Anxiety in autism is an important treatment target because of its consequences for quality of life and well-being. Growing evidence suggests that cognitive behaviour therapies and mindfulness-based therapies can ameliorate anxiety in autism but cost-effective delivery remains a challenge. This pilot randomised controlled trial examined whether online cognitive behaviour therapy and mindfulness-based therapy self-help programmes could help reduce anxiety in 54 autistic adults who were randomly allocated to either an online cognitive behaviour therapy (n = 16) or mindfulness-based therapy (n = 19) programme or a waitlist control group (n = 19). Primary outcome measures of anxiety, secondary outcome measures of broader well-being and potential process of change variables were collected at baseline, after programme completion, and then 3 and 6 months post-completion. Baseline data confirmed that intolerance of uncertainty and emotional acceptance accounted for up to 61% of self-reported anxiety across all participants. The 23 participants who were retained in the active conditions (14 mindfulness-based therapies, 9 cognitive behaviour therapies) showed significant decreases in anxiety that were maintained over 3, and to some extent also 6 months. Overall, results suggest that online self-help cognitive behaviour therapy and mindfulness-based therapy tools may provide a cost-effective method for delivering mental health support to those autistic adults who can engage effectively with online support tools. Lay abstract Anxiety in autism is an important target for psychological therapies because it is very common and because it significantly impacts upon quality of life and well-being. Growing evidence suggests that cognitive behaviour therapies and mindfulness-based therapies can help autistic individuals learn to manage feelings of anxiety but access to such therapies remains problematic. In the current pilot study, we examined whether existing online cognitive behaviour therapy and mindfulness-based therapy self-help tools can help reduce anxiety in autistic adults. Specifically, 35 autistic adults were asked to try either an existing online cognitive behaviour therapy (n = 16) or mindfulness-based therapy (n = 19) programme while a further 19 autistic adults served as a waitlist comparison group. A first important finding was that 23 of the 35 (66%) participants who tried the online tools completed them, suggesting that such tools are, in principle, acceptable to many autistic adults. In addition, adults in the cognitive behaviour therapy and mindfulness-based therapy conditions reported significant decreases in anxiety over 3 and to some extent also 6 months that were less apparent in the waitlist group of participants. On broader measures of mental health and well-being, the benefits of the online tools were less apparent. Overall, the results suggest that online self-help cognitive behaviour therapy and mindfulness-based therapy tools should be explored further as a means of providing cost-effective mental health support to at least those autistic individuals who can engage effectively with such online tools.
How do pathogens deal with antimicrobial oxidants produced by the innate immune system during infection? Uropathogenic Escherichia coli (UPEC), the most common etiological agent of urinary tract infections (UTIs), is particularly exposed to infiltrating neutrophils and, therefore, must counter elevated levels of the antimicrobial oxidant HOCl to establish infection. Our study provides fundamentally new insights into a defense mechanism that enables UPEC to fend off the toxic effects of HOCl stress.
The ability to overcome stressful environments is critical for pathogen survival in the host. One challenge for bacteria is the exposure to reactive chlorine species (RCS), which are generated by innate immune cells as critical part of the oxidative burst. Hypochlorous acid (HOCl) is the most potent antimicrobial RCS and associated with extensive macromolecular damage in the phagocytized pathogen. However, bacteria have evolved defense strategies to alleviate the effects of HOCl-mediated damage. Among these are RCS-sensing transcriptional regulators that control the expression of HOCl-protective genes under non- and HOCl stress. Uropathogenic Escherichia coli (UPEC), the major causative agent of urinary tract infections (UTIs), is particularly exposed to infiltrating neutrophils during pathogenesis, however, their responses to and defenses of HOCl are still completely unexplored. Here, we present evidence that UPEC strains tolerate higher levels of HOCl and are better protected from neutrophil-mediated killing compared to other E. coli. Transcriptomic analysis of HOCl-stressed UPEC revealed the upregulation of an operon consisting of three genes, one of which encodes the transcriptional regulator C3600. We identified C3600 as a HOCl-sensing transcriptional repressor, which, under non-stress conditions, is bound to the operator and represses the expression of its target genes. During HOCl exposure, however, the repressor forms reversible intermolecular disulfide bonds and dissociates from the DNA resulting in the de-repression of the operon. Deletion of one of the target genes renders UPEC significantly more susceptible to HOCl indicating that the HOCl-mediated induction of the regulon plays a major role for UPEC’s HOCl resistance.
A large number of mutations have been reported in SCO2 (synthesis of cytochrome c oxidase) gene in association with COX deficiency reported in different diseases such as cardioencephalomyopathy, cardiomyopathy and Leigh syndrome. However, very few of these mutations have been functionally analyzed.SCO2 gene encodes for an essential assembly factor for the formation of cytochrome c oxidase (COX). It is a nuclear encoded protein that helps in transfer of copper ions to COX. This study is an attempt to understand the possible effect of these mutations on the structure and function of SCO2 protein, by using different in silico tools. As per Human Gene Mutation Database, total 11 non synonymous variations have been reported in SCO2 gene. Among these 11 variations, only E140K and R171W are functionally proven to cause COX deficiency. They have been used as controls in this study. The remaining variations were further analyzed using ClustalW, SIFT, PolyPhen-2, GOR4, MuPro and Panther softwares. As compared to the results of the controls, most of these variations were predicted to affect the structure of SCO2 protein and hence, may cause COX dysfunction. Thus, we hypothesize that these variations have the potential to result in a disease phenotype and should be investigated by subsequent functional analyses. This will help in an appropriate diagnosis and management of the wide spectrum of COX deficiency diseases.
Biomedical waste is defined as the waste segregated from the healthcare system that can be contagious, infective and hazardous. If this type of harmful waste is not managed properly it can lead to various health hazards. Thus, the housekeeping staff that are responsible for maintaining cleanliness in hospital and discarding waste should have keen knowledge about Biomedical waste and its handling. Objective- 1. To assess the pre-test knowledge and practice of housekeeping staff regarding biomedical waste management. 2. To assess the post-test knowledge and practice of housekeeping staff regarding biomedical waste management. 3. To assess the effectiveness of structured teaching programme on knowledge and practice regarding biomedical waste management among housekeeping staff. 4. To find out the correlation between knowledge and practice regarding biomedical waste management among housekeeping staff 5. To find out the association between the pre-test level of knowledge and practice score of housekeeping staff with their selected demographic variable. Methodology- A quantitative research approach with pre-experimental research design was used to assess pre test and post test knowledge and practice of housekeeping staff regarding biomedical waste management. A total of 70 samples were taken by using convenience sampling technique. Self structured questionnaire and practice checklist was used to assess knowledge and practice of housekeeping staff. Results- The findings of our study shows that the mean score and standard deviation of pre test knowledge is 6.91±2.37 and post test knowledge is 13.87±1.96 whereas of pre test practice is 3.90±1.78 and post test practice is 8.46±1.00. The t value of knowledge was 21.87 and of practice was 19.37 which is more than tabulated t value 2.00. p<0.05 which shows that there is significant difference in knowledge and practice after the structured teaching programme among the housekeeping staff regarding biomedical waste management.. Conclusion-The findings indicates significant improvement in level of knowledge and practice regarding biomedical waste management among housekeeping staff of Govt. Doon Medical College Hospital, Dehradun.
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