45 research outputs found

    Child and parent outcomes following parent interventions for child emotional and behavioral problems in autism spectrum disorders: A systematic review and meta-analysis

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    There is growing interest in the development of behavioral parent interventions targeting emotional and behavioral problems in children with autism spectrum disorders. Such interventions have potential to improve a number of child and parental well-being outcomes beyond disruptive child behavior. This systematic review and meta-analysis assesses evidence for the efficacy of behavioral parent interventions for disruptive and hyperactive child behavior in autism spectrum disorders, as well as parenting efficacy and stress. A total of 11 articles from nine randomized controlled trials were included. Sufficient data were available to calculate standardized mean difference and show favorable effects of behavioral parent interventions on parent-reported measures of child disruptive behavior (standardized mean difference = 0.67), hyperactivity (standardized mean difference = 0.31) and parent stress (standardized mean difference = 0.37); effects on parent efficacy are less clear (standardized mean difference = 0.39, p = 0.17). There were insufficient data to explore intervention effects on internalizing behavior in autism spectrum disorders, parenting behaviors, or observational and teacher-reported outcomes, providing important avenues for future research. This review adds to growing evidence of the efficacy of behavioral parent interventions for child behavior and parental well-being in autism spectrum disorders (Prospero: CRD42016033979)

    Una oportunitat per intercanviar bones pràctiques en l’atenció a la cronicitat a nivell europeu: el projecte JA-CHRODIS

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    Good practices; Chronic patient; JA-CHRODISBuenas prácticas; Paciente crónico; JA-CHRODISBones pràctiques; Pacient crònic; JA-CHRODISEl nombre de persones que pateixen malalties cròniques ha augmentat considerablement durant les últimes dècades. Aquesta situación ha provocat que el sistema sanitari hagi hagut de reorientar-se i desenvolupar diverses pràctiques que pretenen optimitzar l’atenció als pacients crònics. La Comissió Europea va posar en marxa el 2014 una acció conjunta en la qual han participat 60 institucions que pertanyen a 26 països de la Unió Europea; el projecte JA-CHRODIS. L’objectiu de l’acció ha consistit en identificar les millors experiències que s’estan duent a terme actualment a Europa en atenció a la cronicitat, a partir d’uns criteris d’avaluació unificats i consensuats, per tal de posar-les a disposició tant dels professionals com dels gestors i responsables polítics de serveis d’atenció a la salut a través d’un repositori; es permet així l’intercanvi d’informació sobre aquelles experiències més exitoses i es promou la transferència i la implementació de les millors pràctiques.El número de personas que sufren enfermedades crónicas ha aumentado considerablemente durante las últimas décadas. Esta situación ha provocado que el sistema sanitario haya tenido que reorientarse y desarrollar varias prácticas que pretenden optimizar la atención a los pacientes crónicos. La Comisión Europea puso en marcha el 2014 una acción conjunta en la cual han participado 60 instituciones que pertenecen en 26 países de la Unión Europea; el proyecto JA-CHRODIS. El objetivo de la acción ha consistido en identificar las mejores experiencias que se están llevando a cabo actualmente en Europa en atención a la cronicidad, a partir de unos criterios de evaluación unificados y consensuados, para ponerlas a disposición tanto de los profesionales cómo de los gestores y responsables políticos de servicios de atención a la salud a través de un repositorio; se permite así el intercambio de información sobre aquellas experiencias más exitosas y se promueve la transferencia y la implementación de las mejores prácticas.The number of people are living with a chronic disease has increased considerably during the last decades. This situation has caused a change in the health system. It has to reorient itself and develop several practices that aim to optimize the care of chronic patients. The European Commission launched in 2014 a joint action in which 60 institutions that belong in 26 countries of the European Union have participated; the JA-CHRODIS project. The objective of the action has been to identify the best experiences that is being currently carried out in Europe about attention to chronicity, based on unified and agreed evaluation criteria, to make them available to both professionals and managers and policy makers of health care services through a repository; In this way allows the exchange of information on those most successful experiences and promotes the transfer and implementation of best practices

    Description of arts therapies practice with adults suffering from depression in the UK: quantitative results from the nationwide survey

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    There is growing evidence that arts therapies may be under-used treatments for the 'global burden' of depression. However, the experiences of arts therapists, their methods, tools and ways of working with this client group remain unclear. Arts therapies in the UK are a form of psychotherapy. They use arts media alongside therapeutic relationship as means of therapeutic change and include four disciplines: Art Therapy (AT), Music Therapy (MT), Dance Movement Psychotherapy (DMP) and Drama Therapy (DT). In 2011, all arts therapists registered in the UK were invited to complete an online questionnaire concerning their practice in general and specifically in relation to clients with depression. The Arts Therapies Survey received 395 responses. Arts therapists who work primarily with depression were identified and compared to those who do not work with depression on a range of factors, including preferred theoretical approaches and style of working. Arts therapists who specialise in depression tend to follow Psychodynamic principles more often, are more likely to be older and experienced, work with groups, in health settings and with adults more often than children or adolescents. These quantitative findings enable the description of most common practice of arts therapies with depression in the UK and are intended to serve as a reference for arts therapists themselves and other professionals interested in the treatment of depression. Qualitative data gathered in the survey will be presented in a separate paper, with the aim of deepening the understanding already gained. © 2013 Elsevier Ltd

    Imaging biomarker roadmap for cancer studies.

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    Imaging biomarkers (IBs) are integral to the routine management of patients with cancer. IBs used daily in oncology include clinical TNM stage, objective response and left ventricular ejection fraction. Other CT, MRI, PET and ultrasonography biomarkers are used extensively in cancer research and drug development. New IBs need to be established either as useful tools for testing research hypotheses in clinical trials and research studies, or as clinical decision-making tools for use in healthcare, by crossing 'translational gaps' through validation and qualification. Important differences exist between IBs and biospecimen-derived biomarkers and, therefore, the development of IBs requires a tailored 'roadmap'. Recognizing this need, Cancer Research UK (CRUK) and the European Organisation for Research and Treatment of Cancer (EORTC) assembled experts to review, debate and summarize the challenges of IB validation and qualification. This consensus group has produced 14 key recommendations for accelerating the clinical translation of IBs, which highlight the role of parallel (rather than sequential) tracks of technical (assay) validation, biological/clinical validation and assessment of cost-effectiveness; the need for IB standardization and accreditation systems; the need to continually revisit IB precision; an alternative framework for biological/clinical validation of IBs; and the essential requirements for multicentre studies to qualify IBs for clinical use.Development of this roadmap received support from Cancer Research UK and the Engineering and Physical Sciences Research Council (grant references A/15267, A/16463, A/16464, A/16465, A/16466 and A/18097), the EORTC Cancer Research Fund, and the Innovative Medicines Initiative Joint Undertaking (grant agreement number 115151), resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and European Federation of Pharmaceutical Industries and Associations (EFPIA) companies' in kind contribution

    Exploiting novel valve interstitial cell lines to study calcific aortic valve disease

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    Calcific aortic valve disease (CAVD) involves progressive valve leaflet thickening and severe calcification, impairing leaflet motion. The in vitro calcification of primary rat, human, porcine and bovine aortic valve interstitial cells (VICs) is commonly employed to investigate CAVD mechanisms. However, to date, no published studies have utilised cell lines to investigate this process. The present study has therefore generated and evaluated the calcification potential of immortalized cell lines derived from sheep and rat VICs. Immortalised sheep (SAVIC) and rat (RAVIC) cell lines were produced by transduction with a recombinant lentivirus encoding the Simian virus (SV40) large and small T antigens (sheep), or large T antigen only (rat), which expressed markers of VICs (vimentin and -smooth muscle actin). Calcification was induced in the presence of calcium (Ca; 2.7 mM) in SAVICs (1.9 fold;

    A novel role for the mineralocorticoid receptor in glucocorticoid driven vascular calcification

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    AbstractVascular calcification, which is common in the elderly and in patients with atherosclerosis, diabetes and chronic renal disease, increases the risk of cardiovascular morbidity and mortality. It is a complex, active and highly regulated cellular process that resembles physiological bone formation. It has previously been established that pharmacological doses of glucocorticoids facilitate arterial calcification. However, the consequences for vascular calcification of endogenous glucocorticoid elevation have yet to be established. Glucocorticoids (cortisol, corticosterone) are released from the adrenal gland, but can also be generated within cells from 11-keto metabolites of glucocorticoids (cortisone, 11-dehydrocorticosterone [11-DHC]) by the enzyme, 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1). In the current study we hypothesized that endogenous glucocorticoids facilitate vascular smooth muscle cell (VSMC) calcification and investigated the receptor-mediated mechanism underpinning this process.In vitro studies revealed increased phosphate-induced calcification in mouse VSMCs following treatment for 7days with corticosterone (100nM; 7.98 fold; P<0.01), 11-DHC (100nM; 7.14 fold; P<0.05) and dexamethasone (10nM; 7.16 fold; P<0.05), a synthetic glucocorticoid used as a positive control. Inhibition of 11β-HSD isoenzymes by 10μM carbenoxolone reduced the calcification induced by 11-DHC (0.37 fold compared to treatment with 11-DHC alone; P<0.05). The glucocorticoid receptor (GR) antagonist mifepristone (10μM) had no effect on VSMC calcification in response to corticosterone or 11-DHC. In contrast, the mineralocorticoid receptor (MR) antagonist eplerenone (10μM) significantly decreased corticosterone- (0.81 fold compared to treatment with corticosterone alone; P<0.01) and 11-DHC-driven (0.64 fold compared to treatment with 11-DHC alone; P<0.01) VSMC calcification, suggesting this glucocorticoid effect is MR-driven and not GR-driven. Neither corticosterone nor 11-DHC altered the mRNA levels of the osteogenic markers PiT-1, Osx and Bmp2. However, DAPI staining of pyknotic nuclei and flow cytometry analysis of surface Annexin V expression showed that corticosterone induced apoptosis in VSMCs.This study suggests that in mouse VSMCs, corticosterone acts through the MR to induce pro-calcification effects, and identifies 11β-HSD-inhibition as a novel potential treatment for vascular calcification

    <i>Strongyloides</i> questions-a research agenda for the future.

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    The Strongyloides genus of parasitic nematodes have a fascinating life cycle and biology, but are also important pathogens of people and a World Health Organization-defined neglected tropical disease. Here, a community of Strongyloides researchers have posed thirteen major questions about Strongyloides biology and infection that sets a Strongyloides research agenda for the future. This article is part of the Theo Murphy meeting issue 'Strongyloides: omics to worm-free populations'

    Imaging biomarker roadmap for cancer studies.

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    Imaging biomarkers (IBs) are integral to the routine management of patients with cancer. IBs used daily in oncology include clinical TNM stage, objective response and left ventricular ejection fraction. Other CT, MRI, PET and ultrasonography biomarkers are used extensively in cancer research and drug development. New IBs need to be established either as useful tools for testing research hypotheses in clinical trials and research studies, or as clinical decision-making tools for use in healthcare, by crossing 'translational gaps' through validation and qualification. Important differences exist between IBs and biospecimen-derived biomarkers and, therefore, the development of IBs requires a tailored 'roadmap'. Recognizing this need, Cancer Research UK (CRUK) and the European Organisation for Research and Treatment of Cancer (EORTC) assembled experts to review, debate and summarize the challenges of IB validation and qualification. This consensus group has produced 14 key recommendations for accelerating the clinical translation of IBs, which highlight the role of parallel (rather than sequential) tracks of technical (assay) validation, biological/clinical validation and assessment of cost-effectiveness; the need for IB standardization and accreditation systems; the need to continually revisit IB precision; an alternative framework for biological/clinical validation of IBs; and the essential requirements for multicentre studies to qualify IBs for clinical use.Development of this roadmap received support from Cancer Research UK and the Engineering and Physical Sciences Research Council (grant references A/15267, A/16463, A/16464, A/16465, A/16466 and A/18097), the EORTC Cancer Research Fund, and the Innovative Medicines Initiative Joint Undertaking (grant agreement number 115151), resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and European Federation of Pharmaceutical Industries and Associations (EFPIA) companies' in kind contribution
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