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1.
J Interprof Care ; 34(3): 353-361, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31429340

RESUMO

Collaborative care (interdisciplinary/interprofessional teamwork) in mental health is emerging as best practice in primary care, hospitals, and government agencies. Counsellors have much to offer and benefit from working with other professions in service of their clients. While most health professions are well on their way integrating collaborating with one another in practice, it is yet unclear how often, and in what ways, counsellors are included in these teams. This scoping review of the literature on collaborative practice in counselling addresses the question: "What is the role of Professional Counselling and Clinical/Counselling Psychology in a collaborative model of mental health care?" This scoping review looks at 40 studies published between 2012 and 2015. Counsellors are often included on multidisciplinary teams in diverse roles. Specific collaborative activities are discussed along with ethical and educational implications.


Assuntos
Comportamento Cooperativo , Aconselhamento , Educação Interprofissional , Relações Interprofissionais , Transtornos Mentais/terapia , Humanos , Equipe de Assistência ao Paciente
2.
Hippocampus ; 25(5): 605-15, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25483019

RESUMO

Hippocampal atrophy is associated with memory impairment and dementia and serves as a key biomarker in the preclinical stages of Alzheimer's disease. Physical activity, one of the most promising behavioral interventions to prevent or delay cognitive decline, has been shown to be associated with hippocampal volume; specifically increased aerobic activity and fitness may have a positive effect on the size of the hippocampus. The majority of older adults, however, are sedentary and have difficulty initiating and maintaining exercise programs. A modestly more active lifestyle may nonetheless be beneficial. This study explored whether greater objectively measured daily walking activity was associated with larger hippocampal volume. We additionally explored whether greater low-intensity walking activity, which may be related to leisure-time physical, functional, and social activities, was associated with larger hippocampal volume independent of exercise and higher-intensity walking activity. Segmentation of hippocampal volumes was performed using Functional Magnetic Resonance Imaging of the Brain's Software Library (FSL), and daily walking activity was assessed using a step activity monitor on 92, nondemented, older adult participants. After controlling for age, education, body mass index, cardiovascular disease risk factors, and the Mini Mental State Exam, we found that a greater amount, duration, and frequency of total daily walking activity were each associated with larger hippocampal volume among older women, but not among men. These relationships were specific to hippocampal volume, compared with the thalamus, used as a control brain region, and remained significant for low-intensity walking activity, independent of moderate- to vigorous-intensity activity and self-reported exercise. This is the first study, to our knowledge, to explore the relationship between objectively measured daily walking activity and hippocampal volume in an older adult population. Findings suggest the importance of examining whether increasing nonexercise, lifestyle physical activities may produce measurable cognitive benefits and affect hippocampal volume through molecular pathways unique to those related to moderate-intensity exercise.


Assuntos
Hipocampo/anatomia & histologia , Caminhada , Actigrafia , Idoso , Exercício Físico , Feminino , Humanos , Modelos Lineares , Imageamento por Ressonância Magnética , Masculino , Tamanho do Órgão , Caracteres Sexuais , Tálamo/anatomia & histologia
3.
J Strength Cond Res ; 29(2): 528-33, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25627452

RESUMO

Compression socks have become a popular recovery aid for distance running athletes. Although some physiological markers have been shown to be influenced by wearing these garments, scant evidence exists on their effects on functional recovery. This research aims to shed light onto whether the wearing of compression socks for 48 hours after marathon running can improve functional recovery, as measured by a timed treadmill test to exhaustion 14 days following marathon running. Athletes (n = 33, age, 38.5 ± 7.2 years) participating in the 2012 Melbourne, 2013 Canberra, or 2013 Gold Coast marathons were recruited and randomized into the compression sock or placebo group. A graded treadmill test to exhaustion was performed 2 weeks before and 2 weeks after each marathon. Time to exhaustion, average and maximum heart rates were recorded. Participants were asked to wear their socks for 48 hours immediately after completion of the marathon. The change in treadmill times (seconds) was recorded for each participant. Thirty-three participants completed the treadmill protocols. In the compression group, average treadmill run to exhaustion time 2 weeks after the marathon increased by 2.6% (52 ± 103 seconds). In the placebo group, run to exhaustion time decreased by 3.4% (-62 ± 130 seconds), P = 0.009. This shows a significant beneficial effect of compression socks on recovery compared with placebo. The wearing of below-knee compression socks for 48 hours after marathon running has been shown to improve functional recovery as measured by a graduated treadmill test to exhaustion 2 weeks after the event.


Assuntos
Recuperação de Função Fisiológica/fisiologia , Corrida/fisiologia , Meias de Compressão , Adulto , Método Duplo-Cego , Teste de Esforço , Feminino , Humanos , Masculino , Esforço Físico/fisiologia , Distribuição Aleatória
4.
Artigo em Inglês | MEDLINE | ID: mdl-24634690

RESUMO

BACKGROUND: The prevalence of cannabis use in HIV-infected individuals is high and its long-term effects are unclear. METHODS: The prevalence, perceived benefits and consequences, and predictors of cannabis use were studied using a cross-sectional survey in two immunodeficiency clinics in Maritime Canada. RESULTS: Current cannabis use was identified in 38.5% (87 of 226) of participants. Almost all cannabis users (85 of 87 [97.7%]) acknowledged its use for recreational purposes, with 21.8% (19 of 87) reporting medicinal cannabis use. The majority of patients enrolled in the present study reported mild or no symptoms related to HIV (n=179). Overall, 80.5% (70 of 87) of the cannabis-using participants reported a symptom-relieving benefit, mostly for relief of stress, anorexia or pain. Participants consumed a mean (± SD) of 18.3±21.1 g of cannabis per month and spent an average of $105.15±109.87 on cannabis per month. Cannabis use was associated with rural residence, lower income level, driving under the influence of a substance, and consumption of ecstasy and tobacco. Income level, ecstasy use and tobacco use were retained as significant predictors in regression modelling. Cannabis use was not associated with adverse psychological outcomes. DISCUSSION: Prolonged previous cannabis consumption and the substantial overlap between recreational and medicinal cannabis use highlight the challenges in obtaining a tenable definition of medicinal cannabis therapy.


HISTORIQUE: La prévalence de consommation de cannabis est élevée chez les personnes infectées par le VIH, mais on n'en connaît pas les effets à long terme. MÉTHODOLOGIE: Les chercheurs ont étudié la prévalence, les avantages perçus et les conséquences et prédicteurs de consommation de cannabis au moyen d'un sondage transversal mené dans deux cliniques d'immunodéficience des Maritimes, au Canada. RÉSULTATS: Les chercheurs ont constaté une consommation courante de cannabis chez 38,5 % des participants (87 sur 226). Presque tous les consommateurs de cannabis (85 sur 87 [97,7 %]) admettaient en prendre pour des fins récréatives, et 21,8 % (19 sur 87) indiquaient en prendre pour des fins médicinales. La majorité des patients qui participaient à la présente étude a déclaré des symptômes du VIH légers, sinon inexistants (n=179). Dans l'ensemble, 80,5 % des participants consommateurs de cannabis (70 sur 87) ont affirmé remarquer un soulagement des symptômes, particulièrement le stress, l'anorexie ou la douleur. Les participants consommaient en moyenne 18,3±21,1 g de cannabis par mois et dépensaient en moyenne 105,15±109,87 $ par mois pour se le procurer. La consommation de cannabis était liée à un logement en milieu rural, à un niveau de revenu plus bas, à la conduite sous l'influence d'une substance et à la consommation d'ecstasy et de tabac. Le niveau de revenu, la consommation d'ecstasy et la consommation de tabac étaient considérés comme des prédicteurs importants selon le modèle de régression. La consommation de cannabis ne s'associait pas à des résultats psychologiques indésirables. EXPOSÉ: Une consommation antérieure prolongée de cannabis et le chevauchement important entre la consommation de cannabis à des fins récréatives et médicinales font ressortir la difficulté d'obtenir une définition viable du traitement médicinal par le cannabis.

5.
Work ; 78(2): 489-503, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38427522

RESUMO

BACKGROUND: As a large number of people live with HIV, it is worthwhile to examine the integration of this group in the workplace. OBJECTIVE: To investigate how the operationalization of GIPA/MEPA supports workplace policies and practices for PLHIV. The study aims to explore what is being offered to support PLHIV in community-based agencies and what can be done to enhance the offerings. METHODS: For this community-based research, 2 bilingual online surveys were sent to 150 Canadian organizations that work closely with PLHIV or offer support to them. One of the surveys was for Executive Directors of these organizations while the other was sent to peers; i.e. PLHIV whose job is to offer services to PLHIV. Questions in the surveys varied between open-ended, binary, and Likert. RESULTS: GIPA/MEPA are implemented in most organizations and Executive Directors affirmed that PLHIV and their impacts on the workplace are valued. There is a consensus among Executive Directors that formal support is provided but most respondents argued that this support is not specific for PLHIV. More than half of respondents were either unaware or uncertain about the existence of informal support. Peer-employees claimed that one of the challenges of disclosing HIV to receive peer support is that they may face stigma. CONCLUSION: The application of GIPA/MEPA results in positive outcomes in the workplace. The study emphasizes the need to facilitate access to informal support.


Assuntos
Infecções por HIV , Local de Trabalho , Humanos , Local de Trabalho/psicologia , Local de Trabalho/normas , Inquéritos e Questionários , Canadá , Estigma Social , Política Organizacional , Grupo Associado , Masculino , Feminino , Apoio Social , Adulto
6.
BMJ Open ; 13(9): e072979, 2023 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-37748847

RESUMO

OBJECTIVES: This cross-sectional study aims to characterise the understanding and attitudes medical practitioners have towards sports and exercise medicine (SEM). By identifying knowledge gaps, misunderstandings and barriers to SEM referral, interventions may be suggested to improve the integration of SEM within a multidisciplinary approach to healthcare. DESIGN: A survey was constructed with a multidisciplinary expert panel. Refinement and consensus were achieved through a modified Delphi method. Both quantitative and qualitative data were analysed and intergroup comparisons made using χ2 test of independence and post-hoc paired comparisons. SETTING: The questionnaire was distributed across Australian public and private health sectors, in community and hospital-based settings. PARTICIPANTS: Australian medical doctors practising in specialties likely to intersect with SEM were invited; including general practice, orthopaedics, emergency, rheumatology and anaesthetics/pain. Invitation was uncapped with no reportable response rate. A total of 120 complete responses were collected RESULTS: The minority (42.5%) of respondents understood the role and scope of sports and exercise physicians. SEM was poorly recognised and comprehended, with the most common misconception being that SEM is solely for elite athletes and performance. Few (20%) doctors were familiar with referral pathways to SEM services. Lack of awareness, clear scope and public presence were seen as major barriers. There was near unanimous (92.5%) agreement that 'exercise is medicine'. A strong majority felt SEM would be valuable to collaborate with more in their current practice (63.3%) and as a part of the Australian public health system (82.5%). There were some significant differences among subgroups, including that junior doctors were more likely to express confusion about SEM. CONCLUSIONS: Among non-SEM doctors, there is significant lack of clarity regarding the role of SEM and its optimal integration. Interdisciplinary education and addressing misconceptions may improve the contribution of SEM to community healthcare.


Assuntos
Anestesiologia , Médicos , Medicina Esportiva , Humanos , Estudos Transversais , Austrália , Confusão
7.
Clin J Sport Med ; 22(6): 488-94, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22584963

RESUMO

OBJECTIVE: To determine the incidence of and risk factors for exercise-associated hyponatremia (EAH) in cyclists completing a long-distance bike ride and to assess whether postexercise serum NT-proBNP concentration (brain natriuretic protein precursor) differed between riders with and without EAH. DESIGN: Observational study. SETTING: "Around the Bay in a Day" cycle event, October 2010. PARTICIPANTS: One hundred thirty-nine cyclists prospectively enrolled, with 90 completing 210 or 250 km. MAIN OUTCOME MEASURES: Body weight change and fluid intake during the event, and postevent serum sodium concentration ([Na+]) and NT-proBNP concentration ([NT-proBNP]). RESULTS: Four riders (4.5%) were hyponatremic ([Na+] < 135 mmol/L). The lowest postride [Na+] was 126 mmol/L. Hyponatremia was associated with a mean weight gain of 3.4 kg (3.9% of total body weight). Significant negative correlations were found between postride [Na+] and change in weight (r = -0.34; P < 0.01) and fluid intake when expressed as total volume (r = -0.35; P < 0.01), mL/kg body weight (r = 0.33; P < 0.01), mL·kg·h (r = -0.27; P < 0.01), or mL/h (r = -0.29; P < 0.01). NT-proBNP concentrations levels in 3 of the 4 hyponatremic subjects were markedly elevated compared with eunatremic subjects matched for age, sex, distance ridden, training, and medical history. CONCLUSIONS: Exercise-associated hyponatremia was found to occur in 4.5% of the study group and was associated with weight gain during a prolonged bike ride. Postride [Na+] varied inversely with weight change and with fluid intake. Three of 4 hyponatremic riders had significant elevations of [NT-proBNP]. These results support the hypothesis that overconsumption of hypotonic fluids in this setting is the most important cause of EAH.


Assuntos
Ciclismo/fisiologia , Hiponatremia/sangue , Hiponatremia/fisiopatologia , Peptídeo Natriurético Tipo C/sangue , Sódio/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ingestão de Líquidos/fisiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Aumento de Peso/fisiologia , Adulto Jovem
8.
Int J Adv Manuf Technol ; 120(9-10): 6547-6563, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35437337

RESUMO

Additive manufacturing is often used in rapid prototyping and manufacturing, allowing the creation of lighter, more complex designs that are difficult or too expensive to build using traditional manufacturing methods. This work considers the implementation of a novel digital twin ecosystem that can be used for testing, process monitoring, and remote management of an additive manufacturing-fused deposition modeling machine in a simulated virtual environment. The digital twin ecosystem is comprised of two approaches. One approach is data-driven by an open-source 3D printer web controller application that is used to capture its status and key parameters. The other approach is data-driven by externally mounted sensors to approximate the actual behavior of the 3D printer and achieve accurate synchronization between the physical and virtual 3D printers. We evaluate the sensor-data-driven approach against the web controller approach, which is considered to be the ground truth. We achieve near-real-time synchronization between the physical machine and its digital counterpart and have validated the digital twin in terms of position, temperature, and run duration. Our digital twin ecosystem is cost-efficient, reliable, replicable, and hence can be utilized to provide legacy equipment with digital twin capabilities, collect historical data, and generate analytics.

9.
Appl Ergon ; 100: 103673, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34936980

RESUMO

This paper provides a review of studies containing safety and ergonomic outcomes in lean manufacturing (LM) environments over the past 40 years. The aim is to identify effects from specific LM methods on specific safety/ergonomic outcomes, to understand the relationship in greater detail. One hundred and one studies containing one hundred and seventy outcomes were identified. Thirty-seven outcomes pertained to just-in-time (JIT) production, which contained twenty-three negative, eleven neutral, and three positive safety/ergonomic outcomes. Conversely, twenty-six outcomes pertained to 5S and consisted of twenty-four positive, two negative, and no neutral outcomes. The most common negative JIT outcome was stress and mental strain, while the most common positive 5S outcome was a tie between safety performance and hazard exposure. Studies containing other methods were fewer in number with more mixed outcomes. These findings suggest that individual LM methods, especially JIT and 5S, uniquely contribute to the safety/ergonomic outcomes attributed to LM.


Assuntos
Ergonomia , Humanos
10.
Neuroimage ; 54(1): 328-36, 2011 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-20600977

RESUMO

The BRAINS (Brain Research: Analysis of Images, Networks, and Systems) image analysis software has been in use, and in constant development, for over 20 years. The original neuroimage analysis pipeline using BRAINS was designed as a semiautomated procedure to measure volumes of the cerebral lobes and subcortical structures, requiring manual intervention at several stages in the process. Through use of advanced image processing algorithms the need for manual intervention at stages of image realignment, tissue sampling, and mask editing have been eliminated. In addition, inhomogeneity correction, intensity normalization, and mask cleaning routines have been added to improve the accuracy and consistency of the results. The fully automated method, AutoWorkup, is shown in this study to be more reliable (ICC ≥ 0.96, Jaccard index ≥ 0.80, and Dice index ≥ 0.89 for all tissues in all regions) than the average of 18 manual raters. On a set of 1130 good quality scans, the failure rate for correct realignment was 1.1%, and manual editing of the brain mask was required on 4% of the scans. In other tests, AutoWorkup is shown to produce measures that are reliable for data acquired across scanners, scanner vendors, and across sequences. Application of AutoWorkup for the analysis of data from the 32-site, multivendor PREDICT-HD study yield estimates of reliability to be greater than or equal to 0.90 for all tissues and regions.


Assuntos
Encéfalo/anatomia & histologia , Encéfalo/fisiologia , Algoritmos , Transtorno do Deficit de Atenção com Hiperatividade/patologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Automação/métodos , Encefalopatias/diagnóstico por imagem , Encefalopatias/patologia , Encefalopatias/fisiopatologia , Criança , Maus-Tratos Infantis , Humanos , Processamento de Imagem Assistida por Computador/métodos , Rede Nervosa/anatomia & histologia , Rede Nervosa/fisiologia , Valor Preditivo dos Testes , Radiografia , Reprodutibilidade dos Testes , Medula Espinal/anatomia & histologia , Medula Espinal/fisiologia
11.
Biomedicines ; 9(5)2021 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-33925613

RESUMO

Spinal cord injury (SCI) results in cell death, demyelination, and axonal loss. The spinal cord has a limited ability to regenerate, and current clinical therapies for SCI are not effective in helping promote neurologic recovery. We have developed a novel scaffold biomaterial that is fabricated from the biodegradable hydrogel oligo(poly(ethylene glycol)fumarate) (OPF). We have previously shown that positively charged OPF scaffolds (OPF+) in an open spaced, multichannel design can be loaded with Schwann cells to support axonal generation and functional recovery following SCI. We have now developed a hybrid OPF+ biomaterial that increases the surface area available for cell attachment and that contains an aligned microarchitecture and extracellular matrix (ECM) proteins to better support axonal regeneration. OPF+ was fabricated as 0.08 mm thick sheets containing 100 µm high polymer ridges that self-assemble into a spiral shape when hydrated. Laminin, fibronectin, or collagen I coating promoted neuron attachment and axonal outgrowth on the scaffold surface. In addition, the ridges aligned axons in a longitudinal bipolar orientation. Decreasing the space between the ridges increased the number of cells and neurites aligned in the direction of the ridge. Schwann cells seeded on laminin coated OPF+ sheets aligned along the ridges over a 6-day period and could myelinate dorsal root ganglion neurons over 4 weeks. This novel scaffold design, with closer spaced ridges and Schwann cells, is a novel biomaterial construct to promote regeneration after SCI.

12.
Mol Immunol ; 45(10): 2962-9, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18321578

RESUMO

The type A subspecies of Francisella tularensis is a highly virulent facultative intracellular bacterial pathogen, and a potential biological weapon. Recently, there has been renewed interest in developing new vaccines and therapeutics against this bacterium. Natural cases of disease, tularemia, caused by the type A subspecies are very rare. Therefore, the United States Food and Drug Administration will rely on the so-called Animal Rule for efficacy testing of anti-Francisella medicines. This requires the human disease to be modeled in one or more animal species in which the pathogenicity of the agent is reasonably well understood. Mice are natural hosts for F. tularensis, and might be able to satisfy this requirement. Tularemia pathogenesis appears to be primarily due to the host inflammatory response which is poorly understood at the molecular level. Additionally, the extent to which this response varies depending on host and pathogen genetic background, or by pathogen challenge route or dose is unknown. Therefore, the present study examined sera and infected tissues from C57BL/6 and BALB/c mice challenged by natural intradermal (ID) and respiratory routes with one of two distinct type A strains of the pathogen for cytokine and chemokine responses that might help to explain the morbidity associated with tularemia. The results show that the molecular immune response was mostly similar regardless of the variables examined. For instance, mRNA for the proinflammatory cytokine IL-6, and chemokines KC, and IP-10 was consistently upregulated at all sites of infection. Upregulation of mRNA for several other cytokines and chemokines occurred in a more tissue restricted manner. For instance, IFN-gamma was highly upregulated in the skin of BALB/c, but not C57BL/6 mice after ID inoculation of the pathogen, whilst IL-10 mRNA upregulation was only consistently seen in the skin and lungs.


Assuntos
Derme/microbiologia , Francisella tularensis/imunologia , Sistema Respiratório/microbiologia , Tularemia/imunologia , Aerossóis , Animais , Quimiocinas/sangue , Quimiocinas/genética , Derme/imunologia , Feminino , Francisella tularensis/crescimento & desenvolvimento , Francisella tularensis/isolamento & purificação , Regulação da Expressão Gênica , Cinética , Fígado/imunologia , Fígado/microbiologia , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Sistema Respiratório/imunologia , Baço/imunologia , Baço/microbiologia , Tularemia/sangue , Tularemia/genética
13.
Peptides ; 29(5): 795-800, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18423937

RESUMO

Activation of PPAR-gamma through the administration of glitazones has shown promise in preserving function following cardiac injury, although recent evidence has suggested their use may be contraindicated in the case of severe heart failure. This study tested the hypothesis that PPAR-gamma expression increases in a time dependent manner in response to chronic volume overload (VO) induced heart failure. Additionally, we attempted to determine what effect 4 week administration of Urotensin II (UTII) may have on PPAR-gamma expression. VO induced heart failure was produced in Sprague-Dawley rats (n=32) by aorta-caval fistula. Animals were sacrificed at 1, 4, and 14 weeks following shunt creation. In a separate set of experiments, animals were administered 300 pmol/kg/h of UTII for 4 weeks, subjected to 4 weeks of volume overload, or given UTII+VO. Densitometric analysis of left ventricular (LV) protein demonstrated PPAR-gamma expression was significantly ((*)p<0.05) upregulated at 4 and 14 weeks (31.5% and 37%, respectively) post-fistula formation compared to control values. PPAR-gamma activation was decreased in the 4 and 14 week (39.16% and 42.4%, respectively), but not in the 1-week animals, and these changes did not correlate with NF-kappaB activity. Animals given UTII either with or without VO demonstrated increased expression of PPAR-gamma as did animals subjected to 4 week VO alone. Animals given UTII either with or without VO had decreased activity vs. control. These data suggest PPAR-gamma may play a role in the progression of heart failure, however, the exact nature has yet to be determined.


Assuntos
Volume Cardíaco , Insuficiência Cardíaca , PPAR gama/metabolismo , Urotensinas , Animais , Insuficiência Cardíaca/metabolismo , Humanos , Masculino , NF-kappa B/metabolismo , Ratos , Ratos Sprague-Dawley , Urotensinas/administração & dosagem , Urotensinas/metabolismo
14.
J Health Psychol ; 13(3): 401-15, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18420773

RESUMO

The purpose of this article is to: (a) explore and describe experiences of hope in the context of high-risk behaviors; and (b) identify sources of hope for participants dealing with an HIV diagnosis. Following qualitative case study methodology along with philosophical hermeneutics, 12 people diagnosed with HIV or AIDS were interviewed to understand their experiences of hope. Participants were selected based on self-report for continuing or increasing high-risk behaviors following diagnosis. Results include participant descriptions of hope as well as five higher order categories that highlight sources of hope following an HIV diagnosis. Implications for treatment of those newly diagnosed and engaged in high-risk behaviors are discussed.


Assuntos
Adaptação Psicológica , Infecções por HIV/diagnóstico , Assunção de Riscos , Adulto , Canadá , Aconselhamento , Feminino , Infecções por HIV/psicologia , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Psicoterapia
15.
Cardiovasc Res ; 74(1): 140-50, 2007 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-17320065

RESUMO

OBJECTIVES: Myofibroblasts (myoFb) are the major cell types that appear at the site of myocardial infarction (MI) in response to injury and play a vital role in tissue repair/remodeling. Since vascular endothelial growth factor (VEGF) plays a crucial role in the infarcted/ischemic heart, we hypothesized that activation of the peroxisome proliferator-activated receptor (PPAR)-gamma by its agonists induces VEGF expression while simultaneously decreasing inflammation (NF-kappaB). Such an increase in myoFb VEGF expression by PPAR-gamma agonists may play a role in angiogenesis. METHODS: Rat myoFb were treated with PPAR-gamma agonists and VEGF expression was measured by ELISA. The effect of these agonists on VEGF receptors was determined by qRT-PCR and flow-cytometric analysis. VEGF produced by these cells was also used for analysis of in vitro tubule formation (Matrigel assay). RESULTS: The PPAR-gamma activators troglitazone (TZ) and 15-deoxy-prostaglandin J2 (15J2) induced the expression of VEGF and its receptors (Flt-1 and KDR) in myoFb. TZ and 15J2 elicited a significant increase in the expression of KDR (14.7+/-1.0% and 9.6+/-2.1% respectively) and Flt-1 (24.5+/-2.0%, and 14.0+/-2.2% respectively) when compared to untreated myoFb. MyoFb treated with PPAR-gamma agonists increased extracellular VEGF, augmenting tubule formation on a Matrigel. The PPAR-gamma activator 15J2 significantly decreased the NF-kappaB activity in myoFb. CONCLUSION: This study demonstrates the induction of the VEGF accompanied by a reduction of NF-kappaB activity (inflammatory signaling) by PPAR-gamma agonists in cardiac myoFb. These results may further the understanding of the beneficial effects of PPAR-gamma agonists on infarcted tissue repair and angiogenesis.


Assuntos
Cromanos/farmacologia , Miócitos Cardíacos/metabolismo , PPAR gama/metabolismo , Prostaglandina D2/análogos & derivados , Receptores de Fatores de Crescimento do Endotélio Vascular/metabolismo , Tiazolidinedionas/farmacologia , Fator A de Crescimento do Endotélio Vascular/metabolismo , Animais , Células Cultivadas , Colágeno , Combinação de Medicamentos , Ensaio de Imunoadsorção Enzimática/métodos , Regulação da Expressão Gênica , Laminina , Masculino , Microscopia de Fluorescência , Fibras Musculares Esqueléticas/fisiologia , Infarto do Miocárdio/metabolismo , NF-kappa B/metabolismo , Prostaglandina D2/farmacologia , Proteoglicanas , Ratos , Ratos Sprague-Dawley , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Troglitazona , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/metabolismo , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/metabolismo
16.
J Alzheimers Dis ; 63(2): 655-664, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29660936

RESUMO

BACKGROUND: Emerging evidence suggests a possible role of the renin angiotensin system in the pathophysiologic process of Alzheimer's disease, of which angiotensin converting enzyme-1 (ACE-1) and angiotensin II (ANGII) are important proteins. Few studies evaluated associations between blood ACE-1 and none between ANGII levels, and cognition. OBJECTIVE: Our pilot study was aimed to examine associations between blood ACE-1 and ANG II levels and cognitive function in non-demented participants at baseline and over a 1-year period. METHODS: 56 participants were included from the Brain Health Substudy of the Baltimore Experience Corps Study. Linear regression analysis, adjusting for confounders, was used to determine associations between baseline ACE-1 and ANGII, and baseline and 1-year follow-up measures of psychomotor and processing speed, executive function, verbal learning memory and working memory, and whether these associations were mediated by blood pressure. RESULTS: Participants were predominantly female (75%), African-American (93%), with mean age of 67.8 years and education of 14.3 years. There were no associations between baseline ACE-1 or ANGII levels and cognitive function; however, there were significant association between baseline ACE-1 levels and 1-year follow-up Trail Making Test, Part A (ß= 0.003, p = 0.04) and Digit Span (ß= -0.001, p = 0.02). CONCLUSIONS: In this cognitively intact sample, elevated ACE-1 levels were associated with worse processing speed and working memory after 1 year. Findings from this pilot study suggest that changes in the RAS are associated with alterations in cognitive function warranting further assessment of the role of RAS in neurodegenerative disorders.


Assuntos
Angiotensina II/sangue , Cognição , Peptidil Dipeptidase A/sangue , Idoso , Biomarcadores/sangue , Cognição/fisiologia , Feminino , Seguimentos , Humanos , Masculino , Projetos Piloto
17.
Focus (Am Psychiatr Publ) ; 16(4): 407-414, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31975936

RESUMO

Psychiatrists often have difficulty understanding how to document, code, and bill for their services in a way that expedites adequate payment and avoids billing problems or future issues. This is very understandable because many psychiatrists in small or solo practices do their own billing without any formal training in the vagaries of coding and reimbursement policies. For many years, the American Psychiatric Association (APA) has devoted substantial resources to guiding psychiatrists through this maze, with direct member assistance and resources publicly available at www.psychiatry.org. APA staff, councils, and committees have also been working for many years to improve coding and reimbursement for psychiatric services. Current and former members and staff of the APA Committee on RBRVS, Codes, and Reimbursement have authored this article to help psychiatrists gain a better understanding of the current coding and reimbursement structure for psychiatric services, including how it evolved and what the future holds.

18.
Peptides ; 28(8): 1483-9, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17553596

RESUMO

Urotensin II (UTII) is a potent vasoactive peptide. Recent studies have demonstrated increased expression of both UTII and its receptor (UTR) expression in end-stage congestive heart failure (CHF), but it is unclear whether UTII and UTR are late stage markers of decompensation, or earlier adaptive responses. The purpose of this study was to measure the effects of chronic UTII administration in normal and volume overloaded animals. Chronic 4 weeks administration of UTII produced decreases in hemodynamic function in animals not subjected to volume overload while returning function to control levels in animals with overload. Expression levels of calcium regulatory proteins phospholamban (PLN), sarcoplasmic reticulum Ca(2+) ATPase (SERCA2), and Na(+)/Ca(2+) exchanger (NCX) were measured to determine if administration of UTII resulted in aberrant Ca(2+) handling. Changes in protein expression revealed that UTII influenced Ca(2+) handling proteins in normal animals although these changes are not seen in the volume overload.


Assuntos
Fístula Arteriovenosa/fisiopatologia , Urotensinas/administração & dosagem , Animais , Doenças da Aorta/fisiopatologia , Fístula Arteriovenosa/genética , Pressão Sanguínea/efeitos dos fármacos , Proteínas de Ligação ao Cálcio/metabolismo , Insuficiência Cardíaca/genética , Insuficiência Cardíaca/fisiopatologia , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Isoenzimas/metabolismo , Masculino , Cadeias Pesadas de Miosina/genética , Proteínas Serina-Treonina Quinases/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Ratos , Ratos Sprague-Dawley , Receptores Acoplados a Proteínas G/genética , Proteínas Recombinantes/administração & dosagem , ATPases Transportadoras de Cálcio do Retículo Sarcoplasmático/metabolismo , Trocador de Sódio e Cálcio/metabolismo , Urotensinas/genética , Urotensinas/fisiologia , Veias Cavas , Função Ventricular Esquerda/efeitos dos fármacos , Quinases Associadas a rho
19.
Am J Health Behav ; 41(6): 775-783, 2017 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-29025505

RESUMO

OBJECTIVES: We determined the degree of parent-adolescent concordance in reported household food security, and delineated variation in concordance as a function of selected household and parent-adolescent relationship characteristics. METHODS: Cross-tabulations and Cohen's Kappa determined concordance. Multinomial logistic regressions delineated variation in concordance as a function of selected household and parent-adolescent relationship characteristics for Latino parent and adolescent dyads (N = 70). RESULTS: Nearly half the households had concordant reports of household food security, but 34% were "discordant" such that parents reported food insecurity but adolescents did not, and 17% were "discordant" wherein adolescents reported food insecurity but parents did not. Elevated parent-adolescent conflict was associated with greater odds of discordance wherein adolescent reported food insecurity but parent did not. Households with female adolescents and income ≥ $30,000/year were associated with lower odds of discordance wherein parent reported food insecurity but adolescent did not. CONCLUSIONS: Discordant reports of Latino household food security suggest the burden of unequal access to sufficient foods may be underestimated. Discordant reports may follow from cultural values that may encourage adolescents to keep hunger from their parents.


Assuntos
Comportamento do Adolescente/psicologia , Abastecimento de Alimentos/estatística & dados numéricos , Hispânico ou Latino/psicologia , Relações Pais-Filho , Adolescente , Adulto , Idoso , Criança , Conflito Psicológico , Feminino , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
20.
J Health Psychol ; 21(9): 1918-27, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-25637069

RESUMO

Harmful alcohol consumption among university students continues to be a significant issue. This study examined whether variables identified in the positive deviance literature would predict responsible alcohol consumption among university students. Surveyed students were categorized into three groups: abstainers, responsible drinkers and binge drinkers. Multinomial logistic regression modelling was significant (χ(2) = 274.49, degrees of freedom = 24, p < .001), with several variables predicting group membership. While the model classification accuracy rate (i.e. 71.2%) exceeded the proportional by chance accuracy rate (i.e. 38.4%), providing further support for the model, the model itself best predicted binge drinker membership over the other two groups.


Assuntos
Consumo de Bebidas Alcoólicas/tendências , Consumo Excessivo de Bebidas Alcoólicas/tendências , Estudantes/psicologia , Universidades , Adolescente , Feminino , Humanos , Modelos Logísticos , Masculino , Inquéritos e Questionários
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