An Evidence-Free Zone

Dissertação de mestrado em Psicologia Clínica (Sistémica, Saúde e Família), apresentada à Faculdade de Psicologia e de Ciências da Educação da Universidade de CoimbraO presente trabalho tem como objetivo principal estudar o funcionamento familiar e a congruência numa amostra Angolana de doentes crónicos. Esta investigação envolveu uma amostra de 100 sujeitos com tuberculose tendo sido utilizada a versão portuguesa do Systemic Clinical Outcome and Routine Evaluation (SCORE; Stratton, Bland, Janes & Lask, 2010; tradução, de A. P. Relvas, M. Vilaça, L. Sotero, D. Cunha, & A. Portugal, 2010) para avaliar o funcionamento familiar e a versão portuguesa da Congruence Scale (CS; Lee, 2002; tradução de D. Cunha, J. T. Silva, M. Vilaça, S. Gonçalves, & A. P. Relvas, 2013) para avaliar a congruência dos sujeitos. Os estudos de precisão efetuados com o SCORE-15 apontam para uma elevada consistência interna, acima do resultado obtido por Cardoso (2012) e Sambuta (2012). Contrariamente, os estudos de precisão realizados com a CE revelaram uma fraca consistência interna, provavelmente devido à dificuldade que os indivíduos tiveram na interpretação dos itens deste instrumento. Apenas a dimensão Universal/Espiritual da CE obteve uma boa consistência interna. Os resultados obtidos mostraram ainda que o funcionamento familiar e a relação dos doentes crónicos com a transcendência não parecem estar associados. Em suma, espera-se que sejam feitas novas e futuras investigações com estes instrumentos em Angola, de modo a aprofundar o conhecimento sobre a intervenção com doentes crónicos.The present work aims to study family functioning and coherence in a sample of chronically ill Angolan. This research involved a sample of 100 individuals with tuberculosis the English version of the Systemic Clinical Outcome and Routine Evaluation (SCORE having been used; Stratton, Bland, Janes & Lask, 2010; translatioa, L. Sotero, D. Cunha, A. & Portugal, 2010) to assess family functioning and the English version of the Congruence Scale (CS; Lee, 2002; translation of D. Cunha, JT Silva, M. Va, S. Gonça, 2013) to assess the consistency of the subject. The precision studies performed with the SCORE_15 indicate a high internal consistency, above the result obtained by Cardoso (2012) and Sambuta (2012). In contrast, the precision studies performed with the EC revealed a weak internal consistency, probably due to the difficulty that individuals have in interpreting the items of this instrument. Only Universal / Spiritual dimension of EC got a good internal consistency. The results also showed that family functioning and the relationship of chronic patients with transcendence seem to be associated. In short, it is expected that new and future research with these instruments are made in Angola, in order to deepen the knowledge about the intervention with chronically ill

Anatomical and molecular properties of long descending propriospinal neurons in mice

Long descending propriospinal neurons (LDPNs) are interneurons that form direct connections between cervical and lumbar spinal circuits. LDPNs are involved in interlimb coordination and are important mediators of functional recovery after spinal cord injury (SCI). Much of what we know about LDPNs comes from a range of species, however, the increased use of transgenic mouse lines to better define neuronal populations calls for a more complete characterisation of LDPNs in mice. In this study, we examined the cell body location, inhibitory neurotransmitter phenotype, developmental provenance, morphology and synaptic inputs of mouse LDPNs throughout the cervical and upper thoracic spinal cord. LDPNs were retrogradely labelled from the lumbar spinal cord to map cell body locations throughout the cervical and upper thoracic segments. Ipsilateral LDPNs were distributed throughout the dorsal, intermediate and ventral grey matter as well as the lateral spinal nucleus and lateral cervical nucleus. In contrast, contralateral LDPNs were more densely concentrated in the ventromedial grey matter. Retrograde labelling in GlyT2GFP and GAD67GFP mice showed the majority of inhibitory LDPNs project either ipsilaterally or adjacent to the midline. Additionally, we used several transgenic mouse lines to define the developmental provenance of LDPNs and found that V2b positive neurons form a subset of ipsilaterally projecting LDPNs. Finally, a population of Neurobiotin (NB) labelled LDPNs were assessed in detail to examine morphology and plot the spatial distribution of contacts from a variety of neurochemically distinct axon terminals. These results provide important baseline data in mice for future work on their role in locomotion and recovery from SCI

1998 Fine Art Graduation Exhibition Catalogue

Fine Art ProgramFanshawe College McIntosh GalleryUniversity of Western Ontario April 16th to May 3rd., 1998 Guest Speaker: Michael P. Gibson Director: Michael Gibson Galleryhttps://first.fanshawec.ca/famd_design_fineart_gradcatalogues/1009/thumbnail.jp

Prevalence and predictors of antidepressant prescribing in Northern Ireland

Background Antidepressant prescription rates in the United Kingdom (UK) are among the highest in Western Europe and prescription rates in Northern Ireland (NI) are significantly higher than the rest of the UK. Moreover, while prescription rates are climbing annually, rates of depression are not changing, and evidence suggests that a range of socio-economic and geographical factors may be responsible. Objectives The primary aim was to calculate the rates of antidepressant prescribing for the Northern Ireland population for years 2011 to 2015 and identify significant socio-demographic predictors. Methods (including data) This Administrative Research Centre (Northern Ireland) study linked data from the 2011 census and prescribing records (Enhanced Prescribing Database). The British National Formulary codes was used to identify the four main antidepressant drug types. Findings Results indicated high levels of antidepressant prescribing for years 2011 to 2015 and significant associations were found with demographic, health, and economic variables. Conclusions Northern Ireland has high levels of antidepressant prescribing compared to other parts of the UK and other European countries. This suggests that there is a need to extend the provision of social prescribing, where people can avail of local, non-clinical options to alleviate mental health problems

Chytridiomycosis and Amphibian Population Declines Continue to Spread Eastward in Panama

Chytridiomycosis is a globally emerging disease of amphibians and the leading cause of population declines and extirpations at species-diverse montane sites in Central America. We continued long-term monitoring efforts for the presence of the fungal pathogen Batrachochytrium dendrobatidis (Bd) and for amphibian populations at two sites in western Panama, and we began monitoring at three new sites to the east. Population declines associated with chytridiomycosis emergence were detected at Altos de Campana National Park. We also detected Bd in three species east of the Panama Canal at Soberanía National Park, and prevalence data suggests that Bd may be enzootic in the lowlands of the park. However, no infected frogs were found further east at Tortí (prevalence <7.5% with 95% confidence). Our results suggest that Panama's diverse and not fully described amphibian communities east of the canal are at risk. Precise predictions of future disease emergence events are not possible until factors underlying disease emergence, such as dispersal, are understood. However, if the fungal pathogen spreads in a pattern consistent with previous disease events in Panama, then detection of Bd at Tortí and other areas east of the Panama Canal is imminent. Therefore, development of new management strategies and increased precautions for tourism, recreation, and biology are urgently neede

Obesity as a Potential Risk Factor for Vincristine Induced Peripheral Neuropathy

Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer. Vincristine is a core chemotherapeutic agent for patients with ALL; unfortunately, approximately 78% will develop vincristine-induced peripheral neuropathy (VIPN). VIPN can result in vincristine dose reductions that decrease therapeutic efficacy: making it important to understand which children are at highest risk for VIPN. We hypothesized that pediatric ALL patients who were obese at diagnosis would develop worse VIPN than healthy weight children with ALL within the first year. Our results confirmed that obese pediatric patients have significantly (p=0.03) worse VIPN than patients of healthy weight

A sibling study of whether maternal exposure to different types of natural space is related to birth weight

Background: Birthweight is an important determinant of health across the life course. Maternal exposure to natural space has been linked to higher birthweight, but stronger evidence of a causal link is needed. We use a quasi-experimental sibling study design to investigate if change in the mother’s exposure to natural space between births was related to birthweight, in urban Scotland. Methods: Amount (% area) of total natural space, total accessible (public) natural space, parks, woodlands and open water within 100 m of the mother’s postcode was calculated for eligible births (n = 40 194; 1991–2010) in the Scottish Longitudinal Study (a semi-random 5.3% sample of the Scottish population). Associations between natural space and birthweight were estimated, using ordinary least squares and fixed effects models. Results: Birthweight was associated with the total amount of natural space around the mother’s home (+8.2 g for interquartile range increase), but was unrelated to specific types of natural space. This whole-sample relationship disappeared in the sibling analysis, indicating residual confounding. The sibling models showed effects for total natural space with births to women who already had children (+20.1 g), and to those with an intermediate level of education (+14.1 g). Conclusions: The importance of total natural space for birthweight suggests that benefits can be experienced near to as well as within natural space. Ensuring expectant mothers have good access to high quality neighbourhood natural space has the potential to improve the infant’s start in life, and consequently their health trajectory over the life course

Clinical Trial of Oral Nelfinavir before and during Radiation Therapy for Advanced Rectal Cancer

Purpose Nelfinavir, a PI3-kinase pathway inhibitor, is a radiosensitizer which increases tumor blood flow in preclinical models. We conducted an early-phase study to demonstrate the safety of nelfinavir combined with hypofractionated radiotherapy (RT) and to develop biomarkers of tumor perfusion and radiosensitization for this combinatorial approach. Patients and Methods Ten patients with T3-4 N0-2 M1 rectal cancer received 7 days of oral nelfinavir (1250 mg bd) and a further 7 days of nelfinavir during pelvic RT (25 Gy/5 fractions/7 days). Perfusion CT (p-CT) and DCE-MRI scans were performed pre-treatment, after 7 days of nelfinavir and prior to last fraction of RT. Biopsies taken pre-treatment and 7 days after the last fraction of RT were analysed for tumor cell density (TCD). Results There were 3 drug-related grade 3 adverse events: diarrhea, rash, lymphopenia. On DCE-MRI, there was a mean 42% increase in median Ktrans, and a corresponding median 30% increase in mean blood flow on p-CT during RT in combination with nelfinavir. Median TCD decreased from 24.3% at baseline to 9.2% in biopsies taken 7 days after RT (P=0.01). Overall, 5/9 evaluable patients exhibited good tumor regression on MRI assessed by Tumor Regression Grade (mrTRG). Conclusions This is the first study to evaluate nelfinavir in combination with RT without concurrent chemotherapy. It has shown that nelfinavir-RT is well tolerated and is associated with increased blood flow to rectal tumors. The efficacy of nelfinavir-RT versus RT alone merits clinical evaluation, including measurement of tumor blood flow