1,754 research outputs found
Introspective interest and insight in the context of Mindfulness-Based Stress Reduction:A randomized trial
Objective Introspective interest and insight have long been argued to be important factors in psychotherapy. However, empirical studies are scarce and their results equivocal. Therefore, in the present study, the potential moderating and mediating roles of introspective interest and insight were examined in the context of mindfulness-based stress reduction (MBSR). Methods In a randomized controlled trial, 72 MBSR participants were compared with 71 waitlist control participants. Their mean age was 46.1 years (SD = 10.3), 31.5% were male and all were white. Pre-to-post changes in mood, perceived stress, quality of life, mindfulness skills, and introspective interest and insight were compared between the groups and the moderating and mediating effects of introspective interest and insight were examined, adjusting for effects of mindfulness skills. Results Introspective interest nor insight moderated the effects of MBSR. However, increase in insight, but not interest, significantly mediated favorable effects of MBSR on all outcome variables, over and above changes in mindfulness skills: perceived stress (B = − 1.43, 95% CI − 2.63 to − 0.54), negative affect (B = − 0.11, 95% CI − 0.23 to − 0.00), positive affect (B = 0.12, 95% CI 0.03–0.23) and psychological quality of life (B = 0.16, 95% CI 0.02–0.34). Conclusions Increase in introspective insight may form a potentially important mechanism of the effectiveness of mindfulness-based interventions, and possibly also other psychological interventions
Identifying tree populations for conservation action through geospatial analyses
Rapid development of information and communication technologies has made it possible to easily collect georeferenced information on species and their environment, and to use it for analyzing biological diversity, its distribution and threats to it. Such analyses can importantly inform development of conservation strategies and priorities, especially across countries or species distribution ranges (Guarino et al. 2002). Data for spatial analyses on species or genetic diversity and its distribution are collected in specifically designed studies, obtained from existing records of species occurrence, or both. Observations may be complemented by species distribution modelling, where the potential occurrence of a species is predicted based on its documented geographic distribution and climate in those areas. Results on the distribution of diversity, documented or modelled, can then be compared, for example, with existing protected areas, rates of forest degradation, threats of environmental changes, or socio-economic indicators, to identify priority tree populations and tailor strategies for their conservation and sustainable use (Pautasso 2009). In this paper recent case studies on spatial biodiversity analyses across the tropics are presented, demonstrating how such analyses can help to identify most unique or most threatened populations of a tree species for conservation actions. Insights on initiating collaborative research on diversity and distributions of important Asian tree species are also discussed
Prognostic value of serial score measurements of the national early warning score, the quick sequential organ failure assessment and the systemic inflammatory response syndrome to predict clinical outcome in early sepsis
BACKGROUND AND IMPORTANCE: Sepsis is a common and potentially lethal syndrome, and early recognition is critical to prevent deterioration. Yet, currently available scores to facilitate recognition of sepsis lack prognostic accuracy. OBJECTIVE: To identify the optimal time-point to determine NEWS, qSOFA and SIRS for the prediction of clinical deterioration in early sepsis and to determine whether the change in these scores over time improves their prognostic accuracy. DESIGN: Post hoc analysis of prospectively collected data. SETTINGS AND PARTICIPANTS: This study was performed in the emergency department (ED) of a tertiary-care teaching hospital. Adult medical patients with (potential) sepsis were included. OUTCOME MEASURES AND ANALYSIS: The primary outcome was clinical deterioration within 72 h after admission, defined as organ failure development, the composite outcome of ICU-admission and death. Secondary outcomes were the composite of ICU-admission/death and a rise in SOFA at least 2. Scores were calculated at the ED with 30-min intervals. ROC analyses were constructed to compare the prognostic accuracy of the scores. RESULTS: In total, 1750 patients were included, of which 360 (20.6%) deteriorated and 79 (4.5%) went to the ICU or died within 72 h. The NEWS at triage (AUC, 0.62; 95% CI, 0.59-0.65) had a higher accuracy than qSOFA (AUC, 0.60; 95% CI, 0.56-0.63) and SIRS (AUC, 0.59; 95% CI, 0.56-0.63) for predicting deterioration. The AUC of the NEWS at 1 h (0.65; 95% CI, 0.63-0.69) and 150 min after triage (0.64; 95% CI, 0.61-0.68) was higher than the AUC of the NEWS at triage. The qSOFA had the highest AUC at 90 min after triage (0.62; 95% CI, 0.58-0.65), whereas the SIRS had the highest AUC at 60 min after triage (0.60; 95% CI, 0.56-0.63); both are not significantly different from triage. The NEWS had a better accuracy to predict ICU-admission/death <72 h compared with qSOFA (AUC difference, 0.092) and SIRS (AUC difference, 0.137). No differences were found for the prediction of a rise in SOFA at least 2 within 72 h between the scores. Patients with the largest improvement in any of the scores were more prone to deteriorate. CONCLUSION: NEWS had a higher prognostic accuracy to predict deterioration compared with SIRS and qSOFA; the highest accuracy was reached at 1 h after triage
Global strategy for the conservation and use of eggplants
Common eggplant (Solanum melongena L.), also known as brinjal eggplant or aubergine, is a vegetable crop grown for its large soft fruits which are used in cooking. There are also two African eggplant species grown locally: scarlet eggplant (Solanum aethiop icum L.) and gboma eggplant (Solanum macrocarpon L.). According to the statistics of the United Nations Food and Agriculture Organization (FAO), eggplant is grown on 1.8 million hectares (ha) globally, and 90% of eggplant production takes place in Asia. Breeding and research on eggplant is carried out in many coun tries. Numerous germplasm collections of eggplant and its related species exist to provide plant materials for breeding and related research. In the present study, we overview the current status of eggplant germplasm conservation efforts and the use of eggplant diversity with the aim of providing a forward-looking strategy document. To do this, we surveyed the global databases Genesys and WIEWS (World Information and Early Warning System on Plant Genetic Resources for Food and Agriculture) to obtain information about existing eggplant ex situ collections. The most often represented species in these databases is brinjal eggplant with 12,715 acces sions conserved in total. This is followed by scarlet eggplant (886 accessions) and gboma eggplant (209 accessions). Wild relatives of eggplant are conserved in some collections, but some species are not well represented. In total, 109 eggplant collection holders were iden tified through the database searches. The collection holders were asked to complete an online survey on the status of their collections and the challenges that they faced. Responses were received from 32 collec tion holders, 27 of which provided sufficient data for further analyses. Most of the collection holders that responded were governmental organizations or publicly funded institutions. Two respondents were non-governmental organizations (NGOs). Several challenges related to the sustainability of eggplant conservation and use were identified. Shortages of funds and staff were reported as major threats to collection viability and security by many of the collec tion holders. Opportunities for improvement included recruiting new and/or young people interested in eggplant conservation, and increased collaborations across national borders and among institutions. Improved documentation of existing plant materials and increased information sharing were also identi fied as areas for improvement.publishedVersio
Assessing the experience of person‐centred coordinated care of people with chronic conditions in the Netherlands:Validation of the Dutch P3CEQ
Effective group training for patients with unexplained physical symptoms: A randomized controlled trial with a non-randomized one-year follow-up
Background: Although cognitive-behavioral therapy for Unexplained Physical Symptoms (UPS) is effective in secondary care, studies done in primary care produced implementation problem
Effect of long-term physical activity and acute exercise on markers of systemic inflammation in persons with chronic spinal cord injury: a systematic review
Objective: To evaluate the effect of long-term physical activity (PA) and acute exercise on markers of systemic inflammation in persons with chronic spinal cord injury (SCI)
Evaluation of the presence of clinically significant hemolytic disease of the fetus and newborn due to RhD antibodies in multi-ethnic Suriname
Sex-specific microRNAs in neurovascular units in ischemic stroke
Accumulating evidence pinpoints sex differences in stroke incidence, etiology and outcome. Therefore, more understanding of the sex-specific mechanisms that lead to ischemic stroke and aggravation of secondary damage after stroke is needed. Our current mechanistic understanding of cerebral ischemia states that endothelial quiescence in neurovascular units (NVUs) is a major physiological parameter affecting the cellular response to neuron, astrocyte and vascular smooth muscle cell (VSMC) injury. Although a hallmark of the response to injury in these cells is transcriptional activation, noncoding RNAs such as microRNAs exhibit cell-type and context dependent regulation of gene expression at the post-transcriptional level. This review assesses whether sex-specific microRNA expression (either derived from X-chromosome loci following incomplete X-chromosome inactivation or regulated by estrogen in their biogenesis) in these cells controls NVU quiescence, and as such, could differentiate stroke pathophysiology in women compared to men. Their adverse expression was found to decrease tight junction affinity in endothelial cells and activate VSMC proliferation, while their regulation of paracrine astrocyte signaling was shown to neutralize sex-specific apoptotic pathways in neurons. As such, these microRNAs have cell type-specific functions in astrocytes and vascular cells which act on one another, thereby affecting the cell viability of neurons. Furthermore, these microRNAs display actual and potential clinical implications as diagnostic and prognostic biomarkers in ischemic stroke and in predicting therapeutic response to antiplatelet therapy. In conclusion, this review improves the current mechanistic understanding of the molecular mechanisms leading to ischemic stroke in women and highlights the clinical promise of sex-specific microRNAs as novel diagnostic biomarkers for (silent) ischemic stroke.Paroxysmal Cerebral Disorder
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