The study examined interrelationships among three components--domains, values and perspectives--in self-esteem of children ages 11, 14 and 17. Specific objectives were: to ascertain relationship ...between interest in a domain and self-esteem in that domain; to test James' formulation that self-esteem in a highly valued domain was more related to general self-esteem than was self-esteem in an unvalued domain; and to examine developmental trends for increasing cognitive differentiation of domains (athletics, scholatics, general), perspectives (real, ideal, social self-images), and response categories. Subjects (240 Caucasian girls and boys) were grouped according to self-reported interest in athletics and scholastics. Interest was assessed through an importance value scale and an activity preference measure. Self-esteem ratings were obtained from questionnaires with self-esteem items in the three domains and were administered using three different orientations for real, ideal and social self-image. Data were analyzed by a repeated measures ANCOVA with IQ as covariate. Results confirmed that degree of interest in a domain and self-esteem in that domain were positively related. The strength of relationship varied with domain, being stronger for athletics than scholastics. Furthermore, a negative relationship was found between interest in scholastics and athletics self-esteem while a positive relationship was found between interest in athletics and general self-esteem. Domain comparisons revealed two patterns: (1) gender difference with boys having more positive athletics self-esteem than girls; and (2) scholastics self-esteem being, for all children, the most negative relative to self-esteem in other domains. James' formulation received partial support; specifically, it was upheld for girls highly interested in scholastics and for boys highly interested in athletics. While no differences were found among the three age groups in differentiation of domains, differentiation of response categories was found to increase with developmental maturity. Results were discussed in terms of the importance of a components model approach when studying self-esteem. Athletics emerged as a potent definer of self-worth for children of these ages; this was discussed in terms of peer group valuational influences upon children's self-values and subsequent self-esteem. Recommendations for future research were inclusion of more domains and examination of directionality in the relationship between interest and self-esteem in domain.
The Academy of Nutrition and Dietetics and the National Kidney Foundation collaborated to provide an update to the Clinical Practice Guidelines (CPG) for nutrition in chronic kidney disease (CKD). ...These guidelines provide a valuable update to many aspects of the nutrition care process. They include changes in the recommendations for nutrition screening and assessment, macronutrients, and targets for electrolytes and minerals. The International Society of Renal Nutrition and Metabolism assembled a special review panel of experts and evaluated these recommendations prior to public review. As one of the highlights of the CPG, the recommended dietary protein intake range for patients with diabetic kidney disease is 0.6-0.8 g/kg/day, whereas for CKD patients without diabetes it is 0.55-0.6 g/kg/day. The International Society of Renal Nutrition and Metabolism endorses the CPG with the suggestion that clinicians may consider a more streamlined target of 0.6-0.8 g/kg/day, regardless of CKD etiology, while striving to achieve intakes closer to 0.6 g/kg/day. For implementation of these guidelines, it will be important that all stakeholders work to detect kidney disease early to ensure effective primary and secondary prevention. Once identified, patients should be referred to registered dietitians or the region-specific equivalent, for individualized medical nutrition therapy to slow the progression of CKD. As we turn our attention to the new CPG, we as the renal nutrition community should come together to strengthen the evidence base by standardizing outcomes, increasing collaboration, and funding well-designed observational studies and randomized controlled trials with nutritional and dietary interventions in patients with CKD.
CFI-400945 is a selective oral polo-like kinase 4 (PLK4) inhibitor that regulates centriole duplication. PLK4 is aberrantly expressed in patients with acute myeloid leukemia (AML). Preclinical ...studies indicate that CFI-400945 has potent in vivo efficacy in hematological malignancies and xenograft models, with activity in cells harboring TP53 mutations. In this phase 1 study in very high-risk patients with relapsed/refractory AML and myelodysplastic syndrome (MDS) (NCT03187288), 13 patients were treated with CFI-400945 continuously in dose escalation from 64 mg/day to 128 mg/day. Three of the 9 efficacy evaluable AML patients achieved complete remission (CR). Two of 4 AML patients (50%) with TP53 mutations and complex monosomal karyotype achieved a CR with 1 patient proceeding to allogenic stem cell transplant. A third patient with TP53 mutated AML had a significant reduction in marrow blasts by > 50% with an improvement in neutrophil and platelet counts. Responses were observed after 1 cycle of therapy. Dose-limiting toxicity was enteritis/colitis. A monotherapy and combination therapy study with a newer crystal form of CFI-400945 in patients with AML, MDS and chronic myelomonocytic leukemia (CMML) is ongoing (NCT04730258).
The zoonotic Plasmodium knowlesi parasite is a growing public health concern in Southeast Asia, especially in Malaysia, where elimination of P. falciparum and P. vivax malaria has been the focus of ...control efforts. Understanding of the genetic diversity of P. knowlesi parasites can provide insights into its evolution, population structure, diagnostics, transmission dynamics, and the emergence of drug resistance. Previous work has revealed that P. knowlesi fall into three main sub-populations distinguished by a combination of geographical location and macaque host (Macaca fascicularis and M. nemestrina). It has been shown that Malaysian Borneo groups display profound heterogeneity with long regions of high or low divergence resulting in mosaic patterns between sub-populations, with some evidence of chromosomal-segment exchanges. However, the genetic structure of non-Borneo sub-populations is less clear. By gathering one of the largest collections of P. knowlesi whole-genome sequencing data, we studied structural genomic changes across sub-populations, with the analysis revealing differences in Borneo clusters linked to mosquito-related stages of the parasite cycle, in contrast to differences in host-related stages for the Peninsular group. Our work identifies new genetic exchange events, including introgressions between Malaysian Peninsular and M. nemestrina-associated clusters on various chromosomes, including in parasite invasion genes (DBPFormula: see text, NBPXFormula: see text and NBPXFormula: see text), and important proteins expressed in the vertebrate parasite stages. Recombination events appear to have occurred between the Peninsular and M. fascicularis-associated groups, including in the DBPFormula: see text and DBPFormula: see text invasion associated genes. Overall, our work finds that genetic exchange events have occurred among the recognised contemporary groups of P. knowlesi parasites during their evolutionary history, leading to apparent mosaicism between these sub-populations. These findings generate new hypotheses relevant to parasite evolutionary biology and P. knowlesi epidemiology, which can inform malaria control approaches to containing the impact of zoonotic malaria on human communities.
Abstract
Background
Self-efficacy is an important determinant of physical activity but it is unclear how best to increase self-efficacy for physical activity and to maintain these changes.
Purpose
...This systematic review aimed to identify which specific behavior change techniques (BCTs), BCT clusters, and number of BCTs were associated with changes in postintervention and maintained changes in self-efficacy for physical activity across all adult populations.
Methods
A systematic search yielded 180 randomized trials (204 comparisons) which reported changes in self-efficacy. BCTs were coded using the BCT Taxonomy v1. Hierarchical cluster analysis explored the clustering of BCTs. Meta-analyses and moderator analyses examined whether the presence and absence of individual BCTs in interventions were associated with effect-size changes for self-efficacy.
Results
Small intervention effects were found for postintervention self-efficacy for physical activity (d = 0.26; 95% CI: 0.21, 0.31; I2 = 75.8 per cent). “Information about social, environmental, and emotional consequences” was associated with higher effect sizes, whereas “social support (practical)” was associated with lower effect sizes. Small and nonsignificant effects were found for maintained changes in self-efficacy for physical activity (d = 0.08; CI: −0.05, 0.21; I2 = 83.8 per cent). Lack of meaningful clustering of BCTs was found. A significant positive relationship was found between number of BCTs and effect sizes for maintained changes in self-efficacy for physical activity.
Conclusions
There does not appear to be a single effective approach to change self-efficacy for physical activity in all adults: different approaches are required for different populations. Interventions with more BCTs seem more effective at maintaining changes in self-efficacy for physical activity.
A universal approach for increasing self-efficacy for physical activity across all adult populations does not appear to be practical. It is important to tailor intervention content and Behaviour Change Techniques to different populations.
Outcomes relevant to treatment decision-making are inconsistently reported in trials involving glomerular disease. Here, we sought to establish a consensus-derived set of critically important ...outcomes designed to be reported in all future trials by using an online, international two-round Delphi survey in English. To develop this, patients with glomerular disease, caregivers and health professionals aged 18 years and older rated the importance of outcomes using a Likert scale and a Best-Worst scale. The absolute and relative importance was assessed and comments were analyzed thematically. Of 1198 participants who completed Round 1, 734 were patients/caregivers while 464 were health care professionals from 59 countries. Of 700 participants that completed Round 2, 412 were patients/caregivers and 288 were health care professionals. Need for dialysis or transplant, kidney function, death, cardiovascular disease, remission-relapse and life participation were the most important outcomes to patients/caregivers and health professionals. Patients/caregivers rated patient-reported outcomes higher while health care professionals rated hospitalization, death and remission/relapse higher. Four themes explained the reasons for their priorities: confronting death and compounded suffering, focusing on specific targets in glomerular disease, preserving meaning in life, and fostering self-management. Thus, consistent reporting of these critically important outcomes in all trials involving glomerular disease is hoped to improve patient-centered decision-making.
Display omitted
•Microencapsulated PCM and glass bubble as complementary passive cooling strategies.•Microencapsulated PCM and glass bubble coating system on mortar panels is developed.•Maximum surface reduction of ...3.2 °C in a laboratory-based study.•Maximum ambient reduction of 7.0 °C in an outdoor-based study.
As climate change intensifies in recent years, many are paying much attention to efficient energy-saving solutions to reduce the cooling load in buildings. In this work, a passive cooling strategy involving the incorporation of microencapsulated phase change material (MEPCM) and glass bubble (GB) into the paint and coating on mortar panels was investigated in the tropics. Results indicated that the integrated MEPCM-GB mortar panel consisting of 30% PCM and 20 % GB was found to have a maximum surface temperature and ambient temperature reduction of 3.2 °C and 7.0 °C in a laboratory-based and outdoor-based parametric study respectively.
PDF
