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The function and homeostasis of the mammalian ovary depend on complex paracrine interactions between multiple cell types. Using primary mouse tissues and isolated cells, we showed in vitro that ovarian follicles secrete a factor(s) that suppresses growth of ovarian epithelial cells in culture. Most of the growth suppressive activity was accounted for by Anti-Mullerian Hormone/Mullerian Inhibitory Substance (AMH/MIS) secreted by granulosa cells of the follicles, as determined by immune depletion experiments. Additionally, conditioned medium from granulosa cells from wild type control, but not AMH knockout, suppressed epithelial cell growth. Tracing of the AMH regulated cells using AMHR2 (AMH receptor 2)-Cre:ROSA26 mutant mice indicated the presence of populations of AMHR2-positive epithelial cells on the ovarian surface and oviduct epithelia. Cells isolated from the mutant mice indicated that a subpopulation of cells marked by AMHR2-Cre:ROSA26 accounted for most cell growth and expansion in ovarian surface epithelial cells, and the AMHR2 lineage derived cells were regulated by AMH in vitro; whereas, fewer AMHR2-Cre:ROSA26 marked cells accounted for oviduct epithelial cell outgrowth. The results reveal a paracrine pathway in maintaining follicle-epithelial homeostasis in ovary and support a subpopulation of AMHR2 lineage marked epithelial cells as ovarian epithelial stem/progenitor cells with higher proliferative potential regulatable by follicle secreted AMH.
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BACKGROUND: Evaluation approaches such as ripple effects mapping (REM) and realist evaluation have emerged as popular methodologies to evidence impact, and the processes of change within public health as part of whole systems approaches. Despite the various examples of their implementation across different evaluation settings, there has been little or no evidence of how they might be effective when combined. METHODS: With REM's potential to pragmatically illustrate impact, and realist evaluation's strength to identify how and why impacts emerge, this paper develops a rationale and process for their amalgamation. Following this, we outline a realist-informed ripple effects mapping (RREM) protocol drawing upon a physical activity based case study in Essex that may be suitable for application within evaluation settings in a range of public health, whole system and physical activity settings. DISCUSSION: Combining these two approaches has the potential to more effectively illuminate the impacts that we see within public health and whole system approaches and initiatives. What is more, given the complexity often imbued within these approaches and initiatives, they hold capability for also capturing the causal mechanisms that explain these impacts. CONCLUSIONS: It is our conclusion that when combined, this novel approach may help to inspire future research as well as more effective evaluation of public health and whole system approaches. This is crucial if we are to foster a culture for learning, refinement and reflection.
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Saúde Pública , Humanos , Saúde Pública/métodos , Exercício Físico/fisiologia , Projetos de PesquisaRESUMO
BACKGROUND: Grasses populate most biogeographical zones, and their diversity influences allergic sensitisation to pollen. Previously, the contribution of different Poaceae subfamilies to airborne pollen has mostly been inferred from historical herbarium records. We recently applied environmental (e)DNA metabarcoding at one subtropical site revealing that successive airborne grass pollen peaks were derived from repeated flowering of Chloridoid and Panicoid grasses over a season. This study aimed to compare spatiotemporal patterns in grass pollen exposure across seasons and climate zones. METHODS: Airborne pollen concentrations across two austral pollen seasons spanning 2017-2019 at subtropical (Mutdapilly and Rocklea, Queensland) and temperate (Macquarie Park and Richmond, New South Wales) sites, were determined with a routine volumetric impaction sampler and counting by light microscopy. Poaceae rbcL metabarcode sequences amplified from daily pollen samples collected once per week were assigned to subfamily and genus using a ribosomal classifier and compared with Atlas of Living Australia sighting records. RESULTS: eDNA analysis revealed distinct dominance patterns of grass pollen at various sites: Panicoid grasses prevailed in both subtropical Mutdapilly and temperate Macquarie Park, whilst Chloridoid grasses dominated the subtropical Rocklea site. Overall, subtropical sites showed significantly higher proportion of pollen from Chloridoid grasses than temperate sites, whereas the temperate sites showed a significantly higher proportion of pollen from Pooideae grasses than subtropical sites. Timing of airborne Pooid (spring), Panicoid and Chloridoid (late spring to autumn), and Arundinoid (autumn) pollen were significantly related to number of days from mid-winter. Proportions of eDNA for subfamilies correlated with distributions grass sighting records between climate zones. CONCLUSIONS: eDNA analysis enabled finer taxonomic discernment of Poaceae pollen records across seasons and climate zones with implications for understanding adaptation of grasslands to climate change, and the complexity of pollen exposure for patients with allergic respiratory diseases.
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DNA Ambiental , Poaceae , Humanos , Poaceae/genética , Estações do Ano , Alérgenos/análise , Pólen/genéticaRESUMO
Although commonly performed, optimal techniques, strategies, and content to achieve the most effective prenatal counseling have not been explored. We investigate the efficacy of prenatal counseling via survey feedback of parents of children with prenatally diagnosed single ventricle. Grades of counseling using a Likert scale (1-5) were solicited to assess: (1) overall impression of quantity of counseling, (2) explanation of the heart defect, (3) preparation for heart surgery, (4) preparation for hospital course and care, (5) preparation for complications and outcomes of a Fontan circulation, and (6) preparation for neurological, school-related, or behavioral problems. Impressions were solicited concerning specific providers. A comprehensive fetal counseling score was calculated for each participant. Burden of care including length of hospitalization was explored as impacting prenatal counseling grades. There were 59 survey respondents. Average age of the children at the time of survey was 4.6 ± 3.3 years (range 1-10 years). Highest grades were for explanation of the heart condition, with lowest grades for preparation for neurological, school-related, or behavioral problems. Cardiac surgeon received the highest with social worker lowest grade for provider. Negative correlation was found between the composite fetal counseling score and parental recollection of length of hospitalization (Pearson r = - 0.357, p < 0.01). Prenatal counseling for neurological, school-related, and behavioral problems in single ventricle is deficient. Further studies analyzing prenatal counseling techniques and content can help improve upon the delivery of this important aspect of prenatal care.
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Técnica de Fontan , Cardiopatias Congênitas , Coração Univentricular , Gravidez , Criança , Feminino , Humanos , Lactente , Pré-Escolar , Cardiopatias Congênitas/cirurgia , Cardiopatias Congênitas/diagnóstico , Cuidado Pré-Natal , Pais/psicologia , Aconselhamento/métodos , Diagnóstico Pré-Natal , Ultrassonografia Pré-NatalRESUMO
OBJECTIVE: Effective handoffs are critical for patient safety and high-quality care. The pediatric emergency department serves as the initial reception for patients where optimal communication is crucial. The complexities of interfacility handoffs can result in information loss due to lack of standardization. The aim of our project was a 50% reduction in monthly calls routed through the communication center from 157 to 78, for interfacility transfers to the emergency department from outpatient sites within our organization over a 1-year period, through utilization of an electronic handoff activity. METHODS: We designed a quality improvement project in a tertiary care pediatric hospital to improve the process of interfacility transfer. The initiative aimed to streamline the transfer of patients from ambulatory, urgent care, and nurse triage encounters to the pediatric emergency department by using the electronic health record. The primary outcome measure was number of monthly calls received by the telecommunications center for these transfers.Our process measure was tracked by measuring the utilization of the electronic handoff. In addition, the number of safety events reported because of information lost through using the electronic handoff served as a balancing measure. RESULTS: One year after the enterprise-wide rollout of the handoff, the telecommunications center was receiving an average of 29 calls per month versus 157 at time of study initiation, a decrease of 81.5%. Monthly usage increased from zero to an average of 544 during the same period. The project was continued after the initial 12-month data collection and demonstrated stability. CONCLUSIONS: Our initiative facilitated the safe and efficient transfer of patients and streamlined workflows without sacrificing quality of patient care. Our telecommunications center has been freed up for other tasks with fewer interruptions during patient throughput. Next steps will analyze the encounters of transferred patients to further optimize patient flow at our organization.
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Importance: Dialysis-dependent patients experience high rates of morbidity from fractures, yet little evidence is available on optimal treatment strategies. Chronic kidney disease-mineral and bone disorder is nearly universal in dialysis-dependent patients, complicating diagnosis and treatment of skeletal fragility. Objective: To examine the incidence and comparative risk of severe hypocalcemia with denosumab compared with oral bisphosphonates among dialysis-dependent patients treated for osteoporosis. Design, Setting, and Participants: Retrospective cohort study of female dialysis-dependent Medicare patients aged 65 years or older who initiated treatment with denosumab or oral bisphosphonates from 2013 to 2020. Clinical performance measures including monthly serum calcium were obtained through linkage to the Consolidated Renal Operations in a Web-Enabled Network database. Exposures: Denosumab, 60 mg, or oral bisphosphonates. Main Outcomes and Measures: Severe hypocalcemia was defined as total albumin-corrected serum calcium below 7.5 mg/dL (1.88 mmol/L) or a primary hospital or emergency department hypocalcemia diagnosis (emergent care). Very severe hypocalcemia (serum calcium below 6.5 mg/dL [1.63 mmol/L] or emergent care) was also assessed. Inverse probability of treatment-weighted cumulative incidence, weighted risk differences, and weighted risk ratios were calculated during the first 12 treatment weeks. Results: In the unweighted cohorts, 607 of 1523 denosumab-treated patients and 23 of 1281 oral bisphosphonate-treated patients developed severe hypocalcemia. The 12-week weighted cumulative incidence of severe hypocalcemia was 41.1% with denosumab vs 2.0% with oral bisphosphonates (weighted risk difference, 39.1% [95% CI, 36.3%-41.9%]; weighted risk ratio, 20.7 [95% CI, 13.2-41.2]). The 12-week weighted cumulative incidence of very severe hypocalcemia was also increased with denosumab (10.9%) vs oral bisphosphonates (0.4%) (weighted risk difference, 10.5% [95% CI, 8.8%-12.0%]; weighted risk ratio, 26.4 [95% CI, 9.7-449.5]). Conclusions and Relevance: Denosumab was associated with a markedly higher incidence of severe and very severe hypocalcemia in female dialysis-dependent patients aged 65 years or older compared with oral bisphosphonates. Given the complexity of diagnosing the underlying bone pathophysiology in dialysis-dependent patients, the high risk posed by denosumab in this population, and the complex strategies required to monitor and treat severe hypocalcemia, denosumab should be administered after careful patient selection and with plans for frequent monitoring.
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Conservadores da Densidade Óssea , Hipocalcemia , Osteoporose , Estados Unidos , Humanos , Idoso , Feminino , Hipocalcemia/induzido quimicamente , Hipocalcemia/sangue , Denosumab/efeitos adversos , Conservadores da Densidade Óssea/efeitos adversos , Cálcio/uso terapêutico , Estudos Retrospectivos , Diálise Renal , Medicare , Osteoporose/tratamento farmacológico , Difosfonatos/efeitos adversosRESUMO
BACKGROUND: Noninvasive ventilation (NIV) is frequently used in the intensive care unit (ICU), yet there is a paucity of evidence to guide nutrition management during this therapy. Understanding clinicians' views on nutrition practices during NIV will inform research to address this knowledge gap. OBJECTIVE: The objective of this study was to describe Australian and New Zealand clinicians' views and perceptions of nutrition management during NIV in critically ill adults. METHODS: A cross-sectional quantitative online survey of Australian and New Zealand medical and nursing staff with ≥12 months ICU experience was disseminated through professional organisations via purposive snowball sampling from 29 August to 9 October 2022. Data collection included demographics, current practices, and views and perceptions of nutrition during NIV. Surveys <50% complete were excluded. Data are represented in number (%). RESULTS: A total of 152 surveys were analysed; 71 (47%) nursing, 69 (45%) medical, and 12 (8%) not specified. There was limited consensus on nutrition management during NIV; however, most clinicians (n = 108, 79%) reported that nutrition during NIV was 'important or very important'. Oral intake was perceived to be the most common route (n = 83, 55%), and 29 (21%) respondents viewed this as the safest. Most respondents (n = 106, 78%) reported that ≤50% of energy targets were met, with gastric enteral nutrition considered most likely to meet targets (n = 55, 40%). Reported nutrition barriers were aspiration risk (n = 87, 64%), fasting for intubation (n = 84, 62%), and nutrition perceived as a lower priority (n = 73, 54%). Reported facilitators were evidence-based guidelines (n = 77, 57%) and an NIV interface compatible with enteral nutrition tube (n = 77, 57%). CONCLUSION: ICU medical and nursing staff reported nutrition during NIV to be important; however, there was a lack of consensus on the route of feeding considered to be the safest and most likely to achieve nutrition targets. Interventions to minimise aspiration and fasting, including an interface with nasoenteric tube compatibility, should be explored.
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Ventilação não Invasiva , Adulto , Humanos , Estado Terminal , Estudos Transversais , Nova Zelândia , Austrália , Cuidados Críticos , Unidades de Terapia Intensiva , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Use of high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV) in the intensive care unit (ICU) is increasing, yet reporting of nutrition intake, muscle thickness, or recovery outcomes in this population is limited. OBJECTIVE: The objective of this study was to quantify muscle thickness, nutrition intake, and functional recovery outcomes for patients receiving HFNC/NIV within the ICU. METHODS: A single-centre, prospective, observational study in adult ICU patients recruited within 48 hrs of commencing HFNC/NIV. Change in quadriceps muscle layer thickness using ultrasound (primary outcome) and 24 hr nutrition intake from study inclusion to day 7 (D7), functional capacity (Barthel Index), and quality of life (EuroQol five-dimension five-level utility index) at D90 were assessed. Data are n (%), mean ± standard deviation or median [interquartile range], are compared using paired sample t-test, and a P value of <0.05 was considered significant. RESULTS: Primary outcome data were available for n = 28/42: 64 ± 13 y, 61% male, body mass index: 29.1 ± 9.0 kg/m2, and Acute Physiology and Chronic Health Evaluation II score: 17 ± 5. Quadriceps muscle layer thickness reduced from 2.41 ± 0.87 to 2.12 ± 0.73 cm; mean difference: -0.29 cm (95% confidence interval: -0.44, -0.13). Nutrition intake increased from study inclusion to D7: 1735 ± 1283 to 5448 ± 2858 kJ and 17.4 ± 16.6 to 60.9 ± 36.8g protein. Barthel Index was 87 ± 20 at baseline and 91 ± 15 at D90 (out of 100). Quality of life was impaired at D90: 0.64 ± 0.23 (health = 1.0). CONCLUSION: Critically ill patients receiving HFNC/NIV experienced muscle loss and impaired quality of life.
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The inverted triangle shape of South America places Argentina territory as a geographical crossroads between the two principal peopling streams that followed either the Pacific or the Atlantic coasts, which could have then merged in Central Argentina (CA). Although the genetic diversity from this region is therefore crucial to decipher past population movements in South America, its characterization has been overlooked so far. We report 92 modern and 22 ancient mitogenomes spanning a temporal range of 5000 years, which were compared with a large set of previously reported data. Leveraging this dataset representative of the mitochondrial diversity of the subcontinent, we investigate the maternal history of CA populations within a wider geographical context. We describe a large number of novel clades within the mitochondrial DNA tree, thus providing new phylogenetic interpretations for South America. We also identify several local clades of great temporal depth with continuity until the present time, which stem directly from the founder haplotypes, suggesting that they originated in the region and expanded from there. Moreover, the presence of lineages characteristic of other South American regions reveals the existence of gene flow to CA. Finally, we report some lineages with discontinuous distribution across the Americas, which suggest the persistence of relic lineages likely linked to the first population arrivals. The present study represents to date the most exhaustive attempt to elaborate a Native American genetic map from modern and ancient complete mitochondrial genomes in Argentina and provides relevant information about the general process of settlement in South America.
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DNA Mitocondrial/genética , Variação Genética , Genética Populacional , Genoma Mitocondrial/genética , Migração Humana , Argentina , DNA Antigo/análise , DNA Mitocondrial/análise , DNA Mitocondrial/classificação , Geografia , Haplótipos , Humanos , Filogenia , Análise de Sequência de DNA , América do Sul , Fatores de TempoRESUMO
RATIONALE: The respiratory outcomes for adult survivors of preterm birth in the postsurfactant era are wide-ranging with prognostic factors, especially those encountered after the neonatal period, poorly understood. OBJECTIVES: To obtain comprehensive 'peak' lung health data from survivors of very preterm birth and identify neonatal and life-course risk factors for poorer respiratory outcomes in adulthood. METHODS: 127 participants born ≤32 weeks gestation (64%, n=81 with bronchopulmonary dysplasia (BPD), initially recruited according to a 2 with-BPD:1 without-BPD strategy), and 41 term-born controls completed a lung health assessment at 16-23 years, including lung function, imaging and symptom review. Risk factors assessed against poor lung health included neonatal treatments, respiratory hospitalisation in childhood, atopy and tobacco smoke exposure. MEASUREMENTS AND MAIN RESULTS: Young adults born prematurely had greater airflow obstruction, gas trapping and ventilation inhomogeneity, in addition to abnormalities in gas transfer and respiratory mechanics, compared with term. Beyond lung function, we observed greater structural abnormalities, respiratory symptoms and inhaled medication use. A previous respiratory admission was associated with airway obstruction; mean forced expiratory volume in 1 s/forced vital capacity z-score was -0.561 lower after neonatal confounders were accounted for (95% CI -0.998 to -0.125; p=0.012). Similarly, respiratory symptom burden was increased in the preterm group with a respiratory admission, as was peribronchial thickening (6% vs 23%, p=0.010) and bronchodilator responsiveness (17% vs 35%, p=0.025). Atopy, maternal asthma and tobacco smoke exposure did not influence lung function or structure at 16-23 years in our preterm cohort. CONCLUSIONS: Even after accounting for the neonatal course, a respiratory admission during childhood remained significantly associated with reduced peak lung function in the preterm-born cohort, with the largest difference seen in those with BPD. A respiratory admission during childhood should, therefore, be considered a risk factor for long-term respiratory morbidity in those born preterm, especially for individuals with BPD.
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Displasia Broncopulmonar , Nascimento Prematuro , Poluição por Fumaça de Tabaco , Feminino , Humanos , Recém-Nascido , Adulto Jovem , Adolescente , Pulmão , Volume Expiratório ForçadoRESUMO
Robust agricultural yields require consistent flower production throughout fluctuating environmental conditions. Floral primordia are produced in the inflorescence meristem, which contains a pool of continuously dividing stem cells. Daughter cells of these divisions either retain stem cell identity or are pushed to the SAM periphery, where they become competent to develop into floral primordia after receiving the appropriate signal. Thus, flower production is inherently linked to regulation of the stem cell pool. The plant hormone auxin promotes flower development throughout its early phases and has been shown to interact with the molecular pathways regulating stem cell maintenance. Here, we will summarize how auxin signaling contributes to stem cell maintenance and promotes flower development through the early phases of initiation, outgrowth, and floral fate establishment. Recent advances in this area suggest that auxin may serve as a signal that integrates stem cell maintenance and new flower production.
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Proteínas de Arabidopsis , Arabidopsis , Proteínas de Arabidopsis/metabolismo , Arabidopsis/metabolismo , Ácidos Indolacéticos/metabolismo , Mutação , Flores , Células-Tronco , Meristema , Regulação da Expressão Gênica de PlantasRESUMO
[Figure: see text].
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Átrios do Coração/inervação , Nó Sinoatrial/inervação , Neurônios Adrenérgicos/fisiologia , Animais , Nó Atrioventricular/inervação , Nó Atrioventricular/fisiologia , Sistema Nervoso Autônomo/anatomia & histologia , Sistema Nervoso Autônomo/fisiologia , Biomarcadores/análise , Neurônios Colinérgicos/fisiologia , Vasos Coronários/anatomia & histologia , Feminino , Gânglios Autônomos/anatomia & histologia , Humanos , Masculino , Ilustração Médica , Contração Miocárdica/fisiologia , Fenótipo , Nó Sinoatrial/fisiologia , Suínos , Porco Miniatura , Sinapses/fisiologia , Função Ventricular Esquerda/fisiologia , Proteínas Vesiculares de Transporte de Acetilcolina/análiseRESUMO
PURPOSE OF REVIEW: Critical care nutrition guidelines primarily focus on patients receiving invasive mechanical ventilation, yet noninvasive ventilation (NIV) is an increasingly common intervention. The optimal route of nutrition delivery in patients receiving NIV has not been established. This review aims to describe the implications of NIV on the route of feeding prescribed. RECENT FINDINGS: Five small, mostly observational, studies have quantified energy or protein intake in patients receiving NIV in critical care, which demonstrate intake to be poor. No study has assessed the impact of feeding route on outcomes. The predominant route of feeding observed is oral intake, yet nutrition intake via this route is lower than that from enteral or parenteral nutrition. Barriers to oral intake include fasting for intubation, the inability to remove NIV apparatus to eat, breathlessness, fatigue and poor appetite, while barriers to enteral nutrition include the impact of the naso-enteric tube on the mask seal and potential aspiration. SUMMARY: Until evidence to support the optimal route of feeding is developed, patient safety should be the key driver of route selection, followed by the ability to achieve nutrition targets, perhaps utilizing a combination of routes to overcome barriers to nutrition delivery.
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Ventilação não Invasiva , Respiração Artificial , Humanos , Apoio Nutricional , Nutrição Enteral , Nutrição Parenteral , Estado Terminal/terapiaRESUMO
BACKGROUND: Beverly Hills and Manhattan Beach, California, are the first two US cities to prohibit the sale of tobacco products, passing ordinances that went into effect on 1 January 2021. We sought to learn about retailers' experiences with these laws 22 months after implementation. METHODS: Brief in-person interviews with owners or managers of businesses that formerly sold tobacco (n=22). RESULTS: Participant experiences varied by type of retailer. Managers at large chain stores reported no problems adapting to the law and little effect on overall sales. Many were largely indifferent to the sales bans. By contrast, most managers or owners of small, independent retailers reported losses of both revenue and customers, and expressed dissatisfaction with the laws. Small retailers in Beverly Hills objected particularly to exemptions that city made allowing hotels and cigar lounges to continue their sales, which they saw as undermining the health rationale for the law. The small geographical area covered by the policies was also a source of frustration, and retailers reported that they had lost business to retailers in nearby cities. The most common advice small retailers had for other retailers was to organise to oppose any similar attempts in their cities. A few retailers were pleased with the law or its perceived effects, including a reduction in litter. CONCLUSION: Planning for tobacco sales ban or retailer reduction policies should include considering impacts on small retailers. Adopting such policies in as wide a geographical area as possible, as well as allowing no exemptions, may help reduce opposition.
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Taxanes (Taxol/paclitaxel, Docetaxel/taxotere) are a key group of successful drugs commonly used in chemotherapy to treat several major malignant tumors also as a front-line agent in combination with carboplatin/cisplatin, as well as a second line drug with a dose dense regimen following recurrence. Overall, the response to paclitaxel is excellent, though drug resistance inevitably develops in subsequent treatments. The commonly accepted mechanism of action is that the hindrance of microtubule function by paclitaxel leads to cell cycle arrest at mitosis, and subsequent apoptosis. The mechanisms for resistance to paclitaxel have also been extensively investigated, such as ABC transporter overexpression, altered signaling and apoptotic gene expression to resist cell death, and changes associated with microtubules to reduce influences of the drugs. Meanwhile, another important mechanism of paclitaxel resistance has been proposed: increased nuclear lamina/envelope sturdiness to retard the breaking of nuclear envelop and the paclitaxel-induced multinucleation as well as the formation of multiple micronuclei. Here in this review, we focus on experimental findings and ideas on the mechanism of paclitaxel resistance related to cancer nuclear envelope, to provide new insights on overcoming paclitaxel resistance.
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Neoplasias , Paclitaxel , Humanos , Paclitaxel/farmacologia , Paclitaxel/uso terapêutico , Membrana Nuclear , Taxoides , Docetaxel , Cisplatino , Apoptose , Neoplasias/tratamento farmacológico , Neoplasias/genética , Resistencia a Medicamentos Antineoplásicos/genéticaRESUMO
OBJECTIVE: We tested the effect of music on idiographic cognitive inferences about stressful events. METHOD: In Study 1 (n = 336), adult participants from the United States were randomly assigned to non-familiar songs that differed by lyrical content and tempo. In Studies 2 (n = 302) and 3 (n = 323), adult participants from the United States were randomly assigned to either a positive, neutral or no-song condition. RESULTS: The results of Study 1 failed to support any of the study hypotheses. Given the null results, we decided to conduct a second study focused on increasing external validity and power (i.e., including fewer experimental conditions). The results of Study 2 showed that adults randomly assigned to a familiar upbeat song condition experienced an increase in positive affect and a decrease in event-specific negative cognitions. A third study was then conducted to replicate the results and rule out a potential confound. Results of Study 3 corroborated the results of Study 2. CONCLUSION: Taken together (Studies 2 and 3), results indicate it may be useful for future research to test the extent to which familiar upbeat music can be helpful during cognitive restructuring activities in psychotherapy to nudge people to generate more adaptive cognitions.
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Música , Humanos , Adulto , Música/psicologia , Percepção Auditiva , Cognição , PsicoterapiaRESUMO
Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) individuals experience health inequities and barriers to accessing appropriate, affirming care. Little is known about differing health care experiences within the LGBTQ+ population, particularly among individuals living in underserved areas. This study explored health care experiences and utilization among LGBTQ+ subgroups: lesbian and gay cisgender individuals (n = 258), bisexual+ cisgender individuals (n = 71), and transgender and gender-diverse individuals (n = 80). Participants were recruited from a geographic region in South Carolina and Georgia and completed an online survey regarding negative health care experiences, barriers to care, and utilization of different health care venues and services. Results revealed significant differences between LGBTQ+ subgroups, with transgender and gender-diverse participants reporting more discriminatory experiences and greater barriers to care. Bisexual+ cisgender individuals also experienced some disparities compared with lesbian and gay cisgender individuals. Most participants endorsed a need for more competent providers. Findings and recommendations are considered within the context of the Southeastern United States for addressing access and utilization disparities among LGBTQ+ communities.
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Homossexualidade Feminina , Minorias Sexuais e de Gênero , Pessoas Transgênero , Feminino , Estados Unidos , Humanos , Acessibilidade aos Serviços de Saúde , BissexualidadeRESUMO
Once established within a water resource, harmful algal blooms (HABs) can occur seasonally with an intense and rapid onset, giving water resource managers limited time to respond to lessen risks. An attractive strategy to decrease human, ecological, and economic risks from HABs is to implement proactive algaecide treatments applied to overwintering cyanobacteria (i.e., akinetes and quiescent vegetative cells) in sediments prior to the formation of a HAB; however, this approach is novel and very limited efficacy data exist. Therefore, the specific objectives of this research were to 1) evaluate copper- and peroxide-based algaecides, applied as single and repeat treatments at the bench scale, to identify effective proactive treatments, and 2) compare correlations between cell density and other response measurements (i.e., in vivo chlorophyll a and phycocyanin concentrations and percent benthic coverage), to identify informative metrics to assess overwintering cyanobacteria responses. Twelve treatment scenarios using copper- and peroxide-based algaecides were applied to sediments containing overwintering cyanobacteria prior to a 14 d incubation under favorable growth conditions. Responses of cyanobacteria in the planktonic (i.e., cell density, in vivo chlorophyll a and phycocyanin concentrations) and benthic (percent coverage) phases after a 14 d incubation were evaluated in treatments and controls. The HAB-forming cyanobacteria present after a 14 d incubation were: Aphanizomenon, Dolichospermum, Microcystis, Nostoc, and Planktonthrix. Successive treatments of copper sulfate (CuSulfate) followed by sodium carbonate peroxyhydrate (PeroxiSolid) (second algaecide applied after 24 h) as well as repeat applications of a single algaecide, PeroxiSolid (second treatment applied after 24 h) resulted in statistically significant (p ≤ 0.05; α = 0.05) declines in cell density relative to untreated controls. Planktonic cyanobacteria responses measured in terms of phycocyanin concentrations were strongly correlated with cyanobacteria density measurements (Pearson's correlation coefficient (r) = 0.89). Chlorophyll a concentrations and percent benthic coverage did not correlate with planktonic cyanobacteria density measurements (r = 0.37 and -0.49, respectively) and therefore, were unreliable metrics for cyanobacterial responses in this study. These data provide initial evidence of the efficacy of algaecides for treating overwintering cells in sediments and contribute to our overarching hypothesis that proactive treatments may delay the onset and intensity of HABs in impacted waterbodies.
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BACKGROUND: Skill-based practice (e.g., communication skills) is important for individuals to incorporate into students' learning and can be challenging in large classes. Simulation-based education (SBE) is a method where students can learn and practice skills in a safe environment to use in real world settings with assistance of peer coaching. The COVID-19 pandemic presented challenges to providing students with sufficient SBE. The purpose of this paper is to: a.) describe a SBE approach for health coaching referred to as "Demo, Debrief, and Do" (DDD), b.) discuss how this approach became important in COVID-19 classroom experiences, c.) describe the impact of DDD activity on students in a health sciences curriculum. DDD is a collaborative activity where graduate health coaching students demonstrate coaching skills, debrief their demonstration, and support undergraduate students to demonstrate (or do) their own coaching skills in a small virtual online setting. METHODS: Qualitative feedback from 121 undergraduate students enrolled in 3 sections of a behavior change strategies course and quantitative surveys to examine their confidence in applying the skills and overall satisfaction with DDD were gathered. RESULTS: The overall average confidence level following the lab was 31.7 (0-35). The average satisfaction level following the lab was 23.3 (0-25 range). The most common highlight of this DDD experience described was observing the coaching demonstration (i.e., demo), followed by the feedback (i.e., debrief), and the practice (i.e., do). CONCLUSION: The (DDD) simulation approach fulfilled an educational need during the COVID 19 pandemic and filled a gap in offering SBE opportunities for both graduate and undergraduate students while learning effective client-communication skills health coaching delivery.
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Aprendizagem , Pandemias , Humanos , Currículo , Estudantes , RetroalimentaçãoRESUMO
OBJECTIVE: White and non-White adolescents report different experiences in the legal system. This disparity impacts their evaluations of, and attitudes toward, legal authorities such that non-White and older adolescents tend to perceive the legal system more negatively. Yet, many researchers assume that the process of legal socialization, which involves internalizing norms and information about the law and the legal system, is universal for all ages and races. HYPOTHESES: We hypothesized that legal socialization models would change over the course of adolescent development and would differ by race. METHOD: We used data from two longitudinal studies to examine racial differences in the integrated legal socialization model in early, middle, and late adolescence. Study 1 included 140 young adolescents (59% White, 41% non-White), and Study 2 included 296 midadolescents (82% White, 18% non-White) followed into late adolescence/emerging adulthood. RESULTS: Study 1 identified differences in the integrated legal socialization model for young White and non-White adolescents. Normative status predicted rule-violating behavior for White participants, whereas no predictors or mediators related to rule-violating behavior for non-White participants. In Study 2, legal and moral reasoning during midadolescence became relevant in the model for both groups. Enforcement status predicted rule-violating behavior for non-White youth, whereas normative status continued to predict rule-violating behavior for White youth. In late adolescence/emerging adulthood, differences in the model shifted toward the relation between reasoning and legal attitudes. CONCLUSIONS: Our findings suggest that legal socialization is a developmental process occurring and changing throughout adolescence and that this developmental process differs for White and non-White youth. (PsycInfo Database Record (c) 2023 APA, all rights reserved).