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1.
Sci Rep ; 13(1): 13378, 2023 08 17.
Artículo en Inglés | MEDLINE | ID: mdl-37591906

RESUMEN

A renewed interest in the use of psychedelics for treating obsessive compulsive disorder (OCD) has emerged in the last 20 years. But pre-clinical and clinical evidence remain scarce, and little is known about the factor determining the magnitude and persistence of the therapeutic effect. We therefore designed a retrospective online survey to explore, in the general population using psychoactive drugs, their impact on OCD symptoms. We also assessed the attitude of the participants towards the substance in term of frequency of intakes. In a sample of 174 participants, classic psychedelics were reported as the only substances effective at reducing OCD symptoms. In classic psychedelics users, symptoms reduction was associated with the intensity of acute effects, itself correlated to the dose. Reports on the persistence of the therapeutic effect varied from weeks to months, but we could not find any predicting factor. Finally, the occurrence and frequency of subsequent intakes, which seemed to be limited in our sample, were predicted by the magnitude and persistence of the therapeutic effect, respectively. Our observations support the hypothesis of classic psychedelics efficacy in reducing OCD symptoms but a careful evaluation of the persistence of this effect is still needed.


Asunto(s)
Alucinógenos , Trastorno Obsesivo Compulsivo , Humanos , Alucinógenos/uso terapéutico , Estudios Retrospectivos , Trastorno Obsesivo Compulsivo/tratamiento farmacológico
2.
Rev Panam Salud Publica ; 47: e44, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36945250

RESUMEN

Objectives: To identify the factors contributing to coronavirus disease 2019 (COVID-19) vaccine hesitancy in Grenada. Methods: A phenomenological study was conducted using semi-structured interviews at vaccination and pop-up testing clinics during a spike in COVID-19 cases on the island. Interview questions were developed using the health belief model related to perceived threat of COVID-19, perceived benefits of and barriers to COVID-19 vaccination, and cues to action. Data were analyzed using a deductive approach to identify themes, categories, and subcategories. Results: Twenty-five interviews were transcribed and coded. In all, 68% of participants were unvaccinated, 12% were partially vaccinated, and 20% were fully vaccinated. Data analysis revealed two main themes: facilitators and barriers. Factors more likely to encourage vaccination (facilitators) included trust in medical advice and vaccine efficacy, social responsibility, and vaccine mandates for travel, employment, and social activities. Factors hindering vaccination (barriers) included: perceived low threat of COVID-19; preference for natural remedies; concerns about contraindications because of underlying health conditions; fear; mistrust of vaccines and related messaging; vaccine accessibility; and the many different information sources. Conclusions: Overcoming vaccine hesitancy is key to combating the detrimental effects of COVID-19 in Grenada. Public health interventions and policies that address barriers and capitalize on facilitators can increase vaccine uptake.

3.
Artículo en Inglés | PAHO-IRIS | ID: phr-57281

RESUMEN

[ABSTRACT]. Objectives. To identify the factors contributing to coronavirus disease 2019 (COVID-19) vaccine hesitancy in Grenada. Methods. A phenomenological study was conducted using semi-structured interviews at vaccination and pop-up testing clinics during a spike in COVID-19 cases on the island. Interview questions were developed using the health belief model related to perceived threat of COVID-19, perceived benefits of and barriers to COVID-19 vaccination, and cues to action. Data were analyzed using a deductive approach to identify themes, categories, and subcategories. Results. Twenty-five interviews were transcribed and coded. In all, 68% of participants were unvaccinated, 12% were partially vaccinated, and 20% were fully vaccinated. Data analysis revealed two main themes: facilitators and barriers. Factors more likely to encourage vaccination (facilitators) included trust in medical advice and vaccine efficacy, social responsibility, and vaccine mandates for travel, employment, and social activities. Factors hindering vaccination (barriers) included: perceived low threat of COVID-19; preference for natural remedies; concerns about contraindications because of underlying health conditions; fear; mistrust of vaccines and related messaging; vaccine accessibility; and the many different information sources. Conclusions. Overcoming vaccine hesitancy is key to combating the detrimental effects of COVID-19 in Gre- nada. Public health interventions and policies that address barriers and capitalize on facilitators can increase vaccine uptake.


[RESUMEN]. Objetivos. Determinar cuáles son los factores que contribuyen con la reticencia a la vacunación contra la enfermedad por el coronavirus del 2019 (COVID-19) en Granada. Métodos. Se realizó un estudio fenomenológico utilizando entrevistas semiestructuradas realizadas en pues- tos transitorios de prueba y vacunación durante un aumento en el número de casos de COVID-19 en la isla. Se elaboraron las preguntas de la entrevista según el modelo de creencias de salud en relación con la amenaza percibida respecto de la COVID-19, los obstáculos y los beneficios percibidos respecto de la vacunación contra la COVID-19 y los incentivos para la acción. Los datos se analizaron mediante un enfoque deductivo con el fin de determinar los principales temas, categorías y subcategorías. Resultados. Se transcribieron y codificaron veinticinco entrevistas. En total, el 68% de los participantes no estaban vacunados, el 12% estaban parcialmente vacunados y el 20% tenían el esquema completo de vacu- nación. El análisis de los datos reveló dos temas principales: los factores facilitadores y los obstáculos. Entre los factores con mayores probabilidades de incentivar la vacunación (factores facilitadores) se encuentran la confianza en el asesoramiento médico y la eficacia de la vacuna, la responsabilidad social y los mandatos de vacunación para viajes, empleo y actividades sociales. Entre los factores que obstaculizan la vacunación (obstáculos) se encuentran la percepción de que la COVID-19 no es una amenaza grave; la preferencia por los remedios naturales; las preocupaciones por las contraindicaciones debido a afecciones de salud subya- centes; el miedo; la desconfianza en las vacunas y los mensajes relacionados; la accesibilidad a las vacunas; y las muy diferentes fuentes de información. Conclusiones. Es necesario superar la reticencia a la vacunación para combatir los efectos nocivos de la COVID-19 en Granada. Las políticas e intervenciones de salud pública que abordan los obstáculos y capital- izan los factores facilitadores pueden aumentar el uso efectivo de las vacunas.


[RESUMO]. Objetivos. Identificar os fatores que contribuem para a hesitação em relação à vacina contra a doença por coronavírus 2019 (covid-19) em Granada. Métodos. Realizou-se um estudo fenomenológico com entrevistas semiestruturadas em clínicas de vaci- nação e testagem rápida durante um pico de casos de covid-19 na ilha. As perguntas da entrevista foram elaboradas com base no modelo de crenças em saúde relacionado à percepção de ameaça da covid-19, à percepção de benefícios e barreiras relativos à vacinação contra a covid-19, e aos estímulos para ação. Os dados foram analisados por um método dedutivo para identificar temas, categorias e subcategorias. Resultados. Vinte e cinco entrevistas foram transcritas e codificadas. No total, 68% dos participantes não eram vacinados, 12% eram parcialmente vacinados e 20% eram totalmente vacinados. A análise dos dados evidenciou dois temas principais: facilitadores e barreiras. Os fatores mais propensos a incentivar a vaci- nação (facilitadores) foram confiança na orientação médica e na eficácia da vacina, responsabilidade social e exigência de vacinação em viagens, no emprego e em atividades sociais. Entre os fatores que impediam a vacinação (barreiras) estavam: percepção de baixa ameaça da covid-19; preferência por remédios naturais; preocupação com contraindicações em razão de problemas de saúde preexistentes; medo; desconfiança das vacinas e mensagens relacionadas; acessibilidade da vacina; e as muitas diferentes fontes de informação. Conclusões. Superar a hesitação vacinal é imprescindível para combater as consequências negativas da covid-19 em Granada. As intervenções e políticas de saúde pública que afastam barreiras e promovem facil- itadores podem aumentar a aceitação da vacina.


Asunto(s)
COVID-19 , Vacunas contra la COVID-19 , Vacilación a la Vacunación , Investigación Cualitativa , Grenada , Vacunas contra la COVID-19 , Vacilación a la Vacunación , Investigación Cualitativa , Vacunas contra la COVID-19 , Vacilación a la Vacunación , Investigación Cualitativa
4.
Eur J Hosp Pharm ; 30(5): 279-283, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-34853014

RESUMEN

OBJECTIVES: To assess the impact of self-administration of medicines (facilitated by a midwife formulary) on postnatal women's knowledge of certain post-delivery medications, awareness of the Green Bag Scheme, factors contributing to constipation, pain satisfaction, adherence, and time released to midwives plus feedback from these women and their midwives. METHODS: The study was conducted in consented postnatal women, who self-administered medications from their bedside lockers. The mode of delivery and parity were recorded. Data were compared in women who self-administered to those who did not. Midwives used our established midwife formulary to write their essential unprescribed medications. Direct interview questionnaires were used to obtain their knowledge on chosen post-delivery medicines, pain satisfaction, the Green Bag Scheme and factors contributing to constipation. Regular medicines counts were used to check adherence. Midwives' time not administering these self-administered medications was estimated. Self-reported questionnaires were used to obtain feedback from participants and midwives. Responses were analysed proportionately and where appropriate by simple statistics. RESULTS: Women (n=203) who self-administered were compared with those (n=401) who did not. Greater medicines' knowledge and better (96% vs 79%) pain satisfaction were found in self-administering women. Knowledge of each contributing factor to constipation varied. Mode of delivery and parity had no impact on these outcomes. Adherence seemed high 96% (195/203). Awareness of the Green Bag Scheme was poor (66/604). Most women, 94% (191/203) found the service helpful and 89% (178/200) would take part again. At least 224 hours were released to midwives by these self-administering women. 164/203 (81%) midwives felt the scheme was beneficial. CONCLUSIONS: Self-administering women had better pain satisfaction, medication knowledge and adherence. The need to improve engagement in the Green Bag Scheme was flagged. This service, supported by use of a midwife formulary, can release time to midwives to do other tasks including care for women with more complex issues. A business case for this service is under review.


Asunto(s)
Cumplimiento de la Medicación , Partería , Dolor , Conocimiento de la Medicación por el Paciente , Satisfacción del Paciente , Periodo Posparto , Humanos , Femenino , Autoadministración , Farmacéuticos , Formularios Farmacéuticos como Asunto , Autoinforme , Dolor/psicología
5.
Rev. panam. salud pública ; 47: e44, 2023. tab
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1432092

RESUMEN

ABSTRACT Objectives. To identify the factors contributing to coronavirus disease 2019 (COVID-19) vaccine hesitancy in Grenada. Methods. A phenomenological study was conducted using semi-structured interviews at vaccination and pop-up testing clinics during a spike in COVID-19 cases on the island. Interview questions were developed using the health belief model related to perceived threat of COVID-19, perceived benefits of and barriers to COVID-19 vaccination, and cues to action. Data were analyzed using a deductive approach to identify themes, categories, and subcategories. Results. Twenty-five interviews were transcribed and coded. In all, 68% of participants were unvaccinated, 12% were partially vaccinated, and 20% were fully vaccinated. Data analysis revealed two main themes: facilitators and barriers. Factors more likely to encourage vaccination (facilitators) included trust in medical advice and vaccine efficacy, social responsibility, and vaccine mandates for travel, employment, and social activities. Factors hindering vaccination (barriers) included: perceived low threat of COVID-19; preference for natural remedies; concerns about contraindications because of underlying health conditions; fear; mistrust of vaccines and related messaging; vaccine accessibility; and the many different information sources. Conclusions. Overcoming vaccine hesitancy is key to combating the detrimental effects of COVID-19 in Grenada. Public health interventions and policies that address barriers and capitalize on facilitators can increase vaccine uptake.


RESUMEN Objetivos. Determinar cuáles son los factores que contribuyen con la reticencia a la vacunación contra la enfermedad por el coronavirus del 2019 (COVID-19) en Granada. Métodos. Se realizó un estudio fenomenológico utilizando entrevistas semiestructuradas realizadas en puestos transitorios de prueba y vacunación durante un aumento en el número de casos de COVID-19 en la isla. Se elaboraron las preguntas de la entrevista según el modelo de creencias de salud en relación con la amenaza percibida respecto de la COVID-19, los obstáculos y los beneficios percibidos respecto de la vacunación contra la COVID-19 y los incentivos para la acción. Los datos se analizaron mediante un enfoque deductivo con el fin de determinar los principales temas, categorías y subcategorías. Resultados. Se transcribieron y codificaron veinticinco entrevistas. En total, el 68% de los participantes no estaban vacunados, el 12% estaban parcialmente vacunados y el 20% tenían el esquema completo de vacunación. El análisis de los datos reveló dos temas principales: los factores facilitadores y los obstáculos. Entre los factores con mayores probabilidades de incentivar la vacunación (factores facilitadores) se encuentran la confianza en el asesoramiento médico y la eficacia de la vacuna, la responsabilidad social y los mandatos de vacunación para viajes, empleo y actividades sociales. Entre los factores que obstaculizan la vacunación (obstáculos) se encuentran la percepción de que la COVID-19 no es una amenaza grave; la preferencia por los remedios naturales; las preocupaciones por las contraindicaciones debido a afecciones de salud subyacentes; el miedo; la desconfianza en las vacunas y los mensajes relacionados; la accesibilidad a las vacunas; y las muy diferentes fuentes de información. Conclusiones. Es necesario superar la reticencia a la vacunación para combatir los efectos nocivos de la COVID-19 en Granada. Las políticas e intervenciones de salud pública que abordan los obstáculos y capitalizan los factores facilitadores pueden aumentar el uso efectivo de las vacunas.


RESUMO Objetivos. Identificar os fatores que contribuem para a hesitação em relação à vacina contra a doença por coronavírus 2019 (covid-19) em Granada. Métodos. Realizou-se um estudo fenomenológico com entrevistas semiestruturadas em clínicas de vacinação e testagem rápida durante um pico de casos de covid-19 na ilha. As perguntas da entrevista foram elaboradas com base no modelo de crenças em saúde relacionado à percepção de ameaça da covid-19, à percepção de benefícios e barreiras relativos à vacinação contra a covid-19, e aos estímulos para ação. Os dados foram analisados por um método dedutivo para identificar temas, categorias e subcategorias. Resultados. Vinte e cinco entrevistas foram transcritas e codificadas. No total, 68% dos participantes não eram vacinados, 12% eram parcialmente vacinados e 20% eram totalmente vacinados. A análise dos dados evidenciou dois temas principais: facilitadores e barreiras. Os fatores mais propensos a incentivar a vacinação (facilitadores) foram confiança na orientação médica e na eficácia da vacina, responsabilidade social e exigência de vacinação em viagens, no emprego e em atividades sociais. Entre os fatores que impediam a vacinação (barreiras) estavam: percepção de baixa ameaça da covid-19; preferência por remédios naturais; preocupação com contraindicações em razão de problemas de saúde preexistentes; medo; desconfiança das vacinas e mensagens relacionadas; acessibilidade da vacina; e as muitas diferentes fontes de informação. Conclusões. Superar a hesitação vacinal é imprescindível para combater as consequências negativas da covid-19 em Granada. As intervenções e políticas de saúde pública que afastam barreiras e promovem facilitadores podem aumentar a aceitação da vacina.

6.
Plant J ; 104(4): 1009-1022, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32890421

RESUMEN

Barley (Hordeum vulgare L) grain is comparatively rich in (1,3;1,4)-ß-glucan, a source of fermentable dietary fibre that protects against various human health conditions. However, low grain (1,3;1,4)-ß-glucan content is preferred for brewing and distilling. We took a reverse genetics approach, using CRISPR/Cas9 to generate mutations in members of the Cellulose synthase-like (Csl) gene superfamily that encode known (HvCslF6 and HvCslH1) and putative (HvCslF3 and HvCslF9) (1,3;1,4)-ß-glucan synthases. Resultant mutations ranged from single amino acid (aa) substitutions to frameshift mutations causing premature stop codons, and led to specific differences in grain morphology, composition and (1,3;1,4)-ß-glucan content. (1,3;1,4)-ß-Glucan was absent in the grain of cslf6 knockout lines, whereas cslf9 knockout lines had similar (1,3;1,4)-ß-glucan content to wild-type (WT). However, cslf9 mutants showed changes in the abundance of other cell-wall-related monosaccharides compared with WT. Thousand grain weight (TGW), grain length, width and surface area were altered in cslf6 knockouts, and to a lesser extent TGW in cslf9 knockouts. cslf3 and cslh1 mutants had no effect on grain (1,3;1,4)-ß-glucan content. Our data indicate that multiple members of the CslF/H family fulfil important functions during grain development but, with the exception of HvCslF6, do not impact the abundance of (1,3;1,4)-ß-glucan in mature grain.


Asunto(s)
Hordeum/enzimología , Proteínas de Plantas/metabolismo , beta-Glucanos/metabolismo , Pared Celular/metabolismo , Grano Comestible , Edición Génica , Glucosiltransferasas/genética , Glucosiltransferasas/metabolismo , Hordeum/genética , Mutagénesis Sitio-Dirigida , Mutación , Proteínas de Plantas/genética , Plantas Modificadas Genéticamente , Polisacáridos/metabolismo
7.
J Psychopharmacol ; 34(11): 1218-1225, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32842838

RESUMEN

BACKGROUND: Cocaine addiction is a global health issue with limited therapeutic options and a high relapse rate. Attentional bias towards substance-related cues may be an important factor for relapse. However, it has never been compared in former and current cocaine-dependent patients. METHODS: Attentional bias towards cocaine-related words was assessed using an emotional Stroop task in cocaine-dependent patients (N = 40), long-term abstinent former cocaine-dependent patients (N = 24; mean abstinence: 2 years) and control subjects (N = 28). Participants had to name the colour of cocaine-related words, neutral words and colour names. We assessed response times using an automatic voice-onset detection method we developed and we measured attentional bias as the difference in response times between cocaine-related and neutral conditions. RESULTS: There was an overall group effect on attentional bias towards cocaine, but no group effect on the colour Stroop effect. Two-by-two comparison showed a difference in attentional bias between cocaine-dependent patients and controls, whereas long-term abstinent former cocaine-dependent patients were not different from either. Although cocaine-dependent patients showed a significant attentional bias, consistent with the literature, neither long-term abstinent former cocaine-dependent patients nor controls showed a significant attentional bias towards cocaine-related words. We found no link between attentional bias size and either addiction severity or craving. CONCLUSIONS: Cocaine abstinence was associated with an absence of significant attentional bias towards cocaine-related words, which may be interpreted either as an absence of attentional bias predicting success in maintaining abstinence, or as attentional bias being able to disappear with long-term cocaine abstinence. Further research is needed to distinguish the role of attentional bias in maintaining abstinence.


Asunto(s)
Afecto/fisiología , Sesgo Atencional/fisiología , Trastornos Relacionados con Cocaína/fisiopatología , Señales (Psicología) , Desempeño Psicomotor/fisiología , Test de Stroop , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
8.
J R Coll Physicians Edinb ; 50(2): 114-117, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32568279

RESUMEN

BACKGROUND: The UK Medicines and Healthcare products Regulatory Agency (MHRA) published guidelines restricting the use of sodium valproate in women of childbearing age unless they consented to the pregnancy prevention programme (PPP), receiving counselling by an epilepsy specialist, or meeting exclusion criteria. METHODS: We contacted every woman of childbearing age on valproate for epilepsy in NHS Tayside (122). RESULTS: Seventeen out of 122 (13.9%) responded to the initial invitation to attend, and 25 out of 122 (20.4%) responded to a letter sent to their GP. Twenty-five attended, 21 completed a consent form, seven switched to another drug and three attended to express dissatisfaction with the MHRA guidance. There were 53 patients identified with learning difficulties. Consent was only taken from three patients, with carers declining to sign consent because the patient was not sexually active. CONCLUSION: Our study suggests that patients and carers do not wish to stop valproate or engage in PPP despite being made aware of MHRA guidance.


Asunto(s)
Epilepsia , Ácido Valproico , Anticonvulsivantes/uso terapéutico , Atención a la Salud , Epilepsia/tratamiento farmacológico , Femenino , Agencias Gubernamentales , Humanos , Embarazo , Ácido Valproico/uso terapéutico
9.
Commun Biol ; 3(1): 258, 2020 05 22.
Artículo en Inglés | MEDLINE | ID: mdl-32444849

RESUMEN

During plant growth, sodium (Na+) in the soil is transported via the xylem from the root to the shoot. While excess Na+ is toxic to most plants, non-toxic concentrations have been shown to improve crop yields under certain conditions, such as when soil K+ is low. We quantified grain Na+ across a barley genome-wide association study panel grown under non-saline conditions and identified variants of a Class 1 HIGH-AFFINITY-POTASSIUM-TRANSPORTER (HvHKT1;5)-encoding gene responsible for Na+ content variation under these conditions. A leucine to proline substitution at position 189 (L189P) in HvHKT1;5 disturbs its characteristic plasma membrane localisation and disrupts Na+ transport. Under low and moderate soil Na+, genotypes containing HvHKT1:5P189 accumulate high concentrations of Na+ but exhibit no evidence of toxicity. As the frequency of HvHKT1:5P189 increases significantly in cultivated European germplasm, we cautiously speculate that this non-functional variant may enhance yield potential in non-saline environments, possibly by offsetting limitations of low available K+.


Asunto(s)
Proteínas de Transporte de Catión/metabolismo , Regulación de la Expresión Génica de las Plantas , Hordeum/metabolismo , Proteínas de Plantas/metabolismo , Raíces de Plantas/metabolismo , Brotes de la Planta/metabolismo , Sodio/metabolismo , Proteínas de Transporte de Catión/genética , Estudio de Asociación del Genoma Completo , Hordeum/genética , Hordeum/crecimiento & desarrollo , Proteínas de Plantas/genética , Raíces de Plantas/genética , Raíces de Plantas/crecimiento & desarrollo , Brotes de la Planta/genética , Brotes de la Planta/crecimiento & desarrollo
10.
J Neuroendocrinol ; 32(6): e12855, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32436241

RESUMEN

Phoenixin (PNX) is a neuropeptide shown to play roles in the control of reproduction. The nucleus of the solitary tract (NTS), a critical autonomic integrating centre in the hindbrain, is one of many areas with dense expression of PNX. Using coronal NTS slices obtained from male Sprague-Dawley rats, the present study characterised the effects of PNX on both spike frequency and membrane potential of NTS neurones. Extracellular recordings demonstrated that bath-applied 10 nmol L-1 PNX increased the firing frequency in 32% of NTS neurones, effects which were confirmed with patch-clamp recordings showing that 50% of NTS neurones tested depolarised in response to application of the peptide. Surprisingly, the responsiveness to PNX in NTS neurones then declined suddenly to 9% (P < 0.001). This effect was subsequently attributed to stress associated with construction in our animal care facility because PNX responsiveness was again observed in slices from rats delivered and maintained in a construction-free facility. We then examined whether this loss of PNX responsiveness could be replicated in rats placed on a chronic stress regimen involving ongoing corticosterone (CORT) treatment in the construction-free facility. Slices from animals treated in this way showed a similar lack of neuronal responsiveness to PNX (9.1 ± 3.9%) within 2 weeks of CORT treatment. These effects were specific to PNX responsiveness because CORT treatment had no effect on the responsiveness of NTS neurones to angiotensin II. These results are the first to implicate PNX with respect to directly controlling the excitability of NTS neurones and also provide intriguing data showing the plasticity of these effects associated with environmental and glucocorticoid stress levels of the animal.


Asunto(s)
Microambiente Celular , Glucocorticoides/efectos adversos , Neuronas/efectos de los fármacos , Hormonas Peptídicas/farmacología , Núcleo Solitario/efectos de los fármacos , Potenciales de Acción/efectos de los fármacos , Animales , Microambiente Celular/efectos de los fármacos , Microambiente Celular/fisiología , Estimulación Eléctrica , Fenómenos Electrofisiológicos/efectos de los fármacos , Masculino , Potenciales de la Membrana/efectos de los fármacos , Neuronas/fisiología , Ratas , Ratas Sprague-Dawley , Núcleo Solitario/citología , Núcleo Solitario/fisiología , Estrés Fisiológico/efectos de los fármacos , Estrés Fisiológico/fisiología
11.
Home Health Care Serv Q ; 38(1): 1-13, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30570415

RESUMEN

We describe a community-engaged approach to develop and pilot a home care aide (HCA) administered health interview with Medicaid Home and Community-based Services clients. Stakeholders identified five priority health topics and selected a card sorting methodology for interviews. A barrier to interviewing clients was decreased communication skills among HCAs, and we modified health interview training to include communication training. Stakeholders reported the interview methodology was feasible within usual care, acceptable to clients, and contributed to increased knowledge on providing person-centered care. Stakeholder engagement resulted in valuable insights regarding the health interview methodology and relevant training needs.


Asunto(s)
Servicios de Salud Comunitaria/normas , Servicios de Atención de Salud a Domicilio/normas , Auxiliares de Salud a Domicilio/educación , Entrevistas como Asunto/normas , Medicaid/normas , Desarrollo de Personal/métodos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Grupos Focales , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos
12.
Brain Sci ; 8(8)2018 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-30096863

RESUMEN

Obsessive⁻compulsive disorder (OCD) affects about 2% of the general population, for which several etiological factors were identified. Important among these is immunological dysfunction. This review aims to show how immunology can inform specific etiological factors, and how distinguishing between these etiologies is important from a personalized treatment perspective. We found discrepancies concerning cytokines, raising the hypothesis of specific immunological etiological factors. Antibody studies support the existence of a potential autoimmune etiological factor. Infections may also provoke OCD symptoms, and therefore, could be considered as specific etiological factors with specific immunological impairments. Finally, we underline the importance of distinguishing between different etiological factors since some specific treatments already exist in the context of immunological factors for the improvement of classic treatments.

13.
Physiol Rep ; 6(10): e13704, 2018 05.
Artículo en Inglés | MEDLINE | ID: mdl-29802680

RESUMEN

Brain-derived neurotrophic factor (BDNF), a neurotrophin traditionally associated with neural plasticity, has more recently been implicated in fluid balance and cardiovascular regulation. It is abundantly expressed in both the central nervous system (CNS) and peripheral tissue, and is also found in circulation. Studies suggest that circulating BDNF may influence the CNS through actions at the subfornical organ (SFO), a circumventricular organ (CVO) characterized by the lack of a normal blood-brain barrier (BBB). The SFO, well-known for its involvement in cardiovascular regulation, has been shown to express BDNF mRNA and mRNA for the TrkB receptor at which BDNF preferentially binds. This study was undertaken to determine if: (1) BDNF influences the excitability of SFO neurons in vitro; and (2) the cardiovascular consequences of direct administration of BDNF into the SFO of anesthetized rats. Electrophysiological studies revealed that bath application of BDNF (1 nmol/L) influenced the excitability of the majority of neurons (60%, n = 13/22), the majority of which exhibited a membrane depolarization (13.8 ± 2.5 mV, n = 9) with the remaining affected cells exhibiting hyperpolarizations (-11.1 ± 2.3 mV, n = 4). BDNF microinjections into the SFO of anesthetized rats caused a significant decrease in blood pressure (mean [area under the curve] AUC = -364.4 ± 89.0 mmHg × sec, n = 5) with no effects on heart rate (mean AUC = -12.2 ± 3.4, n = 5). Together these observations suggest the SFO to be a CNS site at which circulating BDNF could exert its effects on cardiovascular regulation.


Asunto(s)
Presión Sanguínea/efectos de los fármacos , Factor Neurotrófico Derivado del Encéfalo/fisiología , Frecuencia Cardíaca/efectos de los fármacos , Neuronas/fisiología , Órgano Subfornical/fisiología , Potenciales de Acción/efectos de los fármacos , Animales , Factor Neurotrófico Derivado del Encéfalo/administración & dosificación , Masculino , Neuronas/efectos de los fármacos , Ratas Sprague-Dawley , Órgano Subfornical/efectos de los fármacos
14.
Sci Rep ; 6: 34728, 2016 10 05.
Artículo en Inglés | MEDLINE | ID: mdl-27703225

RESUMEN

Schizophrenia has been characterized by an impaired mentalizing. It has been suggested that distinguishing implicit from explicit processes is crucial in social cognition, and only the latter might be affected in schizophrenia. Two other questions remain open: (1) Is schizophrenia characterized by an hypo- or hyper attribution of intentions? (2) Is it characterized by a deficit in the attribution of intention or of contingency? To test these three questions, spontaneous mentalizing was tested in 29 individuals with schizophrenia and 29 control subjects using the Frith-Happé animations, while eye movements were recorded. Explicit mentalizing was measured from participants' verbal descriptions and was contrasted with implicit mentalizing measured through eye tracking. As a group, patients made less accurate and less intentional descriptions of the goal-directed and theory of mind animations. No group differences were found in the attribution of contingency. Eye tracking results revealed that patients and controls showed a similar modulation of eye movements in response to the mental states displayed in the Frith-Happé animations. To conclude, in this paradigm, participants with schizophrenia showed a dissociation between explicit and implicit mentalizing, with a decrease in the explicit attribution of intentions, whereas their eye movements suggested a preserved implicit perception of intentions.


Asunto(s)
Movimientos Oculares/fisiología , Esquizofrenia/fisiopatología , Teoría de la Mente/fisiología , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Reconocimiento Visual de Modelos , Psicología del Esquizofrénico
15.
F1000Res ; 52016.
Artículo en Inglés | MEDLINE | ID: mdl-27092251

RESUMEN

The central nervous system (CNS) in concert with the heart and vasculature is essential to maintaining cardiovascular (CV) homeostasis. In recent years, our understanding of CNS control of blood pressure regulation (and dysregulation leading to hypertension) has evolved substantially to include (i) the actions of signaling molecules that are not classically viewed as CV signaling molecules, some of which exert effects at CNS targets in a non-traditional manner, and (ii) CNS locations not traditionally viewed as central autonomic cardiovascular centers. This review summarizes recent work implicating immune signals and reproductive hormones, as well as gasotransmitters and reactive oxygen species in the pathogenesis of hypertension at traditional CV control centers. Additionally, recent work implicating non-conventional CNS structures in CV regulation is discussed.

16.
Am J Physiol Regul Integr Comp Physiol ; 310(5): R440-8, 2016 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-26719304

RESUMEN

The area postrema (AP) is a circumventricular organ with important roles in central autonomic regulation. This medullary structure has been shown to express the leptin receptor and has been suggested to have a role in modulating peripheral signals, indicating energy status. Using RT-PCR, we have confirmed the presence of mRNA for the leptin receptor, ObRb, in AP, and whole cell current-clamp recordings from dissociated AP neurons demonstrated that leptin influenced the excitability of 51% (42/82) of AP neurons. The majority of responsive neurons (62%) exhibited a depolarization (5.3 ± 0.7 mV), while the remaining affected cells (16/42) demonstrated hyperpolarizing effects (-5.96 ± 0.95 mV). Amylin was found to influence the same population of AP neurons. To elucidate the mechanism(s) of leptin and amylin actions in the AP, we used fluorescence resonance energy transfer (FRET) to determine the effect of these peptides on cAMP levels in single AP neurons. Leptin and amylin were found to elevate cAMP levels in the same dissociated AP neurons (leptin: % total FRET response 25.3 ± 4.9, n = 14; amylin: % total FRET response 21.7 ± 3.1, n = 13). When leptin and amylin were coapplied, % total FRET response rose to 53.0 ± 8.3 (n = 6). The demonstration that leptin and amylin influence a subpopulation of AP neurons and that these two signaling molecules have additive effects on single AP neurons to increase cAMP, supports a role for the AP as a central nervous system location at which these circulating signals may act through common intracellular signaling pathways to influence central control of energy balance.


Asunto(s)
Área Postrema/efectos de los fármacos , Leptina/farmacología , Neuronas/efectos de los fármacos , Receptores de Leptina/agonistas , Potenciales de Acción , Animales , Área Postrema/citología , Área Postrema/metabolismo , Células Cultivadas , AMP Cíclico/metabolismo , Metabolismo Energético/efectos de los fármacos , Técnicas In Vitro , Polipéptido Amiloide de los Islotes Pancreáticos/farmacología , Masculino , Neuronas/metabolismo , ARN Mensajero/metabolismo , Ratas Sprague-Dawley , Receptores de Leptina/genética , Receptores de Leptina/metabolismo , Sistemas de Mensajero Secundario/efectos de los fármacos , Factores de Tiempo
17.
Int J Audiol ; 53(10): 770-3, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25158607

RESUMEN

OBJECTIVE: To investigate the benefits in reported outcomes after providing bluetooth accessories for established hearing aid users. DESIGN: Prospective observational study using validated quantitative outcome measures and detailed patient narrative before and two months after patients were provided with bluetooth accessories. STUDY SAMPLE: Twelve patients with bilateral NHS hearing aids participated. They had a wide range of ages and hearing loss. RESULTS: After two months, 10 patients reported substantial additional benefit and kept the accessories; two returned them for various reasons. Statistically significant changes were seen in two validated outcome measures: the Glasgow Hearing Aid Benefit Profile and the International Outcome Inventory - Hearing Aids, but not in the Speech, Spatial and Qualities of Hearing Scale. Two notable benefits were reported: some described hearing the emotion and mood in a voice for the first time; others were amazed to report an improved ability to hear film or to hold conversations over the telephone. CONCLUSIONS: The provision of bluetooth accessories can give additional reported benefit for some patients - we need better knowledge about who benefits, and whether further support/training to individuals would make a difference.


Asunto(s)
Audífonos , Pérdida Auditiva/terapia , Telecomunicaciones/instrumentación , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Adulto Joven
18.
Front Psychol ; 5: 832, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25120524

RESUMEN

Obesity is a chronic metabolic condition with important public health implications associated with numerous co-morbidities including cardiovascular disease, insulin resistance, and hypertension. The renin angiotensin system (RAS), best known for its involvement in cardiovascular control and body fluid homeostasis has, more recently, been implicated in regulation of energy balance. Interference with the RAS (genetically or pharmacologically) has been shown to influence body weight gain. In this study we investigated the effects of systemic AT1 receptor blockade using losartan on ingestive behaviors and weight gain in diet induced obese (DIO) rats. Prior to losartan administration (30 mg/kg/day) body weight gain remained constant within the DIO animals (3.6 ± 0.3 g/day, n = 8), diet resistant (DR) animals (2.1 ± 0.6 g/day, n = 8) and in the age-matched chow fed control (CHOW) animals (2.8 ± 0.3 g/day, n = 8), Losartan administration abolished body weight gain in animals fed a high fat diet (DIO: -0.4 ± 0.7 g/day, n = 8; and DR: -0.8 ± 0.3 g/day, n = 8) while chow fed animals continued to gain weight (2.2 ± 0.3 g/day, n = 8) as they had previously to oral administration of losartan. This decrease in daily body weight gain was accompanied by a decrease in food intake in the HFD fed animals. Following the removal of losartan, both the DIO and DR animals again showed daily increases in body weight gain and food intake which were similar to control values. Our data demonstrate that oral losartan administration attenuates body weight gain in animals fed a HFD whether the animal is obese (DIO) or not DR while having no effect on body weight gain in age-matched chow fed animals suggesting a protective effect of losartan against body weight gain while on a HFD.

19.
PLoS One ; 9(8): e105772, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25144759

RESUMEN

Hydrogen sulfide (H2S), a gasotransmitter endogenously found in the central nervous system, has recently been suggested to act as a signalling molecule in the brain having beneficial effects on cardiovascular function. This study was thus undertaken to investigate the effect of NaHS (an H2S donor) in the subfornical organ (SFO), a central nervous system site important to blood pressure regulation. We used male Sprague-Dawley rats for both in vivo and in vitro experiments. We first used RT-PCR to confirm our previous microarray analyses showing that mRNAs for the enzymes required to produce H2S are expressed in the SFO. We then used microinjection techniques to investigate the physiological effects of NaHS in SFO, and found that NaHS microinjection (5 nmol) significantly increased blood pressure (mean AUC = 853.5±105.7 mmHg*s, n = 5). Further, we used patch-clamp electrophysiology and found that 97.8% (88 of 90) of neurons depolarized in response to NaHS. This response was found to be concentration dependent with an EC50 of 35.6 µM. Coupled with the depolarized membrane potential, we observed an overall increase in neuronal excitability using an analysis of rheobase and action potential firing patterns. This study has provided the first evidence of NaHS and thus H2S actions and their cellular correlates in SFO, implicating this brain area as a site where H2S may act to control blood pressure.


Asunto(s)
Presión Sanguínea/efectos de los fármacos , Gasotransmisores/farmacología , Sulfuro de Hidrógeno/farmacología , Neuronas/metabolismo , Órgano Subfornical/metabolismo , Animales , Gasotransmisores/metabolismo , Sulfuro de Hidrógeno/metabolismo , Masculino , Proteínas del Tejido Nervioso/biosíntesis , ARN Mensajero/biosíntesis , Ratas , Ratas Sprague-Dawley
20.
J Sci Food Agric ; 94(15): 3234-40, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24668758

RESUMEN

BACKGROUND: Soft-milling wheat has potential use for both grain whisky distilling and bioethanol production. Varietal comparisons over wide-ranging environments would permit assessment of both grain and alcohol yield potential and also permit the stability across environments, for these parameters, to be compared. RESULTS: For 12 varieties, analysis of variance showed highly significant effects of variety, site, season and fertiliser application on grain and alcohol yield. There were also significant interactions between these factors and, consequently, varieties varied in stability across environments as well as in mean values for the parameters assessed. Alcohol production per hectare was affected more strongly by variation in grain yield than alcohol yield, but increasing grain protein content reduced alcohol yield and, therefore, utility for grain distilling. CONCLUSION: To maximise energy production, the best varieties for bioethanol would combine high and stable grain yield with slower reduction of alcohol yield as grain protein increases. For grain distilling, where the energy balance is less important, high alcohol yield will remain the key factor. Data derived using near infrared spectroscopy can be valuable in assessing stability of quality traits across environments.


Asunto(s)
Biocombustibles , Grano Comestible/crecimiento & desarrollo , Etanol/metabolismo , Triticum/crecimiento & desarrollo , Bebidas Alcohólicas , Destilación , Estabilidad de Medicamentos , Grano Comestible/metabolismo , Ambiente , Fertilizantes , Estaciones del Año , Triticum/metabolismo
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