There is significant evidence that athletes are using recombinant human growth hormone (rhGH) to enhance performance, and its use is banned by the World Anti-Doping Agency and professional sports ...leagues. Insulin-like growth factor-1 (IGF-1) is the primary mediator of growth hormone action and is used as a biomarker for the detection of rhGH abuse. The current biomarker-based method requires collection and expedited shipment of venous blood which is costly and may decrease the number of tests performed. Measurement of GH biomarkers in dried blood spots (DBS) would considerably simplify sample collection and shipping methods to allow testing of a greater number of samples regardless of location. A method was developed to quantify intact IGF-1 protein in DBS by liquid chromatography–tandem mass spectrometry. A step-wise acid–acetonitrile extraction was optimized to achieve a sensitive assay with a lower limit of quantification of 50 ng/mL. IGF-1 remained stable at room temperature for up to 8 days, which would allow shipment of DBS cards at ambient temperature. In a comparison between plasma concentrations of IGF-1 and concentrations measured from venous and finger prick DBS, there was good correlation and agreement,
r
2
of 0.8551 and accuracy of 86–113 % for venous DBS and
r
2
of 0.9586 and accuracy of 89–122 % for finger prick DBS. The method is intended for use as a rapid screening method for IGF-1 to be used in the biomarker method of rhGH abuse detection.
Background The neurosteroid allopregnanolone is a potent allosteric modulator of the gamma-aminobutyric acid type A receptor with anxiolytic properties. Exogenous administration of allopregnanolone ...reduces anxiety, and allopregnanolone blockade impairs social and affective functioning. However, the neural mechanism whereby allopregnanolone improves mood and reduces anxiety is unknown. In particular, brain imaging has not been used to link neurosteroid effects to emotion regulation neurocircuitry. Methods To investigate the brain basis of allopregnanolone’s impact on emotion regulation, participants were administered 400 mg of pregnenolone ( n =16) or placebo ( n =15) and underwent 3T functional magnetic resonance imaging while performing the shifted-attention emotion appraisal task, which probes emotional processing and regulation. Results Compared with placebo, allopregnanolone was associated with reduced activity in the amygdala and insula across all conditions. During the appraisal condition, allopregnanolone increased activity in the dorsal medial prefrontal cortex and enhanced connectivity between the amygdala and dorsal medial prefrontal cortex, an effect that was associated with reduced self-reported anxiety. Conclusions These results demonstrate that in response to emotional stimuli, allopregnanolone reduces activity in regions associated with generation of negative emotion. Furthermore, allopregnanolone may enhance activity in regions linked to regulatory processes. Aberrant activity in these regions has been linked to anxiety psychopathology. These results thus provide initial neuroimaging evidence that allopregnanolone may be a target for pharmacologic intervention in the treatment of anxiety disorders and suggest potential future directions for research into neurosteroid effects on emotion regulation neurocircuitry.
•Indegree centrality was associated with education service use.•Positive staff relationships and outdegree were associated with employment service use.•Education, housing, LGBTQ+ identity and ...location were associated with service use.
Youth experiencing homelessness (YEH) face significant obstacles to educational achievement and gainful employment. Drop-in centers offer support services to facilitate these opportunities, but there remains a need to understand which youth are most likely to use them. The present study used a diffusion of innovations framework to examine social network correlates of service use over a three-month period. Positive staff relationships, personal network exposure, and structural network measures were examined.
Participants were 253 YEH (Mage = 21.9, SD = 2.2) participating in an HIV-prevention trial at three drop-in centers in Los Angeles. Surveys were completed at baseline (wave 1), 1-month (wave 2) and 3-months (wave 3) post-baseline. Individual characteristics and sociometric network ties to other youth were assessed. Cross-sectional and lagged logistic regression models were used to identify significant network correlates of service use.
A significant minority of YEH used education (23.6%) or employment (33.7%) services at wave 1, with modest increases at waves 2 and 3. Indegree centrality was associated with education service use at wave 1 (OR = 1.30, 95% CI1.04, 1.64). Positive staff relationships were associated with employment service use at wave 1 (OR = 2.05, 95% CI1.06, 2.99), and outdegree was associated with employment service use at wave 3 (OR = 1.69, 95% CI1.13, 2.55). In addition, education level, housing situation, LGBTQ+ identity, drop-in center location, and duration of drop-in center use were related to service usage.
Youth who occupy more central network positions and/or report positive relationships with staff are more likely to use higher-level drop-in services. Network approaches to engaging youth in services should be considered along with other individual and contextual factors.
Although the U.S. Department of Veterans Affairs (VA) has prioritized care for posttraumatic stress disorder (PTSD), many patients with PTSD remain symptomatic. Patterns of PTSD symptom change are ...not well understood. Thus, the current study was designed to categorize and investigate potential predictors of symptom trajectories in patients with PTSD. The sample comprised 2,237 VA patients who were diagnosed with PTSD in 2013 and completed at least 4 PTSD Checklist (PCL) assessments over 12 weeks. Latent trajectory analysis was used to identify latent classes of patients based on PCL scores. Based on model fit indices, 3 trajectories were identified. Compared to patients in the mild‐improving trajectory (21.9%), those in the severe‐stable trajectory (34.3%) were more likely to be male, relative risk ratio (RRR) = 1.48, 95% CI 1.08, 2.02; non‐White, RRR = 1.77, 95% CI 1.33, 2.35; Hispanic, RRR = 2.07, 95% CI 1.40, 3.04; and have comorbid depression, RRR = 1.58, 95% CI 1.25, 1.99. Compared to patients in the moderate‐improving trajectory (43.8%), those in the severe‐stable trajectory were more likely to have sleep disorders, RRR = 1.25, 95% CI 1.01, 1.55. Our findings suggest that male veterans, minority veterans, and veterans with certain comorbid conditions may be less likely to achieve improved PTSD symptoms. Targeted efforts are needed to improve outcomes for PTSD patients on nonremitting trajectories and to improve the consistency of PTSD assessment across the VA health care system.
Resumen
Spanish s by the Asociación Chilena de Estrés Traumático (ACET)
A pesar que el departamento de asuntos para veteranos (AV) ha priorizado la atención del trastorno por estrés postraumático (TEPT), muchos pacientes con TEPT permanecen sintomáticos. Los patrones de cambio de los síntomas de TEPT no se conocen bien. De este modo, el presente estudio fue formulado para categorizar e investigar los potenciales predictores de las trayectorias de síntomas en pacientes con TEPT. La muestra comprendía a 2.237 pacientes AV que fueron diagnosticados con TEPT en el 2013 y completaron al menos 4 evaluaciones de listas de chequeo de TEPT (PCL) a lo largo de 12 semanas. Se utilizó el análisis de trayectoria latente para identificar clases latentes de pacientes basados en los puntajes de PCL. Basado en los índices de ajuste del modelo, 3 trayectorias fueron identificadas. En comparación con los pacientes en la trayectoria de mejoría leve (21,9%),los de la trayectoria severa estable (34,3%) fueron más propensos a ser hombres (Radio de Riesgo Relativo RRR = 1.48, 95% CI 1.08, 2.02), de color (RRR = 1.77, 95% CI 1.33, 2.35), Hispánicos (RRR = 2.07, 95% CI 1.40, 3.04), y con depresión comorbida (RRR = 1.58, 95% CI 1.25, 1.99).En comparación con los pacientes en la trayectoria de mejoría moderada (43,8%) aquellos en la trayectoria severa estable tenían más probabilidades de tener trastornos del sueño (RRR = 1.25, 95% CI 1.01, 1.55). Nuestros hallazgos sugieren que veteranos hombres, de grupos minoritarios, y con ciertas condiciones de comorbilidad pueden tener menos probabilidad de conseguir una mejoría en los síntomas de TEPT. Es necesario dirigir los esfuerzos en mejorar las consecuencias del TEPT para pacientes en las trayectorias sin remisión y para mejorar la consistencia de la evaluación del TEPT en toda la AV.
摘要
Traditional and Simplified Chinese s by AsianSTSS
標題: 退伍軍人事務部門診患者中PTSD症狀變化的預測變量
撮要: 雖然退伍軍人事務部(VA)會優先治療創傷後壓力症(PTSD)患者, 但仍有很多PTSD患者還未康復。目前我們還未了解PTSD症狀變化的模式。因此, 本研究透過PTSD患者, 分類並探查症狀軌跡的潛在預測變量。樣本為2,237名於2013年在VA被確診患PTSD的患者, 他們在12星期裡進行了至少4次的PTSD檢查表(PCL)評估。我們利用潛在軌跡分析, 基於PCL分數得出患者的潛在類別。
我們基於模型吻合指數, 找出3種軌跡。跟「輕微與正在改善」軌跡的患者(21.9%)相比, 在「嚴重與穩定」軌跡的患者(34.3%)有更大可能是男性 (相對風險率 RRR = 1.48, 95% CI 1.08, 2.02)、非白人 (RRR = 1.77, 95% CI 1.33, 2.35)、西班牙裔 (RRR = 2.07, 95% CI 1.40, 3.04), 並有共病抑鬱症 (RRR = 1.58, 95% CI 1.25, 1.99)。跟「中度與正在改善」軌跡的患者(43.8%)相比, 在「嚴重與穩定」軌跡的患者更大可能有睡眠失常(RRR = 1.25, 95% CI 1.01, 1.55)。結果反映, 男性、少數族裔退役軍人, 和有某些共病狀況的退役軍人, PTSD症狀改善的可能性較小。對於在無改善軌跡的患者, 我們需加以提供針對性治療, 並提升VA普遍評估PTSD的一致性。
标题: 退伍军人事务部门诊患者中PTSD症状变化的预测变量
撮要: 虽然退伍军人事务部(VA)会优先治疗创伤后压力症(PTSD)患者, 但仍有很多PTSD患者还未康复。目前我们还未了解PTSD症状变化的模式。因此, 本研究透过PTSD患者, 分类并探查症状轨迹的潜在预测变量。样本为2,237名于2013年在VA被确诊患PTSD的患者, 他们在12星期里进行了至少4次的PTSD检查表(PCL)评估。我们利用潜在轨迹分析, 基于PCL分数得出患者的潜在类别。
我们基于模型吻合指数, 找出3种轨迹。跟「轻微与正在改善」轨迹的患者(21.9%)相比, 在「严重与稳定」轨迹的患者(34.3%)有更大可能是男性 (相对风险率 RRR = 1.48, 95% CI 1.08, 2.02)、非白人 (RRR = 1.77, 95% CI 1.33, 2.35)、西班牙裔 (RRR = 2.07, 95% CI 1.40, 3.04), 并有共病抑郁症 (RRR = 1.58, 95% CI 1.25, 1.99)。跟「中度与正在改善」轨迹的患者(43.8%)相比, 在「严重与稳定」轨迹的患者更大可能有睡眠失常(RRR = 1.25, 95% CI 1.01, 1.55)。结果反映, 男性、少数族裔退役军人, 和有某些共病状况的退役军人, PTSD症状改善的可能性较小。对于在无改善轨迹的患者, 我们需加以提供针对性治疗, 并提升VA普遍评估PTSD的一致性。
IntroductionMRI and MR spectroscopy (MRS) provide early biomarkers of brain injury and treatment response in neonates with hypoxic-ischaemic encephalopathy). Still, there are challenges to ...incorporating neuroimaging biomarkers into multisite randomised controlled trials. In this paper, we provide the rationale for incorporating MRI and MRS biomarkers into the multisite, phase III high-dose erythropoietin for asphyxia and encephalopathy (HEAL) Trial, the MRI/S protocol and describe the strategies used for harmonisation across multiple MRI platforms.Methods and analysisNeonates with moderate or severe encephalopathy enrolled in the multisite HEAL trial undergo MRI and MRS between 96 and 144 hours of age using standardised neuroimaging protocols. MRI and MRS data are processed centrally and used to determine a brain injury score and quantitative measures of lactate and n-acetylaspartate. Harmonisation is achieved through standardisation—thereby reducing intrasite and intersite variance, real-time quality assurance monitoring and phantom scans.Ethics and disseminationIRB approval was obtained at each participating site and written consent obtained from parents prior to participation in HEAL. Additional oversight is provided by an National Institutes of Health-appointed data safety monitoring board and medical monitor.Trial registration numberNCT02811263; Pre-result.
Images of Life Rampton, Tammy B.; Rosemann, Jessica L.; Latta, Aimee L. ...
Journal of family nursing,
11/2007, Letnik:
13, Številka:
4
Journal Article
Recenzirano
This qualitative, descriptive study used photography to capture important symbols in the lives of 16 siblings living in families raising a child with Down syndrome (CWDS). Content analysis revealed ...two categories: people/nonpeople. The people category included family members and friends, whereas the non-people category included objects, animals, and buildings. Similarities/differences also were noted according to age and gender. Seven- to 9-year-olds took more snapshots of themselves and their parents than did the other age groups; the 10-to 12-year-olds and 13- to 15-year-olds took more photographs of the CWDS than did the younger age group. Female siblings took more snapshots of their typically developing brothers/sisters, family members in mixed groups, and people not in their family than did male siblings. Male siblings took more photographs of their parents and themselves. Results validate the importance of gathering qualitative data from children and confirm the use of photography as one of these methods.
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