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PubMed1992

Child mental health in the Americas: a public health approach.

The systematic, population-wide application of preventive measures based on what is known about the causes and outcomes of psychiatric disorders can markedly reduce morbidity from mental ill health among children in the Americas. The actions proposed here rely partly upon increasing access for all women and their children to thoroughly tested obstetric and pediatric care; in part they depend on improving nutrition and opportunities for cognitive stimulation; and in part they call for enhancing the mental health skills of primary care practitioners by appropriate in-service training. There are limits to our knowledge and to the effectiveness of some of our interventions; nonetheless, the greatest barrier to better child mental health is failure to muster the political will to apply what is known to the care of mothers and children in all sectors of society.

Americas↗
PubMed1991

Behavioral correlates of sympathoadrenal reactivity: the toughness model.

Research with humans is reviewed showing that increased levels of urinary epinephrine (EPI) and norepinephrine (NE) from samples taken following mental challenge/stress situations are associated with better performance in those situations and with emotional stability. Another research tradition with humans and animals shows that various training protocols lead to increased peripheral and central catecholamine capacities. Those training protocols include continuous exposure to cold, periodic exposure to some intermittent stressors such as foot or tail shock (with intervening rest periods), or programs of aerobic exercise. While increasing catecholamine capacities, those procedures also result in lower base rates of the catecholamines and with the delay of pituitary-adrenal-cortical responses in challenge/stress contexts. That physiological pattern of "toughness" leads to improved performance in challenge/stress situations, increased tolerance of stressors (i.e., reduced behavioral suppression or depression), emotional stability, and immune system enhancement. The special conditions are discussed that are required for demonstrating increased catecholamine capacities rather than the attenuation of arousal associated with increased muscular and neuroendocrine efficiency. Finally, the role played by toughness in reducing anxiety while increasing energy in challenge/stress situations is discussed.

Adaptation, Psychological↗
PubMed2000

Immunity in frail elderly: a randomized controlled trial of exercise and enriched foods.

OBJECTIVE: To examine the effects of 17-wk physical exercise and enriched foods on cellular immune response (CIR) in frail elderly. METHODS: A total of 112 independently living, frail elderly men and women (mean age 79.2 +/- 5.9) received: twice weekly comprehensive, moderate intensity, progressive group exercise (group A, N = 26); daily enriched foods (group B, N = 31); both (group C, N = 29); or neither (group D, N = 26). Exercises focused on skills training. Foods were enriched with micronutrients with a high prevalence of deficiency in older people (at 25-100% the RDA). A social program and identical regular foods were offered as a control. CIR was measured by delayed-type hypersensitivity skin test response (DTH) against seven recall antigens expressed as the total number of positive responses and sum of diameters of all positive responses. RESULTS: No independent or interactive effect of enriched foods was observed. Therefore, exercise (groups A + C) was compared with no exercise (groups B + D). Nonexercising subjects showed an average decline of 0.5 responses compared with an unchanged responsiveness among exercising subjects (difference = 0.5, 95% CI: 0.04-0.89, P = 0.03 adjusted for baseline DTH, activity level, and micronutrient status). Nonexercising subjects had a larger decline in the sum of diameters of all positive responses than exercising subjects but the difference did not reach significance (adjusted difference = 2.1 mm, 95% CI:-1.0-4.8). CONCLUSION: Exercise may prevent or slow the age-related decline in immune response. Micronutrient enriched foods showed no effect. As infectious diseases can have debilitating or even fatal consequences for the elderly, prevention of the age-related decline in CIR could significantly improve their quality of life.

Aged↗
PubMed2025

Habitat radiomics predicts occult lymph node metastasis and uncovers immune microenvironment of head and neck cancer.

BACKGROUND: Occult lymph node metastasis (LNM) is a key prognostic factor for patients with head and neck squamous cell carcinoma (HNSCC). This study was to establish radiomics models derived from intratumoral, peritumoral, and habitat regions for identifying occult LNM in HNSCC. METHODS: Patients with pathologically confirmed HNSCC from three medical Centers (from March 2014 to April 2024) and The Cancer Genome Atlas (TCGA) were enrolled. Center 1 was split into training (n = 330) and internal test sets (n = 154), while Center 2 and Center 3 served as the external test set (n = 183). Genomic set (n = 50) from TCGA and single-cell RNA sequencing set (n = 6) from Center 1 were used for biological analysis. We used the intratumoral, peritumoral, and habitat volumes of interest (VOIs) to extract radiomics features, respectively. Based on Logistic Regression (LR), Support Vector Machine (SVM), and Random Forest (RF) classifiers, nine radiomics models were built to confirm the optimal predictive performance. The best-performing model, along with clinical-radiologic data, was combined to develop a hybrid model. The log-rank test was used to evaluate the model's prognostic performance. Additionally, bulk and single-cell RNA sequencing were applied for investigating the biological mechanisms underlying the optimal model. RESULTS: The RF-habitat radiomics model showed the best performance, achieving AUCs of 0.835-0.919 across all datasets. Survival analysis further confirmed the prognostic value of the RF-habitat radiomics model. The RF-habitat radiomics model and the hybrid model notably surpassed the clinical model in predictive performance. Moreover, the RF-habitat radiomics model was associated with the abundance level of exhaustion-associated CD8 + T cells, uncovering the immune microenvironment characteristics contributing to occult LNM in HNSCC. CONCLUSIONS: The RF-habitat radiomics model demonstrated excellent performance for predicting occult LNM in HNSCC across three cohorts, providing a non-invasive solution for occult LNM. Furthermore, radiogenomic analysis further revealed the biological associations of the model, primarily related to T cell dysfunction.

Humans↗
PubMedDate not supplied

Serology as an indicator of Taenia solium tapeworm infections in a rural community in Mexico.

Serial stool examinations were carried out on a sample of 516 persons living in the town of El Salado (1993 inhabitants). In a group of 40 families (198 individuals), selected by random sampling, there were 2 cases of Taenia solium infection (1.2%); an additional group of 67 families (318 individuals), who volunteered for the study, had 4 cases (1.1%). 5 of the 6 T. solium cases were clustered in 4 neighbouring households. Serum antibodies to the larval stage of T. solium were detected by ELISA using bladder fluid as antigen. 22 members of the random sample group were positive (11%); 58 persons of the total sample of 478 were positive (12%). 43% of individuals living in the same household as a T. solium-infected person were positive, compared to 8.6% seropositive individuals among those not known to have been in daily contact with a T. solium carrier. Odds ratio analysis of the random and total samples showed that the risk of being seropositive when living in the same household as a tapeworm carrier was 9.05 and 6.85 respectively. The results showed a significant correlation between T. solium tapeworm clusters and higher seropositivity rates among contacts rather than among non-contacts. The immune response is a sensitive indicator of a tapeworm infection in a household or family, and is easier to determine than the traditional search for taeniid eggs in stool, a method which is difficult to apply in developing countries due to lack of trained personnel.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2005

Use of multiple opportunities for improving feeding practices in under-twos within child health programmes.

OBJECTIVES: In a community randomized trial, we aimed to promote exclusive breastfeeding and appropriate complementary feeding practices in under-twos to ascertain the feasibility of using available channels for nutrition counselling, their relative performance and the relationship between intensity of counselling and behaviour change. We also assessed whether using multiple opportunities to impart nutrition education adversely affected routine activities. METHODS: We conducted a community randomized, controlled effectiveness trial in rural Haryana, India, with four intervention and four control communities. We trained health and nutrition workers in the intervention communities to counsel mothers at multiple contacts on breastfeeding exclusively for 6 months and on appropriate complementary feeding practices thereafter. The intervention was not just training health and nutrition workers in counselling but included community and health worker mobilization. FINDINGS: In the intervention group, about 32% of caregivers were counselled by traditional birth attendants at birth. The most frequent sources of counselling from birth to 3 months were immunization sessions (45.1%) and home visits (32.1%), followed closely by weighing sessions (25.5%); from 7 to 12 months, home visits (42.6%) became more important than the other two. An increase in the number of channels through which caregivers were counselled was positively associated with exclusive breastfeeding prevalence at 3 months (p = 0.002), consumption of milk/cereal gruel or mix use at 9 months (p = 0.004) and 18 months (p = 0.003), undiluted milk at 9 months (p<0.0001) and 24 hour non-breast-milk energy intakes at 18 months (p = 0.023), after controlling for potential confounding factors. Intervention areas, compared with the control, had higher coverage for vitamin A (45% vs. 11.5%) and iron folic acid (45% vs. 0.4%) supplementation. CONCLUSIONS: Using multiple available opportunities and workers for counselling caregivers was feasible, resulted in high coverage and impact, and instead of disrupting ongoing services, resulted in their improvement.

Breast Feeding↗
PubMed2005

Sensitivity to noise in bidirectional associative memory (BAM).

Original Hebbian encoding scheme of bidirectional associative memory (BAM) provides a poor pattern capacity and recall performance. Based on Rosenblatt's perceptron learning algorithm, the pattern capacity of BAM is enlarged, and perfect recall of all training pattern pairs is guaranteed. However, these methods put their emphases on pattern capacity, rather than error correction capability which is another critical point of BAM. This paper analyzes the sensitivity to noise in BAM and obtains an interesting idea to improve noise immunity of BAM. Some researchers have found that the noise sensitivity of BAM relates to the minimum absolute value of net inputs (MAV). However, in this paper, the analysis on failure association shows that it is related not only to MAV but also to the variance of weights associated with synapse connections. In fact, it is a positive monotone increasing function of the quotient of MAV divided by the variance of weights. This idea provides an useful principle of improving error correction capability of BAM. Some revised encoding schemes, such as small variance learning for BAM (SVBAM), evolutionary pseudorelaxation learning for BAM (EPRLAB) and evolutionary bidirectional learning (EBL), have been introduced to illustrate the performance of this principle. All these methods perform better than their original versions in noise immunity. Moreover, these methods have no negative effect on the pattern capacity of BAM. The convergence of these methods is also discussed in this paper. If there exist solutions, EPRLAB and EBL always converge to a global optimal solution in the senses of both pattern capacity and noise immunity. However, the convergence of SVBAM may be affected by a preset function.

Algorithms↗
PubMed1975

Control of adenovirus acute respiratory disease in U.S. Army trainees.

Although limited almost exclusively to military trainees, acute respiratory disease (ARD) caused by adenovirus types 4 and 7 had been the leading cause of hospitalization in U.S. Army personnel. This decrease which resembles influenza in clinical manifestations led to hospitalization of as many as 50% of military trainees in midwinter and imposed a heavy burden on military hospitals and training programs. In studies undertaken from 1965 to 1970, live adenovirus type 4 and subsequently type 7 vaccines were found to be safe and immunogenic and to confer protection against type specific adenovirus ARD. For the past 5 yr. military trainees have been immunized with both adenovirus vaccines during periods of expected adenovirus disease. Since 1966, use of adenovirus vaccines has been monitored through the adenovirus surveillance program which yields weekly data on incidence and etiology of ARD in basic combat trainees. Since 1973, stable adenovirus vaccines have resulted in excellent control of adenovirus ARD. Potential problems with this immunization program are discussed.

Adenoviridae↗
PubMed2001

[Overtraining in endurance athletes].

Optimal training results in exercise-recovery harmonious balance. High frequency and volumic training, associated with insufficient recovery may induce overtraining. It depends on the kind of exercise but occurs mainly in endurance sports. The high frequency of upper respiratory track infection in endurance sportsmen results from a temporary immunosuppression state, possibly associated with overtraining. Many immune and haematological parameters have been associated with overtraining, but none seemed really efficient for diagnosis. Hormonal parameters, despite contradictions in studies, appear to give a good insight of athlete's staleness and are more predictive of overtraining. Actually, overtraining detection needs a combination of different parameters, and cannot sustain on isolated factors.

Endocrine System↗
PubMedDate not supplied

Exercise and the stress system.

Exercise represents a physical stress that challenges homeostasis. In response to this stressor, autonomic nervous system and the hypothalamic-pituitary-adrenal axis are known to react and to participate in the maintenance of homeostasis. This includes elevation of cortisol and cathecholamines in plasma. However, sustained physical conditioning in highly trained athletes is associated with a decreased hypothalamic-pituitary-adrenal response to exercise. On the other hand, highly trained athletes exhibit a chronic mild hypercortisolism at baseline that may be an adaptive change to chronic exercise. In addition the proinflammatory cytokine IL-6 is also activated. Moreover, exercise stimulates the secretion of GH and prolactin, and may influence the type of immunity by stimulating TH2 response profile. Besides, the stress of exercise inhibits the gonadal function, through the production of glucocorticoids and cathecholamines, as well as through activation of the CRH neurons. Nowadays, apart from the beneficial effects of exercise, there is increasing incidence of exercise-related short- and long- term consequences, especially concerning the female athlete that many authors describe as the so-called "exercise-related female reproductive dysfunction". These consequences include amenorrhea, infertility, eating disorders, osteoporosis, coronary heart disease and euthyroid "sick" syndrome. The mechanisms involved in the pathogenesis of the above disorders are discussed in this review.

Adrenal Glands↗
PubMed2002

The unknown mechanism of the overtraining syndrome: clues from depression and psychoneuroimmunology.

When prolonged, excessive training stresses are applied concurrent with inadequate recovery, performance decrements and chronic maladaptations occur. Known as the overtraining syndrome (OTS), this complex condition afflicts a large percentage of athletes at least once during their careers. There is no objective biomarker for OTS and the underlying mechanism is unknown. However, it is not widely recognised that OTS and clinical depression [e.g. major depression (MD)] involve remarkably similar signs and symptoms, brain structures, neurotransmitters, endocrine pathways and immune responses. We propose that OTS and MD have similar aetiologies. Our examination of numerous shared characteristics offers insights into the mechanism of OTS and encourages testable experimental hypotheses. Novel recommendations are proposed for the treatment of overtrained athletes with antidepressant medications, and guidelines are provided for psychological counselling.

Adult↗
PubMed2003

How the health visitor can help when problems between parents add to postnatal stress.

BACKGROUND: Caring for a baby can provoke or intensify discord between parents, with adverse effects on their own well-being and their parenting. AIM: The aim of this study was to appraise evidence obtained from 450 mothers on the quality of the parents' relationship during the postnatal period and the value of support provided by health visitors in cases of discord. DESIGN: The health visitors were based at nine clinics in an outer London borough, and had been trained on a four-day course (the Brief Encounters course) to screen mothers for relationship problems at the 6-8-week check and to offer support (supportive listening, practical advice, referral) if problems were revealed. Data on relationship quality were obtained by a self-report screening scale completed at the 6-8-week check and again at the 12-week visit for immunizations, when the scale was included in a self-report questionnaire on help received from the health visitor. Intervention records kept by the health visitor showed what form any support had taken. Some 6 weeks later, 25 of the 82 mothers offered support, and their health visitors, were interviewed about their experience of the intervention. RESULTS: One in five mothers were identified as having a relationship problem at the 6-8-week check. Most were offered support. One in five of the 351 mothers who completed a questionnaire at the 12-week visit reported receiving support in improving their relationship. The follow-up interviews showed that most mothers valued this support. Responses to a questionnaire completed by health visitors showed that most were enthusiastic about its benefits. CONCLUSIONS: A four-day training course for health visitors enabled them to screen for relationship problems during the postnatal period and to provide support when required in a way that was valued by mothers. Most health visitors were enthusiastic about the value of the intervention in improving their contribution to family welfare.

Attitude of Health Personnel↗
PubMedDate not supplied

Intraventricular administration of antivasopressin serum inhibits retention in mice.

Elevations and decrements in the levels of the posterior pituitary hormone vasopressin result in facilitations and deficits in retention, respectively, in rats. Despite the frequent use of mice in studies of pharmacological influences on retention, there is a paucity of information regarding the role of endogenous peptides, particularly vasopressin, in the memory processes of mice. In the present experiment, mice suffering from acute inactivation of central vasopressin, induced by an immediately posttraining, 2 microliters, intracerebroventricular injection of antivasopressin serum, displayed a retention deficit for passive avoidance training. The results of this experiment suggest that endogenous vasopressin modulates the memory processes of mice, as well as rats.

Animals↗
PubMed1996

Putting together a risk management program for home care providers.

The need for risk management in home care has grown because of several factors--increased consumer awareness, advanced technology, and the loss of charitable immunity for health care organizations. A solid risk management program will prepare providers to meet these challenges with confidence.

Awareness↗
PubMed1987

Continuous high-dose factor VIII for the induction of immune tolerance in haemophilia A patients with high responder state: a description of eleven patients treated.

Eleven severely affected haemophilia A patients (aged 6-42 y) with F VIII:C inhibitor (high responders) were treated with high-dose F VIII in order to eliminate the inhibitors. The patients comprise Danish high responder patients treated during the period 1977-1985. In all patients the inhibitors decreased significantly. In six, the inhibitor apparently disappeared (detection limit 0.4 Bethesda Units per ml) (BU/ml), in four patients a low level inhibitor of 0.4-1.4 BU/ml persisted. One patient is still on high-dose schedule. The duration of high-dose treatments ranged from less than one month up to 18 months. In all patients the tendency to spontaneous bleedings vanished when a measurable VIII:C level appeared in the post-infusion sample. The inhibitor suppression has allowed for extensive physical training and rehabilitation orthopaedic surgery. The patients are now able to conduct a normal haemophilic life on self-administered prophylactic doses of F VIII.

Adolescent↗
PubMed1996

B1-insensitive, single-shot localization and water suppression.

A technique for single-shot, localized, water-suppressed in vivo 1H NMR with high immunity to B1 inhomogeneities is described. The single-shot localization is based on complete outer-volume suppression which is achieved with optimized, adiabatic BIR-4 pulses in combination with BO gradient modulation. B1-insensitive water suppression is achieved with BISTRO, a train of selective adiabatic full-passage pulses interleaved with BO gradient crushers. Computer simulations based on the Bloch equations, experimental images of the localized volume, and in vivo 1H spectroscopy experiments demonstrate the excellent spatial localization and water suppression.

Artifacts↗