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1.
Scand J Med Sci Sports ; 32(8): 1258-1267, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35478463

RESUMO

Physical activity (PA) motives are associated with both moderate-to-vigorous intensity PA (MVPA) and mental health. Studies examining whether PA motives relate directly to mental health or indirectly through MVPA are lacking. This study examined the direct effect of five PA motives (i.e., enjoyment, competence, fitness, social, appearance) on mental health and their indirect effects through MVPA in adolescents. A total of 424 participants (57.1% females) ages 14-15 years from the longitudinal MATCH study were included. Mediation analyses, based on the counterfactual framework, assessed the natural direct effect of PA motives on mental health, and the natural indirect effects through MVPA. Separate models were conducted for each PA motive. Natural direct effects were observed for enjoyment ( ß Ì‚ [95%CI] = 2.12 [0.34, 3.90]), competence ( ß Ì‚ [95%CI] = 1.58[0.28, 2.88]), fitness ( ß Ì‚ [95%CI] = 1.42[0.04, 2.80]), and social ( ß Ì‚ [95%CI] = 2.32[1.03, 3.60]) motives. No natural direct effects were observed for appearance motives. A natural indirect effect through MVPA was observed for fitness motives, and no other natural indirect effects were found. Interventions and public health strategies in adolescents need to acknowledge the importance of enjoyment, competence social and fitness motives in PA to promote mental health, and integrate specific recommendations on the importance of the reasons why adolescents participate in PA.


Assuntos
Exercício Físico , Saúde Mental , Adolescente , Exercício Físico/psicologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Motivação
2.
Int J Behav Nutr Phys Act ; 17(1): 58, 2020 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-32393296

RESUMO

PURPOSE: Canada was the first to adopt comprehensive 24-h movement guidelines that include recommendations for physical activity, screen time and sleep to promote health benefits. No studies have investigated the concurrent development of these behaviours in youth. The objectives were to assess adherence to the Canadian 24-h movement guidelines for children and youth and estimate co-development of self-reported moderate-to-vigorous intensity physical activity (MVPA), screen time and sleep during 8-years from childhood to adolescence. METHODS: Nine hundred and twenty three participants of the MATCH study self-reported their MVPA, screen time and sleep duration at least twice over 8 years. MVPA and screen time were measured three times per year (24 cycles), and sleep was measured once per year (8 cycles). Guideline adherence was dichotomised as meeting each specific health behaviour recommendation or not. Multi-group trajectory modeling was used to identify unique trajectories of behavioural co-development. Analyses were stratified by sex. RESULTS: Between 10 and 39% of youth did not meet any recommendation at the various cycles of data collection. More than half of youth met only one or two recommendation, and roughly 5% of participants met all three recommendations at one or more study cycle throughout the 8 years of follow-up. Four different trajectories of behavioural co-development were identified for boys and for girls. For boys and girls, a complier (good adherence to the guideline recommendations; 12% boys and 9% girls), a decliner (decreasing adherence to the guideline recommendations; 23% boys and 18% girls) and a non-complier group (low adherence to the guideline recommendations; 42% boys and 42% girls) were identified. In boys, a MVPA-complier group (high MVPA-low screen time; 23%) was identified, whereas in girls a screen-complier group (moderate screen time-low MVPA; 30%) was identified. CONCLUSIONS: There is a need to recognise that variations from general trends of decreasing MVPA, increasing screen time and decreasing sleep exist. Specifically, we found that although it is uncommon for youth to adhere to the Canadian 24-h movement guidelines, some youth displayed a high likelihood of attaining one or multiple of the behavioural recommendations. Further, patterns of adherence to the guidelines can differ across different sub-groups of youth.


Assuntos
Comportamento do Adolescente , Comportamento Infantil , Exercício Físico , Fidelidade a Diretrizes/estatística & dados numéricos , Tempo de Tela , Sono , Adolescente , Canadá/epidemiologia , Criança , Feminino , Guias como Assunto , Humanos , Masculino , Autorrelato
3.
Br J Nutr ; 114(2): 161-8, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26132208

RESUMO

Serum 25-hydroxyvitamin D (25(OH)D) concentrations have been reported to increase following weight loss. Moreover, both weight loss and higher serum 25(OH)D concentrations have been associated with a lower risk of developing type 2 diabetes. The objective of the present study was to determine whether the increase in serum 25(OH)D concentration following weight loss is associated with improved insulin sensitivity, insulin secretion and disposition index (ß-cell function). Data from two prospective lifestyle modification studies had been combined. Following a lifestyle-modifying weight loss intervention for 1 year, eighty-four men and women with prediabetes and a BMI ≥ 27 kg/m(2) were divided based on weight loss at 1 year: < 5% (non-responders, n 56) and ≥ 5% (responders, n 28). The association between the change in serum 25(OH)D concentration and changes in insulin sensitivity (homeostasis model assessment of insulin sensitivity (HOMA%S) and Matsuda), insulin secretion (AUC of C-peptide) and disposition index after adjustment for weight loss was examined. Participants in the responders' group lost on average 9.5% of their weight when compared with non-responders who lost only 0.8% of weight. Weight loss in responders resulted in improved insulin sensitivity (HOMA%S, P = 0.0003) and disposition index (P = 0.02); however, insulin secretion remained unchanged. The rise in serum 25(OH)D concentration following weight loss in responders was significantly higher than that in non-responders (8.9 (SD 12.5) v. 3.6 (SD 10.7) nmol/l, P = 0.05). However, it had not been associated with amelioration of insulin sensitivity and ß-cell function, even after adjustment for weight loss and several confounders. In conclusion, the increase in serum 25(OH)D concentration following weight loss does not contribute to the improvement in insulin sensitivity or ß-cell function.


Assuntos
Resistência à Insulina , Células Secretoras de Insulina/fisiologia , Insulina/metabolismo , Vitamina D/análogos & derivados , Redução de Peso , Idoso , Composição Corporal , Índice de Massa Corporal , Peptídeo C/metabolismo , Suplementos Nutricionais , Feminino , Humanos , Insulina/sangue , Secreção de Insulina , Estilo de Vida , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/sangue , Estudos Prospectivos , Vitamina D/sangue
4.
Sante Ment Que ; 40(1): 227-49, 2015.
Artigo em Francês | MEDLINE | ID: mdl-26355489

RESUMO

OBJECTIVES: To support knowledge application of evidence-based practices in mental health rehabilitation in Quebec, the Centre for Studies on Rehabilitation, Recovery and Social Inclusion (CÉRRIS--www.cerrisweb.com) has set up a community of practice and has organized online activities. In this article, the authors present the community of practice (457 members to date) and the results of a three-year experience aimed at evaluating their appreciation with two online activities of dissemination and knowledge exchange: Web conference and debate blog. METHODS: The methodology used in this publication is part of a process of program evaluation. More specifically, a research mixed method was used (concurrent triangulation design). Qualitative data (from qualitative questionnaires) and quantitative data (from Google analytics -participation and attendance data) were collected in parallel and incorporated into analysis step. Forty qualitative questionnaires were completed to identify the benefits, barriers, challenges and facilitators encountered during their participation in the activity. The participants are members of the community of practice of the CÉRRIS and are people with mental illness, family members, practitioners, researchers, students, managers and policy makers in the field of mental health rehabilitation and come from different regions of Quebec, Canada and French speaking areas of Europe. Quantitative data on participation and attendance were collected and analyzed throughout the first three years of implementation of the CÉRRIS. Qualitative data from the questionnaires were analyzed following a content analysis process. Quantitative data were analyzed using Excel. RESULTS: Since September 2010, 14,061 unique visitors navigated on the CÉRRIS website (23,391 visits) and 2,278 people visited the blog (10,393 visits). Ninety-nine members of the community of practice attended at least one of the 13 Web conferences. Web conference allows a) access to evidence-based practices, b) networking and contact between individuals of different areas and c) access to continuing education remotely. A total of 62 members of the community of practice have actively taken part in one of the 5 debates on the blog. The activity of debate blog a) promotes egalitarian exchanges between different actors in mental health sector, b) encourages diversity of viewpoints and c) create a forum for dialogue and reduce stigma towards people with mental illnesses. For both types of Web activities, technological barriers (network security, outdated computer equipment, etc.) restrained the full participation of the participants. However, the assistance received from organizations and their openness towards new technologies has facilitated the experience of participants in both activities. CONCLUSION: Online activities as Web conference and debate blog are interesting avenues to facilitate access to knowledge and support exchanges between clinical, academic, community-based communities, people who use mental health services and their families.


Assuntos
Blogging , Internet , Psiquiatria , Humanos , Quebeque
5.
J Adolesc Health ; 73(5): 931-939, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37610392

RESUMO

PURPOSE: Half of adolescents are trying to change their weight and body-related self-conscious emotions may influence these intentions. We estimated associations between body-related shame, guilt, embarrassment, envy, authentic pride, and hubristic pride and weight control status (trying to maintain, lose, or gain weight) throughout adolescence in girls and boys. METHODS: Six annual cycles of self-administered questionnaires were collected from age 12-17 in the Monitoring Activities of Teenagers to Comprehend their Habits (MATCH) study (n = 776). Average associations over all cycles were estimated with generalized estimating equations to describe the relationship between emotions (predictors) and weight control status (outcome). To explore the impact of changes in emotions on weight control status, fixed effects logistic regressions were used. Separate models were conducted for each emotion and for boys and girls. RESULTS: On average, boys and girls with higher scores for negative emotions (shame, guilt, embarrassment and, exclusively among girls, envy) had higher odds of trying to lose weight. Higher scores for positive emotions (authentic and hubristic pride) were associated with lower odds of trying to lose weight among girls. Higher scores for authentic pride were associated with trying to gain weight among boys. Girls with increases in any of the negative emotions presented higher odds of trying to lose weight. Girls with increases in hubristic pride had increased odds of trying to maintain weight. DISCUSSION: Body-related self-conscious emotions may be promising healthy-weight intervention targets as they represent important predictors of weight control status, particularly in girls.


Assuntos
Emoções , Autoimagem , Masculino , Feminino , Adolescente , Humanos , Criança , Culpa , Vergonha , Redução de Peso
6.
Sci Rep ; 13(1): 13740, 2023 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-37612356

RESUMO

Among same-age adolescents, those who enter puberty relatively later and those who are relatively younger (e.g., born later in the year) might be at greater risk of physical activity discontinuation. This study aimed to (1) describe gender-specific discontinuation, re-engagement, and uptake rates in various types of physical activities from the age of 11 to 17 years, and (2) assess puberty timing and relative age as predictors of discontinuation from organized, unorganized, individual, and group-based physical activities. Longitudinal data from 781 (56% girls, age 10-13 years at study baseline) Canadian participants who self-reported puberty status, birthdate, and involvement in 36 physical activities every four months from 2011 to 2018 was analyzed. The incidence of discontinuation, re-engagement, and uptake in organized/unorganized and individual/group activities from grade 6 until grade 12 was described and Cox proportional hazard models were used to estimate associations of puberty timing and relative age with organized/unorganized and individual/group activity discontinuation. Results demonstrate that individual and unorganized activities are maintained longer than group-based and organized activities. Girls who started puberty earlier were more likely to discontinue organized activities than girls with average-puberty timing [Hazard ratio (HR) (95% confidence interval (CI)) 1.68 (1.05-2.69)]. Compared to boys born in the 4th quarter of the year, boys born in the 2nd quarter of the year were less likely to discontinue organized [HR (95% CI) 0.41 (0.23-0.74)], unorganized [HR (95% CI) 0.33 (0.16-0.70)], group [HR (95% CI) 0.58 (0.34-0.98)], and individual activities[HR (95% CI) 0.46 (0.23-0.91)], and boys born in the 3rd quarter were less likely to discontinue unorganized activities[HR (95% CI) 0.41 (0.19-0.88)]. This study illustrates the patterns of physical activity participation throughout adolescence. However, the generalizability of findings may be limited due to participant representation.


Assuntos
Exercício Físico , Puberdade , Humanos , Feminino , Adolescente , Estudos Longitudinais , Fatores Sexuais , Masculino , Estudantes , Esportes Juvenis , Canadá
7.
Prev Med Rep ; 36: 102498, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38107420

RESUMO

This study aimed to estimate associations between weight control status (trying to lose, gain or maintain weight) and lifestyle behaviors (moderate-to-vigorous physical activity (MVPA), screen time, and the consumption of breakfast, fast food, fruits and vegetables, and sugar-sweetened beverages (SSB)) in adolescents. Data from 919 adolescents in the MATCH study, in New Brunswick, Canada, who self-reported their weight control status at least once within 24 data collection cycles over 8 years (from 2011 to 2019) and from 812 who provided data at least once over the 7 cycles on eating behaviors were used. Generalized estimating equations were used. At the first cycle, mean age was 11.3 (SD = 1.2) years old and 56% were girls. Trying to gain (ß = 0.47, CI = [0.15, 0.79]) and maintain weight (ß = 0.35, CI = [0.12, 0.57]) were positively associated with MVPA. Trying to lose weight was negatively associated with breakfast (IRR = 0.90, CI = [0.85, 0.94]) and positively associated with screen time (ß = 0.62, CI = [0.15, 1.10]), fruit and vegetable (IRR = 1.12, CI = [1.01, 1.25]) and SSB (IRR = 1.42, CI = [1.10, 1.84]). Changes from one weight control status to trying to lose weight were associated with increases in fast food consumption (ß = 0.49, CI = [0.15, 0.84]). Weight control status was associated with healthy and unhealthy behaviors in adolescents. Trying to gain or maintain weight was generally associated with more favorable health-related behaviors. Education on healthy weight management behaviors is needed to improve adolescents' health.

8.
Soc Sci Med ; 315: 115543, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36413860

RESUMO

Body image is a commonly-reported factor perpetuating declines in physical activity levels during adolescence. However, the evidence is predominantly qualitative, cross-sectional, and focused on girls. Furthermore, the affective dimension of body image has been overlooked compared to the perceptual (e.g., misrepresentations of body size) and cognitive (e.g., dissatisfaction) dimensions. Affective body image includes a range of self-conscious emotions including guilt, shame, envy, embarrassment, and authentic and hubristic pride. This study examined (i) body-related self-conscious emotions over time, and (ii) associations between body-related emotions and physical activity over five years during early-to-mid adolescence. Potential gender differences were also explored. Self-report data for this study were collected once a year over 5 years as part of the MATCH study. The main analyses involved mixed-effects modeling. Participants (n = 776, 55.8% girls) initially aged 12.6 (SD = 0.6) years who provided data on at least one occasion were included in the analysis. Girls reported higher body-related guilt, shame, envy, and embarrassment than boys, and boys reported higher hubristic pride than girls. Over five years from early to mid-adolescence, body-related shame, guilt, envy, and embarrassment significantly increased for boys and girls, authentic pride did not change, and hubristic pride increased for girls only. Controlling for gender and puberty status, body-related guilt, shame, and embarrassment were negatively, and body-related authentic and hubristic pride were positively, associated with physical activity over time. Body-related envy was not significantly related to physical activity. These findings suggest that adolescents express greater negative body-related self-conscious emotions over time. Since these were negatively related to physical activity, interventions focused on reducing negative body-related emotions and enhancing positive body-related emotions may be valuable in adolescence to help curb declining physical activity.


Assuntos
Imagem Corporal , Emoções , Masculino , Feminino , Humanos , Adolescente , Estudos Transversais , Ciúme , Exercício Físico
9.
CMAJ Open ; 10(1): E269-E277, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35318251

RESUMO

BACKGROUND: There is a need for better alignment between research on sport and physical activity and the needs of those who are in a position to implement the findings. To facilitate advancement and alignment, we identified the top research priorities of sport and physical activity knowledge users from various sectors. METHODS: For this priority-setting study, we used an iterative process of data collection and analysis. Sport and physical activity knowledge users from multiple sectors participated in a workshop (September 2019), which included small working group exercises followed by large-group syntheses leading to the identification of issues that required better understanding. We then sent an online questionnaire to participants for content validation and interim prioritization, to reduce the number of priorities (December 2019 to January 2020). A new questionnaire containing a shortened list of research priorities was sent to an expanded group of respondents to further streamline the list of priorities (January-March 2020). RESULTS: The 24 workshop participants identified 68 issues, of which 21 were retained by the 18 participants in the interim priority-setting questionnaire. The final prioritization questionnaire was completed by 33 stakeholder groups; this step produced a final list of 8 top research priorities. The final priorities identified for sport and physical activity research related to financial support, suboptimal promotion, dropout, best interventions, participation among Indigenous populations, volunteer engagement, safe and inclusive experiences, and knowledge exchange. INTERPRETATION: The 8 priorities identified in this study provide guidance to Canadian sport and physical activity researchers. Research efforts on these priorities will reflect pressing issues as identified by representatives of all sport and physical activity sectors.


Assuntos
Pesquisa Biomédica , Prioridades em Saúde , Canadá , Exercício Físico , Humanos , Pesquisadores
10.
J Neurosci ; 30(17): 6058-71, 2010 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-20427664

RESUMO

Age-dependent metabolic syndrome (MetS) is a well established risk factor for cardiovascular disease, but it also confers major risk for impaired cognition in normal aging or Alzheimer's disease (AD). However, little is known about the specific pathways mediating MetS-brain interactions. Here, we performed the first studies quantitatively linking MetS variables to aging changes in brain genome-wide expression and mitochondrial function. In six young adult and six aging female rhesus monkeys, we analyzed gene expression in two major hippocampal subdivisions critical for memory/cognitive function [hippocampus proper, or cornu ammonis (CA), and dentate gyrus (DG)]. Genes that changed with aging [aging-related genes (ARGs)] were identified in each region. Serum variables reflecting insulin resistance and dyslipidemia were used to construct a quantitative MetS index (MSI). This MSI increased with age and correlated negatively with hippocampal mitochondrial function (state III oxidation). More than 2000 ARGs were identified in CA and/or DG, in approximately equal numbers, but substantially more ARGs in CA than in DG were correlated selectively with the MSI. Pathways represented by MSI-correlated ARGs were determined from the Gene Ontology Database and literature. In particular, upregulated CA ARGs representing glucocorticoid receptor (GR), chromatin assembly/histone acetyltransferase, and inflammatory/immune pathways were closely associated with the MSI. These results suggest a novel model in which MetS is associated with upregulation of hippocampal GR-dependent transcription and epigenetic coactivators, contributing to decreased mitochondrial function and brain energetic dysregulation. In turn, these MSI-associated neuroenergetic changes may promote inflammation, neuronal vulnerability, and risk of cognitive impairment/AD.


Assuntos
Envelhecimento/genética , Envelhecimento/metabolismo , Giro Denteado/metabolismo , Expressão Gênica , Hipocampo/metabolismo , Síndrome Metabólica/genética , Síndrome Metabólica/metabolismo , Envelhecimento/sangue , Animais , Bases de Dados Genéticas , Dislipidemias/sangue , Dislipidemias/genética , Dislipidemias/metabolismo , Feminino , Insulina/metabolismo , Resistência à Insulina , Macaca mulatta , Síndrome Metabólica/sangue , Mitocôndrias/metabolismo , Receptores de Glucocorticoides/metabolismo , Transdução de Sinais , Especificidade da Espécie
11.
Can Med Educ J ; 12(5): 40-47, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34804287

RESUMO

BACKGROUND: Although participation of patients is essential for completing the training of medical residents, little is known about the relationships among patients' level of knowledge about the role and responsibilities of medical residents, their confidence in residents' abilities, and their acceptance toward receiving care from residents. The study sought to clarify if and how these three patient-resident relationship components are interrelated. METHODS: This is a cross-sectional study using a self-administered questionnaire distributed in 2016 to a convenience sample of adult patients (≥ 18 years old) visiting a family medicine teaching clinic. Proportions and chi-square statistics were used to describe and compare groups, respectively. RESULTS: Of the 471 patients who answered the questionnaire, only 28% were found to be knowledgeable about the role of family medicine residents. Between 54% and 83% of patients reported being highly confident in the ability of residents to perform five routine tasks. Of the patients surveyed, 69% agreed to see a resident during their next appointments. Patients with a high level of confidence in residents' abilities were more likely to agree to see a resident during future appointments (p <0.0001). There was no significant association between level of knowledge and either confidence or acceptance. CONCLUSIONS: Although the majority of patients had poor knowledge about the role of residents, this was not related to their acceptance of being cared for by residents. A higher level of confidence in residents' ability to perform certain tasks was associated with greater acceptance toward seeing a resident during future appointments.


CONTEXTE: Tandis que la participation des patients est essentielle pour la formation de résidents en médecine, on en sait peu sur le rapport entre le niveau de connaissance qu'ont les patients du rôle et des responsabilités des résidents, leur confiance dans les compétences des résidents et leur acceptation de recevoir des soins de leur part. La présente étude visait à clarifier si et de quelle manière ces trois composantes du rapport patient-résident sont interreliées. MÉTHODES: Il s'agit d'une étude transversale réalisée au moyen d'un questionnaire auto-administré distribué en 2016 à un échantillon de convenance de patients adultes (≥ 18 ans) ayant fréquenté une clinique universitaire de médecine familiale. La proportion et le test du khi carré ont été utilisés respectivement pour décrire et pour comparer les groupes. RÉSULTATS: Parmi les 471 patients qui ont répondu au questionnaire, à peine 28 % connaissaient bien le rôle des résidents en médecine familiale. Entre 54 % et 83 % des patients ont déclaré avoir une grande confiance dans la capacité des résidents à effectuer cinq tâches de routine. Parmi les patients interrogés, 69 % ont accepté de voir un résident lors de leurs prochains rendez-vous. Les patients ayant un niveau de confiance élevé dans les capacités des résidents étaient plus susceptibles d'accepter de voir un résident lors de leurs prochains rendez-vous (p <0,0001). Il n'y avait pas d'association significative entre le niveau de connaissance des patients et leur confiance dans les résidents ou leur acceptation d'être traités par ces derniers. CONCLUSIONS: Bien que la majorité des patients aient une mauvaise connaissance du rôle des résidents, celle-ci n'a pas d'incidence sur leur acceptation d'être soignés par de résidents. Un niveau de confiance plus élevé dans la capacité des résidents à effectuer certaines tâches était associé à une plus grande acceptation de voir un résident à l'avenir.

12.
Brain Res ; 1151: 20-31, 2007 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-17433272

RESUMO

Excessive glutamate (Glu) stimulation of the NMDA-R is a widely recognized trigger for Ca(2+)-mediated excitotoxicity. Primary neurons typically show a large increase in vulnerability to excitotoxicity with increasing days in vitro (DIV). This enhanced vulnerability has been associated with increased expression of the NR2B subunit or increased NMDA-R current, but the detailed age-courses of these variables in primary hippocampal neurons have not been compared in the same study. Further, it is not clear whether the NMDA-R is the only source of excess Ca(2+). Here, we used primary hippocampal neurons to examine the age dependence of the increase in excitotoxic vulnerability with changes in NMDA-R current, and subunit expression. We also tested whether L-type voltage-gated Ca(2+) channels (L-VGCCs) contribute to the enhanced vulnerability. The EC(50) for Glu toxicity decreased by approximately 10-fold between 8-9 and 14-15 DIV, changing little thereafter. Parallel experiments found that during the same period both amplitude and duration of NMDA-R current increased dramatically; this was associated with an increase in protein expression of the NR1 and NR2A subunits, but not of the NR2B subunit. Compared to MK-801, ifenprodil, a selective NR2B antagonist, was less effective in protecting older than younger neurons from Glu insult. Conversely, nimodipine, an L-VGCC antagonist, protected older but not younger neurons. Our results indicate that enhanced excitotoxic vulnerability with age in culture was associated with a substantial increase in NMDA-R current, concomitant increases in NR2A and NR1 but not NR2B subunit expression, and with apparent recruitment of L-VGCCs into the excitotoxic process.


Assuntos
Envelhecimento/fisiologia , Hipocampo/citologia , Neurônios/fisiologia , Receptores de N-Metil-D-Aspartato/metabolismo , Animais , Cálcio/metabolismo , Canais de Cálcio Tipo L , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Maleato de Dizocilpina/farmacologia , Embrião de Mamíferos , Feminino , Expressão Gênica/efeitos dos fármacos , Ácido Glutâmico/toxicidade , L-Lactato Desidrogenase/metabolismo , Potenciais da Membrana/efeitos dos fármacos , Potenciais da Membrana/fisiologia , N-Metilaspartato/farmacologia , Neurônios/efeitos dos fármacos , Fármacos Neuroprotetores/farmacologia , Técnicas de Patch-Clamp/métodos , Gravidez , Ratos , Ratos Sprague-Dawley
13.
Can J Diabetes ; 41(2): 190-196, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27908559

RESUMO

OBJECTIVES: We evaluated the influence of the introduction of a pay-for-performance program implemented in 2010 for family physicians on the glycemic control of patients with diabetes. METHODS: Administrative data for all 583 eligible family physicians and 83,580 adult patients with diabetes in New Brunswick over 10 years were used. We compared the probability of receiving at least 2 tests for glycated hemoglobin (A1C) levels and achieving glycemic control before (2005-2009) and after (2010-2014) the implementation of the program and between patients divided based on whether a physician claimed the incentive or did not. RESULTS: Patients living with diabetes showed greater odds of receiving at least 2 A1C tests per year if the detection of their diabetes occurred after (vs. before) the implementation of the program (OR, 99% CI=1.23, 1.18 to 1.28), if a physician claimed the incentive (vs. not claiming it) for their care (1.92, 1.87 to 1.96) in the given year, and if they were followed by a physician who ever (vs. never) claimed the incentive (1.24, 1.15 to 1.34). In a cohort-based analysis, patients for whom an incentive was claimed (vs. not claimed) had greater odds of receiving at least 2 A1C tests per year before implementation of the incentive, and these odds increased by 56% (1.49 to 1.62) following its implementation. However, there was no difference in A1C values among the various comparison groups. CONCLUSIONS: Introduction of the incentive was associated with greater odds of having a minimum of 2 A1C tests per year, which may suggest that it led physicians to provide better follow-up care for patients with diabetes. However, the incentive program has not been associated with differences in glycemic control.


Assuntos
Glicemia , Diabetes Mellitus/diagnóstico , Planos de Incentivos Médicos , Médicos de Família , Reembolso de Incentivo , Idoso , Canadá , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade
14.
J Neurosci ; 25(18): 4649-58, 2005 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-15872113

RESUMO

Astrocyte reactivity (i.e., activation) and associated neuroinflammation are increasingly thought to contribute to neurodegenerative disease. However, the mechanisms that trigger astrocyte activation are poorly understood. Here, we studied the Ca2+-dependent phosphatase calcineurin, which regulates inflammatory signaling pathways in immune cells, for a role in astrogliosis and brain neuroinflammation. Adenoviral transfer of activated calcineurin to primary rat hippocampal cultures resulted in pronounced thickening of astrocyte somata and processes compared with uninfected or virus control cultures, closely mimicking the activated hypertrophic phenotype. This effect was blocked by the calcineurin inhibitor cyclosporin A. Parallel microarray studies, validated by extensive statistical analyses, showed that calcineurin overexpression also induced genes and cellular pathways representing most major markers associated with astrocyte activation and recapitulated numerous changes in gene expression found previously in the hippocampus of normally aging rats or in Alzheimer's disease (AD). No genomic or morphologic evidence of apoptosis or damage to neurons was seen, indicating that the calcineurin effect was mediated by direct actions on astrocytes. Moreover, immunocytochemical studies of the hippocampus/neocortex in normal aging and AD model mice revealed intense calcineurin immunostaining that was highly selective for activated astrocytes. Together, these studies show that calcineurin overexpression is sufficient to trigger essentially the full genomic and phenotypic profiles associated with astrocyte activation and that hypertrophic astrocytes in aging and AD models exhibit dramatic upregulation of calcineurin. Thus, the data identify calcineurin upregulation in astrocytes as a novel candidate for an intracellular trigger of astrogliosis, particularly in aging and AD brain.


Assuntos
Envelhecimento/fisiologia , Doença de Alzheimer/metabolismo , Astrócitos/metabolismo , Calcineurina/fisiologia , Inflamação/metabolismo , Adenoviridae/fisiologia , Fatores Etários , Doença de Alzheimer/patologia , Precursor de Proteína beta-Amiloide/genética , Precursor de Proteína beta-Amiloide/metabolismo , Animais , Astrócitos/efeitos dos fármacos , Astrócitos/patologia , Células Cultivadas , Ciclosporina/farmacologia , Modelos Animais de Doenças , Inibidores Enzimáticos/farmacologia , Imunofluorescência/métodos , Vetores Genéticos/fisiologia , Proteína Glial Fibrilar Ácida/metabolismo , Imuno-Histoquímica/métodos , Proteínas de Membrana/genética , Proteínas de Membrana/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Análise em Microsséries/métodos , Presenilina-1 , Ratos , Ratos Endogâmicos F344 , Regulação para Cima
15.
Diabetol Metab Syndr ; 8: 71, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27833664

RESUMO

BACKGROUND: The prevalence of diabetes has increased since the last decade in New Brunswick. Identifying factors contributing to the increase in diabetes prevalence will help inform an action plan to manage the condition. The objective was to describe factors that could explain the increasing prevalence of type 2 diabetes in New Brunswick since 2001. METHODS: A critical literature review was conducted to identify factors potentially responsible for an increase in prevalence of diabetes. Data from various sources were obtained to draw a repeated cross-sectional (2001-2014) description of these factors concurrently with changes in the prevalence of type 2 diabetes in New Brunswick. Linear regressions, Poisson regressions and Cochran Armitage analysis were used to describe relationships between these factors and time. RESULTS: Factors identified in the review were summarized in five categories: individual-level risk factors, environmental risk factors, evolution of the disease, detection effect and global changes. The prevalence of type 2 diabetes has increased by 120% between 2001 and 2014. The prevalence of obesity, hypertension, prediabetes, alcohol consumption, immigration and urbanization increased during the study period and the consumption of fruits and vegetables decreased which could represent potential factors of the increasing prevalence of type 2 diabetes. Physical activity, smoking, socioeconomic status and education did not present trends that could explain the increasing prevalence of type 2 diabetes. During the study period, the mortality rate and the conversion rate from prediabetes to diabetes decreased and the incidence rate increased. Suggestion of a detection effect was also present as the number of people tested increased while the HbA1c and the age at detection decreased. Period and birth cohort effect were also noted through a rise in the prevalence of type 2 diabetes across all age groups, but greater increases were observed among the younger cohorts. CONCLUSIONS: This study presents a comprehensive overview of factors potentially responsible for population level changes in prevalence of type 2 diabetes. Recent increases in type 2 diabetes in New Brunswick may be attributable to a combination of some individual-level and environmental risk factors, the detection effect, the evolution of the disease and global changes.

16.
PLoS One ; 7(7): e40128, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22792227

RESUMO

BACKGROUND: Many aging changes seem similar to those elicited by sleep-deprivation and psychosocial stress. Further, sleep architecture changes with age suggest an age-related loss of sleep. Here, we hypothesized that sleep deprivation in young subjects would elicit both stress and aging-like transcriptional responses. METHODOLOGY/PRINCIPAL FINDINGS: F344 rats were divided into control and sleep deprivation groups. Body weight, adrenal weight, corticosterone level and hippocampal CA1 transcriptional profiles were measured. A second group of animals was exposed to novel environment stress (NES), and their hippocampal transcriptional profiles measured. A third cohort exposed to control or SD was used to validate transcriptional results with Western blots. Microarray results were statistically contrasted with prior transcriptional studies. Microarray results pointed to sleep pressure signaling and macromolecular synthesis disruptions in the hippocampal CA1 region. Animals exposed to NES recapitulated nearly one third of the SD transcriptional profile. However, the SD-aging relationship was more complex. Compared to aging, SD profiles influenced a significant subset of genes. mRNA associated with neurogenesis and energy pathways showed agreement between aging and SD, while immune, glial, and macromolecular synthesis pathways showed SD profiles that opposed those seen in aging. CONCLUSIONS/SIGNIFICANCE: We conclude that although NES and SD exert similar transcriptional changes, selective presynaptic release machinery and Homer1 expression changes are seen in SD. Among other changes, the marked decrease in Homer1 expression with age may represent an important divergence between young and aged brain response to SD. Based on this, it seems reasonable to conclude that therapeutic strategies designed to promote sleep in young subjects may have off-target effects in the aged. Finally, this work identifies presynaptic vesicular release and intercellular adhesion molecular signatures as novel therapeutic targets to counter effects of SD in young subjects.


Assuntos
Envelhecimento/genética , Região CA1 Hipocampal/metabolismo , Privação do Sono/genética , Privação do Sono/metabolismo , Estresse Fisiológico/genética , Transcriptoma , Animais , Análise por Conglomerados , Perfilação da Expressão Gênica , Regulação da Expressão Gênica , Masculino , Proteômica , Ratos , Transdução de Sinais
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