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Krasnovsky L, Crowley AP, Naeem F, Wang LS, Wu GD, Chao AM. A Scoping Review of Nutritional Biomarkers Associated with Food Security. Nutrients 2023; 15:3576. [PMID: 37630766 PMCID: PMC10459650 DOI: 10.3390/nu15163576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/05/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Food insecurity affects more than 40 million individuals in the United States and is linked to negative health outcomes due, in part, to poor dietary quality. Despite the emergence of metabolomics as a modality to objectively characterize nutritional biomarkers, it is unclear whether food security is associated with any biomarkers of dietary quality. This scoping review aims to summarize studies that examined associations between nutritional biomarkers and food security, as well as studies that investigated metabolomic differences between people with and without food insecurity. PubMed, Embase, Scopus, and AGRICOLA were searched through August 2022 for studies describing food insecurity and metabolic markers in blood, urine, plasma, hair, or nails. The 78 studies included consisted of targeted assays quantifying lipids, dietary nutrients, heavy metals, and environmental xenobiotics as biochemical features associated with food insecurity. Among those biomarkers which were quantified in at least five studies, none showed a consistent association with food insecurity. Although three biomarkers of dietary quality have been assessed between food-insecure versus food-secure populations, no studies have utilized untargeted metabolomics to characterize patterns of small molecules that distinguish between these two populations. Further studies are needed to characterize the dietary quality profiles of individuals with and without food insecurity.
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Affiliation(s)
- Lev Krasnovsky
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (A.P.C.); (F.N.); (L.S.W.)
| | - Aidan P. Crowley
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (A.P.C.); (F.N.); (L.S.W.)
| | - Fawaz Naeem
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (A.P.C.); (F.N.); (L.S.W.)
| | - Lucy S. Wang
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (A.P.C.); (F.N.); (L.S.W.)
| | - Gary D. Wu
- Division of Gastroenterology and Hepatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | - Ariana M. Chao
- Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, MD 21205, USA;
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Husain MO, Khoso AB, Kiran T, Chaudhry N, Husain MI, Asif M, Ansari M, Rajput AH, Dawood S, Naqvi HA, Nizami AT, Tareen Z, Rumi J, Sherzad S, Khan HA, Bhatia MR, Siddiqui KMS, Zadeh Z, Mehmood N, Talib U, de Oliveira C, Naeem F, Wang W, Voineskos A, Husain N, Foussias G, Chaudhry IB. Culturally adapted psychosocial interventions (CaPSI) for early psychosis in a low-resource setting: study protocol for a large multi-center RCT. BMC Psychiatry 2023; 23:444. [PMID: 37328751 PMCID: PMC10276384 DOI: 10.1186/s12888-023-04904-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 05/26/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Psychosis treatment guidelines recommend cognitive behaviour therapy (CBT) and family intervention (FI), for all patients with first episode psychosis (FEP), though guidance borrows heavily from literature in adults from high income countries. To our knowledge, there are few randomized controlled trials (RCTs) examining the comparative effect of these commonly endorsed psychosocial interventions in individuals with early psychosis from high-income countries and no such trials from low and middle-income countries (LMICs). The present study aims to confirm the clinical-efficacy and cost-effectiveness of delivering culturally adapted CBT (CaCBT) and culturally adapted FI (CulFI) to individuals with FEP in Pakistan. METHOD A multi-centre, three-arm RCT of CaCBT, CulFI, and treatment as usual (TAU) for individuals with FEP (n = 390), recruited from major centres across Pakistan. Reducing overall symptoms of FEP will be the primary outcome. Additional aims will include improving patient and carer outcomes and estimating the economic impact of delivering culturally appropriate psychosocial interventions in low-resource settings. This trial will assess the clinical-efficacy and cost-effectiveness of CaCBT and CulFI compared with TAU in improving patient (positive and negative symptoms of psychosis, general psychopathology, depressive symptoms, quality of life, cognition, general functioning, and insight) and carer related outcomes (carer experience, wellbeing, illness attitudes and symptoms of depression and anxiety). CONCLUSIONS A successful trial may inform the rapid scale up of these interventions not only in Pakistan but other low-resource settings, to improve clinical outcomes, social and occupational functioning, and quality of life in South Asian and other minority groups with FEP. TRIAL REGISTRATION NCT05814913.
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Affiliation(s)
- M O Husain
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 1025 Queen St West, Toronto, ON, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - A B Khoso
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - T Kiran
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - N Chaudhry
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - M I Husain
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 1025 Queen St West, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - M Asif
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - M Ansari
- Department of Psychiatry, Liaquat University of Medical and Health Sciences, Hyderabad, Pakistan
| | - A H Rajput
- Department of Psychiatry, Liaquat University of Medical and Health Sciences, Hyderabad, Pakistan
| | - S Dawood
- Centre for Clinical Psychology, University of the Punjab, Lahore, Pakistan
| | - H A Naqvi
- Department of Psychiatry, Dow University Health Sciences, Karachi, Pakistan
| | - A T Nizami
- Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi, Pakistan
| | - Z Tareen
- Department of Psychiatry, Balochistan Institute of Psychiatry & Behavioural Sciences, Quetta, Pakistan
| | - J Rumi
- Department of Psychiatry, Balochistan Institute of Psychiatry & Behavioural Sciences, Quetta, Pakistan
| | - S Sherzad
- Department of Psychiatry, Balochistan Institute of Psychiatry & Behavioural Sciences, Quetta, Pakistan
| | - H A Khan
- Department of Psychiatry, Balochistan Institute of Psychiatry & Behavioural Sciences, Quetta, Pakistan
| | - M R Bhatia
- Department of Psychiatry, Peoples University of Medical and Health Sciences, Shaheed Benazirabad, Pakistan
| | | | - Z Zadeh
- Pakistan Institute of Living and Learning, Karachi, Pakistan
| | - N Mehmood
- Institute for Mental Health, Karwan-E-Hayat, Karachi, Pakistan
| | - U Talib
- Institute for Mental Health, Karwan-E-Hayat, Karachi, Pakistan
| | - C de Oliveira
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 1025 Queen St West, Toronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- ICES, Toronto, Canada
| | - F Naeem
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 1025 Queen St West, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - W Wang
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 1025 Queen St West, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - A Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 1025 Queen St West, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - N Husain
- Mersey Care NHS Foundation Trust, Prescott, UK
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - G Foussias
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 1025 Queen St West, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - I B Chaudhry
- Pakistan Institute of Living and Learning, Karachi, Pakistan
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Psychiatry, Ziauddin University, Karachi, Pakistan
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Zaki A, Soomar S, Niazi M, Naeem F, Jabbar A. 434P Outcome of high grade glioma patients: A single institution experience. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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Naeem F, Sabar M, Ghani M, Ain Q, Zafar QUA. IDENTIFICATION OF DIAGNOSTIC AND THERAPEUTIC TARGET GENES TO ADDRESS ASTHMA DISEASE IN PAKISTAN. Chest 2020. [DOI: 10.1016/j.chest.2020.05.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Gire N, Chaudhry I, Naeem F, Duxbury J, Riley M, McKeown M, Taylor C, Taylor P, Emsley R, Caton N, Kelly J, Kingdon D, Husain N. TechCare: Mobile-assessment and therapy for psychosis: An intervention for clients within the early intervention service. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2016.01.2274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionIn the UK, mental illness is a major source of disease burden costing in the region of £105 billion pounds. mHealth is a novel and emerging field in psychiatric and psychological care for the treatment of mental health difficulties such as psychosis.ObjectiveTo develop an intelligent real-time therapy (iRTT) mobile intervention (TechCare) which assesses participant's symptoms in real-time and responds with a personalised self-help based psychological intervention, with the aim of reducing participant's symptoms. The system will utilise intelligence at two levels:– intelligently increasing the frequency of assessment notifications if low mood/paranoia is detected;– an intelligent machine learning algorithm which provides interventions in real-time and also provides recommendations on the most popular selected interventions.AimThe aim of the current project is to develop a mobile phone intervention for people with psychosis, and to conduct a feasibility study of the TechCare App.MethodsThe study consists of both qualitative and quantitative components. The study will be run across three strands:– qualitative work;– test run and intervention refinement;– feasibility trial.ResultsPreliminary analysis of qualitative data from Strand 2 (test run and intervention refinement) in-depth interviews with service users (n = 2) and focus group with health professionals (n = 1), highlighted main themes around security of the device, multimedia and the acceptability of psychological interventions being delivered via the TechCare App.ConclusionsResearch in this area can be potentially helpful in addressing the demand on mental health services globally, particularly improving access to psychological interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Husain N, Mehmood N, Husain M, Kiran T, Naeem F, Chaudhry I. Feasibility study of culturally adapted cognitive behaviour therapy for psychosis in Pakistan. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2016.01.2144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BackgroundIt is becoming well established that CBT is both effective and cost efficient in the treatment of positive and negative symptoms of schizophrenia. However, there is a need to adapt CBT to the cultural, linguistic, and socioeconomic context of diverse cultural groups. We aimed to establish the feasibility of culturally adaptive cognitive behavior therapy for treatment of psychosis in a low-income country.MethodsThis is a rater-blind, randomized, controlled trial of the use of CBT in patients with psychosis from a low-income country. Patients with a DSM-IV diagnosis of schizophreniform disorder were assessed using Positive and Negative Syndrome Scale for Schizophrenia (PANSS), PSYRATS (Psychotic Symptom Rating Scales), and the Insight Scale. Participants were randomized into the intervention group (n = 18) and TAU group (n = 18). The intervention group received 12 weekly sessions of culturally adapted CBT for psychosis (CaCBTp).ResultsThere were no significant differences between the two groups at baseline. At three months follow-up, there was a statistically significant improvement in the CaCBTp group on PANSS general Psychopathology subscale, PANSS overall score and Insight scale, as compared to the TAU group. The CaCBTp group had lower scores on PANSS positive, PANSS negative sub-scales, and the two subscales of Psychotic Symptom Rating Scale, but differences were not statistically significant.ConclusionCulturally adapted CBT added to pharmacological treatment as usual was acceptable to patients and was helpful in reduction of severity of psychotic symptoms. Adjunctive culturally adapted CBT should be further investigated in this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Naeem F, Rodriguez S, MacRae A. 25IMPLEMENTATION OF AN ANALGESIA AND BOWELS PROTOCOL TO IMPROVE PATIENT CARE AFTER HIP FRACTURE. Age Ageing 2019. [DOI: 10.1093/ageing/afz055.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- F Naeem
- Department of elderly care, Royal Alexandria Hospital, Paisley
| | - S Rodriguez
- Department of elderly care, Royal Alexandria Hospital, Paisley
| | - A MacRae
- Department of elderly care, Royal Alexandria Hospital, Paisley
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Sale JEM, Marwah A, Naeem F, Yu W, Meadows L. Evidence of patient beliefs, values, and preferences is not provided in osteoporosis clinical practice guidelines. Osteoporos Int 2019; 30:1325-1337. [PMID: 30859238 DOI: 10.1007/s00198-019-04913-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 02/20/2019] [Indexed: 01/13/2023]
Abstract
UNLABELLED We examined how patient beliefs, values, and preferences (BVPs) were included and conceptualized in international osteoporosis guidelines. The majority of guidelines did not mention BVPs. When mentioned, BVPs were conceptualized as preference for one medication over another. A broader conceptualization and inclusion of BVPs should be incorporated in osteoporosis guidelines. INTRODUCTION Our objectives were to determine (1) the extent to which osteoporosis guidelines reflected patients' beliefs, values, and preferences (BVPs); (2) how BVPs were conceptualized; and (3) the methods used to elicit BVPs in the references cited by the guidelines. METHODS We conducted a document analysis of English-language international osteoporosis guidelines based on the International Osteoporosis Foundation website. We examined each guideline and extracted all instances of statements pertaining to BVPs. The statements were reviewed by two independent researchers. Discrepancies in data extraction were resolved by the first author. We developed categories based on five common elements that represented the BVP statements. RESULTS Twenty-seven of 70 (39%) guidelines included 95 statements about patient BVPs. Of the 95 statements, 32 statements (14 guidelines) were classified under BVP related to the choice of pharmacotherapy or general treatment, 10 (7 guidelines) under BVP related to adherence to pharmacotherapy or treatment in general, 5 (5 guidelines) under BVP related to financial costs and benefits, 43 (19 guidelines) under other BVP mentioned but not supported by a reference to a primary study or systematic review, and 5 (3 guidelines) under other BVP mentioned and supported by at least one reference to a primary study or systematic review. Twenty-nine references were cited to reflect the BVPs mentioned, including an editorial and quantitative studies. CONCLUSIONS Twenty-seven (39%) of the guidelines included mention of patients' BVPs. In 19 guidelines, the importance of BVPs was mentioned but these statements were not supported by references to a primary study or systematic review. BVPs were most often (14 guidelines) conceptualized as preference for one medication over another. We suggest that qualitative data be included as evidence of BVPs in guidelines.
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Affiliation(s)
- J E M Sale
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, Ontario, M5T 3M6, Canada.
| | - A Marwah
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada
| | - F Naeem
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada
| | - W Yu
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada
| | - L Meadows
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3D10, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
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Husain N, Kiran T, Fatima B, Chaudhry I, Saeed Q, Masood S, Husain M, Zafar S, Gire N, Alvi M, Khoja S, Naeem F. Development and assessment of a mobile phone-based intervention to reduce maternal depression and improve child health. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.2276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionPostnatal depression is known to cause disability and suffering in women and negative consequences both for their infants and their families, with huge costs globally. Several studies from low and middle income countries (LAMIC) have demonstrated that effectively delivered psychological interventions are cost effective for improving maternal and child health, but access to these interventions is limited in both the low and high income countries.ObjectiveThe objective of the study is to develop and test a mobile phone-based intervention (TechMotherCare), which will include components of cognitive behavioural therapy (CBT) and child development related psychoeducation.AimThe aim of the study is to examine the feasibility and acceptability of the TechMotherCare intervention.MethodsA total of 36 participants will be recruited from health centers in Karachi, Pakistan for this 2-arm randomized pilot study. The TechMotherCare App intervention will be based on principles of CBT and learning-through-play (LTP) a parenting intervention and will assess the real-time depressive symptoms of participants and respond, using intelligent real time therapy (iRTT) dependent on symptoms reported by participants.ResultsOutcome assessments will be completed after 3 months (end of intervention). In-depth qualitative interviews will also be conducted with participants pre- and post-intervention. The trial is ongoing and we will present both the qualitative and quantitative results.ConclusionsThe results of this pilot trial will inform the design of a larger randomised controlled trial using a mobile based technology platform to address the huge treatment gap in LAMICs.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Vincent J, Jamil T, Rafiq M, Anwar Z, Ayaz M, Hameed A, Nasr T, Naeem F, Khattak N, Carter M, Ahmed I, John P, Wiame E, Andrade D, Schaftingen E, Mir A, Ayub M. Phosphoserine phosphatase (PSPH) gene mutation in an intellectual disability family from Pakistan. Clin Genet 2014; 87:296-8. [DOI: 10.1111/cge.12445] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 06/08/2014] [Accepted: 06/16/2014] [Indexed: 11/29/2022]
Affiliation(s)
- J.B. Vincent
- Molecular Neuropsychiatry and Development (MiND) Laboratory, The Campbell Family Brain Research Institute; The Centre for Addiction and Mental Health (CAMH); Toronto ON Canada
- Department of Psychiatry; University of Toronto; Toronto ON Canada
- Institute of Medical Science; University of Toronto; Toronto ON Canada
| | - T. Jamil
- Human Molecular Genetics Laboratory, Department of Bioinformatics and Biotechnology, FBAS; International Islamic University; Islamabad Pakistan
| | - M.A. Rafiq
- Molecular Neuropsychiatry and Development (MiND) Laboratory, The Campbell Family Brain Research Institute; The Centre for Addiction and Mental Health (CAMH); Toronto ON Canada
| | - Z. Anwar
- Human Molecular Genetics Laboratory, Department of Bioinformatics and Biotechnology, FBAS; International Islamic University; Islamabad Pakistan
| | - M. Ayaz
- Lahore Institute of Research and Development; Lahore Pakistan
| | - A. Hameed
- Institute of Biomedical and Genetic Engineering; Islamabad Pakistan
| | - T. Nasr
- Mayo Hospital, Lahore and Chaudry Hospital; Gujranwala Pakistan
| | - F. Naeem
- Lahore Institute of Research and Development; Lahore Pakistan
- Department of Psychiatry; Queen's University; Kingston ON Canada
| | - N.A. Khattak
- Department of Biochemistry; PMAS-Arid Agriculture University; Rawalpindi Pakistan
| | - M. Carter
- Department of Pediatrics, Division of Clinical and Metabolic Genetics; The Hospital for Sick Children; Toronto ON Canada
| | - I. Ahmed
- Molecular Neuropsychiatry and Development (MiND) Laboratory, The Campbell Family Brain Research Institute; The Centre for Addiction and Mental Health (CAMH); Toronto ON Canada
- Atta-ur-Rehman School of Applied Biosciences (ASAB); National University of Sciences and Technology (NUST); Islamabad Pakistan
| | - P. John
- Krembil Neuroscience Centre; Toronto Western Research Institute; Toronto Canada
| | - E. Wiame
- Laboratory of Physiological Chemistry, de Duve Institute; Université Catholique de Louvain; B-1200 Brussels Belgium
| | - D.M. Andrade
- Krembil Neuroscience Centre; Toronto Western Research Institute; Toronto Canada
- Division of Neurology, Department of Medicine; University or Toronto; Toronto ON Canada
| | - E.V. Schaftingen
- Laboratory of Physiological Chemistry, de Duve Institute; Université Catholique de Louvain; B-1200 Brussels Belgium
| | - A. Mir
- Human Molecular Genetics Laboratory, Department of Bioinformatics and Biotechnology, FBAS; International Islamic University; Islamabad Pakistan
| | - M. Ayub
- Lahore Institute of Research and Development; Lahore Pakistan
- Department of Psychiatry; Queen's University; Kingston ON Canada
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Affiliation(s)
- F Naeem
- Sevenacres, St Mays Hospital, Newport, Isle of Wight, UK.
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Richter HG, Camm EJ, Modi BN, Naeem F, Cross CM, Cindrova-Davies T, Spasic-Boskovic O, Dunster C, Mudway IS, Kelly FJ, Burton GJ, Poston L, Giussani DA. Ascorbate prevents placental oxidative stress and enhances birth weight in hypoxic pregnancy in rats. J Physiol 2012; 590:1377-87. [PMID: 22289909 PMCID: PMC3382329 DOI: 10.1113/jphysiol.2011.226340] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 01/24/2012] [Indexed: 01/23/2023] Open
Abstract
This study isolated the effects of maternal hypoxia independent of changes in maternal nutrition on maternal circulatory and placental molecular indices of oxidative stress and determined whether maternal antioxidant treatment conferred protection. Pregnant rats were subjected to normoxic pregnancy or 13% O2 chronic hypoxia for most of gestation with and without maternal treatment with vitamin C in the drinking water. Maternal hypoxia with and without vitamin C did not affect maternal food or water intake and led to a significant increase in maternal and fetal haematocrit. At gestational day 20, maternal plasma urate and L-cysteine concentrations, and placental levels of 4-hydroxynonenal and heat shock protein 70 were increased while placental heat shock protein 90 levels were decreased in hypoxic pregnancy. The induction of maternal circulatory and placental molecular indices of oxidative stress in hypoxic pregnancies was prevented by maternal treatment with vitamin C. Maternal hypoxia during pregnancy with or without vitamin C increased placental weight, but not total or compartmental volumes. Maternal treatment with vitamin C increased birth weight in both hypoxic and normoxic pregnancies. The data show that maternal hypoxia independent of maternal undernutrition promotes maternal and placental indices of oxidative stress, effects that can be prevented by maternal treatment with vitamin C in hypoxic pregnancy. While vitamin C may not be the ideal candidate of choice for therapy in pregnant women, and taking into consideration differences in ascorbic acid metabolism between rats and humans, the data do underlie that antioxidant treatment may provide a useful intervention to improve placental function and protect fetal growth in pregnancy complicated by fetal hypoxia.
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Affiliation(s)
- H G Richter
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge CB2 3EG, UK
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Naeem F, Hussain N. FC16-02 - Workshop: culutrally adapting CBT. Eur Psychiatry 2011. [DOI: 10.1016/s0924-9338(11)73609-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
There is sufficient evidence to suggest that CBT is an effective treatment for mental health problems. Current evidence suggests that ethnic minorty clients are less likely to engage in psychological interventions. We have adapted CBT for ethnic minorities in the UK. The aim of this workshop is to help the participants to realize the barriers posed by ethnic minority clients in therapy and how to overcome these.Our work has highlighted that culture, capacity of the system and cognitions and beliefs are the areas which need addressing in this regard. We found that although therapists do not need to make major changes in therapy techniques they need to be aware of issues related to culture and patients beliefs about therapy. This workshop will especially focus on difficult areas such as assessment of ethnic minority clients and their engagement with therapy.
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Abstract
High rates of mental illness, particularly depression have been reported in Pakistan. The health system is both under developed and poorly resourced. It is therefore not surprising that psychiatric training is at its very early stages, at both undergraduate and the postgraduate level. In order to look after the mentally ill patients radical changes need to be implemented in training of doctors. Medical curriculum needs to place more focus on psychiatry. This should not only help junior doctors in understanding the need for psychiatry, but will also prepare them for the challenges they will face as a General Practitioner or a Family Physician. Similarly, postgraduate training can be made more useful by placing more emphasis on community based and primary care psychiatry and psychotherapy; especially family interventions. The training needs to aim towards preparing psychiatrists who are not only clinicians, but can be agents of change in the society, through health education.
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Affiliation(s)
- F Naeem
- a Hawthorn Lodge, Moorgreen Hospital , West End , Southampton , SO14 3ED
| | - M Ayub
- b McColl Clinic, Prudho Hospital , Prudho , UK
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