Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 23
Filter
1.
BMJ Open ; 13(12): e079090, 2023 12 27.
Article in English | MEDLINE | ID: mdl-38151276

ABSTRACT

OBJECTIVES: This study aims to map existing literature describing how people with lived experience of self-harm have engaged in codesigning self-harm interventions, understand barriers and facilitators to this engagement, and how the meaningfulness of codesign has been evaluated. DESIGN: Scoping review by Joanna Briggs Institute methodology. A protocol was published online (http://dx.doi.org/10.17605/OSF.IO/P52UD). DATA SOURCES: PubMed, Embase, PsycINFO, Web of Science, Cochrane Library, PROSPERO, ClinicalTrials.gov and relevant websites were searched on 24 December 2022 (repeated 4 November 2023). ELIGIBILITY CRITERIA: We included studies where individuals with lived experience of self-harm (first-hand or caregiver) have codesigned self-harm interventions. DATA EXTRACTION AND SYNTHESIS: Results were screened at title and abstract level, then full-text level by two researchers independently. Prespecified data were extracted, charted and sorted into themes. RESULTS: We included 22 codesigned interventions across mobile health, educational settings, prisons and emergency departments. Involvement varied from designing content to multistage involvement in planning, delivery and dissemination. Included papers described the contribution of 159 female, 39 male and 21 transgender or gender diverse codesigners. Few studies included contributors from a minoritised ethnic or LGBTQIA+ group. Six studies evaluated how meaningfully people with lived experience were engaged in codesign: by documenting the impact of contributions on intervention design or through postdesign reflections. Barriers included difficulties recruiting inclusively, making time for meaningful engagement in stretched services and safeguarding concerns for codesigners. Explicit processes for ensuring safety and well-being, flexible schedules, and adequate funding facilitated codesign. CONCLUSIONS: To realise the potential of codesign to improve self-harm interventions, people with lived experience must be representative of those who use services. This requires processes that reassure potential contributors and referrers that codesigners will be safeguarded, remunerated, and their contributions used and valued.


Subject(s)
Self-Injurious Behavior , Telemedicine , Humans , Male , Female , Self-Injurious Behavior/epidemiology , Research Personnel
3.
Article in English | MEDLINE | ID: mdl-37098409

ABSTRACT

BACKGROUND: Cognitive deficits are often comorbid with mood disorders and can cause significant functional impairment even after resolution of the primary mood symptoms. We do not currently have pharmacological treatments that adequately address these deficits. 5-HT4 receptor agonists show promise as potential procognitive agents in animal and early human translational studies. Optimal cognitive performance in humans is directly associated with appropriate functional connectivity between specific resting-state neural networks. However, so far the effect of 5-HT4 receptor agonism on resting-state functional connectivity (rsFC) in the brain in humans is unknown. METHODS: We collected resting-state functional magnetic resonance imaging scans from 50 healthy volunteers, of whom 25 received 6 days × 1 mg prucalopride (a highly selective 5-HT4 receptor agonist) and 25 received placebo in a randomized double-blind design. RESULTS: Network analyses identified that participants in the prucalopride group had enhanced rsFC between the central executive network and the posterior/anterior cingulate cortex. Seed analyses also showed greater rsFC between the left and right rostral anterior cingulate cortex and the left lateral occipital cortex, and reduced rsFC between the hippocampus and other default mode network regions. CONCLUSIONS: Similar to other potentially procognitive medications, low-dose prucalopride in healthy volunteers appeared to enhance rsFC between regions involved in cognitive networks and reduce rsFC within the default mode network. This suggests a mechanism for the behavioral cognitive enhancement previously seen with 5-HT4 receptor agonists in humans and supports the potential for 5-HT4 receptor agonists to be used in clinical psychiatric populations.


Subject(s)
Brain Mapping , Serotonin , Animals , Humans , Serotonin/pharmacology , Brain Mapping/methods , Brain , Gyrus Cinguli , Comorbidity
4.
J Psychiatr Res ; 158: 226-230, 2023 02.
Article in English | MEDLINE | ID: mdl-36603317

ABSTRACT

Adverse childhood experiences are significantly associated with a worse clinical expression of bipolar disorder, however, the literature has mainly focused on childhood maltreatment (abuse and neglect) with little attention paid to other forms of adversity, such as childhood bullying victimisation (referred to here as bullying), although this is known to have a negative impact on different psychiatric illnesses. The current study aimed to investigate the association between bullying victimisation and the clinical expression of bipolar disorder individually and in combination with childhood maltreatment. This investigation consisted of 63 individuals with a diagnosis of bipolar disorder (mean age 61.4 years) who completed the Retrospective Bullying Questionnaire and the Childhood Trauma Questionnaire to measure exposure to bullying and childhood maltreatment, respectively. The clinical expression variables were assessed using self-report instruments, these were: the Cardiff Anomalous Perceptions Scale (psychotic symptoms), Suicide Behaviours Questionnaire, Self-Report Manic Inventory, Beck Anxiety and Depression Inventories. The results showed that exposure to bullying was significantly associated with more suicidal behaviours (F(1,61) = 11.02, p < .01, η2 = 0.15) and psychotic symptoms (F(1,61) = 4.21, p < .05, η2 = .06). When bullying and childhood maltreatment histories were combined, the results showed that individuals with a history of both adversity types reported significantly more suicidal behaviours (F(2,60) = 6.59, p < .01, R2=.18) compared to those with a history of one or neither form of adversity. The sample size, age and gender distribution, limit the generalisability of the findings. However, the current results underscore the need to account for bullying victimisation when considering the adverse childhood experiences-bipolar disorder relationship, especially its clinical expression.


Subject(s)
Bipolar Disorder , Bullying , Child Abuse , Crime Victims , Humans , Child , Middle Aged , Retrospective Studies , Child Abuse/psychology , Bullying/psychology
5.
Arch Dis Child ; 108(5): 392-397, 2023 05.
Article in English | MEDLINE | ID: mdl-36609536

ABSTRACT

OBJECTIVE: To identify clinical features that could distinguish children presenting with autistic-like features and a history of severe early maltreatment from children with idiopathic autism spectrum disorders (ASDs). DESIGN: Matched-comparison study. SETTING: Great Ormond Street Hospital, UK. PARTICIPANTS: 46 children with a history of early maltreatment, mean (SD) age 10.6 (3.3) years and 47 children with an ASD, mean (SD) age 10.4 (2.9) years. MAIN OUTCOME MEASURES: A range of standardised interview and observational measures that are designed to quantify autistic traits. Caregiver and teacher reports were obtained on broader aspects of behavioural and emotional adjustment. RESULTS: Both groups had normal range IQ and were predominantly male. On the basis of autistic traits alone, caregiver interview and structured observation concurred that over 60% of the formerly maltreated children met criteria for an ASD. Autistic symptom profiles were very similar in both groups, although children with idiopathic ASD had significantly more marked repetitive and stereotyped behaviours. Teacher and caregiver reports indicated that children from both groups had an increased and broadly similar prevalence of emotional and behavioural disorders. CONCLUSION: Children presenting with a history of early maltreatment, who show autistic traits of behaviour, have a high risk of meeting diagnostic criteria for ASD. Their symptom profiles are virtually indistinguishable from children with idiopathic autism.


Subject(s)
Autism Spectrum Disorder , Autistic Disorder , Child , Humans , Male , Female , Autistic Disorder/diagnosis , Autistic Disorder/epidemiology , Autistic Disorder/psychology , Autism Spectrum Disorder/epidemiology , Child Behavior , Emotions , Prevalence
6.
Psychol Med ; 53(10): 4799-4810, 2023 07.
Article in English | MEDLINE | ID: mdl-35903009

ABSTRACT

BACKGROUND: Adolescent major depressive disorder (MDD) is associated with disrupted processing of emotional stimuli and difficulties in cognitive reappraisal. Little is known however about how current pharmacotherapies act to modulate the neural mechanisms underlying these key processes. The current study therefore investigated the neural effects of fluoxetine on emotional reactivity and cognitive reappraisal in adolescent depression. METHODS: Thirty-one adolescents with MDD were randomised to acute fluoxetine (10 mg) or placebo. Seventeen healthy adolescents were also recruited but did not receive any treatment for ethical reasons. During functional magnetic resonance imaging (fMRI), participants viewed aversive images and were asked to either experience naturally the emotional state elicited ('Maintain') or to reinterpret the content of the pictures to reduce negative affect ('Reappraise'). Significant activations were identified using whole-brain analysis. RESULTS: No significant group differences were seen when comparing Reappraise and Maintain conditions. However, when compared to healthy controls, depressed adolescents on placebo showed reduced visual activation to aversive pictures irrespective of the condition. The depressed adolescent group on fluoxetine showed the opposite pattern, i.e. increased visuo-cerebellar activity in response to aversive pictures, when compared to depressed adolescents on placebo. CONCLUSIONS: These data suggest that depression in adolescence may be associated with reduced visual processing of aversive imagery and that fluoxetine may act to reduce avoidance of such cues. This could reflect a key mechanism whereby depressed adolescents engage with negative cues previously avoided. Future research combining fMRI with eye-tracking is nonetheless needed to further clarify these effects.


Subject(s)
Depressive Disorder, Major , Emotional Regulation , Humans , Adolescent , Fluoxetine/pharmacology , Fluoxetine/therapeutic use , Depressive Disorder, Major/diagnostic imaging , Depressive Disorder, Major/drug therapy , Emotions/physiology , Brain/diagnostic imaging , Brain Mapping , Magnetic Resonance Imaging/methods
7.
Front Psychiatry ; 13: 859123, 2022.
Article in English | MEDLINE | ID: mdl-35492722

ABSTRACT

Depression is a common and often recurrent illness with significant negative impact on a global scale. Current antidepressants are ineffective for up to one third of people with depression, many of whom experience persistent symptomatology. 5-HT4 receptor agonists show promise in both animal models of depression and cognitive deficit. We therefore studied the effect of the 5-HT4 partial agonist prucalopride (1 mg daily for 6 days) on the neural processing of emotional faces in 43 healthy participants using a randomised placebo-controlled design. Participants receiving prucalopride were more accurate at identifying the gender of emotional faces. In whole brain analyses, prucalopride was also associated with reduced activation in a network of regions corresponding to the default mode network. However, there was no evidence that prucalopride treatment produced a positive bias in the neural processing of emotional faces. Our study provides further support for a pro-cognitive effect of 5-HT4 receptor agonism in humans. While our current behavioural and neural investigations do not suggest an antidepressant-like profile of prucalopride in humans, it will be important to study a wider dose range in future studies.

8.
Transl Psychiatry ; 11(1): 497, 2021 10 04.
Article in English | MEDLINE | ID: mdl-34602607

ABSTRACT

Cognitive deficits commonly accompany psychiatric disorders but are often underrecognised, and difficult to treat. The 5-HT4 receptor is a promising potential treatment target for cognitive impairment because in animal studies 5-HT4 receptor agonists enhance hippocampal-dependent memory processes. To date, there has been little work translating these effects to humans. We tested whether short-term administration of the 5-HT4 partial agonist, prucalopride, modified behavioural and neural (fMRI) memory processing in 44 healthy human volunteers using an experimental medicine model. We found that participants who had received six days of prucalopride treatment were significantly better at recalling previously seen neutral images and distinguishing them from new images. At a neural level, prucalopride bilaterally increased hippocampal activity and activity in the right angular gyrus compared with placebo. Taken together, these findings demonstrate the potential of 5-HT4-receptor activation for cognitive enhancement in humans, and support the potential of this receptor as a treatment target for cognitive impairment.


Subject(s)
Serotonin 5-HT4 Receptor Agonists , Serotonin , Benzofurans , Hippocampus/metabolism , Humans , Receptors, Serotonin, 5-HT4/metabolism , Serotonin 5-HT4 Receptor Agonists/pharmacology
9.
Psychol Med ; 51(7): 1111-1120, 2021 05.
Article in English | MEDLINE | ID: mdl-32241310

ABSTRACT

Animal experimental studies suggest that 5-HT4 receptor activation holds promise as a novel target for the treatment of depression and cognitive impairment. 5-HT4 receptors are post-synaptic receptors that are located in striatal and limbic areas known to be involved in cognition and mood. Consistent with this, 5-HT4 receptor agonists produce rapid antidepressant effects in a number of animal models of depression, and pro-cognitive effects in tasks of learning and memory. These effects are accompanied by molecular changes, such as the increased expression of neuroplasticity-related proteins that are typical of clinically useful antidepressant drugs. Intriguingly, these antidepressant-like effects have a fast onset of their action, raising the possibility that 5-HT4 receptor agonists may be a particularly useful augmentation strategy in the early stages of SSRI treatment. Until recently, the translation of these effects to humans has been challenging. Here, we review the evidence from animal studies that the 5-HT4 receptor is a promising target for the treatment of depression and cognitive disorders, and outline a potential pathway for the efficient and cost-effective translation of these effects into humans and, ultimately, to the clinic.


Subject(s)
Antidepressive Agents/therapeutic use , Depression/drug therapy , Receptors, Serotonin, 5-HT4/metabolism , Serotonin 5-HT4 Receptor Agonists/therapeutic use , Animals , Mice , Selective Serotonin Reuptake Inhibitors/therapeutic use
10.
J Psychopharmacol ; 34(12): 1461-1465, 2020 12.
Article in English | MEDLINE | ID: mdl-33143532

ABSTRACT

Fluoxetine is commonly prescribed in adolescent depression, but the neural mechanisms underlying its action remain poorly understood. Here, we used resting-state functional magnetic resonance imaging to investigate the effects of a single dose of fluoxetine vs. placebo in adolescents with major depressive disorder. In contrast with previous studies in adults that have demonstrated an acute effect of antidepressants on activity within the default mode network, a single dose of fluoxetine did not alter activity in this network in adolescent depression. There were unexpected group activity differences in the motor network, which should be clarified in future research.


Subject(s)
Cerebral Cortex , Connectome , Default Mode Network , Depressive Disorder, Major , Fluoxetine/pharmacology , Selective Serotonin Reuptake Inhibitors/pharmacology , Adolescent , Cerebral Cortex/diagnostic imaging , Cerebral Cortex/drug effects , Cerebral Cortex/physiopathology , Default Mode Network/diagnostic imaging , Default Mode Network/drug effects , Default Mode Network/physiopathology , Depressive Disorder, Major/diagnostic imaging , Depressive Disorder, Major/drug therapy , Depressive Disorder, Major/physiopathology , Female , Fluoxetine/administration & dosage , Humans , Magnetic Resonance Imaging , Male , Selective Serotonin Reuptake Inhibitors/administration & dosage
11.
BJPsych Open ; 6(6): e124, 2020 Oct 19.
Article in English | MEDLINE | ID: mdl-33070796

ABSTRACT

BACKGROUND: Depression is characterised by negative views of the self. Antidepressant treatment may remediate negative self-schema through increasing processing of positive information about the self. Changes in affective processing during social interactions may increase expression of prosocial behaviours, improving interpersonal communications. AIMS: To examine whether acute administration of citalopram is associated with an increase in positive affective learning biases about the self and prosocial behaviour. METHOD: Healthy volunteers (n = 41) were randomised to either an acute 20 mg dose of citalopram or matched placebo in a between-subjects double-blind design. Participants completed computer-based cognitive tasks designed to measure referential affective processing, social cognition and expression of prosocial behaviours. RESULTS: Participants administered citalopram made more cooperative choices than those administered placebo in a prisoner's dilemma task (ß = 20%, 95% CI: 2%, 37%). Exploratory analyses indicated that participants administered citalopram showed a positive bias when learning social evaluations about a friend (ß = 4.06, 95% CI: 0.88, 7.24), but not about the self or a stranger. Similarly, exploratory analyses found evidence of increased recall of positive words and reduced recall of negative words about others (ß = 2.41, 95% CI: 0.89, 3.93), but not the self, in the citalopram group. CONCLUSIONS: Participants administered citalopram showed greater prosocial behaviours, increased positive recall and increased positive learning of social evaluations towards others. The increase in positive affective bias and prosocial behaviours towards others may, at least partially, be a mechanism of antidepressant effect. However, we found no evidence that citalopram influenced self-referential processing.

12.
Eur Heart J ; 41(1): 12-85, 2020 01 01.
Article in English | MEDLINE | ID: mdl-31820000

ABSTRACT

AIMS: The 2019 report from the European Society of Cardiology (ESC) Atlas provides a contemporary analysis of cardiovascular disease (CVD) statistics across 56 member countries, with particular emphasis on international inequalities in disease burden and healthcare delivery together with estimates of progress towards meeting 2025 World Health Organization (WHO) non-communicable disease targets. METHODS AND RESULTS: In this report, contemporary CVD statistics are presented for member countries of the ESC. The statistics are drawn from the ESC Atlas which is a repository of CVD data from a variety of sources including the WHO, the Institute for Health Metrics and Evaluation, and the World Bank. The Atlas also includes novel ESC sponsored data on human and capital infrastructure and cardiovascular healthcare delivery obtained by annual survey of the national societies of ESC member countries. Across ESC member countries, the prevalence of obesity (body mass index ≥30 kg/m2) and diabetes has increased two- to three-fold during the last 30 years making the WHO 2025 target to halt rises in these risk factors unlikely to be achieved. More encouraging have been variable declines in hypertension, smoking, and alcohol consumption but on current trends only the reduction in smoking from 28% to 21% during the last 20 years appears sufficient for the WHO target to be achieved. The median age-standardized prevalence of major risk factors was higher in middle-income compared with high-income ESC member countries for hypertension {23.8% [interquartile range (IQR) 22.5-23.1%] vs. 15.7% (IQR 14.5-21.1%)}, diabetes [7.7% (IQR 7.1-10.1%) vs. 5.6% (IQR 4.8-7.0%)], and among males smoking [43.8% (IQR 37.4-48.0%) vs. 26.0% (IQR 20.9-31.7%)] although among females smoking was less common in middle-income countries [8.7% (IQR 3.0-10.8) vs. 16.7% (IQR 13.9-19.7%)]. There were associated inequalities in disease burden with disability-adjusted life years per 100 000 people due to CVD over three times as high in middle-income [7160 (IQR 5655-8115)] compared with high-income [2235 (IQR 1896-3602)] countries. Cardiovascular disease mortality was also higher in middle-income countries where it accounted for a greater proportion of potential years of life lost compared with high-income countries in both females (43% vs. 28%) and males (39% vs. 28%). Despite the inequalities in disease burden across ESC member countries, survey data from the National Cardiac Societies of the ESC showed that middle-income member countries remain severely under-resourced compared with high-income countries in terms of cardiological person-power and technological infrastructure. Under-resourcing in middle-income countries is associated with a severe procedural deficit compared with high-income countries in terms of coronary intervention, device implantation and cardiac surgical procedures. CONCLUSION: A seemingly inexorable rise in the prevalence of obesity and diabetes currently provides the greatest challenge to achieving further reductions in CVD burden across ESC member countries. Additional challenges are provided by inequalities in disease burden that now require intensification of policy initiatives in order to reduce population risk and prioritize cardiovascular healthcare delivery, particularly in the middle-income countries of the ESC where need is greatest.


Subject(s)
Cardiology , Cardiovascular Diseases , Hypertension , Cardiovascular Diseases/epidemiology , Europe/epidemiology , Female , Humans , Hypertension/epidemiology , Income , Male , Risk Factors
13.
Psychol Med ; 50(16): 2722-2730, 2020 12.
Article in English | MEDLINE | ID: mdl-31615585

ABSTRACT

BACKGROUND: 5-HT4 receptor stimulation has pro-cognitive and antidepressant-like effects in animal experimental studies; however, this pharmacological approach has not yet been tested in humans. Here we used the 5-HT4 receptor partial agonist prucalopride to assess the translatability of these effects and characterise, for the first time, the consequences of 5-HT4 receptor activation on human cognition and emotion. METHODS: Forty one healthy volunteers were randomised, double-blind, to a single dose of prucalopride (1 mg) or placebo in a parallel group design. They completed a battery of cognitive tests measuring learning and memory, emotional processing and reward sensitivity. RESULTS: Prucalopride increased recall of words in a verbal learning task, increased the accuracy of recall and recognition of words in an incidental emotional memory task and increased the probability of choosing a symbol associated with a high likelihood of reward or absence of loss in a probabilistic instrumental learning task. Thus acute prucalopride produced pro-cognitive effects in healthy volunteers across three separate tasks. CONCLUSIONS: These findings are a translation of the memory enhancing effects of 5-HT4 receptor agonism seen in animal studies, and lend weight to the idea that the 5-HT4 receptor could be an innovative target for the treatment of cognitive deficits associated with depression and other neuropsychiatric disorders. Contrary to the effects reported in animal models, prucalopride did not reveal an antidepressant profile in human measures of emotional processing.


Subject(s)
Benzofurans/pharmacology , Mental Recall/drug effects , Serotonin 5-HT4 Receptor Agonists/pharmacology , Verbal Learning/drug effects , Adult , Double-Blind Method , Female , Healthy Volunteers , Humans , Male , Task Performance and Analysis , Young Adult
14.
J Affect Disord ; 245: 1126-1134, 2019 02 15.
Article in English | MEDLINE | ID: mdl-30699856

ABSTRACT

BACKGROUND: This study aims to understand suicidal ideation and suicide attempts among transgender individuals through an in-depth analysis of a nation-wide population general survey in China. METHODS: Transgender Men (TM) and Women (TW) were investigated through a cross-sectional survey. A structured questionnaire was used to investigate participants' demographic information, perceived sexuality conflicts, childhood adversity and mental health conditions. Logistic regression models were utilized to investigate risk factors associated with suicidal ideation and suicide attempts in these groups. We also conducted a quasi-meta-analysis in order to compare the prevalence of suicidal ideation and attempted suicide between general and transgender populations in China. RESULTS: A total of 1309 participants across 32 provinces and municipalities in China took part in this survey, out of 2060 valid questionnaires. In this transgender population, the lifetime prevalence of suicidal ideation and an attempt at suicide were 56.4% and 16.1%, respectively. This estimated prevalence rate is far greater than in Chinese community samples. For all transgender people, disliking birth-assigned sex, seeking sex reassignment surgery, having intense conflicts with parents, lifetime history of suffering from major depressive disorder, a recent episode of depression, self-harm, and seeking mental health services were significantly associated with increased risk of suicidal ideation. An education level of high school or equivalent, being married and/or separated/divorced, having intense conflicts with parents, or self-harm and seeking mental health services were all significantly associated with increased risk of suicide attempt. Although most risk factors for TM and TW were equivalent across groups, differences were observed in both suicidal ideation and suicide attempt models. LIMITATIONS: The cross-sectional study design and lack of follow-up data are limitations of this study. CONCLUSIONS: This is the first study to examine suicide within a Chinese transgender population. The clinical implications of these findings for Chinese mental health professionals are discussed. Also, the evidence from this study can be used to inform the practices of suicide prevention workers, and policy makers working with the transgender population.


Subject(s)
Depressive Disorder, Major/epidemiology , Suicidal Ideation , Suicide, Attempted/statistics & numerical data , Transgender Persons/statistics & numerical data , Adolescent , Adult , China/epidemiology , Cross-Sectional Studies , Depressive Disorder, Major/psychology , Educational Status , Family Conflict/psychology , Female , Humans , Logistic Models , Male , Mental Health Services , Parents , Patient Acceptance of Health Care , Prevalence , Risk Factors , Self-Injurious Behavior/epidemiology , Self-Injurious Behavior/psychology , Sexuality , Suicide, Attempted/psychology , Surveys and Questionnaires , Transgender Persons/psychology , Young Adult
15.
Eur Heart J ; 39(7): 508-579, 2018 02 14.
Article in English | MEDLINE | ID: mdl-29190377

ABSTRACT

Aims: The European Society of Cardiology (ESC) Atlas has been compiled by the European Heart Agency to document cardiovascular disease (CVD) statistics of the 56 ESC member countries. A major aim of this 2017 data presentation has been to compare high-income and middle-income ESC member countries to identify inequalities in disease burden, outcomes, and service provision. Methods and results: The Atlas utilizes a variety of data sources, including the World Health Organization, the Institute for Health Metrics and Evaluation, and the World Bank to document risk factors, prevalence, and mortality of cardiovascular disease and national economic indicators. It also includes novel ESC-sponsored survey data of health infrastructure and cardiovascular service provision provided by the national societies of the ESC member countries. Data presentation is descriptive with no attempt to attach statistical significance to differences observed in stratified analyses. Important differences were identified between the high-income and middle-income member countries of the ESC with regard to CVD risk factors, disease incidence, and mortality. For both women and men, the age-standardized prevalence of hypertension was lower in high-income countries (18% and 27%) compared with middle-income countries (24% and 30%). Smoking prevalence in men (not women) was also lower (26% vs. 41%) and together these inequalities are likely to have contributed to the higher CVD mortality in middle-income countries. Declines in CVD mortality have seen cancer becoming a more common cause of death in a number of high-income member countries, but in middle-income countries declines in CVD mortality have been less consistent where CVD remains the leading cause of death. Inequalities in CVD mortality are emphasized by the smaller contribution they make to potential years of life lost in high-income countries compared with middle-income countries both for women (13% vs. 23%) and men (20% vs. 27%). The downward mortality trends for CVD may, however, be threatened by the emerging obesity epidemic that is seeing rates of diabetes increasing across all the ESC member countries. Survey data from the National Cardiac Societies showed that rates of cardiac catheterization and coronary artery bypass surgery, as well as the number of specialist centres required to deliver them, were greatest in the high-income member countries of the ESC. The Atlas confirmed that these ESC member countries, where the facilities for the contemporary treatment of coronary disease were best developed, were often those in which declines in coronary mortality have been most pronounced. Economic resources were not the only driver for delivery of equitable cardiovascular health care, as some middle-income ESC member countries reported rates for interventional procedures and device implantations that matched or exceeded the rates in wealthier member countries. Conclusion: In documenting national CVD statistics, the Atlas provides valuable insights into the inequalities in risk factors, health care delivery, and outcomes of CVD across the ESC member countries. The availability of these data will underpin the ESC's ambitious mission 'to reduce the burden of cardiovascular disease' not only in its member countries but also in nation states around the world.

16.
Proc Biol Sci ; 284(1847)2017 01 25.
Article in English | MEDLINE | ID: mdl-28100819

ABSTRACT

A small number of free-living viruses have been found to be obligately vertically transmitted, but it remains uncertain how widespread vertically transmitted viruses are and how quickly they can spread through host populations. Recent metagenomic studies have found several insects to be infected with sigma viruses (Rhabdoviridae). Here, we report that sigma viruses that infect Mediterranean fruit flies (Ceratitis capitata), Drosophila immigrans, and speckled wood butterflies (Pararge aegeria) are all vertically transmitted. We find patterns of vertical transmission that are consistent with those seen in Drosophila sigma viruses, with high rates of maternal transmission, and lower rates of paternal transmission. This mode of transmission allows them to spread rapidly in populations, and using viral sequence data we found the viruses in D. immigrans and C. capitata had both recently swept through host populations. The viruses were common in nature, with mean prevalences of 12% in C. capitata, 38% in D. immigrans and 74% in P. aegeria We conclude that vertically transmitted rhabdoviruses may be widespread in a broad range of insect taxa, and that these viruses can have dynamic interactions with their hosts.


Subject(s)
Infectious Disease Transmission, Vertical , Insecta/virology , Rhabdoviridae , Animals , Butterflies/virology , Ceratitis capitata/virology , Drosophila/virology
17.
Mol Ecol ; 21(14): 3625-35, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22591073

ABSTRACT

For species of conservation concern, knowledge of key life-history and demographic components, such as the number and sex ratio of breeding adults, is essential for accurate assessments of population viability. Species with temperature-dependent sex determination can produce heavily biased primary sex ratios, and there is concern that adult sex ratios may be similarly skewed or will become so as a result of climate warming. Prediction and mitigation of such impacts are difficult when life-history information is lacking. In marine turtles, owing to the difficultly in observing males at sea, the breeding interval of males is unknown. It has been suggested that male breeding periodicity may be shorter than that of females, which could help to compensate for generally female-biased sex ratios. Here we outline how the use of molecular-based paternity analysis has allowed us, for the first time, to assess the breeding interval of male marine turtles across multiple breeding seasons. In our study rookery of green turtles (Chelonia mydas), 97% of males were assigned offspring in only one breeding season within the 3-year study period, strongly suggesting that male breeding intervals are frequently longer than 1year at this site. Our results also reveal a sex ratio of breeding adults of at least 1.3 males to each female. This study illustrates the utility of molecular-based parentage inference using reconstruction of parental genotypes as a method for monitoring the number and sex ratio of breeders in species where direct observations or capture are difficult.


Subject(s)
Breeding , Sexual Behavior, Animal , Turtles/genetics , Animals , Cyprus , Female , Genotype , Male , Microsatellite Repeats , Periodicity , Seasons , Sequence Analysis, DNA , Sex Ratio , Turtles/physiology
18.
Acta Biomater ; 8(5): 1957-65, 2012 May.
Article in English | MEDLINE | ID: mdl-22314314

ABSTRACT

Phosphate-based glasses (PBGs) are excellent controlled delivery agents for antibacterial ions such as silver and gallium. The aim of this study was to assess the potential utility of novel PBGs combining both gallium and silver for use in periodontal therapy. To this end, an in vitro biofilm model with the putative periodontal pathogen, Porphyromonas gingivalis, and an initial colonizer, Streptococcus gordonii, was established. The effect of increasing calcium content in gallium-silver-doped PBG on the susceptibility of P. gingivalis was examined. A decrease in degradation rates (30.34, 25.19, 21.40 µg mm(-2) h(-1)) with increasing PBG calciumcontent (10, 11, 12 mol.% respectively) was observed, correlating well with gallium and silver ion release and antimicrobial activity against planktonic P. gingivalis (approximately 5.4log(10) colony-forming units (CFU) reduction after 24h by the C10 glass compared with controls) and S. gordonii (total growth inhibition after 32h by C10, C11 and C12 glasses compared with controls). The most potent PBG (C10) was evaluated for its ability to inhibit the biofilm growth of P. gingivalis in a newly established constant-depth film fermentor model. The simultaneous release of silver and gallium from the glass reduced P. gingivalis biofilm growth with a maximum effect (1.92log(10) CFU reduction) after 168 h. Given the emergence of antibiotic-resistant bacteria and dearth of new antibiotics in development, the glasses, especially C10, would offer effective alternatives to antibiotics or may complement current therapies through controlled, localized delivery of gallium and silver ions at infected sites in the oral cavity.


Subject(s)
Biofilms/drug effects , Gallium/administration & dosage , Glass/chemistry , Periodontitis/microbiology , Periodontitis/prevention & control , Porphyromonas gingivalis/drug effects , Streptococcus gordonii/drug effects , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/chemistry , Biofilms/growth & development , Gallium/chemistry , Humans , Materials Testing , Phosphates/chemistry , Porphyromonas gingivalis/growth & development , Streptococcus gordonii/growth & development
19.
Proc Biol Sci ; 279(1736): 2122-7, 2012 Jun 07.
Article in English | MEDLINE | ID: mdl-22279164

ABSTRACT

For organisms with temperature-dependent sex determination (TSD), skewed offspring sex ratios are common. However, climate warming poses the unique threat of producing extreme sex ratio biases that could ultimately lead to population extinctions. In marine turtles, highly female-skewed hatchling sex ratios already occur and predicted increases in global temperatures are expected to exacerbate this trend, unless species can adapt. However, it is not known whether offspring sex ratios persist into adulthood, or whether variation in male mating success intensifies the impact of a shortage of males on effective population size. Here, we use parentage analysis to show that in a rookery of the endangered green turtle (Chelonia mydas), despite an offspring sex ratio of 95 per cent females, there were at least 1.4 reproductive males to every breeding female. Our results suggest that male reproductive intervals may be shorter than the 2-4 years typical for females, and/or that males move between aggregations of receptive females, an inference supported by our satellite tracking, which shows that male turtles may visit multiple rookeries. We suggest that male mating patterns have the potential to buffer the disruptive effects of climate change on marine turtle populations, many of which are already seriously threatened.


Subject(s)
Climate Change , Sexual Behavior, Animal/physiology , Turtles/physiology , Animals , Cyprus , Endangered Species , Female , Male , Microsatellite Repeats , Sex Determination Processes , Sex Ratio , Spacecraft
20.
J Anim Ecol ; 78(6): 1191-202, 2009 Nov.
Article in English | MEDLINE | ID: mdl-19594660

ABSTRACT

1. We examined the influence of local weather conditions on reproductive success, timing of breeding and survival in a population of a multi-brooded ground nesting passerine (woodlark Lullula arborea) over 35 years. 2. Woodlarks laid larger clutches when rainfall was low and temperature high during the egg-laying and pre-laying period. Nest success increased with higher temperatures during the nesting period. In successful nests, the number of chicks fledged per egg laid was greater when weather was drier during the brood stage. 3. Although woodlarks bred earlier in years with warmer early spring temperatures, with the onset of breeding varying by 25 days, there was no significant advance in the onset of breeding over the 35 years of study, due to considerable inter-annual variability, and no overall trend, in weather. 4. Simulation modelling of annual reproductive output demonstrated that earlier breeding could increase productivity by 23.5% in the warmest compared to the coldest year, due to birds having more nesting attempts. Other effects of weather on productivity affected breeding output to a lesser extent. 5. Effects of weather on productivity were minor compared to an increased rate of nest predation through the period of study, which reduced productivity by 49.8% by 2004 compared to 1971. 6. Turning points analysis identified three distinct demographic periods: from 1971 to 1988 the population grew slowly, during 1988-1999 the population grew rapidly, but after 1999 the population declined. Increased population growth after 1988 was associated with higher first-year survival rates (estimated using a population model). Population decline after 1999 was caused by a combination of reduced productivity (resulting from increased nest failure rates attributed to predation) and lower first-year survival rates, that appear unrelated to winter temperature. 7. Climate change (long-term changes in weather) did not explain the marked changes observed in the population trajectory over 35 years. We suggest that understanding effects of both climate and habitat change on populations is essential in predictive population modelling.


Subject(s)
Climate Change , Ecosystem , Passeriformes/physiology , Reproduction/physiology , Animals , Computer Simulation , Conservation of Natural Resources , Demography , Models, Biological , Nesting Behavior , Time Factors
SELECTION OF CITATIONS
SEARCH DETAIL
...