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1.
Clin Psychol Sci ; 11(5): 841-862, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37771501

ABSTRACT

Decentering is thought to be protective against a range of psychological symptoms, but little is known about the outcomes of decentering as a momentary state in daily life. We used ecological momentary assessment (42 reports across one week) to examine the temporal ordering of the associations of decentering with affect, dysphoria, participant-specific idiographic symptoms, and wellbeing. We also hypothesized that greater decentering predicts less inertia (persistence) of each variable, and weakens the association of affect with dysphoria, idiographic symptoms, and wellbeing. Results in 345 community participants indicated that decentering and these variables were mutually reinforcing over time, and that greater decentering was associated with less inertia of negative affect and dysphoria. Decentering generally predicted reduced impact of positive and negative affect on dysphoria symptoms, but results were mixed when predicting idiographic symptoms or wellbeing. Clinical implications and refinements for theory on decentering are discussed.

2.
Curr Opin Psychol ; 53: 101654, 2023 10.
Article in English | MEDLINE | ID: mdl-37517164

ABSTRACT

The COVID-19 pandemic resulted in adolescents' increased exposure to daily experiences of risk factors for depression and anxiety (e.g., loneliness). Intensive longitudinal studies examining daily experiences during the pandemic have revealed short-term and long-term consequences on youth mental health. Although evidence suggests small average increases in adolescent depression and anxiety, most of the story is in variability: increases are higher for youth and families with greater pre-existing mental health vulnerabilities and fewer socioeconomic resources, whereas increases are lower when social or financial support and positive coping and health behaviors are available and employed. Public health and economic policies should be mindful of youth mental health risks and actively promote known mental health supports, including family economic resources, access to mental healthcare, and social connection.


Subject(s)
COVID-19 , Humans , Adolescent , Pandemics , Anxiety , Anxiety Disorders , Adaptation, Psychological
3.
Psychol Assess ; 34(6): 546-557, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35175076

ABSTRACT

Assessment of internalizing symptoms has generally relied on cross-sectional and retrospective self-reports, but ecological momentary assessment (EMA) is increasingly used to capture quick fluctuations in symptoms, enhance ecological validity, and improve recall accuracy. However, there are very few measures of internalizing symptoms that have been validated for use in EMA designs. In Study 1, we chose candidate items for EMA short forms of the Dysphoria and Well-Being scales from the Inventory of Depression and Anxiety Symptoms (IDAS), based on principal factor analyses and internal consistency analyses conducted on aggregated cross-sectional datasets (total N = 8,876). In Study 2, we tested the items using an EMA design in a sample of college students (N = 279) oversampled for elevated neuroticism. Scale structure, reliability, and convergent and discriminant validity (regarding baseline IDAS scales, baseline affect, and EMA affect) were evaluated at the within- and between-person levels using multilevel structural equation modeling. Exploratory and confirmatory factor analyses in separate subsamples revealed the expected two-factor structure, yielding a four-item Well-Being scale and a five-item Dysphoria scale. Both scales showed acceptable to good internal consistency, strong convergent validity, and generally adequate discriminant validity. However, some associations of the new scales with EMA affect (i.e., Dysphoria with negative affect; Well-Being with positive affect) were very strong at the between-person level, such that they were not empirically distinct. Overall, this study provides an initial validation of brief EMA-IDAS Dysphoria and Well-Being scales that can be used in research or clinical settings, with particular utility for capturing within-person, dynamic effects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
Depressive Disorder, Major , Ecological Momentary Assessment , Cross-Sectional Studies , Humans , Reproducibility of Results , Retrospective Studies
4.
S Afr J Sports Med ; 33(1): v33i1a9509, 2021.
Article in English | MEDLINE | ID: mdl-36816908

ABSTRACT

Background: Rugby union demands a multifaceted approach to training, given the multiple physical and technical attributes required to play the sport. Objectives: The aim of this study is to describe the distribution of training throughout the week and investigate how this may be influenced by match-related factors. Methods: Training load data (session Rating of Perceived Exertion [sRPE], total distance and high-speed running [HSR]) were collected from six professional English rugby teams during the 2017/18 season. Five contextual factors were also recorded including: standard of opposition, competition type, result of previous fixture, surface type, and match venue. Results: The day prior to matches demonstrated the lowest training load (101 AU (95% CIs: 0-216 AU), 1 047 m (95% CIs:1 128-1 686 m) and 59 m (95% CIs: 0-343 m), respectively), while four days prior to the match demonstrated the highest training load (464 AU (95% CIs: 350-578), 2 983 m (95% CIs: 2 704-3 262m) and 234m (95% CIs: 0-477m), respectively). Of the five contextual factors, competition type was the only variable that demonstrated greater than trivial findings, with training before European fixtures the lowest stimulus across the four different competition types. Standard of opposition, previous result, surface type and venue had only trivial effects on training load (effect sizes = -0.13 to 0.15). Conclusion: Future studies should outline the distribution of other training metrics, including contact and collision training. This study provides a multi-club evaluation that demonstrates the variety of loading strategies prior to competitive match play and highlights competition type as the most influential contextual factor impacting the average training load.

5.
J Helminthol ; 94: e191, 2020 Sep 14.
Article in English | MEDLINE | ID: mdl-32924909

ABSTRACT

Invasive species lose parasites in the process of invasion and tend to be less parasitized than conspecifics in the native range and sympatric native species in the invasive range (enemy release). We evaluated enemy release in an invasive freshwater fish in Ireland, common dace Leuciscus leuciscus, using helminth parasite community surveys at the core and front of the invasive range of common dace. Furthermore, we undertook a systematic literature review of helminth infection in common dace across its native range in Great Britain and Europe and invasive range in Ireland. The helminth parasite community survey revealed that invasive common dace were infected with fewer helminth species at the invasion front than at the core. Four helminth taxa - Acanthocephala, Monogenea, Digenea and Nematoda - were present in dace at the invasion core compared to only a single helminth species (Pomphorhynchus tereticollis) at the front. The systematic review revealed that invasive common dace in Ireland hosted fewer species of helminths than common dace in the native range. We report a total of three helminth species in common dace in Ireland compared to 24 in Great Britain and 84 in Continental Europe. Our results support the hypotheses that invasive populations are less parasitized than native populations and that more recently established populations host fewer parasites. However, we demonstrate that invasive species may continue to experience release from parasites long after initial invasion.


Subject(s)
Cyprinidae/parasitology , Fish Diseases/epidemiology , Fish Diseases/parasitology , Helminthiasis, Animal/epidemiology , Helminths/isolation & purification , Introduced Species , Animals , Fresh Water/parasitology , Helminths/classification , Host-Parasite Interactions , Ireland/epidemiology , Surveys and Questionnaires
6.
Psychol Assess ; 32(8): 796-802, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32309970

ABSTRACT

Research on emotion regulation (ER) strategies has often relied on trait self-report measures, where individuals retrospectively report their tendency to engage in a specific strategy. Although this method is convenient and useful in many clinical and research settings, it is subject to a number of response and memory biases and may not accurately reflect ER as it is naturalistically employed in daily life. We examined the ecological validity of 10 self-report measures of ER strategies (i.e., acceptance, behavioral avoidance, experiential avoidance, expressive suppression, procrastination, reappraisal, reflection, rumination, savoring, social support) with their reported daily use in intensive longitudinal designs in two samples (109 students, 135 treatment-seeking adults). Zero-order correlations revealed convergence between most trait measures and their daily ER strategy counterparts. However, analyses evaluating the specificity of trait measures in their associations with daily ER strategies (both zero-order and multivariate) did not support trait measures' discriminant validity. Rather, correlations between trait measures and factors of the between-person variance in daily ER strategies suggest that most ER trait measures may reflect broader tendencies to use or not use avoidance strategies in daily life. Implications for research using trait measures of ER strategies and recommendations for ER strategy assessment are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Subject(s)
Ecological Momentary Assessment , Emotional Regulation , Self Report , Adult , Female , Follow-Up Studies , Humans , Male , Reproducibility of Results
7.
Psychol Assess ; 32(2): 197-204, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31464465

ABSTRACT

Theory and prior research suggests that decentering-an objective, distanced perspective on one's internal experiences-may vary based upon characteristics such as age, gender, race/ethnicity, and meditation experience. However, little is known about whether decentering measures are comparable in their meaning and interpretation when administered to individuals with different group membership (e.g., men or women; younger or older adults, etc.). The current study examined the measurement invariance of the Experiences Questionnaire (Fresco et al., 2007), a commonly used measure of decentering, evaluating age, gender, race/ethnicity, and meditation experience in three samples (students, community members, and clinical participants). Each sample was tested separately to assess the generalizability of results. The Experiences Questionnaire demonstrated full or partial measurement invariance in all cases, suggesting that scores are not biased based upon group membership and may be compared across individuals who vary in age, race/ethnicity, gender, and meditation experience. The current study also examined mean differences in decentering by groups, finding some evidence that decentering scores are higher for men, racial/ethnic minorities, older adults, and individuals with more meditation experiences. Implications are discussed for assessing decentering in diverse samples. (PsycINFO Database Record (c) 2020 APA, all rights reserved).


Subject(s)
Ethnicity/psychology , Meditation/psychology , Mindfulness , Students/psychology , Adolescent , Adult , Black or African American/psychology , Age Factors , Asian/psychology , Factor Analysis, Statistical , Female , Hispanic or Latino/psychology , Humans , Male , Middle Aged , Sex Factors , Surveys and Questionnaires , Universities , White People/psychology , Young Adult
8.
Am Psychol ; 73(9): 1175-1186, 2018 12.
Article in English | MEDLINE | ID: mdl-30525799

ABSTRACT

Dysfunctional affective processes are central to the experience of internalizing disorders (e.g., depression, anxiety, and related disorders). Specifically, extreme positive affect and elevated negative affect each have unique and robust patterns of associations with internalizing symptoms. This article examines affect as both an individual difference and a within-person dynamic process that unfolds over time. Recent research is reviewed that clarifies the hierarchical structure of affect and facet-level associations with symptoms, affect-laden traits that confer risk for internalizing psychopathology, models of emotion regulation, and how emotion regulation abilities and strategies contribute to or detract from psychological well-being. Several measurement challenges in this literature are identified and discussed, including possible conceptual and content overlap, mood-state distortion, naturalistic assessment in daily life, and the benefits and limitations of self-reported affective experience. (PsycINFO Database Record (c) 2018 APA, all rights reserved).


Subject(s)
Adaptation, Psychological , Affect , Anxiety Disorders/psychology , Depressive Disorder/psychology , Humans
9.
Clin Otolaryngol ; 43(2): 624-631, 2018 04.
Article in English | MEDLINE | ID: mdl-29178168

ABSTRACT

OBJECTIVES: To develop a core information set for informed consent to surgery for oral/oropharyngeal surgery. A core information set is baseline information rated important by patients and surgeons and is intended to improve patients' understanding of the intended procedure. DESIGN: A mixed-methods study. Systematic reviews of scientific and written healthcare literature, qualitative interviews and observations, Delphi surveys, and group consensus meetings identified information domains of importance for consent. SETTING: A regional head and neck clinic in the United Kingdom. Questionnaire participants were recruited from around the UK. PARTICIPANTS: Patients about to undergo, or who had previously undergone, surgery for oral/oropharyngeal cancer. Healthcare professionals involved in the management of head and neck cancer. MAIN OUTCOME MEASURES: The main outcome was a core information set. RESULTS: Systematic reviews, interviews and consultation observations yielded 887 pieces of information that were categorised into 87 information domains. Survey response rates were 67% (n = 50) and 71% (n = 52) for patient and healthcare professional groups in round one. More than 90% responded in each group in the second round. Healthcare professionals were more likely to rate information about short-term or peri-operative events as important while patients rated longer term issues about survival and quality of life. The consensus-building process resulted in an agreed core information set of 13 domains plus two procedure-specific domains about tracheostomy and free-flap surgery. CONCLUSION: This study produced a core information set for surgeons and patients to discuss before surgery for oral/oropharyngeal cancer. Future work will optimise ways to integrate core information into routine consultations.


Subject(s)
Disclosure , Informed Consent , Mouth Neoplasms/surgery , Oropharyngeal Neoplasms/surgery , Adult , Aged , Aged, 80 and over , Delphi Technique , Female , Humans , Male , Middle Aged , Qualitative Research , United Kingdom , Young Adult
10.
Psychol Bull ; 143(4): 384-427, 2017 04.
Article in English | MEDLINE | ID: mdl-28301202

ABSTRACT

Emotion regulation has been examined extensively with regard to important outcomes, including psychological and physical health. However, the literature includes many different emotion regulation strategies but little examination of how they relate to one another, making it difficult to interpret and synthesize findings. The goal of this meta-analysis was to examine the underlying structure of common emotion regulation strategies (i.e., acceptance, behavioral avoidance, distraction, experiential avoidance, expressive suppression, mindfulness, problem solving, reappraisal, rumination, worry), and to evaluate this structure in light of theoretical models of emotion regulation. We also examined how distress tolerance-an important emotion regulation ability -relates to strategy use. We conducted meta-analyses estimating the correlations between emotion regulation strategies (based on 331 samples and 670 effect sizes), as well as between distress tolerance and strategies. The resulting meta-analytic correlation matrix was submitted to confirmatory and exploratory factor analyses. None of the confirmatory models, based on prior theory, was an acceptable fit to the data. Exploratory factor analysis suggested that 3 underlying factors best characterized these data. Two factors-labeled Disengagement and Aversive Cognitive Perseveration-emerged as strongly correlated but distinct factors, with the latter consisting of putatively maladaptive strategies. The third factor, Adaptive Engagement, was a less unified factor and weakly related to the other 2 factors. Distress tolerance was most closely associated with low levels of repetitive negative thought and experiential avoidance, and high levels of acceptance and mindfulness. We discuss the theoretical implications of these findings and applications to emotion regulation assessment. (PsycINFO Database Record


Subject(s)
Adaptation, Psychological , Emotions , Self-Control , Stress, Psychological , Anxiety , Humans , Problem Solving
11.
Scand J Med Sci Sports ; 27(12): 1934-1941, 2017 Dec.
Article in English | MEDLINE | ID: mdl-28028894

ABSTRACT

Global Positioning System (GPS) technology is commonly utilized in team sports, including rugby union. It has been used to describe the average running demands of rugby union. This has afforded an enhanced understanding of the physical fitness requirements for players. However, research in team sports has suggested that training players relative to average demands may underprepare them for certain scenarios within the game. To date, no research has investigated the running demands of attacking 22 entries in rugby union. Additionally, no research has been undertaken to determine whether differences exist in the running intensity of successful and unsuccessful attacking 22 entries in rugby union. The first aim of this study was to describe the running intensity of attacking 22 entries. The second aim of this study was to investigate whether differences exist in the running intensity of successful and unsuccessful attacking 22 entries. Running intensity was measured using meters per minute (m min-1 ) for (a) total distance, (b) running distance, (c) high-speed running distance, and (d) very high-speed running distance. This study provides normative data for the running intensity of attacking 22 entries in rugby union. Forwards achieved greater high-speed running intensity in successful (3.6 m min-1 ) compared to unsuccessful (1.8 m min-1 ) attacking 22 entries. Forwards should try and achieve greater high-speed running intensity in attacking 22 entries to increase the likelihood of successful outcomes during this period of gameplay.


Subject(s)
Athletic Performance , Football/physiology , Running/physiology , Adult , Competitive Behavior , Geographic Information Systems , Humans , Male , Physical Fitness , Young Adult
12.
J Neurol Neurosurg Psychiatry ; 87(4): 373-8, 2016 Apr.
Article in English | MEDLINE | ID: mdl-25857661

ABSTRACT

OBJECTIVES: To explore phenotypic differences between individuals with sporadic inclusion body myositis (sIBM) who are seropositive for the NT5c1A antibody compared with those who are seronegative. METHODS: Cross-sectional clinical, serological and functional analysis in 25 consecutive participants with sIBM. RESULTS: All participants met criteria for clinically defined or probable sIBM. 18 of 25 participants with sIBM (72%) were seropositive for the NT5c1A antibody. No differences between median age and duration of illness between the two groups were seen. Females have higher odds of being seropositive (OR=2.30). Participants with seropositive sIBM took significantly longer to get up and stand (p=0.012). There were no significant differences between the two groups in terms of distance covered on a 6 min walk. Seropositive participants were more likely to require assistive devices such as a walker or wheelchair for mobility (OR=23.00; p=0.007). A number of secondary (exploratory) outcomes were assessed. NT5c1A seropositive sIBM cases had lower total Medical Research Council (MRC) sum score and MRC sum score on the right (p=0.03 and 0.02, respectively). Participants with the NT5c1A antibody were significantly more likely to have symptoms of dysphagia (OR=10.67; p=0.03) and reduced forced vital capacity (p=0.005). Facial weakness occurred in 50% of seropositive participants while it was only seen in 14% of seronegative participants. CONCLUSIONS: Even though the small sample size limits definite conclusions, our cross-sectional study showed seropositivity to the NT5c1A antibody is associated with greater motor and functional disability in sIBM. The study also suggests more prominent bulbar, facial and respiratory involvement in individuals positive for NT5c1A antibodies.


Subject(s)
5'-Nucleotidase/immunology , Myositis, Inclusion Body/complications , Myositis, Inclusion Body/immunology , 5'-Nucleotidase/analysis , Aged , Antibodies/analysis , Cross-Sectional Studies , Deglutition Disorders/epidemiology , Deglutition Disorders/etiology , Disability Evaluation , Female , Humans , Male , Middle Aged , Mobility Limitation , Myositis, Inclusion Body/physiopathology , Psychomotor Performance , Quality of Life , Respiration Disorders/etiology , Respiration Disorders/physiopathology , Self-Help Devices , Spinal Cord Diseases/etiology , Spinal Cord Diseases/physiopathology , Treatment Outcome , Vital Capacity
13.
Br J Dermatol ; 173(1): 201-8, 2015 Jul.
Article in English | MEDLINE | ID: mdl-25645571

ABSTRACT

BACKGROUND: Solar ultraviolet radiation (UVR) is recognized as the principal environmental cause of skin cancer. In particular, the risk of induction of squamous cell carcinoma (SCC) has been shown to increase with cumulative exposure to UVR. Models of risk of SCC induction have been developed but these do not include the use of sunbeds. OBJECTIVES: To explore the links between sunbed exposure and risk of SCC induction. METHODS: To this end, the values of published on-site UVR levels emitted from sunbeds were used to provide real measured sunbed exposure levels to inform the model. The model incorporated three conditions of exposure: day-to-day, holiday and sunbed exposure. The risks associated with different exposure scenarios were implemented in the model. Baseline exposure comprised day-to-day and holiday exposure. Relative risk (RR) was defined as the risk of SCC induction from (sunbed + baseline dose)/baseline dose. RESULTS: The RR of SCC induction from estimated median sunbed exposure output [176 standard erythemal dose (SED) per year; 20-35 years of age] in addition to median baseline sun exposure level (166 SED year + 85.5 SED per year holiday) was 1.9 (90% risk increase) up to 55 years of age. A higher sunbed exposure (302 SED per year; 20-35 years of age) produced an RR value of 2.8 (180% increase) at 55 years of age. CONCLUSIONS: This is the first time that a risk model for SCC of the skin has been developed that includes estimated sunbed doses derived from measured irradiance data. The model demonstrates that the additional risk associated with sunbed use may be significant, particularly when high-output, fast-tan sunbeds are used.


Subject(s)
Carcinoma, Squamous Cell/etiology , Skin Neoplasms/etiology , Sunbathing , Ultraviolet Rays/adverse effects , Adult , Aged , Aged, 80 and over , Beauty Culture , Environmental Exposure/adverse effects , Holidays , Humans , Middle Aged , Neoplasms, Radiation-Induced , Risk Factors , Sunlight/adverse effects , Young Adult
14.
J Laryngol Otol ; 127(8): 773-9, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23866839

ABSTRACT

OBJECTIVE: Voice rest is commonly recommended after vocal fold surgery, but there is a lack of evidence base and no standard protocol. The aim of this study was to establish common practice regarding voice rest following vocal fold surgery. METHOD: An online survey was circulated via e-mail invitation to members of the ENT UK Expert Panel between October and November 2011. RESULTS: The survey revealed that 86.5 per cent of respondents agreed that 'complete voice rest' means no sound production at all, but there was variability in how 'relative voice rest' was defined. There was no dominant type of voice rest routinely recommended after surgery for laryngeal papillomatosis or intermediate pathologies. There was considerable variability in the duration of voice rest recommended, with no statistically significant, most popular response (except for malignant lesions). Surgeons with less than 10 years of experience were more likely to recommend fewer days of voice rest. CONCLUSION: There is a lack of consistency in advice given to patients after vocal fold surgery, in terms of both type and length of voice rest. This may arise from an absence of robust evidence on which to base practice.


Subject(s)
Postoperative Care/methods , Rest/psychology , Vocal Cords/surgery , Voice Quality , Expert Testimony , Humans , Laryngeal Neoplasms/surgery , Laryngoscopy , Papilloma/surgery , Physicians/psychology , Postoperative Care/standards , Rest/physiology , Semantics , Time Factors , Vocal Cords/physiology , Voice Disorders/rehabilitation , Voice Disorders/surgery
15.
Br J Dermatol ; 168(3): 602-8, 2013 Mar.
Article in English | MEDLINE | ID: mdl-23330641

ABSTRACT

BACKGROUND: Exposure to ultraviolet (UV) radiation from sunlight is recognized as the principal cause of skin cancer. Moreover, sunbeds have been classified as carcinogenic by the International Agency for Research on Cancer. Despite this, there is a shortage of objective data on UV exposure levels in sunbeds in England. OBJECTIVES: We set out to measure UV emission levels in sunbeds at sites around England, and to compare these levels with both current standards and natural sunlight. METHODS: Between October 2010 and February 2011, UV spectra were measured on site from a total of 402 artificial tanning units in England. Measurement instrumentation was calibrated, traceable to the National Physical Laboratory. Compliance with the relevant British and European standard was determined, and a skin-cancer weighting factor was used to compare the carcinogenic potential of sunbeds with that of sunlight. RESULTS: For compliance with the European standard, erythemal-effective irradiance should not exceed 0·3 W m(-2). The values that we measured ranged between 0·10 and 1·32 W m(-2) with a mean of 0·56 ± 0·21 W m(-2) . Only 10% of sunbeds surveyed were within the recommended limit. Application of the skin-cancer weighting factor produced values that varied from 0·17 to 2·52 W m(-2) with a mean of 0·99 ± 0·41 W m(-2). The comparable value for Mediterranean noon day sun was 0·43 W m . CONCLUSIONS: Nine out of 10 sunbeds surveyed throughout England emitted levels of UV radiation that exceed the maximum levels contained within the European standard. Moreover, the skin cancer risk for comparable times of exposure was up to six times higher than that for Mediterranean sunlight. This situation is unacceptable and stricter control measures must be put in place.


Subject(s)
Sunbathing/standards , Ultraviolet Rays/adverse effects , England , Equipment Design , Erythema/etiology , Geography, Medical , Humans , Neoplasms, Radiation-Induced/etiology , Radiation Dosage , Reference Standards , Safety , Skin Neoplasms/etiology
16.
Reprod Sci ; 19(10): 1041-56, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22534332

ABSTRACT

Maternal thinness leads to metabolic challenges in the offspring, but it is unclear whether reduced maternal fat mass or muscle mass drives these metabolic changes. Recently, it has been shown that low maternal muscle mass--as measured by arm muscle area (AMA)--is associated with depressed nutrient transport to the fetus. To determine the role of maternal muscle mass on placental function, we analyzed the gene expression profiles of 30 human placentas over the range of AMA (25.2-90.8 cm(2)) from uncomplicated term pregnancies from the Southampton Women's Survey cohort. Eighteen percent of the ∼60 genes that were highly expressed in less muscular women were related to immune system processes and the interferon-γ (IFNG) signaling pathway in particular. Those transcripts related to the IFNG pathway included IRF1, IFI27, IFI30, and GBP6. Placentas from women with low muscularity are, perhaps, more sensitive to the effects of inflammatory cytokines than those from more muscular women.


Subject(s)
Muscle, Skeletal/anatomy & histology , Placenta/anatomy & histology , Placenta/immunology , Thinness/immunology , Transcriptome , Arm , Cohort Studies , Female , Humans , Immunity/genetics , Interferon Regulatory Factor-1/genetics , Interferon Regulatory Factor-1/immunology , Interferon-gamma/genetics , Interferon-gamma/immunology , Male , Membrane Proteins/genetics , Membrane Proteins/immunology , Organ Size , Oxidoreductases Acting on Sulfur Group Donors/genetics , Oxidoreductases Acting on Sulfur Group Donors/immunology , Pregnancy , Signal Transduction/genetics , Signal Transduction/immunology , Thinness/genetics
17.
Ann R Coll Surg Engl ; 93(6): e94-5, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21929897

ABSTRACT

This case report and review of the literature aims to highlight the importance of the use of a chest radiograph to check the placement of nasogastric tubes after insertion in an awake patient with an inflated cuffed tracheostomy tube regardless of an acidic pH test.


Subject(s)
Intubation, Gastrointestinal/methods , Tracheostomy/instrumentation , Aged , Equipment Design , Humans , Laryngeal Neoplasms/surgery , Laryngectomy , Male
18.
J Physiol ; 588(Pt 15): 2879-89, 2010 Aug 01.
Article in English | MEDLINE | ID: mdl-20519318

ABSTRACT

The role of atrial natriuretic peptide (ANP) in regulating fetal cardiac growth is poorly understood. Angiotensin II (Ang II) stimulates proliferation in fetal sheep cardiomyocytes when growth is dependent on the activity of the mitogen-activated protein kinase (MAPK) and phosphoinositol-3-kinase (PI3K) pathways. We hypothesized that ANP would suppress near-term fetal cardiomyocyte proliferation in vitro and inhibit both the MAPK and PI3K pathways. Forty-eight hour 5-bromodeoxyuridine (BrdU) uptake (used as an index of proliferation) was measured in cardiomyocytes isolated from fetal sheep (135 day gestational age) in response to 100 nm Ang II with or without ANP (0.003-100 nm) or 1 microm 8-bromo-cGMP. The effects of these compounds on the MAPK and PI3K pathways were assessed by measuring extracellular signal-regulated kinase (ERK) and AKT phosphorylation following 10 min of treatment with Ang II, ANP or 8-bromo-cGMP. In right ventricular myocytes (RV), the lowest dose of ANP (0.003 nm) inhibited Ang II-stimulated BrdU uptake by 68%. Similarly, 8-bromo-cGMP suppressed Ang II-stimulated proliferation by 62%. The same effects were observed in left ventricular (LV) cardiomyocytes but the RV was more sensitive to the inhibitory effects of ANP than the LV (P < 0.0001). Intracellular cGMP was increased by 4-fold in the presence of 100 nm ANP. Ang II-stimulated ERK and Akt phosphorylation was inhibited by 100 nm ANP. The activity of ANP may in part be cGMP dependent, as 8-bromo-cGMP had similar effects on the cardiomyocytes.


Subject(s)
Angiotensin II/administration & dosage , Atrial Natriuretic Factor/administration & dosage , Myocytes, Cardiac/metabolism , Sheep/embryology , Sheep/physiology , Signal Transduction/physiology , Animals , Cell Proliferation/drug effects , Dose-Response Relationship, Drug , Myocytes, Cardiac/drug effects , Signal Transduction/drug effects
19.
Am J Physiol Regul Integr Comp Physiol ; 299(2): R573-8, 2010 Aug.
Article in English | MEDLINE | ID: mdl-20484695

ABSTRACT

The fetal heart is highly sensitive to changes in mechanical load. We have previously demonstrated that increased cardiac load can stimulate cell cycle activity and maturation of immature cardiomyocytes, but the effects of reduced load are not known. Sixteen fetal sheep were given either continuous intravenous infusion of lactated Ringer solution (LR) or enalaprilat, an angiotensin-converting enzyme inhibitor beginning at 127 days gestational age. After 8 days, fetal arterial pressure in the enalaprilat-infused fetuses (23.8 +/- 2.8 mmHg) was lower than that of control fetuses (47.5 +/- 4.7 mmHg) (P < 0.0001). Although the body weights of the two groups of fetuses were similar, the heart weight-to-body weight ratios of the enalaprilat-infused fetuses were less than those of the LR-infused fetuses (5.6 +/- 0.5 g/kg vs. 7.0 +/- 0.6 g/kg, P < 0.0001). Dimensions of ventricular myocytes were not different between control and enalaprilat-infused fetuses. However, there was a significant decrease in cell cycle activity in both the right ventricle (P < 0.005) and the left ventricle (P < 0.002) of the enalaprilat-infused fetuses. Thus, we conclude a sustained reduction in systolic pressure load decreases hyperplastic growth in the fetal heart.


Subject(s)
Blood Pressure , Cell Cycle , Fetal Heart/pathology , Myocytes, Cardiac/pathology , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Animals , Antihypertensive Agents/administration & dosage , Blood Pressure/drug effects , Carbon Dioxide/blood , Cell Cycle/drug effects , Cell Differentiation , Cell Size , Enalaprilat/administration & dosage , Fetal Heart/drug effects , Fetal Heart/physiopathology , Fetal Weight , Gestational Age , Hyperplasia , Infusions, Intravenous , Myocytes, Cardiac/drug effects , Oxygen/blood , Sheep , Systole , Time Factors
20.
Placenta ; 31 Suppl: S54-9, 2010 Mar.
Article in English | MEDLINE | ID: mdl-20149453

ABSTRACT

Cardiovascular disease remains the number one killer in western nations in spite of declines in death rates following improvements in clinical care. It has been 20 years since David Barker and colleagues showed that slow rates of prenatal growth predict mortality from ischemic heart disease. Thus, fetal undergrowth and its associated cardiovascular diseases must be due, in part, to placental inadequacies. This conclusion is supported by a number of studies linking placental characteristics with various adult diseases. A "U" shaped relationship between placental-to-fetal weight ratio and heart disease provides powerful evidence that placental growth-regulating processes initiate vulnerabilities for later heart disease in offspring. Recent evidence from Finland indicates that placental morphological characteristics predict risks for coronary artery disease, heart failure, hypertension and several cancers. The level of risk imparted by placental shape is sex dependent. Further, maternal diet and body composition strongly influence placental growth, levels of inflammation, nutrient transport capacity and oxidative stress, with subsequent effects on offspring health. Several animal models have demonstrated the placental roots of vulnerability for heart disease. These include findings that abnormal endothelial development in the placenta is associated with undergrown myocardial walls in the embryo, and that placental insufficiency leads to depressed maturation and proliferation of working cardiomyocytes in the fetal heart. Together these models suggest that the ultimate fitness of the heart is determined by hemodynamic, growth factor, and oxygen/nutrient cues before birth, all of which are influenced, if not regulated by the placenta.


Subject(s)
Cardiovascular Diseases/etiology , Heart/embryology , Placenta/physiopathology , Prenatal Exposure Delayed Effects/physiopathology , Adult , Cardiovascular Diseases/physiopathology , Female , Heart/physiopathology , Humans , Maternal-Fetal Exchange/physiology , Pregnancy , Prenatal Nutritional Physiological Phenomena/physiology
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