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1.
Appl Environ Microbiol ; 89(10): e0110123, 2023 10 31.
Artículo en Inglés | MEDLINE | ID: mdl-37728340

RESUMEN

Pseudomonas aeruginosa grows as a biofilm under many environmental conditions, and the bacterium can disperse from biofilms via highly regulated, dynamic processes. However, physiologic triggers of biofilm dispersal remain poorly understood. Based on prior literature describing dispersal triggered by forms of starvation, we tested bacterial respiratory inhibitors for biofilm dispersal in two models resembling chronic airway infections. Our underlying hypothesis was that respiratory inhibitors could serve as a model for the downstream effects of starvation. We used two experimental conditions. In the first condition, biofilms were grown and dispersed from the surface of airway epithelial cells, and the second condition was a model where biofilms were grown on glass in cell culture media supplemented with host-relevant iron sources. In both biofilm models, the respiratory inhibitors potassium cyanide and sodium azide each triggered biofilm dispersal. We hypothesized that cyanide-induced dispersal was due to respiratory inhibition rather than signaling via an alternative mechanism, and, indeed, if respiration was supported by overexpression of cyanide-insensitive oxidase, dispersal was prevented. Dispersal required the activity of the cyclic-di-GMP regulated protease LapG, reinforcing the role of matrix degradation in dispersal. Finally, we examined the roles of individual phosphodiesterases, previously implicated in dispersal to specific triggers, and found signaling to be highly redundant. Combined deletion of the phosphodiesterases dipA, bifA, and rbdA was required to attenuate the dispersal phenotype. In summary, this work adds insight into the physiology of biofilm dispersal under environmental conditions in which bacterial respiration is abruptly limited. IMPORTANCE The bacterium Pseudomonas aeruginosa grows in biofilm communities that are very difficult to treat in human infections. Growing as a biofilm can protect bacteria from antibiotics and the immune system. Bacteria can leave a biofilm through a process called "dispersal." Dispersed bacteria seed new growth areas and are more susceptible to killing by antibiotics. The triggers for biofilm dispersal are not well understood, and if we understood dispersal better it might lead to the development of new treatments for infection. In this paper, we find that inhibiting P. aeurginosa's ability to respire (generate energy) can trigger dispersal from a biofilm grown in association with human respiratory epithelial cells in culture. The dispersal process requires a protease which is previously known to degrade the biofilm matrix. These findings give us a better understanding of how the biofilm dispersal process works so that future research can discover better ways of clearing bacteria growing in biofilms.


Asunto(s)
Biopelículas , Pseudomonas aeruginosa , Humanos , Pseudomonas aeruginosa/genética , Hidrolasas Diéster Fosfóricas/metabolismo , Antibacterianos/farmacología , Péptido Hidrolasas/metabolismo , Cianuros/metabolismo , Cianuros/farmacología , Regulación Bacteriana de la Expresión Génica , Proteínas Bacterianas/metabolismo , GMP Cíclico/metabolismo
2.
Molecules ; 28(6)2023 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-36985500

RESUMEN

(1) Background: Malaria, a vector-borne infectious disease, is caused by parasites of the Plasmodium genus, responsible for increased extreme morbidity and mortality rates. Despite advances in approved vaccines, full protection has not yet been achieved upon vaccination, thus the development of more potent and safe immuno-stimulating agents for malaria prevention is a goal to be urgently accomplished. We have focused our research on a strategy to identify Plasmodium spp. epitopes by naturally acquired human antibodies and rodent malaria infection models immunized with site-directed non-natural antigens. (2) Methods: Some predictive algorithms and bioinformatics tools resembling different biological environments, such as phagosome-lysosome proteolytic degradation, affinity, and the high frequency of malaria-resistant and -sensitive HLA-II alleles were regarded for the proper selection of epitopes and potential testing. Each epitope's binding profile to both host cells and HLA-II molecules was considered for such initial screening. (3) Results: Once selected, we define each epitope-peptide to be synthesized in terms of size and hydrophobicity, and introduced peptide-bond surrogates and non-natural amino acids in a site-directed fashion, and then they were produced by solid-phase peptide synthesis. Molecules were then tested by their antigenic and immunogenic properties compared to human sera from Colombian malaria-endemic areas. The antigenicity and protective capacity of each epitope-peptide in a rodent infection model were examined. The ability of vaccinated mice after being challenged with P. berghei ANKA and P. yoelii 17XL to control malaria led to the determination of an immune stimulation involving Th1 and Th1/Th2 mechanisms. In silico molecular dynamics and modeling provided some interactions insights, leading to possible explanations for protection due to immunization. (4) Conclusions: We have found evidence for proposing MSP1-modified epitopes to be considered as neutralizing antibody stimulators that are useful as probes for the detection of Plasmodium parasites, as well as for sub-unit components of a site-directed designed malaria vaccine candidate.


Asunto(s)
Malaria Falciparum , Malaria , Parásitos , Peptidomiméticos , Humanos , Animales , Ratones , Epítopos , Proteína 1 de Superficie de Merozoito , Plasmodium falciparum , Antígenos de Protozoos , Proteínas Protozoarias/química , Malaria Falciparum/prevención & control , Malaria/prevención & control , Vacunación , Inmunoglobulinas , Péptidos
3.
Nature ; 524(7563): 47-53, 2015 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-26168399

RESUMEN

We have sequenced the genomes of 110 small cell lung cancers (SCLC), one of the deadliest human cancers. In nearly all the tumours analysed we found bi-allelic inactivation of TP53 and RB1, sometimes by complex genomic rearrangements. Two tumours with wild-type RB1 had evidence of chromothripsis leading to overexpression of cyclin D1 (encoded by the CCND1 gene), revealing an alternative mechanism of Rb1 deregulation. Thus, loss of the tumour suppressors TP53 and RB1 is obligatory in SCLC. We discovered somatic genomic rearrangements of TP73 that create an oncogenic version of this gene, TP73Δex2/3. In rare cases, SCLC tumours exhibited kinase gene mutations, providing a possible therapeutic opportunity for individual patients. Finally, we observed inactivating mutations in NOTCH family genes in 25% of human SCLC. Accordingly, activation of Notch signalling in a pre-clinical SCLC mouse model strikingly reduced the number of tumours and extended the survival of the mutant mice. Furthermore, neuroendocrine gene expression was abrogated by Notch activity in SCLC cells. This first comprehensive study of somatic genome alterations in SCLC uncovers several key biological processes and identifies candidate therapeutic targets in this highly lethal form of cancer.


Asunto(s)
Genoma Humano/genética , Genómica , Neoplasias Pulmonares/genética , Mutación/genética , Carcinoma Pulmonar de Células Pequeñas/genética , Alelos , Animales , Línea Celular Tumoral , Puntos de Rotura del Cromosoma , Ciclina D1/genética , Proteínas de Unión al ADN/genética , Modelos Animales de Enfermedad , Femenino , Perfilación de la Expresión Génica , Humanos , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patología , Masculino , Ratones , Sistemas Neurosecretores/metabolismo , Sistemas Neurosecretores/patología , Proteínas Nucleares/genética , Receptores Notch/genética , Receptores Notch/metabolismo , Proteína de Retinoblastoma/genética , Transducción de Señal/genética , Carcinoma Pulmonar de Células Pequeñas/metabolismo , Carcinoma Pulmonar de Células Pequeñas/patología , Proteína Tumoral p73 , Proteína p53 Supresora de Tumor/genética , Proteínas Supresoras de Tumor/genética
4.
Psychol Med ; 50(6): 1002-1009, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31017076

RESUMEN

BACKGROUND: Studies of psychological interventions for the prevention of depression have found significant effects in the short-term, but the long-term efficacy has yet to be determined. This study evaluated the 8-year effect of a randomized controlled trial for indicated prevention of depression in female caregivers. METHODS: A total of 173 non-professional female caregivers with subclinical depressive symptoms not meeting criteria for a major depressive episode (MDE) were randomized to either a brief problem-solving intervention (n = 89) or usual-care control group (n = 84). Blinded evaluators conducted an assessment at the 8-year follow-up. The primary outcome was Depression Status, defined by diagnoses of MDE since the 1-year follow-up using the Structured Clinical Interview for the Disorders of the DSM-5. The secondary outcome was current Depressive Symptom Severity. Regression analyses were conducted to evaluate the effect of the intervention on the outcomes. RESULTS: There were no significant differences in the Depression Status between the problem-solving (30.3%) and control groups (26.2%) (adjusted OR 1.25, 95% CI -0.58 to 2.69). Depressive Symptom Severity, however, was significantly lower in the problem-solving group compared to the control group at this follow-up, amounting to a small effect size of Cohen's d = 0.39 (adjusted B = -3.32, p = 0.018). CONCLUSIONS: This is the first study to assess such a long-term follow-up of intervention of indicated prevention of depression. Results seem to indicate that the protective effect of the intervention became smaller over time during follow-up. Future research should replicate these results.


Asunto(s)
Cuidadores/psicología , Depresión/prevención & control , Solución de Problemas , Intervención Psicosocial/métodos , Adulto , Anciano , Estudios de Casos y Controles , Terapia Cognitivo-Conductual/métodos , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad
5.
Behav Sci Law ; 38(1): 32-50, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32012335

RESUMEN

Competence to stand trial (CST) evaluations are a critical part of certain criminal proceedings, and competence-related evaluation and treatment are an increasing part of public mental health services. Whereas more research describes the defendants undergoing competence evaluations, less research has examined the actual reports detailing those competence evaluations. This study reviewed 3,644 court-ordered CST evaluation reports submitted by 126 evaluators in Virginia since Virginia initiated an oversight system allowing for comprehensive review. The base rate of incompetence opinions was 38.8%, but these rates varied significantly across evaluation type (initial versus post-restoration efforts) and evaluators (ranging from 9.1% to 76.8% incompetence rate). Results suggest generally strong compliance with state statutes guiding CST evaluations, but also highlight marked variability in forensic conclusions and reveal a few areas in which some reports fell short of statutory requirements and practice guidelines.


Asunto(s)
Criminales/psicología , Competencia Mental/legislación & jurisprudencia , Derecho Penal , Bases de Datos Factuales , Personas con Discapacidad , Psiquiatría Forense/métodos , Humanos , Trastornos Mentales/psicología , Virginia
6.
Law Hum Behav ; 44(4): 286-299, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32757609

RESUMEN

OBJECTIVE: We examined the prevalence of criminal defendants facing only misdemeanor charges and referred for forensic mental health evaluations of legal sanity (criminal responsibility) in a state-wide sample of sanity reports. We sought to describe this population of defendants, particularly as compared to defendants facing felony charges and referred for evaluation of legal sanity. HYPOTHESES: We hypothesized that, among those referred for sanity evaluations, defendants facing only misdemeanor charges would have higher rates of serious mental illness than would defendants charged with felonies, as evidenced by their mental status during the evaluation and at the time of alleged offenses. We also hypothesized that defendants charged with only misdemeanors would be more often opined insane, as compared to those charged with felonies. METHOD: We reviewed a statewide sample of 926 court-ordered sanity evaluation reports in Virginia and coded numerous variables describing the defendants, sanity evaluation process, resulting reports, and legal opinions offered within the reports. RESULTS: Approximately 22.3% of sanity evaluations involved defendants charged only with misdemeanor offenses. Defendants facing only misdemeanor charges were 1.82 times more likely to be opined insane than were defendants facing only felony charges, primarily due to their increased likelihood of experiencing psychotic symptoms at the time of the offense (1.83 times more likely than defendants facing felony charges). CONCLUSIONS: The merits of pursuing the insanity defense in response to misdemeanor charges are questionable given the cost- and resource-intensive outcomes associated with insanity acquittals. Diversion strategies may be a more efficient response to those defendants with serious mental illness facing only misdemeanor charges. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Crimen/clasificación , Criminales/psicología , Psiquiatría Forense , Trastornos Mentales/diagnóstico , Evaluación de Síntomas/psicología , Adulto , Femenino , Humanos , Defensa por Insania , Masculino , Servicios de Salud Mental/legislación & jurisprudencia , Virginia
7.
Behav Sci Law ; 36(3): 303-316, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29722059

RESUMEN

Evaluations of legal sanity are some of the most complex and consequential mental health evaluations that forensic clinicians perform for the courts. Thus, there is strong reason to monitor the wide-scale process and conclusions of sanity evaluations. In this study, we review 1,111 court-ordered sanity evaluation reports submitted by 74 evaluators in Virginia from the first year after the state initiated an oversight system that allowed for such comprehensive review. Overall, the base rate of insanity findings was 16.9%, although base rates of insanity findings among individual evaluators varied from 0% to 50%. Similarly, most evaluators cited the cognitive (rather than volitional) criteria of the insanity defense as the basis for their insanity findings, although evaluators varied in their patterns of citing these underlying insanity criteria. Our review revealed other trends in practice, such as the rarity of psychological testing (2% of cases) and the frequency of conveying conclusions in "ultimate issue" format (76%). Overall, findings reveal that a majority of reports seem reasonably consistent with practice guidelines, but also reveal some idiosyncratic practices or patterns that suggest there is opportunity for improvement.


Asunto(s)
Defensa por Insania/estadística & datos numéricos , Trastornos Mentales/diagnóstico , Psiquiatría Forense , Humanos , Trastornos Mentales/clasificación , Trastornos Mentales/psicología , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/epidemiología , Trastornos Psicóticos/psicología , Virginia/epidemiología
8.
Aging Ment Health ; 21(9): 938-946, 2017 09.
Artículo en Inglés | MEDLINE | ID: mdl-27187725

RESUMEN

OBJECTIVES: The primary aim was to assess the feasibility/acceptability of a preventive cognitive-behavioral intervention implemented via conference call for caregivers. The secondary aim was to conduct a preliminary assessment of the efficacy of the behavioral activation component alone compared to the complete cognitive-behavioral intervention. METHOD: Sixty-one caregivers (mean age 58.4 years) were randomly assigned to a cognitive-behavioral intervention via conference call (CBC, n = 20), a behavioral activation intervention via conference call (BAC, n = 22) or a control group receiving usual care (CG, n = 19). Both interventions consisted of five 90-minute group sessions implemented weekly. RESULTS: Only 6.6% of caregivers discontinued the study. In the CBC and BAC groups, attendance and satisfaction with the intervention were similarly high among both groups. Homework adherence was also high in both groups. At post-treatment, there was a lower incidence of depression in the CBC and BAC groups compared to the CG (0.0% for BAC and CBC vs. 10.5% for CG). The relative risk was 0.0, and number needed to treat was 10 in both groups. Depressive symptoms were significantly reduced in the CBC and BAC groups compared to the CG (d = 2.18 and d = 2.06). CONCLUSION: The results support the feasibility of the intervention. Moreover, the BAC intervention was non-inferior to the CBC intervention for reducing depressive symptoms.


Asunto(s)
Cuidadores/psicología , Terapia Cognitivo-Conductual/métodos , Depresión/prevención & control , Anciano , Estudios de Casos y Controles , Depresión/terapia , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Método Simple Ciego , Teléfono
9.
Am J Geriatr Psychiatry ; 24(6): 421-32, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-27067068

RESUMEN

OBJECTIVES: To evaluate the efficacy of a cognitive-behavioral intervention for the prevention of depression in caregivers with elevated depressive symptoms through 12 months of follow-up. DESIGN: Randomized controlled trial. SETTING: Community in Galicia (Spain). PARTICIPANTS: 170 caregivers with elevated depressive symptoms. INTERVENTIONS: Caregivers were randomized to a cognitive-behavioral intervention (N = 88), administered to groups of five participants in five weekly 90-min sessions, or to a usual care control group (N = 82). MEASUREMENTS: Major depressive episodes (according to the Structured Clinical Interview for Axis I Disorders of the DSM-IV), depressive symptoms, emotional distress, caregiver burden, pleasant activities, depressive thoughts, social contacts. Trained blinded interviewers conducted assessments at 1, 3, 6, and 12 months of follow-up. RESULTS: At the 12-month follow-up, there was a lower incidence of major depressive episodes in the intervention group compared with the control group (3.4% versus 22.0%). The relative risk was 0.15 (95% CI: 0.05-0.51) and the number needed to treat was 5 (95% CI: 3-11). The time of delay of the depressive episode onset in the intervention group was significant. Caregivers with good compliance to the intervention had a lower incidence of depression. The effects of the intervention on depressive symptoms, emotional distress, and caregiver burden were maintained for 12 months. Younger caregivers were more likely to benefit from the intervention. The change in depressive thoughts mediated the reduction in depressive symptoms. CONCLUSIONS: Depressive episodes can be successfully prevented in caregivers, with long-term effects.


Asunto(s)
Cuidadores/psicología , Terapia Cognitivo-Conductual/métodos , Depresión/prevención & control , Trastorno Depresivo Mayor/prevención & control , Depresión/terapia , Trastorno Depresivo Mayor/terapia , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Estudios de Seguimiento , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , España , Factores de Tiempo , Resultado del Tratamiento
10.
BMC Psychiatry ; 15: 300, 2015 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-26597295

RESUMEN

BACKGROUND: Although depression is a common problem in caregivers and there are effective cognitive-behavioral interventions for its prevention, the ability of caregivers to attend these treatments is often limited by logistics. Furthermore, the efficacy of the components of these interventions is unknown. The objectives of this study are to (a) evaluate the efficacy of a telephone-administered cognitive-behavioral intervention to prevent depression with all its components (cognitive and behavioral) and only with behavioral activation, and to (b) analyze the mediators of the change in depressive symptoms. METHODS/DESIGN: A randomized controlled clinical trial was designed to dismantle the components of a cognitive-behavioral intervention. Caregivers with elevated depressive symptoms will be randomly assigned to a cognitive-behavioral intervention, an intervention with only the behavioral activation component, or a usual care control group. Each condition will consist of approximately 60 participants. The two interventions will consist of five sessions lasting 90 min each, applied to groups of about 5 participants at a time via conference call. Trained interviewers, blind to the experimental conditions, will conduct the assessments at the pre-treatment, post-treatment and 1-, 3-, 6- and 12-month follow-ups. DISCUSSION: This study will provide evidence of the efficacy of a cognitive-behavioral intervention to prevent depression in caregivers with elevated depressive symptoms administered via conference call, and on the impact of the behavioral activation component on the overall efficacy of the program. If we find favorable results, it would mean that we have developed a program of prevention of depression of higher clinical utility and efficacy than those currently available, which would make it possible for a large number of caregivers to have access to such resources. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02292394. Registered 6 November 2014.


Asunto(s)
Cuidadores/psicología , Terapia Cognitivo-Conductual/métodos , Depresión/terapia , Trastorno Depresivo Mayor/terapia , Psicoterapia Breve/métodos , Depresión/psicología , Trastorno Depresivo Mayor/psicología , Femenino , Humanos , Masculino , Negativismo , Consulta Remota/métodos , Proyectos de Investigación , Autoeficacia , Teléfono , Resultado del Tratamiento
11.
Psychol Rep ; 116(3): 841-54, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25799123

RESUMEN

Activities designed to be performed outside of the intervention are considered an essential aspect of the effectiveness of cognitive-behavioral therapy. However, these have received little attention in interventions aimed at individuals with subclinical depressive symptoms who do not yet meet diagnostic criteria for depression (indicated prevention). In this study, the completion of tasks given as homework and their relationship with post-treatment depressive symptoms was with relation to an indicated prevention of depression intervention. Eighty-nine female non-professional caregivers recruited from an official registry completed an intervention involving 11 homework tasks. Tasks performed were recorded and depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale (CES-D). Among caregivers, 80.9% completed 9-11 tasks. The number of tasks performed was associated with post-treatment depressive symptoms, with 9 being optimal for clinically significant improvement. These findings highlight the relationship between homework and post-treatment depressive symptoms.


Asunto(s)
Cuidadores/psicología , Terapia Cognitivo-Conductual/métodos , Depresión/prevención & control , Adulto , Femenino , Humanos , Persona de Mediana Edad , Resultado del Tratamiento
12.
BMC Bioinformatics ; 15: 94, 2014 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-24684679

RESUMEN

BACKGROUND: In this study we consider DNA sequences as mathematical strings. Total and reduced alignments between two DNA sequences have been considered in the literature to measure their similarity. Results for explicit representations of some alignments have been already obtained. RESULTS: We present exact, explicit and computable formulas for the number of different possible alignments between two DNA sequences and a new formula for a class of reduced alignments. CONCLUSIONS: A unified approach for a wide class of alignments between two DNA sequences has been provided. The formula is computable and, if complemented by software development, will provide a deeper insight into the theory of sequence alignment and give rise to new comparison methods. AMS SUBJECT CLASSIFICATION: Primary 92B05, 33C20, secondary 39A14, 65Q30.


Asunto(s)
ADN/química , Alineación de Secuencia , Análisis de Secuencia de ADN/métodos , Secuencia de Bases , ADN/genética , Programas Informáticos
13.
Psychother Res ; 24(5): 578-93, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24274260

RESUMEN

OBJECT: The high prevalence and negative consequences of depression in caregivers have led to the development of depression prevention programs for this population. Their efficacy might be influenced by depression risk factors, and different interventions might fit specific caregiver profiles. Study goals were to examine (1) which subgroups of female caregivers had the highest likelihood of major depression (MDD) onset by 12-month follow-up based on depression risk factors and participation in two depression prevention programs, and (2) specific MDD predictors for each prevention approach. METHOD: Data were analyzed from two randomized trials: (1) cognitive-behavioral group (CB) vs. usual care (UC); n = 165; (2) problem-solving group (PS) vs. UC; n =165 (mean age = 54.5). RESULTS: Classification tree analysis showed that emotional distress (ED) was the strongest predictor in both trials. Additional MDD predictors were (i) lower age (for caregivers with low ED); (ii) working outside the home (for caregivers with intermediate ED); and (iii) higher autonomy in the care-recipient (for homemakers). The strongest predictors for each prevention intervention were lower age for CB, higher social class for PS, and ED and depressive symptoms for UC. CONCLUSIONS: RESULTS implicate the utility of emotional distress for depression screening and the need to develop tailored interventions.


Asunto(s)
Cuidadores/psicología , Trastorno Depresivo Mayor , Estrés Psicológico/complicaciones , Adulto , Anciano , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/etiología , Trastorno Depresivo Mayor/prevención & control , Femenino , Humanos , Persona de Mediana Edad , Pronóstico , Psicoterapia/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo , Resultado del Tratamiento
14.
Digit Health ; 10: 20552076241233139, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38384369

RESUMEN

Background: Due to the accessibility barriers of in-person programs for active aging, the development of programs that use innovative technologies is needed. Video games can be an engaging tool for disseminating active aging interventions. Objective: The objective of this pilot study was to analyze the feasibility of a cognitive-behavioral intervention to promote active aging administered through a video game. Methods: Fifty-five participants (63.6% women, mean age = 53.0 years) were randomly assigned to a cognitive-behavioral intervention to promote active aging administered through an interactive multimedia online video game with a complementary app (CBI-V; n = 29) or to a control group that received nonspecific online information (CG; n = 26). Results: Only 3.6% of the participants dropped out of the study (6.9% in CBI-V and 0.0% in CG; without significant differences between groups). The mean number of modules completed was 7.6 (SD = 0.9) out of 8 in the CBI-V and 7.9 (SD = 0.5) in the control group (CG), without significant between-group differences. In the CBI-V, the mean total time dedicated to the game was 516.8 min (SD = 94.3), including 143.2 min (SD = 31.6) of cognitive training tasks, and the mean of completed tasks was 206.2 (SD = 33.7) out of 259. Participants were highly engaged (M = 39.9, SD = 8.6) and satisfied (M = 25.8, SD = 4.5) with the intervention. After the intervention, the CBI-V group significantly improved on SF-36 dimensions of General Health (p = .0386), Vitality (p = .0283), Social Functioning (p = .0130), and Physical Summary Index (p = .0370) compared to the CG, with medium effect sizes (d = 0.56-0.75). Conclusions: The results demonstrate the feasibility of the video game intervention to promote active aging and encourage conducting a large-scale randomized controlled trial.

15.
J Cogn Psychother ; 37(1): 7-25, 2023 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-36787998

RESUMEN

New service delivery systems are needed to expand the reach of evidence-based practices for childhood trauma. Cognitive behavioral therapy is an effective approach for treating -childhood trauma, yet treatment barriers remain. Stepped care models that incorporate parent-led -treatment with therapist assistance may be one approach to improve access. This case study highlights the core components of a parent-led therapist-assisted treatment called Stepping Together that serves as a Step 1 treatment within a stepped care model. The components and structure of Stepping Together are described, along with excerpts from therapy sessions to illustrate the therapist's implementation of the model. Results of the case, in which improvements occurred, are presented. Stepping Together, a parent-led therapist-assisted first-line treatment within stepped care trauma-focused cognitive behavioral therapy, may be an effective treatment for some children after trauma and their caregivers, although more research is needed.


Asunto(s)
Terapia Cognitivo-Conductual , Padres , Humanos , Resultado del Tratamiento , Padres/psicología , Terapia Cognitivo-Conductual/métodos
16.
J Clin Med ; 12(18)2023 Sep 09.
Artículo en Inglés | MEDLINE | ID: mdl-37762813

RESUMEN

Due to the limited availability of in-person interventions for caregivers, the development of effective programs that use new technologies to prevent depression is needed. The goal of this research was to assess the efficacy of a cognitive behavioral intervention for the prevention of depression, administered to nonprofessional caregivers through a smartphone application (app). One hundred and seventy-five caregivers were randomly assigned to either an app-based cognitive behavioral intervention (CBIA), the CBIA intervention plus a telephone conference call (CBIA + CC), or an attention control group (ACG). At post-intervention, the incidence of depression was lower in the CBIA and CBIA + CC compared to the ACG (1.7% and 0.0% vs. 7.9%, respectively). The absolute risk, relative risk, and number needed to treat compared to the ACG were 6.2%, 21.6%, and 16 for the CBIA, whilst they were 8%, 0.0%, and 13 for the CBIA + CC. Depressive symptomatology was significantly lower in the CBIA and CBIA + CC compared to the ACG (d = 0.84, Cliff's δ = 0.49; d = 1.56, Cliff's δ = 0.72), as well as in the CBIA + CC compared to the CBIA (d = 0.72, Cliff's δ = 0.44). The prevention of depression was more likely in participants who received the CBIA, and adding the conference call in the CBIA + CC group improved the likelihood of this.

17.
Span J Psychiatry Ment Health ; 16(2): 76-84, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38591720

RESUMEN

INTRODUCTION: Addressing suicide requires an understanding of regional patterns of epidemiology, with health variables being central. However, the clinical profile of people who commit suicide has received little attention. The objectives of this study were to analyze the sociodemographic, clinical, and forensic characteristics of persons who committed suicide in Galicia between 2013 and 2016, analyze suicide mortality rates, and identify trajectories of hospitalizations and associated variables. MATERIAL AND METHODS: A population study was carried out on the 1354 people who died by suicide in Galicia. RESULTS: The most common profile was a retired man, 57.9 years old (SD=18.5), from an urban and inner area. 43.6% had been previously hospitalized, 41.6% had been diagnosed with physical disorders, and 26.8% with mental disorders. 48.2% had been prescribed psychiatric medications and 29.6% had received outpatient psychiatric care. The highest prevalence of death by suicide (27.5%) was in 2014, with the predominant method being hanging (59.1%). The average raw rate was 12.3/100,000. Three trajectories of hospitalizations emerged: 94.83% had experienced few hospitalizations; 2.95% an increasing pattern; and 2.22% a decreasing pattern. These trajectories were associated with number of psychiatric appointments, prescription of psychiatric medications, and diagnoses of physical and mental disorders. CONCLUSIONS: These findings are crucial for detection and prevention.


Asunto(s)
Trastornos Mentales , Suicidio , Masculino , Humanos , Persona de Mediana Edad , Suicidio/psicología , Trastornos Mentales/epidemiología , Hospitalización , Proyectos de Investigación
18.
Soc Psychiatry Psychiatr Epidemiol ; 47(10): 1657-67, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22246416

RESUMEN

PURPOSE: To assess the association between gender-based violence and DSM-IV Axis I disorders in female college students. METHODS: A stratified random sample of 1,043 college women (average age 22.2 years) participated in the study. We collected sociodemographic, socioeconomic and academic information as well as information on the participants' experience of gender-based violence victimization. The presence of mental disorders during the 12 months preceding the study was assessed by clinically trained interviewers applying the Structured Clinical Interview for DSM-IV Axis I disorders-Clinician Version (SCID-CV). RESULTS: 15.2% of the participants reported lifetime gender-based violence victimization. Almost two-thirds of the victims had suffered some Axis I disorder during the past year, a significantly larger proportion than among non-victims (OR = 3.72; 95% CI 2.61-5.30). Mood disorders and anxiety disorders were both significantly more common among victims than non-victims (OR = 4.26; 95% CI 2.81-6.46 and OR = 1.97; 95% CI 1.20-3.24, respectively). The most prevalent individual disorder among victims was major depressive disorder (26.41%). Among victims of purely psychological violence, the overall rate of Axis I disorder was similar to the rate among other victims (67 and 61%, respectively). CONCLUSIONS: Among female university students, the experience of physical or psychological gender-based violence is associated with mental disorder. These findings suggest the need for treatment and prevention interventions designed specifically for this population.


Asunto(s)
Víctimas de Crimen/psicología , Trastornos Mentales/epidemiología , Estudiantes/psicología , Violencia/psicología , Adolescente , Adulto , Víctimas de Crimen/estadística & datos numéricos , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Entrevistas como Asunto , Masculino , Trastornos Mentales/diagnóstico , Trastornos Mentales/psicología , Prevalencia , Factores Sexuales , Delitos Sexuales/psicología , Delitos Sexuales/estadística & datos numéricos , Parejas Sexuales , Factores Socioeconómicos , España/epidemiología , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios , Universidades , Violencia/estadística & datos numéricos
19.
J Clin Med ; 11(23)2022 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-36498539

RESUMEN

This study aimed to determine the quality of life and sexual satisfaction in a sample of 389 women with breast cancer who underwent a surgical treatment and 366 men who were these women's partners. The sample was recruited from the Portuguese League Against Cancer by 10 trained psychologists who assessed the quality of life and sexual satisfaction of the participants. Data on the sociodemographic variables, diagnosis and treatment in the female participants, relationship with their partner, anxiety and depression, and body image were also collected. It was found that 76.6% and 54.2% of the women had low physical and mental health, respectively, while 100% of partners had acceptable physical and mental health. The predictors of women's physical health were months since surgery, current treatment, completed treatments, satisfaction with the current relationship with their partner, lower anxiety and depression, and better body image. The predictors of women's mental health were months since diagnosis and treatment completion, satisfaction with partner support during the illness, lower anxiety and depression, and better body image. The predictors of both physical and mental health of partners were lower anxiety and depression. In addition, 88.4% of women and 100% of partners presented with sexual dysfunction. The predictors of women's sexual satisfaction were being older, satisfaction with their relationship with their partner before the illness, lower anxiety and depression, and better body image. The predictors of sexual satisfaction of the male partners were psychological/psychiatric support, satisfaction with their current relationship with their partner, and lower anxiety and depression. These findings suggest that interventions targeted at the quality of life of women and sexual satisfaction with a couple perspective are needed.

20.
J Interpers Violence ; 37(15-16): NP14215-NP14238, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-33866840

RESUMEN

Although sexual assaults on female university students are a public health concern, studies that have examined this issue have not used behaviorally specific definitions of the various types of sexual victimization. Furthermore, hardly any data exists on female Spanish university students. The objectives of this study were to analyze the prevalence of different forms of sexual assault against female Spanish university students, determine the risk factors associated with sexual assault, analyze the association between sexual victimization and mental health problems, and determine the differential risk of more serious types of sexual assault. A cross-sectional study was conducted among a random sample of 871 students from the University of Santiago de Compostela (Spain) (mean age 20.7 years, SD = 2.8). The current study assessed various types of sexual violence (i.e., unwanted sexual contact, attempted coercion, coercion, attempted rape, rape), as well as rates of depression, anxiety, stress, eating disorders, substance abuse, suicide risk, and suicide attempts. Of the female students surveyed, 28.5% had suffered some form of sexual violence during the previous year, 22.3% reported unwanted sexual contact, 8.8% attempted coercion, 6.5% coercion, 10.4% attempted rape, and 7.9% had been raped. Lower risk was associated with having a partner and being heterosexual. Being 18 years of age and prior experiences of sexual victimization were associated with higher risk. Being the victim of attempted coercion was associated with a higher risk of depression, while victims of attempted rape were at higher risk for substance use. Rape victims were at the highest risk for all mental health conditions studied, with the exception of suicide attempts. Due to the high rates at which Spanish female university students experience sexual violence, planning and resources are needed to address their mental health needs, especially those who are victims of rape.


Asunto(s)
Víctimas de Crimen , Violación , Delitos Sexuales , Trastornos Relacionados con Sustancias , Adulto , Víctimas de Crimen/psicología , Estudios Transversales , Femenino , Humanos , Salud Mental , Violación/psicología , Estudiantes , Trastornos Relacionados con Sustancias/psicología , Universidades , Adulto Joven
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