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There is a substantial research base for addictive eating with development of interventions. The current 3-arm RCT aimed to investigate the efficacy of the TRACE (Targeted Research for Addictive and Compulsive Eating) program to decrease addictive eating symptoms and improve mental health. Participants (18-85 yrs) endorsing ≥3 addictive eating symptoms were randomly allocated to 1) active intervention, 2) passive intervention, or 3) control group. Primary outcome was change in addictive eating symptoms 3-months post-baseline measured by the Yale Food Addiction Scale. Depression, anxiety and stress were also assessed. A total of 175 individuals were randomised. Using Linear Mixed Models, from baseline to 3-months, there was significant improvement in symptom scores in all groups with mean decrease of 4.7 (95% CI: -5.8, -3.6; p < 0.001), 3.8 (95% CI: -5.2, -2.4; p < 0.001) and 1.5 (95% CI: -2.6, -0.4; p = 0.01) respectively. Compared with the control group, participants in the active intervention were five times more likely to achieve a clinically significant change in symptom scores. There was a significant reduction in depression scores in the active and passive intervention groups, but not control group [-2.9 (95% CI: -4.5, -1.3); -2.3 (95% CI: -4.3, -0.3); 0.5 (95% CI: -1.1, 2.1), respectively]; a significant reduction in stress scores within the active group, but not passive intervention or control groups [-1.3 (95% CI: -2.2, -0.5); -1.0 (95% CI: -2.1, 0.1); 0.4 (95% CI: -0.5, 1.2), respectively]; and the reduction in anxiety scores over time was similar for all groups. A dietitian-led telehealth intervention for addictive eating in adults was more effective than a passive or control condition in reducing addictive eating scores from baseline to 6 months. Trial registration: Australia New Zealand Clinical Trial Registry ACTRN12621001079831.
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Conducta Adictiva , Telemedicina , Adulto , Humanos , Australia , Ansiedad/terapia , Ansiedad/psicología , Trastornos de AnsiedadRESUMEN
The active inclusion of students within education systems relies on a curriculum that caters to all. This article presents partial findings from Australian mixed methods research examining 46 teacher perspectives on the curriculum and its ability to support their practice in supporting students aged 12-19 years with severe intellectual disability or profound and multiple learning difficulties who attend specialist school settings. Results reveal that Australian teachers see the current curriculum as insufficient in its design and content and unable to cater to their students educational and social capacities or needs. Strengths essential to the reform process are highlighted, emergent challenges discussed and recommendations for future action are presented.
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In brief: Sperm cryopreservation has been recognised as a tool for preventing loss of genetic diversity in amphibians; however, the combined effect of penetrative and non-penetrative cryoprotectants in cryodiluents is poorly understood. We demonstrate a clear benefit of using low concentrations of non-penetrative cryoprotectants when cryopreserving sperm of Australian tree frogs. Abstract: Sperm cryopreservation protocols have been developed for an increasing number of amphibian species since the recognition of a global amphibian decline. Yet, the development of these protocols has neglected to elucidate the combined effect of the penetrative(PCP) and non-penetrative cryoprotectant (NPCP) on the recovery of live, motile sperm. The two-factor hypothesis of cryoinjury recognises a trade-off between cooling cells slowly enough to allow osmotic dehydration and therefore avoid intracellular ice formation, but fast enough to minimise effects from increasing extracellular osmolality as the frozen fraction of the media increases during freezing. We tested the effect of two concentrations of a PCP (10 and 15% v/v dimethyl sulfoxide (Me2SO)) and two concentrations of an NPCP (1 and 10% w/v sucrose) in various combinations on the sperm of six pelodryadid frogs. In all species, 15% v/v Me2SO with 1% w/v sucrose provided superior post-thaw recovery with high proportions of forward progressive motility, live cells and intact acrosomes (typically >50% for each). Theoretically, it has been suggested that increased NPCP concentration should improve cell survival by increasing the rate and extent of cell dehydration. We suggest, however, that the elevated osmolality in the unfrozen water fraction when 10% sucrose is used may be causing damage to cells via excessive cell shrinkage and solute effects as proposed in the two-factor hypothesis of cryoinjury. We showed this response in sperm across a range of frog species, providing compelling evidence for this hypothesis. We suggest protocol development using the PCP/NPCP ratios demonstrated in our study will be broadly applicable to many amphibian species.
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Deshidratación , Preservación de Semen , Animales , Masculino , Semen , Preservación de Semen/veterinaria , Preservación de Semen/métodos , Motilidad Espermática , Australia , Crioprotectores/farmacología , Criopreservación/veterinaria , Criopreservación/métodos , Espermatozoides/fisiología , Anuros , Sacarosa/farmacologíaRESUMEN
Amphibians are becoming increasingly reliant on captive breeding programs for continued survival. Assisted reproductive technologies including gamete cryopreservation and IVF can help reduce costs of breeding programs, provide insurance against extinction and assist genetic rescue in wild populations. However, the use of these technologies to produce reproductively mature offspring has only been demonstrated in a few non-model species. We aimed to optimise sperm cryopreservation in the threatened frog Litoria aurea and generate mature offspring from frozen-thawed spermatozoa by IVF. We tested three concentrations (1.4, 2.1 and 2.8M) of the cryoprotectants dimethylsulfoxide (DMSO) and glycerol with 0.3M sucrose. Using DMSO was more likely to result in recovery of sperm motility, vitality and acrosome integrity than glycerol, regardless of concentration, with forward progressive motility being most sensitive to damage. The lowest concentrations of 1.4 and 2.1M provided the best protection regardless of cryoprotectant type. Spermatozoa cryopreserved in 2.1M DMSO outperformed spermatozoa cryopreserved in equivalent concentrations of glycerol in terms of their ability to fertilise ova, resulting in higher rates of embryos hatching and several individuals reaching sexual maturity. We have demonstrated that sperm cryopreservation and subsequent offspring generation via IVF is a feasible conservation tool for L. aurea and other threatened amphibians.
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Biosolids produced at wastewater treatment facilities are extensively used in agricultural land and degraded mine sites to improve soil health and soil organic carbon (SOC) stocks. Many studies have reported increases in SOC due to application of biosolids to such sites. However, lack of a comprehensive quantification on overall trends and changes of magnitude in SOC remains. Here, we performed a meta-analysis to identify drivers with a relationship with SOC stocks. A meta-regression of 297 treatments found four variables with a relationship with SOC stocks: cumulative biosolids carbon (C) input rate, time after application, soil depth and type of biosolids. The cumulative biosolids C input rate was the most influencing driver. The highest mean difference for SOC% of 3.3 was observed at 0-15 cm soil depth for a cumulative C input of 100 Mg ha-1 at one year after biosolids application. Although years after biosolids application demonstrated a negative relationship with SOC stocks, mineralization of C in biosolids-applied soils is slow, as indicated with the SOC% decrease from 4.6 to 2.8 at 0-15 cm soil depth over five years of 100 Mg ha-1 biosolids C input. Soil depth illustrated a strong negative effect with SOC stocks decreasing by 2.7% at 0-15 cm soil depth at a cumulative biosolids C input of 100 Mg ha-1 over a year. Overall, our model estimated an effect of 2.8 SOC% change, indicating the application of biosolids as a viable strategy for soil C sequestration on a global scale.
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Secuestro de Carbono , Suelo , Agricultura , Biosólidos , CarbonoRESUMEN
There are many documented benefits of social capital to adolescents in general, and for young people who are deaf or hard of hearing social capital can potentially have a buffering effect against adverse life outcomes. Using the Loneliness and Social Dissatisfaction Questionnaire ( Asher et al., 1984; Cassidy & Asher, 1992) and the Looman Social Capital Scale ( Looman, 2006), this research investigated changes in levels of social capital and loneliness and peer relationships of deaf or hard of hearing adolescents before attending a residential camp and then three, six- and 12-months post-camp. The camp was specifically for DHH adolescents whose primary communication mode was spoken language. The study also investigated associations between social capital and adolescents' perceptions of loneliness and peer relationships. Results indicated no statistically significant change in social capital and loneliness and peer relations over the four-time points. There was a significant association between one social capital scale, common good, and loneliness. Implications of these findings are discussed, and recommendations are made for enhancing social capital development within a residential camp experience.
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Pérdida Auditiva , Capital Social , Adolescente , Audición , Humanos , Soledad , Grupo ParitarioRESUMEN
OBJECTIVE: Clinical practice guidelines recommend that community mental health services provide preventive care for clients' chronic disease risk behaviours; however, such care is often not routinely provided. This study aimed to assess the effectiveness of offering clients an additional consultation with a specialist clinician embedded within a community mental health service, in increasing client-reported receipt of, and satisfaction with, preventive care. METHOD: A randomised controlled trial was undertaken in one Australian community mental health service. Participants (N = 811) were randomised to receive usual care (preventive care in routine consultations; n = 405) or usual care plus the offer of an additional consultation with a specialist preventive care clinician (n = 406). Blinded interviewers assessed at baseline and 1-month follow-up the client-reported receipt of preventive care (assessment, advice and referral) for four key risk behaviours individually (smoking, poor nutrition, alcohol overconsumption and physical inactivity) and all applicable risks combined, acceptance of referrals and satisfaction with preventive care received. RESULTS: Analyses indicated significantly greater increases in 12 of the 18 preventive care delivery outcomes in the intervention compared to the usual care condition from baseline to follow-up, including assessment for all risks combined (risk ratio = 4.00; 95% confidence interval = [1.57, 10.22]), advice for all applicable risks combined (risk ratio = 2.40; 95% confidence interval = [1.89, 6.47]) and offer of referral to applicable telephone services combined (risk ratio = 20.13; 95% confidence interval = [2.56, 158.04]). For each component of care, there was a significant intervention effect for at least one of the individual risk behaviours. Participants reported high levels of satisfaction with preventive care received, ranging from 77% (assessment) to 87% (referral), with no significant differences between conditions. CONCLUSION: The intervention had a significant effect on the provision of the majority of recommended elements of preventive care. Further research is needed to maximise its impact, including identifying strategies to increase client uptake.
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Enfermedad Crónica/prevención & control , Servicios Comunitarios de Salud Mental/organización & administración , Medicina Preventiva/métodos , Medicina Preventiva/organización & administración , Adolescente , Adulto , Australia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Derivación y Consulta/organización & administración , Adulto JovenRESUMEN
BACKGROUND: Clinical practice guidelines and policies direct community mental health services to provide preventive care to address chronic disease risks, however, such care is infrequently provided in routine consultations. An alternative model of care is to appoint a clinician to the dedicated role of offering and providing preventive care in an additional consultation: the 'specialist clinician' model. Economic evaluations of models of care are needed to determine the cost of adhering to guidelines and policies, and to inform pragmatic service delivery decisions. This study is an economic evaluation of the specialist clinician model; designed to achieve policy concordant preventive care delivery. METHODS: A retrospective analysis of the incremental costs, cost-effectiveness, and budget impact of a 'specialist preventive care clinician' (an occupational therapist) was conducted in a randomised controlled trial, where participants were randomised to receive usual care; or usual care plus the offer of an additional preventive care consultation with the specialist clinician. The study outcome was client acceptance of referrals to two free telephone-based chronic disease prevention services. This is a key care delivery outcome mandated by the local health district policy of the service. The base case analysis assumed the mental health service cost perspective. A budget impact analysis determined the annual budget required to implement the model of care for all clients of the community mental health service over 5 years. RESULTS: There was a significantly greater increase from baseline to follow-up in the proportion of intervention participants accepting referrals to both telephone services, compared to usual care. The incremental cost-effectiveness ratio was $347 per additional acceptance of a referral (CI: $263-$494). The annual budget required to implement the model of care for all prospective clients was projected to be $711,446 over 5-years; resulting in 2616 accepted referrals. CONCLUSIONS: The evaluation provides key information regarding the costs for the mental health service to adhere to policy targets, indicating the model of care involved a low per client cost whilst increasing key preventive care delivery outcomes. Additional modelling is required to further explore its economic benefits. TRIAL REGISTRATION: ACTRN12616001519448. Registered 3 November 2016, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371709.
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Enfermedad Crónica/prevención & control , Servicios Comunitarios de Salud Mental/economía , Terapia Ocupacional/economía , Adolescente , Adulto , Anciano , Análisis Costo-Beneficio , Femenino , Humanos , Masculino , Trastornos Mentales , Persona de Mediana Edad , Nueva Gales del Sur , Derivación y Consulta , Estudios Retrospectivos , Teléfono , Adulto JovenRESUMEN
Primary healthcare services are recommended to provide preventive care to address chronic disease risk behaviours. However, all care elements are infrequently provided, and there is a need to understand the impact of partial care provision on behaviour change. This study examined the association between variable levels of preventive care receipt from primary care clinicians on short-term behaviour change for four risk behaviours. A survey was undertaken with 5639 Australian community health service clients (2009-2014). Clients self-reported: engagement in risk behaviours (tobacco smoking, harmful alcohol consumption, inadequate fruit and/or vegetable consumption, physical inactivity) in the month prior to and four week post their community health service appointment; receipt of preventive care during appointments (assessment, advice, referral/follow-up) for each behaviour. Univariate regression models explored the association between change in risk status and preventive care received. The odds of behaviour change for those receiving all three care elements was significant for all behaviours, compared to no care, ranging from 2.02 (alcohol consumption, 95% CI 1.16-3.49) to 4.17 (inadequate fruit and/or vegetable consumption, 95% CI 2.91-5.96). Receipt of both assessment and advice increased the odds of behaviour change, compared to no care, for all behaviours except smoking, ranging from 2.32 (physical inactivity, 95% CI 1.60-3.35) to 2.83 (alcohol consumption, 95% CI 1.84-4.33). Receipt of 'assessment only' increased the odds of behaviour change, compared to no care, for inadequate fruit and/or vegetable consumption (ORâ¯=â¯2.40, 95% CI 1.60-3.59) and physical inactivity (ORâ¯=â¯2.81, 95% CI 1.89-4.17). Results highlight the importance of primary care clinicians providing best practice preventive care to maximise client behaviour change.
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Servicios de Salud Comunitaria/estadística & datos numéricos , Cooperación del Paciente/estadística & datos numéricos , Servicios Preventivos de Salud/estadística & datos numéricos , Atención Primaria de Salud/estadística & datos numéricos , Asunción de Riesgos , Adolescente , Adulto , Factores de Edad , Anciano , Australia , Servicios de Salud Comunitaria/métodos , Intervalos de Confianza , Femenino , Conductas Relacionadas con la Salud , Encuestas de Atención de la Salud , Humanos , Masculino , Persona de Mediana Edad , Nueva Gales del Sur , Oportunidad Relativa , Atención Primaria de Salud/métodos , Salud Pública , Medición de Riesgo , Factores Sexuales , Adulto JovenRESUMEN
The transport function of transfer cells is conferred by an enlarged plasma membrane area, enriched in nutrient transporters, that is supported on a scaffold of wall ingrowth (WI) papillae. Polarized plumes of elevated cytosolic Ca2+ define loci at which WI papillae form in developing adaxial epidermal transfer cells of Vicia faba cotyledons that are induced to trans-differentiate when the cotyledons are placed on culture medium. We evaluated the hypothesis that vesicle trafficking along a Ca2+-regulated remodelled actin network is the mechanism that underpins this outcome. Polarized to the outer periclinal cytoplasm, a Ca2+-dependent remodelling of long actin bundles into short, thin bundles was found to be essential for assembling WI papillae but not the underlying uniform wall layer. The remodelled actin network directed polarized vesicle trafficking to sites of WI papillae construction, and a pharmacological study indicated that both exo- and endocytosis contributed to assembly of the papillae. Potential candidates responsible for the Ca2+-dependent actin remodelling, along with those underpinning polarized exo- and endocyotosis, were identified in a transcriptome RNAseq database generated from the trans-differentiating epidermal cells. Of most significance, endocytosis was controlled by up-regulated expression of a dynamin-like isoform. How a cycle of localized exo- and endocytosis, regulated by Ca2+-dependent actin remodelling, assembles WI papillae is discussed.
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Actinas/metabolismo , Calcio/metabolismo , Pared Celular/metabolismo , Proteínas de Plantas/metabolismo , Vicia faba/metabolismo , Cotiledón/crecimiento & desarrollo , Cotiledón/metabolismo , Vesículas Citoplasmáticas/metabolismo , Endocitosis , Exocitosis , Transporte de Proteínas , Vicia faba/crecimiento & desarrolloRESUMEN
This review aimed to determine the most popular physical activities performed by children, adolescents, and adults globally. Statistic bureau websites and article databases Scopus, ProQuest, SPORTDiscus, and Science Direct were searched between November 17th, 2014 and April 31st, 2015. Eligible studies were published in the last 10years with participation rates for specific physical activities among individuals five years or older. Data extraction for included articles (n=64) was assessed independently and agreed upon by two authors. A random-effects model was used to calculate participation rates in specific activities for each age group and region. In total 73,304 articles were retrieved and 64 articles representing 47 countries were included in the final meta-analysis. Among adults, walking was the most popular activity in the Americas (18.9%; 95% CI 10.2 to 32.5), Eastern Mediterranean (15.0%; 95% CI 5.8 to 33.6), Southeast Asia (39.3%; 95% CI 0.9 to 98.0) and Western Pacific (41.8%; 95% CI 25.2 to 60.6). In Europe and Africa, soccer (10.0%; 95% CI 6.5 to 15.1) and running (9.3%; 95% CI 0.9 to 53.9), respectively, were top activities. Child and adolescent participation results were highly dependent upon region. American youth team sport participation was high, while youth from the Eastern Mediterranean and Western Pacific were more likely to report participation in lifelong physical activities. Global data for adults reflects a consistent pattern of participation in running and walking. Among all age groups and regions soccer was popular. In children and adolescents, preferences were variable between regions.
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Ejercicio Físico/fisiología , Salud Global , Actividades Recreativas , Salud Global/tendencias , Humanos , Carrera , Fútbol , CaminataRESUMEN
OBJECTIVE: Interventions are required to redress the disproportionate tobacco-related health burden experienced by persons with a mental illness. This study aimed to assess the efficacy of a universal smoking cessation intervention initiated within an acute psychiatric inpatient setting and continued post-discharge in reducing smoking prevalence and increasing quitting behaviours. METHOD: A randomised controlled trial was undertaken across four psychiatric inpatient facilities in Australia. Participants ( N = 754) were randomised to receive either usual care ( n = 375) or an intervention comprising a brief motivational interview and self-help material while in hospital, followed by a 4-month pharmacological and psychosocial intervention ( n = 379) upon discharge. Primary outcomes assessed at 6 and 12 months post-discharge were 7-day point prevalence and 1-month prolonged smoking abstinence. A number of secondary smoking-related outcomes were also assessed. Subgroup analyses were conducted based on psychiatric diagnosis, baseline readiness to quit and nicotine dependence. RESULTS: Seven-day point prevalence abstinence was higher for intervention participants (15.8%) than controls (9.3%) at 6 months post-discharge (odds ratio = 1.07, p = 0.04), but not at 12 months (13.4% and 10.0%, respectively; odds ratio = 1.03, p = 0.25). Significant intervention effects were not found on measures of prolonged abstinence at either 6 or 12 months post-discharge. Differential intervention effects for the primary outcomes were not detected for any subgroups. At both 6 and 12 months post-discharge, intervention group participants were significantly more likely to smoke fewer cigarettes per day, have reduced cigarette consumption by ⩾50% and to have made at least one quit attempt, relative to controls. CONCLUSIONS: Universal smoking cessation treatment initiated in inpatient psychiatry and continued post-discharge was efficacious in increasing 7-day point prevalence smoking cessation rates and related quitting behaviours at 6 months post-discharge, with sustained effects on quitting behaviour at 12 months. Further research is required to identify strategies for achieving longer term smoking cessation.
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Trastornos Mentales/complicaciones , Cese del Hábito de Fumar/métodos , Fumar/terapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Australia , Niño , Femenino , Humanos , Pacientes Internos , Masculino , Servicios de Salud Mental , Persona de Mediana Edad , Alta del Paciente , Autocuidado , Resultado del Tratamiento , Adulto JovenRESUMEN
Decline in linguistic function has been associated with decline in cognitive function in previous research. This research investigated the informativeness of written language samples of Australian men from the Health in Men's Study (HIMS) aged from 76 to 93 years using the Computerised Propositional Idea Density Rater (CPIDR 5.1). In total, 60,255 words in 1147 comments were analysed using a linear-mixed model for statistical analysis. Results indicated no relationship with education level (p = 0.79). Participants for whom English was not their first learnt language showed Propositional Idea Density (PD) scores slightly lower (0.018 per 1 word). Mean PD per 1 word for those for whom English was their first language for comments below 60 words was 0.494 and above 60 words 0.526. Text length was found to have an effect (p = <0.0001). The mean PD was higher than previously reported for men and lower than previously reported for a similar cohort for Australian women.
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Diagnóstico por Computador , Trastornos del Lenguaje/diagnóstico , Pruebas del Lenguaje , Lingüística , Escritura , Factores de Edad , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/diagnóstico , Escolaridad , Humanos , Masculino , Multilingüismo , Semántica , Factores Sexuales , Programas Informáticos , Accidente Cerebrovascular/diagnóstico , Australia OccidentalRESUMEN
INTRODUCTION: Persons with a mental disorder smoke at higher rates and suffer disproportionate tobacco-related burden compared with the general population. The aim of this study was to determine if a smoking cessation intervention initiated during a psychiatric hospitalization and continued postdischarge was effective in reducing smoking behaviors among persons with a mental disorder. METHODS: A randomized controlled trial was conducted at an Australian inpatient psychiatric facility. Participants were 205 patient smokers allocated to a treatment as usual control (n = 101) or a smoking cessation intervention (n = 104) incorporating psychosocial and pharmacological support for 4 months postdischarge. Follow-up assessments were conducted at 1 week, 2, 4, and 6 months postdischarge and included abstinence from cigarettes, quit attempts, daily cigarette consumption, and nicotine dependence. RESULTS: Rates of continuous and 7-day point prevalence abstinence did not differ between treatment conditions at the 6-month follow-up; however, point prevalence abstinence was significantly higher for intervention (11.5%) compared with control (2%) participants at 4 months (OR = 6.46, p = .01). Participants in the intervention condition reported significantly more quit attempts (F[1, 202.5] = 15.23, p = .0001), lower daily cigarette consumption (F[4, 586] = 6.5, p < .001), and lower levels of nicotine dependence (F[3, 406] = 8.5, p < .0001) compared with controls at all follow-up assessments. CONCLUSIONS: Postdischarge cessation support was effective in encouraging quit attempts and reducing cigarette consumption up to 6 months postdischarge. Additional support strategies are required to facilitate longer-term cessation benefits for smokers with a mental disorder.
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Pacientes Internos/psicología , Trastornos Mentales/psicología , Admisión del Paciente , Alta del Paciente , Cese del Hábito de Fumar/psicología , Fumar/psicología , Adulto , Australia/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Persona de Mediana Edad , Admisión del Paciente/tendencias , Alta del Paciente/tendencias , Servicio de Psiquiatría en Hospital/tendencias , Método Simple Ciego , Fumar/epidemiología , Fumar/terapia , Cese del Hábito de Fumar/métodosRESUMEN
INTRODUCTION AND HYPOTHESIS: To determine if abobotulinumtoxin A (AboBTXA) is an effective treatment for interstitial cystitis/bladder pain syndrome (IC/BPS). METHODS: We performed a double-blind study of 54 women with severe, refractory IC from three referral centres whom we randomly allocated to treatment with hydrodistension + injection of normal saline or to hydrodistension + injection with AboBTXA. The O'Leary-Sant questionnaire consists of problem (OLS-PI) and symptom (OLS-PI) index scores, and bladder diary data were compared between AboBTXA and control patients at baseline and at 3 months of follow-up. Measurements were made beyond 3 months, but no further randomised comparison was possible due to the ability of nonresponsive patients in either group to have AboBTXA treatment. RESULTS: Complete data were available in 50 patients, and in both groups, OLS questionnaires showed improvement at 3 months. Only the OLS-PI was improved in the AboBTXA group (p = 0.04). At 3 months, no difference was found in either OLS-SI or total OLS score. Twelve patients had urinary tract infection (UTI) treated during the follow-up period, which confounded results. In the 38 patients without UTI, there was improvement in total OLS score (p = 0.02), OLS-PI (0.08), and OLS-SI (p = 0.008) for the AboBTXA group at 3 months. Only five AboBTXA compared with two control patients had a 50% reduction in OLS score. CONCLUSIONS: For chronic refractory IC/BPS patients, AboBTXA was associated with no overall improvement in total OLS score, although significant benefit was noted in a small number of patients. The absence of posttreatment UTI was associated with a better response to AboBTXA.
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Inhibidores de la Liberación de Acetilcolina/administración & dosificación , Toxinas Botulínicas Tipo A/administración & dosificación , Cistitis Intersticial/tratamiento farmacológico , Administración Intravesical , Dilatación/métodos , Método Doble Ciego , Femenino , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Encuestas y Cuestionarios , Resultado del Tratamiento , Agua/administración & dosificaciónRESUMEN
BACKGROUND: Convective warming is effective in maintaining core temperature under anesthesia. It may increase evaporative water loss (EWL). If significant, further investigation of warming modifications to minimize this impact would be warranted. OBJECTIVES: To quantify EWL in two groups of children (warmed and nonwarmed) having surgical procedures under anesthesia. METHODS: We performed an observational study of well children having general anesthesia for elective surgical procedures lasting ≥60 min. They were recruited sequentially to each of three age groups: 1-12 months, 13 months-5 years, and 5-12 years--with each age group divided into convectively warmed (43°C) and nonwarmed (21°C) subgroups. Evaporative heat loss (EHL) was calculated from accurate measurement of net EWL during the surgical period. RESULTS: Sixty children were studied. As a percentage of body mass, mean EWLs were 0.29 (warmed) and 0.09 (nonwarmed). Using an ancova model, only procedure duration had a significant impact and explained why the extended procedural time in some convectively warmed children led to higher mean EWLs for that group. For the nonwarmed group, the mean Tcore drop was 1.27°C with a contribution from EWL of 0.6°C over ~70 min. CONCLUSIONS: Within the age range 1 month-12 years, EHL is not significantly influenced by convective heating under anesthesia. There is no thermal advantage in exploring technique modifications such as humidifying the warming air. Previous estimates of the contribution of EHL to total heat loss in anesthetized children may require revision.
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Anestesia/métodos , Regulación de la Temperatura Corporal , Calefacción/métodos , Recalentamiento/métodos , Composición Corporal , Superficie Corporal , Temperatura Corporal , Niño , Preescolar , Convección , Femenino , Humanos , Lactante , Masculino , Cuidados Preoperatorios , Temperatura Cutánea , Pérdida de PesoRESUMEN
As sperm cryopreservation and other assisted reproductive technologies (ARTs) advance in common amphibian species, focus on applying non-lethal sperm collection methods to the conservation and genetic management of threatened species is imperative. The goal of this study was to examine the application of logistically practical ART protocols in a threatened frog (Litoria aurea). First, we tested the efficacy of various concentrations of human chorionic gonadotropin (hCG) (20, 40 IU/g bodyweight) and Gonadotropin releasing hormone antagonist (0.25 µg/g and 0.5 µg/g body weight GnRH-a) on the induction of spermatozoa. Using the samples obtained from the previous trials, we tested the effect of cold storage and cryopreservation protocols on long-term refrigerated storage and post-thaw sperm recovery. Our major findings include: (1) high quality sperm were induced with 20 and 40 IU/g bodyweight of (hCG); (2) proportions of live, motile sperm post-thaw, were recovered at higher levels than previously reported for L. aurea (>50%) when preserved with 15% v/v DMSO and 1% w/v sucrose; and (3) spermic urine stored at 5 °C retained motility for up to 14 days. Our findings demonstrate that the protocols developed in this study allowed for successful induction and recovery of high-quality spermatozoa from a threatened Australian anuran, L. aurea, providing a prime example of how ARTs can contribute to the conservation of rare and threatened species.
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Preservación de Semen , Semen , Masculino , Humanos , Animales , Australia , Anuros , Espermatozoides , Criopreservación/veterinaria , Criopreservación/métodos , Gonadotropina Coriónica/farmacología , Motilidad Espermática , Preservación de Semen/veterinaria , Preservación de Semen/métodosRESUMEN
Since 2007 a number of investigators have compiled statistics on the length in words of speeches in plays by William Shakespeare and his contemporaries, focusing on a change to shorter speeches around 1600. In this article we take account of several potentially confounding factors in the variation of speech lengths in these works and present a model of this variation in the period 1538-1642 through Linear Mixed Models. We confirm that the mode of speech lengths in English plays changed from nine words to four words around 1600, and that Shakespeare's plays fit this wider pattern closely. We establish for the first time: that this change is independent of authorship, dramatic genre, theatrical company, and the proportion of verse in a play's dialogue; that the chosen time span can be segmented into pre-1597 plays (with high modes), 1597-1602 plays (with mixed high and low modes), and post-1602 plays (with low modes); that some additional secondary modes are evident in speech lengths, at 16 and 24 words, suggesting that the length of a standard blank verse line (around 8 words) is an underlying unit in speech length; and that the general change to short speeches also holds true when the data is viewed through the perspective of the median and the mean. The change in speech lengths is part of a collective drift in the plays towards liveliness and verisimilitude and is evidence of a hitherto hidden constraint on the playwrights: whether or not they were aware of the fact, playwrights as a group were conforming to a structure for the distribution of speech lengths peculiar to the era they were writing in. The authors hope that the full modelling of this variation in the article will help bring this change to the attention of scholars of Shakespeare and his contemporaries.
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Drama , Medicina en la Literatura , Habla , Lenguaje , Autoria , Drama/historiaRESUMEN
Coparenting competence (CC) is a concept that describes the sense of collective efficacy that parents experience in raising children. An advantage of CC is that it bridges a gap between family systems thinking and efficacy theory, where extant research and theory have focused on the self-efficacy of one or both parents. This study aimed to develop a self-reported measure of CC. METHODOLOGY: Participants (n = 302), including cohabiting mothers (n = 240) and fathers (n = 62), completed an online survey (112 items) comprising demographic questions, the Coparenting Relationship Scale (CRS), the Parenting Sense of Competence Scale (PSOC), the Strengths and Difficulties Questionnaire (SDQ), and 36 items designed to explore perceptions of CC. RESULTS: Factor analyses on 36-CC items identified 10 items that reliably formed a brief Coparenting Competence Scale (CCS; Alpha = 0.89). Analysis of convergent and divergent validity demonstrated that the CCS measures a unique construct that is linked to parenting self-efficacy, measured by PSOC (r = 0.47), and coparenting quality, assessed by the CRS (r = 0.63). There was a significant association between CCS and SDQ across age groups and an association stronger than that found for the CRS and SDQ in the current cohort. CONCLUSIONS AND IMPLICATIONS: The study found support for the reliability and validity of the CCS. Coparenting competence, assessed by the CCS, was found to be distinct from factors previously used to represent coparenting quality in multivariate scales. The strength of associations between the CCS and SDQ suggests this new measure may have an important role in coparenting research.
Asunto(s)
Madres , Responsabilidad Parental , Niño , Femenino , Humanos , Reproducibilidad de los Resultados , Autoeficacia , Análisis FactorialRESUMEN
INTRODUCTION: Approximately 15%-20% of the adult population self-report symptoms of addictive eating. There are currently limited options for management. Motivational interviewing-based interventions, containing personalised coping skills training, have been found to be effective for behaviour change in addictive disorders (eg, alcohol). This project builds upon foundations of an addictive eating feasibility study previously conducted and co-design process involving consumers. The primary aim of this study is to examine the efficacy of a telehealth intervention targeting addictive eating symptoms in Australian adults compared with passive intervention and control groups. METHODS AND ANALYSIS: This three-arm randomised controlled trial will recruit participants 18-85 years, endorsing ≥3 symptoms on the Yale Food Addiction Scale (YFAS) 2.0, with body mass index >18.5 kg/m2. Addictive eating symptoms are assessed at baseline (pre-intervention), 3 months (post-intervention) and 6 months. Other outcomes include dietary intake and quality, depression, anxiety, stress, quality of life, physical activity and sleep hygiene. Using a multicomponent clinician-led approach, the active intervention consists of five telehealth sessions (15-45 min each) delivered by a dietitian over 3 months. The intervention uses personalised feedback, skill-building exercises, reflective activities and goal setting. Participants are provided with a workbook and website access. The passive intervention group receives the intervention via a self-guided approach with access to the workbook and website (no telehealth). The control group receives personalised written dietary feedback at baseline and participants advised to follow their usual dietary pattern for 6 months. The control group will be offered the passive intervention after 6 months. The primary endpoint is YFAS symptom scores at 3 months. A cost-consequence analysis will determine intervention costs alongside mean change outcomes. ETHICS AND DISSEMINATION: Human Research Ethics Committee of University of Newcastle, Australia provided approval (H-2021-0100). Findings will be disseminated via publication in peer-reviewed journals, conference presentations, community presentations and student theses. TRIAL REGISTRATION NUMBER: Australia New Zealand Clinical Trials Registry (ACTRN12621001079831).