136986 research outputs found
Sort by
LY6H is a marker of human pancreatic delta cells
No full textThe identification of cell surface markers specific to pancreatic islet cell subsets is important for both the study of islet biology and for investigating the pathophysiology of diseases in which these cell types are lost or damaged. Analysis of publicly available single-cell RNAseq data showed that LY6H transcripts are highly enriched in the delta cells of the pancreas. This finding was confirmed using immunofluorescence analysis of histological sections of human pancreas, and flow cytometric analysis of human islet preparations. We found that expression of LY6H was robustly associated with pancreatic delta cells in samples derived from both control and diabetic donors. Furthermore, we demonstrate that antibodies against LY6H can be used to substantially enrich for live delta cells from preparations of human islets. This study identified LY6H as a novel cell surface marker of human pancreatic delta cells-a finding that will aid in the identification and characterisation of this important cell type.10.1038/s41598-025-18321-
Testing the diagnostic expansion hypothesis with a population-based survey of attitudes to depression in Australia.
No full textINTRODUCTION: There is growing concern about the increasing use of psychiatric terminology to describe behaviours and experiences that do not meet criteria for diagnosis of a mental illness. We aimed to conduct a nationally representative online cross-sectional survey exploring diagnostic labelling of vignettes describing a person with different levels of depression symptoms or risk and whether this was associated with mental health-related intended actions and psychological distress. METHODS: Australian respondents (n=6142) were randomly assigned to read one of five vignettes describing a person in the following situations: (1) currently well (family history of depression), (2) currently well (own history of depression), (3) subthreshold depressive symptoms, (4) major depressive disorder (MDD) and (5) MDD with suicidal thoughts. They were asked what, if anything, was wrong with this person. Further questions covered intentions to seek professional help or take self-help actions; psychological distress and personal experience of depression. RESULTS: Labelling non-clinical or subthreshold vignettes with diagnostic labels was relatively common, with a depression label applied by 19.8% [99% CI 16.6, 23.6], 31.3% [99% CI 27.4, 35.6], 47.7% [99% CI 43.4, 52.0], 68.6 [99% CI 64.5, 72.5] and 77.2 [99% CI 73.1, 80.7] of respondents to vignettes 1 to 5 respectively. Younger people were more likely to give a depression label. Across all vignettes, labelling was associated with a greater likelihood of intentions to speak to a health professional or take medication but not with psychological distress or reductions in effective self-help. CONCLUSIONS: Findings suggest that public messages should have a more nuanced approach, making it clear that, for some mental health difficulties, non-medical solutions may be more appropriate, while also taking care not to increase the proportion of people with more severe problems who meet diagnostic criteria but do not seek help
Immersion to impact: does one or three years of rural immersion influence graduate clinical practice intentions and locations?
No full textBACKGROUND: Addressing rural healthcare workforce shortages requires evidence-based strategies in medical education. Extended rural immersion programs offer a potential solution, but the optimal duration for fostering long-term regional and rural practice remains unclear. METHODS: This retrospective study evaluates the impact of one-year versus three-year rural immersion experiences at the University of Melbourne's Rural Clinical School (RCS) on graduate clinical practice locations of the 2016-2023 graduating cohorts. Using logistic regression analysis, we assessed key predictors of regional and rural practice, including rural immersion duration and intent to practice regionally or rurally. RESULTS: Graduates who completed the three-year rural immersion program were significantly more likely to practice in Modified Monash Model (MMM) 2-7 areas than those with only one year of rural immersion. Intent to practice regionally or rurally and completing a regional/rural internship emerged as strong predictors of regional/rural practice. However, regional/rural intent did not appear to be a strong indicator for students who only completed 1-year of rural immersion. This highlights the importance of the duration of immersion. CONCLUSION: The study demonstrates the effectiveness of extended rural immersion in increasing regional and rural workforce retention. Findings support further investment in rural medical education, including end-to-end rural training models, which integrates rural exposure across the entire medical education journey. Future research should examine long-term workforce retention and strategies for sustaining rural career pathways
Is There an Unholy Collusion Between Science and Religion in India? Interrogating Meera Nanda, of the Five Horse Angels
No full textAbstract
A Mahābhārata kind of textual war has been raging between science (the sciences) and religion (theology and traditional ortho-doxastic systems), for some time now, let us say since the Renaissance period, through Europe’s Enlightenment, to the present era. This war has many protagonists and antagonists on both sides. Both sides of the camp engage in quasi-philosophical and other intellectual disputations to either drive the wedge of disagreement toward, as it were, the death of one side, or attempt a rapprochement between the seemingly incommensurable claimants to the truth. The fangs and reverberations of this war have been spilling over onto the Indian subcontinent as well, since about the late nineteenth century, albeit with significant differences. In this latter fray enters Meera Nanda, a strident apologist for the eventual triumph of science or ‘objectivity’ over the ruse of religions. That in itself is not an ignoble cause. But she further champions a thesis of the wayward contemporary "collusion" of Indian science and religion, i.e., of what she calls ‘the emerging state-temple-corporate complex’. The paper offers a critique of Nanda’s claim, on the one hand, for want of convincing evidence for the overarching claim, and, on the other hand, the utter disregard on the part of the sectarian-right for the methods and intersubjective epistemé of science. The Nobel Laureate C V Raman arguably had chauvinist strains in the way he treated his female research fellows, as Abha Sur points out in a separate study which I discuss. But here too there is no direct complicitous relation between science and religion; rather the problematic relation lies with genderized caste proclivity in modern Indian science practices as in the culture broadly. The present paper is a sequel to ‘War and peace between science and religion: the divine arch after the four horsemen’, published in the Journal of the Indian Council for Philosophical Research 28/2, 2011: 3‐30)
Nonlinear associations of depression and sleep duration with cognitive impairment in older adults with hypertension: findings from a national survey
No full textOBJECTIVES: Cognitive impairment is a major health concern in older adults with hypertension, and both depression and abnormal sleep duration are recognized as potential contributing factors. This study aimed to explore the nonlinear association of depression and sleep duration with cognitive impairment among older adults with hypertension. METHODS: This cross-sectional study was based on the 2017-2018 wave of Chinese Longitudinal Healthy Longevity Survey. Depression and cognitive function were measured using the 10-item Center for Epidemiological Studies Short Depression Scale and Mini Mental State Examination, respectively. Univariate, binary logistic regression, and restricted cubic spline regression analyses were used to examine the associations between depression, sleep duration and cognitive impairment. RESULTS: A total of 3,989 older adults with hypertension were included. The prevalence of depression and cognitive impairment were 28.1% (95%CI = 26.7-29.5%) and 10.1% (95%CI = 9.2-11.1%), respectively. After adjusting for confounding factors, a significant linear association (nonlinear p = 0.814) between depression and cognitive impairment risk was found, while a U-shaped nonlinear association was identified between sleep duration and cognitive impairment risk (p = 0.040). Both shorter (7.7 h) sleep duration per day were associated with higher cognitive impairment risk, with an inflection point at 7.3 h. The effect of sleep duration on cognitive impairment risk was more significant for participants with a higher (≥ 6 years) education level. CONCLUSION: This study highlights the importance of managing depression and optimizing sleep duration in addressing the risk of cognitive decline in older adults with hypertension
A Systematic Review of the Development and Implementability of Complex Interventions After Hospitalization for Survivors of Intensive Care
No full textBackground: Survivors of the ICU can experience physical, mental, and cognitive impairments, limiting activities and societal participation. Limited evidence supports the effectiveness of complex interventions after hospitalization, raising questions regarding how these interventions are developed and evaluated. Recommendations from implementation science and complex intervention research may provide further insight. Research Question: What methods have informed the development and evaluation of complex interventions after hospitalization for survivors of the ICU. How have implementability (acceptability, fidelity, and feasibility) and efficacy been considered in the development and evaluation of these interventions? Study Design and Methods: Studies were included if they developed or evaluated, or both, a complex, structured intervention after hospitalization aimed at improving recovery outcomes for survivors of the ICU. MEDLINE, Embase, PsycINFO, CINAHL, and PEDro were searched through June 4, 2024. Extracted data included intervention development processes; intervention description; and if and how acceptability or satisfaction, fidelity, feasibility, and efficacy were evaluated. Synthesis methods included deductive analysis and scoring using the Template for Intervention Description and Reporting (TIDieR) and the National Institutes of Health's Treatment Fidelity Framework. Quality appraisal was completed using the applicable Johanna Briggs Institute (JBI) guidelines. Results: Seventy-one publications were included involving 62 unique patient cohorts. Twelve studies (19%) used intervention development frameworks, whereas 24 studies (39%) engaged stakeholders in development processes. The median TIDieR score was 16 (interquartile range [IQR], 14-20) of 24. Twenty-two studies (35%) evaluated patient acceptability, of which 2 studies also evaluated clinician acceptability. Median treatment fidelity score was 6 (IQR, 6-9) of 21 with training, delivery, receipt, and enactment domains described poorly. The median consent rate was 48% (IQR, 34%-68%). Thirteen of the 22 studies (59%) designed to test efficacy achieved their sample size. Eight studies (13%) evaluated cost and 20 studies (34% of studies delivering interventions) reported safety. The median JBI score was 61% (IQR, 50%-70%). Interpretation: Few studies reported applying theory-informed methods or engaging stakeholders in intervention development. Treatment fidelity focused on delivery with little description of receipt or enactment. Future efforts may consider applying implementation science theory and complex intervention approaches. Clinical Trial Registration: International Prospective Register of Systematic Reviews; No.: CRD42023444648; URL: https://www.crd.york.ac.uk/prospero
Hope as an enabler of climate change adaptation
No full textAdaptation to climate change continues to fall short of needs. Emerging research in psychology and other social sciences suggests that hope may be an important emotion and cognitive process for enabling climate action, and for keeping despair at bay. Drawing on and extending this research, we present a theoretical model to show how hope has the capacity to be a powerful driving force for adaptation. We suggest that hope can, in theory, spur adaptation to climate change in situations where individuals and collectives identify adaptation goals and pathways to achieve those goals; and that effective collective adaptation can in turn reinforce hope. We propose a program of systematic research in communities experiencing climate change impacts to assess the relationship between hope and adaptation, and explore conditions where hope could be leveraged to promote much-needed momentum in climate change adaptation
Repairability as a Condition of the World: Ernesto Oroza’s Archive of Dis/repair
No full textIn an age of apparent disrepair as the climate crisis takes hold and neoliberalism fails to liberate, as the cost of living rises and rights are retracted, the need for a reparative turn is overdue. But what is repair? If repair is contained in moments of total breakdown, then the reparative acts of care that sustain the world are denied. Countering these forces and the urgency prescribed by the crisis of disrepair and in what too often appears as the proprietary epistemology of repair, in this paper I offer an account of ‘repairability’. Structured in relation to the reparative gaze of feminist theory and poetic thinking, repairability assumes a material trace, I contend, through the vernacular archive of Cuban artist-ethnographer Ernesto Oroza. Oroza’s work offers a compelling case study through which to think the possibility of repair as an act of worldly becoming
Functional connectivity alterations in women with subjective cognitive decline.
No full textBackground: Alzheimer's disease (AD) is an incurable neurodegenerative disorder, which disproportionately affects women. Along the continuum of dementia, those who experience subjective cognitive decline (SCD) are thought to be the earliest group at risk for development of AD. Objective: The current study investigated differences in functional connectivity between healthy older women and older women with SCD in multiple resting-state functional connectivity networks. This study also examined whether additional differences existed between women with and without SCD, in various demographic variables, lifestyle factors, and medical comorbidities. Methods: 3T high-resolution resting-state functional MRI (fMRI) scans were retrieved for 25 healthy older women and 25 older women who self-report SCD from the Women's Healthy Ageing Program (WHAP). A seed-based approach was executed in FMRIB's Software Library (FSL) to examine significant differences in functional connectivity within the default mode network (DMN), frontoparietal network (FPN), and salience network (SN) between groups. Group comparisons were conducted between women with SCD and healthy women on various demographic variables, lifestyle factors, and medical comorbidities. Results: Findings revealed significant increases in functional connectivity in the DMN and FPN in older women with SCD compared to healthy older women. Conclusions: Women with self-reported SCD had increased functional connectivity, with no significant differences were detected between groups on comparisons of various demographic variables, lifestyle factors, and medical comorbidities
Formulating Cognitive Functioning to Guide Personalised Treatment for People Diagnosed With Mental Disorders
No full textABSTRACT
Introduction
Objective and subjective cognitive impairment are highly prevalent in mental disorders and transdiagnostic phenomena. Cognitive impairment is associated with poorer functional outcomes and therefore requires treatment, but little guidance is available for clinicians. The aim of this article is to provide guidance for formulating an individual's cognitive profile and how this can be used to personalise treatments for optimum cognitive and functional outcomes.
Methods
We first critique current models of psychopathology in relation to assessing and addressing cognitive functioning in the clinic. This is followed by a description of key methods for assessing objective and subjective cognitive functioning and how this information can be used to formulate a patient's cognitive profile and tailor treatment.
Results
Within current models of psychopathology, cognition is inadequately or simplistically represented, is only viewed from a deficit lens without considering strengths, does not consider subjective perceptions of cognitive functioning, and therefore, generally does not provide utility for guiding clinical practice. Both the profile of cognitive functioning (strengths and weaknesses) and estimated change from premorbid levels are key considerations for tailoring cognitive and functional treatments. Cognitive profile and change can be assessed using standardised cognitive tests through normative and idiographic methods, respectively. Subjective perception of cognitive functioning is a neglected but important additional aspect of cognitive functioning that warrants assessment. The complete cognitive profile can be used to guide the selection of cognition‐focused treatments, including psychoeducation, lifestyle adaptations, cognitive remediation, compensatory strategies, environmental supports, psychological therapy, and medication review.
Conclusions
We propose that cognition should be assessed in addition to presenting psychopathology because it is an independent transdiagnostic predictor of functional outcomes, which can enhance personalised clinical care. We recommend assessing both objective and subjective cognitive functioning to formulate the personalised treatment for optimal functional outcomes and promote a culture of recovery that includes cognitive health