The Effects of Learning Mindfulness Based Stress Reduction on Psychosocial Variables and HbA1c in Adolescents with Type 1 Diabetes

ABSTRACT THE PHYSIOLOGICAL AND PSYCHOSOCIAL EFFECTS OF AN ONLINE MINDFULNESS BASED STRESS REDUCTION INTERVENTION ON ADOLESCENTS WITH TYPE 1 DIABETES By Denise E. Van Sant – Smith Date: 4-5-2019 Dissertation Supervised by Linda Goodfellow, PhD, RN, FAAN Background: Stress has been shown to increase glucose levels through a sympathetic physiological response resulting in a release of chemicals such as adrenalin and cortisol, a response which results in an even greater need for insulin. Adolescents with Type 1 Diabetes may not be able to change or decrease the amount of stress in their lives but they may be able to change the way they respond to the stress they experience. Mindfulness Based Stress Reduction (MBSR) has been shown to help practitioners change the way they respond to stress and perhaps reduce the psychosocial and physiological effects of stress. Objectives: To determine if learning MBSR has an influence on psychosocial variables and the physiological variable of HbA1c in adolescents with Type 1 Diabetes and explore the relationships between those psychosocial variables and HbA1c in adolescents with Type 1 Diabetes. Methods: This between group experimental design measured the effects of a 6-week, online/web-based instructional MBSR training module at three time points (pre intervention, immediately post intervention and 3 months post intervention) on adolescents with Type 1 Diabetes (N = 65) randomly assigned to either the Active Group or Control (Wait) group. The major dependent variables of Mindful Attention Awareness (MAAS-A), Diabetes Quality of Life (DQOLY) were measured at the three time points to examine the effects of MBSR on those variables. The dependent variable of HbA1c was measured at Time 1 and Time 3 to examine the effects of MBSR. Data Collected on Mindfulness, Quality of Life and HbA1c were correlated with MBSR training to examine their relationships. Prior to hypotheses testing, data collected on perceived stress and characteristics of the sample population were examined to ascertain any confounding variables. Results: 65 individuals participated in the study. Mixed between-within subjects analysis of variance tests were used to determine the effects of MBSR over the two post intervention time points. There was a significant interaction effect of time with group assignment (Active or Control Group) on MAAS-A scores, Wilks’ Lambda = 0.44, F(2, 62) = 38.85, p = 0.000. There were also significant main effects on the score of time and group assignment for MAAS-A. There was a significant interaction effect of time with group on DQOLY scores, Wilks’ Lambda = 0.793, F(2, 62) = 8.08, p = 0.001. There was a significant main effect of time on DQOLY score Wilks’ Lambda = .73, F(2,62) = 11.18 p \u3c 0.001. There was a significant interaction effect of time with group on HbA1c results, Wilks’ Lambda = 0.861, F(1, 63) = 10.13, p = 0.001. Discussion: These findings suggest that learning MBSR may improve Mindful Attention Awareness, quality of life and lower HbA1c. Key Words: adolescents with Type 1 Diabetes *diabetes quality of life * HbA1c *mindful attention * mindfulnes

Da neurastenia ao estresse: notas para uma história das doenças nervosas

O texto trata de alguns aspectos da história da neurastenia e do advento do estresse, incluindo suas relações com o imaginário das doenças nervosas, entre o final do século XIX e as primeiras décadas do século XX. O objetivo principal é o de perceber as diferenças entre aquelas duas patologias, assim como as controvérsias por elas desencadeadas entre cientistas brasileiros e estrangeiros. A hipótese central é fruto de uma pesquisa mais ampla, na qual as doenças são consideradas não apenas como tendo uma história reveladora das maneiras de conceber as fragilidades e as potências do corpo, mas indicam, também, ambições ligadas à produtividade no trabalho e ao progresso social

Descobrir o Corpo: uma história sem fim

The article deals with therelationship between the discovery of the body and the possibility of news risks for thehealth. The paradox between constructing a free body and implementing many formsof body alteration was registered in sciences and arts. Looking back through the actualhistory we can see how this paradox changes and how the events of 1968 and theirrepercussions demonstrated a new sense for the reconstruction of self, revealing problemsand challenges for the humanities.Este artigo trata das relaçõesentre descoberta do corpo e a possibilidade de novos riscos para a saúde. O paradoxoentre a construção do corpo livre e a implementação de inúmeras alterações corporaisfoi estudada nas ciências e nas artes. Através da história atual é possível percebercomo este paradoxo muda e como os eventos de 1968 e suas repercussões apontarampara um novo sentido da reconstrução do eu, revelando a emergência de problemas edesafios para as ciências humanas

From neurastenia to stress: notes for a history of nervous diseases

O texto trata de alguns aspectos da história da neurastenia e do advento do estresse, incluindo suas relações com o imaginário das doenças nervosas, entre o final do século XIX e as primeiras décadas do século XX. O objetivo principal é o de perceber as diferenças entre aquelas duas patologias, assim como as controvérsias por elas desencadeadas entre cientistas brasileiros e estrangeiros. A hipótese central é fruto de uma pesquisa mais ampla, na qual as doenças são consideradas não apenas como tendo uma história reveladora das maneiras de conceber as fragilidades e as potências do corpo, mas indicam, também, ambições ligadas à produtividade no trabalho e ao progresso social.The text deals with some aspects of the history of neurasthenia and the advent of stress, including its relations with the imaginary of nervous diseases, between the end of the 19th century and the first decades of the 20th century. The main objective is to understand the main differences between those two pathologies, as well as the controversies triggered by them between Brazilian and foreign scientists. The central hypothesis that runs throughout the text, the result of broader research, is that diseases not only have a history that reveals the ways of conceiving the weaknesses and strengths of the body, but also indicate ambitions linked to productivity in the field work and social progress

The human Schwann cell transcriptome: species-specificity, long-term stability and changes with differentiation

Cultured Schwann cells of human origin differ from those isolated from experimental animals in both phenotype and function. However, the basis for this divergence and its significance to potential clinical applications of the primary cells are not fully understood. In this study, we used RNA-seq to comprehensively analyze the human Schwann cell transcriptome and compare it to that of ratcells. We also studied the transcriptomics profiles of human Schwann cells subjected to: (1) the pro-mitogenic effect of growth factors in cells undergoing serial passaging in vitro, and (2) the pro-differentiating action of cAMP, a signal known to promote myelin gene expression in rodent cells.Despite the human Schwann cell transcriptome differedas much as 44% from that of rat Schwann cells established under identical conditions, the human cells maintained their expected Schwann cell identity regardless of sub-culture and the continued influence of mitogenic factors. Strikingly, the transcriptomes of low passage (proliferative) and late passage (senescent) human Schwann cells were essentially undistinguishable with the exception of roughly 100 differentially expressed genes in the senescentpopulations. On the contrary, the human Schwann cell transcriptome was readily and persistently shifted in response to a single treatment with cAMP analogs as highlighted by the >1,300 genes that were upregulated and the >1,700 genes that were downregulated within 1-day post-stimulation. In sum, these results confirmed that human Schwann cellsmaintain their typical gene expression profiles in culture unless challenged with a strong pro-differentiating stimulus. The observed stability of the human Schwann celltranscriptome in the face of expansion and mitogenic stimulation adds a level of safety for theuse of these glial cells in clinical transplantation.Fil: Monje, Paula. Indiana University; Estados Unidos. University of Miami; Estados UnidosFil: Sant, David. University of Miami; Estados UnidosFil: Andersen, Natalia Denise. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; ArgentinaFil: Camarena, Vladimir. University of Miami; Estados UnidosFil: Wang, Gaofeng. University of Miami; Estados UnidosXIV European Meeting on Glial cells in Health and DiseasePortoPortugalEuropean Meeting on Glial Cells in Health and Diseas

O HIBRIDISMO DO FENÔMENO SONORO E SEU DESDOBRAMENTO NA PRODUÇÃO DE HERMETO PASCOAL

This article reflects on the sonorities that coexist in cultural dynamics and characterizea hybrid listening, being the target of reinventions in the face of social transformationsand the way of seeing the world. It is from this perspective that we propose an immersionin the universe of sound and music, in its relationship between materiality and meaning,highlighting sound, noise, silence, and music as a hybrid fusion that intensely affects thecontemporary sound field. In this hybridism, from which sound emerges as a physicalphenomenon that unfolds in expressions that range from voiceovers to music, MurraySchafer’s concept of soundscape stands out, and Hermeto Pascoal’s musical hybridismbecomes evident. Based on an interdisciplinary reflection, fundamentals of acoustics andits properties, of musical field, of sound as matter and cultural representation, and of soundhybridism contribute for this interlocution. Sound is conceived as a sign, whose meaning isapprehended by active listening, and the artist Hermeto Pascoal is exposed as an exampleof a human sound texture, a plural subjectivity, generated by memories of daily life, by oralexpression, by emotions, articulation that makes his musical production a peculiar soundhybridism. In its conclusion, the article relates the hybrid form of sounds with the diversityand multiplicity of reality, suggesting that reflection on sound hybridism can be a vehiclefor bringing human beings closer together and renewing.Este artigo reflete sobre sonoridades que coexistem na dinâmica cultural e caracterizam uma escuta híbrida, sendo alvo de reinvenções diante das transformações sociais e da forma de ver o mundo.  É nessa perspectiva que se propõe uma imersão no universo sonoro e musical, em sua relação entre materialidade e sentido, destacando o som, o ruído, o silêncio e a música como uma fusão híbrida que assola, de modo intenso, o campo sonoro contemporâneo. Nesse hibridismo, de onde emerge o som como fenômeno físico que se desdobra em expressões que vão de locuções à música, destaca-se a contribuição do conceito de paisagem sonora de Murray Schafer e se evidencia o hibridismo musical de Hermeto Pascoal. Para essa interlocução, com base em uma reflexão interdisciplinar, contribuem fundamentos da acústica e suas propriedades, do campo musical, do som como matéria e representação cultural e do hibridismo sonoro. O som é concebido como um signo, cuja significação é apreendida pela escuta ativa, e expõe-se o artista Hermeto Pascoal como exemplo de uma textura sonora humana, uma subjetividade plural, gerada por memórias da vida cotidiana, pela expressão oral, por emoções, articulação que faz de sua produção musical um hibridismo sonoro peculiar. Em sua conclusão, o artigo relaciona a forma híbrida dos sons com a diversidade e a multiplicidade do real, sugerindo que a reflexão sobre o hibridismo sonoro pode ser veículo de aproximação entre os seres humanos e de renovação.

Stability of lineage-specific attributes in senescent human peripheral glia

Senescent and non-senescent human Schwann cells (hSCs) established in culture are virtually undistinguishable without the aid of specific tests such as detection of senescence-associated β-galactosidase (SA-βGal) activity. In most cultures, the rate of cell division is maintained high up until the second passage but cells cease to proliferate rapidly thereafter and the populations become senescent. By passage-5 no further expansion is possible and the cells manifest abnormalities such as vacuolization of the cytoplasm, aberrant nuclei (including multinucleation), and clustering. Arrival to senescence in hSC populations cannot be prevented by overexpression of hTERT and indefectibly occur under standard culture conditions regardless of the age of the donor. Even though senescent hSCs remain viable for prolonged periods of time, it is unclear whether they maintain attributes specific to cells of the SC lineage. To address this question, we performed a careful analysis of the progression of hSCs towards senescence to evaluate changes in proliferation rates, viability, purity and expression of SC-specific markers. We also obtained the transcriptomes of hSCs collected at different rounds of subculture and performed a stringent bioinformatics analysis to identify SC-specific and regulatory genes. We found that the hSC transcriptome was very stable and that hSCs maintained their expected identity (or transcriptional signature) regardless of subculture and the continued influence of mitogenic factors. Strikingly, the transcriptomes of low passage (proliferative) and late passage (senescent) hSCs were essentially undistinguishable with the exception of <100 differentially expressed genes known to play a role in replicative senescence, cell cycle arrest, chromatin organization and telomere maintenance. Senescent hSCs expressed invariable levels of SC-specific markers such as S100β and aligned to each other forming typical bundles at confluency. Most importantly, they maintained their ability to engulf and digest myelin granules, which is a function proper of SCs during nerve repair. To conclude, our studies show the value of combining transcriptomics (RNAseq) profiling and cell-based assays to understand hSC senescence. The stability of the hSC transcriptome in the face of expansion and mitogenic stimulation adds a level of safety for the use of these glial cells in autotransplantation therapy.Fil: Monje, Paula. Indiana University. School of Medicine; Estados UnidosFil: Andersen, Natalia Denise. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Investigaciones Bioquímicas de Bahía Blanca. Universidad Nacional del Sur. Instituto de Investigaciones Bioquímicas de Bahía Blanca; Argentina. University of Miami; Estados UnidosFil: Sant, David. University of Miami; Estados UnidosFil: Peng, Kevin. Indiana University. School of Medicine; Estados UnidosFil: Wang, Gaofeng. University of Miami; Estados UnidosFil: Xu, Xiao-Ming. Indiana University. School of Medicine; Estados UnidosXV European Meetingon Glial Cells in Health and DiseaseMarseillesFranciaEuropean Glial Meetin

O campo discursivo da textura sonora: diálogos e polifonias

O tema deste artigo discute conceitos de Bakthin e Maingueneau em uma proposta de análise de um corpus, representado aqui por uma expressão verbal e musical, definida pelo conceito de textura sonora. O objetivo é refletir sobre a forma de estruturação dos elementos musicais e verbais e das relações dialógicas que se estabelecem nesse campo sonoro. O marco teórico para a análise proposta fundamenta-se principalmente nos conceitos de dialogismo, enunciado, polifonia, intertextualidade e de uma possível aproximação com impressões relativas à cena enunciativa, à cenografia e ao ethos. Este artigo caracteriza-se como descritivo e bibliográfico e sua análise é qualitativa. Os resultados confirmam que a estrutura composicional da textura sonora revela uma natureza dialógica e intertextual que, intensificada pela polifonia e por aspectos cenográficos característicos, reforça a possibilidade de criações estéticas servirem para produção e difusão de conhecimento

Phase II Study of Sequential Gemcitabine Followed by Docetaxel for Recurrent Ewing Sarcoma, Osteosarcoma, or Unresectable or Locally Recurrent Chondrosarcoma: Results of Sarcoma Alliance for Research Through Collaboration Study 003

Background.Gemcitabine and docetaxel have a broad spectrum of clinical activity in patients with carcinoma. The Sarcoma Alliance for Research Through Collaboration conducted a phase II trial of gemcitabine in combination with docetaxel in children and adults with recurrent Ewing sarcoma (EWS), osteosarcoma (OS), or unresectable or recurrent chondrosarcoma. The primary objective was to determine the objective response rate using Response Evaluation Criteria in Solid Tumors (RECIST).Methods.Gemcitabine (675 mg/m2 i.v. over 90 minutes on days 1 and 8) was administered in combination with docetaxel (75 mg/m2 i.v. over 1 hour on day 8) every 21 days. All patients received filgrastim or pegfilgrastim. A Bayesian formulation was used to determine the probability of achieving the target response rate for each subtype—0.35 for EWS and OS or 0.20 for chondrosarcoma. If the probability of achieving the target response rate was <0.05, the combination was considered inactive. Toxicity was graded according to Common Terminology Criteria for Adverse Events (CTCAE), version 3.0.Results.Fifty‐three eligible patients were enrolled in the three subtype groups—OS (n = 14), EWS (n = 14), and chondrosarcoma (n = 25). Toxicities included neutropenia, thrombocytopenia, fatigue, dyspnea, bronchospasm, edema, neuropathy, and liver function abnormalities. Dose modification for toxicity was required for eight patients during cycle 1 and 16 patients in subsequent cycles. Seven patients withdrew from therapy as a result of toxicity. No complete responses were observed. Partial responses were observed in OS (n = 1), EWS (n = 2), and chondrosarcoma (n = 2) patients.Conclusion.Gemcitabine in combination with docetaxel was associated with a probability of reaching the target 35% response rate of <5% in OS patients and 5.6% in EWS patients; the probability of reaching a 20% response rate in chondrosarcoma patients was 14%.摘要背景. 吉西他滨与多西他赛对癌症患者有广谱的临床疗效。 肉瘤研究联盟协作组在复发的尤文肉瘤 （EWS）、 骨肉瘤 （OS）、 不可切除或复发的软骨肉瘤成人和儿童患者中开展了吉西他滨联合多西他赛的 II 期试验。 主要目的为通过实体瘤疗效评估标准 （RECIST） 确定客观缓解率。方法. 吉西他滨 （675 mg/m2， 静脉滴注 90 分钟以上， 第 1 和 8 天） 联合多西他赛 （75 mg/m2， 静脉滴注 1 小时以上， 第 8 天） 每 21 天给药 1 次。 全部患者均同时接受非格司亭或乙二醇化非格司亭。 利用贝叶斯公式来确定各个亚型达到目标缓解率的概率——EWS 和 OS 为 0.35， 软骨肉瘤为 0.20。 如果达到目标缓解率的概率 < 0.05， 则认为联合方案无效。 毒性反应根据不良事件通用术语标准 （CTCAE） 3.0 版来分级。结果. 53 例合格患者入组 3 个亚型组 ： OS （n=14）、 EWS （n=14）、 软骨肉瘤 （n=25）。 毒性反应包括中性粒细胞减少、 血小板减少、 乏力、 呼吸困难、 支气管痉挛、 水肿、 神经病变以及肝功能异常。 第 1 个周期有 8 例患者、 其后周期有 16 例患者因毒性反应而需要剂量调整。 7 例患者因毒性反应而撤出治疗。 未观察到完全缓解。 OS （n=1）、 EWS （n=2） 和软骨肉瘤 （n=2） 组均有患者达到部分缓解。结论. 吉西他滨联合多西他赛在 < 5% 的 OS 患者、 5.6% 的 EWS 患者中达到目标缓解率的概率为 35%； 14% 软骨肉瘤患者中达到目标缓解率的概率为 20%。讨论. 贝叶斯公式能够评估各个亚型在分别进行缓解率评估后预测达到目标缓解率的概率。 通过多角度来看这些数据， 在考量达到目标缓解率的概率以及入组率之后即能发现本研究设计方案阻碍了研究的继续开展。 因为这一设计方案并未设定判断治疗为 “有效” 的规则， 所以并不适合与标准的分 2 阶段进行的 II 期试验设计直接比较。 关闭 EWS 和软骨肉瘤亚组的决定， 某种程度上是基于入组缓慢， 另外达到目标缓解率的概率较低也支持这一决定。 入组率而不是统计设计， 对试验周期有显著影响。The Oncologist 2012;17:321‐e329Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139909/1/onco0321-sup-0002.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139909/2/onco0321-sup-0001.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139909/3/onco0321.pd