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91.
Vanessa Pirani Gaioso Antonia Maria Villarruel Lynda Anne Wilson Andres Azuero Gwendolyn Denice Childs Susan Lane Davies 《Revista latino-americana de enfermagem》2015,23(3):500-511
OBJECTIVE:
to test a theoretical model based on the Parent-Based Expansion of the Theory of Planned Behavior examining relation between selected parental, teenager and cultural variables and Latino teenagers'' intentions to engage in sexual behavior.METHOD:
a cross-sectional correlational design based on a secondary data analysis of 130 Latino parent and teenager dyads.RESULTS:
regression and path analysis procedures were used to test seven hypotheses and the results demonstrated partial support for the model. Parent familism and knowledge about sex were significantly associated with parents'' attitudes toward sexual communication with their teenagers. Parent Latino acculturation was negatively associated with parents'' self-efficacy toward sexual communication with their teenagers and positevely associated with parents'' subjective norms toward sexual communication with their teenagers. Teenager knowledge about sex was significantly associated with higher levels of teenagers'' attitudes and subjective norms about sexual communication with parents. Only the predictor of teenagers'' attitudes toward having sex in the next 3 months was significantly associated with teenagers'' intentions to have sex in the next 3 months.CONCLUSION:
the results of this study provide important information to guide future research that can inform development of interventions to prevent risky teenager sexual behavior among Latinos. 相似文献92.
Ofir Moreno Todd Butler Vanessa Zann Ashley Willson Pui Leung Alyson Connor 《Clinical therapeutics》2018,40(11):1855-1867
Purpose
ME-401 is a novel selective inhibitor of phosphatidylinositol 3 kinase p110δ, an enzyme often found overexpressed and overactive in B-cell malignancies. The current study was performed to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of single ascending oral doses of ME-401 in healthy volunteers.Methods
This analysis was an open-label, nonrandomized study in healthy male volunteers. Three sequential groups were dosed. Each group received single doses of ME-401 on two occasions; the doses tested ranged from 10 to 150 mg. Blood was drawn at various time points to analyze plasma concentrations of ME-401 and inhibition of basophil activation, a marker of phosphatidylinositol 3 kinase p110δ inhibition.Findings
Fifteen subjects received a single dose of ME-401 on two occasions. Three adverse events that were considered possibly related to the study drug were reported: one event of pain, one event of headache, and one event of upper abdominal pain. ME-401 exhibited dose proportionality up to 60 mg, and supra-proportional increases in exposure were observed above doses of 60 mg. In addition, there was a dose-proportional increase in the inhibition of basophil activation up to 60 mg. Mean t1/2 ranged from 9.36 to 29.23 hours across the dose range. A 60 mg dose of ME-401 approached 90% inhibition of basophil activation, and thereafter no further increase to the percent inhibition of basophil activation was observed for higher doses. Once-daily dosing of 60 mg ME-401 was forecasted to result in trough plasma levels exceeding the concentration needed for 90% inhibition of basophil activation.Implications
This first-in-human study showed that ME-401 was well tolerated after single doses up to 150 mg. Pharmacologic activity was confirmed after administration of single ascending oral doses of 10 to 150 mg. ME-401 60 mg, administered once daily, was selected as the starting dose for patient studies. ClinicalTrials.gov identifier: NCT02521389. 相似文献93.
94.
95.
Carolyn E. Schwartz Brian Stucky Carly S. Rivers Vanessa K. Noonan Joel A. Finkelstein 《Archives of physical medicine and rehabilitation》2018,99(8):1599-1608.e1
Objective
To investigate response shift effects in spinal cord injury (SCI) over 5 years postinjury.Design
Prospective cohort study observed at 1, 2, and 5 years post-SCI.Setting
Specialized SCI centers.Participants
Sample included 1125, 760, and 219 participants at 1, 2, and 5 years post-SCI (N = 2104). The study sample was 79% men; 39% were motor/sensory complete (mean age, 44.6±18.3y).Interventions
Not applicable.Main Outcome Measures
Patient-reported outcomes included the Medical Outcomes Study 36-Item Short-Form Health Survey version 2 and the Life Satisfaction-11 Questionnaire. Participant latent variable scores were adjusted for (1) potential attrition bias and (2) propensity scores reflecting risk of worse outcomes. The Oort structural equation modeling approach for detecting and accounting for response shift effects was used to test the hypothesis that people with SCI would undergo response shifts over follow-up.Results
The study data comprised the time after FIM scores, an objective measure of motor and cognitive function, had improved and stabilized. Three latent variables (Physical, Mental, and Symptoms) were modeled over time. The response shift model indicated uniform recalibration and reconceptualization response shift effects over time. When adjusted for these response shift effects, Physical showed small true change improvements at 2- and 5-year follow-up, despite FIM stability.Conclusions
We detected recalibration and reconceptualization response shift effects in 1- to 5-year follow-up of people with SCI. Despite stable motor and cognitive function, people with SCI are adapting to their condition. This adaptation reflects a progressive disconnection between symptoms and physical or mental health, and a real improvement in the Physical latent variable. 相似文献96.
Vanessa Chaves Barreto Ferreira de Lima Ana Luiza Bierrenbach Gizelton Pereira Alencar Ana Lucia Andrade Luciano Cesar Pontes Azevedo 《Intensive care medicine》2018,44(7):1090-1096
Purpose
To describe long-term mortality and hospital readmissions of patients admitted to Brazilian intensive care units (ICU).Methods
Retrospective cohort study of adult patients admitted to Brazilian hospitals affiliated to the Public Healthcare System from 10 state capitals. ICU patients were paired to non-ICU patients by frequency matching (ratio 1:2), according to postal code and admission semester. Hospitalization records were linked through deterministic linkage to national mortality data. Primary outcome was mortality up to 1 year. Other outcomes were mortality and readmissions at 30 and 90 days and 3 years. Multiple Cox regressions were used adjusting for age, sex, cancer diagnosis, type of hospital, and surgical status.Results
We included 324,594 patients (108,302 ICU and 216,292 non-ICU). ICU patients had increased hospital length of stay [9 (5–17) vs. 3 (1–6) days, p?<?0.001] and mortality (18.5 vs. 3.6%, p?<?0.001) versus non-ICU patients. One year after discharge, ICU patients were more frequently readmitted to hospital (25.4 vs. 17.4%, p?<?0.001) and to ICU (31.4 vs. 7.3%, p?<?0.001) than controls. Mortality up to 1 year was also higher for ICU patients (14.3 vs. 3.9%, p?<?0.001). A significant interaction between surgical status and mortality was found, with adjusted hazard ratios (HRs) up to 1 year of 2.7 [95% confidence interval (CI) 2.5–2.9] for surgical patients, and 3.4 (95%CI 3.3–3.5) for medical patients. The risk for death and readmission diminished over time up to 3 years.Conclusions
In a public healthcare system of a developing country, ICU patients have excessive long-term mortality and frequent readmissions. The ICU burden tended to reduce over time after hospital discharge.97.
Vanessa Pereira Lima Marcelo Velloso Fabiana Damasceno Almeida Bianca Carmona Giane Amorim Ribeiro-Samora 《Physiotherapy theory and practice》2018,34(10):806-812
Background: The unsupported upper-limb exercise (UULEX) and 6-min peg board ring tests (6PBRTs) have been developed to measure peak unsupported arm exercise capacity and arm endurance, respectively, in individuals with chronic obstructive pulmonary disease. These tests are valid and reproducible in this population; however, the reproducibility of healthy adults is currently unknown. Objective: To determine the within-day test–retest reliability of the UULEX and 6PBRT in healthy adults. Method: The study included 41 healthy adults, aged 38.3 ± 17.9 years old, who performed both tests, twice each on the same day, with a 30-min rest in between. Before and immediately after the tests, blood pressure (BP), heart rate (HR), perception of exertion, and arm fatigue were measured. Time to perform the test and number of rings moved were recorded for the UULEX and 6PBRT, respectively. Results: The UULEX was reproducible on Bland–Altman analysis with lower and upper limits of agreement: 2.40 and ?2.49 min, respectively (bias = ?0.05; p = 0.817) and intraclass correlation coefficient (ICC) = 0.85 (p < 0.0001) for time in minutes for the first and second tests. The 6PBRT was not reproducible on Bland–Altman analysis with lower and upper limits of agreement of 31.64 and ?114.54 (bias = ?41.45; p < 0.0001) and ICC = 0.91 (p < 0.0001) for the number of rings moved. Conclusion: UULEX is a reliable test in healthy adults. Only one test is adequate when measuring peak unsupported arm exercise capacity using the UULEX in healthy adults, while more than two tests may be needed to measure arm endurance using the 6PBRT. 相似文献
98.
99.
Mattijs M. Heemskerk Martin Giera Fatiha el Bouazzaoui Mirjam A. Lips Hanno Pijl Ko Willems van Dijk Vanessa van Harmelen 《Nutrients》2015,7(9):7676-7690
Obese women with type 2 diabetes mellitus (T2DM) have more inflammation in their subcutaneous white adipose tissue (sWAT) than age-and-BMI similar obese women with normal glucose tolerance (NGT). We aimed to investigate whether WAT fatty acids and/or oxylipins are associated with the enhanced inflammatory state in WAT of the T2DM women. Fatty acid profiles were measured in both subcutaneous and visceral adipose tissue (vWAT) of 19 obese women with NGT and 16 age-and-BMI similar women with T2DM. Oxylipin levels were measured in sWAT of all women. Arachidonic acid (AA) and docosahexaenoic acid (DHA) percentages were higher in sWAT, but not vWAT of the T2DM women, and AA correlated positively to the gene expression of macrophage marker CD68. We found tendencies for higher oxylipin concentrations of the 5-LOX leukotrienes in sWAT of T2DM women. Gene expression of the 5-LOX leukotriene biosynthesis pathway was significantly higher in sWAT of T2DM women. In conclusion, AA and DHA content were higher in sWAT of T2DM women and AA correlated to the increased inflammatory state in sWAT. Increased AA content was accompanied by an upregulation of the 5-LOX pathway and seems to have led to an increase in the conversion of AA into proinflammatory leukotrienes in sWAT. 相似文献
100.
Vanessa Ha Adrian I Cozma Vivian LW Choo Sonia Blanco Mejia Russell J de Souza John L Sievenpiper 《Advances in nutrition (Bethesda, Md.)》2015,6(4):504S-511S
Sugars have replaced fat as the dominant public health nutrition concern. A fructose-centric view of cardiometabolic disease has emerged whereby fructose-containing sugars are thought to have deleterious effects on body weight, fasting and postprandial blood lipids, glycemia, blood pressure, uric acid, and markers of nonalcoholic fatty liver disease. Long-term prospective cohort studies have not supported these associations when assessing the relation between total fructose-containing sugars at any amount of intake and incident cardiometabolic disease. Conversely, a consistent signal for harm has been reported for sugary beverages when comparing the highest with the lowest intakes. These associations, however, do not hold at moderate intakes, which are more reflective of real-world intakes, are subject to important collinearity effects, and have small risk estimates with modest population-attributable risk fractions. Higher-level evidence from controlled feeding trials shows that fructose-containing sugars in either liquid or solid form have adverse cardiometabolic effects only when they supplement diets with excess calories compared with the same diets without the excess calories. In the absence of harm when fructose-containing sugars are exchanged for other sources of carbohydrate under energy-matched conditions, excess calories appear to be the dominant consideration. Like with the earlier fat story, it is difficult to separate the contribution of fructose-containing sugars from that of other sources of excess calories in the epidemic of obesity and cardiometabolic disease. Attention needs to remain focused on reducing the overconsumption of all caloric foods associated with obesity and cardiometabolic disease, including sugary beverages and foods, and promoting greater physical activity. 相似文献