Perceived Self-Efficacy in Individuals with Moderate-to-Severe Brain Injury: The Effects of Rehabilitation Outcomes and Depression

Brain injury represents a major public health issue in the United States, accounting for a largely underestimated figure of 2.5 million cases in 2010. The pervasive effects of this chronic medical condition contribute to a growing economic burden, as the physical, cognitive, behavioral, and emotional sequelae of brain injury demand long-term care for those with moderate-to-severe brain injuries. The Centers for Disease Control and Prevention recently proposed new recommendations for improvements in monitoring the incidence of and research on brain injury. The goals of this public health initiative are to better inform health service delivery and ultimately improve quality of life for those affected, as well as their loved ones. In addition to improved quality of life, community reintegration is a primary goal of brain injury rehabilitation. Engagement in rehabilitation is largely dependent upon an individual’s level of impairment, as well as other personal factors. For example, research examining the relationship between targeted interventions and community participation has established support for the protective effects of self-efficacy, or personal belief in one’s abilities to achieve a desired goal. Additional research on the importance of selfefficacy to psychological health has provided further support for the protective effects of this construct against depression and anxiety. Therefore, further research into the relationship between rehabilitation outcomes, psychological health, and self-efficacy is necessary to inform recommendations for improving health service delivery and quality of life for this vulnerable population. The aim of the present study is to examine factors that may be related to self-efficacy in persons with moderate-to-severe brain injury who receive treatment at a longv term postacute brain injury program. The implications of this research include baseline assessment of self-efficacy in this sample that could potentially inform future staff training and overall clinical practice geared towards cultivating self-efficacy in persons with brain injury. The primary limitations of this study are its small sample size and constrained external validity. Despite these limitations, more research is necessary to understand the role of psychological protective factors in brain injury rehabilitation and to inform strategies for improved health service delivery and increased quality of life

IN VITRO EVALUATION OF ANTI-CANCER POTENTIAL OF A3 ADENOSINE RECEPTOR AGONIST ON A549 HUMAN LUNG CANCER CELL LINE

Objective: The objective of this study was to evaluate the cytotoxic potential of A3AR agonist (ABMECA) against human lung cancer cell line A549 by using 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay. Methods: Adenocarcinoma cell line A549 was used to assess MTT based cells viability. In vitro cytotoxic activity was evaluated for 3 different concentration of doxorubicin and A3AR by MTT cytotoxicity assay. Cytotoxicity assay carried out for 3 consecutive days that involves culturing cells into Dulbecco’s MEM medium modified with 10% FBS for 24 h then treatment with different dose of standard and test drug with incubation period of 24 h followed by treatment with MTT for estimation of cytotoxicity and finally, optical density (OD) was measured at 570-630 nm. Results: Different concentration of doxorubicin (1, 5, 10 µM) and ABMECA (10-6M, 10-5M and 10-4M) shown dose-dependent cytotoxicity. There was a significant decrease (p<0.05) in cell viability in both doxorubicin and ABMECA concentration in a dose-dependent manner. This study may guide further for in vivo evaluation of test drug in the lung cancer model. Conclusion: A3 Adenosine Receptor agonist could be potential moiety for the treatment of lung cancer and it would require in vivo study for further research

Chromatographic analysis of age-related changes in mucosal serotonin transmission in the murine distal ileum

BACKGROUND: In the upper bowel, alterations in motility and absorption of key nutrients have been observed as part of the normal ageing process. Serotonin (5-HT) is a key signalling molecule in the gastrointestinal tract and is known to influence motility, however little is known of how the ageing process alters 5-HT signalling processes in the bowel. RESULTS: An isocratic chromatographic method was able to detect all 5-HT precursors and metabolites. Using extracellular and intracellular sampling approaches, we were able to monitor all key parameters associated with the transmission process. There was no alteration in the levels of tryptophan and 5-HTP between 3 and 18 month old animals. There was a significant increase in the ratio of 5-HT:5-HTP and an increase in intracellular 5-HT between 3 and 18 month old animals suggesting an increase in 5-HT synthesis. There was also a significant increase in extracellular 5-HT with age, suggesting increased 5-HT release. There was an age-related decrease in the ratio of intracellular 5-HIAA:extracellular 5-HT, whilst the amount of 5-HIAA did not change with age. In the presence of an increase in extracellular 5-HT, the lack of an age-related change in 5-HIAA is suggestive of a decrease in re-uptake via the serotonin transporter (SERT). CONCLUSIONS: We have used intracellular and extracellular sampling to provide more insight into alterations in the neurotransmission process of 5-HT during normal ageing. We observed elevated 5-HT synthesis and release and a possible decrease in the activity of SERT. Taken together these changes lead to increased 5-HT availability and may alter motility function and could lead to the changes in adsorption observed in the elderly

Does Minimally Invasive Robotic Surgical Treatment Alter Exercise Tolerance in Patients with Atrial Fibrillation and Mitral Regurgitation at Seven to Eleven Weeks Post-Operative?

In the current study, we examined if exercise tolerance was going to be reduced in atrial fibrillation and mitral valve regurgitation patients post a minimally invasive surgery seven to eleven weeks when compared to pre-operative. Patients that participated in this study were diagnosed with atrial fibrillation or mitral valve regurgitation and were previously scheduled for minimally invasive corrective surgery. Subjects were maximally stress tested over two visits, before and after surgery. Oxygen consumption, maximal heart rate, and maximal treadmill time were measured. They also filled out a Physical Activity Scale for the Elderly (PASE) before and after surgery to determine their activity levels. A paired t-test with significance level set at P [less than or equal to] 0.05 revealed that exercise tolerance and activity levels were not found to be significantly different. Subjects in this study were found to be asymptomatic, had mild-moderate atrial fibrillation or mitral valve regurgitation, were younger than previously studied subjects and were active in their daily activities up until the day of their surgery. The principle findings of this study are: 1) patients did not have reduced exercise tolerance after surgery when compared to pre-operative, 2) when compared to age predicted data, VO[subscript]2MAX was not significantly different before or after surgery, and 3) there was no change in activity levels between pre and post surgery.  M.S

Economic evaluation of zinc and copper use in treating acute diarrhea in children: A randomized controlled trial

BACKGROUND: The therapeutic effects of zinc and copper in reducing diarrheal morbidity have important cost implications. This health services research study evaluated the cost of treating a child with acute diarrhea in the hospital, the impact of micronutrient supplementation on the mean predicted costs and its cost-effectiveness as compared to using only standard oral rehydration solution (ORS), from the patient's and government's (providers) perspective. METHODS: Children aged 6 months to 59 months with acute diarrhea were randomly assigned to receive either the intervention or control. The intervention was a daily dose of 40 mg of zinc sulfate and 5 mg of copper sulfate powder dissolved in a liter of standard ORS (n = 102). The control was 50 mg of standard ORS powder dissolved in a liter of standard ORS (n = 98). The cost measures were the total mean cost of treating acute diarrhea, which included the direct medical, the direct non-medical and the indirect costs. The effectiveness measures were the probability of diarrhea lasting ≤ 4 days, the disability adjusted life years (DALYs) and mortality. RESULTS: The mean total cost of treating a child with acute diarrhea was US $14 of which the government incurred an expenditure of 66%. The factors that increased the total were the number of stools before admission (p = 0.01), fever (p = 0.01), increasing grade of dehydration (p = 0.00), use of antibiotics (p = 0.00), use of intra-venous fluids (p = 0.00), hours taken to rehydrate a child (p = 0.00), the amount of oral rehydration fluid used (p = 0.00), presence of any complications (p = 0.00) and the hospital stay (p = 0.00). The supplemented group had a 8% lower cost of treating acute diarrhea, their cost per unit health (diarrhea lasting ≤ 4 days) was 24% less and the incremental cost-effectiveness ratio indicated cost savings (in Rupees) with the intervention [-452; 95%CI (-11306, 3410)]. However these differences failed to reach conventional levels of significance. CONCLUSION: An emphasis on the costs and economic benefits of an alternative therapy is an important aspect of health services research. The cost savings and the attractive cost-effectiveness indicates the need to further assess the role of micronutrients such as zinc and copper in the treatment of acute diarrhea in a larger and more varied population

The utilisation of hydrogels for iPSC-cardiomyocyte research

Cardiac fibroblasts' (FBs) and cardiomyocytes' (CMs) behaviour and morphology are influenced by their environment such as remodelling of the myocardium, thus highlighting the importance of biomaterial substrates in cell culture. Biomaterials have emerged as important tools for the development of physiological models, due to the range of adaptable properties of these materials, such as degradability and biocompatibility. Biomaterial hydrogels can act as alternative substrates for cellular studies, which have been particularly key to the progression of the cardiovascular field. This review will focus on the role of hydrogels in cardiac research, specifically the use of natural and synthetic biomaterials such as hyaluronic acid, polydimethylsiloxane and polyethylene glycol for culturing induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs). The ability to fine-tune mechanical properties such as stiffness and the versatility of biomaterials is assessed, alongside applications of hydrogels with iPSC-CMs. Natural hydrogels often display higher biocompatibility with iPSC-CMs but often degrade quicker, whereas synthetic hydrogels can be modified to facilitate cell attachment and decrease degradation rates. iPSC-CM structure and electrophysiology can be assessed on natural and synthetic hydrogels, often resolving issues such as immaturity of iPSC-CMs. Biomaterial hydrogels can thus provide a more physiological model of the cardiac extracellular matrix compared to traditional 2D models, with the cardiac field expansively utilising hydrogels to recapitulate disease conditions such as stiffness, encourage alignment of iPSC-CMs and facilitate further model development such as engineered heart tissues (EHTs)

Working psychologically in inpatient services

Background: Literature has suggested that therapeutic engagement is considered as an important construct to assess as premature termination of therapy can influence clinical outcome and increase the chances of services becoming cost ineffective (McMurrana, Huband & Overton, 2010). This study aimed to explore how Psychologists' make sense of and understand their engagement with service users in a Medium Secure Unit (MSU). Method: Semi-structured interviews were conducted with six participants (psychologists working in a MSU) and the transcripts were subjected to lnterpretative Phenomenological Analysis (IPA). Results: Three super-ordinate themes emerged from the data with sub-ordinate themes: 'being human together', 'the matryoshka doll of containment' and 'the psychologist as an empowerer in a disempowering system'. The research identified that the participants in the study described experiences of relating to service users at a humanistic level, their experiences of feeling contained, and being a facilitator of containment. The narratives also captured the experiential claims of service users being in a disempowered system but also the psychologists being a facilitator of empowerment. Conclusions: The recommendations that arose were placed within literature and the methodological limitations of the study. They were centered on how services and psychologists can aid service users' engagement in psychological therapies, within MSU

The Utilisation of Hydrogels for iPSC-Cardiomyocyte Research

Cardiac fibroblasts’ (FBs) and cardiomyocytes’ (CMs) behaviour and morphology are influenced by their environment such as remodelling of the myocardium, thus highlighting the importance of biomaterial substrates in cell culture. Biomaterials have emerged as important tools for the development of physiological models, due to the range of adaptable properties of these materials, such as degradability and biocompatibility. Biomaterial hydrogels can act as alternative substrates for cellular studies, which have been particularly key to the progression of the cardiovascular field. This review will focus on the role of hydrogels in cardiac research, specifically the use of natural and synthetic biomaterials such as hyaluronic acid, polydimethylsiloxane and polyethylene glycol for culturing induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs). The ability to fine-tune mechanical properties such as stiffness and the versatility of biomaterials is assessed, alongside applications of hydrogels with iPSC-CMs. Natural hydrogels often display higher biocompatibility with iPSC-CMs but often degrade quicker, whereas synthetic hydrogels can be modified to facilitate cell attachment and decrease degradation rates. iPSC-CM structure and electrophysiology can be assessed on natural and synthetic hydrogels, often resolving issues such as immaturity of iPSC-CMs. Biomaterial hydrogels can thus provide a more physiological model of the cardiac extracellular matrix compared to traditional 2D models, with the cardiac field expansively utilising hydrogels to recapitulate disease conditions such as stiffness, encourage alignment of iPSC-CMs and facilitate further model development such as engineered heart tissues (EHTs)

Inverted appendix mistaken for a polyp during colonoscopy and leading to intussusception

AbstractA spectrum of appendiceal diseases, ranging from simple mucous distension to acute perforated appendicitis, are seen in patients with CF. We report a 6 year old boy with CF and recurrent periumbilical pain. During colonoscopy, a fleshy pedunculated mass at the junction of the ascending colon and caecum was mistaken for a polyp and excised. However, histopathological examination suggested it was a segment of inverted appendix. The remnant of the inverted appendix was subsequently found to be associated with an intussusception