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1.
Glob Chang Biol ; 29(19): 5677-5690, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37522370

RESUMEN

Cover crops increase carbon (C) inputs to agricultural soils, and thus have the potential to mitigate climate change through enhanced soil organic carbon (SOC) storage. However, few studies have explored the fate of belowground C inputs associated with varying root traits into the distinct SOC pools of mineral-associated organic carbon (MAOC) particulate organic carbon (POC). Therefore, a packed 0.5 m column trial was established with 0.25 m topsoil and 0.25 m subsoil with four cover crops species (winter rye, oilseed radish, chicory, and hairy vetch) known to differ in C:N ratio and root morphology. Cover crops were 14 CO2 -labeled for 3 months, and then, half of the columns were sampled to quantify root and rhizodeposition C. In the remaining columns, plant shoots were harvested and the undisturbed soil and roots were left for incubation. Bulk soil from both sampling times was subjected to a simple fractionation scheme, where 14 C in the <50 and >50 µm fraction was assumed to represent MAOC and POC, respectively. The fast-growing rye and radish produced the highest root C. The percentage loss of C via rhizodeposition (%ClvR) showed a distinct pattern, with 22% for the more branched roots (rye and vetch) and 6%-8% for the less branched roots (radish and chicory). This suggests that root morphology plays a key role in determining rhizodeposition C. After 1 year of incubation at room temperature, the remaining MAOC and POC were positively correlated with belowground inputs in absolute terms. However, topsoil MAOC formation efficiencies (cover crop-derived MAOC remaining as a share of belowground inputs) were higher for vetch and rye (21% and 15%, respectively) than for chicory and radish (9% and 10%, respectively), suggesting a greater importance of rhizodeposition (or indirectly, root morphology) than solely substrate C:N ratio for longer term C stabilization.


Asunto(s)
Carbono , Suelo , Nitrógeno/análisis , Agricultura , Productos Agrícolas , Control de Calidad
2.
Ann Allergy Asthma Immunol ; 130(6): 797-804.e2, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36924936

RESUMEN

BACKGROUND: The house dust mite (HDM) sublingual immunotherapy (SLIT)-tablet is a treatment option for allergic rhinitis with/without conjunctivitis (AR/C) approved in adults worldwide and in adolescents in some countries. OBJECTIVE: To supplement existing adolescent HDM SLIT-tablet safety data by conducting the MT-18 trial in adolescents. METHODS: MT-18 (EudraCT:2020-000446-34) was a phase 3, open-label, single-arm, 28-day safety trial of daily HDM SLIT-tablet (12 SQ-HDM dose) in European adolescents (12-17 years) with HDM AR/C, with or without asthma. The primary end point was at least 1 treatment-emergent adverse event (TEAE). MT-18 results were compared with 12 SQ-HDM adolescent subpopulation data from previously described 1-year phase 3 trials conducted in North America (P001; clinicaltrials.gov:NCT01700192) or Japan (TO-203-3-2; JapicCTI:121848). RESULTS: No treatment-related anaphylaxis, epinephrine administrations, severe local swellings, severe mouth or throat edema, or eosinophilic esophagitis occurred in the trials. For MT-18 (N = 253), P001 (N adolescents = 189), and TO-203-3-2 (N adolescents = 206), the percentage of adolescents treated with 12 SQ-HDM reporting any TEAE was 88%, 95%, and 93%, respectively, and the percentage reporting any treatment-related AE (TRAE) was 86%, 93%, and 66%, respectively. The most common TRAEs were local application site reactions. Most TRAEs were mild in intensity and were typically experienced the first 1 to 2 days of treatment. There were no asthma-related TEAEs with the HDM SLIT-tablet. The safety profile appears similar between adolescents with or without asthma at baseline. CONCLUSION: The HDM SLIT-tablet was well tolerated in European, North American, and Japanese adolescents with HDM AR/C, indicating safety of the HDM SLIT-tablet is insensitive to age or geographic region. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: (P001: NCT01700192); EudraCT: (MT-18; 2020-000446-34); JapicCTI: (TO-203-3-2; 121848).


Asunto(s)
Asma , Conjuntivitis Alérgica , Conjuntivitis , Rinitis Alérgica Perenne , Rinitis Alérgica , Inmunoterapia Sublingual , Adolescente , Adulto , Animales , Humanos , Antígenos Dermatofagoides , Asma/tratamiento farmacológico , Conjuntivitis/inducido químicamente , Dermatophagoides pteronyssinus , Método Doble Ciego , Pyroglyphidae , Rinitis Alérgica Perenne/tratamiento farmacológico , Inmunoterapia Sublingual/efectos adversos , Inmunoterapia Sublingual/métodos , Comprimidos/uso terapéutico , Resultado del Tratamiento
3.
Nord J Psychiatry ; 77(2): 188-197, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35697087

RESUMEN

BACKGROUND: Insomnia in depression is common and difficult to resolve. Unresolved depression-related sleep disturbances increase risk of relapse at high costs for individuals and society. Trials have suggested music for insomnia in various populations, but there is little research on the effectiveness of music for depression-related insomnia. METHODS: We examined the efficacy of a music intervention on insomnia, depression symptoms and quality of life in adults with depression-related insomnia. A two-armed randomized controlled trial was conducted, including depression outpatients with insomnia (n = 112) in a 1:1 ratio to music intervention and waitlist control group. The intervention group listened to music at bedtime for 4 weeks. Participants received treatment as usual during 8 weeks with assessments at baseline, at 4 and 8 weeks. The primary outcome measure was Pittsburgh Sleep Quality Index (PSQI), secondary outcomes comprised Actigraphy, the Hamilton Depression Rating Scale (HAMD-17) and World Health Organisation well-being questionnaires (WHO-5, WHOQOL-BREF). RESULTS: The music intervention group experienced significant improvements in sleep quality and well-being at 4 weeks according to global PSQI scores (effect size = -2.1, 95%CI -3.3; -0.9) and WHO-5 scores (effect size 8.4, 95%CI 2.7;14.0). At 8 weeks, i.e. 4 weeks after termination of the music intervention, the improvement in global PSQI scores had decreased (effect size = -0.1, 95%CI -1.3; 1.1). Actigraphy sleep assessments showed no changes and there was no detection of change in depression symptoms. CONCLUSIONS: Music intervention is suggested as a safe and moderately effective sleep aid in depression-related insomnia. Trial registration: Clinicaltrials.gov. ID NCT03676491.


Asunto(s)
Música , Trastornos del Inicio y del Mantenimiento del Sueño , Humanos , Adulto , Trastornos del Inicio y del Mantenimiento del Sueño/etiología , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Calidad del Sueño , Depresión/etiología , Depresión/terapia , Calidad de Vida , Sueño , Resultado del Tratamiento
4.
J Cell Sci ; 133(15)2020 08 06.
Artículo en Inglés | MEDLINE | ID: mdl-32661085

RESUMEN

Lipid flippases of the P4 ATPase family establish phospholipid asymmetry in eukaryotic cell membranes and are involved in many essential cellular processes. The yeast Saccharomyces cerevisiae contains five P4 ATPases, among which Dnf3p is poorly characterized. Here, we demonstrate that Dnf3p is a flippase that catalyzes translocation of major glycerophospholipids, including phosphatidylserine, towards the cytosolic membrane leaflet. Deletion of the genes encoding Dnf3p and the distantly related P4 ATPases Dnf1p and Dnf2p results in yeast mutants with aberrant formation of pseudohyphae, suggesting that the Dnf1p-Dnf3p proteins have partly redundant functions in the control of this specialized form of polarized growth. Furthermore, as previously demonstrated for Dnf1 and Dnf2p, the phospholipid flipping activity of Dnf3p is positively regulated by flippase kinase 1 (Fpk1p) and Fpk2p. Phylogenetic analyses demonstrate that Dnf3p belongs to a subfamily of P4 ATPases specific for fungi and are likely to represent a hallmark of fungal evolution.


Asunto(s)
Proteínas de Saccharomyces cerevisiae , Saccharomyces cerevisiae , Membrana Celular/metabolismo , Fosfatidilserinas , Proteínas de Transferencia de Fosfolípidos/genética , Fosfolípidos , Filogenia , Proteínas Quinasas/metabolismo , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/metabolismo , Proteínas de Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/metabolismo
5.
J Environ Manage ; 317: 115373, 2022 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-35649336

RESUMEN

Extensive oil palm plantations have often resulted in the decrease of soil organic carbon (SOC). Several options exist to counter this, such as recycling empty fruit bunches (EFB) as a soil amendment. However, the extent to which EFB increase SOC has been disputed. Since EFB could also be used as a climate change mitigation tool, it is necessary to truly understand their impact on SOC. The investigation of the impact of nine EFB treatments (differing in frequency and application rates) on a 27-year-old large-scale experiment (Lampung, Sumatra, Indonesia) revealed that, while EFB impacts are heterogeneous throughout the plantation, they can positively affect total SOC and permanganate oxidisable carbon (POX-C) both at shallow and deep depths (measured up to 100 cm). POX-C was closely correlated to SOC, but showed significant increases compared to the untreated control in all treatments, while total SOC was only increased in a few treatments with small and frequent rates of EFB application. Overall, between 12 (±16) and 56 (±12) t ha-1 of carbon were sequestered under the harvesting path after 21 years. Focussing on the mineral nutrition value of the EFB, oil palm companies apply a rate of 60 t of EFB every second year for their commercial production, and the analysis of three commercial plots showed that the commercial rate only increased POX-C while it had no effect on the total SOC and SOC stocks. It seems obvious that a change of paradigm is necessary to consider EFB recycling as a new management perspective, where the potential for carbon sequestration becomes an important variable for climate change mitigation besides the initial objective of integrating EFB application into the fertiliser management plan of a plantation.


Asunto(s)
Aceites Industriales , Suelo , Carbono , Frutas , Aceite de Palma
6.
BMC Psychiatry ; 19(1): 40, 2019 01 24.
Artículo en Inglés | MEDLINE | ID: mdl-30678679

RESUMEN

BACKGROUND: Depression and anxiety are prevalent mental disorders among the working population with potentially high personal and financial cost. The overall aim of this study was to test the applicability of an outreach collaborative model for early identification and treatment of clinical and sub-clinical mental disorders among Danish employees. This applicability was examined by I) investigating the fractions of identified and treated clinical and subclinical cases, II) describing the distribution and characteristics of cases identified and III) investigating the effect of allocated treatment. METHODS: A longitudinal study design with four assessments (T0-T3) over 16 months was applied. Self-reporting questionnaires probing for psychopathology were distributed to all employees in six consecutively enrolled companies at the four time points. Employees meeting the screening criteria at T1 were assessed diagnostically. Subjects diagnosed with a clinical mental disorder were allocated to outpatient psychiatric treatment, and subjects with subclinical conditions were allocated to preventive cognitive behavioural therapy. Follow-up was conducted 6 and 12 months after initiation of treatment. We used chi-squared test and F-test to compare the different groups on baseline characteristics and mixed effects linear regression to analyse the treatment effects. RESULTS: Forty (6.8%) of the 586 responders at T1 were diagnosed with a clinical mental disorder and referred to outpatient psychiatric treatment. Thirty-three (5.6%) were affected by a subclinical condition and referred to preventive treatment. Nearly two-thirds (63%) of the employees diagnosed with a clinical condition had never received treatment before. Symptom severity decreased significantly for both treated groups until follow-up. When compared to a composed control group, subclinical cases displayed a more rapid initial significant symptomatic decrease on the global symptom scale (coefs = - 0.914, 95% CI [- 1.754, - 0,075]) and anxiety sub-scale (coefs = - 1.043, 95% CI [- 2.021, - 0.066]). This did not apply to the clinical cases as no significant difference in change were identified. CONCLUSIONS: The outreach collaborative model demonstrated an applicability to identify both clinical and subclinical cases, among these a high number of employees with an unmet need for treatment. We found evidence of a positive initial effect on symptomatology from the allocated preventive treatment among the subclinical cases, but not for clinical cases. TRIAL REGISTRATION: Retrospectively registered at December 18, 2018 at clinicaltrials.gov, identifier: NCT03786328 .


Asunto(s)
Atención Ambulatoria/métodos , Colaboración Intersectorial , Trastornos Mentales/psicología , Trastornos Mentales/terapia , Lugar de Trabajo/psicología , Adulto , Terapia Cognitivo-Conductual/métodos , Dinamarca/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Psicoterapia/métodos , Estudios Retrospectivos , Encuestas y Cuestionarios , Resultado del Tratamiento
7.
J Allergy Clin Immunol ; 141(2): 529-538.e13, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-28689794

RESUMEN

BACKGROUND: Allergy immunotherapy targets the immunological cause of allergic rhinoconjunctivitis and allergic asthma and has the potential to alter the natural course of allergic disease. OBJECTIVE: The primary objective was to investigate the effect of the SQ grass sublingual immunotherapy tablet compared with placebo on the risk of developing asthma. METHODS: A total of 812 children (5-12 years), with a clinically relevant history of grass pollen allergic rhinoconjunctivitis and no medical history or signs of asthma, were included in the randomized, double-blind, placebo-controlled trial, comprising 3 years of treatment and 2 years of follow-up. RESULTS: There was no difference in time to onset of asthma, defined by prespecified asthma criteria relying on documented reversible impairment of lung function (primary endpoint). Treatment with the SQ grass sublingual immunotherapy tablet significantly reduced the risk of experiencing asthma symptoms or using asthma medication at the end of trial (odds ratio = 0.66, P < .036), during the 2-year posttreatment follow-up, and during the entire 5-year trial period. Also, grass allergic rhinoconjunctivitis symptoms were 22% to 30% reduced (P < .005 for all 5 years). At the end of the trial, the use of allergic rhinoconjunctivitis pharmacotherapy was significantly less (27% relative difference to placebo, P < .001). Total IgE, grass pollen-specific IgE, and skin prick test reactivity to grass pollen were all reduced compared to placebo. CONCLUSIONS: Treatment with the SQ grass sublingual immunotherapy tablet reduced the risk of experiencing asthma symptoms and using asthma medication, and had a positive, long-term clinical effect on rhinoconjunctivitis symptoms and medication use but did not show an effect on the time to onset of asthma.


Asunto(s)
Asma , Rinitis Alérgica Estacional , Inmunoterapia Sublingual , Asma/inmunología , Asma/patología , Asma/terapia , Niño , Preescolar , Conjuntivitis Alérgica/inmunología , Conjuntivitis Alérgica/patología , Conjuntivitis Alérgica/terapia , Método Doble Ciego , Femenino , Estudios de Seguimiento , Humanos , Masculino , Rinitis Alérgica Estacional/inmunología , Rinitis Alérgica Estacional/patología , Rinitis Alérgica Estacional/terapia , Comprimidos
8.
Carcinogenesis ; 39(2): 109-117, 2018 02 09.
Artículo en Inglés | MEDLINE | ID: mdl-29069374

RESUMEN

Cancer cells consistently exhibit decreased stiffness; however, the onset and progression of this change have not been characterized. To study the development of cell stiffness changes, we evaluated the shear stiffness of populations of cells during transformation to a carcinogenic state. Bronchial epithelial cells were exposed to sodium arsenite to initiate early stages of transformation. Exposed cells were cultured in soft agar to further transformation and select for clonal populations exhibiting anchorage-independent growth. Shear stiffness of various cell populations in G1 was assessed using a novel non-invasive assay that applies shear stress with fluid flow and evaluates nanoscale deformation using quantitative phase imaging (QPI). Arsenic-treated cells exhibited reduced stiffness relative to control cells, while arsenic clonal lines, selected by growth in soft agar, were found to have reduced stiffness relative to control clonal lines, which were cultured in soft agar but did not receive arsenic treatment. The relative standard deviation (RSD) of the stiffness of Arsenic clones was reduced compared with control clones, as well as to the arsenic-exposed cell population. Cell stiffness at the population level exhibits potential to be a novel and sensitive framework for identifying the development of cancerous cells.


Asunto(s)
Transformación Celular Neoplásica/patología , Células Epiteliales/patología , Resistencia al Corte/efectos de los fármacos , Arsenitos/toxicidad , Carcinógenos/toxicidad , Línea Celular , Transformación Celular Neoplásica/inducido químicamente , Células Epiteliales/efectos de los fármacos , Fase G1 , Humanos , Mucosa Respiratoria/efectos de los fármacos , Mucosa Respiratoria/patología , Compuestos de Sodio/toxicidad
9.
BMC Psychiatry ; 17(1): 38, 2017 01 23.
Artículo en Inglés | MEDLINE | ID: mdl-28114913

RESUMEN

BACKGROUND: Clinical decision-making is the vehicle of health care provision, and level of involvement predicts implementation and satisfaction. The aim of this study was to investigate the impact of decision-making experience on recovery. METHODS: Data derived from an observational cohort study "Clinical decision making and outcome in routine care for people with severe mental illness" (CEDAR). Adults (aged 18-60) meeting standardised criteria for severe mental illness were recruited from caseloads of outpatient and community mental health services in six European countries. After consenting, they were assessed using standardised measures of decision-making, clinical outcome and stage of recovery at baseline and 1 year later. Latent class analysis was used to identify course of recovery, and proportional odds models to investigate predictors of recovery stage and change. RESULTS: Participants (n = 581) clustered into three stages of recovery at baseline: Moratorium (N = 115; 19.8%), Awareness/Preparation (N = 145; 25.0%) and Rebuilding/Growth (N = 321; 55.2%). Higher stage was cross-sectionally associated with being male, married, living alone or with parents, and having better patient-rated therapeutic alliance and fewer symptoms. The model accounted for 40% of the variance in stage of recovery. An increased chance of worse outcome (change over 1 year to lower stage of recovery) was found for patients with active involvement compared with either shared (OR = 1.84, 95% CI 1.15-2.94) or passive (OR = 1.71, 95% CI = 1.00-2.95) involvement. Overall, both process (therapeutic relationship) and outcome (symptomatology) are cross-sectionally associated with stage of recovery. CONCLUSIONS: Patient-rated decision-making involvement and change in stage of recovery are associated. Joint consideration of decision practise within the recovery process between patient and clinician is supposed to be a useful strategy to improve clinical practice (ISRCTN registry: ISRCTN75841675. Retrospectively registered 15 September 2010).


Asunto(s)
Toma de Decisiones Clínicas , Trastornos Mentales/psicología , Evaluación de Procesos y Resultados en Atención de Salud , Participación del Paciente/psicología , Adulto , Europa (Continente) , Femenino , Humanos , Masculino , Estudios Prospectivos , Adulto Joven
10.
Environ Microbiol ; 18(8): 2565-74, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27119650

RESUMEN

Social interactions in which bacteria respond to one another by modifying their phenotype are central determinants of microbial communities. It is known that interspecific interactions influence the biofilm phenotype of bacteria; a phenotype that is central to the fitness of bacteria. However, the underlying role of fundamental ecological factors, specifically coexistence and phylogenetic history, in biofilm formation remains unclear. This study examines how social interactions affect biofilm formation in multi-species co-cultures from five diverse environments. We found prevalence of increased biofilm formation among co-cultured bacteria that have coexisted in their original environment. Conversely, when randomly co-culturing bacteria across these five consortia, we found less biofilm induction and a prevalence of biofilm reduction. Reduction in biofilm formation was even more predominant when co-culturing bacteria from environments where long-term coexistence was unlikely to have occurred. Phylogenetic diversity was not found to be a strong underlying factor but a relation between biofilm induction and phylogenetic history was found. The data indicates that biofilm reduction is typically correlated with an increase in planktonic cell numbers, thus implying a behavioral response rather than mere growth competition. Our findings suggest that an increase in biofilm formation is a common adaptive response to long-term coexistence.


Asunto(s)
Bacterias/crecimiento & desarrollo , Bacterias/metabolismo , Biopelículas/crecimiento & desarrollo , Consorcios Microbianos/fisiología , Interacciones Microbianas/fisiología , Bacterias/clasificación , Técnicas de Cocultivo , Filogenia , Plancton/crecimiento & desarrollo , Plancton/microbiología
11.
Soc Psychiatry Psychiatr Epidemiol ; 50(3): 363-70, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25242154

RESUMEN

PURPOSE: The helping alliance (HA) between patient and therapist has been studied in detail in psychotherapy research, but less is known about the HA in long-term community mental health care. The aim of this study was to identify typical courses of the HA and their predictors in a sample of people with severe mental illness across Europe over a measurement period of one year. METHODS: Self-ratings of the HA by 588 people with severe mental illness who participated in a multicentre European study (CEDAR; ISRCTN75841675) were examined using latent class analysis. RESULTS: Four main patterns of alliance were identified: (1) high and stable (HS, 45.6 %), (2) high and increasing (HI, 36.9 %), (3) high and decreasing (HD, 11.3 %) and (4) low and increasing (LI, 6.1 %). Predictors of class membership were duration of illness, ethnicity, and education, receipt of state benefits, recovery, and quality of life. CONCLUSIONS: Results support findings from psychotherapy research about a predominantly stable course of the helping alliance in patients with severe mental illness over time. Implications for research and practice indicate to turn the attention to subgroups with noticeable courses.


Asunto(s)
Conducta Cooperativa , Trastornos Mentales/terapia , Relaciones Profesional-Paciente , Psicoterapia/métodos , Calidad de Vida/psicología , Adulto , Europa (Continente) , Femenino , Humanos , Masculino , Trastornos Mentales/psicología , Persona de Mediana Edad
12.
J Ment Health ; 24(1): 15-9, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25734210

RESUMEN

BACKGROUND: Clinical decision making (CDM) in the treatment of people with severe mental illness relates to a wide range of life domains. AIMS: To examine content of CDM in mental health care from the perspectives of service users and staff and to investigate variation in implementation of decisions for differing content. METHOD: As part of the European multicenter study clinical decision making and outcome in routine care for people with severe mental illness (ISRCTN75841675), 588 service users and their clinicians were asked to identify the decisions made during their last meeting. Decisions were then coded into content categories. Two months later, both parties reported if these decisions had been implemented. RESULTS: Agreement between patients and staff regarding decision making was moderate (k = 0.21­0.49; p < 0.001). Decisions relating to medication and social issues were most frequently identified. Overall reported level of implementation was 73.5% for patients and 74.7% for staff, and implementation varied by decision content. CONCLUSIONS: A variety of relevant decision topics were shown for mental health care.Implementation rates varied in relation to topic and may need different consideration within the therapeutic dyad.


Asunto(s)
Toma de Decisiones , Trastornos Mentales/terapia , Evaluación de Procesos y Resultados en Atención de Salud , Participación del Paciente , Relaciones Médico-Paciente , Adulto , Femenino , Humanos , Masculino , Trastornos Mentales/diagnóstico , Persona de Mediana Edad
14.
Aust N Z J Psychiatry ; 48(9): 861-70, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24810873

RESUMEN

BACKGROUND: Patients with psychiatric illness have increased somatic morbidity and increased mortality. Knowledge of how to integrate the prevention and care of somatic illness into the treatment of psychiatric patients is required. The aims of this study were to investigate whether an intervention programme to improve physical health is effective. METHODS: An extension of the European Network for Promoting the Health of Residents in Psychiatric and Social Care Institutions (HELPS) project further developed as a 12-month controlled cluster-randomized intervention study in the Danish centre. Waist circumference was a proxy of unhealthy body fat in view of the increased risk of cardiovascular diseases and type 2 diabetes. RESULTS: Waist circumference was 108 cm for men and 108 cm for women. Controlled for cluster randomization, sex, age, and body fat, the intervention group showed a small, but not significant, reduction in waist circumference, while participants in the control group showed a significant increase in waist circumference. CONCLUSIONS: The intervention had a positive effect on the physical health of the patients measured by a reduction in the increase of waist circumference.


Asunto(s)
Promoción de la Salud , Estilo de Vida , Trastornos Mentales/fisiopatología , Circunferencia de la Cintura , Adulto , Femenino , Estado de Salud , Humanos , Pacientes Internos , Masculino , Persona de Mediana Edad , Factores de Riesgo
15.
BMC Health Serv Res ; 14: 323, 2014 Jul 28.
Artículo en Inglés | MEDLINE | ID: mdl-25066212

RESUMEN

BACKGROUND: The aim of this study was to develop and evaluate a brief quantitative five-language measure of involvement and satisfaction in clinical decision-making (CDIS) - with versions for patients (CDIS-P) and staff (CDIS-S) - for use in mental health services. METHODS: An English CDIS was developed by reviewing existing measures, focus groups, semistructured interviews and piloting. Translations into Danish, German, Hungarian and Italian followed the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force principles of good practice for translation and cultural adaptation. Psychometricevaluation involved testing the measure in secondary mental health services in Aalborg, Debrecen, London, Naples, Ulm and Zurich. RESULTS: After appraising 14 measures, the Control Preference Scale and Satisfaction With Decision-making English-language scales were modified and evaluated in interviews (n = 9), focus groups (n = 22) and piloting (n = 16). Translations were validated through focus groups (n = 38) and piloting (n = 61). A total of 443 service users and 403 paired staff completed CDIS. The Satisfaction sub-scale had internal consistency of 0.89 (0.86-0.89 after item-level deletion) for staff and 0.90 (0.87-0.90) for service users, both continuous and categorical (utility) versions were associated with symptomatology and both staff-rated and service userrated therapeutic alliance (showing convergent validity), and not with social disability (showing divergent validity), and satisfaction predicted staff-rated (OR 2.43, 95%CI 1.54- 3.83 continuous, OR 5.77, 95%CI 1.90-17.53 utility) and service user-rated (OR 2.21, 95%CI 1.51-3.23 continuous, OR 3.13, 95%CI 1.10-8.94 utility) decision implementation two months later. The Involvement sub-scale had appropriate distribution and no floor or ceiling effects, was associated with stage of recovery, functioning and quality of life (staff only) (showing convergent validity), and not with symptomatology or social disability (showing divergent validity), and staff-rated passive involvement by the service user predicted implementation (OR 3.55, 95%CI 1.53-8.24). Relationships remained after adjusting for clustering by staff. CONCLUSIONS: CDIS demonstrates adequate internal consistency, no evidence of item redundancy, appropriate distribution, and face, content, convergent, divergent and predictive validity. It can be recommended for research and clinical use. CDIS-P and CDIS-S in all 3 five languages can be downloaded at http://www.cedar-net.eu/instruments. TRIAL REGISTRATION: ISRCTN75841675.


Asunto(s)
Toma de Decisiones , Lenguaje , Trastornos Mentales/terapia , Servicios de Salud Mental/normas , Encuestas y Cuestionarios , Traducciones , Adolescente , Adulto , Diversidad Cultural , Femenino , Grupos Focales , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Psicometría
16.
Stat Med ; 32(30): 5222-40, 2013 Dec 30.
Artículo en Inglés | MEDLINE | ID: mdl-24114808

RESUMEN

Functional data are data that can be represented by suitable functions, such as curves (potentially multi-dimensional) or surfaces. This paper gives an introduction to some basic but important techniques for the analysis of such data, and we apply the techniques to two datasets from biomedicine. One dataset is about white matter structures in the brain in multiple sclerosis patients; the other dataset is about three-dimensional vascular geometries collected for the study of cerebral aneurysms. The techniques described are smoothing, alignment, principal component analysis, and regression.


Asunto(s)
Interpretación Estadística de Datos , Análisis de Componente Principal/métodos , Análisis de Regresión , Humanos , Aneurisma Intracraneal/patología , Angiografía por Resonancia Magnética , Imagen por Resonancia Magnética , Esclerosis Múltiple/patología
17.
BMC Psychiatry ; 13: 48, 2013 Feb 04.
Artículo en Inglés | MEDLINE | ID: mdl-23379280

RESUMEN

BACKGROUND: The aim of this study was to develop and evaluate psychometric properties of the Clinical Decision Making Style (CDMS) scale which measures general preferences for decision making as well as preferences regarding the provision of information to the patient from the perspectives of people with severe mental illness and staff. METHODS: A participatory approach was chosen for instrument development which followed 10 sequential steps proposed in a current guideline of good practice for the translation and cultural adaptation of measures. Following item analysis, reliability, validity, and long-term stability of the CDMS were examined using Spearman correlations in a sample of 588 people with severe mental illness and 213 mental health professionals in 6 European countries (Germany, UK, Italy, Denmark, Hungary, and Switzerland). RESULTS: In both patient and staff versions, the two CDMS subscales "Participation in Decision Making" and "Information" reliably measure distinct characteristics of decision making. Validity could be demonstrated to some extent, but needs further investigation. CONCLUSIONS: Together with two other five-language patient- and staff-rated measures developed in the CEDAR study (ISRCTN75841675) - "Clinical Decision Making in Routine Care" and "Clinical Decision Making Involvement and Satisfaction" - the CDMS allows empirical investigation of the complex relation between clinical decision making and outcome in the treatment of people with severe mental illness across Europe.


Asunto(s)
Toma de Decisiones , Trastornos Mentales/terapia , Pruebas Psicológicas , Adulto , Comparación Transcultural , Dinamarca , Femenino , Alemania , Humanos , Hungría , Italia , Lenguaje , Masculino , Participación del Paciente/psicología , Psicometría , Reproducibilidad de los Resultados , Suiza , Reino Unido
18.
Curr Probl Cardiol ; 48(1): 101395, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36096454

RESUMEN

Alcohol consumption increases circulating high-density lipoprotein cholesterol (HDL-C), but HDL protein cargo may better reflect HDL function. This study examined the associations between alcohol intake and HDL subspecies containing or lacking apoC3, apoE, and apoJ in a well-phenotyped cohort. We performed a cross-sectional analysis of 2092 Cardiovascular Health Study participants aged 70 or older with HDL subspecies measured in stored specimens from 1998 to 1999. Associations between alcohol intake and apoA1 defined HDL subspecies lacking or containing apoC3, apoE, and apoJ, and circulating levels of total apoA1, apoC3, apoE, and apoJ were examined. HDL subspecies lacking and containing apoC3, apoE, and apoJ were all positively associated with alcohol intake, with ∼1% per additional drink per week or ∼7% per additional drink per day (subspecies without the apolipoproteins, P ≤ 2 × 10-9, subspecies with the apolipoproteins, P ≤ 3 × 10-5). Total apoA1 was also directly associated with alcohol consumption, with a 1% increase per additional drink per week (P = 1 × 10-14). Total apoC3 blood levels were 0.5% higher per additional drink per week (P = 0.01), but the association was driven by a few heavily drinking men. Alcohol intake was positively associated with HDL subspecies lacking and containing apoC3, apoE, or apoJ, and with total plasma apoA1. ApoC3 was directly, albeit not as robustly associated with alcohol intake. HDL protein cargo is crucial for its anti-atherosclerotic functions, but it remains to be determined whether HDL subspecies play a role in the putative association between limited alcohol intake and lower risk of coronary heart disease.


Asunto(s)
Consumo de Bebidas Alcohólicas , Apolipoproteínas , Humanos , Masculino , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/genética , Apolipoproteína C-III , Apolipoproteínas/genética , Apolipoproteínas E/genética , Estudios Transversales
19.
Harmful Algae ; 129: 102509, 2023 11.
Artículo en Inglés | MEDLINE | ID: mdl-37951617

RESUMEN

Ocean acidification is caused by rising atmospheric partial pressure of CO2 (pCO2) and involves a lowering of pH combined with increased concentrations of CO2 and dissolved in organic carbon in ocean waters. Many studies investigated the consequences of these combined changes on marine phytoplankton, yet only few attempted to separate the effects of decreased pH and increased pCO2. Moreover, studies typically target photoautotrophic phytoplankton, while little is known of plastidic protists that depend on the ingestion of plastids from their prey. Therefore, we studied the separate and interactive effects of pH and DIC levels on the plastidic ciliate Mesodinium rubrum, which is known to form red tides in coastal waters worldwide. Also, we tested the effects on their prey, which typically are cryptophytes belonging to the Teleaulax/Plagioslemis/Geminigera species complex. These cryptophytes not only serve as food for the ciliate, but also as a supplier of chloroplasts and prey nuclei. We exposed M. rubrum and the two cryptophyte species, T. acuta, T. amphioxeia to different pH (6.8 - 8) and DIC levels (∼ 6.5 - 26 mg C L-1) and assessed their growth and photosynthetic rates, and cellular chlorophyll a and elemental contents. Our findings did not show consistent significant effects across the ranges in pH and/or DIC, except for M. rubrum, for which growth was negatively affected only by the lowest pH of 6.8 combined with lower DIC concentrations. It thus seems that M. rubrum is largely resilient to changes in pH and DIC, and its blooms may not be strongly impacted by the changes in ocean carbonate chemistry projected for the end of the 21st century.


Asunto(s)
Dióxido de Carbono , Carbono , Clorofila A , Concentración de Iones de Hidrógeno , Agua de Mar , Plastidios , Criptófitas/fisiología , Fitoplancton
20.
Int Urogynecol J ; 23(1): 73-7, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21822711

RESUMEN

INTRODUCTION AND HYPOTHESIS: The objective of this study was to compare puborectal muscle integrity and bulk in women with both major levator ani (LA) defects on MRI and pelvic organ prolapse (POP) to women with normal LA muscle and normal support. METHODS: This is a case-control study comparing 24 cases with known major LA defects and POP to 24 controls with normal LA and normal support. Axial T-2 weighted MRI scans of the pelvis were evaluated for integrity of the puborectal muscle and degree of muscle bulk. RESULTS: There were no significant group differences in age, body mass index, vaginal deliveries, or hysterectomy status. In all 48 subjects, the puborectal muscle was visible and had no disruption noted. There was no difference in muscle bulk between groups (control/case, thin 42% vs. 25%, average 42% vs. 38%, thick-17% vs. 38%; P = 0.47). CONCLUSIONS: Defects and loss of muscle bulk in the puborectal muscle are not seen on MRI in women with major LA defects and POP.


Asunto(s)
Imagen por Resonancia Magnética , Músculo Esquelético/anatomía & histología , Músculo Esquelético/patología , Prolapso de Órgano Pélvico/patología , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagenología Tridimensional , Persona de Mediana Edad
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