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  • Díaz, Miguel
    et al.
    Federal University of Uberlandia, Brazil.
    Bocanegra, Olga L.
    Federal University of Uberlandia, Brazil.
    Teixeira, R. R.
    Federal University of Uberlandia, Brazil.
    Espindola, Foued Salmen
    Federal University of Uberlandia, Brazil.
    Response of salivary markers of autonomic activity to elite competition2012In: International Journal of Sports Medicine, ISSN 0172-4622, E-ISSN 1439-3964, Vol. 33, no 9, p. 763-768Article in journal (Refereed)
    Abstract [en]

    We investigated the response of salivary total protein (TP), alpha-amylase (sAA) and chromogranin A (CgA) to sporting competition and their relation with positive and negative affect. 11 professional swimmers were examined during the first day of a national contest and on a recreated event that matched time-of-the-day and day-of-the-week assessments 2 weeks later. Total protein was determined by the Bradford method and sAA and CgA by Western blotting upon awakening, 30 and 60 min post awakening, immediately before warming up for competition and 5, 20 and 60 min after competition. Psychometric instruments included the Positive Affect and Negative Affect Schedule-X. The concentrations of TP, sAA and CgA differed from controls only prior to and 5 min after the event. We observed positive correlations between higher negative affect scores with higher levels of TP, sAA and CgA prior to the event on the competition day. All 3 markers showed a similar reactivity to sporting competition, which may be attributed to the mechanisms responsible for protein secretion into saliva when collection is performed with no exogenous stimulation. TP is an attractive marker in sports psychology since its determination is faster and cheaper than traditional kinetic or immune assays.

  • Díaz, Miguel
    et al.
    Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil.
    Bocanegra Jaramillo, Olga
    ederal University of Uberlandia, Uberlandia, Minas Gerais, Brazil.
    Teixeira, RR
    ederal University of Uberlandia, Uberlandia, Minas Gerais, Brazil.
    Espindola, Foued Salmen
    ederal University of Uberlandia, Uberlandia, Minas Gerais, Brazil.
    Salivary surrogates of plasma nitrite and catecholamines during a 21-week training season in swimmers2013In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 21, no 8, article id 5Article in journal (Refereed)
    Abstract [en]

    The collection of samples of saliva is noninvasive and straightforward, which turns saliva into an ideal fluid for monitoring the adaptive response to training. Here, we investigated the response of the salivary proteins alpha-amylase (sAA), chromogranin A (sCgA), and the concentration of total protein (sTP) as well as salivary nitrite (sNO2) in relation to plasma catecholamines and plasma nitrite (pNO2), respectively. The variation in these markers was compared to the intensity and load of training during a 21-week training season in 12 elite swimmers. Overall, the salivary proteins tracked the concentration of plasma adrenaline and were inversely correlated with the training outcomes. No correlations were observed between sNO2 and pNO2. However, sNO2 correlated positively with the intensity and load of training. We argue that the decrease in sympathetic activity is responsible for the decrease in the concentration of proteins throughout the training season. Furthermore, the increase in nitrite is likely to reflect changes in hemodynamics and regulation of vascular tone. The association of the salivary markers with the training outcomes underlines their potential as noninvasive markers of training status in professional athletes.

  • Díaz, Miguel M.
    et al.
    Federal University of Uberlandia, Uberlandia, Brazil.
    Bocanegra, Olga L.
    Federal University of Uberlandia, Uberlandia, Brazil.
    Teixeira, R. R.
    Federal University of Uberlandia, Uberlandia, Brazil.
    Soares, S. S.
    Federal University of Uberlandia, Uberlandia, Brazil.
    Espindola, Foued Salmen
    Federal University of Uberlandia, Uberlandia, Brazil.
    Salivary nitric oxide and alpha-amylase as indexes of training intensity and load2013In: International Journal of Sports Medicine, ISSN 0172-4622, E-ISSN 1439-3964, Vol. 34, no 1, p. 8-13Article in journal (Refereed)
    Abstract [en]

    This study examined the variation in salivary nitric oxide (NO), alpha-amylase (sAA) and serum markers of muscle injury during 21 weeks of training in elite swimmers. Samples of saliva and blood were collected once a month during 5 months from 11 male professional athletes during their regular training season. The variation in each marker throughout the 21 weeks was compared with the dynamics of trainingvolume, intensity and load. Unstimulated whole saliva was assessed for NO and sAA whereas venous blood was assessed for lactate dehydrogenase, creatine kinase, and γ-glutamyltransferase. Nitric oxide and sAA showed a proportional response to the intensity of training. However, whereas the concentration of NO increased across the 21 weeks, the activity of sAA decreased. Similar variations in the concentration of NO and the markers of muscle injury were also observed. The higher concentration of NO might be attributed to changes in haemodynamics and muscle regenerative processes. On the other hand, autonomic regulation towards parasympathetic predominance might have been responsible for the decrease in sAA activity. These findings provide appealing evidence for the utilization of salivary constituents in sports medicine to monitor training programmes.

  • Díaz, Miguel Mauricio
    Federal University of Uberlandia, Uberlandia, Brazil.
    Chronic stress induces a hyporeactivity of the autonomic nervous system in response to acute mental stressor and impairs cognitive performance in business executives2015In: PLoS ONE, Vol. 10, no 3, article id e0119025Article in journal (Refereed)
    Abstract [en]

    The present study examined the incidence of chronic stress in business executives (109 subjects: 75 male and 34 female) and its relationship with cortisol levels, cognitive performance, and autonomic nervous system (ANS) reactivity after an acute mental stressor. Blood samples were collected from the subjects to measure cortisol concentration. After the sample collection, the subjects completed the Lipp Inventory of Stress Symptoms for Adults and the Stroop Color-Word Test to evaluate stress and cognitive performance levels, respectively. Saliva samples were collected prior to, immediately after, and five minutes after the test. The results revealed that 90.1% of the stressed subjects experienced stress phases that are considered chronic stress. At rest, the subjects with chronic stress showed higher cortisol levels, and no gender differences were observed. No differences were found between the stressed and non-stressed subjects regarding salivary amylase activity prior to test. Chronic stress also impaired performance on the Stroop test, which revealed higher rates of error and longer reaction times in the incongruent stimulus task independently of gender. For the congruent stimulus task of the Stroop test, the stressed males presented a higher rate of errors than the non-stressed males and a longer reaction time than the stressed females. After the acute mental stressor, the non-stressed male group showed an increase in salivary alpha-amylase activity, which returned to the initial values five minutes after the test; this ANS reactivity was not observed in the chronically stressed male subjects. The ANS responses of the non-stressed vs stressed female groups were not different prior to or after the Stroop test. This study is the first to demonstrate a blunted reactivity of the ANS when male subjects with chronic psychological stress were subjected to an acute mental stressor, and this change could contribute to impairments in cognitive performance.

  • Bexelius, T.
    et al.
    Karolinska Institutet.
    Lachmann, Hanna
    The Swedish Red Cross University College, Department of Health Sciences.
    Järnbert-Pettersson, H.
    Karolinska Institutet.
    Kalén, S.
    Karolinska Institutet.
    Möller, R.
    Karolinska Institutet.
    Ponzer, S.
    Karolinska Institutet.
    Stress among medical students during clinical courses: a longitudinal study using contextual activity sampling system2019In: International Journal of Medical Education, ISSN 2042-6372, E-ISSN 2042-6372, Vol. 10, p. 68-74Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate medical students’ experiences of stress and other emotions related to their professional roles, as defined by the CanMEDS framework, by using the Contextual Activity Sampling System (CASS).

    Methods: Ninety-eight medical students agreed to participate of whom 74 completed this longitudinal cohort study. Data was collected between 6th and 8th term via CASS methodology: A questionnaire was e-mailed to the participants every 3rd week (21questionnaires/measurements) during clinical rotations and scientific project work term. Emotions were measured by a 7-point Likert scale (e.g., maximum stress = 7). Answers were registered through mobile technology. We used a linear mixed-model regression approach to study the association between stress over time in relation to socio-demographic and learning activities related to CanMEDS roles.

    Results: Participants completed 1390 questionnaires. Mean stress level over all time points was 3.6. Stress was reported as highest during the scientific project term. Learning activities related to ‘Communicator,’ ‘Collaborator,’ ‘Scholar,’ ‘Manager’ and ‘Professional’ were associated with increased stress, e.g. ’Scholar’ increased stress with 0.5 points (t=3.91, p<0.001). A reduced level of stress was associated with ’Health Advocate’ of 0.39 points (t=-2.15, p=0.03). No association between perceived stress and demographic factors, such as gender or age was found.

    Conclusions: An association between different learning activities related to CanMEDS Roles and feelings of stress were noted. The CASS methodology was found to be useful when observing learning experiences and might support educational development by identifying course activities linked to stress.

  • Mattsson, Janet
    et al.
    The Swedish Red Cross University College, Department of Health Sciences.
    Östlund, Britt
    KTH.
    Björling, Gunilla
    The Swedish Red Cross University College, Department of Health Sciences. Karolinska Institutet.
    Williamsson, Anna
    KTH.
    Eriksson, Andrea
    KTH.
    Interprofessional Learning for Enhanced Patient Safety: Biomedical Engineering Students and Nursing Students in Joint Learning Activities2019In: Journal of Research in Interprofessional Practice and Education, ISSN 1916-7342, E-ISSN 1916-7342, Vol. 9, no 1Article in journal (Refereed)
    Abstract [en]

    Background: In the last decade, research has highlighted the importance of interprofessional approaches to education and practice. Collaboration between medical practice and engineering has been identified as particularly relevant to developing accountable models for sustainable healthcare and overcoming increased specialization leading to professional barriers. This study aims to analyze insights and understanding expressed by nursing students and biomedical engineering students following a joint learning activity regarding a medical device used in the hospital setting.

    Method: A qualitative approach deriving from a phenomenological view examined an interprofessional learning activity where the focus was on active integration and knowledge exchange.

    Conclusion: The activity was expressed as a positive opportunity for getting insights into perspectives from other professional groups as well as insights into the importance of a system perspective in patient safety. The learning and insights listed in the evaluations included ideas about how the two professional groups could collaborate in the future.

  • Gardell, Malin
    et al.
    The Swedish Red Cross University College.
    Lindström, Hanna
    The Swedish Red Cross University College.
    Jag är inte bara en knarkare: En litteraturstudie om upplevelsen av kontroll och stigma vid substitutionsbehandling vid opioidberoende2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Opioid dependence is a chronic disease. Substitution treatment for opioid addiction involves a lot of rules and control that can lead to stigmatization.

    Purpose: To describe the experience of control and stigma in people with substitution treatment during opioid dependence.

    Method: A literature review with qualitative content analysis inspired by Graneheim & Lundman (2004). The study is based on 14 scientific articles that were applied mainly through the databases Cinahl and Pubmed.

    Result: Two main themes with eight sub-themes emerged. The most prominent in the result was that people with substitution treatment feel stamped as a drug addict. They can also feel suspicious and less credible. Having substitution treatment is associated with shame. One does not always dare to tell the surroundings that one has treatment. Within the framework of treatment, they feel controlled and supervised.

    Conclusion: People with substitution treatment experience stigma in terms of discrimination, preconceived opinions and reduced credibility. Stigma arises in several different contexts, such as work, friends and family, but also in health care and even in substitution treatment. This is because this form of treatment includes a number of rules and controls that make you feel controlled and supervised. This risks contributing to further stigmatization.

  • Holmgren, Jessica
    et al.
    The Swedish Red Cross University College, Department of Health Sciences.
    Paillard-Borg, Stéphanie
    The Swedish Red Cross University College, Department of Health Sciences.
    Saaristo, Panu
    The International Federation of the Red Cross and Red Crescent Societies (IFRC), Geneva, Switzerland.
    von Strauss, Eva
    The Swedish Red Cross University College, Department of Health Sciences.
    Nurses’ experiences of health concerns, teamwork, leadership and knowledge transfer during an Ebola outbreak in West Africa2019In: Article in journal (Refereed)