. Decrements in percent predicted forced expiratory volume in 1 second (ppFEV1) and forced vital capacity (ppFVC) were associated with the highest-P95 exposures to 2,3-pentanedione and SumDA+PD. Among flavoring workers, larger decrements in ppFEV1 and ppFVC were associated with highest-P95 exposures to diacetyl, 2,3-pentanedione, and SumDA+PD. Abnormal FEV1, FVC, and restrictive spirometric patterns were associated with the highest-P95, cumulative, and average exposures for all α-diketone metrics; some of these associations were also present among flavoring and non-flavoring workers. The combined category of small and peripheral airways plus small and large airways abnormalities on IOS had elevated odds for highest-P95 exposure to α-diketones. These results may be affected by the small sample size, few cases of abnormal spirometry, and the healthy worker effect. Associations between lung function abnormalities and exposure to α-diketones suggest it may be prudent to consider exposure controls in both flavoring and non-flavoring settings.


Assuntos
Diacetil , Exposição Ocupacional , Aromatizantes , Humanos , Pulmão , Pentanonas
15.
Front Neurol ; 13: 805007, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35847198

RESUMO

Genetic epilepsies are a spectrum of disorders characterized by spontaneous and recurrent seizures that can arise from an array of inherited or de novo genetic variants and disrupt normal brain development or neuronal connectivity and function. Genetically determined epilepsies, many of which are due to monogenic pathogenic variants, can result in early mortality and may present in isolation or be accompanied by neurodevelopmental disability. Despite the availability of more than 20 antiseizure medications, many patients with epilepsy fail to achieve seizure control with current therapies. Patients with refractory epilepsy-particularly of childhood onset-experience increased risk for severe disability and premature death. Further, available medications inadequately address the comorbid developmental disability. The advent of next-generation gene sequencing has uncovered genetic etiologies and revolutionized diagnostic practices for many epilepsies. Advances in the field of gene therapy also present the opportunity to address the underlying mechanism of monogenic epilepsies, many of which have only recently been described due to advances in precision medicine and biology. To bring precision medicine and genetic therapies closer to clinical applications, experimental animal models are needed that replicate human disease and reflect the complexities of these disorders. Additionally, identifying and characterizing clinical phenotypes, natural disease course, and meaningful outcome measures from epileptic and neurodevelopmental perspectives are necessary to evaluate therapies in clinical studies. Here, we discuss the range of genetically determined epilepsies, the existing challenges to effective clinical management, and the potential role gene therapy may play in transforming treatment options available for these conditions.

16.
Int J Soc Psychiatry ; 68(5): 1100-1107, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35670446

RESUMO

OBJECTIVE: To understand the acceptability of (a) reducing sedentary-behaviour in people with psychosis using 'if-then' plans and (b) the proposed app content. DESIGN: Qualitative acceptability study. METHOD: Three structured focus-groups and an interview were conducted with eight participants who had experience of a psychotic episode. They discussed sedentary-behaviour, being more active, critical situations in which they may be tempted to be sedentary and solutions to these (the if-then plans), and a mock-up of the mobile application. The Theoretical Framework of Acceptability (TFA) was used to analyse qualitatively the transcripts. RESULTS: All TFA constructs were coded in each of the transcripts. The idea of reducing sedentary-behaviour was acceptable to people with psychosis, participants knew the importance of being more active, however it is not always their main priority. Likewise, the proposed content of the app was found to be acceptable, with participants already using some of the proposed solutions. CONCLUSION: This was the first study to use the TFA framework to assess the acceptability of an app that uses critical situations and solutions ('if-then plans') to help reduce sedentary behaviour for people with psychosis. In this sample (male, English speaking mainly white people), participants understood the benefits of being more active. However, reducing sedentary-behaviour is not the main priority of this population and being sedentary has benefits when their mental-health is bad.


Assuntos
Aplicativos Móveis , Transtornos Psicóticos , Inglaterra , Humanos , Masculino , Saúde Mental , Transtornos Psicóticos/terapia , Comportamento Sedentário
17.
Medicine (Baltimore) ; 101(25): e29357, 2022 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-35758366

RESUMO

RATIONALE: Cerebrovascular accident, or stroke, is a leading cause of serious long-term disability, and incidence is expected to continue rising in the coming years. Stroke-related disability can manifest as motor, sensory, or cognitive impairment, and although current therapies can improve these impairments, many stroke patients are still left with reduced abilities and struggle to maintain independence in their daily lives. Virtual reality (VR) has been proposed as a novel therapeutic tool to treat stroke-related disability, particularly in conjunction with traditional post-stroke therapies. PATIENT CONCERNS: Here, we report 1 case of a 75-year-old male with ongoing right upper extremity impairment. DIAGNOSIS: The patient was previously diagnosed with an ischemic stroke. INTERVENTIONS: Seven years post-stroke, during which he did not receive any therapies, and on the recommendation of his neurologist, the patient sought VR therapy as an innovative treatment strategy. His clinicians employed a combination of traditional exercise and VR therapy to improve his strength and mobility. OUTCOMES: The combination of traditional and VR therapy was able to provide meaningful improvement to his daily quality of life, even years after the stroke. CONCLUSIONS: These results suggest that combination therapy with VR is a viable tool for treating post-stroke impairment, even several years on from the cerebrovascular accident.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Terapia de Exposição à Realidade Virtual , Realidade Virtual , Idoso , Dano Encefálico Crônico , Humanos , Masculino , Qualidade de Vida , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Extremidade Superior , Terapia de Exposição à Realidade Virtual/métodos
18.
Front Psychol ; 13: 601523, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35432066

RESUMO

Effective human-robot teaming (HRT) increasingly requires humans to work with intelligent, autonomous machines. However, novel features of intelligent autonomous systems such as social agency and incomprehensibility may influence the human's trust in the machine. The human operator's mental model for machine functioning is critical for trust. People may consider an intelligent machine partner as either an advanced tool or as a human-like teammate. This article reports a study that explored the role of individual differences in the mental model in a simulated environment. Multiple dispositional factors that may influence the dominant mental model were assessed. These included the Robot Threat Assessment (RoTA), which measures the person's propensity to apply tool and teammate models in security contexts. Participants (N = 118) were paired with an intelligent robot tasked with making threat assessments in an urban setting. A transparency manipulation was used to influence the dominant mental model. For half of the participants, threat assessment was described as physics-based (e.g., weapons sensed by sensors); the remainder received transparency information that described psychological cues (e.g., facial expression). We expected that the physics-based transparency messages would guide the participant toward treating the robot as an advanced machine (advanced tool mental model activation), while psychological messaging would encourage perceptions of the robot as acting like a human partner (teammate mental model). We also manipulated situational danger cues present in the simulated environment. Participants rated their trust in the robot's decision as well as threat and anxiety, for each of 24 urban scenes. They also completed the RoTA and additional individual-difference measures. Findings showed that trust assessments reflected the degree of congruence between the robot's decision and situational danger cues, consistent with participants acting as Bayesian decision makers. Several scales, including the RoTA, were more predictive of trust when the robot was making psychology-based decisions, implying that trust reflected individual differences in the mental model of the robot as a teammate. These findings suggest scope for designing training that uncovers and mitigates the individual's biases toward intelligent machines.

20.
Appetite ; 173: 105992, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35306099

RESUMO

The effectiveness of menu calorie labeling in limiting the amount of calories selected has been called into question since it was mandated within the Affordable Care Act. This study examined how contexts that are known to influence motivational and information processing might limit the effectiveness of calorie labeling in order to shed some light on the mixed findings in this area. An online experiment was conducted in which calorie labels were paired or not paired with visual cues in different motivational contexts: greater and lesser variety and energy density choices available. Results contribute to the general conclusion that calorie labels are not particularly effective. Specifically, the only context in which a calorie label succeeded in reducing calories selected was a high variety mix of low and high energy density foods with visual food cues present; however, this type of context elicited the greatest number of calories selected on average, even more than when only highly energy density items were present. The findings from this study add to the body of knowledge about the effectiveness of calorie labeling by defining some boundary conditions on whether and when the presence of calorie labels are likely to reduce caloric intake. This knowledge is helpful in furthering food selection and choice research, but also may help health practitioners design effective intervention strategies.


Assuntos
Fast Foods , Patient Protection and Affordable Care Act , Ingestão de Energia , Rotulagem de Alimentos/métodos , Preferências Alimentares , Humanos , Hiperfagia , Restaurantes , Estados Unidos
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