The neuro-immune pathophysiology of central and peripheral fatigue in systemic immune-inflammatory and neuro-immune diseases

Many patients with systemic immune-inflammatory and neuro-inflammatory disorders, including depression, rheumatoid arthritis, systemic lupus erythematosus, Sjögren's disease, cancer, cardiovascular disorder, Parkinson's disease, multiple sclerosis, stroke, and chronic fatigue syndrome/myalgic encephalomyelitis, endure pathological levels of fatigue. The aim of this narrative review is to delineate the wide array of pathways that may underpin the incapacitating fatigue occurring in systemic and neuro-inflammatory disorders. A wide array of immune, inflammatory, oxidative and nitrosative stress (O&NS), bioenergetic, and neurophysiological abnormalities are involved in the etiopathology of these disease states and may underpin the incapacitating fatigue that accompanies these disorders. This range of abnormalities comprises: increased levels of pro-inflammatory cytokines, e.g., interleukin-1 (IL-1), IL-6, tumor necrosis factor (TNF) α and interferon (IFN) α; O&NS-induced muscle fatigue; activation of the Toll-Like Receptor Cycle through pathogen-associated (PAMPs) and damage-associated (DAMPs) molecular patterns, including heat shock proteins; altered glutaminergic and dopaminergic neurotransmission; mitochondrial dysfunctions; and O&NS-induced defects in the sodium-potassium pump. Fatigue is also associated with altered activities in specific brain regions and muscle pathology, such as reductions in maximum voluntary muscle force, downregulation of the mitochondrial biogenesis master gene peroxisome proliferator-activated receptor gamma coactivator 1-alpha, a shift to glycolysis and buildup of toxic metabolites within myocytes. As such, both mental and physical fatigue, which frequently accompany immune-inflammatory and neuro-inflammatory disorders, are the consequence of interactions between multiple systemic and central pathways.

Long-term follow-up in patients with Lennox-Gastaut syndrome. Epileptological aspects, psychomotor development and social adaptation

In 1989/90 a follow-up was made possible on 72 of 78 patients who have been treated for the supposed or confirmed diagnosis of a Lennox-Gastaut-Syndrome at the university children hospital of Berne between 1964 and 1978. Nine patients were excluded of this study because the diagnosis was proved wrong retrospectively, leaving 63 cases. Of these, eleven patients (17.5%) have died. The remaining 52 (82.5%) were evaluated regarding their epilepsy, psychomotor development and social adaptation. The follow-up was good for 14.3%, intermediate for 23.8% and poor for 44.4%. Bad prognostic factors were found to be: first manifestation of epilepsy during the first year of life, occurrence of infantile spasms or hypsarrhythmia in the EEG and pathological neurological signs at the beginning of the disease. In the course of illness a change of seizure phenomenology was observed. The infantile spasms were seen only during the first three years of epilepsy. After the second year of disease psychomotor seizures became more and more frequent. Atypical absences, already seen at the beginning, were the most frequent form of seizure from the third year of epilepsy until the end of our observations. During the course of disease the frequency of generalized tonic and tonic-clonic seizures decreased little.

Association of fatigue and psychological distress with quality of life in patients with a previous venous thromboembolic event

Health-related quality of life (QoL) has been associated with several social and medical conditions in patients with deep vein thrombosis (DVT) and pulmonary embolism (PE). To the best of our knowledge, there is no study investigating the relationship of QoL with psychological variables in this patient population. We assumed as a hypothesis an association between heightened levels of fatigue and psychological distress, as well as decreased QoL in patients with an objectively diagnosed venous thromboembolic event. Study participants were 205 consecutively enrolled out-patients (47.4 years, 54.6% men) with DVT and/or PE. Approximately 10 days before blood collection for thrombophilia work-up, QoL, fatigue, and psychological distress were assessed using the Short Form Health Survey (SF-12), the Multidimensional Fatigue Symptom Inventory Short Form (MFSI-SF) as well as the Hospitality Anxiety and Depression scale (HADS). After controlling for demographic and medical factors, fatigue (p < 0.01) but not psychological distress (p>0.05) was negatively associated with physical QoL, explaining 11.0% of the variance. Fatigue (p < 0.001) and psychological distress (p < 0.001) were significant predictors of mental QoL, explaining an additional 36.2% and 3.6% of the variance. Further analyses revealed that all subscales of the HADS (e.g. anxiety and depression) and of the MFSI-SF (e.g. general fatigue, physical fatigue, emotional fatigue, mental fatigue and vigor) were significant predictors of mental QoL. MFSI-SF subscales also predicted physical QoL. The findings suggest that fatigue and psychological distress substantially predict QoL in patients with a previous venous thromboembolic event above and beyond demographic factors.

Vulnerability Following a Critical Life Event: Temporary Crisis or Chronic Distress? A Psychological Controversy, Methodological Considerations, and Empirical Evidence

This contribution deals with psychological vulnerability resulting from marital breakup after a long-term relationship. Despite the existing vast body of consolidated knowledge on divorce and psychological adaptation, there are still several controversies concerning the vulnerabilizing impact of marital breakup. One major issue refers to the question of whether vulnerability after marital breakup is a temporary crisis or rather a chronic strain. In this chapter we want to present two possible methodological options to tackle this question: First, comparing a sample of almost 1000 middle-aged persons, who were married on average 19 years, and who experienced a marital split within the last 5 years (4 time groups), with a group of age-matched married controls with regard to various indicators of psychological vulnerability (such as depression and hopelessness). Second, comparing within the divorced group the most vulnerable individuals (in terms of depression, hopelessness, life satisfaction) with those who were the least affected, regarding intra-personal resources (personality, resilience), divorce circumstances, post-divorce situation, and socio-economic resources. The study results underline the vulnerabilizing impact of marital breakup, but at the same time they reveal individual differences in psychological adaptation especially due to personality, new partnership, economic resources, and last but not least due to time. Furthermore our data strongly suggest that there is not a generalized psychological vulnerability after marital breakup, but that the emotional dimensions such as depression or feelings of not overcoming the loss are more affected than the more cognitive ones such as life satisfaction.

Chronic illness in non-heterosexual contexts: an online survey of experiences

In this article we contribute to the expansion of lesbian, gay, bisexual, transgender and queer (LGBTQ) health psychology beyond the confines of sexual health by examining the experiences of lesbian, gay and bisexual people living with non-HIV related chronic illness. Using a (predominantly) qualitative online survey, the perspectives of 190 LGB people with 52 different chronic illnesses from eight countries were collected. The five most commonly reported physical conditions were arthritis, hypertension, diabetes, asthma and chronic fatigue syndrome. Our analysis focuses on four themes within participants’ written comments: (1) ableism within LGBT communities; (2) isolation from LGBT communities and other LGB people living with chronic illness; (3)heteronormativity within sources of information and support and; (4) homophobia from healthcare professionals. We conclude by suggesting that LGBTQ psychology could usefully draw on critical health psychology principles and frameworks to explore non-heterosexual’s lived experiences of chronic illness, and also that there remains a need for specifically targeted support groups and services for LGB people with chronic illnesses.

Social psychological aspects of rape: a study of recorded rape and images of rape victimisation

This thesis is organised into four parts. In Part 1 relevant literature is reviewed and presented in three chapters. Chapter 1 examines legal and cultural factors in identifying the. boundaries of rape. Chapter 2 discusses idiographic features· and causal characteristics of rape suspects and victims. Chapter 3 reviews the evidence relating to attitudes toward rape,. attribution of responsibility to victims and the routine management of rape cases by the police. Part II comprises an experimental investigation of observer perception of the victims of violent crime. The experiment, examined the processes by which impressions were attributed to victims of personal crime. The results suggested that discrepancies from observers' stereotypes were an important factor in their polarisation of victim ratings. The relevance of. examining . both the structure and process of' impression, formation was highlighted. Part III describes an extensive field study in which the West. Midlands police files on rape for an eight year period (1071-1978) were analysed. The study revealed a large number of interesting findings related to a wide range of relevant features of the crime. Further, the impact .of common misconceptions and "myths" of rape were investigated across the legal and judicial processing of rape cases. The evidence suggests that these "myths" lead·to differential biasing effects at different stages in the process. In the final part of this thesis,. salient issues raised by the experiment and field study .are discussed·within the framework outlined in Part 1. Potential implications for future developments and research: are presented.

Idiosyncratic psychological aspects in entrepreneurship

Entrepreneurship is having the courage to transform an idea in reality and with it achieve personal, nancial and recognition satisfaction. The psychological ability to handle failure has proven essential in success. We analysed the importance of idiosyncratic psychological aspects in the success of entrepreneurs through an observational study accompanying 20 entrepreneurs from the idea presentation phase to company incorporation. During the observation period 4 distinct psychological phases of the entrepreneurs were observed, being it possible to describe them as follows: absorption of information and knowledge; application of the gathered knowledge to their speci c cases; frustration generated by criticism, namely from investors who didn’t recognise the value of their projects; realism and implementation of the project. Having passed more than 6 months after the analysis period, one can verify that the entrepreneurs who have travelled the 4 phases are today developing their projects being that the remaining ones are in a similar situation as at the end of the initial two months. Conclusion: The ability to cope with frustration and rejection is a determinant factor in the success of the entrepreneur. The ability to learn from rejection, more than resilience help the entrepreneur to proceed.

Psychological Aspects in Children and Adolescents With Major Thalassemia: A Case-Control Study

Background: Thalassemia is an inherited blood disease. It is a serious public health problem throughout the Mediterranean region, the Middle East and the Indian subcontinent, as well as in Southeast Asia. Objectives: Thalassemia is an inherited blood disease. It is a serious public health problem. In this study we assessed psychological aspects in Iranian children and adolescents with thalassemia major. Patients and Methods: In this case-control study sixty healthy subjects aged 7-18 years and Sixty Patients with confirmed diagnosis of major thalassemia were enrolled. After obtaining informed consent from parents of all participating thalassemia patients and healthycontrols, we assessed psychological aspects and quality of life by Pediatric Quality of LifeTM (PedsQL™), Strengths and Difficulties Questionnaires (SDQ), State and Trait Anxiety, Children's Depression Inventory (CDI). Results: The results of this study indicate that there are significant changes in depression, anxiety, QOL and behavioral screening between children with thalassemia major compared with healthy subjects by means of both parents and children reports. According to the results, children with thalassemia major have more psychological problems than healthy ones. Patients with thalassemia have a lower QOL than their peers (P = 0.001), the rate of depression is higher in this group (P = 0.015), Also behavioral problems in these children are more than healthy subjects (P = 0.009). Conclusions: We recommend appropriate treatment and counseling procedures in addition to specific treatment of thalassemia. According to the results we suggest to establish pediatric psychiatric clinics beside thalassemic clinics to cure psychological aspects of the disease.

Prevalencia y factores asociados a síndrome burnout en docentes vs personal administrativo pertenecientes a una universidad privada en Bogotá en el 2016

El Síndrome de Burnout, es una condición cuya detección ha venido en aumento en las últimas décadas. Sin embargo, son pocos los estudios realizados en docentes universitarios en Colombia. El objetivo del presente estudio es estimar la prevalencia y los factores asociados, en población administrativa y docente de una universidad privada.

Harnessing the complexity of gene expression data from cancer: from single gene to structural pathway methods

High-dimensional gene expression data provide a rich source of information because they capture the expression level of genes in dynamic states that reflect the biological functioning of a cell. For this reason, such data are suitable to reveal systems related properties inside a cell, e.g., in order to elucidate molecular mechanisms of complex diseases like breast or prostate cancer. However, this is not only strongly dependent on the sample size and the correlation structure of a data set, but also on the statistical hypotheses tested. Many different approaches have been developed over the years to analyze gene expression data to (I) identify changes in single genes, (II) identify changes in gene sets or pathways, and (III) identify changes in the correlation structure in pathways. In this paper, we review statistical methods for all three types of approaches, including subtypes, in the context of cancer data and provide links to software implementations and tools and address also the general problem of multiple hypotheses testing. Further, we provide recommendations for the selection of such analysis methods.

Classifying medication use in clinical research

Les données sur l'utilisation des médicaments sont généralement recueillies dans la recherche clinique. Pourtant, aucune méthode normalisée pour les catégoriser n’existe, que ce soit pour la description des échantillons ou pour l'étude de l'utilisation des médicaments comme une variable. Cette étude a été conçue pour développer un système de classification simple, sur une base empirique, pour la catégorisation d'utilisation des médicaments. Nous avons utilisé l'analyse factorielle pour réduire le nombre de groupements de médicaments possible. Cette analyse a fait émerger un modèle de constellations de consommation de médicaments qui semble caractériser des groupes cliniques spécifiques. Pour illustrer le potentiel de la technique, nous avons appliqué ce système de classification des échantillons où les troubles du sommeil sont importants: syndrome de fatigue chronique et l'apnée du sommeil. Notre méthode de classification a généré 5 facteurs qui semblent adhérer de façon logique. Ils ont été nommés: Médicaments cardiovasculaire/syndrome métabolique, Médicaments pour le soulagement des symptômes, Médicaments psychotropes, Médicaments préventifs et Médicaments hormonaux. Nos résultats démontrent que le profil des médicaments varie selon l'échantillon clinique. Le profil de médicament associé aux participants apnéiques reflète les conditions de comorbidité connues parmi ce groupe clinique, et le profil de médicament associé au Syndrome de fatigue chronique semble refléter la perception commune de cette condition comme étant un trouble psychogène