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ABSTRACT IMPACT: This presentation highlights an integrated curriculum in CTR and a scientific entrepreneurship approach to entice and support students and faculty in HP programs into CTR and SE thus expanding the pool of new minority CTR researchers. OBJECTIVES/GOALS: To present the TVMSC as a hub for trainings, mentoring programs, courses, entrepreneurship and support activities for health professionals(HP) and HP students :graduate (GS) and UgS and UgF. Responding to the need for CTR minority researchers, in a virtual setting due to COVID-19 crisis. METHODS/STUDY POPULATION: TVMSC will offer an educational program based in the Center for Research,Entrepreneurship and Scientific Collaboration (CRESCO) with on line courses and workshops in CTR and SE, for HP and students and a continued education curriculum for HP and clinician scientists toward a certification in CTR. Two hands-on experiences: a) a Pilot project program(PiP) with teams composed of an F, that previously completed training cycles and a research experience from a previous project in CTR as PI, with a research mentor and students or an established researcher as a PI with UgS and UgF, and b) participation in a SE team which will engage in training and submission of an SE project proposal. RESULTS/ANTICIPATED RESULTS: By the end of the five-year period the project will have had 200 UgS, 200 GS and 200 F that received online assistance in CTR skills, statistics and SE; 48 UgS and 48 GS with the skills in SEFL. In curricular development the project expects to have 6 online tutorials created, one FLSE online course and 18 modules in CTR content areas available for continued education of HP. Certifications in CTR will be completed by 160F/HPs. The expected participation in CTR on-hands experiences is 32 F, 64 students and 32 established researchers. PiP teams will publish at least 8 scientific papers and SEFL teams will submit at least 5 SE project proposals and 100% increase in CRESCO web based resources DISCUSSION/SIGNIFICANCE OF FINDINGS: This Project and its expected results will provide students and faculty members island-wide with the knowledge, skills and experiences in CTR with IE approach to foster the expansion of a cadre of Hispanic minority CTR researchers in direct benefit of the health of the people of Puerto Rico.
Haemogregarines (Adeleorina) have a high prevalence in turtles. Nevertheless, there is only one Hepatozoon species described that infects Testudines so far; it is Hepatozoon fitzsimonsi which infects the African tortoise Kinixys belliana. Colombia harbours a great diversity of chelonians; however, most of them are threatened. It is important to identify and characterize chelonian haemoparasite infections to improve the clinical assessments, treatments and the conservation and reintroduction programs of these animals. To evaluate such infections for the Colombian wood turtle Rhinoclemmys melanosterna, we analysed blood from 70 individuals. By using the morphological characteristics of blood stages as well as molecular information (18S rRNA sequences), here we report a new Hepatozoon species that represents the first report of a hepatozoid species infecting a semi-aquatic continental turtle in the world. Although the isolated lineage clusters within the phylogenetic clades that have morphological species of parasites already determined, their low nodal support makes their position within each group inconclusive. It is important to identify new molecular markers to improve parasite species identification. In-depth research on blood parasites infecting turtles is essential for increasing knowledge that could assess this potential unknown threat, to inform the conservation of turtles and for increasing the state of knowledge on parasites.
The brown hairy dwarf porcupine Coendou vestitus is a poorly studied Andean species endemic to Colombia. Its current Red List category is contradictory: globally it is categorized as Data Deficient but in Colombia it is categorized as Vulnerable. This contradiction has limited the implementation of conservation programmes. We evaluate the level of rarity of the species and provide consolidated information for a new assessment of its Red List status. We reviewed literature, photographs, and voucher specimens in natural history collections. Using the confirmed records, we estimated the extent of occurrence (EOO) based on the minimum convex polygon and the area of occupancy (AOO) summing the area of grid squares occupied by the species. We found that C. vestitus is very rare, with a small range, low estimated population density, occurrence in only one habitat type and small body size. The species has an EOO of 3,323 km2 and an AOO of 24 km2, based on six confirmed localities, all on the western slopes of the Eastern Cordillera, in the central Andean region of Colombia. Based on the species' rarity, restricted distribution, and threats to its natural habitat, we recommend its categorization as Endangered on the IUCN Red List. This will help delineate research and conservation efforts for this porcupine, which has a highly restricted range and inhabits the threatened Andean forest.
To evaluate the associations of pregestational BMI, gestational weight gain (GWG) and breast-feeding at 1 month postpartum with four patterns of weight change during the first year after delivery: postpartum weight retention (PPWR), postpartum weight gain (PPWG), postpartum weight retention + gain (PPWR + WG) and return to pregestational weight.
In this secondary analysis of a prospective study, we categorised postpartum weight change into four patterns using pregestational weight and weights at 1, 6 and 12 months postpartum. We evaluated their associations with pregestational BMI, GWG and breast-feeding using multinomial logistic regression. Results are presented as relative risk ratios (RRR) and 95 % CI.
Women participating in the Programming Research in Obesity, Growth, Environment and Social Stressors pregnancy cohort.
Five hundred women were included (53 % of the cohort). Most women returned to their pregestational weight by 1 year postpartum (57 %); 8 % experienced PPWR, 14 % PPWG and 21 % PPWR + WG. Compared with normal weight, pregestational overweight (RRR 2·5, 95 % CI 1·3, 4·8) and obesity (RRR 2·2, 95 % CI 1·0, 4·7) were associated with a higher risk of PPWG. Exclusive breast-feeding, compared with no breast-feeding, was associated with a lower risk of PPWR (RRR 0·3, 95 % CI 0·1, 0·9). Excessive GWG, compared with adequate, was associated with a higher risk of PPWR (RRR 3·3, 95 % CI 1·6, 6·9) and PPWR + WG (RRR 2·4, 95 % CI 1·4, 4·2).
Targeting women with pregestational overweight or obesity and excessive GWG, as well as promoting breast-feeding, may impact the pattern of weight change after delivery and long-term women’s health.
Methane (CH4) is a greenhouse gas (GHG) produced and released by eructation to the atmosphere in large volumes by ruminants. Enteric CH4 contributes significantly to global GHG emissions arising from animal agriculture. It has been contended that tropical grasses produce higher emissions of enteric CH4 than temperate grasses, when they are fed to ruminants. A number of experiments have been performed in respiration chambers and head-boxes to assess the enteric CH4 mitigation potential of foliage and pods of tropical plants, as well as nitrates (NO3−) and vegetable oils in practical rations for cattle. On the basis of individual determinations of enteric CH4 carried out in respiration chambers, the average CH4 yield for cattle fed low-quality tropical grasses (>70% ration DM) was 17.0 g CH4/kg DM intake. Results showed that when foliage and ground pods of tropical trees and shrubs were incorporated in cattle rations, methane yield (g CH4/kg DM intake) was decreased by 10% to 25%, depending on plant species and level of intake of the ration. Incorporation of nitrates and vegetable oils in the ration decreased enteric CH4 yield by ∼6% to ∼20%, respectively. Condensed tannins, saponins and starch contained in foliages, pods and seeds of tropical trees and shrubs, as well as nitrates and vegetable oils, can be fed to cattle to mitigate enteric CH4 emissions under smallholder conditions. Strategies for enteric CH4 mitigation in cattle grazing low-quality tropical forages can effectively increase productivity while decreasing enteric CH4 emissions in absolute terms and per unit of product (e.g. meat, milk), thus reducing the contribution of ruminants to GHG emissions and therefore to climate change.
N-acetil-aspartate (NAA) is located inside the soma and dendrites. Its believed to be an indirect indicator of the metabolic activity of these cells. Phosphomonoesters (PME) are involved in synthesis of neuronal membranes and phosphodiesters (PDE) in its degradation. Glutamine, an aminoacid produced by glial cells, is transported into the neurone for its transformation into glutamate and gamma aminobutyric acid.
Review clinical trials performed on schizophrenic patients with SF-MRI, with 31P y 1H, to measure concentration of NAA, PME, PDE and glutamine.
Detecting chemichal alterations that could be used as indicators in schizophrenia.
NAA concentration in temporal and frontal cortex of schizophrenic patients, are significantly lower than in healthy controls. In other trials, differences in NAA concentration (measured in prefrontal cortex) have not been found, comparing patients during their first psychotic episode and healthy controls. Lowered concentrations of PME and increased ones of PDE in prefrontal cortex of schizophrenic patients have been found. Glutamine levels are increased in schizophrenic patients, being directely correlated with the duration of the process. These levels are reduced when antipsychotic drugs are used.
The decrease on NAA levels at schizophrenia onset and on healthy relatives remark its value as an endophenotypical indicator, but not as an illness indicator. Changes on PME and PDE concentrations cannot be used as illness indicators. The increase on glutamine synthesis could be due to glutamatergic hypofunction in schizophrenic patients, but there are other factors that may cause it, so it cannot be used as an indicator.
Despite the high prevalence of obsessive-compulsive symptoms located around 2-3% of the population, there continue to be cases where the characteristics of the patient or the circumstances of their environment, they fall short queries mental health or when they do not for the disorder itself, but for another reason obsessional symptoms worsen.
Expose using clinical case, the existence of patients with obsessive pathology whose characteristics do not seek mental health consultation, until this is associated with a new disease that interferes significantly in vital organization.
We report the case of a man of 88 years old, married at 60, was admitted to the psychiatric consultation at the request of his wife 29 years his junior, for behavioral disorders several years of evolution and history of obsessive symptoms compulsive, which did not interfere with their daily lives by the lack of insight and poor social environment
OCD is included in anxiety disorders.
It is characterized by the presence of obsessions and compulsions that interfere with personal, work and / or patient's social.
There are cases that own personality traits of the patient, this disorder is not diagnosed early and choose to go only when associated with worsening cognitive impairment rituals and interfere with family life.
In this exhibition we aim to describe a clinical case and the different consequences that may present additional problems with eating disorders, focusing with emphasis on development and clinical picture. This disorder usually occurs in non-obese adolescents accused, showing symptoms significantly related to interpersonal functioning of these adolescents, who tend to be isolated or seek company of younger guys. They are characteristic of obsessive-compulsive disorders related or unrelated to the food. Dietary restriction involves biological and physical changes, highlighting the alteration of hypothalamic and endocrine system, leading to signs and symptoms such as amenorrhea, cold intolerance, hypotension … Neurochemical changes have also been attributed to malnutrition.
The present case is a 31 year old woman. Initiates contact with Mental Health at age 15 by anorexia nervosa. Patient requests for worsening nutritional status, family relationships, and alcohol consumption, being the turning point and main motivation, the birth of his daughter. 8 months ago gave birth, being an unexpected delivery at home. Unaware that pregnancy, justifying as secondary amenorrhea eating disorder and abdominal inflammation malnutrition. Daughter born seven months income requires low weight and withdrawal symptoms during pregnancy as continuous with anxiolytic and antidepressant treatment.
It has a favorable, always maintaining therapeutic commitment announced at the beginning of tratamiento. Currently still in out patient reviews with Psychiatry, Clinical Psychology, Nursing and Nutrition.
Immigration in Spain is from the early ‘90s phenomenon of demographic and economic importance, according to INE, in January 2011 first residing in the country nearly 6.7 million people born outside our borders. In recent years, many immigrants are living in especially difficult circumstances.
Show that these people undergo a series of very specific stressors and duels: precarious and harsh working conditions, poor diet, loneliness and lack of social support… This would enhance the appearance of psychiatric symptoms in various areas, closely related to lifestyles that maintain and in some cases precipitate substance use in this group, primarily those that have a sedative profile.
We will present the clinical case of a 34 year old Nigerian male. No somatic or psychiatric history of interest. Cannabis smoker since adolescence. A year after his arrival in Spain admitted to our inpatient unit due to clinical psychotic. Was a challenge from the point of view of psychopharmacological have many side effects with low doses of typical antipsychotics
Disappearance of psychotic and affective symptoms to approach the case from a pharmacological perspective, social and cultural.
Addressing the relationship between life stressors and cannabis as a trigger or catalyst for psychotic episodes in individuals predisposed. Pathological elaborations of cultural integration of an immigrant (whether by denial of the original culture or over-identification with the host culture) facilitates the use of toxic either for blending with Western consumer culture or cultural consumption radicalization toxic in some East African countries.
Currently the Eating Behavior Disorders have become a social and health problem of the first kind that requires a specialized and interdisciplinary approach to these disorders. These clinical conditions are characterized by their complexity and diversity symptomatology, which implies a significant interference in their functioning in different areas of life and clinically significant distress.
Given the high burden of care in the USMC that difficult to monitor these patients at appropriate intervals, as well as the seriousness of the clinical and physical complications that can result, ultimately, in death, it seems necessary to implement group interventions to ensure greater continuity of care.
In all forms of group therapy underlying common advantages which advocate their implementation. Recent studies show that group therapy for eating disorders is equally effective as individual treatment. So in the USMC - Huelva conducted a psychotherapeutic group aimed at people with these clinical pictures. The present work is to analyze the impact of the intervention group in the eating disorder symptoms, anxiety and depression, comparing the results obtained in the tests applied before and after treatment.
Psychometric tests used were:
- Beck Depression Inventory (BDI)
- Inventory of State-Trait Anxiety Inventory (STAI)
- Inventory of Eating disorders (EDI)
The results reflect a clinically relevant improvement in both psychometric testing quality indicators (no hospitalizations, no emergency service attendance, adherence, etc.)
We should consider that group psychotherapy has unique properties that offer individual psychotherapy.
Given the high prevalence, severity and difficulty recognizing psychiatric disorders in patients with TBI, it is necessary to conduct a detailed history, gathering information on the location of the lesion and its relationship with the table in the psychopathological examination.
Illustrated by a clinical case, the close relationship between the injury of specific brain areas and the emergence of psychopathology that allows us to deepen the understanding of the biological substrate of mental disorders.
Exposure of a clinical picture and brief literature review of the existing literature.
We report the case of a man of 49 years old, no personal or family history was admitted to the hospital after a traffic accident with severe TBI. Computed tomography (CT) scan shows intraparenquematoso right temporal hematoma, subarachnoid hemorrhage, subdural hematoma right, pneumocephalus front right, front left fracture of both orbits and right maxillary sinus.
The interest in the study and the relationship of psychiatric symptoms with the location of the lesions, we can provide improved understanding of the biological basis of mental disorders.
Recently, a renaissance of interest in ‘negative symptoms’ as emotional withdrawal or blunted affect, has occurred. Some investigators believe that these symptoms are important indicators of outcome, of response to treatment and of a distinct underlying pathologic process.
Research on the negative-symptom syndrome in schizophrenia has been handicapped until recently.
This research aims at studying whether acute phase proteins, precisely, Alpha1-glycoprotein, can be considered as a marker of negativesymptom in Schizophrenia.
29 chronic schizophrenics were assessed by the Positive and Negative Syndrome Scale (PANSS). A routine blood test including Alpha1-glycoprotein levels was carried out.
Alpha1-glycoprotein shows a positive correlation, according to Pearson correlation coefficient, with the Negative Scale at an almost significant level (p=.05), and at a significant level in the following items, Blunted affect (p=.03), Passive/apathetic Social Withdrawal (p=.01) of the Negative spectrum and Poor Attention (p=.02) of the General Psychopathology Scale.
There is a significant correlation with two Negative variables and an almost significant one, spite of the small sample, with the Negative Scale. Further studies with bigger samples are needed in order to consider alpha1-glycoprotein as a schizophrenia negative psychopathology marker.
Suicide is a public health problem of the first magnitude for both its costs and its implications for the population. The attention to suicide attempts is itself one of the first reasons for psychiatric consultation, if not the first, in hospitals. Among the risk factors for suicide is the presence of mental disorders on Axis I and II, and the existence of previous attempts.
Studying the behavior of some of the risk factors for suicide known (psychiatric history and previous attempts) in a sample from service Emergency Hospital Juan Ramón Jiménez
Performed a retrospective analysis (for a period of 6 months of 2013) of the risk factors associated with suicidal behavior of patients seen in the emergency department of our hospital for attempted suicide.
In an interim analysis found that up to 50% of patients treated for attempted suicide had made ??previous attempts. Most of them had any axis I disorder (> 75%) and were or had been in outpatient psychiatric follow. Extensive treatment with psychotropic drugs performed most (> 80%)
The high number of cases with previous attempts provides a clear example of the problem of suicidal behavior relapse. The importance of this is increased when you consider that most were receiving or had received psychiatric treatment, reflecting the limitations in our daily clinical practice we have to control this pubic health problem.
In the last years and due to the progressive aging of the population, consultations in people over 65 have increased, and this fact is also evident in psychaitry. This also affects in inpatients psychiatric units.
The objective is to review patients older than 65 years admitted over a year in an inpatient psychiactric Unit.
It is to analyzed using a descriptive study of sample patient over 65 who have been admitted during the year 2013, analyzing their most important characteristics, and the main differences with respect to the overall package of the adult population that income during the same year.
We reviewed a total of 679 patients during the 2013, of which 61 income corresponded to persons older than 65 years. The most important results were that the income in this age group were increased approximately 20% compared to the previous year. The average stay of income was one more day (16 versus 17.3 days), due to the fact that 80% of the patients had somatic comorbidity during admission.
In this group of age, the reasons for admission and the diagnosis at discharge were the same, affective disorders (36 % and 41 % respectively).
The elderly patients occupies an increasingly important place in our society due to the aging of the population and the constant need of resources, both social and health. As we have seen, differs from the general population, which would bring attention to their needs in a more specialised way.
Suicidal behavior is a serious public health problem, being one of the leading causes of death in our country. Therefore, the identification of factors that increase or decrease the level of suicidal risk is of great importance for the close link with the conduct. There are several risk factors, including family and contextual, among which are the loss of significant others, including those that have been produced by suicide.
In this paper, we analyze these factors in a group of patients performing a Group Therapy.
Several studies point to the existence of a moderate correlation between the BDI item 9 (‘suicidal impulse’) with a higher score on the SSI. Another goal is to check whether this relationship is between the members of our group.
To this end, two scales were administered prior to the start of Therapy: Beck Depression Inventory, a self-report scale, and the Scale of Suicide Ideation Beck (hetero).
Our study confirms the existence of a moderate correlation between BDI item 9 (‘suicidal impulse’) and SSI. Therefore, item 9 of the BDI predicts a moderate way the result of the SSI that is related to suicidality. Similarly there is a significant correlation between total BDI SSI. We conclude that the intensity of the symptoms of depression is related to suicidality.
Consider necessary after evaluation and detection of these high-risk individuals, conducting therapeutic work aimed at the prevention of suicidal behavior within the individual treatment plan for these patients.
The potential suicide is a person with intense suffering and is always a serious patient, for whom by their despair, future expectations do not exceed a painful present.
Expose more carefully try this idea by describing a case of a patient with highly lethal suicide attempts, severe, recurrent (repeated blows with a hammer to the skull, incised wound in the abdomen after a knife stab, multiple cuts with a knife upper and lower limbs …). Besides these aspects, point out the risk factors found in this patient and further foster suicide problem. Borderline personality disorder and depressive disorder, in which we highlight a high difficulty in solving problems and hopelessness, the harmful use of cocaine and alcohol, and demographic factors such as age, gender and part of socially minority group. The profile of temperament and personality point out a tendency to novelty seeking and harm avoidance, coupled with aggressive and impulsive behavior, without a clear definition of objectives and targets, and low capacity for cooperation which is observed by manipulative attitude posing in repeated hospital admissions.
Therefore, we emphasize that suicide is a complex entity and their pricing strategies, risk detection and prevention, are hampered by the lack of a definition and classification operative. That said, and considering that you have to work in a comprehensive manner, we considered what we should prioritize in the treatment of this patient to prevent another attempted suicide, is the psychiatric disorder, substance use, social status risk that found, or suicidal symptoms itself?
Delusional ideas disorder is characterized by the appearance of a single delusional theme or a group of related ideas together, which normally are very persistent.
This, plus the fact that the definition of the disorder have been changing and that these patients rarely seek psychiatric help, makes it difficult to accurately assess their epidemiology, but it is estimated that delirious take between 1 and 4% of psychiatric entries and its prevalence in the general population is 0.03%.
Analyze the variables that influence the clinical evolution.
- Risk factors
- Protective Factors
Rate the treatments tested in Mental Health since the patient is diagnosed.
Analysis of the clinical history of the patient's mental health. Results-Case report
Male, 36, who was diagnosed with delusional disorder at the age of 21, after starring an episode of hetero-aggressiveness to objects.
From the beginning is characterized by delusional interpretations of referential character, gradually reaching a systematic structure delusional. Secondarily, this causes episodes of behaviour disorders with occasional psychomotor agitation, important social isolation and withdrawal, seriously affecting their daily functioning.
During a year, he required four hospitalizations for exacerbation of clinical psychotic delusional self-referential and prejudice delusional ideation, with intense feelings of hopelessness and suicidal ideation.
Since the possibilities of treatment of this disorder are limited by little or no disease awareness and that his delusions are usually highly structured, we find it important continue investigating the keys to achieving higher therapeutic adherence and successful social adaptation despite continue with chronic delusional ideation.
Concerns about the body and food are present in much of the population. Furthermore, alteration in eating behavior as a symptom may be part of the symptomatology of various clinical profiles. And, of course, is the main symptom of eating disorders.
One of the features offered by these tables is the high comorbidity posing with axis I disorders and Axis II. According to the literature, about half of women with ED experience anxiety disorders. Regarding affective disorders, between 20 and 80% developed at least one major depressive episode during their lifetime. Personality disorders are highly prevalent in this population, mainly the cluster B and C, linking the first and second BN with AN.
The overall goal of this work is to analyze the comorbidity of these diagnosis.
Our research is a descriptive analysis of a sample of 30 patients from the USMC-Huelva with different diagnoses of eating disorders.
The variables studied are:
- Main diagnosis
- No. of entries at Unit Mental Health Hospitalization
- Consultations in the Emergency Department
The results show that the majority of patients have been diagnosed with anorexia nervosa purging type. These patients, mostly, have another disorder, highlighting dependence disorders and / or substance abuse, anxiety disorders and personality disorders. In the sample studied, three of the subjects required hospitalization in Mental Health, and of these, only one was due solely to own principal diagnosis criteria (malnutrition).
The importance of a comprehensive approach that includes history of each patient and associated disorders.
Ahe adult patients with attention deficit hyperactivity disorder (ADHD) are characterized by an increased vulnerability to daily life stressors. Cortisol awakening response (CAR) can be used as an index of the adrenocortical activity that relates to chronic stress. Although gender differences in cortisol response have been explored in children with ADHD, there is a lack of gender studies in adults with this disorder.
The aim of the present study is to evaluate possible gender differences in CAR in adults with ADHD.
A total of 50 patients (22 female, age 37.00±8.62 years, and 28 male, age 33.86±9.57 years), with ADHD were recruited from the program for adults with ADHD in the Department of Psychiatry of the Hospital Universitari Vall d’Hebron. Patients fulfilled current DSM-IV diagnostic criteria for ADHD. Psychiatric and organic comorbid disorders were excluded and all the patients were naïve to psychostimulant treatment. Four salivary cortisol samples were collected at 0, 30, 45 and 60 minutes after awakening (work days).
Mean increase in CAR was 10.39±8.68 nmols/l for men and 10.29±9.13 nmols/l for women. T-test comparisons showed no significant gender differences in CAR in adults with ADHD (t= 0.033, z=0.974).
As reported in children, adults with ADHD show no differences in CAR. Albeit these results are still preliminary, they suggest some gender differences in CAR between adults with ADHD and cortisol response in general population.