Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 60
Filter
1.
Article in English | MEDLINE | ID: mdl-33489245

ABSTRACT

Despite the progress made in HIV treatment and prevention, HIV remains a major cause of adolescent morbidity and mortality in sub-Saharan Africa. As perinatally infected children increasingly survive into adulthood, the quality of life and mental health of this population has increased in importance. This review provides a synthesis of the prevalence of mental health problems in this population and explores associated factors. A systematic database search (Medline, PsycINFO, Scopus) with an additional hand search was conducted. Peer-reviewed studies on adolescents (aged 10-19), published between 2008 and 2019, assessing mental health symptoms or psychiatric disorders, either by standardized questionnaires or by diagnostic interviews, were included. The search identified 1461 articles, of which 301 were eligible for full-text analysis. Fourteen of these, concerning HIV-positive adolescents, met the inclusion criteria and were critically appraised. Mental health problems were highly prevalent among this group, with around 25% scoring positive for any psychiatric disorder and 30-50% showing emotional or behavioral difficulties or significant psychological distress. Associated factors found by regression analysis were older age, not being in school, impaired family functioning, HIV-related stigma and bullying, and poverty. Social support and parental competence were protective factors. Mental health problems among HIV-positive adolescents are highly prevalent and should be addressed as part of regular HIV care.

2.
J Dev Orig Health Dis ; 8(2): 161-167, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28031078

ABSTRACT

Visual processing problems may be one underlying factor for cognitive impairments related to autism spectrum disorders (ASDs). We examined associations between ASD-traits (Autism-Spectrum Quotient) and visual processing performance (Rey-Osterrieth Complex Figure Test; Block Design task of the Wechsler Adult Intelligence Scale-III) in young adults (mean age=25.0, s.d.=2.1 years) born preterm at very low birth weight (VLBW; <1500 g) (n=101) or at term (n=104). A higher level of ASD-traits was associated with slower global visual processing speed among the preterm VLBW, but not among the term-born group (P<0.04 for interaction). Our findings suggest that the associations between ASD-traits and visual processing may be restricted to individuals born preterm, and related specifically to global, not local visual processing. Our findings point to cumulative social and neurocognitive problems in those born preterm at VLBW.


Subject(s)
Autistic Disorder/physiopathology , Infant, Very Low Birth Weight , Visual Cortex/physiopathology , Visual Pathways/physiopathology , Adult , Female , Humans , Infant, Newborn , Male , Pattern Recognition, Visual , Young Adult
3.
Psychol Med ; 47(2): 353-362, 2017 01.
Article in English | MEDLINE | ID: mdl-27776561

ABSTRACT

BACKGROUND: Prenatal maternal obesity has been linked to adverse childhood neuropsychiatric outcomes, including increased symptoms of attention deficit hyperactivity disorder (ADHD), internalizing and externalizing problems, affective disorders and neurodevelopmental problems but few studies have studied neuropsychiatric outcomes among offspring born to very severely obese women or assessed potential familial confounding by maternal psychological distress. METHOD: We evaluated neuropsychiatric symptoms in 112 children aged 3-5 years whose mothers had participated in a longitudinal study of obesity in pregnancy (50 very severe obesity, BMI ⩾40 kg/m2, obese class III and 62 lean, BMI 18.5-25 kg/m2). The mothers completed the Conners' Hyperactivity Scale, Early Symptomatic Syndrome Eliciting Neurodevelopmental Clinical Examination Questionnaire (ESSENCE-Q), Child's Sleep Habits Questionnaire (CSHQ), Strengths and Difficulties Questionnaire (SDQ), and Child Behavior Checklist (CBCL) to assess child neuropsychiatric symptoms. Covariates included child's sex, age, birthweight, gestational age, socioeconomic deprivation levels, maternal age, parity, smoking status during pregnancy, gestational diabetes and maternal concurrent symptoms of anxiety and depression assessed using State Anxiety of Spielberger State-Trait Anxiety Index (STAI) and General Health Questionnaire (GHQ), respectively. RESULTS: Children exposed to prenatal maternal very severe obesity had significantly higher scores in the Conners' Hyperactivity Scale; ESSENCE-Q; total sleep problems in CSHQ; hyperactivity, conduct problems and total difficulties scales of the SDQ; higher externalizing and total problems, anxious/depressed, aggressive behaviour and other problem syndrome scores and higher DSM-oriented affective, anxiety and ADHD problems in CBCL. Prenatal maternal very severe obesity remained a significant predictor of child neuropsychiatric problems across multiple scales independent of demographic factors, prenatal factors and maternal concurrent symptoms of anxiety and depression. CONCLUSIONS: Prenatal maternal very severe obesity is a strong predictor of increased neuropsychiatric problems in early childhood.


Subject(s)
Attention Deficit and Disruptive Behavior Disorders/epidemiology , Child Behavior Disorders/epidemiology , Obesity/epidemiology , Prenatal Exposure Delayed Effects/epidemiology , Adult , Aftercare , Attention Deficit and Disruptive Behavior Disorders/etiology , Child Behavior Disorders/etiology , Child, Preschool , Female , Humans , Obesity/complications , Pregnancy
4.
J Chem Phys ; 145(15): 154707, 2016 Oct 21.
Article in English | MEDLINE | ID: mdl-27782456

ABSTRACT

Surface ordering of pentacene molecules adsorbed on an aperiodic Cu surface has been studied with density functional theory (DFT) and scanning tunnelling microscopy as a function of coverage. Below 0.73 ML (5.3 × 1013 molecules cm-2), the adsorbate structure is row-like with the molecular axes aligned with the rows in the Cu structure. Between this coverage and 1 ML (7.3 × 1013 molecules cm-2), a structural phase with a checkerboard structure is seen. At this coverage region, the molecules are very close to each other which leads to unusual bending. At higher coverages, a further phase transition to a high-density row structure is seen for most of the film. DFT with van der Waals functionals is employed to study how the molecule-molecule and molecule-surface interactions evolve as a function of coverage.

5.
Psychol Med ; 46(10): 2227-38, 2016 07.
Article in English | MEDLINE | ID: mdl-27109930

ABSTRACT

BACKGROUND: Results of adulthood mental health of those born late-preterm (34 + 0-36 + 6 weeks + days of gestation) are mixed and based on national registers. We examined if late-preterm birth was associated with a higher risk for common mental disorders in young adulthood when using a diagnostic interview, and if this risk decreased as gestational age increased. METHOD: A total of 800 young adults (mean = 25.3, s.d. = 0.62 years), born 1985-1986, participated in a follow-up of the Arvo Ylppö Longitudinal Study. Common mental disorders (mood, anxiety and substance use disorders) during the past 12 months were defined using the Composite International Diagnostic Interview (Munich version). Gestational age was extracted from hospital birth records and categorized into early-preterm (<34 + 0, n = 37), late-preterm (34 + 0-36 + 6, n = 106), term (37 + 0-41 + 6, n = 617) and post-term (⩾42 + 0, n = 40). RESULTS: Those born late-preterm and at term were at a similar risk for any common mental disorder [odds ratio (OR) 1.11, 95% confidence interval (CI) 0.67-1.84], for mood (OR 1.11, 95% CI 0.54-2.25), anxiety (OR 1.00, 95% CI 0.40-2.50) and substance use (OR 1.31, 95% CI 0.74-2.32) disorders, and co-morbidity of these disorders (p = 0.38). While the mental disorder risk decreased significantly as gestational age increased, the trend was driven by a higher risk in those born early-preterm. CONCLUSIONS: Using a cohort born during the advanced neonatal and early childhood care, we found that not all individuals born preterm are at risk for common mental disorders in young adulthood - those born late-preterm are not, while those born early-preterm are at a higher risk. Available resources for prevention and intervention should be targeted towards the preterm group born the earliest.


Subject(s)
Anxiety Disorders/epidemiology , Gestational Age , Infant, Premature , Mood Disorders/epidemiology , Registries/statistics & numerical data , Substance-Related Disorders/epidemiology , Adult , Female , Finland/epidemiology , Humans , Longitudinal Studies , Male , Young Adult
6.
Psychol Med ; 45(15): 3217-26, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26096463

ABSTRACT

BACKGROUND: Glucocorticoids and serotonin may mediate the link between maternal environment, fetal brain development and 'programming' of offspring behaviors. The placenta regulates fetal exposure to maternal hormonal signals in animal studies, but few data address this in humans. We measured prospectively maternal depressive symptoms during pregnancy and mRNAs encoding key gene products determining glucocorticoid and serotonin function in term human placenta and explored associations with infant regulatory behaviors. METHOD: Bi-weekly self-ratings of the Center for Epidemiologic Studies Depression Scale from 12th to 13th gestational week onwards and term placental mRNAs of 11beta-hydroxysteroid dehydrogenase type 2 (HSD2B11), type 1 (HSD1B11), glucocorticoid (NR3C1), mineralocorticoid receptors (NR3C2) and serotonin transporter (SLC6A4) were obtained from 54 healthy mothers aged 32.2 ± 5.3 years with singleton pregnancies and without pregnancy complications. Infant regulatory behaviors (crying, feeding, spitting, elimination, sleeping and predictability) were mother-rated at 15.6 ± 4.2 days. RESULTS: Higher placental mRNA levels of HSD2B11 [0.41 standard deviation (s.d.) unit increase per s.d. unit increase; 95% confidence interval (CI) 0.13-0.69, p = 0.005], HSD1B11 (0.30, 0.03-0.57, p = 0.03), NR3C1 (0.44, 0.19-0.68, p = 0.001) and SLC6A4 (0.26, 0.00-0.53, p = 0.05) were associated with more regulatory behavioral challenges of the infant. Higher placental NR3C1 mRNA partly mediated the association between maternal depressive symptoms during pregnancy and infant regulatory behaviors (p < 0.05). CONCLUSIONS: Higher placental expression of genes regulating feto-placental glucocorticoid and serotonin exposure is characteristic of infants with more regulatory behavioral challenges. Maternal depression acts, at least partly, via altering glucocorticoid action in the placenta to impact on offspring regulatory behaviors.


Subject(s)
Depression/metabolism , Glucocorticoids/metabolism , Infant Behavior/physiology , Placenta/metabolism , Pregnancy Complications/metabolism , Prenatal Exposure Delayed Effects/metabolism , Problem Behavior , Serotonin/metabolism , Adult , Female , Follow-Up Studies , Gene Expression , Glucocorticoids/genetics , Humans , Infant , Male , Pregnancy , RNA, Messenger/metabolism , Serotonin/genetics , Serotonin Plasma Membrane Transport Proteins/metabolism
7.
Psychol Med ; 45(10): 2023-30, 2015 Jul.
Article in English | MEDLINE | ID: mdl-25628053

ABSTRACT

BACKGROUND: Maternal prenatal depression predicts post-partum depression and increases risk of prematurity and low birth weight. These effects may be mediated by altered placental function. We hypothesized that placental function would be influenced by the gestational week of experiencing depressive symptoms and aimed to examine associations between maternal depressive symptoms during pregnancy and placental expression of genes involved in glucocorticoid and serotonin transfer between mother and fetus. METHOD: We studied women participating in a prospective pregnancy cohort: the Prediction and Prevention of Preeclampsia (PREDO) Study, Helsinki, Finland. Maternal depressive symptoms were assessed at 2-week intervals throughout pregnancy in 56 healthy women with singleton, term pregnancies. Messenger ribonucleic acid (mRNA) levels of glucocorticoid (GR) and mineralocorticoid (MR) receptors and serotonin transporter (SLC6A4), 11ß-hydroxysteroid dehydrogenase type 1 (HSD1) and 2 (HSD2) were quantified in placental biopsies. RESULTS: In adjusted analyses women who reported higher depressive symptoms across the whole pregnancy had higher mRNA levels of GR [effect size 0.31 s.d. units, 95% confidence interval (CI) 0.01-0.60, p = 0.042] and MR (effect size 0.34 s.d. units, 95% CI 0.01-0.68, p = 0.047). These effects were significant for symptoms experienced in the third trimester of pregnancy for GR; findings for MR were also significant for symptoms experienced in the second trimester. GR and MR mRNA levels increased linearly by having the trimester-specific depressive symptoms scores 0, 1 or 2-3 times above the clinical cut-off for depression (p = 0.003, p = 0.049, respectively, and p = 0.004, p = 0.15 in adjusted analyses). CONCLUSIONS: Our findings offer potential gestational-age-specific mechanisms linking maternal depressive symptoms during pregnancy via placental biology. Future studies will test whether these also link with adverse offspring outcomes.


Subject(s)
Depression/physiopathology , Glucocorticoids/metabolism , Pregnancy Complications/physiopathology , RNA, Messenger/metabolism , 11-beta-Hydroxysteroid Dehydrogenases/analysis , Adult , Female , Finland , Glucocorticoids/genetics , Humans , Linear Models , Placenta/chemistry , Pregnancy , Pregnancy Trimesters , Psychiatric Status Rating Scales , RNA, Messenger/analysis , RNA, Messenger/genetics , Receptors, Mineralocorticoid/analysis , Reverse Transcriptase Polymerase Chain Reaction , Serotonin Plasma Membrane Transport Proteins/analysis , Serotonin Plasma Membrane Transport Proteins/genetics , Young Adult
8.
Psychol Med ; 45(5): 985-99, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25191989

ABSTRACT

BACKGROUND: Late preterm births constitute the majority of preterm births. However, most evidence suggesting that preterm birth predicts the risk of mental disorders comes from studies on earlier preterm births. We examined if late preterm birth predicts the risks of severe mental disorders from early to late adulthood. We also studied whether adulthood mental disorders are associated with post-term birth or with being born small (SGA) or large (LGA) for gestational age, which have been previously associated with psychopathology risk in younger ages. METHOD: Of 12 597 Helsinki Birth Cohort Study participants, born 1934-1944, 664 were born late preterm, 1221 post-term, 287 SGA, and 301 LGA. The diagnoses of mental disorders were identified from national hospital discharge and cause of death registers from 1969 to 2010. In total, 1660 (13.2%) participants had severe mental disorders. RESULTS: Individuals born late preterm did not differ from term-born individuals in their risk of any severe mental disorder. However, men born late preterm had a significantly increased risk of suicide. Post-term birth predicted significantly increased risks of any mental disorder in general and particularly of substance use and anxiety disorders. Individuals born SGA had significantly increased risks of any mental and substance use disorders. Women born LGA had an increased risk of psychotic disorders. CONCLUSIONS: Although men born late preterm had an increased suicide risk, late preterm birth did not exert widespread effects on adult psychopathology. In contrast, the risks of severe mental disorders across adulthood were increased among individuals born SGA and individuals born post-term.


Subject(s)
Fetal Growth Retardation/epidemiology , Fetal Macrosomia/epidemiology , Mental Disorders/epidemiology , Premature Birth/epidemiology , Adult , Aged , Cohort Studies , Female , Finland/epidemiology , Humans , Infant, Newborn , Infant, Postmature , Infant, Premature , Infant, Small for Gestational Age , Male , Middle Aged , Pregnancy , Retrospective Studies , Risk Factors , Severity of Illness Index
9.
BJOG ; 121(12): 1482-91, 2014 Nov.
Article in English | MEDLINE | ID: mdl-24703162

ABSTRACT

OBJECTIVE: To study whether pre-eclampsia and hypertension without proteinuria during pregnancy are associated with adaptive functioning, and psychiatric and psychological problems, of older offspring. DESIGN: Retrospective longitudinal cohort study. SETTING: Participants in the Helsinki Birth Cohort 1934-44 Study. POPULATION: A cohort of 778 participants born after normotensive, pre-eclamptic, or hypertensive pregnancies, defined based on the mother's blood pressure and urinary protein measurements at maternity clinics and birth hospitals. METHODS: Pearson's chi-squared tests and multivariable logistic regression. MAIN OUTCOME MEASURES: Achenbach System of Empirically Based Assessment Older Adult Self-Report scores, completed at age 69.3 years (SD 3.1 years). RESULTS: Compared with offspring born after normotensive pregnancies, offspring born after pre-eclamptic pregnancies had increased odds of reporting total problems (aOR 4.00, 95%CI 1.64-9.77) and problems of particular concern to clinicians (critical items; aOR 5.28, 95%CI 1.87-14.96), as well as: anxious/depressed, functional impairment, memory, thought, and irritable/disinhibited problems on syndrome scales; depressive, somatic, and psychotic problems on Diagnostic and Statistical Manual of Mental Disorders scales; and adjustment problems in relationship satisfaction with spouse/partner. Maternal hypertension without proteinuria was not consistently associated with adjustment and problems (total problems, aOR 1.08, 95%CI 0.75-1.57; critical items, aOR 1.58, 95%CI 0.91-2.72). CONCLUSIONS: Maternal hypertensive disorders in pregnancy, during a period of expectant treatment, carry an increased risk of problems in adaptive functioning and mental wellbeing in the offspring seven decades later. Being the longest follow-up on transgenerational consequences of maternal hypertensive disorders reported thus far, our study points to the life-time increased risk of an adverse intrauterine environment.


Subject(s)
Adaptation, Psychological , Hypertension, Pregnancy-Induced , Mental Disorders/etiology , Prenatal Exposure Delayed Effects/etiology , Adult , Aged , Case-Control Studies , Female , Follow-Up Studies , Humans , Logistic Models , Male , Mental Disorders/psychology , Middle Aged , Pregnancy , Prenatal Exposure Delayed Effects/psychology , Proteinuria , Psychological Tests , Retrospective Studies , Risk Factors , Self Report
10.
J Psychiatr Ment Health Nurs ; 20(5): 411-8, 2013 Apr.
Article in English | MEDLINE | ID: mdl-22672441

ABSTRACT

eLearning may facilitate continuing vocational education, but data on the long-term effects of an eLearning course are lacking. The aim of this study was to explore the long-term impact of an eLearning course entitled ePsychNurse.Net on psychiatric nurses' professional competence in practicing seclusion and restraint and on their job satisfaction and general self-efficacy at 9-month follow-up. In a randomized controlled study, 12 wards were randomly assigned to the ePsychNurse.Net (intervention) or training as usual (control). Baseline and 9-month follow-up data on nurses' knowledge of coercion-related legislation, physical restraint and seclusion, their attitudes towards physical restraint and seclusion, job satisfaction and general self-efficacy were analysed for 137 completers (those who participated in the 9-month follow-up assessment). No between-group differences were found on any variable, with the exception of a change in attitude to seclusion in favour of the control group. The findings of the long-term effects did not differ from the immediate outcomes (3-month follow-up) and the improved level of knowledge acquired and further consolidation of that knowledge did not take place in the 6-month period after the 3-month ePsychNurse.Net course. The ePsychNurse.Net should be further developed and its future modifications will require additional studies, probably with some new outcome measures.


Subject(s)
Computer-Assisted Instruction/methods , Education, Nursing, Continuing/standards , Health Knowledge, Attitudes, Practice , Professional Competence/standards , Psychiatric Nursing/education , Adult , Disease Management , Education, Nursing, Continuing/methods , Female , Humans , Job Satisfaction , Male , Middle Aged , Outcome Assessment, Health Care/methods , Outcome Assessment, Health Care/standards , Restraint, Physical/legislation & jurisprudence , Restraint, Physical/methods , Restraint, Physical/psychology , Self Efficacy , Time Factors
11.
J Phys Condens Matter ; 24(43): 435502, 2012 Oct 31.
Article in English | MEDLINE | ID: mdl-23032482

ABSTRACT

The growth of Bi on Ag(111) induces different surface structures, including (√3 × âˆš3)R30° surface alloy, Bi-(p × âˆš3) overlayer and Bi(110) thin film, as a function of increasing Bi coverage. Here we report the study of electronic states of these structures using core level and valence band photoemission spectroscopy at room temperature. The sp-derived Shockley surface state on Ag(111) is rapidly quenched upon deposition of Bi, due to the strong variation of the in-plane surface potential in the Ag(2)Bi surface alloy. The Bi 4f core levels of the (√3 × âˆš3)R30° alloy and Bi(110) thin film are shifted to lower binding energy by ~0.6 eV and ~0.3 eV compared with the Bi bulk value, respectively. Mechanisms inducing the core level shifts are discussed as due to a complex superposition of several factors. As Bi coverage increases and a Bi(110) overlayer forms on Ag(111), a new state is observed at ~0.9 ML arising from electronic states localized at the Ag-Bi interface. Finally the change of work function as a function of coverage is discussed on the basis of a charge transfer model.


Subject(s)
Bismuth/chemistry , Photoelectron Spectroscopy/methods , Silver/chemistry , Alloys , Electronics , Electrons , Materials Testing , Physics/methods , Surface Properties
12.
Psychol Med ; 42(11): 2275-85, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22405504

ABSTRACT

BACKGROUND: Patients with schizophrenia have excess cardiovascular morbidity and mortality. Previous studies suggest that this may be partly due to inadequate somatic treatment and care, such as non-optimal use of lipid-lowering and antihypertensive pharmacotherapy, but longitudinal studies on such aetiological pathways are scarce. METHOD: We investigated the use of lipid-lowering and antihypertensive pharmacotherapy, and the risk of hospitalization for and death from coronary heart disease and stroke among patients with schizophrenia in a birth cohort of 12 939 subjects (Helsinki Birth Cohort Study). This cohort was followed for over 30 adult years by using national databases on cardio- and cerebrovascular hospitalizations and mortality and on reimbursement entitlements and use of drugs for treatment of hypertension, dyslipidaemia, coronary heart disease and diabetes. RESULTS: Individuals with schizophrenia had a higher risk of hospitalization for coronary heart disease [hazard ratio (HR) 1.65, 95% confidence interval (CI) 1.03-2.57], and mortality from this disease was markedly higher (HR 2.92, 95% CI 1.70-5.00), particularly among women (p=0.001 for women, p=0.008 for men). Women with schizophrenia had also marginally increased stroke mortality (p=0.06). However, patients with schizophrenia used less lipid-lowering (odds ratio 0.47, 95% CI 0.27-0.80) and antihypertensive drug treatment (HR 0.37, 95% CI 0.22-0.61). CONCLUSIONS: In this longitudinal study, coronary heart disease morbidity was increased and coronary heart disease mortality markedly increased in patients, especially in women with schizophrenia. These patients nevertheless received less antihypertensive and lipid-lowering treatment.


Subject(s)
Coronary Disease , Registries/statistics & numerical data , Schizophrenia/epidemiology , Aged , Comorbidity , Coronary Disease/drug therapy , Coronary Disease/epidemiology , Coronary Disease/mortality , Female , Finland/epidemiology , Humans , Male , Sex Factors , Stroke
13.
Pregnancy Hypertens ; 2(3): 235-6, 2012 Jul.
Article in English | MEDLINE | ID: mdl-26105317

ABSTRACT

INTRODUCTION: Hypertensive disorders affect the fetal developmental milieu and may point to mechanisms by which prenatal adversity is associated with lower cognitive ability in subsequent life. OBJECTIVES: We tested whether hypertensive disorders during pregnancy predict age-related change in cognitive ability in the offspring up to old age. METHODS: Using mothers' blood pressure and urinary protein measurements from the maternity clinics and birth hospitals, we defined normotensive or hypertensive pregnancies in mothers of 398 men, who participated in the Helsinki Birth Cohort 1934-44 Study. The men underwent the Finnish Defense Forces basic ability test twice, first, during compulsory military service at age 20.1 (SD=1.4) years and, then, in a re-test at age 68.5 (SD=2.9) years. The test yields a total score and subscores for tests measuring verbal, arithmetic and visuospatial reasoning. Scores were standardized with a mean of 100 and standard deviation of 15. RESULTS: Men born after pregnancies complicated by a hypertensive disorder, compared with men born after normotensive pregnancies, scored 3.84 (95% Confidence Interval, 0.77 to 6.91) points lower on total cognitive ability at 68.5 years, and displayed a greater decline in total cognitive ability (2.31, 0.23 to 4.39) after 20.1 years. Of the subscores, associations were strongest for arithmetic reasoning. CONCLUSION: Maternal hypertensive disorders in pregnancy predict lower cognitive ability and greater cognitive decline up to old age. Multidisciplinary research is essential in order to uncover the mechanisms linking hypertensive pregnancy disorders with lower cognitive abilities in the offspring.

14.
J Psychiatr Ment Health Nurs ; 18(9): 813-21, 2011 Nov.
Article in English | MEDLINE | ID: mdl-21985684

ABSTRACT

Education on the care of aggressive and disturbed patients is fragmentary. eLearning could ensure the quality of such education, but data on its impact on professional competence in psychiatry are lacking. The aim of this study was to explore the impact of ePsychNurse.Net, an eLearning course, on psychiatric nurses' professional competence in seclusion and restraint and on their job satisfaction and general self-efficacy. In a randomized controlled study, 12 wards were randomly assigned to ePsychNurse.Net (intervention) or education as usual (control). Baseline and 3-month follow-up data on nurses' knowledge of coercion-related legislation, physical restraint and seclusion, their attitudes towards physical restraint and seclusion, job satisfaction and general self-efficacy were analysed for 158 completers. Knowledge (primary outcome) of coercion-related legislation improved in the intervention group, while knowledge of physical restraint improved and knowledge of seclusion remained unchanged in both groups. General self-efficacy improved in the intervention group also attitude to seclusion in the control group. In between-group comparison, attitudes to seclusion (one of secondary outcomes) favoured the control group. Although the ePsychNurse.Net demonstrated only slight advantages over conventional learning, it may be worth further development with, e.g. flexible time schedule and individualized content.


Subject(s)
Clinical Competence/standards , Patient Isolation , Psychiatric Nursing/education , Restraint, Physical , Adult , Computer-Assisted Instruction/methods , Educational Measurement , Female , Humans , Male , Mental Disorders/nursing , Mental Disorders/therapy , Middle Aged , Psychiatric Nursing/standards , Young Adult
15.
J Phys Condens Matter ; 23(26): 265006, 2011 Jul 06.
Article in English | MEDLINE | ID: mdl-21666301

ABSTRACT

The deposition of 1/3 of a monolayer of Pb on Ag(111) leads to the formation of PbAg(2) surface alloy with a long range ordered (√3 × âˆš3)R30° superstructure. A detailed analysis of this structure using low-energy electron diffraction (LEED) I-V measurements together with density functional theory (DFT) calculations is presented. We find strong correlation between experimental and calculated LEED I-V data, with the fit between the two data sets having a Pendry's reliability factor of 0.21. The Pb atom is found to replace one top layer Ag atom in each unit cell, forming a substitutional PbAg(2) surface alloy, as expected, with the Pb atoms residing approximately 0.4 Å above the Ag atoms due to their size difference. DFT calculations are in good agreement with the LEED results.

17.
J Pathol ; 211(5): 563-571, 2007 Apr.
Article in English | MEDLINE | ID: mdl-17334980

ABSTRACT

Thymomas are thymic epithelial neoplasms, associated with a variety of autoimmune disorders (especially myasthenia gravis), that apparently result from aberrant intra-tumourous thymopoiesis and export of inefficiently tolerized T-cells to the periphery. The autoimmune regulator (AIRE) drives the expression of self-antigens in the thymic medulla and plays an essential role in 'central' tolerance in both humans and mice. However, while inactivating AIRE mutations result in the 'autoimmune polyendocrinopathy syndrome type 1' (APS-1), its major features are not well reproduced in AIRE-knock-out mice. Therefore, alternative human disease scenarios with concomitant AIRE deficiency may be valuable tools to test conclusions drawn from mouse models. Here we show, in a large series, that approximately 95% of thymoma patients are 'chimeric'; expression of AIRE and major AIRE-related autoantigens (eg insulin) were undetectable in their tumours but maintained in their remnant thymic tissue and lymph nodes. Notably, despite the AIRE-deficient thymopoiesis in thymomas, disorders and autoantibodies typical of APS-1 were distinctly uncommon in these patients. The one striking similarity was in the recently observed neutralizing anti-type I interferon (IFN) antibodies, which are found at diagnosis in 100% of patients with APS-1 and in approximately 60% of patients with thymomas, as we show here. We conclude that APS-1 type autoantigens must be protected from autoimmunity by mechanisms that do not extend to the muscle autoantigens so frequently targeted in thymoma patients but so rarely recognized in APS-1. Thus our findings argue strongly for a tolerogenic function of AIRE beyond its role in negative T-cell selection in human thymopoiesis, and/or for specific autoimmunization against muscle in thymomas.


Subject(s)
Neoplasm Proteins/deficiency , Polyendocrinopathies, Autoimmune/immunology , Thymoma/chemistry , Thymus Neoplasms/chemistry , Transcription Factors/deficiency , Adolescent , Adult , Aged , Aged, 80 and over , Antibodies, Neoplasm/immunology , Antigens, Neoplasm/analysis , Autoantibodies/blood , Autoantigens/analysis , Autoimmune Diseases/immunology , Autoimmune Diseases/metabolism , Cytokines/immunology , Female , Humans , Immunohistochemistry/methods , Interferon Type I/immunology , Male , Middle Aged , Myasthenia Gravis/immunology , Myasthenia Gravis/metabolism , Thymus Gland/immunology , Thymus Gland/metabolism , AIRE Protein
18.
Chemphyschem ; 6(2): 267-76, 2005 Feb.
Article in English | MEDLINE | ID: mdl-15751349

ABSTRACT

Photochemical and photophysical properties were investigated for poly(arylenevinylene)s containing a flexible biphenyl "hinge" unit by applying one-photon (OP) and two-photon (TP) excitation to explore excited-state properties. The poly(arylenevinylene)s were poly[(2,5-dihexyloxy-p-phenylenevinylene)-alt-(4,4'-dihexyloxy-3,3'-biphenylenevinylene)] (1), poly[(2,5-dihexyloxy-p-phenylenevinylene)-alt-(2,2'-dihexyloxy-3,3'-biphenylenevinylene)] (2), and poly[(2,5-dihexyloxy-p-phenylenevinylene)-alt-(2,2'-biphenylenevinylene)] (3). Effective emission quantum yields and related photonic properties were evaluated on a realistic per-chromophore basis using effective conjugation lengths based on the Strickler-Berg relationship. Intramolecular photocyclization was deduced to occur in the one case where the biphenyl molecular connectivity permitted the reaction, based on matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF), heteronuclear multiple-quantum coherence (HMQC)-NMR, and gel-permeation chromatography (GPC) results. The various photoprocesses could be induced by either OP or TP excitation, though the first excited singlet state is the photoactive state. The higher excitation energy of the TP excited state favors indirect population of the S, state by electronic coupling between the TP and OP excited states [lambda(max)TPE (nm): 726; delta (GM): 1=229, 2=215, 3= 109). Photochemical processes occurring from the lowest OP excited state (S1) could therefore also be indirectly induced by TP excitation.

19.
Tree Physiol ; 25(1): 115-22, 2005 Jan.
Article in English | MEDLINE | ID: mdl-15519993

ABSTRACT

Soil temperature is a main factor limiting root growth in the boreal forest. To simulate the possible soil-warming effect of future climate change, 5-year-old Norway spruce (Picea abies (L.) Karst.) seedlings were subjected to three simulated growing seasons in controlled environment rooms. The seedlings were acclimated to a soil temperature of 16 degrees C during the first (GS I) and third growing seasons (GS III), but were assigned to random soil-temperature treatments of 9, 13, 18 and 21 degrees C during the second growing season (GS II). In GS II, shoot diameter growth was lowest in the 21 degrees C treatment and root growth was lowest in the 9 degrees C treatment. In GS III, shoot height and root length growth improved in seedlings that had been kept at 9 degrees C during GS II, indicating compensatory growth in response to increased soil temperature. The temporary decrease in soil temperature had no long-lasting significant effect on seedling biomass or total nutrient uptake. At the end of GS III, fine roots of seedlings exposed to a soil temperature of 21 degrees C in GS II were distributed more evenly between the organic and mineral soil layers than roots of seedlings in the other treatments. During GS II and GS III, root growth started earlier than shoot growth, decreased during the rapid shoot elongation phase and increased again as shoot growth decreased.


Subject(s)
Picea/growth & development , Plant Roots/growth & development , Plant Shoots/growth & development , Trees/growth & development , Picea/physiology , Plant Roots/physiology , Plant Shoots/physiology , Seedlings/growth & development , Seedlings/physiology , Soil , Temperature , Trees/physiology
20.
Br J Cancer ; 91(7): 1287-92, 2004 Oct 04.
Article in English | MEDLINE | ID: mdl-15354210

ABSTRACT

Mismatch repair (MMR) deficiency in tumours from patients with the hereditary nonpolyposis colorectal cancer (HNPCC) syndrome is mainly caused by mutations in the MLH1, MSH2, and MSH6 genes. A major challenge in the clinical management of patients with suspected HNPCC is the frequent occurrence of missense mutations in MSH6. These can be considered neither deleterious nor clinically innocent a priori. To assess their significance we studied five novel MSH6 missense mutations in six patients derived from a series of consecutive endometrial and colorectal cancer patients selected for study after their tumours were determined to be microsatellite unstable. We tested each mutated protein for heterodimerisation with MSH2 and for in vitro MMR capability. Four mutations (R128L, P623L, K728T, G881K+S) showed no impairment of these functions while the fifth (E1193K) displayed marked impairment of both functions. These results, taken together with our previous similar findings concerning six other missense mutations in MSH6, allow us to conclude that many or most missense changes in MSH6 likely are clinically innocent, whereas some missense changes such as E1193K, which lead to impaired MMR, are likely to be clinically significant, but have low penetrance.


Subject(s)
Colorectal Neoplasms/genetics , DNA-Binding Proteins/genetics , Endometrial Neoplasms/genetics , Genetic Predisposition to Disease , Mutation, Missense , Base Pair Mismatch , Blotting, Western , Colorectal Neoplasms/pathology , DNA Mutational Analysis , DNA Repair , Endometrial Neoplasms/pathology , Female , Humans , Male
SELECTION OF CITATIONS
SEARCH DETAIL
...