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The biological mechanisms that explain how adverse early life events influence adult disease risk are poorly understood. One proposed mechanism is via the induction of accelerated biological aging, for which telomere length is considered a biomarker. We aimed to determine if maternal depression pre- and post-partum was associated with telomere length in children at 4 years of age (n = 4299). Mothers completed structured questionnaires assessing depression during pregnancy (Edinburgh Depression Scale), at 9 months (Edinburgh Depression Scale), and at 54 months postpartum (Patient Health Questionnaire 9). Regression methods were used to investigate the relationship between telomere length (DNA from saliva) and maternal depression score recorded at each stage. Significant covariates included in the final model were: maternal age at pregnancy; child sex; child ethnicity; gestational age group, and rurality group. Child telomere length was found to be longer if their mother had a higher depression score at both postpartum time points tested (9 months of age; coefficient 0.003, SE = 0.001, P = 0.01, 54 months of age; coefficient 0.003, SE = 0.002, P = 0.02). Although these findings seem paradoxical, increased telomere length may be an adaptive response to early life stressors. We propose several testable hypotheses for these results and to determine if the positive association between depression and telomere length is a developmental adaptation or an indirect consequence of environmental factors.
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Depressão , Humanos , Feminino , Pré-Escolar , Masculino , Adulto , Gravidez , Lactente , Mães/estatística & dados numéricos , Telômero , Encurtamento do Telômero/fisiologia , Complicações na Gravidez , Depressão Pós-Parto , Escalas de Graduação PsiquiátricaRESUMO
Racism is a determinant of individual and offspring health. Accelerated telomere shortening, an indicator of cellular aging, is a potential mechanism through which parental experience of racism could affect offspring. Here we longitudinally evaluated the relationship between maternal lifetime experience of an ethnically-motivated verbal or physical attack, as reported in pregnancy, with offspring telomere length in 4.5-year-old children. We also explored the potential association between positive feelings about one's culture and offspring telomere length. Data come from a nationally representative, multi-ethnic birth cohort in Aotearoa New Zealand (NZ) (Maori N = 417, Pacific N = 364, Asian N = 381). In models adjusting for covariates, including socioeconomic status and health status, Maori mothers who experienced an ethnically-motivated physical attack had children with significantly shorter telomere length than children of Maori mothers who did not report an attack (B = - 0.20, p = 0.01). Conversely, Maori mothers who had positive feelings about their culture had offspring with significantly longer telomeres (B = 0.25, p = 0.02). Our results suggest that ethnicity-based health inequities are shaped by racism, with impacts for clinical care and policy. Future research should also evaluate the potential protective effects of positive cultural identity.
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Povo Maori , Racismo , Identificação Social , Telômero , Pré-Escolar , Feminino , Humanos , Gravidez , Mães , PaisRESUMO
Several early childhood obesity prediction models have been developed, but none for New Zealand's diverse population. We aimed to develop and validate a model for predicting obesity in 4-5-year-old New Zealand children, using parental and infant data from the Growing Up in New Zealand (GUiNZ) cohort. Obesity was defined as body mass index (BMI) for age and sex ≥ 95th percentile. Data on GUiNZ children were used for derivation (n = 1731) and internal validation (n = 713). External validation was performed using data from the Prevention of Overweight in Infancy Study (POI, n = 383) and Pacific Islands Families Study (PIF, n = 135) cohorts. The final model included: birth weight, maternal smoking during pregnancy, maternal pre-pregnancy BMI, paternal BMI, and infant weight gain. Discrimination accuracy was adequate [AUROC = 0.74 (0.71-0.77)], remained so when validated internally [AUROC = 0.73 (0.68-0.78)] and externally on PIF [AUROC = 0.74 [0.66-0.82)] and POI [AUROC = 0.80 (0.71-0.90)]. Positive predictive values were variable but low across the risk threshold range (GUiNZ derivation 19-54%; GUiNZ validation 19-48%; and POI 8-24%), although more consistent in the PIF cohort (52-61%), all indicating high rates of false positives. Although this early childhood obesity prediction model could inform early obesity prevention, high rates of false positives might create unwarranted anxiety for families.
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Peso ao Nascer/fisiologia , Sobrepeso/epidemiologia , Obesidade Infantil/epidemiologia , Aumento de Peso/fisiologia , Peso ao Nascer/genética , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos de Coortes , Pai , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Nova Zelândia/epidemiologia , Sobrepeso/genética , Sobrepeso/patologia , Ilhas do Pacífico/epidemiologia , Obesidade Infantil/genética , Obesidade Infantil/patologia , Gravidez , Fatores de Risco , Aumento de Peso/genéticaRESUMO
OBJECTIVE: To investigate if applying Kinesiology Tape (KT) on the unstable ankle may improve static postural control in individuals with Functional ankle instability. DESIGN: A repeated measured study. Participants performed a series of static quiet bipedal and unipedal stances on a force platform. Measurements were taken at three different times: baseline or no tape, immediately and 24 h after the taping application with the tape remaining on the ankle. SETTING: A university's psychomotor laboratory. PARTICIPANTS: Twenty young adults with Functional ankle instability aged from 18 to 30 years old. OUTCOME MEASURES: Postural control was assessed by four measures derived from the centre of pressure data: Area of 95% Confidence ellipse, standard deviation of displacements, mean velocity and mean power frequency. The analysis of variance (ANOVA) was performed to determine any significant improvement in postural control over time due to KT. RESULTS: Only minor changes in mean velocity and MPF in unipedal stances were observed immediately after KT application. However, the overall results indicated statistically insignificant improvements in postural control neither immediately after KT application nor after 24 h. CONCLUSION: Results suggest that the use of KT did not affect bipedal and unipedal stances of individuals with functional ankle instability.
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Traumatismos do Tornozelo/reabilitação , Fita Atlética , Instabilidade Articular/reabilitação , Equilíbrio Postural , Adolescente , Adulto , Tornozelo/fisiopatologia , Traumatismos do Tornozelo/fisiopatologia , Articulação do Tornozelo/fisiopatologia , Feminino , Humanos , Instabilidade Articular/fisiopatologia , Masculino , Adulto JovemRESUMO
Research suggests that an external focus or cognitive task may improve postural control. Removing attention from movement production may promote automaticity, or the tasks may promote ankle stiffening. To investigate these two theories, twenty older adults stood while performing baseline standing, internal focus, external focus, and two cognitive tasks. Changes in postural control occurred in external focus and cognitive task conditions compared to baseline and internal focus, while no change occurred in cocontraction indices. This suggests that an external focus and cognitive task can improve postural control in older adults. Since no change occurred in cocontraction indices across conditions, this suggests that stiffening cannot explain these changes. Instead, changes could be due to automaticity of sway.
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Tornozelo/fisiopatologia , Cognição/fisiologia , Posição Ortostática , Idoso , Feminino , Humanos , Masculino , Equilíbrio PosturalRESUMO
Telomeres are repetitive DNA sequences at the end of chromosomes that function to protect chromosomes from degradation. Throughout the life course, telomere length decreases with age and is influenced by environmental factors and health conditions. This study aimed to determine the relative telomere lengths in a diverse cohort of about 4000 four-year-old children in New Zealand. Linear regression was used to investigate the relationship between telomere length, child gender, ethnicity, paternal age and deprivation. We observed substantial variation in telomere length according to sex and self-identified ethnicity. Telomere length was longer in females compared to males (coefficient of 0.042, 95% confidence interval (CI) 0.024-0.060). European children had shorter telomere than both the indigenous Maori (coefficient of 0.03, CI 0.007-0.055) and Pacific children (coefficient of 0.15, CI 0.12-0.18). The data suggest that telomere lengths are highly variable and variability between individuals arise from early age, influenced partly by sex and ethnicity. Longer telomeres in indigenous Maori and Pacific children may reflect the heritability of telomere length in genetically less complex populations. This study increases our understanding of telomere dynamics in young children since the majority of telomere studies are conducted in adults.
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Etnicidade/genética , Caracteres Sexuais , Homeostase do Telômero , Ásia/etnologia , Povo Asiático/genética , Pré-Escolar , Europa (Continente)/etnologia , Feminino , Humanos , Povos Indígenas/genética , Estudos Longitudinais , Masculino , Idade Materna , Havaiano Nativo ou Outro Ilhéu do Pacífico/genética , Nova Zelândia , Idade Paterna , Classe Social , Telômero/ultraestrutura , População Branca/genéticaRESUMO
Brain dopamine-serotonin vesicular transport disease is a rare disease caused by autosomal recessive mutations in the SLC18A2 gene, which encodes the VMAT2 protein. VMAT2 is a membrane protein responsible for vesicular transport of monoamines, and its disruption negatively affects neurotransmission. This results in a severe neurodevelopmental disorder affecting motor skills and development, and causes muscular hypotonia. The condition was initially described in a consanguineous Saudi Arabian family with affected siblings homozygous for a P387L mutation. We subsequently found a second mutation in a New Zealand family (homozygous P237H), which was later also identified in an Iraqi family. Pramipexole has been shown to have some therapeutic benefit. Transgenic Caenorhabditis elegans were developed to model the P237H and P387L mutations. Investigations into dopamine- and serotonin-related C. elegans phenotypes, including pharyngeal pumping and grazing, showed that both mutations cause significant impairment of these processes when compared with a non-transgenic N2 strain and a transgenic containing the wild-type human SLC18A2 gene. Preliminary experiments investigating the therapeutic effects of serotonin and pramipexole demonstrated that serotonin could successfully restore the pharyngeal pumping phenotype. These analyses provide further support for the role of these mutations in this disease.
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Encéfalo/metabolismo , Caenorhabditis elegans/metabolismo , Dopamina/metabolismo , Modelos Biológicos , Serotonina/metabolismo , Vesículas Transportadoras/patologia , Animais , Animais Geneticamente Modificados , Sequência de Bases , Transporte Biológico , Humanos , Faringe/patologia , Fenótipo , Vesículas Transportadoras/metabolismoRESUMO
Neurologic complications of systemic cancer therapy encompass a range of symptoms that can affect the central nervous system (CNS), peripheral nervous system (PNS), or both. Their incidence will likely increase as novel agents, such as targeted therapy and immunotherapy, become incorporated into standard treatment regimens, and the number of long-term cancer survivors rises. Recognizing the common adverse effects of treatment is important to avoid misdiagnosis of cancer recurrence in the nervous system or paraneoplastic disease. Ongoing has focused on identifying patient-specific risk factors that predispose to drug toxicity and the development of appropriate preventive and therapeutic strategies.
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Antineoplásicos/efeitos adversos , Neoplasias/tratamento farmacológico , Síndromes Neurotóxicas , Humanos , Síndromes Neurotóxicas/diagnóstico , Síndromes Neurotóxicas/etiologia , Síndromes Neurotóxicas/patologiaAssuntos
Havaiano Nativo ou Outro Ilhéu do Pacífico , Peso Corporal , Criança , Pré-Escolar , Humanos , PrevalênciaRESUMO
During glycolysis, yeast generates methylglyoxal (MG), a toxic metabolite that affects growth. Detoxification can occur when glyoxylase I (GLO1) and glyoxylase II (GLO2) convert MG to lactic acid. We have identified an additional, previously unrecognized role for GLO1 in sulfur assimilation in the yeast Saccharomyces cerevisiae. During a screening for putative carbon-sulfur lyases, the glo1 deletion strain showed significant production of H2S during fermentation. The glo1 strain also assimilated sulfate inefficiently but grew normally on cysteine. These phenotypes are consistent with reduced activity of the O-acetyl homoserine sulfhydrylase, Met17p. Overexpression of Glo1p gave a dominant negative phenotype that mimicked the glo1 and met17 deletion strain phenotypes. Western analysis revealed reduced expression of Met17p in the glo1 deletion, but there was no indication of an altered conformation of Met17p or any direct interaction between the two proteins. Unravelling a novel function in sulfur assimilation and H2S generation in yeast for a gene never connected with this pathway provides new opportunities for the study of this molecule in cell signaling, as well as the potential regulation of its accumulation in the wine and beer industry.
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Cisteína Sintase/metabolismo , Lactoilglutationa Liase/genética , Proteínas de Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/genética , Cisteína Sintase/genética , Fermentação , Deleção de Genes , Genes Fúngicos , Sulfeto de Hidrogênio/metabolismo , Mutação , Saccharomyces cerevisiae/enzimologia , Proteínas de Saccharomyces cerevisiae/genéticaRESUMO
Fully automated self-help interventions can serve as highly cost-effective mental health promotion tools for massive amounts of people. However, these interventions are often characterised by poor adherence. One way to address this problem is to mimic therapy support by a conversational agent. The objectives of this study were to assess the effectiveness and adherence of a smartphone app, delivering strategies used in positive psychology and CBT interventions via an automated chatbot (Shim) for a non-clinical population - as well as to explore participants' views and experiences of interacting with this chatbot. A total of 28 participants were randomized to either receive the chatbot intervention (n = 14) or to a wait-list control group (n = 14). Findings revealed that participants who adhered to the intervention (n = 13) showed significant interaction effects of group and time on psychological well-being (FS) and perceived stress (PSS-10) compared to the wait-list control group, with small to large between effect sizes (Cohen's d range 0.14-1.06). Also, the participants showed high engagement during the 2-week long intervention, with an average open app ratio of 17.71 times for the whole period. This is higher compared to other studies on fully automated interventions claiming to be highly engaging, such as Woebot and the Panoply app. The qualitative data revealed sub-themes which, to our knowledge, have not been found previously, such as the moderating format of the chatbot. The results of this study, in particular the good adherence rate, validated the usefulness of replicating this study in the future with a larger sample size and an active control group. This is important, as the search for fully automated, yet highly engaging and effective digital self-help interventions for promoting mental health is crucial for the public health.
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Acceptance and Commitment Therapy (ACT) can be effective in treating anxiety disorders, yet there has been no study on Internet-delivered ACT for social anxiety disorder (SAD) and panic disorder (PD), nor any study investigating whether therapist guidance is superior to unguided self-help when supplemented with a smartphone application. In the current trial, n=152 participants diagnosed with SAD and/or PD were randomized to therapist-guided or unguided treatment, or a waiting-list control group. Both treatment groups used an Internet-delivered ACT-based treatment program and a smartphone application. Outcome measures were self-rated general and social anxiety and panic symptoms. Treatment groups saw reduced general (d=0.39) and social anxiety (d=0.70), but not panic symptoms (d=0.05) compared to the waiting-list group, yet no differences in outcomes were observed between guided and unguided interventions. We conclude that Internet-delivered ACT is appropriate for treating SAD and potentially PD. Smartphone applications may partially compensate for lack of therapist support.
Assuntos
Terapia de Aceitação e Compromisso/métodos , Internet , Transtorno de Pânico/terapia , Fobia Social/terapia , Smartphone , Terapia Assistida por Computador , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno de Pânico/complicações , Transtorno de Pânico/psicologia , Fobia Social/complicações , Fobia Social/psicologia , Autocuidado , Resultado do Tratamento , Adulto JovemRESUMO
Assessment and outcome monitoring are critical for the effective detection and treatment of mental illness. Traditional methods of capturing social, functional, and behavioral data are limited to the information that patients report back to their health care provider at selected points in time. As a result, these data are not accurate accounts of day-to-day functioning, as they are often influenced by biases in self-report. Mobile technology (mobile applications on smartphones, activity bracelets) has the potential to overcome such problems with traditional assessment and provide information about patient symptoms, behavior, and functioning in real time. Although the use of sensors and apps are widespread, several questions remain in the field regarding the reliability of off-the-shelf apps and sensors, use of these tools by consumers, and provider use of these data in clinical decision-making.
La evaluación y la supervisión de los resultados son esenciales para la detección efectiva y el tratamiento de la enfermedad mental. Los métodos tradicionales de captación de datos sociales, funcionales y conductuales están limitados a la información que los pacientes reportan retrospectivamente a sus proveedores de atención de salud en momentos seleccionados en el tiempo. Como resultado, esta información no constituye datos precisos del funcionamiento día a día, ya que a menudo están influenciados por sesgos en el auto-informe. La tecnología móvil (como aplicaciones móviles en teléfonos inteligentes, braceletes de actividad) tiene el potencial de superar los problemas de la evaluación tradicional y aporta información acerca de los síntomas, conductas y funcionamiento de los pacientes en tiempo real. Aunque el empleo de estos sensores y aplicaciones está muy extendido, aun persisten algunas preguntas en este campo en cuanto a la fiabilidad de las aplicaciones y sensores comerciales, el uso de estas herramientas por los consumidores y el empleo por los proveedores de esta información en la toma de decisiones clínicas.
L'évaluation et la surveillance de l'évolution sont essentielles pour un diagnostic et un traitement efficaces de la maladie mentale. Les méthodes traditionnellement utilisées pour recueillir les données comportementales, fonctionnelles et sociales sont limitées aux informations rapportées ponctuellement par les patients à leur médecin traitant. Ces données ne reflètent donc pas exactement le fonctionnement quotidien car elles sont souvent biaisées par l'auto-évaluation. La technologie mobile (applications pour smartphones, bracelets de contrôle d'activité) est capable de surmonter ces difficultés de l'évaluation traditionnelle et de fournir en temps réel des informations sur les symptômes des patients, leur comportement et leur fonctionnement. L'utilisation de capteurs et d'applications est répandue mais plusieurs questions restent en suspens en ce qui concerne la fiabilité des applications et capteurs standard, leur utilisation par les consommateurs et l'usage de ces données dans la prise de décision médicale.
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Computadores de Mão/estatística & dados numéricos , Transtornos Mentais/diagnóstico , Transtornos Mentais/terapia , Saúde Mental , Monitorização Ambulatorial/estatística & dados numéricos , Smartphone/estatística & dados numéricos , Humanos , Transtornos Mentais/psicologia , AutorrelatoRESUMO
Traditional RNA extraction methods rely on the use of hazardous chemicals such as phenol, chloroform, guanidinium thiocyanate to disrupt cells and inactivate RNAse simultaneously. RNA isolation from Caenorhabditis elegans presents another challenge due to its tough cuticle, therefore several repeated freeze-thaw cycles may be needed to disrupt the cuticle before the cell contents are released. In addition, a large number of animals are required for successful RNA isolation. To overcome these issues, we have developed a simple and efficient method using proteinase K and a brief heat treatment to release RNA of quality suitable for quantitative PCR analysis.The benefits of the method are: â¢Faster and safer compared to conventional RNA extraction methodsâ¢Released RNA can be used directly for cDNA synthesis without purificationâ¢As little as a single worm is sufficient.
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BACKGROUND: There is need for more cost and time effective treatments for depression. This is the first randomised controlled trial in which a blended treatment--including four face-to-face sessions and a smartphone application--was compared against a full behavioural treatment. Hence, the aim of the current paper was to examine whether a blended smartphone treatment was non-inferior to a full behavioural activation treatment for depression. METHODS: This was a randomised controlled non-inferiority trial (NCT01819025) comparing a blended treatment (n=46) against a full ten-session treatment (n=47) for people suffering from major depression. Primary outcome measure was the BDI-II, that was administered at pre- and post-treatment, as well as six months after the treatment. RESULTS: Results showed significant improvements in both groups across time on the primary outcome measure (within-group Cohen's d=1.35; CI [-0.82, 3.52] to d=1.47; CI [-0.41, 3.35]; between group d=-0.13 CI [-2.37, 2.09] and d=-0.10 CI [-2.53, 2.33]). At the same time, the blended treatment reduced the therapist time with an average of 47%. CONCLUSIONS: We could not establish whether the blended treatment was non-inferior to a full BA treatment. Nevertheless, this study points to that the blended treatment approach could possibly treat nearly twice as many patients suffering from depression by using a smartphone application as add-on. More studies are needed before we can suggest that the blended treatment method is a promising cost-effective alternative to regular face-to-face treatment for depression. TRIAL REGISTRATION: Cognitive Behavioral Therapy Treatment of Depression With Smartphone Support NCT01819025.
Assuntos
Terapia Cognitivo-Comportamental , Depressão/terapia , Smartphone , Adolescente , Adulto , Idoso , Ansiedade/psicologia , Demografia , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Pacientes Desistentes do Tratamento , Escalas de Graduação Psiquiátrica , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
Mercury resistance is the most widespread of all anti-microbial resistance occurring in a wide variety of Gram-negative and Gram-positive bacterial genera. The systems that are most studied and best understood are those encoded in mercury resistance (Mer) operons in Gram-negative bacteria. The mercury detoxification functions by the importation of highly toxic Hg(2+) into cytoplasm and enzymic reduction to volatile Hg(0). MerT is a small (13kDa) inner membrane protein involved in mercuric ion transport system. We have overexpressed recombinant 6His-tagged MerT from Escherichia coli in a native folded form and purified it to homogeneity in n-dodecyl-ß-d-maltopyranoside (DDM) by immobilized metal affinity chromatography (IMAC). Circular dichroism showed that the protein is largely α-helical. Size-exclusion chromatography (SEC) in a variety of detergents showed that the protein exists in a multiple of oligomeric states as also confirmed by SEC coupled with multiple-angle light scattering.
Assuntos
Proteínas de Bactérias/química , Proteínas de Bactérias/isolamento & purificação , Proteínas de Transporte de Cátions/química , Proteínas de Transporte de Cátions/isolamento & purificação , Escherichia coli/química , Proteínas de Bactérias/genética , Proteínas de Transporte de Cátions/genética , Escherichia coli/genética , Maltose/análogos & derivados , Maltose/química , Maltose/genética , Maltose/isolamento & purificação , Proteínas Recombinantes/química , Proteínas Recombinantes/genética , Proteínas Recombinantes/isolamento & purificaçãoRESUMO
OBJECTIVES: Evaluating and comparing the effectiveness of two smartphone-delivered treatments: one based on behavioural activation (BA) and other on mindfulness. DESIGN: Parallel randomised controlled, open, trial. Participants were allocated using an online randomisation tool, handled by an independent person who was separate from the staff conducting the study. SETTING: General community, with recruitment nationally through mass media and advertisements. PARTICIPANTS: 40 participants diagnosed with major depressive disorder received a BA treatment, and 41 participants received a mindfulness treatment. 9 participants were lost at the post-treatment. INTERVENTION BA: An 8-week long behaviour programme administered via a smartphone application. Mindfulness: An 8-week long mindfulness programme, administered via a smartphone application. MAIN OUTCOME MEASURES: The Beck Depression Inventory-II (BDI-II) and the nine-item Patient Health Questionnaire Depression Scale (PHQ-9). RESULTS: 81 participants were randomised (mean age 36.0 years (SD=10.8)) and analysed. Results showed no significant interaction effects of group and time on any of the outcome measures either from pretreatment to post-treatment or from pretreatment to the 6-month follow-up. Subgroup analyses showed that the BA treatment was more effective than the mindfulness treatment among participants with higher initial severity of depression from pretreatment to the 6-month follow-up (PHQ-9: F (1, 362.1)=5.2, p<0.05). In contrast, the mindfulness treatment worked better than the BA treatment among participants with lower initial severity from pretreatment to the 6-month follow-up (PHQ-9: F (1, 69.3)=7.7, p<0.01); BDI-II: (F(1, 53.60)=6.25, p<0.05). CONCLUSIONS: The two interventions did not differ significantly from one another. For participants with higher severity of depression, the treatment based on BA was superior to the treatment based on mindfulness. For participants with lower initial severity, the treatment based on mindfulness worked significantly better than the treatment based on BA. TRIAL REGISTRATION: Clinical Trials NCT01463020.
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Terapia Comportamental , Atenção Plena , Aplicativos Móveis , Autocuidado , Smartphone , Adulto , Transtorno Depressivo Maior/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Adulto JovemRESUMO
BACKGROUND: Smartphone technology presents a novel and promising opportunity to extend the reach of psychotherapeutic interventions by moving selected parts of the therapy into the real-life situations causing distress. This randomised controlled trial will investigate the effects of a transdiagnostic, Internet-administered cognitive behavioural (iCBT) self-help program for anxiety, supplemented with a smartphone application. The effect of added therapist support will also be studied. METHODS/DESIGN: One hundred and fifty participants meeting diagnostic criteria for social anxiety disorder and/or panic disorder will be evenly randomised to either one of three study groups: 1, smartphone-supplemented iCBT with therapist support; 2, smartphone-supplemented iCBT without therapist support; or 3, an active waiting list control group with delayed treatment. Primary outcome measure will be the Generalised Anxiety Disorder 7-item self-rating scale. Secondary measures include other anxiety, depression and quality of life measures. In addition to pre- and post-treatment measurements, the study includes two mid-treatment (days 24 and 48) and two follow-up assessments (12 and 36 months) to assess rapid and long-term effects. DISCUSSION: To our knowledge, this is the first study to investigate the effectiveness of smartphone-supplemented iCBT for anxiety disorders. Hence, the findings from this trial will constitute great advancements in the burgeoning and promising field of smartphone-administered psychological interventions. Limitations are discussed. TRIAL REGISTRATION: Clinicaltrials.gov: NCT01963806.
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Transtornos de Ansiedade/terapia , Telefone Celular , Terapia Cognitivo-Comportamental/instrumentação , Internet , Aplicativos Móveis , Transtorno de Pânico/terapia , Projetos de Pesquisa , Transtornos do Comportamento Social/terapia , Terapia Assistida por Computador/instrumentação , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Protocolos Clínicos , Terapia Cognitivo-Comportamental/métodos , Humanos , Transtorno de Pânico/diagnóstico , Transtorno de Pânico/psicologia , Escalas de Graduação Psiquiátrica , Transtornos do Comportamento Social/diagnóstico , Transtornos do Comportamento Social/psicologia , Inquéritos e Questionários , Suécia , Terapia Assistida por Computador/métodos , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: The need for cost-effective interventions for people suffering from major depressive disorders is essential. Behavioral activation is an intervention that can largely benefit from the use of new mobile technologies (for example smartphones). Therefore, developing smartphone-based behavioral activation interventions might be a way to develop cost-effective treatments for people suffering from major depressive disorders. The aim of this study will be to test the effects of a smartphone-delivered behavioral activation treatment. METHODS: The study will be a randomized controlled trial with a sample size of 120 participants, with 60 patients in each group. The treatment group includes an 8-week smartphone-based behavioral activation intervention, with minimal therapist contact. The smartphone-based intervention consists of a web-based psychoeducation, and a smartphone application. There is also a back-end system where the therapist can see reports from the patients or activities being reported. In the attention control group, we will include brief online education and then recommend use of a smartphone application that is not directly aimed at depression (for example, 'Effective meditation'). The duration of the control condition will also be 8 weeks. For ethical reasons we will give the participants in the control group access to the behavioral activation treatment following the 8-week treatment period. DISCUSSIONS: We believe that this trial has at least three important implications. First, we believe that smartphones can be integrated even further into society and therefore may serve an important role in health care. Second, while behavioral activation is a psychological treatment approach for which there is empirical support, the use of a smartphone application could serve as the therapist's prolonged arm into the daily life of the patient. Third, as we have been doing trials on guided Internet treatment for more than 10 years it is now time to move to the next generation of information technology - smartphones - which are not only relevant for Swedish conditions but also for developing countries in the world which are increasingly empowered by mobile phones with Internet connection. TRIAL REGISTRATION: ClinicalTrials.gov NCT01463020.
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Terapia Comportamental/instrumentação , Telefone Celular , Transtorno Depressivo Maior/terapia , Projetos de Pesquisa , Autocuidado/instrumentação , Terapia Comportamental/métodos , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Internet , Educação de Pacientes como Assunto , Escalas de Graduação Psiquiátrica , Suécia , Fatores de Tempo , Resultado do TratamentoRESUMO
Adenosine 3',5'-monophosphate (cAMP) is a cellular second messenger with central relevance to pharmacology, cell biology, and biochemistry teaching programs. cAMP is produced from adenosine triphosphate by adenylate cyclase, and its production is reduced or enhanced upon activation of many G protein-coupled receptors. Therefore, the measurement of cAMP serves as an indicator of receptor activity. Although there are many assays available for measuring cAMP, few are suitable for large class teaching, and even fewer seem to have been adapted for this purpose. Here, we describe the use of bead-based ALPHAscreen (Amplified Luminescent Proximity Homogenous Assay) technology for teaching a class of more than 300 students the practical aspects of detecting signal transduction. This technology is applicable to the measurement of many different signaling pathways. This resource is designed to provide a practical guide for instructors and a useful model for developing other classes using similar technologies.