1,455 research outputs found

    Impact and experiences of vestibular disorders and psychological distress: Qualitative findings from patients, family members and healthcare professionals.

    Get PDF
    INTRODUCTION: People with vestibular disorders frequently experience reduced quality of life and challenges with activities of daily living. Anxiety, depression and cognitive problems often co-present with vestibular disorders and can aggravate symptoms and prolong clinical recovery. We aimed to gain in-depth insights into the impact of vestibular disorders and the contribution of psychological factors by exploring multistakeholder perspectives. METHODS: Semistructured interviews were conducted between October 2021 and March 2022 with 47 participants in the United Kingdom including: 20 patients (age M = 50.45 ± 13.75; 15 females), nine family members (age M = 61.0 ± 14.10; four females), and 18 healthcare professionals. Data were analysed using framework analysis. RESULTS: Vestibular disorders impact diverse aspects of patients' lives including work, household chores, socialising, and relationships with family and friends. Being unable to engage in valued activities or fulfil social roles contributes to feelings of grief and frustration, affecting identity, confidence, and autonomy. Anxiety and low mood contribute to negative thought processes, avoidance, and social withdrawal, which can impede clinical recovery through reduced activity levels, and end engagement with treatment. Coping strategies were thought to help empower patients to self-manage their symptoms and regain a sense of control, but these require oversight from healthcare providers. CONCLUSIONS: Daily activity limitations, social participation restrictions, and psychological distress can interact to impact quality of life, sense of self, and clinical recovery amongst people with vestibular disorders. Information and resources could aid societal awareness of the impact of vestibular disorders and help patients and families feel understood. An individualised and comprehensive approach that concurrently addresses mental, physical, social, and occupational needs is likely to be beneficial. PATIENT OR PUBLIC CONTRIBUTION: Two group meetings were held at the beginning and end of the study with a patient and public involvement network formed of people with vestibular disorders and family members. These individuals commented on the study aims, interview schedule, participant recruitment practices, and interpretation of the themes identified. Two core patient members were involved at all stages of the research. These individuals contributed to the formulation of the interview schedule, development and application of the coding scheme, development and interpretation of themes, and preparation of the final manuscript

    Transcriptional regulation of the urokinase receptor (u-PAR) - A central molecule of invasion and metastasis

    Get PDF
    The phenomenon of tumor-associated proteolysis has been acknowledged as a decisive step in the progression of cancer. This short review focuses on the urokinase receptor (u-PAR), a central molecule involved in tumor-associated invasion and metastasis, and summarizes the transcriptional regulation of u-PAR. The urokinase receptor (u-PAR) is a heavily glycosylated cell surface protein and binds the serine protease urokinase specifically and with high affinity. It consists of three similar cysteine-rich repeats and is anchored to the cell membrane via a GPI-anchor. The u-PAR gene comprises 7 exons and is located on chromosome 19q13. Transcriptional activation of the u-PAR promoter region can be induced by binding of transcription factors (Sp1, AP-1, AP-2, NF-kappaB). One current study gives an example for transcriptional downregulation of u-PAR through a PEA3/ets transcriptional silencing element. Knowledge of the molecular regulation of this molecule in tumor cells could be very important for diagnosis and therapy in the near future

    Monitoring temporal change in riparian vegetation of Great Basin National Park

    Full text link
    Disturbance in riparian areas of semiarid ecosystems involves complex interactions of pulsed hydrologic flows, herbivory, fire, climatic effects, and anthropogenic influences. We resampled riparian vegetation within ten 10-m × 100-m plots that were initially sampled in 1992 in 4 watersheds of the Snake Range, east central Nevada. Our finding of significantly lower coverage of grasses, forbs, and shrubs within plots in 2001 compared with 1992 was not consistent with the management decision to remove livestock grazing from the watersheds in 1999. Change over time in cover of life-forms or bare ground was not predicted by scat counts within plots in 2001. Cover results were also not well explained by variability between the 2 sampling periods in either density of native herbivores or annual precipitation. In contrast, Engelmann spruce (Picea engelmannii) exhibited reduced abundance at all but the highest-elevation plot in which it occurred in 1992, and the magnitude of change in abundance was strongly predicted by plot elevation. Abundance of white fir (Abies concolor) individuals increased while aspen (Populus tremuloides) individuals decreased at 4 of 5 sites where they were sympatric, and changes in abundance in the 2 species were negatively correlated across those sites. Utility of monitoring data to detect change over time and contribute to adaptive management will vary with sample size, observer bias, use of repeatable or published methods, and precision of measurements, among other factors

    Range-wide assessment of livestock grazing across the sagebrush biome

    Get PDF
    Domestic livestock grazing occurs in virtually all sagebrush habitats and is a prominent disturbance factor. By affecting habitat condition and trend, grazing influences the resources required by, and thus, the distribution and abundance of sagebrush-obligate wildlife species (for example, sage-grouse Centrocercus spp.). Yet, the risks that livestock grazing may pose to these species and their habitats are not always clear. Although livestock grazing intensity and associated habitat condition may be known in many places at the local level, we have not yet been able to answer questions about use, condition, and trend at the landscape scale or at the range-wide scale for wildlife species. A great deal of information about grazing use, management regimes, and ecological condition exists at the local level (for individual livestock management units) under the oversight of organizations such as the Bureau of Land Management (BLM). However, the extent, quality, and types of existing data are unknown, which hinders the compilation, mapping, or analysis of these data. Once compiled, these data may be helpful for drawing conclusions about rangeland status, and we may be able to identify relationships between those data and wildlife habitat at the landscape scale

    A Bose-Einstein Approach to the Random Partitioning of an Integer

    Full text link
    Consider N equally-spaced points on a circle of circumference N. Choose at random n points out of NN on this circle and append clockwise an arc of integral length k to each such point. The resulting random set is made of a random number of connected components. Questions such as the evaluation of the probability of random covering and parking configurations, number and length of the gaps are addressed. They are the discrete versions of similar problems raised in the continuum. For each value of k, asymptotic results are presented when n,N both go to infinity according to two different regimes. This model may equivalently be viewed as a random partitioning problem of N items into n recipients. A grand-canonical balls in boxes approach is also supplied, giving some insight into the multiplicities of the box filling amounts or spacings. The latter model is a k-nearest neighbor random graph with N vertices and kn edges. We shall also briefly consider the covering problem in the context of a random graph model with N vertices and n (out-degree 1) edges whose endpoints are no more bound to be neighbors

    Rest Pain and Movement-Evoked Pain as Unique Constructs in Hip and Knee Replacements

    Get PDF
    OBJECTIVE: There is limited information about the extent to which the association between preoperative and chronic postoperative pain is mediated via pain‐on‐movement or pain‐at‐rest. We explored these associations in patients undergoing total hip replacement (THR) and total knee replacement (TKR). METHODS: A total of 322 and 316 patients receiving THR and TKR, respectively, were recruited into a single‐center UK cohort (Arthroplasty Pain Experience) study. Preoperative, acute postoperative, and 12‐month pain severity was measured using self‐reported pain instruments. The association between preoperative/acute pain and chronic postoperative pain was investigated using structural equation modeling (SEM). RESULTS: Patients with high levels of preoperative pain were more likely to report chronic pain after THR (β = 0.195, P = 0.02) and TKR (β = 0.749, P < 0.0001). Acute postoperative pain‐on‐movement was not associated with chronic pain after TKR or THR after adjusting for preoperative pain; however, acute pain‐at‐rest was associated with chronic pain after THR (β = 0.20, P < 0.0002) but not TKR after adjusting for preoperative pain. Analysis of pain‐at‐rest and pain‐on‐movement highlighted differences between THR and TKR patients. Chronic pain‐at‐rest after THR was weakly associated with pain‐at‐rest during the preoperative (β = 0.11, P = 0.068) and acute postoperative period (β = 0.21, P < 0.0001). In contrast, chronic pain‐on‐movement after TKR was strongly associated with the severity of pain‐on‐movement during the preoperative period (β = 0.51, P = 0.001). CONCLUSION: SEM illustrated the different patterns of association between measures of pain over time in patients undergoing THR and TKR for osteoarthritis. These findings highlight the importance of future work that explores the mechanisms underlying pain‐on‐movement and pain‐at‐rest
    corecore