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1.
Front Immunol ; 15: 1362727, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38585277

RESUMO

Acute pancreatitis is a complex inflammatory disease resulting in extreme pain and can result in significant morbidity and mortality. It can be caused by several factors ranging from genetics, alcohol use, gall stones, and ductal obstruction caused by calcification or neutrophil extracellular traps. Acute pancreatitis is also characterized by immune cell infiltration of neutrophils and M1 macrophages. Toll-like receptor 4 (TLR4) is a pattern recognition receptor that has been noted to respond to endogenous ligands such as high mobility group box 1 (HMGB1) protein and or exogenous ligands such as lipopolysaccharide both of which can be present during the progression of acute pancreatitis. This receptor can be found on a variety of cell types from endothelial cells to resident and infiltrating immune cells leading to production of pro-inflammatory cytokines as well as immune cell activation and maturation resulting in the furthering of pancreatic damage during acute pancreatitis. In this review we will address the various mechanisms mediated by TLR4 in the advancement of acute pancreatitis and how targeting this receptor could lead to improved outcomes for patients suffering from this condition.


Assuntos
Pancreatite , Humanos , Doença Aguda , Células Endoteliais/metabolismo , Pâncreas , Pancreatite/metabolismo , Receptor 4 Toll-Like/metabolismo
2.
Cells ; 13(5)2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38474380

RESUMO

Islet transplantation is a therapeutic option to replace ß-cell mass lost during type 1 or type 3c diabetes. Innate immune responses, particularly the instant blood-mediated inflammatory reaction and activation of monocytes, play a major role in the loss of transplanted islet tissue. In this study, we aimed to investigate the inhibition of toll-like receptor 4 (TLR4) on innate inflammatory responses. We first demonstrate a significant loss of graft function shortly after transplant through the assessment of miR-375 and miR-200c in plasma as biomarkers. Using in vitro models, we investigate how targeting TLR4 mitigates islet damage and immune cell activation during the peritransplant period. The results of this study support the application of TAK-242 as a therapeutic agent to reduce inflammatory and innate immune responses to islets immediately following transplantation into the hepatic portal vein. Therefore, TLR4 may serve as a target to improve islet transplant outcomes in the future.


Assuntos
Imunidade Inata , Transplante das Ilhotas Pancreáticas , Ilhotas Pancreáticas , MicroRNAs , Sulfonamidas , Receptor 4 Toll-Like , Imunidade Inata/efeitos dos fármacos , Transplante das Ilhotas Pancreáticas/métodos , Sulfonamidas/farmacologia , Receptor 4 Toll-Like/antagonistas & inibidores , Ilhotas Pancreáticas/efeitos dos fármacos , Ilhotas Pancreáticas/imunologia , Humanos
3.
Front Immunol ; 14: 1202197, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38077311

RESUMO

Plasmacytoid dendritic cells (pDC) are the major producer of type 1 IFN in response to TLR7 agonists. Aberrant TLR7 activation and type 1 IFN expression by pDCs are linked to the pathogenesis of certain types of autoimmune diseases, including systemic lupus erythematosus (SLE). This study investigated the underlying mechanisms for TLR7-mediated cytokine expression by pDCs using a late endosome trafficking inhibitor, EGA (4-bromobenzaldehyde N-(2,6-dimethylphenyl) semicarbazone). We found that EGA treatment decreased IFNα expression by pDCs stimulated with imiquimod (R837), single-stranded RNA40, and influenza virus. EGA also decreased TNFα expression and secretion by R837-stimulated pDCs. Mechanistically, EGA treatment decreased phosphorylation of IKKα/ß, STAT1, and p38, and prolonged degradation of IκBα. Furthermore, EGA treatment decreased the colocalization of 3F, a substituted adenine TLR7 agonist, with LAMP1+ compartments in pDCs. EGA was also capable of diminishing IFNα expression by SLE pDCs treated with R837 or live PR8/A/34 influenza viruses. Therefore, we concluded that trafficking of TLR7 agonists to LAMP1+ compartments is important for IFNα expression by pDCs. Data from this study support additional examinations of the potential benefits of EGA in treating type 1 IFN-associated inflammatory diseases in the future.


Assuntos
Lúpus Eritematoso Sistêmico , Receptor 7 Toll-Like , Humanos , Receptor 7 Toll-Like/metabolismo , Imiquimode , Células Dendríticas , Citocinas/metabolismo
4.
Front Psychol ; 14: 1016521, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37599750

RESUMO

Introduction: Mental health difficulties in early childhood can have a debilitating and ongoing impact throughout an individual's life; emotion regulation can serve as a protective factor. Therefore, evidence-based prevention programs that teach children effective skills and strategies for emotion regulation are needed. Methods: As part of the Aussie Optimism pilot study evaluating the "I Spy Feelings" program, this study aims to assess the short-term effects of the program on emotion regulation in pre-primary aged children after 2 months via a longitudinal cluster randomized controlled trial. Participants included parents (N = 73) of 5- to 6-year-old children attending four different Catholic primary schools. Children from two of the schools were allocated to the intervention group where they participated in the program (N = 33), while children from the other two schools were allocated to the control group where they did not (N = 40). At each time point, all parents completed abridged Children's Emotional Management Scales measuring how well parents believe their child is able to cope with anger, sadness and worry. Results: A significant intervention effect 2 months after intervention was found for the outcome of anger coping such that parents whose children were in the intervention group reported significantly greater improvement in their children's ability to cope with anger compared to parents whose children were in the control group. No significant effect was found for the outcome of sadness, and results for the worry subscale were inconclusive due to unacceptable internal consistency. Discussion: The present study provides insight into the benefit of programs designed to enhance the emotion regulation skills of very young children. Further follow-up is needed to assess whether the "I Spy Feelings" program has lasting effects.

5.
JAMA Netw Open ; 6(6): e2318715, 2023 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-37326988

RESUMO

Importance: Randomized clinical trials (RCTs) and meta-analyses have reported inconsistent conclusions regarding optimal distal radius fracture (DRF) treatment in older adults and are limited due to the inclusion of cohort studies with small sample sizes. A network meta-analysis (NMA) addresses these limitations by only synthesizing direct and indirect evidence from RCTs and may clarify optimal DRF treatment in older adults. Objective: To examine DRF treatment results in optimal short-term and intermediate-term patient-reported outcomes. Data Sources: Searches of MEDLINE, Embase, Scopus, and Cochrane Central Register of Controlled Trials were conducted for RCTs that investigated DRF treatment outcomes in older adults between January 1, 2000, and January 1, 2022. Study Selection: Randomized clinical trials including patients with a mean age of 50 years or older that compared the following DRF treatments were eligible for inclusion: casting, open reduction and internal fixation with volar lock plating (ORIF), external fixation, percutaneous pinning, and nail fixation. Data Extraction and Synthesis: Two reviewers independently completed all data extraction. An NMA aggregated all direct and indirect evidence among DRF treatments. Treatments were ranked by surface under the cumulative ranking curve score. Data are reported as standard mean differences (SMDs) and 95% CIs. Main Outcomes and Measures: The primary outcome was short-term (≤3 months) and intermediate-term (>3 months to 1 year) Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire scores. Secondary outcomes included Patient-Rated Wrist Evaluation (PRWE) scores and 1-year complication rates. Results: In this NMA, 23 RCTs consisting of 3054 participants (2495 women [81.7%]) with a mean (SD) age of 66 (7.8) years were included. At 3 months, DASH scores were significantly lower for nail fixation (SMD, -18.28; 95% CI, -29.93 to -6.63) and ORIF (SMD, -9.28; 95% CI, -13.90 to -4.66) compared with casting. The PRWE scores were also significantly lower for ORIF (SMD, -9.55; 95% CI, -15.31 to -3.79) at 3 months. In the intermediate term, ORIF was associated with lowered DASH (SMD, -3.35; 95% CI, -5.90 to -0.80) and PRWE (SMD, -2.90; 95% CI, -4.86 to -0.94) scores. One-year complication rates were comparable among all treatments. Conclusions and Relevance: The findings of this NMA suggest that ORIF may be associated with clinically significant improvements in short-term recovery compared with casting for multiple patient-reported outcomes measures with no increase in 1-year complication rates. Shared decision-making with patients may be useful to identify patient preferences regarding recovery to determine optimal treatment.


Assuntos
Fraturas do Rádio , Fraturas do Punho , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Fixação de Fratura/métodos , Fixação Interna de Fraturas/métodos , Metanálise em Rede , Fraturas do Rádio/cirurgia , Masculino
6.
Front Psychol ; 14: 1054723, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37325734

RESUMO

Introduction: The transition to parenthood is a high-risk period for many parents and is an important period for child development. Research has identified that parental mental health, reflective functioning (capacity to consider mental states of oneself and others) and coparenting (capacity to work together well as a parenting team) may be particularly significant predictors of later child outcomes, however these factors have seldom been considered together. The present study therefore aimed to investigate the relationship between these factors and the extent to which they predict child social emotional development. Methods: Three hundred and fifty parents of infants aged 0 to 3 years 11 months were recruited to complete an online Qualtrics questionnaire. Results: Results indicate that both positive coparenting and parental reflective functioning (Pre-mentalizing and Certainty subscales) were found to significantly predict child development. General reflective functioning (Uncertainty subscale) predicted parental depression and anxiety, however unexpectedly, parental mental health was not a significant predictor of child development, but did predict coparenting. General reflective functioning (Certainty subscale) was also found to predict coparenting, which in turn was found to predict parental reflective functioning. We found an indirect effect of general reflective functioning (Certainty) on child SE development via parental reflective functioning (Pre-mentalizing). We also found an indirect effect of negative coparenting on child development via parental reflective functioning (Pre-mentalizing). Discussion: The current results support a growing body of research highlighting the important role reflective functioning plays in child development and wellbeing as well as parental mental health and the interparental relationship.

7.
Mult Scler Relat Disord ; 73: 104677, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37028124

RESUMO

BACKGROUND: Alemtuzumab is effective in reducing relapse rate and disability, but limited data exist on its effect on cognitive function in relapsing multiple sclerosis (RMS). The present study assessed neurocognitive function and safety associated with alemtuzumab treatment in RMS. METHODS: This longitudinal, single-arm, prospective study included people with RMS (aged 25-55 years) who were treated with alemtuzumab in clinical practice in the United States of America and Canada. The first participant was enrolled in December 2016. The primary endpoint was the change from baseline to post-baseline (month [M] 12/24) in MS-COGnitive (MS-COG) composite score. Secondary endpoints included Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), Selective Reminding Test (SRT), Controlled Oral Word Association Test (COWAT), and Automated Neuropsychological Assessment Metrics (ANAM) scores. Depression and fatigue were assessed using Hamilton Rating Scale-Depression (HAM-D) and Fatigue Severity Scale (FSS)/Modified Fatigue Impact Scale (MFIS), respectively. Magnetic resonance imaging (MRI) parameters were assessed when available. Safety was assessed throughout the study. Descriptive statistics were used for the pre-specified statistical analyses. Since the study was terminated early (November 2019) because of operational and resource difficulties, post hoc analyses for statistical inference were performed among participants who had a baseline value and at least one complete post-baseline assessment for cognitive parameters, fatigue, or depression. RESULTS: Of the 112 participants enrolled, 39 were considered as the primary analysis population at M12. At M12, a mean change of 0.25 (95% confidence interval [CI]: 0.04, 0.45; p = 0.0049; effect size [ES]: 0.39) was observed in the MS-COG composite score. Improvements were observed in processing speed (based on PASAT and SDMT; p < 0.0001; ES: 0.62), as well as in individual PASAT, SDMT and COWAT scores. An improvement was also noted in HAM-D (p = 0.0054; ES: -0.44), but not in fatigue scores. Among MRI parameters, decreases in burden of disease volume (BDV; ES: -0.12), new gadolinium-enhancing lesions (ES: -0.41) and newly active lesions (ES: -0.07) were observed at M12. About 92% of participants showed stable or improved cognitive status at M12. There were no new safety signals reported in the study. The most common adverse events (≥10% of participants) were headache, fatigue, nausea, insomnia, urinary tract infection, pain in extremity, chest discomfort, anxiety, dizziness, arthralgia, flushing, and rash. Hypothyroidism (3.7%) was the most frequent adverse event of special interest. CONCLUSION: The findings from this study suggest that alemtuzumab has a positive impact on cognitive function with significant improvements in processing speed and depression in people with RMS over a period of 12 months. The safety profile of alemtuzumab was consistent with previous studies.


Assuntos
Esclerose Múltipla Recidivante-Remitente , Esclerose Múltipla , Humanos , Esclerose Múltipla/complicações , Alemtuzumab/efeitos adversos , Esclerose Múltipla Recidivante-Remitente/complicações , Esclerose Múltipla Recidivante-Remitente/diagnóstico por imagem , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Estudos Prospectivos , Fadiga/complicações , Testes Neuropsicológicos
8.
JAMA Netw Open ; 6(2): e2255786, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-36780156

RESUMO

Importance: Casting is recommended for adults older than 65 years with distal radius fractures (DRFs) because similar long-term outcomes are achieved regardless of treatment. However, physiologically younger adults could benefit from operative DRF management despite advanced chronologic age. Objective: To examine how chronologic age compares with measures of physiologic age in DRF treatment recovery. Design, Setting, and Participants: This retrospective secondary analysis of the Wrist and Radius Injury Surgical Trial (WRIST) was performed from May 1 to August 31, 2022. WRIST was a 24-center randomized clinical trial that enrolled participants older than 60 years with unstable DRFs from April 1, 2012, to December 31, 2016. Interventions: Participants selected casting or surgery. Patients who selected surgery were randomly assigned to volar lock plating, percutaneous pinning, or external fixation. Participants were stratified by chronologic age, number of comorbidities, and activity status. Main Outcomes and Measures: The primary outcome was Michigan Hand Outcomes Questionnaire (MHQ) score assessed at 6 weeks, 3 months, 6 months, and 1 year. Partial correlation (PC) analysis adjusted for confounding. Results: The final cohort consisted of 293 participants (mean [SD] age, 71.1 [8.89] years; 255 [87%] female; 247 [85%] White), with 109 receiving casting and 184 receiving surgery. Increased chronologic age was associated with increased MHQ scores in the surgery group at all time points but decreased MHQ scores in the casting group at 12 months (mean [SD] score, -0.46 [0.21]; P = .03). High activity was associated with improved MHQ scores in the surgical cohort at 6 weeks (mean [SD] score, 12.21 [5.18]; PC = 0.27; P = .02) and 12 months (mean [SD] score, 13.25 [5.77]; PC = 0.17; P = .02). Comorbidities were associated with decreased MHQ scores at all time points in the casting group. Clinically significant differences in MHQ scores were associated with low physical activity, 4 or more comorbidities, or increased age by 15 years. Conclusions and Relevance: In this retrospective secondary analysis of WRIST, chronologic age was not associated with functional demand. These findings suggest that physicians should counsel active older adults with few comorbidities on earlier return to daily activities after surgery compared with casting. Trial Registration: ClinicalTrials.gov Identifier: NCT01589692.


Assuntos
Fraturas do Rádio , Fraturas do Punho , Humanos , Feminino , Idoso , Lactente , Adolescente , Masculino , Resultado do Tratamento , Estudos Retrospectivos , Fraturas do Rádio/cirurgia , Fraturas do Rádio/complicações , Fixação Interna de Fraturas
9.
ACS Med Chem Lett ; 14(1): 110-115, 2023 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-36660224

RESUMO

We previously demonstrated that the potent TLR4 inhibitor TAK-242 could be covalently conjugated to pancreatic islets using a linker that afforded an effective sustained delivery of the active drug after transplant. This drug-eluting tissue achieved local inhibition of TLR4-linked inflammation and proved beneficial to the islet graft survival. Here, we describe a new family of prodrugs with a modular design featuring a self-immolative para-aminobenzyl spacer bonded directly to the TAK-242 sulfonamide nitrogen, a tether for bioconjugation, and a ß-eliminative arylsulfone "trigger". The inclusion of the para-aminobenzyl spacer affords a more stable prodrug which exhibits complex drug-release kinetics due to a two-stage release mechanism. This manuscript reports the preparation and characterization of several TAK-242 prodrugs fitted with different triggers and linkers and demonstrates that these second-generation prodrugs effectively release TAK-242 while avoiding nonproductive sulfonamide hydrolysis.

10.
Plast Reconstr Surg ; 151(2): 255e-266e, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-36696321

RESUMO

BACKGROUND: Patients with Dupuytren contracture can receive a variety of surgical and nonsurgical treatments. The extent to which patients participate in the shared decision-making process is unclear. METHODS: An explanatory-sequential mixed-methods study was conducted. Participants completed the Nine-Item Shared Decision-Making Questionnaire and the brief Michigan Hand Outcomes Questionnaire before completing semi-structured interviews in which they described their experience with selecting treatment. RESULTS: Thirty participants [25 men (83%) and five women (17%); mean age, 69 years (range, 51 to 84 years)] received treatment for Dupuytren contracture (11 collagenase injection, six needle aponeurotomy, and 13 limited fasciectomy). Adjusted mean scores for the Shared Decision-Making Questionnaire and brief Michigan Hand Outcomes Questionnaire were 71 (SD 20) and 77 (SD 16), respectively, indicating a high degree of shared decision-making and satisfaction. Patients who received limited fasciectomy accepted invasiveness and prolonged recovery time because they believed it provided a long-term solution. Patients chose needle aponeurotomy and collagenase injection because the treatments were perceived as safer and more convenient and permitted rapid return to daily activities, which was particularly valued by patients who were employed or had bilateral contractures. CONCLUSIONS: Physicians should help patients choose a treatment that aligns with the patient's preferences for long-term versus short-term results, recovery period and postoperative rehabilitation, and risk of complications, because patients used this information to assist in their treatment selection. Areas of improvement for shared decision-making include equal presentation of all treatments and ensuring realistic patient expectations regarding the chronic and recurrent nature of Dupuytren contracture regardless of treatment received.


Assuntos
Colagenases , Tomada de Decisão Compartilhada , Contratura de Dupuytren , Fasciotomia , Participação do Paciente , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aponeurose/cirurgia , Contratura de Dupuytren/psicologia , Contratura de Dupuytren/cirurgia , Contratura de Dupuytren/terapia , Fasciotomia/métodos , Injeções Intralesionais , Procedimentos Ortopédicos/métodos , Resultado do Tratamento , Participação do Paciente/psicologia
11.
J Hand Surg Eur Vol ; 48(2): 123-130, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36329565

RESUMO

Multiple treatment options are available to patients with Dupuytren contracture, making shared decision-making complex. Our rigorous qualitative analysis sought to understand patient perceptions of shared decision-making in Dupuytren contracture treatment and create a conceptual framework to optimize patient-physician communication. We interviewed 30 patients with Dupuytren contracture to learn about their experience with treatment selection. The following themes were integral to shared decision-making for Dupuytren contracture treatment: discussing disease progression and treatment initiation, presenting all available treatment options, assessing patients' pre-existing biases towards treatment, patient values and preferences for treatment trade-offs, treatment risks and benefits, physician recommendation and active patient participation. This model can optimize communication about treatment options and expectations for relevant outcomes including, recovery time, contracture recurrence, complications, and treatment-related expenses.Level of evidence: V.


Assuntos
Contratura de Dupuytren , Humanos , Contratura de Dupuytren/terapia , Tomada de Decisão Compartilhada , Relações Médico-Paciente , Participação do Paciente , Comunicação , Tomada de Decisões
12.
Death Stud ; 47(9): 1053-1060, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36576780

RESUMO

Advance Care Planning involves having conversations, completing documents detailing individuals' end-of life treatment and care preferences, and appointing legal proxies who make health, lifestyle, or financial decisions. Although beneficial outcomes have been demonstrated, community rates of Advance Care Planning remain low. We developed a theoretically based workshop to increase knowledge and change behaviors in relation to Advance Care Planning; 347 participants completed the workshop. Advance Care Planning knowledge and action significantly improved three months post workshop. The intervention increased Advance Care Planning knowledge and changed behaviors.


Assuntos
Planejamento Antecipado de Cuidados , Assistência Terminal , Humanos , Comunicação
13.
Int J Offender Ther Comp Criminol ; 67(8): 861-883, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-35414291

RESUMO

There is a wealth of research that shows juvenile justice systems that utilize structured and validated assessment tools, such as the YLS/CMI, are far more effective at reducing rates of recidivism than those who do not. In line with this research, the Department of Justice (DoJ) in Western Australia adopted the YLS/CMI as the standard risk assessment tool for evaluating the criminogenic risk and needs of youth entering the justice system. While there is evidence supporting the utility of the YLS/CMI in predicting recidivism, there is little research demonstrating its effectiveness in Australian juvenile populations and no such research in a West Australian population. There is also a lack of research on the utility of the tool with young Indigenous offenders, which is particularly concerning given the significant overrepresentation of Indigenous people in the Australian criminal justice system. Our study was the first to examine the reliability and predictive validity of the YLS/CMI on a sample of West Australian juvenile offenders. In this paper, we present the results of two analyses. The first examines the properties of the YLS/CMI in a cohort of 4,653 juvenile offenders in Western Australia, including factor structure, internal consistency, and differences between male and female youth and between Indigenous and non-Indigenous youth. Consistent with our hypotheses, the tool demonstrated excellent internal consistency (α = .91) and cross-validation analyses identified significant differences between groups on total YLS scores and risk domains. The second analysis examines the predictive validity of the YLS/CMI in a subsample of 921 youth with a minimum follow-up period of 2 years. The overall recidivism rate was 74.8% and there were differences in scores and recidivism rates for Indigenous compared to non-Indigenous youth, although the predictive accuracies in terms of AUC were similar (c. = 0.65 and 0.66, respectively).


Assuntos
Delinquência Juvenil , Reincidência , Adolescente , Humanos , Masculino , Feminino , Reprodutibilidade dos Testes , Austrália , Medição de Risco/métodos
14.
Int J Offender Ther Comp Criminol ; : 306624X221113525, 2022 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-35876314

RESUMO

Indigenous youth are overrepresented in the Australian criminal justice system, yet little is known about how they differ from non-Indigenous youth in terms of criminogenic risk and need profiles in relation to reoffending. The aim of the study was to examine the differences between Indigenous and non-Indigenous youth in terms of criminogenic risk and need profiles. This paper expands on findings of our previous study. and present the results of two analyses. The first is a comparative analysis of the differences in criminogenic risk and need factors in a sample of 4,653 youth. Results raise questions about how Indigenous and non-Indigenous youth differ on type of criminogenic needs and how risk/needs are defined in an Indigenous context. The second analysis examines the predictive validity of a shortened version of the YLS/CMI in a subsample of 921 youth. Results show that a specific combination of five items for Indigenous youth corresponds to an improvement in AUC scores from c. = 0.65 for the full version to c. = 0.73. For non-Indigenous youth, the selected set of five items corresponds to an improvement in AUC scores from c. = 0.66 for the full version of the YLS/CMI to c. = 0.73. Implications of these findings for research, policy, and reducing Indigenous overrepresentation are discussed.

15.
Plast Reconstr Surg ; 150(2): 237-241, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35895519
16.
J Behav Ther Exp Psychiatry ; 76: 101739, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35738686

RESUMO

BACKGROUND AND OBJECTIVES: Perfectionism is associated with the development and maintenance of anxiety, mood, and eating disorders. Cognitive behaviour therapy (CBT) results in significant reductions in perfectionism and psychological symptoms however, the majority of studies have not examined clinical samples or impact on diagnostic status and comorbidity. METHODS: Forty participants with elevated perfectionism, of whom 80% had a range of psychological disorders, were randomised to CBT for perfectionism or waitlist control. RESULTS: The treatment group reported significant large effect size reductions in perfectionism measures of personal standards and concern over mistakes (d = 1.1-1.6), dichotomous thinking (d = 1.2), and medium effect size reductions in depression (d = 0.55) and increases in quality of life (d = 0.73), which were maintained at 4 month follow-up. The participants in the treatment group were significantly less likely to present with comorbid psychological disorders at post-treatment than the control group. LIMITATIONS: The sample size was small, and there was no control condition at follow-up. CONCLUSIONS: Findings lend further support for CBT for perfectionism as an efficacious transdiagnostic treatment for perfectionism and related psychopathology.


Assuntos
Terapia Cognitivo-Comportamental , Perfeccionismo , Terapia Cognitivo-Comportamental/métodos , Comorbidade , Humanos , Projetos Piloto , Qualidade de Vida , Resultado do Tratamento
17.
Plast Reconstr Surg ; 149(5): 1237-1244, 2022 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-35311803

RESUMO

BACKGROUND: Ethical discourse in the scientific community facilitates the humane conduct of research. The urgent response to COVID-19 has rapidly generated a large body of literature to help policymakers and physicians address novel pandemic challenges. Plastic surgeons, in particular, have to manage the postponement of elective procedures and safely provide care for non-COVID-19 patients. Although COVID-19 research may provide guidance on these challenges, the extent to which ethical discussions are present in these publications remains unknown. METHODS: Articles were identified systematically by searching the PubMed, Embase, Central, and Scopus databases using search terms related to ethics and COVID-19. The search included articles published during the first 9 months of the COVID-19 pandemic. The following data were extracted: presence of an ethical discussion, date of publication, topic of ethical discussion, and scientific discipline of the article. RESULTS: One thousand seven hundred fifty-three articles were included, of which seven were related to plastic surgery. The ethical principle with the greatest representation was nonmaleficence, whereas autonomy had the least representation. Equity and access to care was the most common topic of ethical discussion; the mental health effects of COVID-19 were the least common. The principle of justice had the greatest variation in representation. CONCLUSIONS: In a systematic review of COVID-19-related articles that were published during the first 9 months of the pandemic, the ethical principles of autonomy and justice are neglected in ethical discussions. As ethical dilemmas related to COVID-19 remain prevalent in plastic surgery, attention to ethical discourse should remain a top priority for leaders in the field.


Assuntos
COVID-19 , Cirurgia Plástica , Beneficência , COVID-19/epidemiologia , Humanos , Pandemias , Justiça Social
18.
Death Stud ; 46(4): 780-790, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-31858883

RESUMO

We assessed the acceptability and effectiveness of a new childhood bereavement service known as Lionheart Camp for Kids. Using a pre-post-follow-up design, data pertaining to 12 bereaved children (aged 5-12 years) and their primary caregivers were obtained. Results showed that caregivers reported decreases in children's peer relationship problems, improvements in parental consistency, and reductions in coercive parenting, and there was a trend toward lower self-reported grief by the children. Caregivers were highly satisfied with the program. There is a need for a wait-list or randomized controlled trial over a longer time period to determine the full benefits of the camp.


Assuntos
Luto , Criança , Pré-Escolar , Pesar , Humanos , Poder Familiar , Pais , Projetos Piloto
19.
J Interpers Violence ; 37(13-14): NP12453-NP12474, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-33691534

RESUMO

Intimate partner violence (IPV) is a crime that is afflicted by a current or previous romantic relationship partner. One in four women has experienced IPV at least once in their lifetime, with physical and psychological consequences. IPV cases tend to go largely unnoticed and under-reported, with low rates of intervention by bystanders. This cross-sectional correlational study investigated whether a combination of attribution theory and the bystander effect could predict the willingness of strangers to intervene in IPV. There were two models tested. The first model examined attitudes towards the victim, while the second one examined attitudes towards the perpetrator. The relationship between perceived responsibility and willingness to intervene was hypothesized to be mediated by sympathy and anger, with the number of bystanders as a moderator to mediating pathways (sympathy towards victim and anger towards perpetrator). A convenience sample of 278 Australian residents aged 18-years and older was presented in a vignette depicting an IPV incident occurring in public. Participants completed measures about the vignette in an online questionnaire. Model testing was conducted using MPlus; confirmatory factor analysis indicated a good fit of the measurement models. After controlling potential covariates, moderated mediation models of victim and perpetrator were analyzed. Attribution theory was a significant predictor in willingness to intervene (f² = .23, p < .001), but the bystander effect was not. Both attitudes towards victim and perpetrator accounted for unique variance in willingness to intervene in IPV, highlighting the importance of examining both. Findings indicate that psychoeducation campaigns aimed at reducing victim-blaming and promoting intervening behavior could be an effective means of preventing IPV.


Assuntos
Vítimas de Crime , Violência por Parceiro Íntimo , Austrália , Vítimas de Crime/psicologia , Estudos Transversais , Feminino , Humanos , Violência por Parceiro Íntimo/psicologia , Percepção Social
20.
J Med Food ; 25(2): 183-191, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34714139

RESUMO

The trigger for human labor is a scientific mystery. This research examined Rubus idaeus (RI), commonly referred to as red raspberry, which is widely purported to be efficacious in promoting parturition processes and favorable birth outcomes. This randomized controlled trial sought to determine the influence of RI consumption during gestation on C57BL/6N Tac mice and their offspring. The aims of this study were to (1) determine differences in the length of gestation, gestational weight gain, and litter size where RI is consumed daily at varied strengths and (2) determine differences in offspring characteristics and behavior where maternal RI consumption occurred. Once paired, mice were randomly assigned to one of three groups: placebo (n = 10) receiving plain water, RI aqueous extract fluid of 1.78 mg/mL (n = 10), or RI aqueous extract fluid of 2.66 mg/mL (n = 10). All received the same standardized diet throughout gestation. Pregnant mice were weighed with chow intake and fluid consumption determined daily. Gestation length and litter size were recorded at the time of birth. Differences in offspring characteristics were also determined and included physical characteristics (weight, physical development) and neuromotor reflexes and behaviors (locomotive abilities, geotaxis reflex, cliff avoidance reflex, and swimming development). When compared with controls, high-dose RI ingestion resulted in shorter length of gestation and smaller litter size (P ≤ .05). There was also an increase in fluid consumption and a decrease in pup weights on postnatal day 4 and 5 with RI treatment (P ≤ .05). Altogether, results suggest that RI influences parturition and fecundity processes with transplacental exposure impacting offspring characteristics.


Assuntos
Efeitos Tardios da Exposição Pré-Natal , Rubus , Animais , Peso Corporal , Dieta , Feminino , Camundongos , Camundongos Endogâmicos C57BL , Gravidez , Reflexo
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