191 research outputs found
sj-docx-2-bjo-10.1177_03080226231219106 – Supplemental material for Public and professional involvement in a systematic review investigating the impact of occupational therapy on the self-management of rheumatoid arthritis
No full textSupplemental material, sj-docx-2-bjo-10.1177_03080226231219106 for Public and professional involvement in a systematic review investigating the impact of occupational therapy on the self-management of rheumatoid arthritis by James P Gavin, Laura Rossiter, Vicky Fenerty, Jenny Leese, Jo Adams, Alison Hammond, Eileen Davidson and Catherine L Backman in British Journal of Occupational Therapy</p
sj-docx-1-bjo-10.1177_03080226231219106 – Supplemental material for Public and professional involvement in a systematic review investigating the impact of occupational therapy on the self-management of rheumatoid arthritis
No full textSupplemental material, sj-docx-1-bjo-10.1177_03080226231219106 for Public and professional involvement in a systematic review investigating the impact of occupational therapy on the self-management of rheumatoid arthritis by James P Gavin, Laura Rossiter, Vicky Fenerty, Jenny Leese, Jo Adams, Alison Hammond, Eileen Davidson and Catherine L Backman in British Journal of Occupational Therapy</p
The role of occupational therapy for the self‐management of rheumatoid arthritis: a protocol for a mixed methods systematic review
No full textBackground: occupational therapists can support people with rheumatoid arthritis to self-manage their disease symptoms and engage in daily activities. This protocol reports a review to broaden understanding of what is known about the role of occupational therapy in the self-management of rheumatoid arthritis. Methods: studies involving adults with rheumatoid arthritis, having participated in self-management involving occupational therapy, will be included. Patient involvement will help develop the search strategy by identifying patient-centred interventions and outcomes to complement those identified by researchers. An electronic search will be performed using several bibliographic databases, including grey literature from subject-specific, health-related, and social care databases. Searches will run from the database inception until the date that the search is conducted (December 2021–May 2022). Retrieved studies will be de-duplicated, and the remaining titles and abstracts will be screened by three reviewers. Full texts of all eligible studies will be independently reviewed by the reviewers to select papers for data extraction and quality assessment. Outcomes are function, pain, fatigue and lived experience. For quantitative studies, data will be synthesised using descriptive statistics in text and tables, whereas for qualitative studies, data will be synthesised using thematic synthesis. Discussion: this review will synthesise current evidence on how occupational therapy can help the self-management of rheumatoid arthritis. It will include evidence of best practice, including advice, education and training provided by occupational therapists. These findings can inform future research and the selection of strategies to promote quality of life for people with rheumatoid arthritis. Systematic review registration: PROSPERO CRD42022302205.</p
New tricks for the glycyl radical enzyme family
No full textGlycyl radical enzymes (GREs) are important biological catalysts in both strict and facultative anaerobes, playing key roles both in the human microbiota and in the environment. GREs contain a backbone glycyl radical that is post-translationally installed, enabling radical-based mechanisms. GREs function in several metabolic pathways including mixed acid fermentation, ribonucleotide reduction and the anaerobic breakdown of the nutrient choline and the pollutant toluene. By generating a substrate-based radical species within the active site, GREs enable C–C, C–O and C–N bond breaking and formation steps that are otherwise challenging for nonradical enzymes. Identification of previously unknown family members from genomic data and the determination of structures of well-characterized GREs have expanded the scope of GRE-catalyzed reactions as well as defined key features that enable radical catalysis. Here, we review the structures and mechanisms of characterized GREs, classifying members into five categories. We consider the open questions about each of the five GRE classes and evaluate the tools available to interrogate uncharacterized GREs. Keywords: Glycyl radical enzymes; radical chemistry; anaerobic metabolism; pyruvate formate-lyase; class III ribonucleotide reductase; choline trimethylamine-lyase; benzylsuccinate synthase; radical decarboxylasesNational Institutes of Health (U.S.) (Grant GM069857)National Institutes of Health (U.S.) (Grant T32GM007287)National Science Foundation (U.S.) (Grant 1122374
The impact of occupational therapy on the self-management of rheumatoid arthritis: a mixed methods systematic review
No full textObjective: to determine the impact of occupational therapy (OT) on the self-management of function, pain, fatigue and lived experience for people living with rheumatoid arthritis (RA).Methods: five databases and grey literature were searched up to 30 June 2022. Three reviewers screened titles and abstracts, with two independently extracting and assessing full texts using the Cochrane risk of bias (quantitative) and Critical Appraisal Skills Programme (CASP) (qualitative) tools to assess study quality. Studies were categorized into four intervention types. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) (quantitative) and GRADE-CERQual (qualitative) were used to assess the quality of evidence for each intervention type.Results: of 39 eligible papers, 29 were quantitative (n=2,029), 4 qualitative (n=50) and 6 mixed methods (n=896). Good evidence supports patient education and behavior change programs for improving pain and function, particularly group sessions of joint protection education, but these do not translate to long-term improvements for RA (>24 months). Comprehensive OT had mixed evidence (limited to home OT and an arthritis gloves program), whereas limited evidence was available for qualitative insights, splints and assistive devices, and self-management for fatigue.Conclusion: although patient education is promising for self-managing RA, no strong evidence was found to support OT programs for self-managing fatigue or patient experience and long-term effectiveness. More research is required on lived experience and the long-term efficacy of self-management approaches incorporating OT, particularly timing programs to meet the individual’s conditional needs (i.e., early or established RA) to build on the few studies to date
sj-pdf-1-jag-10.1177_07334648221105062 – Supplemental Material for ‘Make the Most of the Situation’. Older Adults’ Experiences during COVID-19: A Longitudinal, Qualitative Study
No full textSupplemental Material, sj-pdf-1-jag-10.1177_07334648221105062 for ‘Make the Most of the Situation’. Older Adults’ Experiences during COVID-19: A Longitudinal, Qualitative Study by E. Brooks, S. Mohammadi, W. B. Mortenson, C. L. Backman, C. Tsukura, I. Rash, J. Chan and W. C. Miller in Journal of Applied Gerontology</p
Experiences of self‐care during the COVID‐19 pandemic among individuals with rheumatoid arthritis: A qualitative study
No full textObjectives: This study aimed to explore the impact of the coronavirus disease 2019 (COVID-19) pandemic on self-care of individuals living with rheumatoid arthritis (RA). Methods: Guided by a constructivist, qualitative design, we conducted one-to-one in-depth telephone interviews between March and October 2020 with participants with RA purposively sampled for maximum variation in age, sex and education, who were participating in one of two ongoing randomized-controlled trials. An inductive, reflexive thematic analysis approach was used. Results: Twenty-six participants (aged 27–73 years; 23 females) in British Columbia, Canada were interviewed. We identified three themes: (1) Adapting to maintain self-care describes how participants took measures to continue self-care activities while preventing virus transmissions. While spending more time at home, some participants reported improved self-care. (2) Managing emotions describes resilience-building strategies such as keeping perspective, positive reframing and avoiding negative thoughts. Participants described both letting go and maintaining a sense of control to accommodate difficulties and emotional responses. (3) Changing communication with health professionals outlined positive experiences of remote consultations with health professionals, particularly if good relationships had been established prepandemic. Conclusion: The insights gained may inform clinicians and researchers on ways to support the self-care strategies of individuals with RA and other chronic illnesses during and after the COVID-19 pandemic. The findings reveal opportunities to further examine remote consultations to optimize patient engagement and care. Patient or Public Contribution: This project is jointly designed and conducted with patient partners in British Columbia, Canada. Patient partners across the United Kingdom also played in a key role in providing interpretations of themes during data analysis.</p
Activities: Experiences of Persons with Rheumatoid Arthritis
No full textObjective: We aimed to advance understanding of how persons with rheumatoid arthritis (RA) experience decision-making about adopting public health measures during the COVID-19 pandemic. Methods: Persons living with RA partnered throughout this nested qualitative study. One-to-one semistructured telephone interviews were conducted with participants with RA between December 2020 and December 2021. They were strategically sampled from a randomized controlled trial that was underway to test a physical activity counseling intervention. Analysis was guided by reflexive thematic analysis. Results: Thirty-nine participants (aged 26–86 years; 36 women) in British Columbia, Canada were interviewed. We developed three themes. Participants described how their decision-making about public health measures related to 1) “upholding moral values of togetherness” because decisions were intertwined with moral values of neighborliness and reciprocity. Some adapted their self-care routines to uphold these moral values; 2) “relational autonomy—supports and challenges,” because they sometimes felt supported and undermined in different relational settings (eg, by family, local community, or provincial government); and 3) “differing trust in information sources,” in which decisions were shaped by the degree of faith they had in various information sources, including their rheumatologists. Conclusion: Across themes, experiences of decision-making about public health measures during the pandemic were embedded with moral concepts of solidarity, autonomy, and trust, with implications for how persons with RA chose and sustained their self-care activities. Insights gained help sensitize researchers and clinicians to moral issues experienced by persons with RA, which may inform support for self-care activities during and after the pandemic. (Figure presented.).</p
Structural and Biochemical Characterization of Glycyl Radical Enzymes Abundant in Mammalian Gut Microbiota
No full textThe glycyl radical enzyme (GRE) superfamily uses a post-translationally installed glycyl radical to catalyze difficult chemical transformations involved in a variety of anaerobic microbial pathways. In Chapter 1, I will provide an overview of the GRE superfamily and the fascinating reactions they are known to catalyze thus far. Although GREs are one of the most abundant enzyme families in the human gut microbiome, a majority of these enzymes still remain uncharacterized, however, limiting our understanding of how they function at the molecular level. To address this need, Chapters 2 and 3 of my dissertation focus on structurally and biochemically characterizing two newly identified gut microbial GREs, hydroxyproline dehydratase (HypD) and isethionate sulfite-lyase (IslA), from the pathogen and disease-associated bacteria, Clostridioides difficile and Bilophila wadsworthia, respectively. Overall, our work on HypD and IslA enabled us to propose enzymatic mechanisms for these new GREs; we can now take structure-based approaches to designing enzyme inhibitors that could lead to treatment of bacterial infections and associated diseases. Next in chapters 4 and 5 of my thesis I present structural, biophysical, and biochemical experiments that provided insight into the mechanism for how the most abundant GRE in the human gut microbiome, pyruvate formate-lyase (PFL), uses a spare part protein YfiD to restore activity upon oxygen damage in Escherichia coli. Lastly, in my concluding chapter, I provide my perspective on how we can use newly developed computational tools, such as AlphaFold and bioinformatic approaches, to prioritize and design targeted experiments to hopefully reveal exciting new discoveries about the GRE superfamily. Overall, my research on GREs and their associated proteins will not only add to the field’s knowledge of these critical metabolic enzymes, many of which could be antibiotic targets and have promising environmental and industrial applications, but will also expand our basic understanding of the biochemical reactions that govern bacterial-host interactions in gut microbiomes.Ph.D
The effects of intravenous lipid emulsion on hemodynamic recovery and myocardial cell mitochondrial function after bupivacaine toxicity in anesthetized pigs
No full textLocal anesthetic toxicity is thought to be mediated partly by inhibition of cardiac mitochondrial function. Intravenous (i.v.) lipid emulsion may overcome this energy depletion, but doses larger than currently recommended may be needed for rescue effect. In this randomized study with anesthetized pigs, we compared the effect of a large dose, 4 mL/kg, of i.v. 20% Intralipid (R) (n = 7) with Ringer's acetate (n = 6) on cardiovascular recovery after a cardiotoxic dose of bupivacaine. We also examined mitochondrial respiratory function in myocardial cell homogenates analyzed promptly after needle biopsies from the animals. Bupivacaine plasma concentrations were quantified from plasma samples. Arterial blood pressure recovered faster and systemic vascular resistance rose more rapidly after Intralipid than Ringer's acetate administration (p <0.0001), but Intralipid did not increase cardiac index or left ventricular ejection fraction. The lipid-based mitochondrial respiration was stimulated by approximately 30% after Intralipid (p <0.05) but unaffected by Ringer's acetate. The mean (standard deviation) area under the concentration-time curve (AUC) of total bupivacaine was greater after Intralipid (105.2 (13.6) mg.min/L) than after Ringer's acetate (88.1 (7.1) mg.min/L) (p = 0.019). After Intralipid, the AUC of the lipid-un-entrapped bupivacaine portion (97.0 (14.5) mg.min/L) was 8% lower than that of total bupivacaine (p <0.0001). To conclude, 4 mL/kg of Intralipid expedited cardiovascular recovery from bupivacaine cardiotoxicity mainly by increasing systemic vascular resistance. The increased myocardial mitochondrial respiration and bupivacaine entrapment after Intralipid did not improve cardiac function.Peer reviewe
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