Mejeredmondson1516

The literature on transdiagnostic psychotherapy among youths is limited. Group transdiagnostic behavior therapy (TBT) has been shown to be effective for adults with affective disorders and may contain beneficial features for youths (e.g., behavioral focus, group format, ease of dissemination, and diversity of targeted diagnoses). This study aimed to investigate group TBT among youths in Canada to determine its feasibility and efficacy.

Twenty participants (ages 16-19) diagnosed as having a principal anxiety disorder completed 12 sessions of group TBT. Symptoms of anxiety, depression, and transdiagnostic impairment were assessed pre- and posttreatment.

Participants demonstrated significant improvements on measures of anxiety (general, cognitive, and somatic) and stress, with moderate effect sizes. Findings for symptoms of depression and transdiagnostic impairment were unreliable, with small effect sizes.

These findings provide preliminary support for the use of group TBT among youths with anxiety disorders. Future research should incorporate comparison groups and larger samples.

These findings provide preliminary support for the use of group TBT among youths with anxiety disorders. Future research should incorporate comparison groups and larger samples.

Patients with heart failure (HF) with diabetes mellitus have distinct biomarker profiles compared with those without diabetes mellitus. SFRP5 (secreted frizzled-related protein 5) is an anti-inflammatory adipokine with an important suppressing role on the development of type 2 diabetes mellitus (T2DM). This study aimed to evaluate the prognostic value of SFRP5 in patients with HF with and without T2DM.

The study included 833 consecutive patients with HF, 312 (37.5%) of whom had T2DM. Blood samples were collected at presentation, and SFRP5 levels were measured. JIB-04 The primary outcome was the composite end points of first occurrence of HF rehospitalization or all-cause mortality during follow-up.

During median follow-up of 2.1 years, 335 (40.2%) patients in the cohort experienced the composite primary outcome. After adjustment for multiple risk factors, each doubling of SFRP5 level was associated with a 21% decreased risk of primary outcomes in the overall study population (

<0.001). Subgroup analyses showed that the association between level of SFPR5 and primary outcomes may be stronger in patients with T2DM (hazard ratio, 0.69 [95% CI, 0.61-0.79]) than in patients without T2DM (hazard ratio, 0.89 [95% CI, 0.79-1.01]; interaction

=0.006). Similar associations were observed when taking SFRP5 as a categorical variable. Addition of SFRP5 significantly improved discrimination and reclassification of the incident primary outcomes beyond clinical risk factors and N-terminal pro-B-type natriuretic peptide in all patients with HF and those with T2DM (all

<0.01).

SFRP5 is an independent novel biomarker for risk stratification in HF, especially in HF with T2DM.

SFRP5 is an independent novel biomarker for risk stratification in HF, especially in HF with T2DM.

Abnormally high cytosolic Na

concentrations in advanced heart failure impair myocardial contractility. Stimulation of the membrane Na

-K

pump should lower Na

concentrations, and the β3 adrenoceptor (β3 AR) mediates pump stimulation in myocytes. We examined if β3 AR-selective agonists given in vivo increase myocyte Na

-K

pump activity and reverse organ congestion in severe heart failure (HF).

Indices for HF were lung-, heart-, and liver body weight ratios and ascites after circumflex coronary artery ligation in rabbits. Na

-K

pump current, I

, was measured in voltage-clamped myocytes from noninfarct myocardium. Rabbits were treated with the β3 AR agonists CL316,243 or ASP9531, starting 2 weeks after coronary ligation.

Coronary ligation caused ascites in most rabbits, significantly increased lung-, heart-, and liver body weight ratios, and decreased I

relative to that for 10 sham-operated rabbits. Treatment with CL316,243 for 3 days significantly reduced lung-, heart-, and liver body weight ratios and prevalence of ascites in 8 rabbits with HF relative to indices for 13 untreated rabbits with HF. It also increased I

significantly to levels of myocytes from sham-operated rabbits. Treatment with ASP9531 for 14 days significantly reduced indices of organ congestion in 6 rabbits with HF relative to indices of 6 untreated rabbits, and it eliminated ascites. β3 AR agonists did not significantly change heart rates or blood pressures.

Parallel β3 AR agonists-induced reversal of Na

-K

pump inhibition and indices of congestion suggest pump inhibition is a useful target for treatment with β3 AR agonists in congestive HF.

Parallel β3 AR agonists-induced reversal of Na+-K+ pump inhibition and indices of congestion suggest pump inhibition is a useful target for treatment with β3 AR agonists in congestive HF.

Palliative care is a care option considered appropriate for those with heart failure, but is uncommon partially due to a lack of timely identification of those needing palliative care. A standard mechanism that triggers which heart failure patients should receive palliative care is not available. The Gold Standards Framework (GSF) identifies those needing palliative care but has not been investigated with heart failure patients.

To describe palliative care provided in the community and determine whether the GSF can identify heart failure patients in need of palliative care.

Descriptive study. A total of 252 heart failure patients in the community completed a demographic characteristics questionnaire, the Edmonton symptom assessment scale-revised and the Minnesota living with heart failure questionnaire. Clinical data were collected from the medical chart and the primary physician completed the GSF prognostic indicator guidance.

Participants had a mean age of 76.9 years (standard deviation 10.9), most at New York Heart Association level III (

=152, 60%). Fewer than half received pain medications (

=76, 30%), anxiolytics (

=35, 14%), antidepressants (

=64, 25%) or sleep medications (

=65, 26%). Eight patients spoke with a psychologist or psychologist (3%). One had an advanced directive and 16 (6%) had a record of discussions with their family caregivers. Three (1%) had end-of-life discussions with their healthcare providers. Most healthcare providers responded 'no' to the 'surprise question' (

=160, 63%). Sensitivity and specificity of the gold standards framework was poor.

Few community dwelling heart failure patients received most aspects of palliative care. The gold standards framework was not a good indicator of those who should receive palliative care.

Few community dwelling heart failure patients received most aspects of palliative care. The gold standards framework was not a good indicator of those who should receive palliative care.