882 resultados para Symptom Clusters


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We review the evidence that the ultra-compact dwarf (UCD) galaxies we recently discovered in the Fornax Cluster form a new, previously unknown class of galaxies and we discuss possible scenarios for their formation. We then present recent results that UCDs are also present in the Virgo Cluster, and that there is a much larger than expected population of fainter UCDs in the Fornax Cluster. The size and properties of this population may lead us to revise our original 'galaxy threshing' hypothesis for the formation of UCDs.

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Background: The patient acceptable symptom state ( PASS) is the value beyond which patients can consider themselves well. This concept can help in interpreting results of clinical trials. Objective: To determine the PASS estimate for patients with knee and hip osteoarthritis (OA) by assessing pain, patient's global assessment of disease activity, and functional impairment. Methods: A 4 week prospective multicentre cohort study of 1362 outpatients with knee or hip OA was carried out. Data on assessment of pain and patient's global assessment of disease, measured on visual analogue scales, and functional impairment, measured on the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) function subscale, were collected at baseline and final visits. The patients assessed their satisfaction with their current state at the final visit. An anchoring method based on the patient's opinion was used. Results: For patients with knee and hip OA, the estimates of PASS were, respectively, 32.3 and 35.0 mm for pain, 32.0 and 34.6 mm for patient global assessment of disease activity, and 31.0 and 34.4 points for WOMAC function score. The PASS varied moderately across the tertiles of baseline scores but not across age, disease duration, or sex. Conclusion: The use of PASS in clinical trials would provide more meaningful results expressed as a proportion of patients in an acceptable symptom state.

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Metallosphaera sedula is a thermoacidophilic Crenarchaeon which is capable of leaching metals from sulfidic ores. The authors have investigated the presence and expression of genes encoding respiratory complexes in this organism when grown heterotrophically or chemolithotrophically on either sulfur or pyrite. The presence of three gene clusters, encoding two terminal oxidase complexes, the quinol oxidase SoxABCD and the SoxM oxidase supercomplex, and a gene cluster encoding a high-potential cytochrome b and components of a bc(1) complex analogue (cbsBA-soxL2N gene cluster) was established. Expression studies showed that the soxM gene was expressed to high levels during heterotrophic growth of M. sedula on yeast extract, while the soxABCD mRNA was most abundant in cells grown on sulfur. Reduced-minus-oxidized difference spectra of cell membranes showed cytochrome-related peaks that correspond to published spectra of Sulfolobus-type terminal oxidase complexes. In pyrite-grown cells, expression levels of the two monitored oxidase gene clusters were reduced by a factor of 10-12 relative to maximal expression levels, although spectra of membranes clearly contained oxidase-associated haems, suggesting the presence of additional gene clusters encoding terminal oxidases in M. sedula. Pyrite- and sulfur-grown cells contained high levels of the cbsA transcript, which encodes a membrane-bound cytochrome b with a possible role in iron oxidation or chemolithotrophy. The cbsA gene is not co-transcribed with the soxL2N genes, and therefore does not appear to be an integral part of this bc(1) complex analogue. The data show for the first time the differential expression of the Sulfolobus-type terminal oxidase gene clusters in a Crenarchaeon in response to changing growth modes.

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Supervision of psychotherapists and counselors, especially in the early years of practice, is widely accepted as being important for professional development and to ensure optimal client outcomes. Although the process of clinical supervision has been extensively studied, less is known about the impact of supervision on psychotherapy practice and client symptom outcome. This study evaluated the impact of clinical supervision on client working alliance and symptom reduction in the brief treatment of major depression. The authors randomly assigned 127 clients with a diagnosis of major depression to 127 supervised or unsupervised therapists to receive eight sessions of problems-solving treatment. Supervised therapists were randomly assigned to either alliance skill- or alliance process-focused supervision and received eight supervision sessions. Before beginning treatment, therapists received one supervision session for brief training in the working alliance supervision approach and in specific characteristics of each case. Standard measures of therapeutic alliance and symptom change were used as dependent variables. The results showed a significant effect for both supervision conditions on working alliance from the first session of therapy, symptom reduction, and treatment retention and evaluation but no effect differences between supervision conditions. It was not possible to separate the effects of supervision from the single pretreatment session and is possible that allegiance effects might have inflated results. The scientific and clinical relevance of these findings is discussed.

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Individuals seeking compensation following traumatic brain injury (TBI) are often found to report a disproportionately high level of symptoms relative to objective indicators of impairment. Previous studies highlight that level of symptom reporting is also related to self-awareness, causal attribution, and emotional wellbeing. Therefore, the reasons for high symptom reporting in the context of compensation are generally unclear. This study aimed to identify whether self-awareness, causal attribution, and emotional wellbeing are significantly associated with level of symptom reporting after controlling for compensation status. A sample of 54 participants with TBI comprised two groups, namely, claimants (n = 27) and non-claimants (n = 27), who were similar in terms of demographic and neuro-cognitive variables. Participants completed the Symptom Expectancy Checklist, Hospital Anxiety Depression Scale, Awareness Questionnaire and a causal attribution scale. A series of independent t tests and Pearson's correlations identified that a higher level of symptom reporting was associated with the following: seeking compensation, less severe TBI, increased age, greater self-awareness, increased post-injury changes reported by relatives, a higher level of mood symptoms, and a tendency to blame other people. Multivariate analysis identified that after controlling for demographic, injury, and compensation status variables, level of mood symptoms and self-awareness were significantly associated with level of symptom reporting. The findings suggest that mood symptoms and heightened self-awareness are significantly related to high symptom reporting independent of compensation status, thus supporting the need for clinicians to interpret symptom reporting within a biopsychosocial context.

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Background: Pain is defined as both a sensory and an emotional experience. Acute postoperative tooth extraction pain is assessed and treated as a physiological (sensory) pain while chronic pain is a biopsychosocial problem. The purpose of this study was to assess whether psychological and social changes Occur in the acute pain state. Methods: A biopsychosocial pain questionnaire was completed by 438 subjects (165 males, 273 females) with acute postoperative pain at 24 hours following the surgical extraction of teeth and compared with 273 subjects (78 males, 195 females) with chronic orofacial pain. Statistical methods used a k-means cluster analysis. Results: Three clusters were identified in the acute pain group: 'unaffected', 'disabled' and 'depressed, anxious and disabled'. Psychosocial effects showed 24.8 per cent feeling 'distress/suffering' and 15.1 per cent 'sad and depressed'. Females reported higher pain intensity and more distress, depression and inadequate medication for pain relief (p

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We are undertaking a program to measure the characteristics of the intracluster light ( ICL; total flux, profile, color, and substructure) in a sample of 10 galaxy clusters with a range of cluster mass, morphology, and redshift. We present here the methods and results for the first cluster in that sample, A3888. We have identified an ICL component in A3888 in V and r that contains 13% +/- 5% of the total cluster light and extends to 700 h(70)(-1) kpc (similar to 0.3r(200)) from the center of the cluster. The ICL color in our smallest radial bin is V - r 0.3 +/- 0.1, similar to the central cluster elliptical galaxies. The ICL is redder than the galaxies at 400 h(70)(-1) kpc < r < 700 h(70)(-1) kpc, although the uncertainty in any one radial bin is high. Based on a comparison of V - r color with simple stellar models, the ICL contains a component that formed more than 7 Gyr ago ( at z less than 1) with a high-metallicity ( 1.0 Z(circle dot) < Z(ICL) less than or similar to 2.5 Z(circle dot)) and a more centralized component that contains stars formed within the past 5 Gyr ( at z similar to 1). The profile of the ICL can be roughly fitted by a shallow exponential in the outer regions and a steeper exponential in the central region. We also find a concentration of diffuse light around a small group of galaxies 1.4 h(70)(-1) Mpc from the center of the cluster. In addition, we find three low surface brightness features near the cluster center that are blue ( V - r 0.0) and contain a total flux of 0.1M*. Based on these observations and X-ray and galaxy morphology, we suggest that this cluster is entering a phase of significant merging of galaxy groups in the core, whereupon we expect the ICL fraction to grow significantly with the formation of a cD galaxy, as well as the infall of groups.

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Non- protein- coding RNAs ( ncRNAs) are increasingly being recognized as having important regulatory roles. Although much recent attention has focused on tiny 22- to 25- nucleotide microRNAs, several functional ncRNAs are orders of magnitude larger in size. Examples of such macro ncRNAs include Xist and Air, which in mouse are 18 and 108 kilobases ( Kb), respectively. We surveyed the 102,801 FANTOM3 mouse cDNA clones and found that Air and Xist were present not as single, full- length transcripts but as a cluster of multiple, shorter cDNAs, which were unspliced, had little coding potential, and were most likely primed from internal adenine- rich regions within longer parental transcripts. We therefore conducted a genome- wide search for regional clusters of such cDNAs to find novel macro ncRNA candidates. Sixty- six regions were identified, each of which mapped outside known protein- coding loci and which had a mean length of 92 Kb. We detected several known long ncRNAs within these regions, supporting the basic rationale of our approach. In silico analysis showed that many regions had evidence of imprinting and/ or antisense transcription. These regions were significantly associated with microRNAs and transcripts from the central nervous system. We selected eight novel regions for experimental validation by northern blot and RT- PCR and found that the majority represent previously unrecognized noncoding transcripts that are at least 10 Kb in size and predominantly localized in the nucleus. Taken together, the data not only identify multiple new ncRNAs but also suggest the existence of many more macro ncRNAs like Xist and Air.

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Objective: The tripartite model of anxiety and depression has been proposed as a representation of the structure of anxiety and depression symptoms. The Mood and Anxiety Symptom Questionnaire (MASQ) has been put forwards as a valid measure of the tripartite model of anxiety and depression symptoms. This research set out to examine the factor structure of anxiety and depression symptoms in a clinical sample to assess the MASQ's validity for use in this population. MethodsThe present study uses confirmatory factor analytic methods to examine the psychometric properties of the MASQ in 470 outpatients with anxiety and mood disorder. Results: The results showed that none of the previously reported two-factor, three-factor or five-factor models adequately fit the data, irrespective of whether items or subscales were used as the unit of analysis. Conclusions: It was concluded that the factor structure of the MASQ in a mixed anxiety/depression clinical sample does not support a structure consistent with the tripartite model. This suggests that researchers using the MASQ with anxious/depressed individuals should be mindful of the instrument's psychometric limitations.

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Objectives: To compare the general psychopathology in an eating disorders (ED) and a child mental health Outpatient sample and investigate the implications of comorbidity on psychological and physical measures of ED severity. Methods: One hundred thirty-six children and adolescents with a DSM-IV ED diagnosis were compared with age- and gender-matched controls. Measures included the Eating Disorders Examination and the Child Behavior Checklist. Results: The ED group had lower general and externalizing psychopathology scores and no difference in internalizing (anxiety-depression) symptoms. Of the anorexia nervosa group, 49% experienced comorbid psychopathology. This group had significantly higher ED psychopathology, longer duration of illness, and more gastrointestinal symptoms, but no difference in malnutrition status. Eating disorders not otherwise specified (EDNos) group measures were less influenced by comorbidity status. Conclusions: Anxiety-depressive symptoms are very common in children and adolescents with EDs. Comorbidity status influences illness severity, especially in the anorexia nervosa group. The management implications of these findings are discussed. (c) 2006 Elsevier Inc. All rights reserved.

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We present 118 new optical redshifts for galaxies in 12 clusters in the Horologium-Reticulum supercluster (HRS) of galaxies. For 76 galaxies, the data were obtained with the Dual Beam Spectrograph on the 2.3 m telescope of the Australian National University at Siding Spring Observatory. After combining 42 previously unpublished redshifts with our new sample, we determine mean redshifts and velocity dispersions for 13 clusters in which previous observational data were sparse. In 6 of the 13 clusters, the newly determined mean redshifts differ by more than 750 km s(-1) from the published values. In three clusters, A3047, A3109, and A3120, the redshift data indicate the presence of multiple components along the line of sight. The new cluster redshifts, when combined with other reliable mean redshifts for clusters in the HRS, are found to be distinctly bimodal. Furthermore, the two redshift components are consistent with the bimodal redshift distribution found for the intercluster galaxies in the HRS by Fleenor and coworkers.

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The spatial heterogeneity in the risk of Ross River virus (family Togaviridae, genus Alphavirus, RRV) disease, the most common mosquito-borne disease in Australia, was examined in Redland Shire in southern Queensland, Australia. Disease cases, complaints from residents of intense mosquito biting exposure, and human population data were mapped using a geographic information system. Surface maps of RRV disease age-sex standardized morbidity ratios and mosquito biting complaint morbidity ratios were created. To determine whether there was significant spatial variation in disease and complaint patterns, a spatial scan analysis method was used to test whether the number of cases and complaints was distributed according to underlying population at risk. Several noncontiguous areas in proximity to productive saline water habitats of Aedes vigilax (Skuse), a recognized vector of RRV, had higher than expected numbers of RRV disease cases and complaints. Disease rates in human populations in areas which had high numbers of adult Ae. vigilax in carbon dioxide- and octenol-baited light traps were up to 2.9 times those in areas that rarely had high numbers of mosquitoes. It was estimated that targeted control of adult Ae. vigilax in these high-risk areas could potentially reduce the RRV disease incidence by an average of 13.6%. Spatial correlation was found between RRV disease risk and complaints from residents of mosquito biting. Based on historical patterns of RRV transmission throughout Redland Shire and estimated future human population growth in areas with higher than average RRV disease incidence, it was estimated that RRV incidence rates will increase by 8% between 2001 and 2021. The use of arbitrary administrative areas that ranged in size from 4.6 to 318.3 km2, has the potential to mask any small scale heterogeneity in disease patterns. With the availability of georeferenced data sets and high-resolution imagery, it is becoming more feasible to undertake spatial analyses at relatively small scales.

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Smoking rate is disproportionately high among patients with schizophrenia, resulting in significant morbidity and mortality. However, cigarette smoking has been reported to have beneficial effects on negative symptoms, extrapyramidal symptoms, cognitive functioning and mood symptoms. Therefore, smoking cessation may worsen disability in schizophrenia. The association between smoking and these key clinical parameters was examined. Additionally, severity of smoking across four different antipsychotic treatment groups was explored. One hundred and forty-six patients with schizophrenia were assessed for smoking using expired carbon monoxide and smoking history. They were administered the Positive and Negative Symptom Scale, The Extrapyramidal Symptom Rating Scale, the Barnes Akathisia Rating Scale, Reitans Trail-making Test (A and B) and General Health Questionnaire-28. There was no difference in the chlorpromazine equivalent dose of any of the medications studied. Atypical agents were associated with significantly lower levels of smoking when compared with typical medications. There was no difference in smoking severity between the individual atypical medications examined. Similarly, there were no significant differences between smoking and non-smoking groups with regard to Positive and Negative Symptom Scale, Extrapyramidal Symptom Rating Scale, Trail-making Test and General Health Questionnaire-28. However, there was a significant difference between these groups with the smoking group demonstrating less akathisia. Smoking is not associated with positive, negative cognitive and mood symptoms in schizophrenia. Smoking is associated with lower levels of antipsychotic induced akathisia. Clinicians should not be discouraged from helping patients stop smoking for fear of worsening symptoms. However, akathisia may emerge upon cessation of smoking. Switching patients from typical to atypical antipsychotics may assist patients with schizophrenia to give up smoking.