Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 327
Filtrar
1.
Appetite ; 168: 105706, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34560159

RESUMO

Negative emotional experiences are associated with dysregulated eating behaviors that impede weight management. While weight loss interventions promote physical activity and self-regulation of eating, no studies have examined how physical activity may directly influence eating by attenuating associations between negative emotions and eating. OBJECTIVE: The current study examined how momentary negative emotions (stress and anxiety), moderate-to-vigorous intensity physical activity (MVPA), and their interactions predict eating dysregulation (i.e., intensity of eating temptations, inability to resist eating tempting foods, overeating), as well as how these associations change during a weight loss intervention. METHODS: Women with overweight/obesity (N = 55) completed 14-day ecological momentary assessment (EMA) protocols with objective measurement of physical activity (i.e., bout-related MVPA time) before and after a three-month internet-based weight loss program. RESULTS: Three-way interactions emerged predicting overeating and eating tempting foods. When women experienced higher than usual levels of momentary anxiety or stress at end-of-treatment, they were less likely to subsequently overeat or eat tempting foods when they had recently engaged in more MVPA (relative to their usual level). No significant associations were found for ratings of temptation intensity. CONCLUSIONS: Findings suggest MVPA may exert direct effects on eating regulation. Specifically, MVPA appears to increasingly buffer the effect of negative emotional states on dysregulated eating behavior over the course of a weight loss intervention. Future work is needed to develop ways of communicating to patients how activity can have both indirect and direct effects on body weight, and examine whether such knowledge improves outcomes.


Assuntos
Exercício Físico , Sobrepeso , Ansiedade , Comportamento Alimentar , Feminino , Humanos , Hiperfagia , Sobrepeso/terapia , Perda de Peso
2.
Appetite ; 168: 105789, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34728251

RESUMO

Eating in response to external food cues (i.e., external eating) and internal emotional experiences (i.e., emotional eating) are associated with obesity. While external and emotional eating co-occur, little is known about how external food cue responsiveness may interact with internal emotional cues to influence eating episodes in adolescents. The current study examined how trait-level external food cue responsiveness modulates momentary associations between affective states and eating in adolescents. Participants were drawn from a prior study of siblings (N = 78; ages 13-17) who completed an ecological momentary assessment protocol to assess eating episodes and affective states. External food cue responsiveness was determined by comparing energy consumption following presentation of an appetizing food (pizza) on one day and a control activity (reading) on another day. Generalized linear mixed models examined positive and negative affective states, cue responsiveness, and their interactions as predictors of the likelihood of eating. The relationship between affective states and likelihood of eating was stronger among adolescents with higher versus lower external food cue responsiveness. Among adolescents with higher cue responsiveness, endorsing negative affect was associated with a lower likelihood of eating, whereas endorsing positive affect was associated with a higher likelihood of eating (within-person effects). Findings suggest that high sensitivity to external food cues and greater proclivity for emotional eating may be likely to coincide such that any cue, internal or external, is likely to disrupt sensitivity to internal hunger and satiety signals. Future studies are needed to elucidate how sensitivities to internal and external cues may interact to influence obesity risk.


Assuntos
Sinais (Psicologia) , Alimentos , Adolescente , Ingestão de Alimentos , Emoções , Comportamento Alimentar , Humanos , Fome , Obesidade
3.
Mult Scler ; : 13524585211059766, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34850641

RESUMO

BACKGROUND: Progressive forms of multiple sclerosis (MS) affect more than 1 million individuals globally. Recent approvals of ocrelizumab for primary progressive MS and siponimod for active secondary progressive MS have opened the therapeutic door, though results from early trials of neuroprotective agents have been mixed. The recent introduction of the term 'active' secondary progressive MS into the therapeutic lexicon has introduced potential confusion to disease description and thereby clinical management. OBJECTIVE: This paper reviews recent progress, highlights continued knowledge and proposes, on behalf of the International Progressive MS Alliance, a global research strategy for progressive MS. METHODS: Literature searches of PubMed between 2015 and May, 2021 were conducted using the search terms "progressive multiple sclerosis", "primary progressive multiple sclerosis", "secondary progressive MS". Proposed strategies were developed through a series of in-person and virtual meetings of the International Progressive MS Alliance Scientific Steering Committee. RESULTS: Sustaining and accelerating progress will require greater understanding of underlying mechanisms, identification of potential therapeutic targets, biomarker discovery and validation, and conduct of clinical trials with improved trial design. Encouraging developments in symptomatic and rehabilitative interventions are starting to address ongoing challenges experienced by people with progressive MS. CONCLUSION: We need to manage these challenges and realise the opportunities in the context of a global research strategy, which will improve quality of life for people with progressive MS.

5.
Am J Pharm Educ ; : 8761, 2021 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-34785498

RESUMO

Objective. The objectives of this study were to (1) develop SJT scenarios for use in teaching empathy, assertiveness, and interprofessional communication in second-year pharmacy (P2) students, and ethics in third-year (P3) pharmacy students, (2) determine if SJTs developed were effective at measuring student's communication skills and ethical judgment, (3) compare the performance of individual P3 students to the performance of teams of P3 students on the ethics SJT and (4) evaluate student feedback about SJTs as a teaching tool.Methods. Pharmacy faculty developed five SJT scenarios related to communications and five SJT scenarios related to ethics and piloted the scenarios with P2 and P3 students, respectively. P2 students completed SJTs individually while P3 students completed theirs individually and as a team. Scenarios and responses were discussed with faculty after completion of the SJT. Students completed a questionnaire to provide feedback on the SJT.Results The communications SJT was completed by 59 P2 students with a mean score of 67.5% and reliability of α=0.594. The ethics SJT was completed by 57 P3 students with a mean score of 80.1% and reliability of α=0.789. The ethics SJT was also completed by 10 teams of P3 students resulting in a mean score of 93.2%. Students indicated the SJT content was realistic and the tests provided the opportunity to reflect on how to approach challenging situations.Conclusion SJTs were useful for teaching empathy, assertiveness, interprofessional communication, and ethics in pharmacy students. Future research should focus on predictive validity of SJTs for these content areas.

6.
Prev Med ; 154: 106864, 2021 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-34740677

RESUMO

It has long been known that social and physical environments can shape individual and population health, for better or worse. Master-planned communities (MPCs) in the US are custom-designed residential neighborhoods with defined boundaries planned and developed under a single, private owner or entity from their inception. Across the US, these vary greatly in scale ranging from 100 to over 50,000 homes, but broadly all provide residents with housing, infrastructure, landscaping, and purpose-built facilities to support socialization. Current research in the urban planning literature suggests that MPCs can influence the health of their residents. However, few studies have examined the use of MPCs as settings to conduct individual or population health research. In this paper, we examine the potential of MPCs as context for observational or intervention studies aimed at understanding individual and population-level health and well-being. We first summarize links between built and social environment and individual and population health research. Next, we describe the history of planned communities in the US. Then, we review specific features of MPCs related to governance, development, design, and social structure. We end by exploring how those specific features may lead to potential opportunities and challenges when using MPCs in health research. Through this discussion, we highlight MPCs as overlooked settings that may offer potential for collaborative, innovative, and socially engaged health research.

7.
Clin Psychol Sci ; 9(4): 752-760, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34765322

RESUMO

This report examined baseline affective response to binge eating as a predictor of binge-eating disorder (BED) treatment outcome. Baseline affective response was defined as: (1) each individual's average net change (i.e., area under the curve [AUC]) of positive affect (PA) or negative affect (NA) before and after binge-eating episodes and (2) post-binge eating slope of PA or NA across seven-days of ecological momentary assessment (EMA). Adults with BED completed Integrative Cognitive-Affective Therapy (ICAT-BED) or cognitive behavioral therapy guided self-help (CBTgsh). Individuals with greater net increases in PA (AUC) following binge eating at baseline exhibited better treatment response in ICAT-BED at end-of-treatment and follow-up. NA affective response was only significant at end-of-treatment; individuals with less rapid post-binge improvements in NA (slope) did better in ICAT-BED, while individuals with lower net improvements in NA (AUC) did better in CBTgsh. Affective response to binge eating may be a marker of BED treatment response.

8.
J Clin Pharmacol ; 2021 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-34775634

RESUMO

The opioid epidemic has resulted in increased opioid-related critical care admissions, presenting challenges in acute pain management. Limited guidance exists in the management of critically ill patients with opioid use disorder (OUD). This narrative review provides the intensive care unit (ICU) clinician with guidance and treatment options, including non-opioid analgesia, for patients receiving medications for opioid use disorder (MOUD) and for patients actively misusing opioids. Verification and continuation of the patient's outpatient MOUD regimen, specifically buprenorphine and methadone formulations, assessment of pain and opioid withdrawal, and treatment of acute pain with non-opioid analgesia, nonpharmacologic strategies, and short-acting opioids as needed, are all essential to adequate management of acute pain in patients with OUD. A multidisciplinary approach to treatment and discharge planning in patients with OUD may be beneficial to engage patients with OUD early in their hospital stay to prevent withdrawal, stabilize their OUD, and to reduce the risk of unplanned discharge and other associated morbidity. This article is protected by copyright. All rights reserved.

9.
J Phys Chem B ; 2021 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-34734716

RESUMO

A computational scheme was used to screen physical solvents for CO2 pre-combustion capture by integrating the commercial NIST database, an in-house computational database, chem-informatics, and molecular modeling. A commercially available screened hydrophobic solvent, diethyl sebacate, was identified from the screening with favorable physical properties and promising absorption performance. The promising performance to use diethyl sebacate in CO2 pre-combustion capture has also been confirmed from experiments. Water loading in diethyl sebacate is very low, and therefore, water is kept with H2 in the gas stream. The favorable CO2 interaction with diethyl sebacate and the intermediate solvent free volume fraction leads to both high CO2 solubility and high CO2/H2 solubility selectivity in diethyl sebacate. An in-house NETL computational database was built to characterize CO2, H2, N2, and H2O interactions with 202 different chemical functional groups. It was found that 13% of the functional groups belong to the strong interaction category with the CO2 interaction energy between -15 and -21 kJ/mol; 62% of the functional groups interact intermediately with CO2 (-8 to -15 kJ/mol). The remaining 25% of functional groups interact weakly with CO2 (below -8 kJ/mol). In addition, calculations show that CO2 interactions with the functional groups are stronger than N2 and H2 interactions but are weaker than H2O interactions. The CO2 and H2O interactions with the same functional groups exhibit a very strong linear positive correlation coefficient of 0.92. The relationship between CO2 and H2 gas solubilities and solvent fractional free volume (FFV) has been systematically studied for seven solvents at 298.2 K. A skewed bell-shaped relation was obtained between CO2 solubility and solvent FFV. When an organic compound has a density approximately 10% lower than its density at 298.2 K and 1 bar, it exhibits the highest CO2 loading at that specific solvent density and FFV. Note that the solvent densities were varied using simulations, which are difficult to be obtained from the experiment. In contrast, H2 solubility results exhibit an almost perfect positive linear correlation with the solvent FFV. The theoretical maximum and minimum physical CO2 solubilities in any organic compound at 298.2 K were estimated to be 11 and 0.4 mol/MPa L, respectively. An examination of 182 experimental CO2 physical solubility data and 29 simulated CO2 physical solubilities shows that all the CO2 physical solubility data are within the maximum and minimum with only a few exceptions. Finally, simulations suggest that in order to develop physical solvents with both high CO2 solubility and high CO2/H2 solubility selectivity, the solvents should contain functional groups which are available to interact strongly with CO2 while minimizing FFV.

10.
Psychol Sport Exerc ; 572021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34737670

RESUMO

Background: Affective responses are posited to be key predictors of the uptake and maintenance of health behaviors. However, few studies have examined how individuals' affective response to physical activity, as well as the degree to which their affect response changes, may predict changes in physical activity and sedentary time during behavioral weight loss treatment. Purpose: The current study examined how baseline momentary affective response (i.e., stress and anxiety) to moderate-to-vigorous physical activity (MVPA) and the degree of pre--post intervention change in this response predicted change in daily sedentary, light, and MVPA time during a three-month internet-based weight loss program. Methods: Women with overweight/obesity (final N=37) completed 14-day ecological momentary assessment (EMA) protocols with objective measurement of physical activity (i.e., bout-related MVPA time) before and after the intervention. Results: Women who had more reinforcing responses to MVPA (i.e., greater reductions in anxiety and stress response following MVPA bouts) at baseline had greater increases in overall MVPA at the end of the intervention. Those who had greater anxiety reductions after MVPA bouts at baseline also evidenced less sedentary time at the end of the intervention. Changes in affective responses across the intervention were not related to changes in physical activity levels. Conclusions: Findings suggest initial levels of affective reinforcement from MVPA bouts predict future change in MVPA and sedentary time during behavioral weight loss. Future work is needed to examine the utility of more precisely targeting affective responses to physical activity to optimize intervention approaches.

11.
Adv Mater ; : e2101874, 2021 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-34606146

RESUMO

Organic electrochemical transistors (OECTs) are presently a focus of intense research and hold great potential in expanding the horizons of the bioelectronics industry. The notable characteristics of OECTs, including their electrolyte-gating, which offers intimate interfacing with biological environments, and aqueous stability, make them particularly suitable to be operated within a living organism (in vivo). Unlike the existing in vivo bioelectronic devices, mostly based on rigid metal electrodes, OECTs form a soft mechanical contact with the biological milieu and ensure a high signal-to-noise ratio because of their powerful amplification capability. Such features make OECTs particularly desirable for a wide range of in vivo applications, including electrophysiological recordings, neuron stimulation, and neurotransmitter detection, and regulation of plant processes in vivo. In this review, a systematic compilation of the in vivo applications is presented that are addressed by the OECT technology. First, the operating mechanisms, and the device design and materials design principles of OECTs are examined, and then multiple examples are provided from the literature while identifying the unique device properties that enable the application progress. Finally, one critically looks at the future of the OECT technology for in vivo bioelectronic applications.

12.
Biomol Concepts ; 12(1): 132-143, 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34648701

RESUMO

Stromal cell-derived factor 1 (SDF-1) is known to influence bone marrow stromal cell (BMSC) migration, osteogenic differentiation, and fracture healing. We hypothesize that SDF-1 mediates some of its effects on BMSCs through epigenetic regulation, specifically via microRNAs (miRNAs). MiRNAs are small non-coding RNAs that target specific mRNA and prevent their translation. We performed global miRNA analysis and determined several miRNAs were differentially expressed in response to SDF-1 treatment. Gene Expression Omnibus (GEO) dataset analysis showed that these miRNAs play an important role in osteogenic differentiation and fracture healing. KEGG and GO analysis indicated that SDF-1 dependent miRNAs changes affect multiple cellular pathways, including fatty acid biosynthesis, thyroid hormone signaling, and mucin-type O-glycan biosynthesis pathways. Furthermore, bioinformatics analysis showed several miRNAs target genes related to stem cell migration and differentiation. This study's findings indicated that SDF-1 induces some of its effects on BMSCs function through miRNA regulation.

14.
Int J Eat Disord ; 54(11): 2019-2024, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34553396

RESUMO

OBJECTIVE: The purpose of the current study is to examine expressed emotion (EE) and long-term treatment outcome among adolescents participating in a randomized controlled trial (RCT) for treatment of anorexia nervosa (AN). It was hypothesized that patients with high EE parents at baseline would show more severe symptoms at end-of-treatment, 12-month follow-up, and 4-year follow-up than patients from low EE families. METHOD: Secondary data analysis was conducted of original RCT data from a two-site eating disorder treatment trial conducted in the United States. Participants were 121 adolescents with AN who completed measures of EE, eating disorder psychopathology, depression, and self-esteem. RESULTS: Generalized estimating equations showed that participants who were in the Low EE group achieved a more accelerated drop in depression scores in the context of treatment (first 12 months) than participants in the High EE group. No other significant Group × Time interactions were found. DISCUSSION: Findings suggest that high parental EE at baseline does not indicate that adolescent patients with AN will fare poorly 4 years later.


Assuntos
Anorexia Nervosa , Emoções Manifestas , Adolescente , Anorexia Nervosa/terapia , Humanos , Pais , Psicopatologia , Resultado do Tratamento
15.
Eat Disord ; : 1-10, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34383627

RESUMO

The acquired preparedness (AP) model of eating disorder (ED) risk suggests transaction between impulsive traits and eating expectancies, though there remains a lack of research investigating distinct facets of impulsivity within this framework. This study examined how different facets of impulsivity moderate associations between eating expectancies and binge-eating severity in daily life. Women with binge-eating symptoms (N = 40) completed surveys followed by 10 days of ecological momentary assessment (EMA). Generalized estimating equations examined the independent and interactive effects of impulsivity facets and eating expectancies on EMA-measured binge-eating severity. Significant interactions were found between eating expectancies and emotional and behavioral impulsivity, but not a cognitive facet. Results suggest that among women high in emotional impulsivity, those with greater eating expectancies report higher binge-eating severity. Conversely, among those with lower behavioral impulsivity, those with lower eating expectancies report lower binge-eating severity. Future prospective work is needed with non-clinical samples.

16.
Artigo em Inglês | MEDLINE | ID: mdl-34458883

RESUMO

Background: Rumination is linked to negative affect (NA), and there is accumulating support for an association between rumination and eating disorder (ED) behaviors. However, no research has examined the dynamic interrelationships between negative affect, rumination, and binge eating in naturalistic settings. Methods: The present study used ecological momentary assessment (EMA) to assess the hypotheses that momentary rumination would mediate relationships between NA and binge eating, and momentary NA would mediate relationships between rumination and binge eating. Given that rumination may be focused on weight, shape, and food in ED samples, models were examined separately for general and ED-specific rumination. Forty women completed a 10-day EMA protocol that included measures of NA, general and ED-specific rumination, and binge eating. Results: Multilevel mediation models indicated significant within-subjects indirect effects, such that momentary general rumination mediated the association between NA and binge eating, and NA also mediated the association between general but not ED-specific rumination and binge eating. Between-subjects effects indicated women with higher overall NA reported greater ED-specific rumination, which was associated with greater binge eating. Limitations: The study was limited by a modest sample size, and the design precludes causal inferences. Conclusions: Results highlight the momentary interplay between rumination and NA as a mechanism underlying binge eating, as well as the specificity of ruminative thought content in relationship to binge eating. Future work is needed to address the construct of rumination in the context of eating disorder interventions.

17.
Tissue Eng Part A ; 2021 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-34409861

RESUMO

Volumetric muscle loss (VML) injuries are characterized by permanent loss of muscle mass, structure, and function. Hydrogel biomaterials provide an attractive platform for skeletal muscle tissue engineering due to the ability to easily modulate their biophysical and biochemical properties to match a range of tissue characteristics. In this work we successfully developed a mechanically tunable hyaluronic acid (HA) hydrogel system to investigate the influence of hydrogel stiffness on VML repair. HA was functionalized with photoreactive norbornene groups to create hydrogel networks that rapidly crosslink via thiol-ene click chemistry with tailored mechanics. Mechanical properties were controlled by modulating the amount of matrix metalloproteinase (MMP)-degradable peptide crosslinker to produce hydrogels with increasing elastic moduli of 1.1 ± 0.002, 3.0 ± 0.002, and 10.6 ± 0.006 kPa mimicking a relevant range of developing and mature muscle stiffnesses. Functional muscle recovery was assessed following implantation of the HA hydrogels by in situ photopolymerization into rat latissimus dorsi (LD) VML defects at 12 and 24 weeks post-injury. After 12 weeks, muscles treated with medium stiffness (3.0 kPa) hydrogels produced maximum isometric forces most similar to contralateral healthy LD muscles. This trend persisted at 24 weeks post-injury, suggestive of sustained functional recovery. Histological analysis revealed a significantly larger zone of regeneration with more de novo muscle fibers following implantation of medium stiffness hydrogels in VML-injured muscles compared to other experimental groups. Lower (low and medium) stiffness hydrogels also appeared to attenuate the chronic inflammatory response characteristic of VML injuries, displaying similar levels of macrophage infiltration and polarization to healthy muscle. Together these findings illustrate the importance of hydrogel mechanical properties in supporting functional repair of VML injuries.

18.
Body Image ; 39: 139-145, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34358817

RESUMO

Body dissatisfaction (BD) and preoccupation with thoughts of food (PTF) are intertwined and are components of thought-shape fusion. Thought-shape fusion describes the process by which PTF lead to beliefs about weight and shape. To study thought-shape fusion in daily life and explore various transitions between BD and PTF, 30 women with binge eating completed ecological momentary assessment for 14 days. BD and PTF were assessed using continuous rating scales at each prompt. Multi-state modeling, which analyzes micro-temporal transitions between discrete states, was used to examine transitions among four states created with BD and PTF ratings. The four states included low BD/low PTF, low BD/high PTF, high BD/low PTF, and high BD/high PTF. Affect and disordered eating were examined as covariates of state transitions. Results showed high BD states were self-perpetrating, such that when in high BD states, transition to low BD states were less likely. Regarding covariates, positive affect buffered against maladaptive transitions whereas negative affect and disordered eating increased risk. Findings highlighted high BD states as influential, and negative affect and disordered eating as risk factors and positive affect as preventive. This study enhances theory of thought-shape fusion and implicates transitions from BD to PTF as possible underlying transitions.

20.
Curr Pharm Teach Learn ; 13(8): 1078-1098, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34294251

RESUMO

BACKGROUND: To identify and classify methods for assessing professionalism across health profession degree programs and identify gaps in the literature regarding types of assessments. METHODS: The authors conducted a scoping review of articles published from database inception through 24 January 2020. Included articles described an assessment approach for professionalism in health profession degree programs available in full-text in the English language. Articles were classified based on profession, timing of assessment, feedback type, assessment type, professionalism dimension, and Barr's modified Kirkpatrick hierarchy. RESULTS: Authors classified 277 articles meeting inclusion criteria. Most articles were from medical education (62.5%) conducted during didactic (62.1%) or experiential/clinical curriculum (49.8%). Few articles (15.5%) described longitudinal assessment. Feedback type was formative (32.2%) or summative (35%), with only 8.3% using both. Assessment types frequently reported included self-administered rating scales (30%), reflections (18.8%), observed clinical encounters (17.3%), and knowledge-based tests (13.4%). Ethical practice principles (65%) and effective interactions with patients (48.4%) were the most frequently assessed dimensions of professionalism. Authors observed balanced distribution among Barr's modified Kirkpatrick model at levels of reaction (38.3%), modification of perceptions and attitudes (33.6%), acquisition of knowledge and skills (39%), and behavioral change (36.1%). IMPLICATIONS: The classification scheme identified in current literature on professionalism assessment does not align with International Ottawa Conference Working Group on the Assessment of Professionalism recommendations. Gaps identified were limited description of professionalism assessment during admissions, infrequent longitudinal assessment, limited use of methods for both formative and summative assessment, and limited reports of assessments applicable to interprofessional education settings.


Assuntos
Educação Médica , Profissionalismo , Currículo , Retroalimentação , Ocupações em Saúde , Humanos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...