Calcium channel activation and self-biting in mice

The L type calcium channel agonist (±)Bay K 8644 has been reported to cause characteristic motor abnormalities in adult mice. The current study shows that administration of this drug can also cause the unusual phenomenon of self-injurious biting, particularly when given to young mice. Self-biting is provoked by injecting small quantities of (±)Bay K 8644 directly into the lateral ventricle of the brain, suggesting a central effect of the drug. Similar behaviors can be provoked by administration of another L type calcium channel agonist, FPL 64176. The self-biting provoked by (±)Bay K 8644 can be inhibited by pretreating the mice with dihydropyridine L type calcium channel antagonists such as nifedipine, nimodipine, or nitrendipine. However, self-biting is not inhibited by nondihydropyridine antagonists including diltiazem, flunarizine, or verapamil. The known actions of (±)Bay K 8644 as an L type calcium channel agonist, the reproduction of similar behavior with another L type calcium channel agonist, and the protection afforded by certain L type calcium channel antagonists implicate calcium channels in the mediation of the self-biting behavior. This phenomenon provides a model for studying the neurobiology of this unusual behavior.

Enlisting the influence of others: Alternative strategies for persuasive media campaigns

This study investigated an Australian antidrug campaign that targeted adolescents directly and indirectly via recruiting parents into drug prevention. Eighty-six parent-child dyads completed surveys measuring campaign evaluations, discussions about drugs, and beliefs about risks to self (own child) and to the average young Australian. Adolescents were optimistic about risks, and media impact was evident only in perceptions of risk to others. Parents were less optimistic, and perceptions of campaign quality predicted perceived risk to own child and discussion about drugs. However, this was moderated by negative affect associated with the campaign. There was some evidence that discussions influenced adolescents' perceptions of personal risk. This demonstrates the importance of individual responses and communication processes in determining the impact of persuasive media messages.

Medical advice and diabetes self-management reported by Mexican-American, Black- and White-non-Hispanic adults across the United States

Background Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. Methods We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 Mexican-Americans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with 'undiagnosed diabetes' [N = 815(171 MA, 281 BNH and 364 WNH)] who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight) predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants' diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Results Although medical advice to the patient is considered a standard of care for diabetes, approximately one-third of the sample reported not receiving dietary, weight management, or physical activity self-management advice. Participants who reported being given medical advice for each specific diabetes self-management behaviors were 4-8 times more likely to report performing the corresponding behaviors, independent of race. These results supported the ecological model with certain caveats. Conclusions Providing standard medical advice appears to lead to diabetes self-management behaviors as reported by adults across the United States. Moreover, it does not appear that race/ethnicity influenced reporting performance of the standard diabetes self-management behavior. Longitudinal studies evaluating patient-provider communication, medical advice and diabetes self-management behaviors are needed to clarify our findings.

Medical Advice and Diabetes Self-Management Reported by Mexican-American, Black- and White-Non-Hispanic Adults Across the United States

Background: Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and diabetes self-management behaviors. Methods: We analyzed data from 654 adults aged 21 years and over with diagnosed diabetes [130 MexicanAmericans; 224 Black non-Hispanics; and, 300 White non-Hispanics] and an additional 161 with ‘undiagnosed diabetes’ [N = 815(171 MA, 281 BNH and 364 WNH)] who participated in the National Health and Nutrition Examination Survey (NHANES) 2007-2008. Logistic regression models were used to evaluate whether medical advice to engage in particular self-management behaviors (reduce fat or calories, increase physical activity or exercise, and control or lose weight) predicted actually engaging in the particular behavior and whether the impact of medical advice on engaging in the behavior differed by race/ethnicity. Additional analyses examined whether these relationships were maintained when other factors potentially related to engaging in diabetes self management such as participants’ diabetes education, sociodemographics and physical characteristics were controlled. Sample weights were used to account for the complex sample design. Results: Although medical advice to the patient is considered a standard of care for diabetes, approximately onethird of the sample reported not receiving dietary, weight management, or physical activity self-management advice. Participants who reported being given medical advice for each specific diabetes self-management behaviors were 4-8 times more likely to report performing the corresponding behaviors, independent of race. These results supported the ecological model with certain caveats. Conclusions: Providing standard medical advice appears to lead to diabetes self-management behaviors as reported by adults across the United States. Moreover, it does not appear that race/ethnicity influenced reporting performance of the standard diabetes self-management behavior. Longitudinal studies evaluating patient-provider communication, medical advice and diabetes self-management behaviors are needed to clarify our findings.

Economics of Ethical and Prosocial Behavior: Experiments on Social Responsibility, Ignorance, and Cheating

In this thesis I experimentally investigate prosocial and ethical behavior in economic interactions. The thesis consists of three experimental research papers that have a broad range of research questions on social responsibility, ignorance and cheating. With these experiments I aim to better understand when and why people behave ethically and/or prosocially and which consequences it has on their own and other players’ payoffs, and on overall efficiency. The results from the three experimental studies suggest that (i) donations to charity by employees are rewarded in an experimental setting, and the effect is driven by reciprocal concerns; (ii) there is a significant fraction of people who decide not to know about negative consequences of own actions, and the sorting of social agents of a low type into ignorance drives self-interested behavior of ignorant agents; and (iii) if the possibility of being exposed as a liar is small, the tendency to lie increases with incentives, indicating that some people have positive and finite costs of lying. Furthermore, when the participants lie, they lie to the full extent, which suggests that the intrinsic cost of lying is fixed.

STUDIES OF FUNCTIONALIZED NANOPARTICLES FOR SMART SELF-ASSEMBLY AND AS CONTROLLED DRUG DELIVERY

This dissertation is related to the studies of functionalized nanoparticles for self-assembly and as controlled drug delivery system. The whole topic is composed of two parts. In the first part, the research was conducted to design and synthesize a new type of ionic peptide-functionalized copolymer conjugates for self-assembly into nanoparticle fibers and 3D scaffolds with the ability of multi-drug loading and governing the release rate of each drug for tissue engineering. The self-assembly study confirmed that such peptide-functionalized amphiphilic copolymers underwent different self-assembly behavior. The bigger nanoparticles were more easily assembled into nanoparticle fibers and 3D scaffolds with larger pore size, while the smaller nanoparticle underwent faster self-assembly to form more compact 3D scaffolds with smaller porosity but more stable structure. Controlled release studies confirmed the ability of governing simultaneous release of different model drugs with independent release rate from a same scaffold. Cytotoxicity tests showed that all synthesized peptides, copolymers and peptide-copolymer conjugates were biocompatible with SW-620 cell lines and NIH3T3 cell lines. This new type of self-assembled scaffolds combined the advantages of peptide nanofibers and versatile controlled release of polymeric nanoparticles to achieve simultaneous multi-drug loading and controlled release of each drug, uniform distribution and flexibility of hydrogel scaffolds. The investigations in second part were first to design and synthesize organic biocide-loaded nanoparticles for low-leaching wood preservation using a cost-effective one-pot method to synthesize amphiphilic chitosan-g-PMMA nanoparticles loading with ~25-28 wt.% of the fungicide tebuconazole with particle size of ~100 nm diameter by FESEM. FESEM analysis confirmed efficient penetration of nanoparticles throughout the treated wooden stake with dimension of 19 × 19 × 455 mm^3. Leaching studies showed that biocide introduced into sapwood via nanoparticles leached only ~9% compared with the amount leached from tebuconazole solution-treated control, while soil jar tests showed that the nanoparticle-treated wood blocks were effectively protected from biological decay tested against G. trabeum, a brown rot fungus. Copper oxide nanoparticles with and without polymer stabilizers were also investigated to use as inorganic wood preservatives to clarify the factor affecting copper leaching from treated wood. Copper oxide nanoparticles with uniform diameters of ~10 nm and ~50 nm were prepared, and the leachates from southern pine sapwood treated with these nanoparticles were analyzed. It was found by TEM and EDS analysis that significant numbers of nanoparticles leached from the treated wood. The 50 nm nanoparticles leached slightly less than a soluble copper salt control, but 10 nm nanoparticles leached substantially more than the control. The effect of polymer stabilizers on nanoparticle leaching was also investigated. Results showed that polymer stabilizers increased leaching. The trends showed that nanoparticle size was a major factor in copper leaching.

Análise comportamental de recém-nascidos pré-termos incluídos em um programa de estimulação tátil-cinestésica durante a internação hospitalar

OBJETIVO: Avaliar o efeito da estimulação tátil-cinestésica na evolução do padrão comportamental e clínico de recém-nascidos pré-termos (RNPT) durante o período de internação hospitalar. MÉTODOS: Trinta e dois RNPT, com peso ao nascimento inferior a 2.500 gramas, clinicamente estáveis e destituídos de asfixia perinatal importante foram divididos em 16 bebês do grupo controle (GC) e 16 do experimental (GE). Foram coletados dados da evolução clínica a partir dos registros hospitalares e da avaliação comportamental por meio de filmagens semanais de oito minutos, desde a inclusão do RNPT na amostra até a alta hospitalar. RESULTADOS: Tendência a redução do tempo de internação hospitalar, aumento do ganho de peso diário e predominância de comportamentos auto-organizados (respiração regular, estado de alerta, tônus equilibrado, posturas mistas, movimentação coordenada, movimentos de mão na face, sucção, preensão, apoio) para os RNPT do GE. A análise comparativa das idades pós-conceptuais divididas em intervalos (I - 31 a 33 semanas 6/7; II - 34 a 36 semanas 6/7; e III - 37 a 39 semanas 6/7) ressaltou, no aspecto motor, um tônus equilibrado e movimentação voluntária coordenada para os três períodos, maior permanência em posturas mistas (intervalo I) ou em flexão (intervalo II) e a obtenção de respiração mais regular na faixa etária I do GE. CONCLUSÃO: Destaque da estimulação tátil-cinestésica como método de intervenção durante o período de internação hospitalar, contribuindo para a auto-organização e regulação comportamental de RNPT. Artigo registrado no Australian New Zealand Clinical Trials Registry (ANZCTR) sob o número ACTRN12610000133033.

The effectiveness of educational practice in diabetic foot: a view from Brazil

Background: The aim of the present study was to evaluate the prevention and self-inspection behavior of diabetic subjects with foot at ulcer risk, no previous episode, who participated in the routine visits and standardized education provided by the service and who received prescribed footwear. This evaluation was carried out using a questionnaire scoring from 0-10 (high scores reflect worse practice compliance). Results: 60 patients were studied (30 of each sex); mean age was 62 years, mean duration of the disease was 17 years. As for compliance, 90% showed a total score <= 5, only 8.7% regularly wore the footwear supplied; self foot inspection 65%, 28,3% with additional familiar inspection; creaming 77%; proper washing and drying 88%; proper cutting of toe nails 83%; no cuticle cutting 83%; routine shoe inspection 77%; no use of pumice stones or similar abrasive 70%; no barefoot walking 95%. Conclusion: the planned and multidisciplinary educational approach enabled high compliance of the ulcer prevention care needed in diabetic patients at risk for complications. In contrast, compliance observed for the use of footwear provided was extremely low, demonstrating that the issue of its acceptability should be further and carefully addressed. In countries of such vast dimensions as Brazil multidisciplinary educational approaches can and should be performed by the services providing care for patients with foot at risk for complications according to the reality of local scenarios. Furthermore, every educational program should assess the learning, results obtained and efficacy in the target population by use of an adequate evaluation system.

The limits of environmental responsibility - A stormwater case study

The motivation for concern about the environment beyond one's neighborhood is still relatively poorly understood. This article examines the determinants of feelings of responsibility at a regional watershed level. Using demographic, attitudinal, self-reported behavior and neighborhood mapping measures from four cities in Australia, five hypotheses were derived. These were that wider environmental concerns would depend on (a) the physical and social characteristics of the respondents' neighborhoods, (b) the size of their perceived neighborhoods, (c) the length of residence at their localities, (d) educational level and attitudes toward environmental moral responsibility (and the interaction between them), and (e) the level of reported environmentally friendly behavior. Support was gained for all hypotheses except length of residence and the role of general moral attitudes toward the environment. It is concluded that to explain community action at the regional level, it is important to include both spatial and psychological insights and methodologies in research.

Academic dishonesty: understanding how undergraduate students think and act

The purpose of this investigation is to explore and understand the justifications given by students to the existence of dishonest behavior and understanding the extent to which the justifications given might influence denouncing and cheating behavior. 1277 undergraduate students of two Portuguese Public Universities were surveyed about their own cheating behavior, their propensity to denounce and the ―neutralizing attitudes‖. As predicted, ―neutralizing attitudes‖ was negatively correlated with self cheating behavior and positively correlated with reporting. The likelihood of copying is greater when the purpose is ―helping a friend‖, ―when the courses are more difficult‖, ―to get higher marks/grades‖, and because ―peers accept and tend to see copying practices as normal‖. Results support the notion that context emerges as a very important influence in the decision to cheating. The environment-peer pressure and the normalized attitudes towards academic dishonesty are the main influences on the propensity to cheating.

Perspetivas dos profissinais e dos pais de crianças com incapacidades sobre autodeterminação

Mestrado em Educação Especial: Multideficiência e Problemas de Cognição

A skin-picking disorder case report: a psychopathological explanation

We describe the case of a 44-year-old woman, without known previous psychiatric history, hospitalized after a significant hemorrhage caused by self-inflicted deep facial dermal lesions (with muscle exposition). Psychopathological possible explanations of this case, as in similar reviewed ones, are related to frustration, aggression, and impulsivity.

Oncology clinicians' defenses and adherence to communication skills training with simulated patients: an exploratory study.

The aim of this exploratory study was to assess the impact of clinicians' defense mechanisms-defined as self-protective psychological mechanisms triggered by the affective load of the encounter with the patient-on adherence to a communication skills training (CST). The population consisted of oncology clinicians (N = 31) who participated in a CST. An interview with simulated cancer patients was recorded prior and 6 months after CST. Defenses were measured before and after CST and correlated with a prototype of an ideally conducted interview based on the criteria of CST-teachers. Clinicians who used more adaptive defense mechanisms showed better adherence to communication skills after CST than clinicians with less adaptive defenses (F(1, 29) = 5.26, p = 0.03, d = 0.42). Improvement in communication skills after CST seems to depend on the initial levels of defenses of the clinician prior to CST. Implications for practice and training are discussed. Communication has been recognized as a central element of cancer care [1]. Ineffective communication may contribute to patients' confusion, uncertainty, and increased difficulty in asking questions, expressing feelings, and understanding information [2, 3], and may also contribute to clinicians' lack of job satisfaction and emotional burnout [4]. Therefore, communication skills trainings (CST) for oncology clinicians have been widely developed over the last decade. These trainings should increase the skills of clinicians to respond to the patient's needs, and enhance an adequate encounter with the patient with efficient exchange of information [5]. While CSTs show a great diversity with regard to their pedagogic approaches [6, 7], the main elements of CST consist of (1) role play between participants, (2) analysis of videotaped interviews with simulated patients, and (3) interactive case discussion provided by participants. As recently stated in a consensus paper [8], CSTs need to be taught in small groups (up to 10-12 participants) and have a minimal duration of at least 3 days in order to be effective. Several systematic reviews evaluated the impact of CST on clinicians' communication skills [9-11]. Effectiveness of CST can be assessed by two main approaches: participant-based and patient-based outcomes. Measures can be self-reported, but, according to Gysels et al. [10], behavioral assessment of patient-physician interviews [12] is the most objective and reliable method for measuring change after training. Based on 22 studies on participants' outcomes, Merckaert et al. [9] reported an increase of communication skills and participants' satisfaction with training and changes in attitudes and beliefs. The evaluation of CST remains a challenging task and variables mediating skills improvement remain unidentified. We recently thus conducted a study evaluating the impact of CST on clinicians' defenses by comparing the evolution of defenses of clinicians participating in CST with defenses of a control group without training [13]. Defenses are unconscious psychological processes which protect from anxiety or distress. Therefore, they contribute to the individual's adaptation to stress [14]. Perry refers to the term "defensive functioning" to indicate the degree of adaptation linked to the use of a range of specific defenses by an individual, ranging from low defensive functioning when he or she tends to use generally less adaptive defenses (such as projection, denial, or acting out) to high defensive functioning when he or she tends to use generally more adaptive defenses (such as altruism, intellectualization, or introspection) [15, 16]. Although several authors have addressed the emotional difficulties of oncology clinicians when facing patients and their need to preserve themselves [7, 17, 18], no research has yet been conducted on the defenses of clinicians. For example, repeated use of less adaptive defenses, such as denial, may allow the clinician to avoid or reduce distress, but it also diminishes his ability to respond to the patient's emotions, to identify and to respond adequately to his needs, and to foster the therapeutic alliance. Results of the above-mentioned study [13] showed two groups of clinicians: one with a higher defensive functioning and one with a lower defensive functioning prior to CST. After the training, a difference in defensive functioning between clinicians who participated in CST and clinicians of the control group was only showed for clinicians with a higher defensive functioning. Some clinicians may therefore be more responsive to CST than others. To further address this issue, the present study aimed to evaluate the relationship between the level of adherence to an "ideally conducted interview", as defined by the teachers of the CST, and the level of the clinician' defensive functioning. We hypothesized that, after CST, clinicians with a higher defensive functioning show a greater adherence to the "ideally conducted interview" than clinicians with a lower defensive functioning.

Recomendaciones sobre la detección, prevención e intervención de la Conducta Suicida

Publicado en la página web del Servicio Andaluz de Salud: http://www.juntadeandalucia.es/servicioandaluzdesalud/publicaciones/

Núm 4, octubre de 2013

Artículos destacados: Buenas prácticas en gestión clínica: Utilidad de la ecografía en rehabilitación. Seguimiento del acuerdo de gestión clínica. Organigrama de funciones de la Unidad de Gestión Clínica. Los antibióticos se acaban, es tiempo de actuar.