Psychological and weight-related characteristics of patients with anorexia nervosa-restricting type who later develop bulimia nervosa

<p>Abstract</p> <p>Background</p> <p>Patients with anorexia nervosa-restricting type (AN-R) sometimes develop accompanying bulimic symptoms or the full syndrome of bulimia nervosa (BN). If clinicians could predict who might change into the bulimic sub-type or BN, preventative steps could be taken. Therefore, we investigated anthropometric and psychological factors possibly associated with such changes.</p> <p>Method</p> <p>All participants were from a study by the Japanese Genetic Research Group for Eating Disorders. Of 80 patients initially diagnosed with AN-R, 22 changed to the AN-Binge Eating/Purging Type (AN-BP) and 14 to BN for some period of time. The remaining 44 patients remained AN-R only from the onset to the investigation period. Variables compared by ANOVA included anthropometric measures, personality traits such as Multiple Perfectionism Scale scores and Temperament and Character Inventory scores, and Beck Depression Inventory-II scores.</p> <p>Results</p> <p>In comparison with AN-R only patients, those who developed BN had significantly higher current BMI (p < 0.05) and maximum BMI in the past (p < 0.05). They also scored significantly higher for the psychological characteristic of parental criticism (p < 0.05) and lower in self-directedness (p < 0.05), which confirms previous reports, but these differences disappeared when the depression score was used as a co-variant. No significant differences were obtained for personality traits or depression among the AN-R only patients irrespective of their duration of illness.</p> <p>Conclusion</p> <p>The present findings suggest a tendency toward obesity among patients who cross over from AN-R to BN. Low self-directedness and high parental criticism may be associated with the development of BN by patients with AN-R, although the differences may also be associated with depression.</p

Desafios para a oferta de prótese dentária na rede de saúde pública

Objective: To describe the challenges faced by local health managers during the implementation and maintenance of Regional Laboratories Dental Prosthetics (RLDP), and identify the profile of the cities with RLDP. Method: A cross-sectional study using a questionnaire that was replied by 317 local health managers between 2014 and 2015 and information extracted from official database. A chi-square test was used to analyze secondary data, with the existence of credentialed RLDP as a dependent variable and the coverage of Dental Health Team (DHT), local population, Human Development Indices (HDI), Allocation Factor (AF) and data about local health managers being the co-variables. Result: The low number of dental prosthetic technician was the main challenge regarding the implementation of the RLDP and low funding was the main one related to maintenance. Cities a population of less than 10,000 inhabitants were more likely to have a credentialed RLDP (rate = 2.42). Conclusion: To meet the challenges faced by cities in offering dental prosthesis in the public health, the system demands actions that go beyond the local public sphere. The educational institutions’ involvement is needed in order to meet human-resources training requirements and state and federal levels involvement is required to promote strategies that reduce costs and increase access to RLDP by small cities.Objetivo: Conhecer os desafios enfrentados pelos municípios na implantação e manutenção dos Laboratórios Regionais de Próteses Dentárias (LRPD), além de identificar o perfil dos municípios com LRPD implantados. Método: Estudo exploratório, transversal, baseado em um questionário aplicado a 317 gestores municipais de saúde, no ano de 2014-2015, e em informações extraídas dos bancos oficiais. Para análise dos dados secundários, foi realizado o teste do Qui-quadrado, tendo como variável dependente a presença do LRPD credenciado e, como covariáveis, a Cobertura de Equipe de Saúde Bucal (ESB), o Contingente populacional, o Índice de Desenvolvimento Humano (IDH), o Fator de Alocação (FA) e os dados relativos aos Gestores Municipais de Saúde. Resultado: A baixa oferta do Técnico de Prótese Dentária (TPD) foi o maior desafio para a implantação dos LRPD e, para a manutenção dos LRPD, o baixo financiamento foi o fator limitante. Os municípios com população maior que dez mil habitantes tiveram mais chance de possuir um LRPD credenciado (RP = 2,42). Conclusão: Os desafios enfrentados pelos municípios para a oferta de prótese dentária na rede de saúde pública demandam ações que extrapolam a esfera municipal, sendo necessário o envolvimento das instituições de ensino, a fim de garantir a capacitação dos recursos humanos e dos demais entes da federação na criação de estratégias de regionalização que minimizem os custos e ampliem o acesso dos municípios de menor porte populacional aos LRPD

Guidelines for the use and interpretation of assays for monitoring autophagy

In 2008 we published the first set of guidelines for standardizing research in autophagy. Since then, research on this topic has continued to accelerate, and many new scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Accordingly, it is important to update these guidelines for monitoring autophagy in different organisms. Various reviews have described the range of assays that have been used for this purpose. Nevertheless, there continues to be confusion regarding acceptable methods to measure autophagy, especially in multicellular eukaryotes. A key point that needs to be emphasized is that there is a difference between measurements that monitor the numbers or volume of autophagic elements (e.g., autophagosomes or autolysosomes) at any stage of the autophagic process vs. those that measure flux through the autophagy pathway (i.e., the complete process); thus, a block in macroautophagy that results in autophagosome accumulation needs to be differentiated from stimuli that result in increased autophagic activity, defined as increased autophagy induction coupled with increased delivery to, and degradation within, lysosomes (in most higher eukaryotes and some protists such as Dictyostelium) or the vacuole (in plants and fungi). In other words, it is especially important that investigators new to the field understand that the appearance of more autophagosomes does not necessarily equate with more autophagy. In fact, in many cases, autophagosomes accumulate because of a block in trafficking to lysosomes without a concomitant change in autophagosome biogenesis, whereas an increase in autolysosomes may reflect a reduction in degradative activity. Here, we present a set of guidelines for the selection and interpretation of methods for use by investigators who aim to examine macroautophagy and related processes, as well as for reviewers who need to provide realistic and reasonable critiques of papers that are focused on these processes. These guidelines are not meant to be a formulaic set of rules, because the appropriate assays depend in part on the question being asked and the system being used. In addition, we emphasize that no individual assay is guaranteed to be the most appropriate one in every situation, and we strongly recommend the use of multiple assays to monitor autophagy. In these guidelines, we consider these various methods of assessing autophagy and what information can, or cannot, be obtained from them. Finally, by discussing the merits and limits of particular autophagy assays, we hope to encourage technical innovation in the field