Brain site-specific regulation of hedonic intake by orexin and DYN peptides: role of the PVN and obesity.

The orexin peptides promote hedonic intake and other reward behaviors through different brain sites. The opioid dynorphin peptides are co-released with orexin peptides but block their effects on reward in the ventral tegmental area (VTA). We previously showed that in the paraventricular hypothalamic nucleus (PVN), dynorphin and not orexin peptides enhance hedonic intake, suggesting they have brain-site-specific effects. Obesity alters the expression of orexin and dynorphin receptors, but whether their expression across different brain sites is important to hedonic intake is unclear. We hypothesized that hedonic intake is regulated by orexin and dynorphin peptides in PVN and that hedonic intake in obesity correlates with expression of their receptors. Here we show that in mice, injection of DYN-A1-13 (an opioid dynorphin peptide) in the PVN enhanced hedonic intake, whereas in the VTA, injection of OXA (orexin-A, an orexin peptide) enhanced hedonic intake. In PVN, OXA blunted the increase in hedonic intake caused by DYN-A1-13. In PVN, injection of norBNI (opioid receptor antagonist) reduced hedonic intake but a subsequent OXA injection failed to increase hedonic intake, suggesting that OXA activity in PVN is not influenced by endogenous opioid activity. In the PVN, DYN-A1-13 increased the intake of the less-preferred food in a two-food choice task. In obese mice fed a cafeteria diet, orexin 1 receptor mRNA across brain sites involved in hedonic intake correlated with fat preference but not caloric intake. Together, these data support that orexin and dynorphin peptides regulate hedonic intake in an opposing manner with brain-site-specific effects.

Traducción y análisis de validez de contenido del instrumento Opening Minds Scale for Healthcare Practitioners (OMS-HC) para la evaluación del estigma hacia la enfermedad mental en profesionales de la salud en Chile / Translation and content analysis of the Opening Minds Scale for Healthcare Practitioners (OMS-HC) for the assessment of stigma towards mental illness in health care professionals in Chile

INTRODUCCIÓN: Las personas con enfermedades mentales con frecuencia experimentan estigma por parte de profesionales de la salud, por lo que es necesario disponer de instrumentos para evaluar el estigma e implementar acciones para reducirlo. Este manuscrito describe el proceso de traducción y validación de contenido en Chile del instrumento Opening Minds Scale for Healthcare Practitioners (OMS-HC), para la evaluación del estigma en profesionales de la salud hacia personas con enfermedad mental desarrollado originalmente en Canadá. MÉTODO: Se realizó la traducción y análisis de validación de contenido, incluyendo etapas de traducción inglés-castellano y traducción inversa por traductora profesional, triangulación, y finalmente consulta a expertos para evaluación de validez de contenido según Índice de Validez de Contenido (IVC) con 10 expertos de investigación, academia, y experto por experiencia en salud mental. Se consideró aceptables ítems con IVC entre 0,51-0,99. RESULTADOS: Del total de 20 ítems del cuestionario, dos fueron evaluados con IVC menor al establecido, relacionados con constructos "hope" y "compassion", propios del marco teórico-modelo de Recovery, base del instrumento. Los dos ítems fueron re-evaluados con autores originales para adaptarlos procurando fidelidad al constructo, en un proceso iterativo con expertos. CONCLUSIONES: Se presenta la traducción del instrumento Opening Minds Scale for Healthcare Practitioners (OMS-HC) adaptado al castellano y con análisis de su validación de contenido, consistente de 20 ítems para evaluación del estigma hacia personas con enfermedades mentales en profesionales de la salud, posibilitando nuevos estudios que analicen su validez de criterio, y la exploración de su utilidad a nivel local.

INTRODUCTION: People with mental illnesses frequently experience stigma from health care professionals, which is why it is an urge to count with adequate assessments to evaluate stigma to address it. This manuscript describes the process of language translation and content validation in Chile of the Opening Minds Scale for the assessment of stigma against people with mental illnesses in Healthcare Practitioners (WHO-HC), originally developed in Canada. METHODS: Language translation and content validation analysis were performed, including English-Spanish translation and reverse translation by professional translator, item triangulation by researchers, and content validity analysis of the translated questionnaire by expert evaluation based on the Content Validity Index (CVI), including 10 experts in academia, research, and one expert by experience. Items rated with CVI 0.51-0.99 were considered acceptable. RESULTS: From the total of 20 items of the questionnaire, two were rated with lower CVI than acceptable, specifically related to the constructs "hope" and "compassion", part of the theoretical framework of Recovery in which the questionnaire is based on. The two items were re-evaluated including original authors to adapt them seeking fidelity to the foundational constructs, through an iterative process with experts. CONCLUSIONS: The translation of the Opening Minds Scale for Healthcare Practitioners (WHO-HC) is presented, adapted to Spanish in Chile after content analysis, consisting of 20 items for the evaluation of stigma towards people with mental illness in health professionals, enabling the development of new studies to analyze criterion validity, and the exploration of feasibility and utility at the local level.