Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 958
Filtrar
Mais filtros

Intervalo de ano de publicação
1.
Mol Cell ; 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39232584

RESUMO

Selective compartmentalization of cellular contents is fundamental to the regulation of biochemistry. Although membrane-bound organelles control composition by using a semi-permeable barrier, biomolecular condensates rely on interactions among constituents to determine composition. Condensates are formed by dynamic multivalent interactions, often involving intrinsically disordered regions (IDRs) of proteins, yet whether distinct compositions can arise from these dynamic interactions is not known. Here, by comparative analysis of proteins differentially partitioned by two different condensates, we find that distinct compositions arise through specific IDR-mediated interactions. The IDRs of differentially partitioned proteins are necessary and sufficient for selective partitioning. Distinct sequence features are required for IDRs to partition, and swapping these sequence features changes the specificity of partitioning. Swapping whole IDRs retargets proteins and their biochemical activity to different condensates. Our results demonstrate that IDR-mediated interactions can target proteins to specific condensates, enabling the spatial regulation of biochemistry within the cell.

2.
Proc Natl Acad Sci U S A ; 121(9): e2318181121, 2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38346210

RESUMO

While it is commonly assumed that farmers have higher, and foragers lower, fertility compared to populations practicing other forms of subsistence, robust supportive evidence is lacking. We tested whether subsistence activities-incorporating market integration-are associated with fertility in 10,250 women from 27 small-scale societies and found considerable variation in fertility. This variation did not align with group-level subsistence typologies. Societies labeled as "farmers" did not have higher fertility than others, while "foragers" did not have lower fertility. However, at the individual level, we found strong evidence that fertility was positively associated with farming and moderate evidence of a negative relationship between foraging and fertility. Markers of market integration were strongly negatively correlated with fertility. Despite strong cross-cultural evidence, these relationships were not consistent in all populations, highlighting the importance of the socioecological context, which likely influences the diverse mechanisms driving the relationship between fertility and subsistence.


Assuntos
Economia , Fertilidade , Feminino , Humanos , Dinâmica Populacional , Fatores Socioeconômicos , Países em Desenvolvimento
3.
Mol Cell ; 69(1): 24-35.e5, 2018 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-29290612

RESUMO

The protection and efficient restart of stalled replication forks is critical for the maintenance of genome integrity. Here, we identify a regulatory pathway that promotes stalled forks recovery from replication stress. We show that the mammalian replisome component C20orf43/RTF2 (homologous to S. pombe Rtf2) must be removed for fork restart to be optimal. We further show that the proteasomal shuttle proteins DDI1 and DDI2 are required for RTF2 removal from stalled forks. Persistence of RTF2 at stalled forks results in fork restart defects, hyperactivation of the DNA damage signal, accumulation of single-stranded DNA (ssDNA), sensitivity to replication drugs, and chromosome instability. These results establish that RTF2 removal is a key determinant for the ability of cells to manage replication stress and maintain genome integrity.


Assuntos
Proteínas de Ciclo Celular/metabolismo , Dano ao DNA/genética , Replicação do DNA/genética , Proteínas de Ligação a DNA/metabolismo , DNA/genética , Instabilidade Genômica/genética , Ácido Aspártico Proteases/genética , Ciclo Celular/genética , Proteínas de Ciclo Celular/genética , Linhagem Celular Tumoral , DNA/biossíntese , Reparo do DNA/genética , DNA de Cadeia Simples/metabolismo , Proteínas de Ligação a DNA/genética , Células HeLa , Humanos , Interferência de RNA , RNA Interferente Pequeno/genética , Origem de Replicação/genética , Estresse Fisiológico/genética
4.
Arterioscler Thromb Vasc Biol ; 44(7): 1683-1693, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38779854

RESUMO

BACKGROUND: Heterozygous familial hypercholesterolemia (FH) is among the most common genetic conditions worldwide that affects ≈ 1 in 300 individuals. FH is characterized by increased levels of low-density lipoprotein cholesterol (LDL-C) and increased risk of coronary artery disease (CAD), but there is a wide spectrum of severity within the FH population. This variability in expression is incompletely explained by known risk factors. We hypothesized that genome-wide genetic influences, as represented by polygenic risk scores (PRSs) for cardiometabolic traits, would influence the phenotypic severity of FH. METHODS: We studied individuals with clinically diagnosed FH (n=1123) from the FH Canada National Registry, as well as individuals with genetically identified FH from the UK Biobank (n=723). For all individuals, we used genome-wide gene array data to calculate PRSs for CAD, LDL-C, lipoprotein(a), and other cardiometabolic traits. We compared the distribution of PRSs in individuals with clinically diagnosed FH, genetically diagnosed FH, and non-FH controls and examined the association of the PRSs with the risk of atherosclerotic cardiovascular disease. RESULTS: Individuals with clinically diagnosed FH had higher levels of LDL-C, and the incidence of atherosclerotic cardiovascular disease was higher in individuals with clinically diagnosed compared with genetically identified FH. Individuals with clinically diagnosed FH displayed enrichment for higher PRSs for CAD, LDL-C, and lipoprotein(a) but not for other cardiometabolic risk factors. The CAD PRS was associated with a risk of atherosclerotic cardiovascular disease among individuals with an FH-causing genetic variant. CONCLUSIONS: Genetic background, as expressed by genome-wide PRSs for CAD, LDL-C, and lipoprotein(a), influences the phenotypic severity of FH, expanding our understanding of the determinants that contribute to the variable expressivity of FH. A PRS for CAD may aid in risk prediction among individuals with FH.


Assuntos
LDL-Colesterol , Doença da Artéria Coronariana , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Hiperlipoproteinemia Tipo II , Lipoproteína(a) , Herança Multifatorial , Fenótipo , Sistema de Registros , Humanos , Hiperlipoproteinemia Tipo II/genética , Hiperlipoproteinemia Tipo II/sangue , Hiperlipoproteinemia Tipo II/diagnóstico , Hiperlipoproteinemia Tipo II/epidemiologia , Feminino , Masculino , Pessoa de Meia-Idade , LDL-Colesterol/sangue , Doença da Artéria Coronariana/genética , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico , Medição de Risco , Lipoproteína(a)/sangue , Lipoproteína(a)/genética , Adulto , Idoso , Canadá/epidemiologia , Reino Unido/epidemiologia , Índice de Gravidade de Doença , Fatores de Risco , Estudos de Casos e Controles , Biomarcadores/sangue , Incidência
5.
Nucleic Acids Res ; 51(3): 1409-1423, 2023 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-36124719

RESUMO

The introduction of phosphorothioate (PS) linkages to the backbone of therapeutic nucleic acids substantially increases their stability and potency. It also affects their interactions with cellular proteins, but the molecular mechanisms that underlie this effect are poorly understood. Here, we report structural and biochemical studies of interactions between annexin A2, a protein that does not possess any known canonical DNA binding domains, and phosphorothioate-modified antisense oligonucleotides. We show that a unique mode of hydrophobic interactions between a sulfur atom of the phosphorothioate group and lysine and arginine residues account for the enhanced affinity of modified nucleic acid for the protein. Our results demonstrate that this mechanism of interaction is observed not only for nucleic acid-binding proteins but can also account for the association of PS oligonucleotides with other proteins. Using the anomalous diffraction of sulfur, we showed that preference for phosphorothioate stereoisomers is determined by the hydrophobic environment around the PS linkage that comes not only from protein but also from additional structural features within the ASO such as 5-Me groups on cytosine nucleobases.


Assuntos
Anexina A2 , Anexina A2/metabolismo , Ligação Proteica/genética , Oligonucleotídeos Antissenso/química , Oligonucleotídeos Fosforotioatos/química , DNA/metabolismo , Proteínas/metabolismo , Interações Hidrofóbicas e Hidrofílicas , Enxofre/metabolismo
6.
Nucleic Acids Res ; 51(4): 1583-1599, 2023 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-36727438

RESUMO

Inefficient endosomal escape remains the primary barrier to the broad application of oligonucleotide therapeutics. Liver uptake after systemic administration is sufficiently robust that a therapeutic effect can be achieved but targeting extrahepatic tissues remains challenging. Prior attempts to improve oligonucleotide activity using small molecules that increase the leakiness of endosomes have failed due to unacceptable toxicity. Here, we show that the well-tolerated and orally bioavailable synthetic sphingolipid analog, SH-BC-893, increases the activity of antisense oligonucleotides (ASOs) and small interfering RNAs (siRNAs) up to 200-fold in vitro without permeabilizing endosomes. SH-BC-893 treatment trapped endocytosed oligonucleotides within extra-lysosomal compartments thought to be more permeable due to frequent membrane fission and fusion events. Simultaneous disruption of ARF6-dependent endocytic recycling and PIKfyve-dependent lysosomal fusion was necessary and sufficient for SH-BC-893 to increase non-lysosomal oligonucleotide levels and enhance their activity. In mice, oral administration of SH-BC-893 increased ASO potency in the liver by 15-fold without toxicity. More importantly, SH-BC-893 enabled target RNA knockdown in the CNS and lungs of mice treated subcutaneously with cholesterol-functionalized duplexed oligonucleotides or unmodified ASOs, respectively. Together, these results establish the feasibility of using a small molecule that disrupts endolysosomal trafficking to improve the activity of oligonucleotides in extrahepatic tissues.


Assuntos
Endossomos , Oligonucleotídeos , Animais , Camundongos , Oligonucleotídeos/metabolismo , Endossomos/genética , Endocitose/fisiologia , Transporte Biológico , Oligonucleotídeos Antissenso/genética , RNA Interferente Pequeno/genética
7.
Clin Infect Dis ; 2024 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-39036871

RESUMO

BACKGROUND: Tuberculosis (TB) preventive therapy (TPT) reduces the risk of TB disease in people with human immunodeficiency virus (HIV), yet uptake has been suboptimal in many countries. We assessed whether QuantiFERON Gold In-Tube (QGIT) during routine HIV care increased TB infection (TBI) testing and TPT prescriptions. METHODS: This parallel-arm, 1:1 cluster-randomized controlled trial compared the standard-of-care tuberculin skin test to QGIT in South Africa. We enrolled consenting, TPT-eligible adults diagnosed with HIV ≤30 days prior and used intention-to-treat analyses for the outcomes: proportion of patients with documented TBI results, proportion with documented TPT, and time from enrollment to outcomes. FINDINGS: We enrolled 2232 patients across 14 clinics from November 2014 to May 2017 (58% in intervention clinics). At 24 months of follow-up, more participants in intervention clinics had TBI results (69% vs 2%, P < .001) and TPT prescriptions (45% vs 30%, P = .13) than control clinics. Controlling for baseline covariates, intervention clinics had 60% (95% confidence interval, 51-68; P < .001) more participants with TBI results and 12% (95% confidence interval, -6 to 31; P = .18) more with TPT prescriptions. Among participants with results, those in intervention clinics received results and TPT faster (intervention: median of 6 and 29 days after enrollment vs control: 21 and 54 days, respectively). INTERPRETATION: In this setting, QGIT in routine HIV care resulted in more patients with TBI results. Clinicians also initiated more people with HIV on TPT in QGIT intervention clinics, and did so more quickly, than the control arm. CLINICAL TRIALS REGISTRATION: NCT02119130.

8.
J Am Chem Soc ; 146(6): 3805-3815, 2024 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-38316431

RESUMO

Advancements in DNA sequencing technologies and bioinformatics have enabled the discovery of new metabolic reactions from overlooked microbial species and metagenomic sequences. Using a bioinformatic co-occurrence strategy, we previously generated a network of ∼600 uncharacterized quorum-sensing-regulated biosynthetic gene clusters that code for ribosomally synthesized and post-translationally modified peptide (RiPP) natural products and are tailored by radical S-adenosylmethionine (RaS) enzymes in streptococci. The most complex of these is the GRC subfamily, named after a conserved motif in the precursor peptide and found exclusively in Streptococcus pneumoniae, the causative agent of bacterial pneumonia. In this study, using both in vivo and in vitro approaches, we have elucidated the modifications installed by the grc biosynthetic enzymes, including a ThiF-like adenylyltransferase/cyclase that generates a C-terminal Glu-to-Cys thiolactone macrocycle, and two RaS enzymes, which selectively epimerize the ß-carbon of threonine and desaturate histidine to generate the first instances of l-allo-Thr and didehydrohistidine in RiPP biosynthesis. RaS-RiPPs that have been discovered thus far have stood out for their exotic macrocycles. The product of the grc cluster breaks this trend by generating two noncanonical residues rather than an unusual macrocycle in the peptide substrate. These modifications expand the landscape of nonproteinogenic amino acids in RiPP natural product biosynthesis and motivate downstream biocatalytic applications of the corresponding enzymes.


Assuntos
Aminoácidos , Processamento de Proteína Pós-Traducional , Sequência de Aminoácidos , Aminoácidos/metabolismo , Peptídeos/química , Streptococcus , S-Adenosilmetionina/metabolismo
9.
PLoS Pathog ; 18(8): e1010657, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35925892

RESUMO

Activation of the complement pathway results in the production of bioactive C3a, a product of C3 cleavage, which interacts with membrane-bound receptor C3aR to regulate innate immune cell function and outcome of bacterial infection. Specifically, previous research has identified mechanistically distinct and cell type-specific roles for C3aR in regulating innate immune cell inflammatory state, antimicrobial killing capacity, and metabolism. Historically, the production of C3a has been relegated to the serum; however, recent studies have provided evidence that various cell types can produce intracellular C3a that stimulates intracellular C3aR. In light of these new results, it is imperative that we revisit previous studies regarding the role of C3aR in controlling bacterial infections and analyze these results in the context of both extracellular and intracellular C3a production and C3aR activation. Thus, this review will cover specific roles of C3aR in driving cell type-specific and tissue specific responses during bacterial infections and emphasize the contribution of the C3a-C3aR axis in regulating host resistance to bacterial infection.


Assuntos
Infecções Bacterianas , Receptores de Complemento , Humanos , Imunidade Inata , Receptores de Complemento/metabolismo
10.
Evol Anthropol ; 33(3): e22023, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38340074

RESUMO

Concerns about cuckoldry are a dominant theme in evolutionary studies of mating, frequently used to explain sex differences in reproductive strategies. However, studies in nonhuman species have shown that cuckoldry can be associated with important benefits. These insights have not been well integrated with the human literature, which continues to focus on anticuckoldry tactics and negative repercussions for men. I evaluate two key assumptions central to human models of cuckoldry: (1) men are being tricked into investing in nonbiological offspring and (2) investment in nonbiological offspring is wasted. The ethnographic data on fatherhood shows that the concepts of pater and genitor are complex and locally constructed ideas that often include explicit knowledge of extra-pair paternity, countering the idea that nonpaternity results from trickery. Furthermore, rather than being a "waste," paternity loss can be associated with important gains for men, helping to explain why men invest in nonbiological offspring.


Assuntos
Relações Extramatrimoniais , Paternidade , Feminino , Humanos , Masculino , Pai , Reprodução/fisiologia
11.
J Emerg Med ; 67(3): e268-e276, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39030088

RESUMO

BACKGROUND: Salicylate poisoning may lead to critical acid-base disturbances. Tracheal intubation and mechanical ventilation for patients with severe salicylism has been strongly discouraged. STUDY OBJECTIVE: This study aims to describe pH trends, complications, and outcomes in a cohort of salicylate-poisoned patients who were intubated. METHODS: This retrospective observational study included adults presenting to the emergency department (ED) with severe salicylate poisoning (serum salicylate concentration >40 mg/dL and admission to an intensive care unit) over a 14-year period (2007-2021). The primary and secondary outcomes were the change in serum pH and the occurrence of severe complications (systolic blood pressure <80 mm Hg, oxygen saturation <80%, or cardiac arrest), respectively, in the 6 h after presentation. RESULTS: Among 32 adults with severe salicylate poisoning (median serum salicylate level 64.2, interquartile range 52.5-70.7), 11 (34%) underwent tracheal intubation. The initial mean pH (±SD) in the no intubation group was 7.48 ± 0.07 and was 7.36 ± 0.04 in the intubation group. The mean absolute difference in pH measured before and after intubation was -0.02 (95% confidence interval -0.11 to 0.07). No severe complications were observed during or up to 6 h after tracheal intubation and mechanical ventilation. CONCLUSION: In our single-center experience managing adults with severe salicylate poisoning, tracheal intubation and mechanical ventilation were not associated with substantial perturbation of serum pH or severe complications. These findings challenge the current paradigm that these interventions should be avoided in salicylate-poisoned patients.


Assuntos
Intubação Intratraqueal , Respiração Artificial , Salicilatos , Humanos , Masculino , Estudos Retrospectivos , Feminino , Intubação Intratraqueal/métodos , Respiração Artificial/métodos , Adulto , Pessoa de Meia-Idade , Salicilatos/intoxicação , Serviço Hospitalar de Emergência , Unidades de Terapia Intensiva/estatística & dados numéricos
12.
Multivariate Behav Res ; 59(3): 566-583, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38414280

RESUMO

Recent shifts to prioritize prediction, rather than explanation, in psychological science have increased applications of predictive modeling methods. However, composite predictors, such as sum scores, are still commonly used in practice. The motivations behind composite test scores are largely intertwined with reducing the influence of measurement error in answering explanatory questions. But this may be detrimental for predictive aims. The present paper examines the impact of utilizing composite or item-level predictors in linear regression. A mathematical examination of the bias-variance decomposition of prediction error in the presence of measurement error is provided. It is shown that prediction bias, which may be exacerbated by composite scoring, drives prediction error for linear regression. This may be particularly salient when composite scores are comprised of heterogeneous items such as in clinical scales where items correspond to symptoms. With sufficiently large training samples, the increased prediction variance associated with item scores becomes negligible even when composite scores are sufficient. Practical implications of predictor scoring are examined in an empirical example predicting suicidal ideation from various depression scales. Results show that item scores can markedly improve prediction particularly for symptom-based scales. Cross-validation methods can be used to empirically justify predictor scoring decisions.


Assuntos
Ideação Suicida , Humanos , Modelos Lineares , Modelos Estatísticos , Psicometria/métodos , Depressão/diagnóstico , Depressão/psicologia
13.
Genes Dev ; 30(6): 645-59, 2016 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-26980189

RESUMO

Deficiency of FANCD2/FANCI-associated nuclease 1 (FAN1) in humans leads to karyomegalic interstitial nephritis (KIN), a rare hereditary kidney disease characterized by chronic renal fibrosis, tubular degeneration, and characteristic polyploid nuclei in multiple tissues. The mechanism of how FAN1 protects cells is largely unknown but is thought to involve FAN1's function in DNA interstrand cross-link (ICL) repair. Here, we describe a Fan1-deficient mouse and show that FAN1 is required for cellular and organismal resistance to ICLs. We show that the ubiquitin-binding zinc finger (UBZ) domain of FAN1, which is needed for interaction with FANCD2, is not required for the initial rapid recruitment of FAN1 to ICLs or for its role in DNA ICL resistance. Epistasis analyses reveal that FAN1 has cross-link repair activities that are independent of the Fanconi anemia proteins and that this activity is redundant with the 5'-3' exonuclease SNM1A. Karyomegaly becomes prominent in kidneys and livers of Fan1-deficient mice with age, and mice develop liver dysfunction. Treatment of Fan1-deficient mice with ICL-inducing agents results in pronounced thymic and bone marrow hypocellularity and the disappearance of c-kit(+) cells. Our results provide insight into the mechanism of FAN1 in ICL repair and demonstrate that the Fan1 mouse model effectively recapitulates the pathological features of human FAN1 deficiency.


Assuntos
Endodesoxirribonucleases/deficiência , Endodesoxirribonucleases/genética , Rim/patologia , Hepatopatias/genética , Animais , Medula Óssea/efeitos dos fármacos , Reagentes de Ligações Cruzadas/farmacologia , Dano ao DNA/genética , Reparo do DNA/genética , Proteínas de Ligação a DNA/metabolismo , Modelos Animais de Doenças , Endodesoxirribonucleases/metabolismo , Endonucleases/metabolismo , Epistasia Genética , Exodesoxirribonucleases/metabolismo , Fígado/patologia , Camundongos , Enzimas Multifuncionais , Estrutura Terciária de Proteína , Transporte Proteico
14.
J Fish Biol ; 104(5): 1579-1586, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38417911

RESUMO

The ability to detect and respond to the presence of predation risk is under intense selection, especially for small-bodied fishes. Damselfishes (Pomacentridae) use auditory vocalizations during inter- and intrasexual interactions, but it is not known if they can use vocalizations in the context of predator-prey interactions. Here, we test if yellowtail damselfish, Chrysiptera parasema, can learn to associate the territorial vocalization of heterospecific humbug damselfish Dascyllus aruanus with predation risk. In conditioning trials yellowtail damselfish were presented with the territorial call of humbug damselfish while either blank water (control treatment) or chemical alarm cue derived from damaged skin of conspecific yellowtail damselfish was introduced. In conditioning trials, fish exposed to alarm cue exhibited increased activity and spent more time in the water column relative to fish that received the control treatment. After a single conditioning trial, conditioned fish were exposed again to the territorial call of humbug damselfish. Fish conditioned with the call + alarm cue showed increased activity and spent more time in the water column relative to fish that had been conditioned with the control treatment. These data indicate associative learning of an auditory stimulus with predation risk in a species that regularly uses auditory signalling in other contexts. Recordings of conditioning and test trials failed to detect any acoustic calls produced by test fish in response to the perception of predation risk. Thus, although yellowtail damselfish can associate risk with auditory stimuli, we found no evidence that they produce an alarm call.


Assuntos
Sinais (Psicologia) , Perciformes , Comportamento Predatório , Vocalização Animal , Animais , Perciformes/fisiologia , Territorialidade
15.
J Clin Psychol ; 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38943339

RESUMO

The use of intensive time sampling methods, such as ecological momentary assessment (EMA), has increased in clinical, and specifically suicide, research during the past decade. While EMA can capture dynamic intraindividual processes, repeated assessments increase participant burden, potentially resulting in low compliance. This study aimed to shed light on study-level and psychological variables, including suicidal ideation (SI), that may predict momentary prompt (i.e., prompt-to-prompt) completion. We combined data from three EMA studies examining mental health difficulties (N = 103; 10,656 prompts; 7144 completed), using multilevel models and machine learning to determine how well we can predict prompt-to-prompt completion and which variables are most important. The two most important variables in prompt-to-prompt completion were hours since the last prompt and time in study. Psychological variables added little predictive validity; similarly, trait-level SI demonstrated a small effect on prompt-to-prompt completion. Our study showed how study-level characteristics can be used to explain prompt-to-prompt compliance rates in EMA research, highlighting the potential for developing adaptive assessment schedules to improve compliance.

16.
Artigo em Inglês | MEDLINE | ID: mdl-39255476

RESUMO

Workplace tokenism, the use of superficial efforts to appear equitable, which often leads to burnout of marginalized groups, is pervasive, even in health and human service organizations dedicated to improving their community's health and well-being. An original research project to identify interventions addressing tokenism within Lesbian, Gay, Bisexual, Transgender, Queer plus serving health and human service agencies in New York was unable to engage staff in focus groups. A follow-up survey with 41 potential participants reported burnout as the main reason for nonparticipation. Qualitative data revealed desired aftercare for the retraumatizing nature of sharing individual experiences. Utilizing a community-based participatory research approach with an antiracism lens may mitigate challenges addressing tokenism, thereby increasing workplace inclusion of our Lesbian, Gay, Bisexual, Transgender, Queer plus community.

17.
J Clin Psychol Med Settings ; 31(1): 91-107, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37249719

RESUMO

Orthopedic traumas are common, costly, and burdensome - particularly for patients who transition from acute to chronic pain. Psychosocial factors, such as pain catastrophizing and pain anxiety, increase risk for poor outcomes after injury. The Toolkit for Optimal Recovery (TOR) is a novel multi-component mind-body intervention informed by the fear-avoidance model to promote re-engagement in daily activities and prevent transition toward chronic pain and physical dysfunction. The current case series aims to 1) describe the intervention and 2) showcase the treatment course of three TOR completers from diverse geographic locations in the U.S. with distinct injury types and varying personal identities to illustrate how the intervention can be delivered flexibly. Results indicate pre-to-post program improvement in physical function, pain severity, pain catastrophizing, pain anxiety, and other relevant outcomes targeted by the intervention (i.e., depression, mindfulness, coping). Experiences of our three TOR completers suggest that integrating TOR with standard orthopedic care may promote physical recovery after injury.


Assuntos
Dor Crônica , Tutoria , Humanos , Dor Crônica/prevenção & controle , Dor Crônica/psicologia , Inquéritos e Questionários , Ansiedade/psicologia , Catastrofização/psicologia
18.
Arch Psychiatr Nurs ; 49: 56-66, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38734456

RESUMO

BACKGROUND: Psychiatric mental health nurse practitioners have rapidly adopted and implemented tele-mental health in their practice; however it is unclear how this modality of care affects the experiential quality of therapeutic alliance, simply defined as the interpersonal working bond between provider and patient. OBJECTIVE: This study is the first to explore how psychiatric mental health nurse practitioners experience therapeutic alliance while using tele-mental health. DESIGN: Husserlian phenomenological qualitative study. PARTICIPANTS: A purposive, convenience sample of 17 American psychiatric mental health nurse practitioners who engaged in tele-mental health care were recruited online and interviewed. METHODS: Phenomenological interview transcripts recorded and later thematically coded in the qualitative software MaxQDA. RESULTS: From 1426 individual codes, five major themes and 16 subthemes were discovered. Overall, themes illuminated that psychiatric mental health nurse practitioners could build therapeutic alliance over tele-mental health using inherent interpersonal skills that had to be adapted to the technology. Adaptions included working with patient environmental factors, individual patient considerations, provider ambivalence, and technological observation shifting awareness and communication patterns. CONCLUSIONS: When adapting for the tele-mental health environment, psychiatric mental health nurse practitioners experienced building and sustaining therapeutic alliance with most patients. Unparalleled aspects of tele-mental health allowed for a fuller clinical picture and logistical convenience to see patients more often with ease for both the provider and patient. However, experiential aspects of therapeutic alliance created during in-person care could not be replaced with tele-mental health. In conclusion, participants concluded that a hybrid care model would enhance therapeutic alliance for most patients.


Assuntos
Profissionais de Enfermagem , Enfermagem Psiquiátrica , Pesquisa Qualitativa , Telemedicina , Aliança Terapêutica , Humanos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Transtornos Mentais/terapia , Transtornos Mentais/enfermagem , Serviços de Saúde Mental
19.
J Manage ; 50(7): 2641-2674, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39183941

RESUMO

Integrating a social identity approach with Cortina's (2008) theorizing about selective incivility as modern discrimination, we examine how identification-with an organization, with one's gender, and as a feminist-shapes bystanders' interpretations and responses to witnessed incivility (i.e., interpersonal acts of disrespect) and selective incivility (i.e., incivility motivated by targets' social group membership) toward women at work. We propose that bystanders with stronger organizational identification are less likely to perceive incivility toward female colleagues as discrimination and intervene, but female bystanders with stronger gender identification are more likely to do so. Results from two-wave field data in a cross-lagged panel design (Study 1, N = 336) showed that organizational identification negatively predicted observed selective incivility 1 year later but revealed no evidence of an effect of female bystanders' gender identification. We replicated and extended these results with a vignette experiment (Study 2, N = 410) and an experimental recall study (Study 3, N = 504). Findings revealed a "dark side" of organizational identification: strongly identified bystanders were less likely to perceive incivility as discrimination, but there were again no effects of women's gender identification. Study 3 also showed that bystander feminist identification increased intervention via perceived discrimination. These results raise doubts that female bystanders are more sensitive to recognizing other women's mistreatment as discrimination, but more strongly identified feminists (male or female) were more likely to intervene. Although strongly organizationally identified bystanders were more likely to overlook women's mistreatment, they were also more likely to intervene once discrimination was apparent.

20.
Aesthet Surg J ; 44(8): 797-804, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-38452148

RESUMO

BACKGROUND: Patients with symptoms of body dysmorphia often seek consultation for aesthetic rhinoplasty. While body dysmorphic disorder is a formal psychiatric diagnosis, recent evidence indicates that patients with symptoms of this condition who seek rhinoplasty may experience increased satisfaction with their appearance following surgery. OBJECTIVES: To determine the psychological impact of rhinoplasty in patients screened preoperatively and postoperatively with a body dysmorphia screening questionnaire. METHODS: Retrospective chart review was performed of patients who underwent aesthetic and/or functional rhinoplasty by a single surgeon from June 2021 to April 2023. Adult patients with a complete preoperative and postoperative Body Dysmorphic Disorder-Aesthetic Surgery questionnaire (BDDQ-AS), Standardized Cosmesis and Health Nasal Outcomes Survey-Obstruction and Cosmesis (SCHNOS), and visual analog scale (VAS) were included. Patient characteristics and outcomes were analyzed, stratifying by BDDQ-AS screen. RESULTS: One-hundred fifteen patients (88% female) met criteria for inclusion. There was an 83% resolution rate of BDDQ-AS positive screening following rhinoplasty. Positive BDDQ-AS screening status preoperatively and postoperatively correlated with worse aesthetic satisfaction (all P < .002). No patient-reported outcome measures were indicative of which patients with a BDDQ-AS positive screen preoperatively would experience "resolution" postoperatively. CONCLUSIONS: Body dysmorphia screening resolution following surgical intervention correlated with improved patient aesthetic satisfaction, pointing to a potential positive psychological impact of undergoing rhinoplasty.


Assuntos
Transtornos Dismórficos Corporais , Satisfação do Paciente , Rinoplastia , Humanos , Rinoplastia/psicologia , Feminino , Transtornos Dismórficos Corporais/psicologia , Transtornos Dismórficos Corporais/diagnóstico , Adulto , Masculino , Estudos Retrospectivos , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem , Inquéritos e Questionários/estatística & dados numéricos , Estética , Imagem Corporal/psicologia , Medidas de Resultados Relatados pelo Paciente
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA