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1.
Sci Rep ; 13(1): 16709, 2023 10 04.
Artículo en Inglés | MEDLINE | ID: mdl-37794120

RESUMEN

Individuals may have a different body odor, when they are sick compared to healthy. In the non-human animal literature, olfactory cues have been shown to predict avoidance of sick individuals. We tested whether the mere experimental activation of the innate immune system in healthy human individuals can make an individuals' body odor be perceived as more aversive (intense, unpleasant, and disgusting). Following an endotoxin injection (lipopolysaccharide; 0.6 ng/kg) that creates a transient systemic inflammation, individuals smelled more unpleasant compared to a placebo group (saline injection). Behavioral and chemical analyses of the body odor samples suggest that the volatile components of samples from "sick" individuals changed qualitatively rather than quantitatively. Our findings support the hypothesis that odor cues of inflammation in axillary sweat are detectable just a few hours after experimental activation of the innate immune system. As such, they may trigger behavioral avoidance, hence constituting a first line of defense against pathogens of infected conspecifics.


Asunto(s)
Olor Corporal , Inflamación , Humanos
2.
AMA J Ethics ; 23(11): E840-846, 2021 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-34874251

RESUMEN

The COVID-19 pandemic underscores long-standing challenges to the health of persons experiencing homelessness. This case commentary considers primary care clinicians' response to a patient who declines COVID-19 testing and isolation. This article also considers other outbreaks in the United States in which the autonomy of persons with low income or persons of color was neglected and calls for community engagement, policies that center interests of marginalized groups, and economic relief, including supportive housing.


Asunto(s)
COVID-19 , Personas con Mala Vivienda , Prueba de COVID-19 , Humanos , Pandemias , Salud Pública , SARS-CoV-2 , Estados Unidos
3.
Prog Transplant ; 30(2): 88-94, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32223514

RESUMEN

INTRODUCTION: Early hospital readmission following liver transplantation is associated with lower survival and worse long-term graft function. Language, cultural practices, and health literacy influence patient understanding of posttransplant care education. Complex medication regimes, changes in metabolism and nutrition absorption, and infection/rejection further complicate the prevention of readmission. PURPOSE: The purpose of this study was to compare the 30-day readmissions of single-organ liver transplant recipients for 1-year prior and 1-year following the implementation of nurse-led education. The study examined the demographics, clinical characteristics, and 30-day readmissions of 35 liver transplant recipients who participated in the newly designed nurse-led education and 51 liver transplant recipients who experienced the prior post-liver transplant education. DESIGN: A single-center, correlational study with a convenience sample was conducted at a Hispanic-serving South Texas hospital. The new education intervention maintained the standard education and added twice-daily mutual patient-focused goal setting between the nurse and the recipient that aligned with readiness for discharge activities/goals, structured education using abbreviated handouts written at a second-grade level available in both English and Spanish, and the use of repetition through multimodal methods. RESULTS: The odds for 30-day readmissions the year prior to the nurse-led patient education intervention were 2.088 times greater than the year following the implementation. Thirty-day readmissions were reduced by 16.3% from the 2017 cohort to the 2018 cohort. DISCUSSION: Understanding unique risk factors facilitates structured patient education which can be individualized to the patient and caregiver including collaborative nurse-patient goals.


Asunto(s)
Trasplante de Hígado/educación , Readmisión del Paciente/estadística & datos numéricos , Pautas de la Práctica en Enfermería , Adulto , Anciano , Estudios de Cohortes , Femenino , Humanos , Trasplante de Hígado/enfermería , Masculino , Persona de Mediana Edad , Texas , Adulto Joven
4.
Chem Senses ; 43(9): 711-719, 2018 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-30321293

RESUMEN

Contagious disease is a major threat to survival, and the cost of relying on the immune system to defeat pathogens is high; therefore, behavioral avoidance of contagious individuals is arguably an adaptive strategy. Animal findings demonstrate the ability to detect and avoid sick individuals by the aid of olfactory cues, and a recent study indicated that human axillary odor also becomes more aversive as a function of immune activation. By injecting healthy human participants with lipopolysaccharide (0.6 ng/kg body weight) to experimentally induce inflammation, this study demonstrates that natural daily rhythms of urine odor-its perceived dimensions and volatile profile-are altered within hours of inflammation onset. Whereas healthy human urine decreases in averseness over the course of a single day, inflammation interrupts this process and results in an increased urine odor averseness and an altered volatile composition. These results support the notion that subtle and early cues of sickness may be detected and avoided, thereby complementing the immune system in its role of keeping us alive and healthy.


Asunto(s)
Señales (Psicología) , Inflamación/orina , Odorantes , Olfato/fisiología , Volatilización , Adulto , Reacción de Prevención , Femenino , Cromatografía de Gases y Espectrometría de Masas , Humanos , Inflamación/sangre , Lipopolisacáridos/toxicidad , Masculino , Placebos , Adulto Joven
5.
Am J Prev Med ; 55(4): 433-444, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30166082

RESUMEN

INTRODUCTION: This study estimated the U.S. lifetime per-victim cost and economic burden of intimate partner violence. METHODS: Data from previous studies were combined with 2012 U.S. National Intimate Partner and Sexual Violence Survey data in a mathematical model. Intimate partner violence was defined as contact sexual violence, physical violence, or stalking victimization with related impact (e.g., missed work days). Costs included attributable impaired health, lost productivity, and criminal justice costs from the societal perspective. Mean age at first victimization was assessed as 25 years. Future costs were discounted by 3%. The main outcome measures were the mean per-victim (female and male) and total population (or economic burden) lifetime cost of intimate partner violence. Secondary outcome measures were marginal outcome probabilities among victims (e.g., anxiety disorder) and associated costs. Analysis was conducted in 2017. RESULTS: The estimated intimate partner violence lifetime cost was $103,767 per female victim and $23,414 per male victim, or a population economic burden of nearly $3.6 trillion (2014 US$) over victims' lifetimes, based on 43 million U.S. adults with victimization history. This estimate included $2.1 trillion (59% of total) in medical costs, $1.3 trillion (37%) in lost productivity among victims and perpetrators, $73 billion (2%) in criminal justice activities, and $62 billion (2%) in other costs, including victim property loss or damage. Government sources pay an estimated $1.3 trillion (37%) of the lifetime economic burden. CONCLUSIONS: Preventing intimate partner violence is possible and could avoid substantial costs. These findings can inform the potential benefit of prioritizing prevention, as well as evaluation of implemented prevention strategies.


Asunto(s)
Costo de Enfermedad , Víctimas de Crimen/estadística & datos numéricos , Derecho Penal/economía , Costos de la Atención en Salud/estadística & datos numéricos , Violencia de Pareja/economía , Adulto , Derecho Penal/estadística & datos numéricos , Eficiencia , Femenino , Humanos , Violencia de Pareja/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Acecho/psicología , Encuestas y Cuestionarios
6.
Sci Rep ; 7(1): 13635, 2017 10 20.
Artículo en Inglés | MEDLINE | ID: mdl-29057956

RESUMEN

Chemosignals are used by predators to localize prey and by prey to avoid predators. These cues vary between species, but the odor of blood seems to be an exception and suggests the presence of an evolutionarily conserved chemosensory cue within the blood odor mixture. A blood odor component, E2D, has been shown to trigger approach responses identical to those triggered by the full blood odor in mammalian carnivores and as such, is a key candidate as a food/alarm cue in blood. Using a multidisciplinary approach, we demonstrate that E2D holds the dual function of affecting both approach and avoidance behavior in a predator-prey predicted manner. E2D evokes approach responses in two taxonomically distant blood-seeking predators, Stable fly and Wolf, while evoking avoidance responses in the prey species Mouse. We extend this by demonstrating that this chemical cue is preserved in humans as well; E2D induces postural avoidance, increases physiological arousal, and enhances visual perception of affective stimuli. This is the first demonstration of a single chemical cue with the dual function of guiding both approach and avoidance in a predator-prey predicted manner across taxonomically distant species, as well as the first known chemosignal that affects both human and non-human animals alike.


Asunto(s)
Reacción de Prevención , Sangre , Conducta de Elección , Odorantes , Percepción Olfatoria , Adulto , Animales , Nivel de Alerta/fisiología , Reacción de Prevención/fisiología , Sangre/metabolismo , Conducta de Elección/fisiología , Señales (Psicología) , Femenino , Humanos , Masculino , Ratones , Muscidae , Conducta Predatoria , Percepción Visual , Lobos , Adulto Joven
7.
Chem Senses ; 41(5): 407-14, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26926034

RESUMEN

Chemical signals arising from body secretions and excretions communicate information about health status as have been reported in a range of animal models of disease. A potential common pathway for diseases to alter chemical signals is via activation of immune function-which is known to be intimately involved in modulation of chemical signals in several species. Based on our prior findings that both immunization and inflammation alter volatile body odors, we hypothesized that injury accompanied by inflammation might correspondingly modify the volatile metabolome to create a signature endophenotype. In particular, we investigated alteration of the volatile metabolome as a result of traumatic brain injury. Here, we demonstrate that mice could be trained in a behavioral assay to discriminate mouse models subjected to lateral fluid percussion injury from appropriate surgical sham controls on the basis of volatile urinary metabolites. Chemical analyses of the urine samples similarly demonstrated that brain injury altered urine volatile profiles. Behavioral and chemical analyses further indicated that alteration of the volatile metabolome induced by brain injury and alteration resulting from lipopolysaccharide-associated inflammation were not synonymous. Monitoring of alterations in the volatile metabolome may be a useful tool for rapid brain trauma diagnosis and for monitoring recovery.


Asunto(s)
Lesiones Encefálicas/patología , Compuestos Orgánicos Volátiles/metabolismo , Animales , Conducta Animal/efectos de los fármacos , Lesiones Encefálicas/metabolismo , Análisis Discriminante , Modelos Animales de Enfermedad , Inflamación/etiología , Lipopolisacáridos/toxicidad , Masculino , Ratones , Ratones Endogámicos C57BL , Compuestos Orgánicos Volátiles/farmacología , Compuestos Orgánicos Volátiles/orina
8.
Psychol Sci ; 25(3): 817-23, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24452606

RESUMEN

Observational studies have suggested that with time, some diseases result in a characteristic odor emanating from different sources on the body of a sick individual. Evolutionarily, however, it would be more advantageous if the innate immune response were detectable by healthy individuals as a first line of defense against infection by various pathogens, to optimize avoidance of contagion. We activated the innate immune system in healthy individuals by injecting them with endotoxin (lipopolysaccharide). Within just a few hours, endotoxin-exposed individuals had a more aversive body odor relative to when they were exposed to a placebo. Moreover, this effect was statistically mediated by the individuals' level of immune activation. This chemosensory detection of the early innate immune response in humans represents the first experimental evidence that disease smells and supports the notion of a "behavioral immune response" that protects healthy individuals from sick ones by altering patterns of interpersonal contact.


Asunto(s)
Señales (Psicología) , Inmunidad Innata/efectos de los fármacos , Lipopolisacáridos/farmacología , Odorantes , Percepción Olfatoria , Conducta Social , Adulto , Femenino , Humanos , Masculino , Adulto Joven
9.
Chem Senses ; 38(2): 167-74, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23118205

RESUMEN

Given that context affects olfaction and the elderly exhibit olfactory deficits, the current study tested whether a subtle change in internal context, evoked by priming the elderly stereotype, would affect performance in a variety of olfactory tasks including odor sensitivity, discrimination, and identification (Experiment 1), as well as perceived odor intensity, pleasantness and familiarity, and an odor reaction time task (Experiment 2). Such internalization of the elderly stereotype has been demonstrated with slower walking speeds and fewer words recalled in a memory task. In the current study, 76 participants first listened to a presentation about age-related declines in olfaction and then participated in 3 language tasks which, unbeknownst to them, served as the elderly stereotype priming manipulation. This priming manipulation was effective at decreasing walking speed and word recall, confirming the findings of previous researchers; however, olfaction was not affected. Whether olfaction is resistant to stereotype priming is discussed.


Asunto(s)
Envejecimiento , Percepción Olfatoria , Olfato , Adulto , Femenino , Humanos , Recuerdo Mental , Tiempo de Reacción , Conducta Estereotipada , Estereotipo , Adulto Joven
10.
Biol Psychol ; 92(2): 135-41, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23174695

RESUMEN

Increased sensitivity to specific cues in the environment is common in anxiety disorders. This increase in sensory processing can emerge through attention processes that enhance discrimination of a cue from other cues as well as through augmented senses that reduce the absolute intensity of sensory stimulation needed for detection. Whereas it has been established that aversive conditioning can enhance odor quality discrimination, it is not known whether it also changes the absolute threshold at which an odor can be detected. In two separate experiments, we paired one odor of an indistinguishable odor pair with an aversive outcome using a classical conditioning paradigm. Ability to discriminate and to detect the paired odor was assessed before and after conditioning. The results demonstrate that aversive conditioning increases absolute sensory sensitivity to a predictive odor cue in an odor-specific manner, rendering the conditioned odor detectable at a significantly lower (20%) absolute concentration. As animal research has found long-lasting change in behavior and neural signaling resulting from conditioning, absolute threshold was also tested eight weeks later. Detection threshold had returned to baseline level at the eight week follow-up session suggesting that the change in detection threshold was mediated by a transient reorganization. Taken together, we can for the first time demonstrate that increasing the biological salience of a stimulus augments the individual's absolute sensitivity in a stimulus-specific manner outside conscious awareness. These findings provide a unique framework for understanding sensory mechanisms in anxiety disorders as well as further our understanding of mechanisms underlying classical conditioning.


Asunto(s)
Reacción de Prevención/fisiología , Discriminación en Psicología/fisiología , Olfato/fisiología , Adulto , Análisis de Varianza , Atención/fisiología , Señales (Psicología) , Femenino , Humanos , Masculino , Odorantes , Dimensión del Dolor , Psicofísica , Adulto Joven
11.
PLoS One ; 7(5): e38110, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22666457

RESUMEN

Our natural body odor goes through several stages of age-dependent changes in chemical composition as we grow older. Similar changes have been reported for several animal species and are thought to facilitate age discrimination of an individual based on body odors, alone. We sought to determine whether humans are able to discriminate between body odor of humans of different ages. Body odors were sampled from three distinct age groups: Young (20-30 years old), Middle-age (45-55), and Old-age (75-95) individuals. Perceptual ratings and age discrimination performance were assessed in 41 young participants. There were significant differences in ratings of both intensity and pleasantness, where body odors from the Old-age group were rated as less intense and less unpleasant than body odors originating from Young and Middle-age donors. Participants were able to discriminate between age categories, with body odor from Old-age donors mediating the effect also after removing variance explained by intensity differences. Similarly, participants were able to correctly assign age labels to body odors originating from Old-age donors but not to body odors originating from other age groups. This experiment suggests that, akin to other animals, humans are able to discriminate age based on body odor alone and that this effect is mediated mainly by body odors emitted by individuals of old age.


Asunto(s)
Envejecimiento/metabolismo , Discriminación en Psicología , Odorantes/análisis , Percepción , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
12.
Chem Senses ; 37(4): 371-8, 2012 May.
Artículo en Inglés | MEDLINE | ID: mdl-22267652

RESUMEN

Taste, smell, and chemical irritation (so-called trigeminal sensation) combine in our daily experience to produce the supramodal sensation of flavor, are processed by partly overlapping neural mechanisms, and show functional interconnectivity in experiments. Given their collaboration in flavor formation and the well-established connections between these senses, it is plausible that polymodal detection mechanisms might contribute to individual differences in measured sensitivity. One would expect the existence of a general chemosensory sensitivity factor to result in associations among taste, smell, and trigeminal stimulation thresholds. Measures of 5 detection thresholds from all the chemical senses were assessed in the same group of young healthy subjects (n=57). An unbiased principal components analysis (PCA) yielded a 2-component solution. Component 1, on which taste thresholds loaded strongly, accounted for 29.4% of the total variance. Component 2, on which the odor and trigeminal lateralization thresholds loaded strongly, accounted for 26.9% of the total variance. A subsequent PCA restricted to a 3-component solution cleanly separated the 3 sensory modalities and accounted for 75% of the total variance. Thus, though there may be a common underlying factor that determines some individual differences in odor and trigeminal lateralization thresholds, a general chemical sensitivity that spans chemosensory modalities seems unlikely.


Asunto(s)
Percepción Olfatoria/fisiología , Olfato/fisiología , Percepción del Gusto/fisiología , Gusto/fisiología , Adolescente , Adulto , Femenino , Humanos , Individualidad , Irritantes/farmacología , Odorantes , Percepción Olfatoria/efectos de los fármacos , Análisis de Componente Principal , Umbral Sensorial/efectos de los fármacos , Umbral Sensorial/fisiología , Percepción del Gusto/efectos de los fármacos , Nervio Trigémino/fisiología
13.
J Neurosci Methods ; 205(1): 10-6, 2012 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-22200409

RESUMEN

BACKGROUND: Most existing olfactory identification (ID) tests have the primary aim of diagnosing clinical olfactory dysfunction, thereby rendering them sub-optimal for experimental settings where the aim is to detect differences in healthy subjects' odor ID abilities. MATERIALS AND METHODS: We have developed an extended version of the olfactory ID subtest of the Sniffin' Sticks test battery to better assess the variability in ID scores and thereby olfactory abilities of healthy, adult individuals. Twenty-four odorants, corresponding cue labels, and distractor labels were added to the existing 16-item Sniffin' Sticks ID test to create the 40-item Monell Extended Sniffin' Sticks Identification Test (MONEX-40). The MONEX-40 was administered to 259 healthy young subjects, of which 72 were retested on an average of 212 days (SD 112 days) later. RESULTS: The added odor items demonstrated good validity, as shown by a significant correlation of the results with the original 16-item ID test. In addition, the MONEX-40 achieved a significant test-retest and split-half reliability. CONCLUSIONS: Taken together, these results suggest that the MONEX-40 is a reliable method for experimental assessment of odor ID ability in healthy, young individuals. Moreover, its use of a wider range of odors allows the experimenter to present subsets of the MONEX-40 within the same experiment while maintaining statistical power.


Asunto(s)
Trastornos del Olfato/diagnóstico , Olfato/fisiología , Adolescente , Adulto , Interpretación Estadística de Datos , Femenino , Humanos , Masculino , Odorantes , Reproducibilidad de los Resultados , Umbral Sensorial , Caracteres Sexuales , Adulto Joven
15.
Int J Psychophysiol ; 78(2): 179-89, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20688109

RESUMEN

Many human olfactory experiments call for fast and stable stimulus-rise times as well as exact and stable stimulus-onset times. Due to these temporal demands, an olfactometer is often needed. However, an olfactometer is a piece of equipment that either comes with a high price tag or requires a high degree of technical expertise to build and/or to run. Here, we detail the construction of an olfactometer that is constructed almost exclusively with "off-the-shelf" parts, requires little technical knowledge to build, has relatively low price tags, and is controlled by E-Prime, a turnkey-ready and easily-programmable software commonly used in psychological experiments. The olfactometer can present either solid or liquid odor sources, and it exhibits a fast stimulus-rise time and a fast and stable stimulus-onset time. We provide a detailed description of the olfactometer construction, a list of its individual parts and prices, as well as potential modifications to the design. In addition, we present odor onset and concentration curves as measured with a photo-ionization detector, together with corresponding GC/MS analyses of signal-intensity drop (5.9%) over a longer period of use. Finally, we present data from behavioral and psychophysiological recordings demonstrating that the olfactometer is suitable for use during event-related EEG experiments.


Asunto(s)
Diseño Asistido por Computadora/normas , Computadores/normas , Odorantes/análisis , Olfato , Adulto , Diseño Asistido por Computadora/economía , Computadores/economía , Potenciales Evocados/fisiología , Femenino , Humanos , Masculino , Dimensión del Dolor/métodos , Olfato/fisiología , Programas Informáticos/economía , Programas Informáticos/normas , Factores de Tiempo , Adulto Joven
16.
Aust Fam Physician ; 38(6): 454-8, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19530378

RESUMEN

BACKGROUND: General practitioner stress is a recognised problem for which meditation is a potential intervention. The aim of this project was to evaluate the feasibility, acceptability and effectiveness of an initiative to train GPs in a set of evidence based meditation skills. METHOD: General practitioners attended a seminar comprising a 1 hour lecture on GP wellbeing, a 45 minute session on meditation, meditation skills practise in groups with an experienced instructor, a larger group review and the provision of take home kits. At the seminar's conclusion, GPs were offered the option of meditating at home twice daily. Measures were taken before and after the seminar and after 2 weeks home practise. The measures included the Kessler Psychological Distress Scale - 10 (K10), personal experience rating by visual analogue scale, and diary card. RESULTS: A total of 299 GPs attended the seminar, from which 293 provided visual analogue scale on the day. Pre- and post-K10 data was provided by 111 GPs. The mean pre-K10 score for these GPs was 17.2 (SD: 5.67); the post-K10 score was 14.7 (SD: 3.92), with 25.1% of the 'at risk' participants moving to the 'low risk' category. Mean compliance with meditation was 79.5%. DISCUSSION: A meditation workshop for GP wellbeing is practical, feasible and appealing to GPs. Quantitative feedback from the workshop indicates its potential as an effective mental health promotion and prevention strategy.


Asunto(s)
Educación Médica Continua , Medicina Familiar y Comunitaria/educación , Meditación , Estrés Psicológico/prevención & control , Estudios de Factibilidad , Humanos , Dimensión del Dolor
17.
Child Welfare ; 82(1): 77-96, 2003.
Artículo en Inglés | MEDLINE | ID: mdl-12641379

RESUMEN

This article describes findings from a series of focus groups conducted with formal kinship caregivers in Maryland. The findings reveal that kinship caregivers are committed to providing safety and stability for the children placed with them. The findings also suggest that caregiving can be a significant adjustment for many kinship caregivers and that expanded support services are needed to enhance their relationship with the child welfare agency.


Asunto(s)
Cuidadores/psicología , Cuidado del Niño , Apoyo Social , Adopción/psicología , Adulto , Niño , Maltrato a los Niños/prevención & control , Protección a la Infancia , Preescolar , Relaciones Comunidad-Institución , Relaciones Familiares , Femenino , Grupos Focales , Humanos , Lactante , Masculino , Maryland , Persona de Mediana Edad , Padres/psicología
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