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1.
Am J Physiol Cell Physiol ; 326(1): C112-C124, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38047304

RESUMEN

The gut peptide cholecystokinin (CCK) is released during feeding and promotes satiation by increasing excitation of vagal afferent neurons that innervate the upper gastrointestinal tract. Vagal afferent neurons express CCK1 receptors (CCK1Rs) in the periphery and at central terminals in the nucleus of the solitary tract (NTS). While the effects of CCK have been studied for decades, CCK receptor signaling and coupling to membrane ion channels are not entirely understood. Previous findings have implicated L-type voltage-gated calcium channels as well as transient receptor potential (TRP) channels in mediating the effects of CCK, but the lack of selective pharmacology has made determining the contributions of these putative mediators difficult. The nonselective ion channel transient receptor potential vanilloid subtype 1 (TRPV1) is expressed throughout vagal afferent neurons and controls many forms of signaling, including spontaneous glutamate release onto NTS neurons. Here we tested the hypothesis that CCK1Rs couple directly to TRPV1 to mediate vagal signaling using fluorescent calcium imaging and brainstem electrophysiology. We found that CCK signaling at high concentrations (low-affinity binding) was potentiated in TRPV1-containing afferents and that TRPV1 itself mediated the enhanced CCK1R signaling. While competitive antagonism of TRPV1 failed to alter CCK1R signaling, TRPV1 pore blockade or genetic deletion (TRPV1 KO) significantly reduced the CCK response in cultured vagal afferents and eliminated its ability to increase spontaneous glutamate release in the NTS. Together, these results establish that TRPV1 mediates the low-affinity effects of CCK on vagal afferent activation and control of synaptic transmission in the brainstem.NEW & NOTEWORTHY Cholecystokinin (CCK) signaling via the vagus nerve reduces food intake and produces satiation, yet the signaling cascades mediating these effects remain unknown. Here we report that the capsaicin receptor transient receptor potential vanilloid subtype 1 (TRPV1) potentiates CCK signaling in the vagus and mediates the ability of CCK to control excitatory synaptic transmission in the nucleus of the solitary tract. These results may prove useful in the future development of CCK/TRPV1-based therapeutic interventions.


Asunto(s)
Ácido Glutámico , Canales de Potencial de Receptor Transitorio , Ácido Glutámico/metabolismo , Núcleo Solitario , Neuronas Aferentes/metabolismo , Nervio Vago , Colecistoquinina/farmacología , Canales de Potencial de Receptor Transitorio/metabolismo
2.
J Sports Sci ; : 1-11, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-39087581

RESUMEN

Whilst research has assessed the multidimensionality of organizational stressors, severity has been overlooked. This study aimed to develop and validate a severity response scale, before examining the relationship between organizational stressor severity, physical health, and well-being, and if severity mediated the relationship between stressor occurrence and outcomes. 403 sport performers (186 male; Mage = 21.43) completed a questionnaire assessing study variables and data were analysed using structural equation modelling. Organizational stressor severity had a significant, negative relationship with physical health (r = -.374, p < .001), but notwith hedonic or eudaimonic well-being (p = .624 and .203). Direct effects were found for neuroticism (ß = -0.632, p < .001) and stressor frequency (ß = -0.226, p = .016) on physical health; however, when adding severity as a mediator, stressor frequency positively predicted stressor severity (ß = 1.025, p < .001); however, the indirect effect of stressor frequency on physical health via stressor severity (ß = -0.018, p = .885) and the direct effect between stressor frequency and physical health (ß = -0.191, p = .204) were non-significant. These novel findings highlight that higher stressor severity is associated with higher physical health complaints, and that repeated exposure to stressors may heighten an vulnerability to future stressors.

3.
Med Educ ; 57(12): 1248-1256, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37392166

RESUMEN

INTRODUCTION: Experiencing psychological stress may affect clinician performance in acute emergencies. While simulation is used extensively in healthcare education, it is unknown whether simulation effectively replicates the psychophysiological stress of real-world conditions. Thus, this study explored whether measurable differences exist in psychophysiological responses to acute stress in simulated compared with real-world clinical practice. METHODS: In this within-subjects observational study, stress appraisals, state anxiety and heart rate variability (HRV) were recorded during simulated and real-world emergencies in a 6-month training placement in neonatal medicine. Eleven postgraduate trainees and one advanced neonatal nurse practitioner participated. Mean (SD) participant age was 33 (8) years; and eight participants (67%) were female. Data were collected at rest and immediately before, during and 20 min after simulated and real-world neonatal emergencies. In situ simulation scenarios were modelled on those used in accredited neonatal basic life support training. Stress appraisals and state anxiety were assessed using Demand Resource Evaluation Scores and the short State-Trait Anxiety Inventory, respectively. High-frequency power, a component of HRV associated with parasympathetic tone, was derived from electrocardiogram recordings. RESULTS: Simulation was associated with greater likelihood of threat appraisal and higher state anxiety. High-frequency HRV reduced from baseline in simulated and real-world emergencies but recovered further towards baseline 20 min after simulated events. Possible explanations for the observed differences between conditions include participants' previous experiences and expectations of simulation and the effect of post-simulation debrief and feedback. DISCUSSION: This study identifies important differences in psychophysiological stress responses to simulated and real-world emergencies. Threat appraisals, state anxiety and parasympathetic withdrawal are educationally and clinically significant, given their known associations with performance, social functioning and health regulation. While simulation may facilitate interventions aimed at optimising clinicians' stress responses, it is vital to confirm that outcomes transfer to real-world clinical practice.


Asunto(s)
Urgencias Médicas , Estrés Psicológico , Recién Nacido , Humanos , Femenino , Adulto , Masculino , Estrés Psicológico/psicología , Ansiedad , Competencia Clínica
4.
Mol Phylogenet Evol ; 171: 107459, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-35351632

RESUMEN

The macroevolutionary consequences of evolving in the deep-sea remain poorly understood and are compounded by the fact that convergent adaptations for living in this environment makes elucidating phylogenetic relationships difficult. Lophiiform anglerfishes exhibit extreme habitat and predatory specializations, including the use of a fin-spine system as a luring device and unique reproductive strategies where parasitic males attach and fuse to females. Despite their notoriety for these odd characteristics, evolutionary relationships among these fishes remain unclear. We sought to clarify the evolutionary history of Lophiiformes using data from 1000 ultraconserved elements and phylogenomic inference methods with particular interest paid to the Ceratioidei (deep-sea anglerfishes) and Antennarioidei (frogfishes and handfishes). At the suborder level, we recovered similar topologies in separate phylogenomic analyses: The Lophioidei (monkfishes) are the sister group to the rest of the Lophiiformes, Ogcocephaloidei (batfishes) and Antennarioidei (frogfishes) form a sister group, and Chaunacioidei (coffinfishes) and Ceratioidei (deep-sea anglerfishes) form a clade. The relationships we recover within the ceratioids disagree with most previous phylogenetic investigations, which used legacy phylogenetic markers or morphology. We recovered non-monophyletic relationships in the Antennarioidei and proposed three new families based on molecular and morphological evidence: Histiophrynidae, Rhycheridae, and Tathicarpidae. Antennariidae was re-evaluated to include what was known as Antennariinae, but not Histiophryninae. Non-bifurcating signal in splits network analysis indicated reticulations among and within suborders, supporting the complicated history of the Lophiiformes previously found with morphological data. Although we resolve relationships within Antennarioidei, Ceratioidei relationships remain somewhat unclear without better taxonomic sampling.


Asunto(s)
Evolución Biológica , Peces , Animales , Ecosistema , Femenino , Humanos , Masculino , Filogenia , Conducta Predatoria
5.
J Couns Psychol ; 69(5): 722-731, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35311300

RESUMEN

It is not yet fully understood how alliance, cohesion, and climate differentially correlate with client outcome in group therapy, especially when assessed simultaneously. This study aims to elucidate these relationships through an archival analysis of continuous Group Questionnaire (GQ) and Outcome Questionnaire-45 (OQ-45) data from 412 group therapy clients at college counseling centers, which were originally collected by Burlingame, Whitcomb, et al. (2018). We predicted that alliance, cohesion, and climate would each correlate with improvements in outcome and, further, that they would have similar relationships with change in outcome. Results indicate that greater alliance, cohesion, and climate are individually associated with lower distress. This relationship was significant regarding session-to-session fluctuations on individual client scores (p < .01), as well as regarding differences between clients in their personal averages across sessions (p < .01). However, when linear growth trajectories were considered, only alliance was significantly associated with improvement (p < .05). In other words, alliance, climate, and cohesion all correlate with outcome when time is ignored; however, alliance alone significantly correlates with outcome when change over time is taken into account. This study highlights the importance of the client-therapist relationship, emphasizing how alliance is significantly related to change in group therapy. Thus, therapists should prioritize a strong bond with clients. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Asunto(s)
Relaciones Profesional-Paciente , Psicoterapia de Grupo , Consejo , Humanos , Encuestas y Cuestionarios , Universidades
6.
Psychol Sport Exerc ; 582022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34776790

RESUMEN

Research has found that greater lifetime stressor exposure increases the risk for mental and physical health problems. Despite this, few studies have examined how stressors occurring over the entire lifespan affect sport performers' health, well-being, and performance, partly due to the difficulty of assessing lifetime stressor exposure. To address this issue, we developed a sport-specific stress assessment module (Sport SAM) for the Stress and Adversity Inventory (STRAIN) and then analyzed the instrument's usability, acceptability, validity, and test-retest reliability. Furthermore, we examined whether trait-like tendencies to appraise stressful situations as a challenge or threat mediated the association between lifetime stressor exposure and health, well-being, and performance. Participants were 395 sport performers (Mage = 22.50 years, SD = 5.33) who completed an online survey. Results revealed that the Sport SAM demonstrated good usability and acceptability, good concurrent validity in relation to the Adult STRAIN (rs = 0.23 to 0.29), and very good test-retest reliability (r icc = 0.87 to 0.89). Furthermore, the Sport SAM was significantly associated with symptoms of depression (ß = 0.21 to 0.24, ps ≤ .001) and anxiety (ß = 0.13 to 0.19, ps ≤ .012), and general physical (ß = 0.24 to 0.27, ps = ≤ 0.001) and mental (ß = 0.23 to 0.32, p ≤ .001) health complaints. Finally, we found that associations between total lifetime non-sport and sport-specific stressor severity and health were mediated by trait stress appraisals. Consequently, these findings may help practitioners better identify sport performers who are at risk of developing stress-related health problems.

7.
J Sport Exerc Psychol ; 44(3): 206-219, 2022 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-35468589

RESUMEN

This study examined the effect of slow diaphragmatic breathing on psychophysiological stress responses and pressurized performance. Sixty-seven participants (40 female; Mage = 20.17 ± 2.77 years) were randomly assigned to either a diaphragmatic-breathing, paced-breathing, or control group. Participants completed a nonpressurized shooting task and then received instructions about a pressurized version. Next, the diaphragmatic group was told to breathe at 6 breaths/min, the paced group at 12 breaths/min, and the control group received no instructions. Following a 5-min intervention period, participants completed the pressurized task while performance was assessed. Psychophysiological stress responses (e.g., cognitive anxiety, heart rate) were recorded throughout. Results revealed that diaphragmatic breathing had mixed effects on stress responses, with some unaffected (e.g., heart rate) and others reduced (e.g., cognitive anxiety), and little effect on performance. Findings suggested that slow diaphragmatic breathing might not aid pressurized performance but could benefit psychological stress responses.


Asunto(s)
Estrés Psicológico , Femenino , Frecuencia Cardíaca/fisiología , Humanos
8.
J Sport Exerc Psychol ; 44(6): 427-438, 2022 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-36450294

RESUMEN

This study addressed whether lifetime stressor exposure was associated with psychophysiological reactivity and habituation to a novel laboratory-based stressor. Eighty-six participants (Mage = 23.31 years, SD = 4.94) reported their exposure to lifetime non-sport and sport-specific stressors before completing two consecutive trials of the Trier Social Stress Test, while cardiovascular (i.e., heart rate) and endocrine (i.e., salivary cortisol) data were recorded. Exposure to a moderate number of lifetime non-sport and sport-specific stressors was associated with adaptive cardiovascular reactivity, whereas very low or very high stressor exposure was related to maladaptive reactivity. Moreover, experiencing a very low number of lifetime non-sport (but not sport-specific) stressors was associated with poorer habituation. In contrast, lifetime stressor severity was unrelated to cardiovascular reactivity. Finally, greater lifetime non-sport and sport-specific stressor counts were associated with blunted cortisol reactivity and poorer habituation. These results suggest that lifetime stressor exposure may influence sport performers' acute stress responses.


Asunto(s)
Habituación Psicofisiológica , Deportes , Humanos , Hidrocortisona , Frecuencia Cardíaca
9.
J Neurophysiol ; 125(1): 199-210, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-33296617

RESUMEN

Vagal afferent fibers contact neurons in the nucleus of the solitary tract (NTS) and release glutamate via three distinct release pathways: synchronous, asynchronous, and spontaneous. The presence of TRPV1 in vagal afferents is predictive of activity-dependent asynchronous glutamate release along with temperature-sensitive spontaneous vesicle fusion. However, pharmacological blockade or genetic deletion of TRPV1 does not eliminate the asynchronous profile and only attenuates the temperature-dependent spontaneous release at high temperatures (>40°C), indicating additional temperature-sensitive calcium conductance(s) contributing to these release pathways. The transient receptor potential cation channel melastatin subtype 3 (TRPM3) is a calcium-selective channel that functions as a thermosensor (30-37°C) in somatic primary afferent neurons. We predict that TRPM3 is expressed in vagal afferent neurons and contributes to asynchronous and spontaneous glutamate release pathways. We investigated these hypotheses via measurements on cultured nodose neurons and in brainstem slice preparations containing vagal afferent to NTS synaptic contacts. We found histological and genetic evidence that TRPM3 is highly expressed in vagal afferent neurons. The TRPM3-selective agonist, pregnenolone sulfate, rapidly and reversibly activated the majority (∼70%) of nodose neurons; most of which also contained TRPV1. We confirmed the role of TRPM3 with pharmacological blockade and genetic deletion. In the brain, TRPM3 signaling strongly controlled both basal and temperature-driven spontaneous glutamate release. Surprisingly, genetic deletion of TRPM3 did not alter synchronous or asynchronous glutamate release. These results provide convergent evidence that vagal afferents express functional TRPM3 that serves as an additional temperature-sensitive calcium conductance involved in controlling spontaneous glutamate release onto neurons in the NTS.NEW & NOTEWORTHY Vagal afferent signaling coordinates autonomic reflex function and informs associated behaviors. Thermosensitive transient receptor potential (TRP) channels detect temperature and nociceptive stimuli in somatosensory afferent neurons, however their role in vagal signaling remains less well understood. We report that the TRPM3 ion channel provides a major thermosensitive point of control over vagal signaling and synaptic transmission. We conclude that TRPM3 translates physiological changes in temperature to neurophysiological outputs and can serve as a cellular integrator in vagal afferent signaling.


Asunto(s)
Ácido Glutámico/metabolismo , Neuronas Aferentes/metabolismo , Canales Catiónicos TRPM/metabolismo , Nervio Vago/metabolismo , Potenciales de Acción , Animales , Potenciales Postsinápticos Excitadores , Exocitosis , Calor , Masculino , Neuronas Aferentes/fisiología , Pregnenolona/farmacología , Ratas , Ratas Sprague-Dawley , Canales Catiónicos TRPM/agonistas , Canales Catiónicos TRPM/genética , Nervio Vago/citología , Nervio Vago/fisiología
10.
J Sports Sci ; 39(3): 239-247, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32873133

RESUMEN

Presently, disability athletes remain under-represented in organisational stressor research. Our study sought to bring novel insights to this area by determining the organisational stressors experienced by international disability footballers. Twelve current international disability footballers (10 male, 2 female) from a range of UK impairment squads took part in the study. Semi-structured interviews were completed with each participant, and data were analysed by content analysis procedures. Organisational stressors data were abstracted into Arnold, Wagstaff, Steadman and Pratt's (2017) concepts, and Arnold and Fletcher's (2012) four general dimensions: leadership and personnel issues, cultural and team issues, logistical and environmental issues, and performance and personal issues, revealing a series of football-specific nuances. Our study is the first exploration of the prevalence of organisational stressors within international disability football. Our study also provides practitioners with an understanding of the common and unique organisational stressors faced by international disability footballers. Finally, we suggest a series of practical recommendations for policy development within disability football organisations to aid athletes to effective manage organisational stressors.


Asunto(s)
Cultura Organizacional , Fútbol/psicología , Deportes para Personas con Discapacidad/psicología , Rendimiento Atlético/psicología , Ambiente , Femenino , Humanos , Relaciones Interpersonales , Liderazgo , Masculino , Administración de Personal , Equipo Deportivo , Estrés Psicológico
11.
J Sports Sci ; 39(1): 64-77, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32851916

RESUMEN

Organizational stressors can undermine the psychological well-being and performance of athletes. Less is known, however, about how these relationships unfold over time and whether organizational stressors can impact upon perceived physical health. The current study, therefore, used a repeated-measures design to examine relationships between organizational stressors with components of perceived psychological (anxiety and depression) and physical (illness symptoms and missed training days via illness) ill-health, and perceived performance at the within-person level. Twenty-three semi-elite female rowers completed monthly measures of study variables for six-months. Multilevel models indicated that selection-related stressors positively predicted symptoms of perceived psychological and physical ill-health, and negatively predicted perceived performance. Conversely, coaching stressors negatively predicted symptoms of perceived psychological ill-health. Logistics and operations stressors positively predicted perceived performance, whereas goals and development stressors negatively predicted perceived performance. These findings demonstrate for the first time that, with a repeated-measures design, organizational stressors can predict components of perceived physical and psychological ill-health, and perceived performance at the within-person level in athletes. From a practical perspective, practitioners should incorporate these findings when diagnosing the need for, developing, and optimally implementing primary and secondary stress management interventions.


Asunto(s)
Ansiedad/psicología , Atletas/psicología , Rendimiento Atlético/psicología , Depresión/psicología , Estrés Psicológico/psicología , Deportes Acuáticos/psicología , Enfermedad Aguda , Adolescente , Adulto , Femenino , Humanos , Cultura Organizacional , Reproducibilidad de los Resultados , Estrés Psicológico/epidemiología , Evaluación de Síntomas/métodos , Evaluación de Síntomas/estadística & datos numéricos , Deportes de Equipo , Factores de Tiempo , Deportes Acuáticos/fisiología , Adulto Joven
12.
Artículo en Inglés | MEDLINE | ID: mdl-33551692

RESUMEN

This report builds on a previous study that describes the collaboration between an urban academic medical center and a rural drug treatment center, the goal of which is to provide medication-based treatment to individuals with OUD via videoconferencing. We describe results of a retrospective chart review of 472 patients treated in the program between August 2015 and April 2019. We examined several demographic and substance use variables for individuals who consented to telemedicine treatment, retention in treatment over time, and opioid use over time to understand further the impact of prescribing buprenorphine and naltrexone via telemedicine to patients in a rural OUD treatment setting. Our findings support the effectiveness of prescribing medications via telemedicine. The inclusion of more than three times as many patients as in our prior report revealed retention rates and toxicology results that are comparable to face-to-face treatment. These findings have implications for policymakers and clinicians considering implementation of similar programs.

13.
Psychol Sport Exerc ; 522021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33281503

RESUMEN

Research suggests that elite athletes are at increased risk of poor mental health, partly due to the intense demands associated with top-level sport. Despite growing interest in the topic, the factors that influence the mental health and well-being of elite athletes remain unclear. From a theoretical perspective, the accumulation of stress and adversity experienced over the life course may be an important factor. To investigate this possibility, we employed a mixed-method design to: (a) examine whether cumulative lifetime stress predicted depression, anxiety, and well-being in elite athletes; and (b) help explain why cumulative lifetime stress exposure might have resulted in poor mental health and well-being. Ninety-five elite athletes (M age = 29.81, SD = 10.88) completed the Stress and Adversity Inventory, Patient Health Questionnaire, Generalized Anxiety Disorder 7-item scale, and the Scales of General Well-Being. Hierarchical regression analyses revealed that total count and severity of lifetime stressor exposure significantly predicted greater depression (ß = .42, p < .001; ß = .46, p < .001) and anxiety symptoms (ß = .34, p = .003; ß = .28, p = .018), and worse well-being (ß = -.42, p < .001; ß = -.30, p = .015). Semi-structured interviews were then conducted with six athletes. Thematic analysis revealed that cumulative lifetime stress exposure fostered poor mental health and well-being by promoting maladaptive long-term coping strategies, increasing susceptibility to future stress, and limiting interpersonal relationships. We believe these findings can help practitioners identify, and intervene accordingly with, elite athletes at risk of experiencing stress-related mental health problems.

14.
Am J Physiol Cell Physiol ; 319(6): C1097-C1106, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-32966126

RESUMEN

Circulating blood glucocorticoid levels are dynamic and responsive to stimuli that impact autonomic function. In the brain stem, vagal afferent terminals release the excitatory neurotransmitter glutamate to neurons in the nucleus of the solitary tract (NTS). Vagal afferents integrate direct visceral signals and circulating hormones with ongoing NTS activity to control autonomic function and behavior. Here, we investigated the effects of corticosterone (CORT) on glutamate signaling in the NTS using patch-clamp electrophysiology on brain stem slices containing the NTS and central afferent terminals from male C57BL/6 mice. We found that CORT rapidly decreased both action potential-evoked and spontaneous glutamate signaling. The effects of CORT were phenocopied by dexamethasone and blocked by mifepristone, consistent with glucocorticoid receptor (GR)-mediated signaling. While mRNA for GR was present in both the NTS and vagal afferent neurons, selective intracellular quenching of G protein signaling in postsynaptic NTS neurons eliminated the effects of CORT. We then investigated the contribution of retrograde endocannabinoid signaling, which has been reported to transduce nongenomic GR effects. Pharmacological or genetic elimination of the cannabinoid type 1 receptor signaling blocked CORT suppression of glutamate release. Together, our results detail a mechanism, whereby the NTS integrates endocrine CORT signals with fast neurotransmission to control autonomic reflex pathways.


Asunto(s)
Corticosterona/farmacología , Endocannabinoides/metabolismo , Ácido Glutámico/metabolismo , Neuronas Aferentes/metabolismo , Núcleo Solitario/fisiología , Transmisión Sináptica/fisiología , Potenciales de Acción/fisiología , Animales , Dexametasona/farmacología , Potenciales Evocados/fisiología , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Mifepristona/farmacología , Técnicas de Placa-Clamp , Receptores de Glucocorticoides/metabolismo , Transducción de Señal/efectos de los fármacos , Transmisión Sináptica/efectos de los fármacos
15.
AIDS Behav ; 24(6): 1893-1902, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31838589

RESUMEN

This pilot randomized controlled trial evaluated the feasibility and efficacy of a brief motivational enhancement intervention to improve adherence to antiretroviral therapy in persons with HIV called Personal Approach to Treatment Choices for HIV (PATCH). We compared PATCH to an active control condition on self-reported adherence, clinical outcomes, and psychosocial outcomes. Participants were 34 individuals (61.8% male, Mage = 47.1) receiving HIV-related services who were suboptimally engaged in care. Participants completed baseline measures, participated in either PATCH or a stress reduction skills control intervention, and completed post-treatment and 3-month follow-up assessments. Results revealed no differences between conditions on adherence or clinical outcomes. At post-treatment, PATCH participants reported greater improvements in alcohol use, psychiatric symptoms, subjective mental functioning, and emotion-focused coping; improvements in subjective mental functioning were maintained at 3-months. Results suggest that motivational enhancement interventions can improve psychosocial outcomes for people with HIV. That some improvements were not maintained at follow-up suggests that effects wane over time and longer treatment may be indicated for lasting effects.


Asunto(s)
Infecciones por VIH , Cumplimiento de la Medicación , Motivación , Femenino , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad
16.
BMC Pregnancy Childbirth ; 19(1): 307, 2019 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-31443691

RESUMEN

BACKGROUND: Healthcare providers are the vital link between evidence-based policies and women receiving high quality maternity care. Explanations for suboptimal care often include poor working conditions for staff and a lack of essential supplies. Other explanations suggest that doctors, midwives and care assistants might lack essential skills or be unaware of the rights of the women for whom they care. This ethnography examined the everyday lives of maternal healthcare providers working in a tertiary maternity hospital in Kabul, Afghanistan between 2010 and 2012. The aim was to understand their notions of care, varying levels of commitment, and the obstacles and dilemmas that affected standards. METHODS: The culture of care was explored through six weeks of observation, 41 background interviews, 23 semi-structured interviews with doctors, midwives and care assistants. Focus groups were held with two diverse groups of women in community settings to understand their experiences and desires regarding care in maternity hospitals. Data were analysed thematically. RESULTS: Women related many instances of neglect, verbal abuse and demands for bribes from staff. Doctors and midwives concurred that they did not provide care as they had been taught and blamed the workload, lack of a shift system, insufficient supplies and inadequate support from management. Closer inspection revealed a complex reality where care was impeded by low levels of supplies and medicines but theft reduced them further; where staff were unfairly blamed by management but others flouted rules with impunity; and where motivated staff tried hard to work well but, when overwhelmed with the workload, admitted that they lost patience and shouted at women in childbirth. In addition there were extreme examples of both abusive and vulnerable staff. CONCLUSIONS: Providing respectful quality maternity care for women in Afghanistan requires multifaceted initiatives because the factors leading to suboptimal care or mistreatment are complex and interrelated. Standards need enforcing and abusive practices confronting to provide a supportive, facilitating environment for both staff and childbearing women. Polarized perspectives such as 'villain' or 'victim' are unhelpful as they exclude the complex realities of human behaviour and consequently limit the scope of problem solving.


Asunto(s)
Actitud del Personal de Salud , Atención a la Salud/normas , Personal de Salud/psicología , Servicios de Salud Materna/normas , Relaciones Profesional-Paciente , Adulto , Afganistán , Antropología Cultural , Atención a la Salud/métodos , Parto Obstétrico/psicología , Femenino , Grupos Focales , Personal de Salud/normas , Maternidades/normas , Humanos , Partería/normas , Obstetricia/normas , Parto/psicología , Embarazo , Investigación Cualitativa , Respeto , Carga de Trabajo/psicología , Adulto Joven
17.
J Sports Sci ; 35(7): 694-703, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27173730

RESUMEN

Organisational stressors are associated with positive and negative outcomes in extant literature; however, little is known about which demands predict which outcomes. Extant theory and literature also suggests that coping style may influence an individual's resilience or vulnerability to stressors and, subsequently, their psychological responses and outcomes. The purpose of this study was, therefore, to examine the main effects of organisational stressors and coping styles on various outcomes (e.g., positive and negative affect, performance satisfaction). Sport performers (n = 414) completed measures of organisational stressors, coping styles, positive and negative affect, and performance satisfaction. Multiple regression analyses revealed positive relationships of both goals and development stressors (duration and intensity) and team and culture stressors (frequency and intensity) on negative affect. Furthermore, problem-focused coping was positively related to positive affect, and emotion-focused coping was positively related to negative affect. This study furthers theoretical knowledge regarding the associations that both organisational stressors (and their dimensions) and coping styles can have with various outcomes, and practical understanding regarding the optimal design of stress management interventions.


Asunto(s)
Adaptación Psicológica , Atletas/psicología , Organizaciones , Deportes/psicología , Estrés Psicológico/etiología , Adolescente , Adulto , Anciano , Conducta Competitiva , Cultura , Emociones , Ambiente , Femenino , Objetivos , Humanos , Masculino , Persona de Mediana Edad , Solución de Problemas , Medio Social , Adulto Joven
18.
J Sports Sci ; 35(12): 1187-1196, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27472292

RESUMEN

Organisational stressors have been found to be prevalent and problematic for sport performers, with research identifying demographic differences in the stressors encountered. Nevertheless, extant sport psychology research on the topic of stress has generally focused on able-bodied athletes; whilst that which has been conducted on performers with a disability has typically recruited relatively small samples to explore a narrow selection of organisational stressors, or examined other components of the stress process. The purpose of the present study was to explore the various organisational stressors that athletes with a disability encounter. The sample comprised 18 elite athletes with a disability (10 male, 8 female) who had a classified disability and experience of competing at a major championships in their sport (e.g., Paralympic Games, World Championships). Participants took part in a semi-structured interview which was analysed by drawing from grounded theory procedures. A total of 316 organisational stressors were identified, which were abstracted into 31 concepts and four, previously conceptualised, exploratory schemes: leadership and personnel issues, cultural and team issues, logistical and environmental issues, and performance and personal issues. This study not only provides the first illustration of the prevalence of organisational stressors for athletes with a disability, but also significantly points to salient similarities and distinct differences between the stress experiences of performers with and without a disability.


Asunto(s)
Deportes para Personas con Discapacidad/psicología , Estrés Psicológico , Adolescente , Adulto , Rendimiento Atlético/psicología , Comunicación , Ambiente , Femenino , Humanos , Relaciones Interpersonales , Liderazgo , Masculino , Cultura Organizacional , Administración de Personal , Adulto Joven
19.
J Sport Exerc Psychol ; 39(6): 423-437, 2017 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-29436923

RESUMEN

Although considerable research exists on performers' responses to sporting encounters, little is known about thriving in sport contexts. The current study examined if distinct response patterns existed between sport performers who thrived in competitive encounters compared with those who did not. Participants were 535 sport performers (134 women; Mage = 23.60 years, SDage = 8.08; Mcompeting = 11.84 years, SDcompeting = 7.11). Results of factor mixture analysis supported a four-profile solution comprising a thriving group (n = 146), a low-functioning group (n = 38), and two groups characterized by scores marginally above (n = 131) and below (n = 209) the sample mean. Profile membership was found to be predicted by personal enablers (viz., personal resilient qualities, psychological skills use) and process variables (viz., basic psychological need satisfaction and frustration, challenge appraisal). This examination of thriving in sport performers offers significant implications for research and practice.


Asunto(s)
Atletas/psicología , Rendimiento Atlético/psicología , Deportes/psicología , Estrés Psicológico , Adolescente , Adulto , Análisis Factorial , Femenino , Humanos , Masculino , Adulto Joven
20.
J Sports Sci ; 33(2): 169-79, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25375248

RESUMEN

The Sport Emotion Questionnaire (SEQ) (Jones, M. V., Lane, A. M., Bray, S. R., Uphill, M., & Catlin, J. (2005). Development and validation of the SEQ. Journal of Sport and Exercise Psychology, 27, 407-431) was developed and initially validated to assess sport performers' pre-competitive emotions. The purpose of this study was to test the factor structure of the SEQ in a different environment (viz. organisational) and at a different time point (viz. the past month). A further aim was to examine if the SEQ was invariant across different groups of sport performers. A diverse sample of athletes (n = 1277) completed the questionnaire. Fit indices from confirmatory factor analyses provided partial support for the hypothesised measurement model, with equal or better fit demonstrated than evident in initial validation. The comparative fit index values were above acceptable guidelines for all factors at subscale level. Evidence was also found for the invariance of the SEQ across different groups. Overall, the findings support the reliability and validity of the SEQ as a measure of the emotions experienced by sport performers in an organisational environment during the past month.


Asunto(s)
Emociones , Organizaciones , Deportes/psicología , Encuestas y Cuestionarios , Adolescente , Adulto , Anciano , Ambiente , Análisis Factorial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Adulto Joven
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