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1.
Behav Ther ; 53(6): 1233-1249, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36229119

RESUMO

Groups 4 Health (G4H) is a group psychotherapy program that targets social group disconnection. An emerging evidence base supports its efficacy in reducing loneliness, depression, and social anxiety. However, to date there has been no formal analysis of its acceptability to clients and therapists, nor an investigation of its feasibility for wider implementation. This input from end users is crucial to ensure the program's wider suitability and to contribute to its improvement. This study drew data from three clinical trials, including 266 G4H clients and 68 G4H therapists. From the Phase III trial only, additional data were available from 90 clients in a dose-controlled cognitive-behavioral therapy (CBT) comparison group, and focus groups/interviews with 6 therapists and 13 clients. Client satisfaction was high, with all average ratings >7/10, significantly exceeding the CBT comparison group. Therapist satisfaction with each module was >5/7. Retention was >80%. Homework completion was high, with <10% of clients saying that they had not attempted the homework. Therapists and clients both emphasized the benefits arising from G4H, and the contribution of the group context itself as a vehicle to achieve positive outcomes.


Assuntos
Terapia Cognitivo-Comportamental , Psicoterapia de Grupo , Ensaios Clínicos Fase III como Assunto , Estudos de Viabilidade , Humanos , Solidão , Satisfação Pessoal , Resultado do Tratamento
2.
J Vis Exp ; (184)2022 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-35815999

RESUMO

Identification and isolation of contagious individuals along with quarantine of close contacts, is critical for slowing the spread of COVID-19. Large-scale testing in a surveillance or screening capacity for asymptomatic carriers of COVID-19 provides both data on viral spread and the follow-up ability to rapidly test individuals during suspected outbreaks. The COVID-19 early detection program at Michigan State University has been utilizing large-scale testing in a surveillance or screening capacity since fall of 2020. The methods adapted here take advantage of the reliability, large sample volume, and self-collection benefits of saliva, paired with a cost-effective, reagent conserving two-dimensional pooling scheme. The process was designed to be adaptable to supply shortages, with many components of the kits and the assay easily substituted. The processes outlined for collecting and processing SARS-CoV-2 samples can be adapted to test for future viral pathogens reliably expressed in saliva. By providing this blueprint for universities or other organizations, preparedness plans for future viral outbreaks can be developed.


Assuntos
COVID-19 , SARS-CoV-2 , COVID-19/diagnóstico , Teste para COVID-19 , Humanos , Reprodutibilidade dos Testes , Saliva , Manejo de Espécimes
3.
BMC Public Health ; 21(1): 869, 2021 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-33952235

RESUMO

BACKGROUND: The social identity model of risk taking proposes that people take more risks with ingroup members because they trust them more. While this can be beneficial in some circumstances, in the context of the COVID-19 pandemic it has the potential to undermine an effective public health response if people underestimate the risk of contagion posed by ingroup members, or overestimate the risk of vaccines or treatments developed by outgroup members. METHODS: Three studies (two prospective surveys, one experiment) with community-based adults tested the potential for the social identity model of risk taking to explain risk perception and risk taking in the context of COVID-19. RESULTS: Study 1 was a two-wave study with a pre-COVID baseline, and found that people who identified more strongly as a member of their neighborhood pre-COVID tended to trust their neighbors more, and perceive interacting with them during COVID-19 lockdown to be less risky. Study 2 (N = 2033) replicated these findings in a two-wave nationally representative Australian sample. Study 3 (N = 216) was a pre-registered experiment which found that people indicated greater willingness to take a vaccine, and perceived it to be less risky, when it was developed by an ingroup compared to an outgroup source. We interpret this as evidence that the tendency to trust ingroup members more could be harnessed to enhance the COVID-19 response. CONCLUSIONS: Across all three studies, ingroup members were trusted more and were perceived to pose less health risk. These findings are discussed with a focus on how group processes can be more effectively incorporated into public health policy, both for the current pandemic and for future contagious disease threats.


Assuntos
COVID-19 , Confiança , Adulto , Austrália/epidemiologia , Controle de Doenças Transmissíveis , Humanos , Pandemias , Estudos Prospectivos , SARS-CoV-2
4.
Neurol Neuroimmunol Neuroinflamm ; 4(5): e390, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28828394

RESUMO

OBJECTIVE: To assess, using structural image evaluation using normalization of atrophy (SIENA), the effect of teriflunomide, a once-daily oral immunomodulator, on brain volume loss (BVL) in patients with relapsing forms of MS enrolled in the phase 3 TEMSO study. METHODS: TEMSO MR scans were analyzed (study personnel masked to treatment allocation) using SIENA to assess brain volume changes between baseline and years 1 and 2 in patients treated with placebo or teriflunomide. Treatment group comparisons were made via rank analysis of covariance. RESULTS: Data from 969 patient MRI visits were included in this analysis: 808 patients had baseline and year 1 MRI; 709 patients had baseline and year 2 MRI. Median percentage BVL from baseline to year 1 and year 2 for placebo was 0.61% and 1.29%, respectively, and for teriflunomide 14 mg, 0.39% and 0.90%, respectively. BVL was lower for teriflunomide 14 mg vs placebo at year 1 (36.9% relative reduction, p = 0.0001) and year 2 (30.6% relative reduction, p = 0.0001). Teriflunomide 7 mg was also associated with significant reduction in BVL vs placebo over the 2-year study. The significant effects of teriflunomide 14 mg on BVL were observed in both patients with and without on-study disability worsening. CONCLUSIONS: The significant reduction of BVL vs placebo over 2 years achieved with teriflunomide is consistent with its effects on delaying disability worsening and suggests a neuroprotective potential. CLASSIFICATION OF EVIDENCE: Class II evidence shows that teriflunomide treatment significantly reduces BVL over 2 years vs placebo. CLINICALTRIALSGOV IDENTIFIER: NCT00134563.

5.
Tissue Barriers ; 4(3): e1206378, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27583193

RESUMO

The bronchial epithelium and underlying fibroblasts form an epithelial mesenchymal trophic unit (EMTU) which controls the airway microenvironment. We hypothesized that cell-cell communication within the EMTU propagates and amplifies the innate immune response to respiratory viral infections. EMTU co-culture models incorporating polarized (16HBE14o-) or differentiated primary human bronchial epithelial cells (HBECs) and fibroblasts were challenged with double-stranded RNA (dsRNA) or rhinovirus. In the polarized EMTU model, dsRNA affected ionic but not macromolecular permeability or cell viability. Compared with epithelial monocultures, dsRNA-stimulated pro-inflammatory mediator release was synergistically enhanced in the basolateral compartment of the EMTU model, with the exception of IL-1α which was unaffected by the presence of fibroblasts. Blockade of IL-1 signaling with IL-1 receptor antagonist (IL-1Ra) completely abrogated dsRNA-induced basolateral release of mediators except CXCL10. Fibroblasts were the main responders to epithelial-derived IL-1 since exogenous IL-1α induced pro-inflammatory mediator release from fibroblast but not epithelial monocultures. Our findings were confirmed in a differentiated EMTU model where rhinovirus infection of primary HBECs and fibroblasts resulted in synergistic induction of basolateral IL-6 that was significantly abrogated by IL-1Ra. This study provides the first direct evidence of integrated IL-1 signaling within the EMTU to propagate inflammatory responses to viral infection.


Assuntos
Comunicação Celular , Microambiente Celular , Células Epiteliais/metabolismo , Fibroblastos/metabolismo , Interleucina-1alfa/metabolismo , Mucosa Respiratória/metabolismo , Permeabilidade Capilar , Linhagem Celular , Células Cultivadas , Quimiocina CXCL10/metabolismo , Células Epiteliais/virologia , Fibroblastos/virologia , Humanos , Mucosa Respiratória/citologia , Mucosa Respiratória/virologia , Rhinovirus/patogenicidade , Transdução de Sinais
6.
Nature ; 505(7482): 186-9, 2014 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-24317694

RESUMO

Galaxies observed at redshift z > 6, when the Universe was less than a billion years old, thus far very rarely show evidence of the cold dust that accompanies star formation in the local Universe, where the dust-to-gas mass ratio is around one per cent. A prototypical example is the galaxy Himiko (z = 6.6), which--a mere 840 million years after the Big Bang--is forming stars at a rate of 30-100 solar masses per year, yielding a mass assembly time of about 150 × 10(6) years. Himiko is thought to have a low fraction (2-3 per cent of the Sun's) of elements heavier than helium (low metallicity), and although its gas mass cannot yet be determined its dust-to-stellar mass ratio is constrained to be less than 0.05 per cent. The local dwarf galaxy I Zwicky 18, which has a metallicity about 4 per cent that of the Sun's and is forming stars less rapidly (assembly time about 1.6 × 10(9) years) than Himiko but still vigorously for its mass, is also very dust deficient and is perhaps one of the best analogues of primitive galaxies accessible to detailed study. Here we report observations of dust emission from I Zw 18, from which we determine its dust mass to be 450-1,800 solar masses, yielding a dust-to-stellar mass ratio of about 10(-6) to 10(-5) and a dust-to-gas mass ratio of 3.2-13 × 10(-6). If I Zw 18 is a reasonable analogue of Himiko, then Himiko's dust mass must be around 50,000 solar masses, a factor of 100 below the current upper limit. These numbers are quite uncertain, but if most high-z galaxies are more like Himiko than like the very-high-dust-mass galaxy SDSS J114816.64 + 525150.3 at z ≈ 6, which hosts a quasar, then our prospects for detecting the gas and dust inside such galaxies are much poorer than hitherto anticipated.

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