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1.
Am J Physiol Endocrinol Metab ; 327(4): E512-E523, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39140974

RESUMO

Diabetic kidney disease (DKD) remains as one of the leading long-term complications of type 2 diabetic mellitus (T2DM). Studies have shown that decreased expression of glucose-6-phosphate dehydrogenase (G6PD) plays an important role in DKD. However, the upstream and downstream pathways of G6PD downregulation leading to DKD have not been elucidated. We conducted a series of studies including clinical study, animal studies, and in vitro studies to explore this. First, a total of 90 subjects were evaluated including 30 healthy subjects, 30 patients with T2DM, and 30 patients with DKD. The urinary G6PD activity and its association with the clinical markers were analyzed. Multivariate linear regression analysis was used to analyze the risk factors of urinary G6PD in these patients. Then, microRNAs that were differentially expressed in urine and could bind and degrade G6PD were screened and verified in patients with DKD. After that, high glucose (HG)-cultured human kidney cells (HK-2) and Zucker diabetic fatty (ZDF) rats were used to test the roles of miR-7977/G6PD/albumin-induced autophagy in DKD. Beclin and P62 were used as markers of kidney autophagy indicators. A dual-luciferase reporter assay system was used to test the binding of G6PD by mir-7977. The plasma and urinary G6PD activity were decreased significantly in patients with DKD, accompanied by increased urinary mir-7977 level. The fasting plasma glucose (FPG), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and urinary albumin excretion were independent predictors of urinary G6PD activity, according to multiple linear regression analysis. The increased expression of miR-7977 and decreased expression of G6PD were also found in the kidney of ZDF rats with early renal tubular damage. The correlation analysis showed that beclin protein expression levels were positively correlated with kidney G6PD activity, whereas P62 protein expression was negatively correlated with kidney G6PD activity in rats. In HK-2 cells cultured with normal situation, a low level of albumin could induce autophagy along with the stimulation of G6PD, although this was impaired under high glucose. Overexpression of G6PD reversed albumin-induced autophagy in HK-2 cells under high glucose. Further study revealed that G6PD was a downstream target of miR-7977. Inhibition of miR-7977 expression led to significantly increased expression of G6PD and reversed the effects of high glucose on albumin-induced autophagy. In conclusion, our study supports a new mechanism of G6PD downregulation in DKD. Therapeutic measures targeting the miR-7977/G6PD/autophagy signaling pathway may help in the prevention and treatment of DKD.NEW & NOTEWORTHY This study provides new evidence that reduced glucose-6-phosphate dehydrogenase (G6PD) may damage the endocytosis of renal tubular epithelial cells by reducing albumin-induced autophagy. More importantly, for the first time, our study has provided evidence from humans that the decrease in urinary G6PD activity is positively associated with renal injury, and abnormal glucose and lipid metabolism may be important reasons for reduced G6PD levels. Increased miR-7977 may at least in part explain the downregulation of G6PD.


Assuntos
Autofagia , Diabetes Mellitus Tipo 2 , Nefropatias Diabéticas , Glucosefosfato Desidrogenase , MicroRNAs , Humanos , MicroRNAs/genética , MicroRNAs/metabolismo , Nefropatias Diabéticas/metabolismo , Nefropatias Diabéticas/genética , Nefropatias Diabéticas/urina , Autofagia/fisiologia , Masculino , Animais , Pessoa de Meia-Idade , Ratos , Glucosefosfato Desidrogenase/metabolismo , Glucosefosfato Desidrogenase/genética , Feminino , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/urina , Túbulos Renais Proximais/metabolismo , Túbulos Renais Proximais/patologia , Ratos Zucker , Estudos de Casos e Controles , Células Epiteliais/metabolismo , Adulto , Linhagem Celular , Idoso
2.
JAMA ; 331(7): 573-581, 2024 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-38324415

RESUMO

Importance: Atrial cardiopathy is associated with stroke in the absence of clinically apparent atrial fibrillation. It is unknown whether anticoagulation, which has proven benefit in atrial fibrillation, prevents stroke in patients with atrial cardiopathy and no atrial fibrillation. Objective: To compare anticoagulation vs antiplatelet therapy for secondary stroke prevention in patients with cryptogenic stroke and evidence of atrial cardiopathy. Design, Setting, and Participants: Multicenter, double-blind, phase 3 randomized clinical trial of 1015 participants with cryptogenic stroke and evidence of atrial cardiopathy, defined as P-wave terminal force greater than 5000 µV × ms in electrocardiogram lead V1, serum N-terminal pro-B-type natriuretic peptide level greater than 250 pg/mL, or left atrial diameter index of 3 cm/m2 or greater on echocardiogram. Participants had no evidence of atrial fibrillation at the time of randomization. Enrollment and follow-up occurred from February 1, 2018, through February 28, 2023, at 185 sites in the National Institutes of Health StrokeNet and the Canadian Stroke Consortium. Interventions: Apixaban, 5 mg or 2.5 mg, twice daily (n = 507) vs aspirin, 81 mg, once daily (n = 508). Main Outcomes and Measures: The primary efficacy outcome in a time-to-event analysis was recurrent stroke. All participants, including those diagnosed with atrial fibrillation after randomization, were analyzed according to the groups to which they were randomized. The primary safety outcomes were symptomatic intracranial hemorrhage and other major hemorrhage. Results: With 1015 of the target 1100 participants enrolled and mean follow-up of 1.8 years, the trial was stopped for futility after a planned interim analysis. The mean (SD) age of participants was 68.0 (11.0) years, 54.3% were female, and 87.5% completed the full duration of follow-up. Recurrent stroke occurred in 40 patients in the apixaban group (annualized rate, 4.4%) and 40 patients in the aspirin group (annualized rate, 4.4%) (hazard ratio, 1.00 [95% CI, 0.64-1.55]). Symptomatic intracranial hemorrhage occurred in 0 patients taking apixaban and 7 patients taking aspirin (annualized rate, 1.1%). Other major hemorrhages occurred in 5 patients taking apixaban (annualized rate, 0.7%) and 5 patients taking aspirin (annualized rate, 0.8%) (hazard ratio, 1.02 [95% CI, 0.29-3.52]). Conclusions and Relevance: In patients with cryptogenic stroke and evidence of atrial cardiopathy without atrial fibrillation, apixaban did not significantly reduce recurrent stroke risk compared with aspirin. Trial Registration: ClinicalTrials.gov Identifier: NCT03192215.


Assuntos
Fibrilação Atrial , Cardiopatias , AVC Isquêmico , Pirazóis , Acidente Vascular Cerebral , Humanos , Feminino , Idoso , Masculino , Fibrilação Atrial/complicações , Fibrilação Atrial/tratamento farmacológico , Método Duplo-Cego , Canadá , Acidente Vascular Cerebral/prevenção & controle , Acidente Vascular Cerebral/complicações , Aspirina/efeitos adversos , Piridonas/efeitos adversos , Piridonas/administração & dosagem , Hemorragia/induzido quimicamente , Hemorragia/tratamento farmacológico , Cardiopatias/complicações , AVC Isquêmico/tratamento farmacológico , Anticoagulantes/efeitos adversos , Anticoagulantes/administração & dosagem , Hemorragias Intracranianas/induzido quimicamente
3.
Nano Lett ; 23(24): 11932-11939, 2023 Dec 27.
Artigo em Inglês | MEDLINE | ID: mdl-38100376

RESUMO

Interfacing perovskites with two-dimensional materials such as metal-organic frameworks (MOFs) for improved stability and electron or hole extraction has emerged as a promising path forward for the generation of highly efficient and stable solar cells. In this work, we examine the structural properties and excitation dynamics of two MOF-perovskite systems: UMCM309-a@MAPbI3 and ZrL3@MAPbI3. We find that precise band alignment and electronegativity of the MOF-linkers are necessary to facilitate the capture of excited charge carriers. Furthermore, we demonstrate that intraband relaxation of hot electrons to the MOF subsystem results in optically disallowed transitions across the band gap, suppressing radiative recombination. Furthermore, we elucidate the key mechanisms associated with improved structural stability afforded to the perovskites by the two-dimensional MOFs, highlighting the necessity of broad surface coverage and strong MOF-perovskite interaction.

4.
Issues Ment Health Nurs ; 45(9): 979-989, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39012920

RESUMO

Mental health carers are crucial in improving the physical health outcomes of people diagnosed with a mental illness (hereafter referred to as consumers). The long-term and multifaceted mental and physical health support carers provide to consumers can contribute to caregiver burden. Consequently, carers advocate for coordinated and integrated physical healthcare to improve the physical health outcomes of consumers and alleviate caregiver burden. The aim of this qualitative exploratory study is to explore carers' perceptions and experiences with the Physical Health Nurse Consultant role. Semi-structured interviews with nine carers nominated by consumers were conducted. Interviews were transcribed and reflexively thematically analysed. Three main themes were identified: (i) Therapeutic relationship s were a catalyst for health behaviour change; (ii) Overt and covert positive changes were observed by carer and (iii) Cares' involvement in integrated mental health and physical health care. Nine carers who were nominated by consumers to be involved in their physical healthcare planning, preferred to adopt a supporting role as this prevented or reduced caregiver burden. The findings support the adoption and continuation of the Physical Health Nurse Consultant role to facilitate positive physical health outcomes for consumers and a reduction in caregiving burden. The benefits of the Physical Health Nurse Consultant provide a compelling argument to embed the role in routine practice. Mental healthcare services should advocate for continued funding and career development for such positions to provide long term benefits for consumers and carers. Future research is required to explore carer and consumer involvement in co-producing future and localised iterations of the Physical Health Nurse Consultant role. This research should also measure the outputs and outcomes of co-production to clarify how the process worked in practice.


Assuntos
Cuidadores , Consultores , Transtornos Mentais , Humanos , Transtornos Mentais/enfermagem , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Feminino , Masculino , Pessoa de Meia-Idade , Cuidadores/psicologia , Adulto , Consultores/psicologia , Pesquisa Qualitativa , Idoso
5.
J Ment Health ; : 1-23, 2024 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-39150334

RESUMO

BACKGROUND: People experiencing mental illness receive physical healthcare from nurses in a variety of settings including acute inpatient, secure extended care, forensic, and community services. While nurse-led clinical practice addressing sub-optimal consumer physical health is salient, a detailed understanding and description of the contribution by nurses to physical health interventions in people experiencing mental illness is not clearly articulated in the literature. AIMS: The aim of this integrative review is to describe the state of knowledge on nurse-led physical health intervention for consumers, focusing on nursing roles, nursing assessment, and intervention settings. METHODS: A systematic search of six databases using Medical Subject Headings from 2001 and 2022 inclusive was conducted. The Mixed Methods Appraisal Tool (MMAT) was utilised for quality appraisal. RESULTS: Seventy-four studies were identified as "nurse-led". Interventions were most common among community settings (n = 34, 46%). Nurses performed varied roles, often concurrently, including the collection of 341 physical health outcomes, and multiple roles with 225 distinct nursing actions identified across the included studies. A nurse as lead author was common among the included studies (n = 46, 62%). However, nurses were not always recognised for their efforts or contributions in authorship. CONCLUSIONS: There is potential gap in role recognition that should be considered when designing and reporting nurse-led physical health interventions.

6.
Stroke ; 54(12): 3169-3172, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37916458

RESUMO

BACKGROUND: Outreach campaigns have sought to reduce the burden of stroke by improving knowledge of stroke risk factors (RF) and warning signs (WS). We describe trends in stroke knowledge from 1995 to 2021. METHODS: From 1995 to 2021, 6 separate surveys were conducted in the Greater Cincinnati Northern Kentucky Region. Temporal trends in RF/WS knowledge were analyzed using logistic regression adjusting for Race, sex, age, and education. RESULTS: In 1995, 28.6% of participants (537/1880) could name ≥2 WS, compared with 50.6% (983/1944) in 2021 (trend P<0.0001 after adjustment). In 1995, 44.5% of participants (836/1880) knew ≥2 RF, compared with 56.7% (1103/1944) in 2021 (trend P<0.0001 after adjustment). Although still improved compared with 1995, fewer participants could identify ≥2 RF in 2021 (1103/1944, 56.7%) when compared with 2011 (1287/2036, 63.2%, pairwise P<0.05). This decline in RF knowledge was disproportionately larger in women (odds ratio of 0.67 for knowledge in 2021 compared with 2011 in females, P=0.047 for the interaction between sex and study year). CONCLUSIONS: Although stroke knowledge has overall improved since 1995, there is evidence for lost gains since 2011, particularly in women. Stroke outreach campaigns need ongoing evaluation.


Assuntos
Educação em Saúde , Acidente Vascular Cerebral , Humanos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Acidente Vascular Cerebral/diagnóstico , Inquéritos e Questionários , Kentucky/epidemiologia , Fatores de Risco
7.
Stroke ; 54(4): 1009-1014, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36852687

RESUMO

BACKGROUND: Clinical trial enrollment and completion is challenging, with nearly half of all trials not being completed or not completed on time. In 2014, the National Institutes of Health StrokeNet in collaboration with stroke epidemiologists from GCNKSS (Greater Cincinnati/Northern Kentucky Stroke Study) began providing proposed clinical trials with formal trial feasibility assessments. Herein, we describe the process of prospective feasibility analyses using epidemiological data that can be used to improve enrollment and increase the likelihood a trial is completed. METHODS: In 2014, DEFUSE 3 (Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3) trialists, National Institutes of Health StrokeNet, and stroke epidemiologists from GCNKSS collaborated to evaluate the initial inclusion/exclusion criteria for the DEFUSE 3 study. Trial criteria were discussed and an assessment was completed to evaluate the percent of the stroke population that might be eligible for the study. The DEFUSE 3 trial was stopped early with the publication of DAWN (Thrombectomy 6 to 24 Hours After Stroke With a Mismatch Between Deficit and Infarct), and the Wilcoxon rank-sum statistic was used to analyze whether the trial would have been stopped had the proposed changes not been made, following the DEFUSE 3 statistical analysis plan. RESULTS: After initial epidemiological analysis, 2.4% of patients with acute stroke in the GCNKSS population would have been predicted to be eligible for the study. After discussion with primary investigators and modifying 4 key exclusion criteria (upper limit of age increased to 90 years, baseline modified Rankin Scale broadened to 0-2, time since last well expanded to 16 hours, and decreased lower limit of National Institutes of Health Stroke Scale score to <6), the number predicted to be eligible for the trial increased to 4%. At the time of trial conclusion, 57% of the enrolled patients qualified only by the modified criteria, and the trial was stopped at an interim analysis that demonstrated efficacy. We estimated that the Wilcoxon rank-sum value for the unadjusted predicted enrollment would not have crossed the threshold for efficacy and the trial not stopped. CONCLUSIONS: Objectively assessing trial inclusion/exclusion criteria using a population-based resource in a collaborative and iterative process including epidemiologists can lead to improved recruitment and can increase the likelihood of successful trial completion.


Assuntos
Isquemia Encefálica , Procedimentos Endovasculares , AVC Isquêmico , Acidente Vascular Cerebral , Humanos , Resultado do Tratamento , Estudos Prospectivos , Estudos de Viabilidade , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/terapia , Trombectomia/métodos , Procedimentos Endovasculares/métodos , Isquemia Encefálica/diagnóstico por imagem , Isquemia Encefálica/epidemiologia , Isquemia Encefálica/terapia
8.
J Chem Phys ; 159(6)2023 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-37555613

RESUMO

The increased computational and experimental interest in perovskite systems comprising novel phases and reduced dimensionality has greatly expanded the search space for this class of materials. In similar fields, unified frameworks exist for the procedural generation and subsequent analysis of these complex condensed matter systems. Given the relatively recent rise in popularity of these novel perovskite phases, such a framework is yet to be created. In this work, we introduce Pyrovskite, an open source software package, to aid in both the high-throughput and fine-grained generation, simulation, and subsequent analysis of this expanded family of perovskite systems. Additionally, we introduce a new descriptor for octahedral distortions in systems, including, but not limited to, perovskites. This descriptor quantifies diagonal displacements of the B-site cation in a BX6 octahedral coordination environment, which has been shown to contribute to increased Rashba-Dresselhaus splitting in perovskite systems.

9.
BMC Public Health ; 23(1): 1036, 2023 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-37259042

RESUMO

BACKGROUND: Surf lifesavers and lifeguards have provided essential education, preventative, and rescue services to the Australian community for over 110 years. In this first responder role, surf lifesavers and lifeguards are inadvertently exposed to high risk and trauma related experiences, which may negatively impact mental well-being. To date however, there has been limited research into the mental health of surf lifesavers and lifeguards, and no studies at all on the mental health of adolescent surf lifesavers. The preliminary study aimed to measure the exposure of potentially traumatic events (PTEs), post-traumatic stress symptoms (PTSS), self-efficacy, social support, and attitudes towards mental health problems in Surf Life Saving (SLS) members. METHODS: An anonymous, online survey was developed (adolescent and adult versions) and created to measure the domain of mental health in surf lifesavers and lifeguards. Pearson's correlations investigated relationships between PTEs, PTSS, self-efficacy, social support, attitudes towards mental health problems, age, years as a SLS member, and years patrolling. Spearman's Rank was used for violations of normality. RESULTS: A total of 57 surf lifesavers/lifeguards aged 13-59 years were included in the final analysis. There was a significant positive relationship between exposure to direct trauma and PTSS, which in turn, were associated with greater negative attitudes towards mental health problems towards the mental health of others, and lower levels of self-efficacy. Male and female adults with PTSS reported lower social support, whereas for adolescent males, a positive relationship between direct trauma and PTSS was observed. CONCLUSION: This research is the first to explore the mental health of Australian surf lifesavers and lifeguards. The results highlight the potential risks to mental health and well-being associated with this first responder role. More research to protect the vulnerability of this population is warranted.


Assuntos
Saúde Mental , Transtornos de Estresse Pós-Traumáticos , Adolescente , Adulto , Feminino , Humanos , Masculino , Austrália/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Inquéritos e Questionários , Natação/lesões , Adulto Jovem , Pessoa de Meia-Idade
10.
BMC Public Health ; 23(1): 569, 2023 03 27.
Artigo em Inglês | MEDLINE | ID: mdl-36973705

RESUMO

BACKGROUND: Exercise during pregnancy is associated with various health benefits for both mother and child. Despite these benefits, most pregnant women do not meet physical activity recommendations. A known barrier to engaging in exercise during pregnancy is a lack of knowledge about appropriate and safe exercise. In our current era of social media, many pregnant women are turning to online information sources for guidance, including social media influencers. Little is known about attitudes towards pregnancy exercise information provided by influencers on social media platforms. This study aimed to explore attitudes towards exercise during pregnancy depicted by social media influencers on Facebook, and user engagement with posted content. METHODS: A mixed-methods approach was used to analyse data from 10 Facebook video posts of social media influencers exercising during pregnancy. Quantitative descriptive analyses were used to report the number of views, shares, comments and emotive reactions. Qualitative analysis of user comments was achieved using an inductive thematic approach. RESULTS: The 10 video posts analysed were viewed a total of 12,117,200 times, shared on 11,181 occasions, included 13,455 user comments and 128,804 emotive icon reactions, with the most frequently used icon being 'like' (81.48%). The thematic analysis identified three themes associated with attitudes including [1] exercise during pregnancy [2] influencers and [3] type of exercise. A fourth theme of community was also identified. Most user comments were associated with positive attitudes towards exercise during pregnancy and the influencer. However, attitudes towards the types of exercise the influencer performed were mixed (aerobic and body weight exercises were positive; resistance-based exercise with weights were negative). Finally, the online community perceived by users was mostly positive and recognised for offering social support and guidance. CONCLUSIONS: User comments imply resistance-based exercise with weights as unsafe and unnecessary when pregnant, a perception that does not align with current best practice guidelines. Collectively, the findings from this study highlight the need for continued education regarding exercise during pregnancy and the potential for social media influencers to disseminate evidence-based material to pregnant women who are highly receptive to, and in need of reliable health information.


Assuntos
Mídias Sociais , Criança , Humanos , Feminino , Gravidez , Gestantes , Exercício Físico , Apoio Social , Terapia por Exercício
11.
Clin Rehabil ; 37(8): 1041-1051, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36727206

RESUMO

OBJECTIVE: To investigate the effects of multidirectional elastic tape on pain and function in individuals with lateral elbow tendinopathy. STUDY DESIGN: Randomised crossover trial. SETTING: Biomechanics laboratory. SUBJECTS: 27 participants (11 females, mean (SD) age: 48.6 (11.9) years) with clinically diagnosed lateral elbow tendinopathy of at least six weeks' duration. INTERVENTIONS: Tensioned multidirectional elastic tape applied over the wrist, compared to control tape (untensioned), and no tape conditions. MAIN MEASURES: Pain-free grip strength and pressure pain threshold were recorded at three timepoints for each condition: baseline, post-application, and following an exercise circuit. Change scores were calculated as the post-application or post-exercise value minus baseline. Repeated-measure analyses of variance were used to examine differences between conditions. RESULTS: There were no statistically significant differences in pain-free grip strength between conditions (flexed position: F2,52 = 0.02, p = 0.98; extended position: F2,52 = 2.26, p = 0.12) or across timepoints (post-application vs post-exercise) (flexed position: F1,26 = 0.94, p = 0.34; extended position: F1,26 = 0.79, p = 0.38). Seven participants (26%) increased pain-free grip strength above the minimal detectable change following application of multidirectional elastic tape. There were no statistically significant differences in pressure pain threshold between conditions (affected lateral epicondyle: F1.51,39.17 = 0.54, p = 0.54) or across timepoints (affected lateral epicondyle: F1,26 = 0.94, p = 0.34). CONCLUSION: Tensioned multidirectional elastic tape may not immediately improve pain-free grip strength or pressure pain threshold in our lateral elbow tendinopathy population; however, individual variation may exist.


Assuntos
Tendinopatia do Cotovelo , Doenças Musculoesqueléticas , Cotovelo de Tenista , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Cross-Over , Cotovelo de Tenista/diagnóstico , Dor/diagnóstico , Dor/etiologia , Cotovelo , Força da Mão
12.
Issues Ment Health Nurs ; 44(6): 458-473, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37294933

RESUMO

People with mental illness have a higher prevalence of co-occurring physical health conditions and poor health behaviors, leading a mortality gap of up to 16 years, compared with the general population. Nurses working in mental health settings play an important role in addressing factors influencing sub-optimal physical health. Therefore, this scoping review aimed to identify nurse-led physical health interventions and align interventions to eight recognized physical healthcare priority areas (i.e. Equally Well in Victoria Framework). A systematic search strategy was used to identify relevant literature. Data extraction included alignment to the Equally Well priority areas, research design, and indication of co-design (meaningful and collaborative involvement of consumers and significant others) and recovery-oriented practice (focusing on needs and goals of a consumer's recovery journey). All included papers (n = 74) were aligned to at least one of eight Equally Well priority areas. Papers were predominately quantitative (n = 64, 86%), with the remainder mixed methods (n = 9, 9%) or qualitative (n = 4, 5%). Most papers were aligned to improving metabolic health and support to quit smoking. One study focused on nurse-led intervention designed to reduce falls. Recovery-oriented practice was evident in six papers. No paper described evidence of co-design. A research gap was identified for nurse-led intervention to reduce falls and improve dental/oral care. Relative to mental healthcare policy, there is a need for future nurse-led physical health research to be co-designed and include recovery-oriented practice. Evaluation and description of future nurse-led physical interventions should seek to report perspectives of key stakeholders as these remain relatively unknown.


Assuntos
Transtornos Mentais , Papel do Profissional de Enfermagem , Humanos , Transtornos Mentais/terapia , Saúde Mental
13.
Rural Remote Health ; 23(1): 7438, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36966523

RESUMO

INTRODUCTION: Poor mental health is an under-recognised burden in rural locations. This is evident in suicide rates that are 40% higher in rural communities than in urban ones, despite a similar prevalence of mental disorders. The level of readiness and engagement of rural communities to adapt or even acknowledge poor mental health can impact effective interventions. For interventions to be culturally appropriate, community engagement should include individuals, their support networks and relevant stakeholders. Community participation guides people living in rural communities to be aware of and take responsibility for community mental health. Community engagement and participation foster empowerment. This review examines how community engagement, participation and empowerment were used in the development and implementation of interventions aimed at improving mental health of adults residing in rural communities. METHODS: Databases CINAHL, EmCare, Google Scholar, Medline, PsychInfo, PubMed and Scopus were systematically searched from database inception to July 2021. Eligible studies included adults living in a rural cohort where community engagement was used to develop and implement a mental health intervention. RESULTS: From 1841 records identified, six met the inclusion criteria. Methods were both qualitative and quantitative, including participatory-based research, exploratory descriptive research, community-built approach, community-based initiative and participatory appraisal. Studies were located in rural communities of the USA, UK and Guatemala. Sample size ranges was 6-449 participants. Participants were recruited using prior relationships, project steering committee, local research assistants and local health professionals. All six studies underwent various strategies of community engagement and participation. Only two articles progressed to community empowerment where locals influenced one another independently. The underlying purpose of each study was to improve community mental health. The duration of the interventions ranged from 5 months to 3 years. Studies on the early stages of community engagement discovered a need to address community mental health. Studies where interventions were implemented resulted in improved community mental health. CONCLUSION: This systematic review found similarities in community engagement when developing and implementing interventions for community mental health. Community engagement should involve adults residing in rural communities when developing interventions - if possible, both with a diverse gender representation and a background in health. Community participation can include upskilling adults living in rural communities and providing appropriate training materials to do so. Community empowerment was achieved when the initial contact with rural communities was through local authorities and there was support from community management. Future use of the strategies of engagement, participation and empowerment could determine if they can be replicated across rural communities for mental health.


Assuntos
Transtornos Mentais , Saúde Mental , Humanos , Adulto , População Rural , Transtornos Mentais/terapia , Participação da Comunidade , Pessoal de Saúde
14.
RNA ; 26(8): 903-909, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32284352

RESUMO

In recent years, RNA-sequencing (RNA-seq) has emerged as a powerful technology for transcriptome profiling. For a given gene, the number of mapped reads is not only dependent on its expression level and gene length, but also the sequencing depth. To normalize these dependencies, RPKM (reads per kilobase of transcript per million reads mapped) and TPM (transcripts per million) are used to measure gene or transcript expression levels. A common misconception is that RPKM and TPM values are already normalized, and thus should be comparable across samples or RNA-seq projects. However, RPKM and TPM represent the relative abundance of a transcript among a population of sequenced transcripts, and therefore depend on the composition of the RNA population in a sample. Quite often, it is reasonable to assume that total RNA concentration and distributions are very close across compared samples. Nevertheless, the sequenced RNA repertoires may differ significantly under different experimental conditions and/or across sequencing protocols; thus, the proportion of gene expression is not directly comparable in such cases. In this review, we illustrate typical scenarios in which RPKM and TPM are misused, unintentionally, and hope to raise scientists' awareness of this issue when comparing them across samples or different sequencing protocols.


Assuntos
Perfilação da Expressão Gênica/métodos , Sequenciamento de Nucleotídeos em Larga Escala/métodos , RNA/genética , Análise de Sequência de RNA/métodos , Expressão Gênica/genética , Humanos
15.
J Chem Inf Model ; 62(9): 2239-2247, 2022 05 09.
Artigo em Inglês | MEDLINE | ID: mdl-34865473

RESUMO

By analyzing data sets of replicate DNA-Encoded Library (DEL) selections, an approach for estimating the noise level of the experiment has been developed. Using a logarithm transformation of the number of counts associated with each compound and a subset of compounds with the highest number of counts, it is possible to assess the quality of the data through normalizing the replicates and use this same data to estimate the noise in the experiment. The noise level is seen to be dependent on sequencing depth as well as specific selection conditions. The noise estimation is independent of any cutoff used to remove low frequency compounds from the data analysis. The removal of compounds with only 1-5 read counts greatly reduces some of the challenges encountered in DEL data analysis as it can reduce the data set by greater than 100-fold without impacting the interpretation of the results.


Assuntos
DNA , Bibliotecas de Moléculas Pequenas , Análise de Dados , Incerteza
16.
BMC Public Health ; 22(1): 491, 2022 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-35279118

RESUMO

BACKGROUND: COVID-19 has resulted in substantial global upheaval. Resilience is important in protecting wellbeing, however few studies have investigated changes in resilience over time, and associations between resilience with depression, anxiety, stress, and physical activity during the COVID-19 pandemic. METHODS: Online surveys were conducted to collect both longitudinal and cross-sectional data at three time points during 2020. Australian adults aged 18 years and over were invited to complete the online surveys. Measures include the six-item Brief Resilience Scale, the 21-item Depression, Anxiety and Stress Scale, and the Active Australia Survey which have eight items identifying the duration and frequency of walking, and moderate and vigorous physical activities (MVPA), over the past 7 days. General linear mixed models and general linear models were used in the analysis. RESULTS: In the longitudinal sample, adjusted differences (aDif) in resilience scores did not significantly change over time (time 2 vs. time 1 [aDif = - 0.02, 95% CI = - 0.08, 0.03], and time 3 vs. time 1 [aDif = < 0.01, 95% CI = - 0.07, 0.06]). On average, those engaging in at least 150 min of MVPA per week (aDif = 0.10, 95% CI = 0.04, 0.16), and having depression (aDif = 0.40, 95% CI = 0.33), anxiety (aDif = 0.34, 95% CI = 0.26, 0.41), and stress scores (aDif = 0.30, 95% CI = 0.23, 0.37) within the normal range had significantly higher resilience scores. The association between resilience and physical activity was independent of depression, anxiety, and stress levels. All results were similar for the cross-sectional sample. CONCLUSIONS: Resilience scores did not change significantly during the COVID-19 pandemic. However, there were significant associations between resilience with physical activity and psychological distress. This research helps inform future interventions to enhance or nurture resilience, particularly targeted at people identified as at risk of psychological distress.


Assuntos
COVID-19 , Resiliência Psicológica , Adolescente , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Austrália/epidemiologia , COVID-19/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Exercício Físico , Humanos , Pandemias
17.
J Strength Cond Res ; 36(10): 2942-2945, 2022 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33337699

RESUMO

ABSTRACT: Fox, JL, Scanlan, AT, Stanton, R, and Sargent, C. The effect of game-related contextual factors on sleep in basketball players. J Strength Cond Res 36(10): 2942-2945, 2022-The purpose of this study was to determine whether contextual factors including game location, game outcome, and score-line margin influence subsequent nightly sleep duration and quality in basketball players. Seven semiprofessional, male basketball players were monitored across one competitive season using self-reported sleep diaries and activity monitors. Linear mixed models and effect sizes (ESs) were used to compare sleep duration and quality following games based on game location (played at home or away venues), game outcome (win or loss), and score-line margin (balanced [≤ 8-point margin] or unbalanced [≥ 9-point margin]). Sleep onset was later following away games (ES = 0.79 ± 0.86 [ moderate ], p = 0.12), losses (ES = 0.63 ± 0.79 [ moderate ], p = 0.18), and unbalanced games (ES = 1.36 ± 0.90 [ large ], p = 0.01). Wake time was later following losses (ES = 1.14 ± 0.85 [ moderate ], p = 0.02). Sleep fragmentation was higher following wins (ES = 0.65 ± 0.74 [ moderate ], p = 0.17). Sleep efficiency was higher following losses (ES = 0.70 ± 0.80 [ moderate ], p = 0.14). All other differences in sleep variables yielded trivial - small ESs ( p > 0.05). Because of the later sleep onset times of players, basketball practitioners should consider avoiding early morning travel or training sessions following away games, losses, and unbalanced games, to maintain similar nightly sleep durations in light of the contextual factors encountered. Basketball practitioners may also need to ensure player sleep is optimized following wins compared with losses given the lower quality observed.


Assuntos
Desempenho Atlético , Basquetebol , Monitores de Aptidão Física , Humanos , Masculino , Autorrelato , Sono , Privação do Sono
18.
J Women Aging ; 34(1): 54-64, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-32567525

RESUMO

Older adults' participation in resistance training is low. Recent research suggests social aspects are important determinants of exercise engagement. In this study, 13 older women (50 years and older) were interviewed to examine their experiences of powerlifting training. Data were thematically analyzed revealing two main themes: Challenging Beliefs and Positive Social Influences. Peer advocates were essential for uptake, with social interactions in group resistance training, and having a skilled trainer, identified as important adherence factors. Strategies to improve resistance training uptake in older women could leverage off the experience of others and powerlifting training culture and practices.


Assuntos
Treinamento Resistido , Levantamento de Peso , Idoso , Exercício Físico , Humanos
19.
Biol Sport ; 39(1): 95-100, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35173368

RESUMO

To investigate associations between acute workload and in-game performance in basketball. Eight semi-professional, male basketball players were monitored during all training sessions (N = 28) and games (N = 18) across the season. External workload was determined using absolute (arbitrary units[AU]) and relative (AU·min-1) PlayerLoadTM (PL), and absolute (count) and relative (count·min-1) low-intensity, medium-intensity, high-intensity, and total Inertial Movement Analysis (IMA) events (accelerations, decelerations, changes-of-direction, and jumps). Internal workload was determined using absolute and relative Summated-Heart-Rate-Zones workload, session-rating of perceived exertion, rating of perceived exertion, and time (min) spent working > 90% of maximal heart rate. In-game performance was indicated by the player efficiency statistic. Repeated measures correlations were used to determine associations between acute workload variables (across the previous 7 days) and player efficiency. Relative PL (r = 0.13, small) and high-intensity IMA events (r = 0.13, small) possessed the strongest associations with player efficiency of the investigated workload variables (P > 0.05). All other associations were trivial in magnitude (P > 0.05). Given the trivial-small associations between all external and internal workload variables and player efficiency, basketball practitioners should not rely solely on monitoring acute workloads to determine performance potential in players.

20.
Curr Diab Rep ; 21(2): 6, 2021 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-33449215

RESUMO

PURPOSE OF REVIEW: Diabetic kidney disease (DKD) continues to be the primary cause of chronic kidney disease in the USA and around the world. The numbers of people with DKD also continue to rise despite current treatments. Certain newer hypoglycemic drugs offer a promise of slowing progression, but it remains to be seen how effective these will be over time. Thus, continued exploration of the mechanisms underlying the development and progression of DKD is essential in order to discover new treatments. Hyperglycemia is the main cause of the cellular damage seen in DKD. But, exactly how hyperglycemia leads to the activation of processes that are ultimately deleterious is incompletely understood. RECENT FINDINGS: Studies primarily over the past 10 years have provided novel insights into the interplay of hyperglycemia, glucose metabolic pathways, mitochondrial function, and the potential importance of what has been called the Warburg effect on the development and progression of DKD. This review will provide a brief overview of glucose metabolism and the hypotheses concerning the pathogenesis of DKD and then discuss in more detail the supporting data that indicate a role for the interplay of glucose metabolic pathways and mitochondrial function.


Assuntos
Diabetes Mellitus , Nefropatias Diabéticas , Hiperglicemia , Insuficiência Renal Crônica , Glucose , Humanos , Mitocôndrias
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