Abstract Assessment of cortisol concentrations in hair is one of the latest innovations for measuring long-term cortisol exposure. We performed a systematic review of correlates of cortisol in human ...hair to inform the design, analysis, and interpretation of future epidemiologic studies. Relevant publications were identified through electronic searches on PubMed, WorldCat, and Web of Science using keywords, “cortisol,” “hair,” “confounders,” “chronic,” “stress,” and “correlates.” Thirty-nine studies were included in this review. Notwithstanding scarce data and some inconsistencies, investigators have found hair cortisol concentrations to be associated with stress-related psychiatric symptoms and disorders (e.g., post-traumatic stress disorder), medical conditions indicating chronic activation of the hypothalamic-pituitary-adrenal axis (e.g., Cushing's syndrome), and other life situations associated with elevated risk of chronic stress (e.g., shiftwork). Results from some studies suggest that physical activity, adiposity, and substance abuse may be correlates of hair cortisol concentrations. In contrast to measures of short-term cortisol release (saliva, blood, and urine), cigarette smoking and use of oral contraceptives appear not to be associated with hair cortisol concentrations. Studies of pregnant women indicate increased hair cortisol concentrations across successive trimesters. The study of hair cortisol presents a unique opportunity to assess chronic alterations in cortisol concentrations in epidemiologic studies.
This national survey finds that only 4% of physicians use an extensive, fully functional system for electronic health records, and 13% use some form of basic electronic records. Those who use ...electronic records are generally satisfied with the systems and believe that they improve the quality of care that patients receive.
Only 4% of physicians use an extensive, fully functional system for electronic health records, and 13% use some form of basic electronic records. Those who use electronic records believe that they improve the quality of care that patients receive.
Health-information technology, such as sophisticated electronic health records, has the potential to improve health care.
1
–
3
Nevertheless, electronic-records systems have been slow to become part of the practices of physicians in the United States.
4
,
5
To date, there have been no definitive national studies that provide reliable estimates of the adoption of electronic health records by U.S. physicians. Recent estimates of such adoption by physicians range from 9 to 29%.
4
,
5
These percentages were derived from studies that either had a small number of respondents or incompletely specified definitions of an electronic health record.
5
,
6
To provide clearer estimates of . . .
Abstract
Background
The goal of this study was to understand prospective cohort study Principal Investigators’ (PIs’) attitudes regarding the importance of religion and spirituality (R/S) on disease ...etiology in order to identify barriers and opportunities for greater inclusion of these domains in high-quality epidemiological research.
Methods
One-hour, semi-structured qualitative interviews were conducted with 20 PIs, who represent 24 different National Institutes of Health (NIH)-funded prospective cohort studies in the U.S. Collectively, these PIs collect detailed health data on approximately 1.25 of every 100 adult Americans. Sample size was calculated to achieve thematic saturation.
Results
The majority of PIs we interviewed viewed R/S as potentially important factors influencing disease etiology, particularly among minority communities that report higher levels of religiosity. Yet nearly all PIs interviewed felt there was not yet a compelling body of evidence elucidating R/S influences on health, and the potential mechanisms through which R/S may be operating to affect health outcomes. PIs identified 5 key areas that would need to be addressed before they would be persuaded to collect more R/S measures in their cohorts: (1) high-quality, prospective studies that include all appropriate covariates for the outcome under study; (2) studies that posit a plausible biological mechanism of effect; (3) well-validated R/S measures, collected in common across multiple cohorts; (4) the need to address bias against R/S research among investigators; and (5) NIH funding for R/S research.
Conclusions
Results of this study provide a roadmap for future R/S research investigating the impact of R/S influences on disease etiology within the context of U.S. prospective cohort studies. Identifying significant R/S influences on health could inform novel interventions to improve population health. Given the higher levels of religiosity/spirituality among minority communities, R/S research may also provide new leverage points for reducing health disparities.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
HPA axis genes implicated in glucocorticoid regulation play an important role in regulating the physiological impact of social and environmental stress, and have become a focal point for ...investigating the role of glucocorticoid regulation in the etiology of disease. We conducted a systematic review to critically assess the full range of clinical associations that have been reported in relation to DNA methylation of CRH, CRH-R1/2, CRH-BP, AVP, POMC, ACTH, ACTH-R, NR3C1, FKBP5, and HSD11β1/2 genes in adults. A total of 32 studies were identified. There is prospective evidence for an association between HSD11β2 methylation and hypertension, and functional evidence of an association between NR3C1 methylation and both small cell lung cancer (SCLC) and breast cancer. Strong associations have been reported between FKBP5 and NR3C1 methylation and PTSD, and biologically-plausible associations have been reported between FKBP5 methylation and Alzheimer's Disease. Mixed associations between NR3C1 methylation and mental health outcomes have been reported according to different social and environmental exposures, and according to varying gene regions investigated. We conclude by highlighting key challenges and future research directions that will need to be addressed in order to develop both clinically meaningful prognostic biomarkers and an evidence base that can inform public policy practice.
•Systematic review assessing clinical associations reported in relation to DNA methylation of HPA axis genes in adults.•Strong associations have been reported for hypertension, SCLC, breast cancer, and Alzheimer's.•Strong associations have been reported for PTSD, however mixed associations are reported for other mental health outcomes.
Abstract
N
6
-methyladenosine (m
6
A), the most prevalent internal modification on eukaryotic mRNA, plays an essential role in various stress responses. The brain is uniquely vulnerable to cellular ...stress, thus defining how m
6
A sculpts the brain’s susceptibility may provide insight to brain aging and disease-related stress. Here we investigate the impact of m
6
A mRNA methylation in the adult
Drosophila
brain with stress. We show that m
6
A is enriched in the adult brain and increases with heat stress. Through m
6
A-immunoprecipitation sequencing, we show 5′UTR
Mettl3
-dependent m
6
A is enriched in transcripts of neuronal processes and signaling pathways that increase upon stress.
Mettl3
knockdown results in increased levels of m
6
A targets and confers resilience to stress. We find loss of
Mettl3
results in decreased levels of nuclear m
6
A reader
Ythdc1
, and knockdown of
Ythdc1
also leads to stress resilience. Overall, our data suggest that m
6
A modification in
Drosophila
dampens the brain’s biological response to stress.
Previous longitudinal studies have consistently shown an association between attendance at religious services and lower all-cause mortality, but the literature on associations between other measures ...of religion and spirituality (R/S) and mortality is limited. We followed 36,613 respondents from the Black Women's Health Study from 2005 through December 31, 2013 to assess the associations between R/S and incident all-cause mortality using proportional hazards models. After control for numerous demographic and health covariates, together with other R/S variables, attending religious services several times per week was associated with a substantially lower mortality rate ratio (mortality rate ratio = 0.64, 95% confidence interval: 0.51, 0.80) relative to never attending services. Engaging in prayer several times per day was not associated with mortality after control for demographic and health covariates, but the association trended towards a higher mortality rate ratio when control was made for other R/S variables (for >2 times/day vs. weekly or less, mortality rate ratio = 1.28, 95% confidence interval: 0.99, 1.67; P-trend < 0.01). Religious coping and self-identification as a very religious/spiritual person were associated with lower mortality when adjustment was made only for age, but the association was attenuated when control was made for demographic and health covariates and was almost entirely eliminated when control was made for other R/S variables. The results indicate that service attendance was the strongest R/S predictor of mortality in this cohort.
...although this is a contested field, there is also recent evidence that maternal stressors and trauma experienced before pregnancy might leave DNA methylation signatures in a woman's epigenome that ...are then passed on to her children. Poor women are also at increased risk of exposure to air pollution and other environmental toxins (34 ,35). Because of racism, residential segregation, and structural inequality in our society, minority women are disproportionately represented among low-income women and are disproportionately exposed to poor environments. Using epigenetics research to prioritize data collection across national cohort studies As epigenetics research continues to generate a growing list of various psychosocial, social and environmental exposures linked to increased risk of numerous chronic diseases, not only demonstrating an association, but shedding light on the biological pathway though which such exposures are translated into increased risk of disease, it makes sense to prioritize tracking such exposures in national data collection efforts used to understand disease risk over time. Serious studies of spirituality and religious coping (42) have perhaps been hampered by the unfortunate intersections between religion and public health to date, but this is unfortunate since some of the most systematically disadvantaged communities in American society - African-American and Hispanic/Latino communities - are also the nation's most religious communities (43). ...an important opportunity to explore new avenues for creative, effective interventions is likely being missed.
Chronic cellular stress has a profound impact on the brain, leading to degeneration and accelerated aging. Recent work has revealed the vital role of RNA modifications, and the proteins responsible ...for regulating them, in the stress response. In our study, we defined the role of CG14618/dTrmt10A, the Drosophila counterpart of human TRMT10A a N1-methylguanosine methyltransferase, on m6A regulation and heat stress resilience in the Drosophila brain. By m6A-IP RNA sequencing on Drosophila head tissue, we demonstrated that manipulating dTrmt10A levels indirectly regulates m6A levels on polyA + RNA. dTrmt10A exerted its influence on m6A levels on transcripts enriched for neuronal signaling and heat stress pathways, similar to the m6A methyltransferase Mettl3. Intriguingly, its impact primarily targeted 3' UTR m6A, setting it apart from the majority of Drosophila m6A-modified transcripts which display 5' UTR enrichment. Upregulation of dTrmt10A led to increased resilience to acute heat stress, decreased m6A modification on heat shock chaperones, and coincided with decreased decay of chaperone transcripts and increased translation of chaperone proteins. Overall, these findings establish a potential mechanism by which dTrmt10A regulates the acute brain stress response through m6A modification.
Persons with multiple chronic conditions are a large and growing segment of the US population. However, little is known about how chronic conditions cluster, and the ramifications of having specific ...combinations of chronic conditions. Clinical guidelines and disease management programs focus on single conditions, and clinical research often excludes persons with multiple chronic conditions. Understanding how conditions in combination impact the burden of disease and the costs and quality of care received is critical to improving care for the 1 in 5 Americans with multiple chronic conditions. This Medline review of publications examining somatic chronic conditions co-occurring with 1 or more additional specific chronic illness between January 2000 and March 2007 summarizes the state of our understanding of the prevalence and health challenges of multiple chronic conditions and the implications for quality, care management, and costs.
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