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1.
J Child Sex Abus ; : 1-24, 2024 Jul 29.
Article in English | MEDLINE | ID: mdl-39075746

ABSTRACT

Comparing women's and men's sexual offending patterns in educational settings is a relatively recent empirical endeavor. Accordingly, gender-based examinations of schools' management of sexual allegations are lacking. We address this gap by drawing on a unique administrative dataset from an Australian jurisdiction that captures alleged improper sexual conduct by educational employees. We compare 809 female- and male-perpetrated cases reported between 2015 and 2019 with respect to event, location, victim, and perpetrator characteristics, as well as the ensuing risk management strategies and sanctions. Compared to men, reported women were younger, employed on more secure employment arrangements, and less often had a relevant discipline history. Most alleged event characteristics did not significantly differ based on perpetrator gender. Women's alleged perpetration, however, more often occurred in places external to school and involved more serious sexual victimization of comparatively older male students. After controlling for event, victim, perpetrator, and allegation characteristics there was nearly no support for a gender bias in institutional responses. However, a lack of any action was more often observed in female-perpetrated cases under very specific and limited conditions. Resultant implications for the management and oversight of employee-related allegations are discussed.

2.
Pediatr Radiol ; 54(8): 1325-1336, 2024 07.
Article in English | MEDLINE | ID: mdl-38777883

ABSTRACT

BACKGROUND: Moyamoya is a progressive, non-atherosclerotic cerebral arteriopathy that may present in childhood and currently has no cure. Early diagnosis is critical to prevent a lifelong risk of neurological morbidity. Blood-oxygen-level-dependent (BOLD) MRI cerebrovascular reactivity (CVR) imaging provides a non-invasive, in vivo measure of autoregulatory capacity and cerebrovascular reserve. However, non-compliant or younger children require general anesthesia to achieve BOLD-CVR imaging. OBJECTIVE: To determine the same-day repeatability of BOLD-CVR imaging under general anesthesia in children with moyamoya. MATERIALS AND METHODS: Twenty-eight examination pairs were included (mean patient age = 7.3 ± 4.0 years). Positive and negatively reacting voxels were averaged over signals and counted over brain tissue and vascular territory. The intraclass correlation coefficient (ICC), Wilcoxon signed-rank test, and Bland-Altman plots were used to assess the variability between the scans. RESULTS: There was excellent-to-good (≥ 0.59) within-day repeatability in 18 out of 28 paired studies (64.3%). Wilcoxon signed-rank tests demonstrated no significant difference in the grey and white matter CVR estimates, between repeat scans (all p-values > 0.05). Bland-Altman plots of differences in mean magnitude of positive and negative and fractional positive and negative CVR estimates illustrated a reasonable degree of agreement between repeat scans and no systematic bias. CONCLUSION: BOLD-CVR imaging provides repeatable assessment of cerebrovascular reserve in children with moyamoya imaged under general anesthesia.


Subject(s)
Anesthesia, General , Cerebrovascular Circulation , Magnetic Resonance Imaging , Moyamoya Disease , Humans , Moyamoya Disease/diagnostic imaging , Moyamoya Disease/physiopathology , Female , Child , Male , Cerebrovascular Circulation/physiology , Magnetic Resonance Imaging/methods , Child, Preschool , Reproducibility of Results , Oxygen/blood , Adolescent
3.
medRxiv ; 2024 Apr 08.
Article in English | MEDLINE | ID: mdl-38645071

ABSTRACT

Objective: Dystonia is a movement disorder defined by involuntary muscle contractions leading to abnormal postures or twisting and repetitive movements. Classically dystonia has been thought of as a disorder of the basal ganglia, but newer results in idiopathic dystonia and lesion-induced dystonia in adults point to broader motor network dysfunction spanning the basal ganglia, cerebellum, premotor cortex, sensorimotor, and frontoparietal regions. It is unclear whether a similar network is shared between different etiologies of pediatric lesion-induced dystonia. Methods: Three cohorts of pediatric patients with lesion-induced dystonia were identified. The lesion etiologies included hypoxia, kernicterus, and stroke versus comparison subjects with acquired lesions not associated with dystonia. Multivariate lesion-symptom mapping and lesion network mapping were used to evaluate the anatomy and networks associated with dystonia. Results: Multivariate lesion-symptom mapping showed that lesions of the putamen (stroke: r = 0.50, p <0.01; hypoxia, r = 0.64, p <0.001) and globus pallidus (kernicterus, r = 0.61, p <0.01) were associated with dystonia. Lesion network mapping using normative connectome data from healthy children demonstrated that these regional findings occurred within a common brain-wide network that involves the basal ganglia, anterior and medial cerebellum, and cortical regions that overlap the cingulo-opercular and somato-cognitive-action networks. Interpretation: We interpret these findings as novel evidence for a unified dystonia brain network that involves the somato-cognitive-action network, which is involved in higher order coordination of movement. Elucidation of this network gives insight into the functional origins of dystonia and provides novel targets to investigate for therapeutic intervention.

4.
Child Abuse Negl ; 145: 106419, 2023 11.
Article in English | MEDLINE | ID: mdl-37625366

ABSTRACT

The last two decades have seen global public recognition of the scale and impact of adult-perpetrated institutional child sexual abuse. A sizeable body of knowledge about generalized safeguarding measures has since been generated to inform organizations' prevention efforts. Apparent in the extant literature, however, is a notable lack of evidence-based and context-specific prevention strategies targeting perpetration in distinct institutional environments. This absence extends to educational settings where most reported contemporary cases occur or originate. The recommendations outlined in this article contribute to this gap. Derived from empirical findings establishing the role of context-specific rather than person-specific factors, a range of prevention strategies framed by Situational Crime Prevention are proposed for secondary educational settings. These recommendations are supplemented by the unique insights of interviewed experts with specialist professional knowledge. Recommendations center around targeting features of the environment such as high-risk locations, available guardians, and intimacy-promoting situations available in educational contexts. Taken together, this robust prevention and control agenda can create conditions for safer educational environments.


Subject(s)
Child Abuse, Sexual , Child , Adult , Humans , Child Abuse, Sexual/prevention & control , Schools , Organizations , Sexual Partners
5.
Neuroimage Clin ; 39: 103438, 2023.
Article in English | MEDLINE | ID: mdl-37354865

ABSTRACT

Childhood stroke occurs from birth to 18 years of age, ranks among the top ten childhood causes of death, and leaves lifelong neurological impairments. Arterial ischemic stroke in infancy and childhood occurs due to arterial occlusion in the brain, resulting in a focal lesion. Our understanding of mechanisms of injury and repair associated with focal injury in the developing brain remains rudimentary. Neuroimaging can reveal important insights into these mechanisms. In adult stroke population, multi-center neuroimaging studies are common and have accelerated the translation process leading to improvements in treatment and outcome. These studies are centered on the growing evidence that neuroimaging measures and other biomarkers (e.g., from blood and cerebrospinal fluid) can enhance our understanding of mechanisms of risk and injury and be used as complementary outcome markers. These factors have yet to be studied in pediatric stroke because most neuroimaging studies in this population have been conducted in single-centred, small cohorts. By pooling neuroimaging data across multiple sites, larger cohorts of patients can significantly boost study feasibility and power in elucidating mechanisms of brain injury, repair and outcomes. These aims are particularly relevant in pediatric stroke because of the decreased incidence rates and the lack of mechanism-targeted trials. Toward these aims, we developed the Pediatric Stroke Neuroimaging Platform (PEDSNIP) in 2015, funded by The Brain Canada Platform Support Grant, to focus on three identified neuroimaging priorities. These were: developing and harmonizing multisite clinical protocols, creating the infrastructure and methods to import, store and organize the large clinical neuroimaging dataset from multiple sites through the International Pediatric Stroke Study (IPSS), and enabling central searchability. To do this, developed a two-pronged approach that included building 1) A Clinical-MRI Data Repository (standard of care imaging) linked to clinical data and longitudinal outcomes and 2) A Research-MRI neuroimaging data set acquired through our extensive collaborative, multi-center, multidisciplinary network. This dataset was collected prospectively in eight North American centers to test the feasibility and implementation of harmonized advanced Research-MRI, with the addition of clinical information, genetic and proteomic studies, in a cohort of children presenting with acute ischemic stroke. Here we describe the process that enabled the development of PEDSNIP built to provide the infrastructure to support neuroimaging research priorities in pediatric stroke. Having built this Platform, we are now able to utilize the largest neuroimaging and clinical data pool on pediatric stroke data worldwide to conduct hypothesis-driven research. We are actively working on a bioinformatics approach to develop predictive models of risk, injury and repair and accelerate breakthrough discoveries leading to mechanism-targeted treatments that improve outcomes and minimize the burden following childhood stroke. This unique transformational resource for scientists and researchers has the potential to result in a paradigm shift in the management, outcomes and quality of life in children with stroke and their families, with far-reaching benefits for other brain conditions of people across the lifespan.


Subject(s)
Ischemic Stroke , Stroke , Adult , Child , Humans , Proteomics , Quality of Life , Stroke/diagnostic imaging , Stroke/therapy , Neuroimaging
6.
Transl Stroke Res ; 13(5): 757-773, 2022 10.
Article in English | MEDLINE | ID: mdl-35338434

ABSTRACT

Moyamoya disease is a major arteriopathy characterised by progressive steno-occlusion of the arteries of the circle of Willis. Studies in adults with moyamoya suggest an association between abnormal fronto-parietal and white matter regional haemodynamics and cognitive impairments, even in the absence of focal infarction. However, these associations have not been investigated in children with moyamoya. We examined the relationship between regional haemodynamics and ratings of intellectual ability and executive function, using hypercapnic challenge blood oxygen level-dependent magnetic resonance imaging of cerebrovascular reactivity in a consecutive cohort of children with confirmed moyamoya. Thirty children were included in the final analysis (mean age: 12.55 ± 3.03 years, 17 females, 15 idiopathic moyamoya and 15 syndromic moyamoya). Frontal haemodynamics were abnormal in all regardless of stroke history and comorbidity, but occipital lobe haemodynamics were also abnormal in children with syndromic moyamoya. Executive function deficits were noted in both idiopathic and syndromic moyamoya, whereas intellectual ability was impaired in syndromic moyamoya, even in the absence of stroke. Analysis of the relative effect of regional abnormal haemodynamics on cognitive outcomes demonstrated that executive dysfunction was predominantly explained by right parietal and white matter haemodynamics independent of stroke and comorbidity, while posterior circulation haemodynamics predicted intellectual ability. These results suggest that parietal and posterior haemodynamics play a compensatory role in overcoming frontal vulnerability and cognitive impairment.


Subject(s)
Moyamoya Disease , Stroke , White Matter , Adolescent , Adult , Child , Cognition , Female , Hemodynamics , Humans , Magnetic Resonance Imaging/methods , Moyamoya Disease/complications , Moyamoya Disease/diagnostic imaging , Stroke/complications , Stroke/diagnostic imaging , White Matter/diagnostic imaging , White Matter/pathology
7.
Blood Adv ; 6(11): 3321-3328, 2022 06 14.
Article in English | MEDLINE | ID: mdl-35358295

ABSTRACT

Transforming growth factor ß1 (TGF-ß1) regulates a wide variety of events in adult bone marrow (BM), including quiescence of hematopoietic stem cells, via undefined mechanisms. Because megakaryocytes (MKs)/platelets are a rich source of TGF-ß1, we assessed whether TGF-ß1 might inhibit its own production by comparing mice with conditional inactivation of Tgfb1 in MKs (PF4Cre;Tgfb1flox/flox) and control mice. PF4Cre;Tgfb1flox/flox mice had ∼30% more MKs in BM and ∼15% more circulating platelets than control mice (P < .001). Thrombopoietin (TPO) levels in plasma and TPO expression in liver were approximately twofold higher in PF4Cre;Tgfb1flox/flox than in control mice (P < .01), whereas TPO expression in BM cells was similar between these mice. In BM cell culture, TPO treatment increased the number of MKs from wild-type mice by approximately threefold, which increased approximately twofold further in the presence of a TGF-ß1-neutralizing antibody and increased the number of MKs from PF4Cre;Tgfb1flox/flox mice approximately fourfold. Our data reveal a new role for TGF-ß1 produced by MKs/platelets in regulating its own production in BM via increased TPO production in the liver. Additional studies are required to determine the mechanism.


Subject(s)
Bone Marrow/metabolism , Megakaryocytes , Thrombopoietin , Transforming Growth Factor beta1/metabolism , Animals , Blood Platelets/metabolism , Liver/metabolism , Megakaryocytes/cytology , Megakaryocytes/metabolism , Mice , Thrombopoietin/metabolism
8.
J Surg Case Rep ; 2022(3): rjac059, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35350219

ABSTRACT

Umbilical lumps are a common presentation that can represent a diagnostic challenge as the differentials are broad. Epidermal inclusion cysts occur when epidermal cells are implanted in the dermis following trauma, or surgery. Although epidermal inclusion cysts are common, they are rarely cause of umbilical mass, with less than 10 cases described in the literature. Very few cases have been reported following abdominal surgery and none following laparoscopy. These lesions can occur with or without pain, mass, redness or spontaneous discharge and symptoms can persist for years. This paper reports a case of an umbilical epidermal inclusion cyst in a 52-year-old female presenting with a 6-week history of a painful, red umbilical lump on a background of two previous diagnostic laparoscopies. This was successfully treated with complete excision of the lesion.

9.
J Child Adolesc Trauma ; 15(1): 37-46, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35222774

ABSTRACT

Although research on populations of incarcerated female adolescents has increased, there remains a dearth of qualitative research that speaks to the life narratives of these girls. Existing research suggests this population is deeply troubled, which necessitates a better understanding of their lived experience to more thoroughly inform prevention and rehabilitation efforts. This article is one of the first to assess a wide range of traits and characteristics of girls in custody. The Multidimensional Inventory of Development, Sex, and Aggression (MIDSA) was administered to 30 girls in custody at a juvenile detention facility in California. Individual narrative reports were generated, and their aggregate results were analyzed. Results are first presented at an aggregate level and details from some individual cases are used to provide an especially rich description of particular circumstances, behaviors, and motivations of these girls. Preliminary findings illustrate the chaotic family backgrounds of the sample and the prolonged and varied trauma they have experienced. Results also suggest that the high rates of self-reported antisocial behavior in which these girls engaged involved a considerable amount of physical aggression and interpersonal violence. Trauma-informed approaches in the juvenile justice space are discussed.

10.
ANZ J Surg ; 91(12): 2571, 2021 12.
Article in English | MEDLINE | ID: mdl-34913560
11.
Intern Med J ; 49(3): 384-387, 2019 Mar.
Article in English | MEDLINE | ID: mdl-30897662

ABSTRACT

There are national and international guidelines for donor workup and acceptance criteria of potential living kidney donor candidates (LKDC), but there is significant variation in clinical practice. We examined our local practice in assessing potential LKDC against current guidelines; nearly all of our accepted donors met these guidelines. LKDC who did not proceed to donation had an identified health issue (60%), the presence of risk factors for long-term end-stage kidney disease (17%), social (13%) or immunological reasons (7%).


Subject(s)
Decision Support Techniques , Donor Selection/standards , Kidney Failure, Chronic/surgery , Kidney Transplantation/standards , Living Donors , Adult , Aged , Clinical Decision-Making , Donor Selection/methods , Female , Humans , Kidney Transplantation/adverse effects , Kidney Transplantation/methods , Male , Middle Aged , Practice Guidelines as Topic , Predictive Value of Tests , Risk Assessment , Risk Factors , Victoria
12.
Hum Brain Mapp ; 39(7): 2907-2916, 2018 07.
Article in English | MEDLINE | ID: mdl-29573366

ABSTRACT

Emotion regulation mediates socio-cognitive functions and is essential for interactions with others. The capacity to automatically inhibit responses to emotional stimuli is an important aspect of emotion regulation; the underlying neural mechanisms of this ability have been rarely investigated. Forty adults completed a Go/No-go task during magnetoencephalographic (MEG) recordings, where they responded rapidly to either a blue or purple frame which contained angry or happy faces. Subjects responded to the target color in an inhibition (75% Go trials) and a vigilance condition (25% Go trials). As expected, inhibition processes showed early, sustained activation (200-450 ms) in the right inferior frontal gyrus (IFG). Emotion-related inhibition processes showed greater activity with angry faces bilaterally in the orbital-frontal gyri (OFG) starting at 225 ms and temporal poles from 250 ms, with right hemisphere dominance. The presence of happy faces elicited earlier activity in the right OFG. This study demonstrates that the timing of inhibition processes varies with the emotional context and that there is much greater activation in the presence of angry faces. It underscores the importance of the right IFG for inhibition processes, but the OFG in automatic emotion regulation.


Subject(s)
Emotions/physiology , Executive Function/physiology , Facial Recognition/physiology , Functional Neuroimaging/methods , Inhibition, Psychological , Magnetoencephalography/methods , Prefrontal Cortex/physiology , Self-Control , Social Perception , Adult , Female , Humans , Male , Prefrontal Cortex/diagnostic imaging , Young Adult
14.
Front Neurol ; 7: 163, 2016.
Article in English | MEDLINE | ID: mdl-27799919

ABSTRACT

OBJECTIVE: Among good outcome survivors of aneurysmal subarachnoid hemorrhage (aSAH), only 23% have normal neurocognitive performance, despite imaging that is often normal. The aim of this work is to explore the use of magnetoencephalography (MEG) after endovascular treatment of ruptured aneurysms. METHODS: Good outcome aSAH patients treated with coiling and matched controls were recruited. Clinical assessments and resting-state MEG and anatomical MRI images were obtained. Brain space was normalized to standard Montreal Neurological Institute (MNI) brain. Areas of interest were identified with Automated Anatomical Labeling (AAL) and "electrodes" reconstructed using vector beamformer. Spectral power density estimates for each location was averaged across the brain to derive mean signal power. Virtual-sensor data closest to the coil was assessed for signal quality. RESULTS: Thirteen aSAH patients and 13 matched controls were recruited. Mean age was 54.5 years (SD = 9.9) for controls and 56.8 years (SD = 11.8) for aSAH. The majority of aneurysms (62%) were in the midline. Mean time from aSAH to MEG was 18.8 months (2.4-67.5; SD = 19). Data quality was comparable in both groups, including the virtual-sensors close to the coil mass. Mean signal power showed no significant spectral alterations in the aSAH group. CONCLUSION: MEG is feasible in aSAH patients after endovascular treatment. Our results suggest that the signal quality and strength is good, and the presence of coils does not interfere with testing. Considering the common neurocognitive complaints of aSAH survivors MEG could be developed to diagnose, quantify, and monitor neurocognitive problems after aSAH.

15.
Stroke ; 47(10): 2503-10, 2016 10.
Article in English | MEDLINE | ID: mdl-27531345

ABSTRACT

BACKGROUND AND PURPOSE: Neurocognitive deficits are common among survivors of aneurysmal subarachnoid hemorrhage, even among those with good outcomes and no structural lesions. This study aims to probe the neurophysiological underpinnings of cognitive dysfunction among patients with ruptured intracranial aneurysms using magnetoencephalography (MEG). METHODS: Thirteen patients who had undergone uncomplicated coiling for aneurysmal subarachnoid hemorrhage and 13 matched controls were enrolled. Neuropsychological tests were done before magnetoencephalography scans. Magnetoencephalography data were acquired in a 151-channel, whole-head magnetoencephalography system for resting state and 2 cognitive tasks (go-no-go and set-shifting). Mean time from treatment to test was 18.8 months. RESULTS: Cognitive tasks of inhibition (go-no-go) indicated greater activation in the right anterior cingulate and inferior frontal gyrus, and cognitive set-shifting tasks (mental flexibility) indicated greater activity in the bilateral anterior cingulate cortex and right medial frontal gyrus among aneurysmal subarachnoid hemorrhage patients, with significantly different timing of activation between groups. Resting-state, beta-band connectivity of the anterior cingulate correlated negatively with Montreal Cognitive Assessment scores (left: r=-0.56; P<0.01 and right: r=-0.55; P<0.01): higher connectivity of this region was linked to poorer cognitive test performance. CONCLUSIONS: We have shown increased activation in areas of the anterior cingulate gyrus and frontobasal regions during the execution of more demanding tasks in good grade. The degree of activation in the anterior cingulate gyrus has a negative correlation with cognitive (Montreal Cognitive Assessment) scores. These subtle differences may be related to the common neurocognitive and behavioral complaints seen in this patient population.


Subject(s)
Brain/diagnostic imaging , Cognition/physiology , Cognitive Dysfunction/diagnostic imaging , Subarachnoid Hemorrhage/diagnostic imaging , Adult , Aged , Cognitive Dysfunction/etiology , Cognitive Dysfunction/psychology , Female , Humans , Magnetoencephalography , Male , Middle Aged , Neuropsychological Tests , Set, Psychology , Subarachnoid Hemorrhage/complications , Subarachnoid Hemorrhage/psychology
16.
Asia Pac J Clin Oncol ; 12(2): e311-8, 2016 Jun.
Article in English | MEDLINE | ID: mdl-24975644

ABSTRACT

AIMS: Complementary therapy use by patients with cancer is highly prevalent, although little is known about the optimal model of integration with conventional care. This study explored patient preferences regarding integration in an Australian context. METHODS: Cancer patients participated in focus groups conducted by an experienced facilitator. Transcripts of discussions were subjected to thematic analysis. RESULTS: Fourteen female and four male patients took part in eight focus groups. Eleven had received conventional cancer treatment for early-stage disease, and seven for advanced stage. Participants had sound understanding of the distinction between complementary and alternative medicines. There were differing views on whether complementary therapy and conventional cancer services should be colocated. Some participants described colocation as discordant with their reasons for using complementary therapy. Participants valued guidance from oncology health professionals regarding complementary therapy that was tailored to their individual needs. In addition to medical oncologists, nursing staff and affiliated complementary therapists were considered to be appropriate sources for guidance. Additional themes identified in the analysis were also informative: patients achieve autonomy and self-expression through complementary therapies; the knowledge and attitudes of health professionals and limited consultation time are barriers to integration; self-funding of complementary therapies is acceptable to participants. CONCLUSIONS: The study findings suggest that while patients have diverse views regarding the optimal integration model, there is no strong preference for geographic colocation of complementary therapy with conventional cancer care. Patients valued personalized information and guidance regarding complementary therapy from health professionals involved in their cancer care.


Subject(s)
Complementary Therapies/methods , Complementary Therapies/psychology , Neoplasms/psychology , Neoplasms/therapy , Patient Preference , Aged , Australia , Female , Focus Groups , Humans , Male , Middle Aged , Patient Satisfaction
17.
BMC Nephrol ; 16: 89, 2015 Jun 27.
Article in English | MEDLINE | ID: mdl-26116581

ABSTRACT

BACKGROUND: The FAVOURED study is an international multicentre, double-blind, placebo-controlled trial which commenced recruitment in 2008 and examines whether omega-3 polyunsaturated fatty acids (omega-3 PUFAs) either alone or in combination with aspirin will effectively reduce primary access failure of de novo arteriovenous fistulae (AVF) in patients with stage 4 and 5 chronic kidney disease. Publication of new evidence derived from additional studies of clopidogrel and a high screen failure rate due to prevalent aspirin usage prompted an updated trial design. METHODS/DESIGN: The original trial protocol published in 2009 has undergone two major amendments, which were implemented in 2011. Firstly, the primary outcome 'early thrombosis' at 3 months following AVF creation was broadened to a more clinically relevant outcome of 'AVF access failure'; a composite of thrombosis, AVF abandonment and cannulation failure at 12 months. Secondly, participants unable to cease using aspirin were allowed to be enrolled and randomised to omega-3 PUFAs or placebo. The revised primary aim of the FAVOURED study is to test the hypothesis that omega-3 PUFAs will reduce rates of AVF access failure within 12 months following AVF surgery. The secondary aims are to examine the effect of omega-3 PUFAs and aspirin on the individual components of the primary end-point, to examine the safety of study interventions and assess central venous catheter requirement as a result of access failure. DISCUSSION: This multicentre international clinical trial was amended to address the clinically relevant question of whether the usability of de novo AVF at 12 months can be improved by the early use of omega-3 PUFAs and to a lesser extent aspirin. This study protocol amendment was made in response to a large trial demonstrating that clopidogrel is effective in safely preventing primary AVF thrombosis, but ineffective at increasing functional patency. Secondly, including patients taking aspirin will enroll a more representative cohort of haemodialysis patients, who are significantly older with a higher prevalence of cardiovascular disease and diabetes which may increase event rates and the power of the study. TRIAL REGISTRATION: Australia & New Zealand Clinical Trial Register (ACTRN12607000569404).


Subject(s)
Arteriovenous Shunt, Surgical/methods , Aspirin/therapeutic use , Docosahexaenoic Acids/therapeutic use , Eicosapentaenoic Acid/therapeutic use , Kidney Failure, Chronic/therapy , Platelet Aggregation Inhibitors/therapeutic use , Postoperative Complications/prevention & control , Renal Dialysis/methods , Thrombosis/prevention & control , Central Venous Catheters/statistics & numerical data , Double-Blind Method , Drug Combinations , Drug Therapy, Combination , Fatty Acids, Omega-3/therapeutic use , Fish Oils/therapeutic use , Humans , Renal Insufficiency, Chronic/therapy
18.
Biol Psychiatry ; 78(12): 821-9, 2015 Dec 15.
Article in English | MEDLINE | ID: mdl-26094019

ABSTRACT

BACKGROUND: Posttraumatic stress disorder (PTSD) is linked to elevated arousal and alterations in cognitive processes. Yet, whether a traumatic experience is linked to neural and behavioral differences in selective attentional tuning to traumatic stimuli is not known. The present study examined selective awareness of threat stimuli and underlying temporal-spatial patterns of brain activation associated with PTSD. METHODS: Participants were 44 soldiers from the Canadian Armed Forces, 22 with PTSD and 22 without. All completed neuropsychological tests and clinical assessments. Magnetoencephalography data were collected while participants identified two targets in a rapidly presented stream of words. The first target was a number and the second target was either a combat-related or neutral word. The difference in accuracy for combat-related versus neutral words was used as a measure of attentional bias. RESULTS: All soldiers showed a bias for combat-related words. This bias was enhanced in the PTSD group, and behavioral differences were associated with distinct patterns of brain activity. At early latencies, non-PTSD soldiers showed activation of midline frontal regions associated with fear regulation (90-340 ms after the second target presentation), whereas those with PTSD showed greater visual cortex activation linked to enhanced visual processing of trauma stimuli (200-300 ms). CONCLUSIONS: These findings suggest that attentional biases in PTSD are linked to deficits in very rapid regulatory activation observed in healthy control subjects. Thus, sufferers with PTSD may literally see a world more populated by traumatic cues, contributing to a positive feedback loop that perpetuates the effects of trauma.


Subject(s)
Attention/physiology , Brain/physiopathology , Military Personnel/psychology , Stress Disorders, Post-Traumatic/physiopathology , Stress Disorders, Post-Traumatic/psychology , War Exposure/adverse effects , Adult , Cues , Emotions/physiology , Humans , Magnetoencephalography , Male , Middle Aged , Neuropsychological Tests
19.
Conserv Biol ; 29(5): 1268-78, 2015 Oct.
Article in English | MEDLINE | ID: mdl-25926277

ABSTRACT

Natural-resource managers and other conservation practitioners are under unprecedented pressure to categorize and quantify the vulnerability of natural systems based on assessment of the exposure, sensitivity, and adaptive capacity of species to climate change. Despite the urgent need for these assessments, neither the theoretical basis of adaptive capacity nor the practical issues underlying its quantification has been articulated in a manner that is directly applicable to natural-resource management. Both are critical for researchers, managers, and other conservation practitioners to develop reliable strategies for assessing adaptive capacity. Drawing from principles of classical and contemporary research and examples from terrestrial, marine, plant, and animal systems, we examined broadly the theory behind the concept of adaptive capacity. We then considered how interdisciplinary, trait- and triage-based approaches encompassing the oft-overlooked interactions among components of adaptive capacity can be used to identify species and populations likely to have higher (or lower) adaptive capacity. We identified the challenges and value of such endeavors and argue for a concerted interdisciplinary research approach that combines ecology, ecological genetics, and eco-physiology to reflect the interacting components of adaptive capacity. We aimed to provide a basis for constructive discussion between natural-resource managers and researchers, discussions urgently needed to identify research directions that will deliver answers to real-world questions facing resource managers, other conservation practitioners, and policy makers. Directing research to both seek general patterns and identify ways to facilitate adaptive capacity of key species and populations within species, will enable conservation ecologists and resource managers to maximize returns on research and management investment and arrive at novel and dynamic management and policy decisions.


Subject(s)
Biodiversity , Climate Change , Conservation of Natural Resources/methods , Animals , Ecology , Genetics , Physiology , Plants , Risk Assessment
20.
J Neurosci ; 35(16): 6506-16, 2015 Apr 22.
Article in English | MEDLINE | ID: mdl-25904801

ABSTRACT

Emotionally salient aspects of the world are experienced with greater perceptual vividness than mundane ones; however, such emotionally enhanced vividness (EEV) may be experienced to different degrees for different people. We examined whether BOLD activity associated with a deletion variant of the ADRA2b gene coding for the α2b adrenoceptor modulates EEV in humans. Relative to noncarriers, ADRA2b deletion carriers showed higher levels of perceptual vividness, with the ventromedial prefrontal cortex (VMPFC) showing greater modulation by EEV. Deletion carriers were also more sensitive to the featural salience of the images, suggesting a more pervasive role of norepinephrine in perceptual encoding. Path analysis revealed that, whereas a simple model by which the amygdala modulated the lateral occipital complex best characterized EEV-related activity in noncarriers, contributions of an additional VMPFC pathway best characterized deletion carriers. Thus, common norepinephrine-related neurogenetic differences enhance the subjective vividness of perceptual experience and its emotional enhancement.


Subject(s)
Emotions/physiology , Norepinephrine/physiology , Perception/physiology , Receptors, Adrenergic, alpha-2/genetics , Adolescent , Adult , Female , Functional Neuroimaging , Gene Deletion , Heterozygote , Humans , Magnetic Resonance Imaging , Male , Norepinephrine/genetics , Photic Stimulation , Prefrontal Cortex/physiology , Young Adult
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