Effectiveness of creative arts therapy for adult patients with cancer: a systematic review and meta-analysis.

OBJECTIVES: This systematic review and meta-analysis aimed to assess the effectiveness of creative arts therapy (CAT) interventions on the health outcomes of adult patients with cancer. METHODS: A comprehensive search was conducted in six databases from their inception to June 10, 2023, with no restrictions on sex, age, cancer type, cancer stage, or treatment type. The Cochrane Risk of Bias (RoB2) tool for randomized controlled trials (RCTs) and the equivalent tool for non-RCTs (ROBINS-I) were used to assess the risk of bias. Meta-analyses were conducted to pool estimates of the effects of CAT on patients' health-related outcomes. A narrative synthesis of outcomes was performed where meta-analysis was not appropriate. RESULTS: A total of 25 studies (8 RCTs and 17 quasi-RCTs) involving 1489 cancer patients and survivors were included in the final data analysis. Most studies focused on patients with mixed cancer diagnoses who were undergoing active chemotherapy treatment. Most studies utilized painting, drawing, and/or sculpting as CAT interventions. The overall risk of bias in the included studies was moderate to high. Meta-analysis demonstrated a significant improvement in quality of life (SMD with 95% CI = 17.50, 10.05-24.95, P =.0000) and the social aspect of quality of life in cancer patients (SMD with 95% CI = 03.1 (0.06-0.55), P = .01), but no significant effects were found for depressive symptoms and coping strategies among patients who participated in CAT compared to control groups. Narrative analysis and non-RCTs suggested the potential of CAT in reducing levels of depression and anxiety, as well as improving self-image, hope, emotional expression/state, and processing in patients with cancer. However, inconsistent findings were reported regarding the effectiveness of CAT interventions on fatigue, spirituality, and psychosomatic distress/symptom intensity. CONCLUSION: The findings indicated significant and potential benefits of CAT for individuals with cancer, primarily related to quality of life. However, caution is needed in interpreting these findings due to limitations in the methodologies utilized in the included studies. Further large-scale RCTs are needed to examine the effectiveness of CAT on health outcomes, particularly in relation to self-image, hope, and emotional expression/state and processing among patients with cancer or those in palliative care.

Effectiveness of dance movement therapy and dance movement interventions on cancer patients' health-related outcomes: a systematic review and meta-analysis.

OBJECTIVES: This review examined the effectiveness of using dance movement therapy (DMT) and dance movement interventions (DMIs) with cancer and palliative care patients. METHODS: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six databases were searched from inception to July 9, 2022, without limits on year or age. Searching was updated on July 10, 2023. The risk of bias was assessed by the Cochrane (RoB 2) and ROBINS-I tools. Meta-analyses were conducted to pool estimates of the effects of DMT and DMI on patients' health-related outcomes. A narrative synthesis of outcomes was performed where meta-analysis was not appropriate. RESULTS: Among a total of 16 studies included in this review, nine were randomized controlled trials and seven were non-randomized trials, with a total of 893 participants. Only six of these studies were fully or partially described as true DMTs (some with less clarity than others), whereas the majority (n = 10) were DMIs with unclear therapeutic alignment. Most studies focused on female patients with breast cancer. Cancer patients undergoing palliative care received little attention. The overall risk of bias from the evaluated studies was high. Meta-analysis of two trials revealed that DMTs had no effect on QOL in cancer patients (SMD - 0.09, 95% CI - 0.21-0.40, P = 0.54), while narrative analysis and non-randomized trials showed no overall effect of DMTs on anxiety, depression, body image, self-esteem, or sleep disturbance but significant positive effects on perceived stress, pain severity, and pain interference. DMIs had significant positive effects on cancer patients' depression (SMD - 0.53, 95% CI - 0.93 to - 0.14, P = 0.008) and fatigue (SMD - 0.42, 95% CI - 0.70 to - 0.14, P = 0.003). DMI trials synthesized narratively showed an effect on patients' body image, self-esteem, physical function, right and left handgrip strength, life satisfaction, and the mental component of QOL. CONCLUSION: Both DMT and DMIs had promising effects on several health outcomes, but results were inconsistent, and the evidence was weak. The reviewed studies' low evidence quality and small sample sizes affected the findings' robustness and reliability. Large-scale, high-quality randomized controlled trials with sufficient sample sizes, and clear and veracious DMT and DMI protocols and data are required to provide more credible research evidence and influence practice.

Systematic review and meta-analysis of the effectiveness of expressive writing disclosure on cancer and palliative care patients' health-related outcomes.

OBJECTIVES: This review aimed to synthesize the available evidence on the effectiveness of expressive writing (EW) on health outcomes of patients with cancer. METHODS: A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Six databases were searched from 1986 to 9 July 2022. The searches were updated on 3 October 2023. Methodological quality was assessed using the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and ROBINS-I tool for non-RCTs Mixed Methods Appraisal Tool. Narrative synthesis of outcomes was performed where meta-analysis was not appropriate. RESULTS: Thirty-four studies with 4316 participants were identified, including 31 RCTs and three non-RCTs. Twenty-one studies focused on women with breast cancer; the remainder recruited people with various cancer types. There was a significant improvement in fatigue (SMD = - 0.3, 95% CI - 0.55 to - 0.66, P = .002), passive mood (MD = - 3.26, 95% CI = - 5.83 to - 0.69, P = 0.001), and the physical dimension of quality of life (MD = 3.21, 95% CI 0.18 to 6.25, P = 0.04) but not for anxiety, depression, and global quality of life among patients who participated in EW when compared with control groups. CONCLUSION: Findings showed some benefits of EW for people with cancer, but not necessarily in anxiety or depression. Heterogeneity in the delivery of interventions and their content, and shortcomings in the methodologies used highlight the need for stronger evidence in the field through high-quality trials and consistencies in the protocol, focusing on outcomes that this review highlighted as potential outcome targets.

PBK modelling of topical application and characterisation of the uncertainty of Cmax estimate: A case study approach.

Combined with in vitro bioactivity data, physiologically based kinetic (PBK) models has increasing applications in next generation risk assessment for animal-free safety decision making. A tiered framework of building PBK models for such application has been developed with increasing complexity and refinements, as model parameters determined in silico, in vitro, and with human pharmacokinetic data become progressively available. PBK modelling has been widely applied for oral/intravenous administration, but less so on topically applied chemicals. Therefore, building PBK models for topical applications and characterizing their uncertainties in the tiered approach is critical to safety decision making. The purpose of this study was to assess the confidence of PBK modelling of topically applied chemicals following the tiered framework, using non-animal methods derived parameters. Prediction of maximum plasma concentration (Cmax) and area under the curve were compared to observed kinetics from published dermal clinical studies for five chemicals (diclofenac, salicylic acid, coumarin, nicotine, caffeine). A bespoke Bayesian statistical model was developed to describe the distributions of Cmax errors between the predicted and observed data. We showed a general trend that confidence in model predictions increases when more quality in vitro data, particularly those on hepatic clearance and dermal absorption, are available as model input. The overall fold error distributions are useful for characterizing model uncertainty. We concluded that by identifying and quantifying the uncertainties in the tiered approach, we can increase the confidence in using PBK modelling to help make safety decisions on topically applied chemicals in the absence of human pharmacokinetic data.

Improving screening and management of latent tuberculosis infection: development and evaluation of latent tuberculosis infection primary care model.

BACKGROUND: In Australia, demand for specialist infectious diseases services exceeds capacity to provide timely management of latent tuberculosis infection (LTBI) in areas of high refugee and asylum seeker settlement. A model for treating LTBI patients in primary care has been developed and piloted in a refugee-focused primary health service (Monash Health Refugee Health and Wellbeing [MHRHW]) and a universal primary care clinic. This study reports on the development and evaluation of the model, focusing on the model feasibility, and barriers and enablers to its success. METHODS: A convergent mix-methods design was used to evaluate the model for treating LTBI patients in primary care, where a prospective cohort study of patients commencing treatment either at MHRHW or the universal primary care clinic determined the model feasibility, while focus groups with clinicians directly involved in treating these patients explored barriers and enablers to sustainability and success of the model. RESULTS: From January 2017 to April 2018, 65 patients with confirmed LTBI presented at participating clinics. Treatment was accepted by 31 (48%) patients, of whom 15(48%) were treated at MHRHW and 16 (52%) at the universal primary care clinic. The 6-months' treatment completion rate was higher at MHRHW compared to the universal primary care clinic (14 (93%) compared to 9 (56%) respectively, p = 0.0373). Reasons for non-completion included adverse reaction, opting out and relocation. At the completion of the pilot, 15 clinicians participated in two focus groups. Clinicians identified barriers and enablers for successful LTBI management at patient, provider, organisational and clinical levels. While barriers for treatment completion and adherence were consistent across the two pilot sites, enablers, such as resources to facilitate patient education and follow-up, were available only at MHRHW. CONCLUSION: Screening and management of LTBI patients can be achieved within the primary care setting, considerate of barriers and enablers at patient, provider, organisational and clinical levels. Upscaling of a primary care response to the management of LTBI will require supporting primary care clinics with resources to employ dedicated clinical staff for patient education, follow-up communication and monitoring medication adherence.

Systematic Review of Self-Monitoring of Blood Glucose in Patients With Type 2 Diabetes.

BACKGROUND: The benefit of self-monitoring of blood glucose in reducing HbA1c in non-insulin-treated participants remains unclear. HbA1c may be improved in this population with said self-monitoring. OBJECTIVE: The aim of this study was to conduct meta-analyses of glycemic control in non-insulin-treated participants with Type 2 diabetes: self-monitoring of blood glucose versus usual care, structured versus unstructured self-monitoring of blood glucose, and use of self-monitoring of blood glucose readings by clinicians to adjust (or modify) therapy versus usual care. METHODS: MEDLINE, Embase, and Cochrane Central were electronically searched to identify articles published from January 1, 2000, to June 30, 2020. Trials investigating changes in HbA1c were selected. Screening was performed independently by two investigators. Two investigators extracted HbA1c at baseline and follow-up for each trial. RESULTS: Nineteen trials involving 4,965 participants were included. Overall, self-monitoring of blood glucose reduced HbA1c. Preplanned subgroup analysis showed that using self-monitoring of blood glucose readings to adjust therapy contributed significantly to the reduction. No significant improvement in HbA1c was shown in self-monitoring of blood glucose without therapy adjustment. The same difference was observed in structured versus unstructured self-monitoring of blood glucose. DISCUSSION: HbA1c is improved with clinician therapy modification based on structured self-monitoring of blood glucose readings. Implications are for clinicians to prescribe structured self-monitoring of blood glucose to modify therapy based on the readings and not prescribe unstructured self-monitoring of blood glucose. Participants with suboptimal glycemic control may benefit most. A self-monitoring of blood glucose regimen that improves clinical and cost-effectiveness is presented. Future studies can investigate this regimen specifically.

Group singing improves quality of life for people with Parkinson's: an international study.

Objectives: Group singing has been reported to enhance quality of life (QoL) and mental health in older people. This paper explored whether there are differences in the effects of group singing intervention on people with Parkinson's (PwPs) in Australia, UK and South Korea.Methods: The study included PwPs (N = 95; mean age = 70.26; male 45%) who participated in a standardised 6-month weekly group singing programme. Parkinson's health-related QoL measure (PDQ39) and mental health assessment (DASS) were administered at baseline and follow-up. ANOVAs were performed with significance set as p < .05.Results: ANOVAs revealed main effects of Time on the Stigma and Social Support subscales of PDQ39; both showed a small but significant improvement over time. However, the social support reduction was moderated by country; social support was improved only in South Korean participants. The reduction in stigma was greater than previously reported minimal clinically important differences, as was the social support reduction in South Korean participants. In terms of mental health, ANOVAs revealed that the scores of Anxiety and Stress domains of DASS significantly decreased from pre-test to post-test with small effect sizes.Conclusion: This first international singing study with PwPs demonstrated that group singing can reduce stigma, anxiety and stress and enhance social support in older adults living with Parkinson's. The findings are encouraging and warrant further research using more robust designs.

The myotubularin MTMR4 regulates phagosomal phosphatidylinositol 3-phosphate turnover and phagocytosis.

Macrophage phagocytosis is required for effective clearance of invading bacteria and other microbes. Coordinated phosphoinositide signaling is critical both for phagocytic particle engulfment and subsequent phagosomal maturation to a degradative organelle. Phosphatidylinositol 3-phosphate (PtdIns(3)P) is a phosphoinositide that is rapidly synthesized and degraded on phagosomal membranes, where it recruits FYVE domain- and PX motif-containing proteins that promote phagosomal maturation. However, the molecular mechanisms that regulate PtdIns(3)P removal from the phagosome have remained unclear. We report here that a myotubularin PtdIns(3)P 3-phosphatase, myotubularin-related protein-4 (MTMR4), regulates macrophage phagocytosis. MTMR4 overexpression reduced and siRNA-mediated Mtmr4 silencing increased levels of cell-surface immunoglobulin receptors (i.e. Fcγ receptors (FcγRs)) on RAW 264.7 macrophages, associated with altered pseudopodal F-actin. Furthermore, MTMR4 negatively regulated the phagocytosis of IgG-opsonized particles, indicating that MTMR4 inhibits FcγR-mediated phagocytosis, and was dynamically recruited to phagosomes of macrophages during phagocytosis. MTMR4 overexpression decreased and Mtmr4-specific siRNA expression increased the duration of PtdIns(3)P on phagosomal membranes. Macrophages treated with Mtmr4-specific siRNA were more resistant to Mycobacterium marinum-induced phagosome arrest, associated with increased maturation of mycobacterial phagosomes, indicating that extended PtdIns(3)P signaling on phagosomes in the Mtmr4-knockdown cells permitted trafficking of phagosomes to acidic late endosomal and lysosomal compartments. In conclusion, our findings indicate that MTMR4 regulates PtdIns(3)P degradation in macrophages and thereby controls phagocytosis and phagosomal maturation.

Digital Self-Management Interventions for People With Osteoarthritis: Systematic Review With Meta-Analysis.

BACKGROUND: Osteoarthritis (OA) is not curable, but the symptoms can be managed through self-management programs (SMPs). Owing to the growing burden of OA on the health system and the need to ensure high-quality integrated services, delivering SMPs through digital technologies could be an economic and effective community-based approach. OBJECTIVE: This study aims to analyze the effectiveness of digital-based structured SMPs on patient outcomes in people with OA. METHODS: A total of 7 web-based and 3 gray literature databases were searched for randomized controlled trials assessing digital-based structured SMPs on self-reported outcomes including pain, physical function, disability, and health-related quality of life (QoL) in people with OA. Two reviewers independently screened the search results and reference lists of the identified papers and related reviews. Data on the intervention components and delivery and behavioral change techniques used were extracted. A meta-analysis, risk of bias sensitivity analysis, and subgroup analysis were performed where appropriate. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to assess the quality of evidence. RESULTS: A total of 8 studies were included in this review involving 2687 patients with knee (n=2); knee, hip, or both (n=5); and unspecified joint (n=1) OA. SMPs were delivered via telephone plus audio and video, internet, or mobile apps. Studies reported that digital-based structured SMPs compared with the treatment as usual control group (n=7) resulted in a significant, homogeneous, medium reduction in pain and improvement in physical function (standardized mean difference [SMD] -0.28, 95% CI -0.38 to -0.18 and SMD -0.26, 95% CI -0.35 to -0.16, respectively) at posttreatment. The digital-based structured SMP effect on pain and function reduced slightly at the 12-month follow-up but remained to be medium and significant. The posttreatment effect of digital-based structured SMPs was small and significant for disability, but nonsignificant for QoL (SMD -0.10, 95% CI -0.17 to 0.03 and SMD -0.17, 95% CI -0.47 to 0.14, respectively; each reported in 1 study only). The 12-month follow-up effect of the intervention was very small for disability and QoL. The quality of evidence was rated as moderate for pain and physical function and low and very low for disability and QoL, respectively, using the GRADE approach. CONCLUSIONS: Digital-based structured SMPs may result in improvement in pain and physical function that is largely sustained at the 12-month follow-up in people with knee and hip OA. The effects on disability and QoL are smaller and less clear. The quality of evidence is moderate to low, and further research is required to confirm the findings of the review and assess the effects of digital-based structured SMPs on other health-related outcomes.

Sweating the small stuff: A meta-analysis of skin conductance on the Iowa gambling task.

To systematically examine the role of anticipatory skin conductance responses (aSCRs) in predicting Iowa Gambling Task (IGT) performance. Secondly, to assess the quality of aSCR evidence for the Somatic Marker Hypothesis (SMH) during the IGT. Finally, to evaluate the reliability of current psychophysiological measurements on the IGT. Electronic databases, journals and reference lists were examined for inclusion. Data were extracted by two reviewers and validated by another reviewer, using a standardised extraction sheet along with a quality assessment. Two meta-analyses of aSCR measures were conducted to test the relationship between overall aSCR and IGT performance, and differences in aSCR between advantageous and disadvantageous decks. Twenty studies were included in this review. Quality assessment revealed that five studies did not measure anticipatory responses, and few stated they followed standard IGT and/or psychophysiological procedures. The first meta-analysis of 15 studies revealed a significant, small-to-medium relationship between aSCR and IGT performance (r= .22). The second meta-analysis of eight studies revealed a significant, small difference in aSCR between the advantageous and disadvantageous decks (r= .10); however, publication bias is likely to be an issue. Meta-analyses revealed aSCR evidence supporting the SMH. However, inconsistencies in the IGT and psychophysiological methods, along with publication bias, cast doubt on these effects. It is recommended that future tests of the SMH use a range of psychophysiological measures, a standardised IGT protocol, and discriminate between advantageous and disadvantageous decks.

Exploring the relationship between gamma-band activity and maths anxiety.

Previous research has outlined high anxiety in connection with gamma modulation, identifying that gamma-band activity (40-100 Hz) correlates with processing of threat perception, attention and anxiety. Maths anxiety research has also noted the involvement of these aspects, yet this has not been investigated from a neurophysiological standpoint. Electroencephalography (EEG) was used to research gamma-band activity in relation to maths anxiety over two studies. The first measured gamma differences during the processing of complex addition and multiplication stimuli. Results identified differences between high and low maths anxious individuals; significantly greater gamma power was observed in those with high maths anxiety than those with low maths anxiety. As a control condition was not used, the second study replicated the design, but also applied a non-numerical control condition amongst the other stimuli sets. This showed significantly greater gamma activity in high maths anxious individuals across numerical conditions, but not in the non-numerical condition. High maths anxious individuals likely show attentional bias and threat perception to numerical-based stimuli, as indexed by gamma power. This study provides the first evidence of greater gamma-band activity in high maths anxious individuals and serves as a foundation for the exploration of gamma activity in high maths anxious individuals.

Nature: a new paradigm for well-being and ergonomics.

Nature is presented as a new paradigm for ergonomics. As a discipline concerned with well-being, the importance of natural environments for wellness should be part of ergonomics knowledge and practice. This position is supported by providing a concise summary of the evidence of the value of the natural environment to well-being. Further, an emerging body of research has found relationships between well-being and a connection to nature, a concept that reveals the integrative character of human experience which can inform wider practice and epistemology in ergonomics. Practitioners are encouraged to bring nature into the workplace, so that ergonomics keeps pace with the move to nature-based solutions, but also as a necessity in the current ecological and social context. Practitioner Summary: Nature-based solutions are coming to the fore to address societal challenges such as well-being. As ergonomics is concerned with well-being, there is a need for a paradigm shift in the discipline. This position is supported by providing a concise summary of the evidence of the value of the natural environment to well-being.

Athletes and Experimental Pain: A Systematic Review and Meta-Analysis.

The evidence that athletes respond to and report indices of experimental pain differently to non-athlete populations was analysed. Databases screened were SPORTDiscus, PubMED, PsycArticles, the Cochrane Library (Cochrane Database of Systematic Reviews), Web of Science, Scopus, and CINAHL. Studies that compared experimentally induced pain responses (threshold, tolerance, intensity, unpleasantness, bothersomeness, and effect on performance) in athletes and controls were included. Meta-analyses were performed where appropriate and effects were described as standardised mean differences, pooled using random effects models. Thirty-six studies (2,492 participants) met the inclusion criteria comprising 19 pain tolerance, 17 pain threshold, 21 pain intensity, 5 pain unpleasantness, 2 performance in pain and 1 bothersomeness study. Athletes demonstrated greater pain tolerance (g = .88 [95% confidence interval [CI] .65, .13]) and reported less pain intensity (g = -.80, [95% CI -1.13, -.47]) compared to controls; they also had higher pain threshold but with smaller effects (g = .41, [95% CI .08, .75]). Differences for unpleasantness did not reach statistical significance but the effects were large (g = -1.23 [95% CI -2.29, .18]). Two studies reported that performance in pain was better in contact athletes than non-athletes, and one concluded that athletes find pain less bothersome than controls. There were considerable inconsistencies in the methods employed that were reflected in the meta-analyses' findings. Sub-group analyses of tolerance and intensity were conducted between endurance, contact, and other athlete groups, but were not significant. The data suggest that athletic participation is associated with altered pain responses, but mechanisms remain unclear and more transparent methods are recommended.This study was registered on the PROSPERO site in January 2019 (ref ID: CRD42019119611). PERSPECTIVE: This review examined differences in pain outcomes (threshold, tolerance, intensity, unpleasantness, bothersomeness) and the effect of pain on performance, in athletes versus controls. Meta-analyses revealed athletes had higher threshold and tolerance and found pain less intense than controls; there was some evidence of differences in bothersomeness and performance.

Method validation and environmental monitoring of triethanolamine ester quaternary ammonium compounds.

In this study water and sediment samples, collected from the River Nene (Northamptonshire) at several sites in the vicinity of the Great Billing sewage treatment plant (STP), were analysed for triethanolamine quaternary compounds (TEAQ, ester quats). A method was developed using liquid chromatography tandem mass spectrometry (LC/MS/MS) with a electrospray ionisation source (ESI). Ten components were determined using a characterised commercial sample of Tallow TEAQ as a standard. To our knowledge this is the first time environmental concentrations of a wide spectrum of individual homologues of TEAQ have been reliably quantified covering a broad range of environmental matrices (STP influent, STP effluent, surface waters and sediments), due to the challenging nature of the analytical method. The method featured novel solutions for the determination of long and multiple chain length alkyl quats, controlling loss processes, background contamination and chromatographic performance. TEAQ compounds were found to be highly removed in the sewage treatment plant resulting in low effluent concentrations. Low concentrations in both river water and sediment samples were found also. In many cases levels were below the Method Detection Limit (MDL). In river water samples, mean values of TEAQ compounds found were 210-398 ng/L for C16:0/C18:0 TEAQ diester and 126-287 ng/L for C18:0/C18:0 TEAQ diester. River sediment was found to contain mean TEAQ levels of 7.07-12.5, 19.7 to 40.3 and 7.04-35.1 µg/kg dry weight for C16:0/C16:0, C16:0/C18:0, and C18:0/C18:0 TEAQ, respectively. At Great Billing STP monoesters and diesters of TEAQ were shown to be efficiently removed (>97 and 99 %, respectively), although limited samples were taken on this occasion.

Impact of a varied set of stimuli on a suite of immunological parameters within peripheral blood mononuclear cells: toward a non-animal approach for assessing immune modulation by materials intended for human use.

Introduction: In toxicology, steps are being taken towards more mechanism-focused and human relevant approaches to risk assessment, requiring new approaches and methods. Additionally, there is increasing emphasis by regulators on risk assessment of immunotoxicity. Methods: Here we present data from a peripheral blood mononuclear cell (PBMC) system whereby a varied set of stimuli, including those against the TCR and Toll-like receptors, enable readouts of cytokine and prostaglandin E2 (PGE2) production with monocyte, T cell and B cell viability, proliferation, and associated activation markers. In addition to results on the impact of the stimuli used, initial profiling data for a case study chemical, curcumin, is presented, illustrating how the system can be used to generate information on the impact of exogenous materials on three major constituent immune cell subsets for use in risk assessment and to direct follow-on studies. Results: The different stimuli drove distinct responses, not only in relation to the "quantity" of the response but also the "quality". Curcumin had a limited impact on the B cell parameters measured, with the stimuli used, and it was noted that in contrast to T cells where there was either no impact or a reduction in viability and proliferation with increasing concentration, for B cells there was a small but significant increase in both measurements at curcumin concentrations below 20 µM. Similarly, whilst expression of activation markers by T cells was reduced by the highest concentration of curcumin, they were increased in B cells. Curcumin only impacted the viability of stimulated monocytes at the highest concentration and had differential impact on different activation markers. Levels of all cytokines and PGE2 were reduced at higher concentrations. Discussion: Although the platform has certain limitations, it nevertheless enables assessment of healthy baseline monocyte, T-, and B-cell responses, and scrutiny of the impact of different stimuli to detect potential immune suppression or enhancement from exogenous materials. In the case of curcumin, a pattern of responses indicative of immune suppressive / anti-inflammatory effects was detected. It is an accessible, highly modifiable system that can be used to screen materials and guide further studies, providing a holistic, integrated picture of effects.

The PTEN and Myotubularin phosphoinositide 3-phosphatases: linking lipid signalling to human disease.

Two classes of lipid phosphatases selectively dephosphorylate the 3 position of the inositol ring of phosphoinositide signaling molecules: the PTEN and the Myotubularin families. PTEN dephosphorylates PtdIns(3,4,5)P(3), acting in direct opposition to the Class I PI3K enzymes in the regulation of cell growth, proliferation and polarity and is an important tumor suppressor. Although there are several PTEN-related proteins encoded by the human genome, none of these appear to fulfill the same functions. In contrast, the Myotubularins dephosphorylate both PtdIns(3)P and PtdIns(3,5)P(2), making them antagonists of the Class II and Class III PI 3-kinases and regulators of membrane traffic. Both phosphatase groups were originally identified through their causal mutation in human disease. Mutations in specific myotubularins result in myotubular myopathy and Charcot-Marie-Tooth peripheral neuropathy; and loss of PTEN function through mutation and other mechanisms is evident in as many as a third of all human tumors. This chapter will discuss these two classes of phosphatases, covering what is known about their biochemistry, their functions at the cellular and whole body level and their influence on human health.

Cognitive and affective components of challenge and threat states.

We explored the cognitive and affective components of the Theory of Challenge and Threat States in Athletes (TCTSA) using a cross-sectional design. One hundred and seventy-seven collegiate athletes indicated how they typically approached an important competition on measures of self-efficacy, perceived control, achievement goals, emotional states and interpretation of emotional states. Participants also indicated to what extent they typically perceived the important competition as a challenge and/or a threat. The results suggest that a perception of challenge was not predicted by any of the cognitive components. A perception of threat was positively predicted by avoidance goals and negatively predicted by self-efficacy and approach goals. Both challenge and threat had a positive relationship with anxiety. Practical implications of this study are that an avoidance orientation appeared to be related to potentially negative constructs such as anxiety, threat and dejection. The findings may suggest that practitioners and researchers should focus on reducing an avoidance orientation, however the results should be treated with caution in applied settings, as this study did not examine how the combination of constructs exactly influences sport performance. The results provided partial support for the TCTSA with stronger support for proposed relationships with threat rather than challenge states.

Who thrives under pressure? Predicting the performance of elite academy cricketers using the cardiovascular indicators of challenge and threat states.

This study assessed whether cardiovascular (CV) reactivity patterns indexing challenge and threat states predicted batting performance in elite male county (N = 12) and national (N = 30) academy cricketers. Participants completed a batting test under pressure, before which CV reactivity was recorded in response to ego-threatening audio instructions. Self-reported self-efficacy, control, achievement goals, and emotions were also assessed. Challenge CV reactivity predicted superior performance in the Batting Test, compared with threat CV reactivity. The relationships between self-report measures and CV reactivity, and self-report measures and performance were inconsistent. A small subsample of participants who exhibited threat CV reactivity, but performed well, reported greater self-efficacy than participants who exhibited threat CV reactivity, but performed poorly. Also a small subsample of participants who exhibited challenge reactivity, but performed poorly, had higher avoidance goals than participants with challenge reactivity who performed well. The mechanisms for the observed relationship between CV reactivity and performance are discussed alongside implications for future research and applied practice.