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1.
Heliyon ; 10(3): e25025, 2024 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-38318030

RESUMO

Topaz (Al2F1·44(OH)0·56SiO4)/corundum (Al2O3) composites were prepared by a facile and novel reversible process from the sintering of synthetic topaz and AlF3 powders, with corundum formed in situ into the topaz matrix. The corundum formation reaction occurs in the temperature range 875-975 °C, from 40 min sintering time, obtaining the topaz- Al2F1·44(OH)0·56SiO4/corundum- Al2O3 composites. Although sintering temperature and time increment lead to higher corundum formation in the topaz matrix (78.4 wt % Al2O3 at 975 °C for 60 min), longer residence times give place to corundum percentage decrease due to topaz reconversion. The composites' microstructure is characterized by a rectangular bar with stacked pyramidal ends and polycrystals of hexagonal plates for topaz and corundum, respectively. For the topaz/corundum composites, the maximum density was 3.05 g/cm3 (17 % porosity) for specimens sintered at 925 °C for 20 min. The glow curves of the topaz/in situ corundum composite sintered at 975 °C and 0 min dwell time show thermoluminescent peaks between 180 and 250 °C, useful for dosimetric applications. The most helpful peak (at 221 °C) in the topaz/corundum composite's glow curves determined by computational deconvolution is sharp and exhibits the highest thermoluminescent response. Dose-response analysis of the composite (sintered at 975 °C for 0 min) with the best thermoluminescent response revealed two ranges of linear behavior, the first from 2 to 200 mGy, with an adjustment of 99.9 % and the second in the range 5-300 Gy (99.8 % fitting). The thermoluminescent response improvement of the topaz/corundum composites is attributed to the corundum formed in situ during sintering. Fading rate studies of the composite with the best sintering treatment revealed a signal decrease of 4 % after 15 days, which remained constant for up to 30 days, and 8 % after 60 days. The kinetic parameters, kinetics order (b), activation energy (E), and frequency factor (s) determined using the glow peak shape method showed second-order kinetics. The topaz/corundum composite with the best TL response (975 °C, 0 min) presents an effective atomic number (Zeff) of 11.74. The detection of lower doses (mGy) and the linear response at higher doses (Gy) of beta 90Sr, together with the other thermoluminescent properties, suggest that the topaz/corundum composites sintered at 975° for 0 min dwell time may find application in radiotherapy, geological dating, and environmental dosimetry.

2.
Int J Nurs Stud ; 128: 104174, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35183865

RESUMO

BACKGROUND: Randomized controlled trials (RCTs) are the gold standard for generating evidence to inform clinical oncology practice. Knowledge gained through qualitative research methodologies can be complementary to that gained through RCTs. How qualitative research has been combined with RCTs in oncology has not been previously characterized. OBJECTIVE: This scoping review was conducted to summarize how qualitative research associated with RCTs in the oncology setting has been conducted and examine the quality of reporting. ELIGIBILITY CRITERIA: Manuscripts reporting on qualitative research linked with RCTs in the cancer context that involved patients (both adult and pediatric) and/or informal caregiver (friends/family) were included. SOURCES OF EVIDENCE: Peer-reviewed manuscripts indexed in MEDLINE (OVID) and CINAHL, published in English between 2008 and January 2019. CHARTING METHODS: Formal scoping review methods were followed. A data extraction tool informed by the research questions as well as the COnsolidated criteria for REporting Qualitative research (COREQ) was utilized. Extraction was conducted independently by two authors, with disagreements resolved by a third. RESULTS: Fifty-four articles were included. Assessing information sharing, diet/exercise, and psychotherapeutic interventions were the most common focuses of the RCTs. The most common focus of the qualitative component was on gaining insight into the experience of receiving the intervention or participating in RCT procedures. How the intervention impacted the cancer experience was not a common focus of the qualitative components. Some reports provided insufficient information to understand how the qualitative components aligned with the RCT components. The results of the qualitative and RCT components were not integrated to draw meaningful conclusions about the efficacy of the intervention under study in most cases. Reports focusing on only qualitative methods had higher median (Mdn) reporting of COREQ items compared to reports that included both the qualitative and RCT components (Mdn = 18 vs. Mdn = 14, respectively; p <0.001). CONCLUSIONS: This review identified that qualitative research has been combined with RCTs in the cancer context in a number of ways, most commonly to understand the experience of receiving study interventions or participating in trial procedures. Exploring how interventions impact other aspects of the cancer experience is an approach that should be considered in future work. Formalized guidelines for the design and reporting of investigations that combine qualitative and RCT approaches in the cancer context are expected to be of value. TWEETABLE ABSTRACT: Combining qualitative research with randomized controlled trials in oncology: an impornt opportunity for discovery.


Assuntos
Cuidadores , Exercício Físico , Adulto , Criança , Humanos , Oncologia , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Curr Oncol ; 27(2): 90-99, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32489251

RESUMO

Background: Patient-reported outcomes (pros) are essential to capture the patient's perspective and to influence care. Although pros and pro measures are known to have many important benefits, they are not consistently being used and there is there no Canadian pros oversight. The Position Statement presented here is the first step toward supporting the implementation of pros in the Canadian health care setting. Methods: The Canadian pros National Steering Committee drafted position statements, which were submitted for stakeholder feedback before, during, and after the first National Canadian Patient Reported Outcomes (canpros) scientific conference, 14-15 November 2019 in Calgary, Alberta. In addition to the stakeholder feedback cycle, a patient advocate group submitted a section to capture the patient voice. Results: The canpros Position Statement is an outcome of the 2019 canpros scientific conference, with an oncology focus. The Position Statement is categorized into 6 sections covering 4 theme areas: Patient and Families, Health Policy, Clinical Implementation, and Research. The patient voice perfectly mirrors the recommendations that the experts reached by consensus and provides an overriding impetus for the use of pros in health care. Conclusions: Although our vision of pros transforming the health care system to be more patient-centred is still aspirational, the Position Statement presented here takes a first step toward providing recommendations in key areas to align Canadian efforts. The Position Statement is directed toward a health policy audience; future iterations will target other audiences, including researchers, clinicians, and patients. Our intent is that future versions will broaden the focus to include chronic diseases beyond cancer.


Assuntos
Atenção à Saúde/estatística & dados numéricos , Oncologia/estatística & dados numéricos , Neoplasias/terapia , Medidas de Resultados Relatados pelo Paciente , Assistência Centrada no Paciente/estatística & dados numéricos , Canadá , Atenção à Saúde/métodos , Atenção à Saúde/normas , Humanos , Oncologia/métodos , Oncologia/normas , Neoplasias/diagnóstico , Assistência Centrada no Paciente/métodos , Assistência Centrada no Paciente/normas , Qualidade de Vida
4.
Plant Signal Behav ; 15(1): 1687175, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31696764

RESUMO

Earlier, we demonstrated that transcript levels of METAL TOLERANCE PROTEIN2 (MTP2) and of HEAVY METAL ATPase2 (HMA2) increase strongly in roots of Arabidopsis upon prolonged zinc (Zn) deficiency and respond to shoot physiological Zn status, and not to the local Zn status in roots. This provided evidence for shoot-to-root communication in the acclimation of plants to Zn deficiency. Zn-deficient soils limit both the yield and quality of agricultural crops and can result in clinically relevant nutritional Zn deficiency in human populations. Implementing Zn deficiency during cultivation of the model plant Arabidopsis thaliana on agar-solidified media is difficult because trace element contaminations are present in almost all commercially available agars. Here, we demonstrate root morphological acclimations to Zn deficiency on agar-solidified medium following the effective removal of contaminants. These advancements allow reproducible phenotyping toward understanding fundamental plant responses to deficiencies of Zn and other essential trace elements.


Assuntos
Arabidopsis/metabolismo , Raízes de Plantas/metabolismo , Zinco/deficiência , Zinco/metabolismo , Proteínas de Arabidopsis/genética , Proteínas de Arabidopsis/metabolismo , Regulação da Expressão Gênica de Plantas
5.
Plant Signal Behav ; 15(1): 1687185, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31696770

RESUMO

Previously, we reported that the allelic de-etiolated by zinc (dez) and trichome birefringence (tbr) mutants exhibit photomorphogenic development in the dark, which is enhanced by high Zn. TRICHOME BIREFRINGENCE-LIKE proteins had been implicated in transferring acetyl groups to various hemicelluloses. Pectin O-acetylation levels were lower in dark-grown dez seedlings than in the wild type. We observed Zn-enhanced photomorphogenesis in the dark also in the reduced wall acetylation 2 (rwa2-3) mutant, which exhibits lowered O-acetylation levels of cell wall macromolecules including pectins and xyloglucans, supporting a role for cell wall macromolecule O-acetylation in the photomorphogenic phenotypes of rwa2-3 and dez. Application of very short oligogalacturonides (vsOGs) restored skotomorphogenesis in dark-grown dez and rwa2-3. Here we demonstrate that in dez, O-acetylation of non-pectin cell wall components, notably of xyloglucan, is enhanced. Our results highlight the complexity of cell wall homeostasis and indicate against an influence of xyloglucan O-acetylation on light-dependent seedling development.


Assuntos
Proteínas de Arabidopsis/metabolismo , Arabidopsis/metabolismo , Parede Celular/metabolismo , Acetilação/efeitos da radiação , Arabidopsis/genética , Arabidopsis/efeitos da radiação , Proteínas de Arabidopsis/genética , Parede Celular/efeitos da radiação , Regulação da Expressão Gênica de Plantas/genética , Regulação da Expressão Gênica de Plantas/efeitos da radiação , Glucanos/metabolismo , Luz , Xilanos/metabolismo
6.
J Dev Orig Health Dis ; 10(1): 115-122, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30223914

RESUMO

Indigenous women and children experience some of the most profound health disparities globally. These disparities are grounded in historical and contemporary trauma secondary to colonial atrocities perpetuated by settler society. The health disparities that exist for chronic diseases may have their origins in early-life exposures that Indigenous women and children face. Mechanistically, there is evidence that these adverse exposures epigenetically modify genes associated with cardiometabolic disease risk. Interventions designed to support a resilient pregnancy and first 1000 days of life should abrogate disparities in early-life socioeconomic status. Breastfeeding, prenatal care and early child education are key targets for governments and health care providers to start addressing current health disparities in cardiometabolic diseases among Indigenous youth. Programmes grounded in cultural safety and co-developed with communities have successfully reduced health disparities. More works of this kind are needed to reduce inequities in cardiometabolic diseases among Indigenous women and children worldwide.


Assuntos
Equidade em Saúde , Povos Indígenas , Efeitos Tardios da Exposição Pré-Natal , Doença Crônica/epidemiologia , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Serviços de Saúde Materna , Gravidez , Fatores Socioeconômicos
8.
Heart Lung Circ ; 26(3): 235-239, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27475261

RESUMO

BACKGROUND: The New Zealand Cardiac Implanted Device Registry (Device) has recently been developed under the auspices of the New Zealand Branch of the Cardiac Society of Australia and New Zealand. This study describes the initial Device registry cohort of patients receiving a new pacemaker, their indications for pacing and their perioperative complications. METHODS: The Device Registry was used to audit patients receiving a first pacemaker between 1st January 2014 and 1st June 2015. RESULTS: We examined 1611 patients undergoing first pacemaker implantation. Patients were predominantly male (59%), and had a median age of 70 years. The most common symptom for pacemaker implantation was syncope (39%), followed by dizziness (30%) and dyspnoea (12%). The most common aetiology for a pacemaker was a conduction tissue disorder (35%), followed by sinus node dysfunction (22%). Atrioventricular (AV) block was the most common ECG abnormality, present in 44%. Dual chamber pacemakers were most common (62%), followed by single chamber ventricular pacemakers (34%), and cardiac resynchronisation therapy - pacemakers (CRT-P) (2%). Complications within 24hours of the implant procedure were reported in 64 patients (3.9%), none of which were fatal. The most common complication was the need for reoperation to manipulate a lead, occurring in 23 patients (1.4%). CONCLUSION: This is the first description of data entered into the Device registry. Patients receiving a pacemaker were younger than in European registries, and there was a low use of CRT-P devices compared to international rates. Complications rates were low and compare favourably to available international data.


Assuntos
Terapia de Ressincronização Cardíaca , Eletrocardiografia , Marca-Passo Artificial , Complicações Pós-Operatórias , Sistema de Registros , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Nova Zelândia/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/fisiopatologia , Complicações Pós-Operatórias/terapia , Fatores de Tempo
10.
Psychol Med ; 46(7): 1485-96, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26875722

RESUMO

BACKGROUND: To determine the functional integrity of the neural systems involved in emotional responding/regulation and response control/inhibition in youth (age 10-18 years) with disruptive behavioral disorders (DBDs: conduct disorder and/or oppositional defiant disorder) as a function of callous-unemotional (CU) traits. METHOD: Twenty-eight healthy youths and 35 youths with DBD [high CU (HCU), n = 18; low CU (LCU), n = 17] performed the fMRI Affective Stroop task. Participants viewed positive, neutral, and negative images under varying levels of cognitive load. A 3-way ANOVA (group×emotion by task) was conducted on the BOLD response data. RESULTS: Youth with DBD-HCU showed significantly less activation of ventromedial prefrontal cortex (vmPFC) and amygdala in response to negative stimuli, compared to healthy youth and youth with DBD-LCU. vmPFC responsiveness was inversely related to CU symptoms in DBD. Youth with DBD-LCU showed decreased functional connectivity between amygdala and regions including inferior frontal gyrus in response to emotional stimuli. Youth with DBD (LCU and HCU) additionally showed decreased insula responsiveness to high load (incongruent trials) compared to healthy youth. Insula responsiveness was inversely related to ADHD symptoms in DBD. CONCLUSIONS: These data reveal two forms of pathophysiology in DBD. One associated with reduced amygdala and vmPFC responses to negative stimuli and related to increased CU traits. Another associated with reduced insula responses during high load task trials and related to ADHD symptoms. Appropriate treatment will need to be individualized according to the patient's specific pathophysiology.


Assuntos
Tonsila do Cerebelo/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Córtex Cerebral/fisiopatologia , Emoções/fisiologia , Inibição Psicológica , Adolescente , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/classificação , Criança , Transtorno da Conduta/fisiopatologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Córtex Pré-Frontal/fisiopatologia , Teste de Stroop
11.
Br Dent J ; 220(1): 9-10, 2016 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-26768457

RESUMO

Situational judgement tests (SJTs) are multiple-choice psychological assessments that claim to measure professional attributes such as empathy, integrity, team involvement and resilience. One of their attractions is the ability to rank large numbers of candidates. Last year SJTs formed a major component (50% of the assessment marks) of the selection process for dental foundation training (DFT). However, it is not clear what SJTs are actually assessing. There is also the concern that applicants who have developed ethical reasoning skills may be disadvantaged by such tests. The DFT selection process needs to explicitly recognise the importance of ethical reasoning.


Assuntos
Educação Continuada em Odontologia , Ética Odontológica , Julgamento , Critérios de Admissão Escolar , Educação Continuada em Odontologia/organização & administração , Educação Continuada em Odontologia/normas , Fundações/organização & administração , Fundações/normas , Humanos , Melhoria de Qualidade , Reprodutibilidade dos Testes , Inquéritos e Questionários/normas
12.
Eur Cell Mater ; 29: 124-39; discussion 139-40, 2015 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-25636786

RESUMO

Post-traumatic arthritis (PTA) is a rapidly progressive form of arthritis that develops due to joint injury, including articular fracture. Current treatments are limited to surgical restoration and stabilization of the joint; however, evidence suggests that PTA progression is mediated by the upregulation of pro-inflammatory cytokines, such as interleukin-1 (IL-1) or tumor necrosis factor-α (TNF-α). Although these cytokines provide potential therapeutic targets for PTA, intra-articular injections of anti-cytokine therapies have proven difficult due to rapid clearance from the joint space. In this study, we examined the ability of a cross-linked elastin-like polypeptide (xELP) drug depot to provide sustained intra-articular delivery of IL-1 and TNF-α inhibitors as a beneficial therapy. Mice sustained a closed intra-articular tibial plateau fracture; treatment groups received a single intra-articular injection of drug encapsulated in xELP. Arthritic changes were assessed 4 and 8 weeks after fracture. Inhibition of IL-1 significantly reduced the severity of cartilage degeneration and synovitis. Inhibition of TNF-α alone or with IL-1 led to deleterious effects in bone morphology, articular cartilage degeneration, and synovitis. These findings suggest that IL-1 plays a critical role in the pathogenesis of PTA following articular fracture, and sustained intra-articular cytokine inhibition may provide a therapeutic approach for reducing or preventing joint degeneration following trauma.


Assuntos
Artrite Experimental/tratamento farmacológico , Cartilagem Articular/efeitos dos fármacos , Preparações de Ação Retardada/farmacologia , Proteína Antagonista do Receptor de Interleucina 1/farmacologia , Peptídeos/farmacologia , Sequência de Aminoácidos , Animais , Artrite Experimental/etiologia , Artrite Experimental/metabolismo , Proteína de Matriz Oligomérica de Cartilagem/metabolismo , Cartilagem Articular/diagnóstico por imagem , Cartilagem Articular/lesões , Preparações de Ação Retardada/administração & dosagem , Preparações de Ação Retardada/química , Sistemas de Liberação de Medicamentos/métodos , Elastina/química , Injeções Intra-Articulares , Proteína Antagonista do Receptor de Interleucina 1/administração & dosagem , Proteína Antagonista do Receptor de Interleucina 1/química , Interleucina-1/antagonistas & inibidores , Interleucina-1/metabolismo , Masculino , Metaloproteinase 3 da Matriz/sangue , Metaloproteinase 3 da Matriz/metabolismo , Camundongos Endogâmicos C57BL , Dados de Sequência Molecular , Peptídeos/administração & dosagem , Peptídeos/química , Líquido Sinovial/efeitos dos fármacos , Líquido Sinovial/metabolismo , Temperatura , Fatores de Tempo , Resultado do Tratamento , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Fator de Necrose Tumoral alfa/metabolismo , Ferimentos e Lesões/complicações , Microtomografia por Raio-X
13.
BMJ Open ; 4(5): e004536, 2014 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-24821713

RESUMO

OBJECTIVE: Women with multiple sclerosis are often diagnosed and treated during their reproductive years. Limited data are available on the safety of treatment during pregnancy. The Betaseron Pregnancy Registry prospectively monitored women exposed to interferon ß-1b (IFNß-1b) during pregnancy to estimate the rates of birth defects, spontaneous abortions (SABs) and other negative outcomes in this population. DESIGN: From 2006 to 2011, this observational registry enrolled women exposed prior to conception or during pregnancy (but prior to or without abnormalities on prenatal screening). Follow-up continued from enrolment through the 4-month paediatric visit. SETTING: Patients in the USA who met these criteria were enrolled in the registry. RESULTS: The registry enrolled 99 pregnant women; 3 were lost to follow-up. The earliest exposure to IFNß-1b occurred during the first trimester for 95 pregnancies and in the third trimester for 1 pregnancy. There were 99 birth outcomes (3 twins), including 86 (86.9%) live births, 11 (11.1%) SABs and 2 (2%) stillbirths. Birth defects were reported in five (5.1%) cases. Rates of birth defects and SAB were not significantly different from population comparators. No developmental concerns were identified at the 4-month paediatric visit. CONCLUSIONS: The small sample size limits the ability to draw definitive conclusions; however, there was no pattern to suggest increased negative outcomes with IFNß-1b. CLINICAL TRIALS REGISTRATION NUMBER: NCT00317564.


Assuntos
Anormalidades Induzidas por Medicamentos/epidemiologia , Adjuvantes Imunológicos/efeitos adversos , Interferon beta-1b/efeitos adversos , Complicações na Gravidez/induzido quimicamente , Complicações na Gravidez/epidemiologia , Adulto , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Estudos Prospectivos , Sistema de Registros , Adulto Jovem
14.
J Control Release ; 171(1): 38-47, 2013 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-23830979

RESUMO

Radiculopathy, a painful neuroinflammation that can accompany intervertebral disc herniation, is associated with locally increased levels of the pro-inflammatory cytokine tumor necrosis factor alpha (TNFα). Systemic administration of TNF antagonists for radiculopathy in the clinic has shown mixed results, and there is growing interest in the local delivery of anti-inflammatory drugs to treat this pathology as well as similar inflammatory events of peripheral nerve injury. Curcumin, a known antagonist of TNFα in multiple cell types and tissues, was chemically modified and conjugated to a thermally responsive elastin-like polypeptide (ELP) to create an injectable depot for sustained, local delivery of curcumin to treat neuroinflammation. ELPs are biopolymers capable of thermally-triggered in situ depot formation that have been successfully employed as drug carriers and biomaterials in several applications. ELP-curcumin conjugates were shown to display high drug loading, rapidly release curcumin in vitro via degradable carbamate bonds, and retain in vitro bioactivity against TNFα-induced cytotoxicity and monocyte activation with IC50 only two-fold higher than curcumin. When injected proximal to the sciatic nerve in mice via intramuscular (i.m.) injection, ELP-curcumin conjugates underwent a thermally triggered soluble-insoluble phase transition, leading to in situ formation of a depot that released curcumin over 4days post-injection and decreased plasma AUC 7-fold.


Assuntos
Anti-Inflamatórios/administração & dosagem , Curcumina/administração & dosagem , Sistemas de Liberação de Medicamentos , Animais , Anti-Inflamatórios/química , Anti-Inflamatórios/farmacocinética , Linhagem Celular Tumoral , Curcumina/química , Curcumina/farmacocinética , Preparações de Ação Retardada , Elastina/química , Feminino , Engenharia Genética , Temperatura Alta , Humanos , Inflamação/tratamento farmacológico , Deslocamento do Disco Intervertebral , Camundongos , Camundongos Endogâmicos C57BL , Peptídeos/química , Nervo Isquiático/metabolismo , Células U937
15.
Bull Menninger Clin ; 77(1): 70-93, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23428172

RESUMO

Psychoanalytic theories suggest that color perception on the Rorschach relates to affective modulation. However, this idea has minimal empirical support. Using a clinical sample, the authors explored the cognitive and clinical correlates of Rorschach color determinants and differences among four affective modulation subtypes: Controlled, Balanced, Under-Controlled, and Flooded. Subtypes were differentiated by measures of affective regulation, reality testing/confusion, and personality traits. Initial support for the relationship of chromatic color response styles and affective modulation was found.


Assuntos
Afeto , Transtornos de Ansiedade/psicologia , Transtorno Bipolar/psicologia , Percepção de Cores , Transtorno Depressivo/psicologia , Transtornos Psicóticos/psicologia , Adolescente , Adulto , Idoso , Cor , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Teste de Rorschach , Adulto Jovem
16.
J Cancer Surviv ; 6(4): 359-71, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22777364

RESUMO

PURPOSE: The impact of cancer and cancer treatment on the long-term health and quality of life of survivors is substantial, leading to questions about the most appropriate configuration of services and models of care for follow-up of post-primary treatment survivors. METHODS: A systematic review and quality appraisal of the health literature for structure of services and models of follow-up care for post-treatment survivors was identified through a search of guideline sources and empirical databases including MEDLINE, EMBASE, PsycINFO, the Cochrane Library, CINAHL, and EBSCO from 1999 through December 2009. RESULTS: Ten practice guidelines and nine randomized controlled trials comprised the evidence base for models of care for adult cancer survivors. Although the evidence base was rated as low quality, nurse-led and primary care physician models of follow-up care were equivalent for detecting recurrence. Consensus also suggests that cancer survivors may benefit from coordinated transition planning that includes the provision of survivorship care plans as part of standard care. CONCLUSIONS: Realignment of models of care is identified as a health system priority to meet the supportive care and surveillance needs of a burgeoning survivor population. Further research is needed to evaluate the efficacy of models of care in a broader population of cancer survivors with differing needs and risks. While the evidence is limited, there is research that may be used to guide the configuration of health care services and planning.


Assuntos
Continuidade da Assistência ao Paciente/organização & administração , Modelos Organizacionais , Neoplasias/terapia , Projetos de Pesquisa , Sobreviventes , Adulto , Atenção à Saúde/organização & administração , Seguimentos , Necessidades e Demandas de Serviços de Saúde , Humanos , Neoplasias/mortalidade , Projetos de Pesquisa/estatística & dados numéricos , Apoio Social , Sobreviventes/estatística & dados numéricos
17.
Plant Sci ; 188-189: 102-10, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22525250

RESUMO

Synthesis of wound-inducible pyridine alkaloids is characteristic of species in the genus Nicotiana. The enzyme quinolinate phosphoribosyltransferase (QPT) plays a key role in facilitating the availability of precursors for alkaloid synthesis, in addition to its ubiquitous role in enabling NAD(P)(H) synthesis. In a previous study, we reported that Nicotiana tabacum L. var. NC 95 possesses a QPT RFLP pattern similar to its model paternal progenitor species, Nicotiana tomentosiformis Goodsp. Here we show that although some varieties of N. tabacum (e.g. NC 95 and LAFC 53) possess QPT genomic contributions from only its paternal progenitor species, this is not the case for many other N. tabacum varieties (e.g. Xanthi, Samsun, Petite Havana SR1 and SC 58) where genomic QPT sequences from both diploid progenitor species have been retained. We also report that QPT is encoded by duplicate genes (designated QPT1 and QPT2) not only in N. tabacum, but also its model progenitor species Nicotiana sylvestris Speg. and Comes and N. tomentosiformis as well as in the diploid species Nicotiana glauca Graham. Previous studies have demonstrated that the N. tabacum QPT2 gene encodes a functional enzyme via complementation of a nadC(-)Escherichia coli mutant. Using a similar experimental approach here, we demonstrate that the N. tabacum QPT1 gene also encodes a functional QPT protein. We observe too that QPT2 is the predominate transcript present in both alkaloid and non-alkaloid synthesising tissues in N. tabacum and that promoter regions of both QPT1 and QPT2 are able to produce GUS activity in reproductive tissues. In N. tabacum and in several other Nicotiana species tested, QPT2 transcript levels increase following wounding or methyl jasmonate treatment whilst QPT1 transcript levels remain largely unaltered by these treatments. Together with conclusions from recently published studies involving functional interaction of MYC2-bHLH and specific ERF-type and transcription factors with QPT2-promoter sequences from N. tabacum, our results suggest that whilst both members of the QPT gene family can contribute to the transcript pool in both alkaloid producing and non-producing tissues, it is QPT2 that is regulated in association with inducible defensive pyridine alkaloid synthesis in species across the genus Nicotiana.


Assuntos
Acetatos/farmacologia , Ciclopentanos/farmacologia , Nicotiana/enzimologia , Oxilipinas/farmacologia , Pentosiltransferases/genética , Reguladores de Crescimento de Plantas/farmacologia , Alcaloides/metabolismo , Sequência de Bases , Escherichia coli/genética , Escherichia coli/metabolismo , Duplicação Gênica , Teste de Complementação Genética , Dados de Sequência Molecular , Pentosiltransferases/metabolismo , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Raízes de Plantas/efeitos dos fármacos , Raízes de Plantas/enzimologia , Raízes de Plantas/genética , Plantas Geneticamente Modificadas , Regiões Promotoras Genéticas/genética , Análise de Sequência de DNA , Nicotiana/efeitos dos fármacos , Nicotiana/genética
18.
J Pers Assess ; 94(5): 533-40, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22448959

RESUMO

The Social Cognition and Object Relations Scale-Global rating method (SCORS-G; Stein, Hilsenroth, Slavin-Mulford, & Pinsker, 2011; Westen, 1995) measures the quality of object relations in narrative material. This study employed a multimethod approach to explore the structure and construct validity of the SCORS-G. The Thematic Apperception Test (TAT; Murray, 1943) was administered to 59 patients referred for psychological assessment at a large Northeastern U.S. hospital. The resulting 301 TAT narratives were rated using the SCORS-G method. The 8 SCORS variables were found to have high interrater reliability and good internal consistency. Principal components analysis revealed a 3-component solution with components tapping emotions/affect regulation in relationships, self-image, and aspects of cognition. Next, the construct validity of the SCORS-G components was explored using measures of intellectual and executive functioning, psychopathology, and normal personality. The 3 SCORS-G components showed unique and theoretically meaningful relationships across these broad and diverse psychological measures. This study demonstrates the value of using a standardized scoring method, like the SCORS-G, to reveal the rich and complex nature of narrative material.


Assuntos
Transtornos Mentais/psicologia , Apego ao Objeto , Escalas de Graduação Psiquiátrica , Percepção Social , Adulto , Cognição , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Personalidade , Determinação da Personalidade , Reprodutibilidade dos Testes , Autoimagem , Comportamento Social , Teste de Apercepção Temática
19.
Curr Oncol ; 18(6): e265-81, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22184494

RESUMO

OBJECTIVE: Our goal was to develop evidence-based recommendations for the organization and structure of cancer survivorship services, and best-care practices to optimize the health and well-being of post-primary treatment survivors. This review sought to determine the optimal organization and care delivery structure for cancer survivorship services, and the specific clinical practices and interventions that would improve or maximize the psychosocial health and overall well-being of adult cancer survivors. DATA SOURCES: We conducted a systematic search of the Inventory of Cancer Guidelines at the Canadian Partnership Against Cancer, the U.S. National Guideline Clearinghouse, the Canadian Medical Association InfoBase, medline (ovid: 1999 through November 2009), embase (ovid: 1999 through November 2009), Psychinfo (ovid: 1999 through November 2009), the Cochrane Library (ovid; Issue 1, 2009), and cinahl (ebsco: 1999 through December 2009). Reference lists of related papers and recent review articles were scanned for additional citations. METHODS: Articles were selected for inclusion as evidence in the systematic review if they reported on organizational system components for survivors of cancer, or on psychosocial or supportive care interventions HOWELL et al. designed for survivors of cancer. Articles were excluded from the systematic review if they focused only on pediatric cancer survivor populations or on populations that transitioned from pediatric cancer to adult services; if they addressed only pharmacologic interventions or diagnostic testing and follow-up of cancer survivors; if they were systematic reviews with inadequately described methods; if they were qualitative or descriptive studies; and if they were opinion papers, letters, or editorials. DATA EXTRACTION AND SYNTHESIS: Evidence was selected and reviewed by three members of the Cancer Journey Survivorship Expert Panel (SM, TC, TKO). The resulting summary of the evidence was guided further and reviewed by the members of Cancer Journey Survivorship Expert Panel. Fourteen practice guidelines, eight systematic reviews, and sixty-thee randomized controlled trials form the evidence base for this guidance document. These publications demonstrate that survivors benefit from coordinated post-treatment care, including interventions to address specific psychosocial, supportive care, and rehabilitative concerns. CONCLUSIONS: Ongoing high-quality research is essential to optimize services for cancer survivors. Interventions that promote healthy lifestyle behaviours or that address psychosocial concerns and distress appear to improve physical functioning, psychosocial well-being, and quality of life for survivors.

20.
Arthritis Res Ther ; 13(4): R137, 2011 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-21871102

RESUMO

INTRODUCTION: Tumor necrosis factor-α (TNFα) has received significant attention as a mediator of lumbar radiculopathy, with interest in TNF antagonism to treat radiculopathy. Prior studies have demonstrated that TNF antagonists can attenuate heightened nociception resulting from lumbar radiculopathy in the preclinical model. Less is known about the potential impact of TNF antagonism on gait compensations, despite being of clinical relevance. In this study, we expand on previous descriptions of gait compensations resulting from lumbar radiculopathy in the rat and describe the ability of local TNF antagonism to prevent the development of gait compensations, altered weight bearing, and heightened nociception. METHODS: Eighteen male Sprague-Dawley rats were investigated for mechanical sensitivity, weight-bearing, and gait pre- and post-operatively. For surgery, tail nucleus pulposus (NP) tissue was collected and the right L5 dorsal root ganglion (DRG) was exposed (Day 0). In sham animals, NP tissue was discarded (n = 6); for experimental animals, autologous NP was placed on the DRG with or without 20 µg of soluble TNF receptor type II (sTNFRII, n = 6 per group). Spatiotemporal gait characteristics (open arena) and mechanical sensitivity (von Frey filaments) were assessed on post-operative Day 5; gait dynamics (force plate arena) and weight-bearing (incapacitance meter) were assessed on post-operative Day 6. RESULTS: High-speed gait characterization revealed animals with NP alone had a 5% decrease in stance time on their affected limbs on Day 5 (P ≤0.032). Ground reaction force analysis on Day 6 aligned with temporal changes observed on Day 5, with vertical impulse reduced in the affected limb of animals with NP alone (area under the vertical force-time curve, P <0.02). Concordant with gait, animals with NP alone also had some evidence of affected limb mechanical allodynia on Day 5 (P = 0.08) and reduced weight-bearing on the affected limb on Day 6 (P <0.05). Delivery of sTNFRII at the time of NP placement ameliorated signs of mechanical hypersensitivity, imbalanced weight distribution, and gait compensations (P <0.1). CONCLUSIONS: Our data indicate gait characterization has value for describing early limb dysfunctions in pre-clinical models of lumbar radiculopathy. Furthermore, TNF antagonism prevented the development of gait compensations subsequent to lumbar radiculopathy in our model.


Assuntos
Adaptação Fisiológica/efeitos dos fármacos , Transtornos Neurológicos da Marcha/tratamento farmacológico , Radiculopatia/tratamento farmacológico , Receptores Tipo II do Fator de Necrose Tumoral/farmacologia , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Animais , Fenômenos Biomecânicos , Modelos Animais de Doenças , Marcha/efeitos dos fármacos , Marcha/fisiologia , Transtornos Neurológicos da Marcha/etiologia , Hiperalgesia/tratamento farmacológico , Hiperalgesia/etiologia , Região Lombossacral , Masculino , Radiculopatia/complicações , Ratos , Ratos Sprague-Dawley , Suporte de Carga
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