The SARS-CoV-2 pandemic led to a general uncertainty about risk and consequences of the disease. Older adults are specifically vulnerable with regard to severe courses of the disease and have been ...particularly encouraged to self-isolate during the pandemic. Subsequently, expressions of concern have been raised regarding the negative impact of disease risk and quarantine on the mental health of older people.
Assessment of psychosocial stress, coping strategies, need for support, and sense of coherence of older people during the COVID-19 pandemic.
The study follows a qualitative research design. Between May and June 2020 N = 11 guided telephone interviews were conducted with older adults (70+ years). Telephone interviews were recorded by audio tape and fully transcribed. A qualitative content analysis was performed according to Mayring and Fenzl (2019) using MAXQDA.
Participants were 74.8 years old on average. Participants showed predominantly good psychosocial health and functional coping strategies. Life experience, an optimistic attitude, understanding of the necessity of restrictions, and previous crises that have been mastered were the most important resources during the COVID-19 pandemic for older adults. Offers of support were rarely used. Participants were critical of the closing of centers or meeting points for older people.
Older adults appear to be able to preserve their mental wellbeing during the COVID-19 pandemic. The relevance of mental resources of older adults for supporting younger generations seems to be unrecognized.
Zusammenfassung
Hintergrund
Mit dem SARS-CoV-2-Ausbruchsgeschehen („Severe acute respiratory syndrome coronavirus type 2“, COVID-19) ist es zu einer Verunsicherung über Erkrankungsrisiko und Folgen ...der Virusinfektion in der Bevölkerung gekommen. Ältere Menschen gelten als Risikogruppe für schwere Infektionsverläufe und wurden im besonderen Maße zu sozialer Distanzierung aufgerufen. Gleichzeitig wurde die Sorge geäußert, dass sich Erkrankungsrisiko und soziale Isolation negativ auf die psychische Gesundheit älterer Menschen auswirken würden.
Ziele der Arbeit
Erfassung von psychosozialen Belastungen, vorhandenen Bewältigungsstrategien, Unterstützungsbedarfen und Kohärenzerleben älterer Menschen im Zusammenhang mit dem COVID-19-Ausbruchsgeschehen.
Material und Methoden
Die Studie folgt einem qualitativen Untersuchungsdesign. Zwischen Mai und Juni 2020 wurden telefonische Interviews mit 11 älteren Personen (70+) durchgeführt. Die Durchführung der Interviews erfolgte leitfadengestützt. Die Daten wurden mittels Audioaufzeichnung festgehalten, transkribiert und inhaltsanalytisch nach Mayring und Fenzl (2019) unter Nutzung von MAXQDA ausgewertet.
Ergebnisse
Die Probanden waren im Durchschnitt 74,8 Jahre alt. Bei den Befragten zeigte sich ein überwiegend stabiles Befinden und gutes Zurechtkommen mit dem COVID-19-Geschehen. Als wesentliche Ressourcen wurden Lebenserfahrung, frühere bewältigte Krisen, eine optimistische Grundhaltung und Einsicht in die Notwendigkeit der Maßnahmen genannt. Externe Unterstützungsangebote seien kaum in Anspruch genommen worden. Das Schließen seniorenspezifischer Treffpunkte wurde kritisch bewertet.
Diskussion
Ältere Menschen scheinen sich ihre psychosoziale Gesundheit trotz COVID-19-Pandemie überwiegend zu erhalten. Die Bedeutsamkeit mentaler Ressourcen älterer Menschen für die Unterstützung jüngerer Generationen bleibt bisher unerkannt.
The cellular response to heat stress is an ancient and evolutionarily highly conserved defence mechanism characterised by the transcriptional up-regulation of cyto-protective genes and a partial ...inhibition of splicing. These features closely resemble the proteotoxic stress response during tumor development. The bromodomain protein BRD4 has been identified as an integral member of the oxidative stress as well as of the inflammatory response, mainly due to its role in the transcriptional regulation process. In addition, there are also several lines of evidence implicating BRD4 in the splicing process. Using RNA-sequencing we found a significant increase in splicing inhibition, in particular intron retentions (IR), following heat treatment in BRD4-depleted cells. This leads to a decrease of mRNA abundancy of the affected transcripts, most likely due to premature termination codons. Subsequent experiments revealed that BRD4 interacts with the heat shock factor 1 (HSF1) such that under heat stress BRD4 is recruited to nuclear stress bodies and non-coding SatIII RNA transcripts are up-regulated. These findings implicate BRD4 as an important regulator of splicing during heat stress. Our data which links BRD4 to the stress induced splicing process may provide novel mechanisms of BRD4 inhibitors in regard to anti-cancer therapies.
The Patient Assessment of Chronic Illness Care (PACIC-5A) was developed to assess the satisfaction with patient-provider interaction based on the Chronic Care Model. The additional 5A approach ...(assess, advise, agree, assist, arrange) allows to score behavioral counseling. The aim of the study was to assess the psychometric properties of the German adaptation of the PACIC-5A questionnaire in a sample of general practitioners (GP) patients with obesity.
Analyses were based on data from the study "Five A's counseling in weight management of obese patients in primary care: a cluster randomized controlled trial (INTERACT)". Data were collected via standardized questionnaires containing the 26-item version of the PACIC-5A questionnaire. A total of 117 patients with obesity were included in the analyses. Statistical procedures comprised descriptive analyses, the calculation of Cronbach's alpha, test-retest analyses and factor analyses in order to assess the psychometric properties including reliability and validity of the PACIC-5A.
The patient's mean age was 43.4 years and the sample was mostly female (59%). Middle educational level was found for the majority (78%) and the mean Body Mass Index was 38.9 kg/m
. Descriptive analyses revealed a mean PACIC score of 2.33 and 5A sum score of 2.29. Notable floor effects were found. PACIC-5A showed high level of internal consistency (Cronbach's alphas > 0.9) and exploratory factor analyses resulted in a unidimensional structure.
The results of this study provide evidence regarding the psychometric properties of the German version of the PACIC-5A used in a sample of GP patients with obesity and make an important contribution to the reliable and valid assessment of the patient-GP interaction with regard to obesity counseling in primary care.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Background
There is a need for biomarker to identify patients “at risk” for rheumatoid arthritis (risk-RA) and to better predict the therapeutic response and in this study we tested the ...hypothesis that novel native and citrullinated heterogeneous nuclear ribonucleoprotein (hnRNP)-DL autoantibodies could be possible biomarkers.
Methods
Using protein macroarray and ELISA, epitope recognition against hnRNP-DL was analysed in sera from different developed RA disease and diagnosed SLE patients. Toll-like receptor (TLR) 7/9 and myeloid differentiation primary response gene 88 (MyD88)-dependency were studied in sera from murine disease models. HnRNP-DL expression in cultivated cells and synovial tissue was analysed by indirect immunofluorescence, immunoblot and immunohistochemistry.
Results
HnRNP-DL was highly expressed in stress granules, citrullinated in the rheumatoid joint and targeted by autoantibodies either as native or citrullinated proteins in patient subsets with different developed RA disease. Structural citrullination dependent epitopes (SCEs) of hnRNP-DL were detected in 58% of the SLE patients although 98% of these sera were α-CCP-2-negative. To obtain a specific citrullinated signal value, we subtracted the native antibody value from the citrullinated signal. The citrullinated/native index of autoantibodies against hnRNP-DL (CN
DL
-Index) was identified as a new value for an “individual window of treatment success” in early RA and for the detection of RF IgM/α-CCP-2 seronegative RA patients (24–46%). Negative CN
DL
-index was found in SLE patients, risk-RA and early RA cohorts such as EIRA where the majority of these patients are DAS28-responders to methotrexate (MTX) treatment (87%). High positive CN
DL
-values were associated with more severe RA, shared epitope and parenchymal changes in the lung. Specifically, native α-hnRNP-DL is TLR7/9-dependent, associated with pain and ROC analysis revealed an association to initial MTX or etanercept treatment response, especially in seronegative RA patients.
Conclusion
CN
DL
-index defines people at risk to develop RA and the “window of treatment success” thereby closing the sensitivity gap in RA.
The death of a close person is a highly stressful, yet common life event in later life. While most individuals seem to cope well with bereavement, a substantial proportion of older individuals suffer ...from prolonged grief symptoms. E-mental health interventions have been shown to be efficient for a variety of psychological illnesses. Yet, there is a large research gap of studies with a special focus on older adults. This study protocol describes a randomized controlled trial for an internet-based self-help intervention addressing bereavement and loss in adults aged 60 years and over. The self-management intervention is based on techniques of cognitive behavioral therapy and consists of 8 modules. The objective of the AgE-health study is to evaluate the effectiveness and acceptability of this intervention in comparison to a bibliotherapy control group.
The AgE-health study aims at implementing a randomized controlled trial. Eligible participants aged 60+ years will be randomly allocated to an intervention group (access to the intervention) or to an active control group (access to bibliotherapy). Primary outcome is the reduction in grief symptoms (13-item Prolonged Grief Inventory); secondary outcomes are depression, social activity and network, quality of life, self-efficacy, satisfaction with the intervention/bibliotherapy, loneliness, acceptability, up-take and adherence. Assessments will take place before the intervention (baseline) as well as 4 months (follow-up 1) after the intervention.
This study addresses an under-recognized and understudied mental health burden in later life and may add valuable insight into our knowledge about the effectiveness of eHealth interventions for loss and bereavement in late life. To our knowledge, the AgE-health study will be the first randomized controlled trial to evaluate the effectiveness of an internet-based intervention targeting prolonged grief in adults aged 60 years and over.
The study has been registered at the German Clinical Trials Register (Identifier: DRKS00020595, Registered 30th July 2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00020595).
•Older adults seem under-recognized with regard to mental health care and eHealth.•First RCT on an eHealth intervention targeting prolonged grief in adults 60+ years.•The eHealth intervention was developed under participation of older adults.•The intervention is expected to improve mental health of adults 60+ years.
Background
There are very few studies examining the determinants of frequent attendance in primary care among the oldest old.
Aims
The purpose of this study was to determine the characteristics of ...frequent attendance among individuals aged 85 years or older.
Methods
Cross-sectional data stem from the multicenter prospective cohort “Study on needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients (85 +)” (AgeQualiDe). This study covers very old primary care patients (
n
= 861, mean age of 89.0 years ± 2.9; 85–100 years). The number of self-reported GP visits in the preceding 3 months was used to quantify frequent attenders. We defined patients in the top decile as frequent attenders.
Results
Multiple logistic regressions showed that frequent attendance was associated with more chronic diseases (adjusted OR 1.12, 95% CI 1.01–1.23), worse functioning (OR 0.97, 95% CI 0.95–0.99), worries about one’s financial situation (OR 2.20, 95% CI 1.07–4.53) and it was inversely associated with depression (OR 0.26, 95% CI 0.08–0.80).
Discussion
In contrast to studies based on younger samples, different factors were associated with frequent users in our study, showing that it is important to study the determinants of frequent attendance among the oldest old.
Conclusion
In Germany, among the group of the oldest old, frequent attendance was positively associated with worse physical health status (e.g., number of chronic diseases), but negatively with depression. This might indicate that the German health care system is responsive to the physical, but not psychological needs of the oldest old.
Alternative splicing is a fundamental posttranscriptional mechanism for controlling gene expression, and splicing defects have been linked to various human disorders. The splicing factor FOX-2 is ...part of a main protein interaction hub in a network related to human inherited ataxias, however, its impact remains to be elucidated. Here, we focused on the reported interaction between FOX-2 and ataxin-1, the disease-causing protein in spinocerebellar ataxia type 1. In this line, we further evaluated this interaction by yeast-2-hybrid analyses and co-immunoprecipitation experiments in mammalian cells. Interestingly, we discovered that FOX-2 localization and splicing activity is affected in the presence of nuclear ataxin-1 inclusions. Moreover, we observed that FOX-2 directly interacts with ataxin-2, a protein modulating spinocerebellar ataxia type 1 pathogenesis. Finally, we provide evidence that splicing of pre-mRNA of ataxin-2 depends on FOX-2 activity, since reduction of FOX-2 levels led to increased skipping of exon 18 in ataxin-2 transcripts. Most striking, we observed that ataxin-1 overexpression has an effect on this splicing event as well. Thus, our results demonstrate that FOX-2 is involved in splicing of ataxin-2 transcripts and that this splicing event is altered by overexpression of ataxin-1.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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