2 resultados para withholding and withdrawing life-sustaining treatment

em DigitalCommons@University of Nebraska - Lincoln


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The role of social cognition in severe mental illness (SMI) has gained much attention, especially over the last decade. The impact of deficits in socio-cognitive functioning has been found to have detrimental effects on key areas of day-to-day functioning in individuals with SMI, such as gaining and maintaining employment and overall experienced quality of life. Treatment of individuals with SMI is challenging, as the presentation of individual signs and symptoms is rather heterogeneous. There are several treatment approaches addressing deficits ranging from broader social and interpersonal functioning to neurocognitive and more intrapersonal functioning. As research in the domain of social cognition continues to identify specific deficits and its functional detriments, treatment options need to evolve to better target identified functional deficits. Social Cognition and Interaction Training (SCIT) was recently developed to address specific socio-cognitive deficits in an inpatient population of individuals with schizophrenia-spectrum disorders. This study applied SCIT in an outpatient SMI population as many deficits remain after individuals’ symptoms are less severe and overall functioning is more stable than during the acute inpatient phase of their rehabilitation. Specifically, this study has two objectives. First, to demonstrate that deficits in social cognition persist after the acute phase of illness has abated. Second, to demonstrate that these deficits can be ameliorated via targeted treatment such as SCIT. Data was gathered in local outpatient treatment settings serving a heterogeneous SMI population. Adviser: William D. Spaulding

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Artificial selection for starvation resistance provided insight into the relationships between evolved physiological and life history trait responses following exposure to biologically induced stress. Investigations of alterations to body composition, metabolic rate, movement, and life history traits including development time, female egg production, and longevity in response to brief periods of starvation were conducted on genetically based starvation-resistant and control lines of Drosophila melanogaster. Analysis of the starvation-resistant lines indicated increased energy storage with increased triglyceride deposition and conversion of carbohydrates to lipid, as identified by respiratory quotient values. Correlations between reductions in metabolic rates and movement in the starvation-resistant lines, suggested the presence of an evolved physiological response resulting in energy conservation. Investigations of life history traits in the starvation-resistant lines indicated no significant differences in development time or reproduction between the selected and control lines. Measurements of longevity, however, indicated a significant reduction in starvation-resistant D. melanogaster lifespan. These results suggested that elevated lipid concentrations, similar to that observed with obesity, were correlated with premature mortality. Exposure of the starvation-resistant and control lines to diets supplemented with glucose, palmitic acid, and a 2:1 mixture of casein to albumin were used to investigate alterations in body composition, movement, and life history traits. Results obtained from this study indicated that increased sugar in the diet led to increased carbohydrate, glycogen, total sugar, trehalose, and triglyceride concentrations, while increased fat and protein in the diet resulted in increased soluble protein, carbohydrate, glycogen, total sugar, and trehalose concentrations. Examination of life history trait responses indicated reduced fecundity in females exposed to increased glucose concentrations. Increased supplementations of palmitic acid was consistently correlated with an overall reduction in lifespan in both the starvation-resistant and control Drosophila lines, while measurements of movement indicated increased female activity levels in flies exposed to diets supplemented with fat and protein. Analyses of the physiological and life history trait responses to starvation and dietary supplementation on Drosophila melanogaster used in the present study has implications for investigating the mechanisms underlying the development and persistence of human obesity and associated metabolic disorders.