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The risk of abuse/dependence of alcohol or drugs in schizofrenia have been estimed about 4 times the prevalence in general population. This fact difficults the treatment results and efficcacy: more relapses, more treatments withdrawal and poorer prognosis. The aims of our study is to evaluate the effect of Zyprasidone, an atypical antipsychotic with 5HT propierties, in patients with schizofrenia and comorbid substance use disorder in a single, open, prospective-naturalistic design.
36 outpatients were selected with Schizofrenic disorder diagnosis (DSMIV) and abuse/dependence of at least 1 substance in which Zyprasidone was recommended (inneficacy, intolerance of prior treatments,..). They were evaluated clinically and data about actual consum and craving were collected at inicial visit and follow-up monthly (3 to 6 months). Results were analized with SPSS pack.
The mean follow-up period was 3 month. 28 patients finished the evaluation showing a decrease in clinical measures (PANSS, ICG) with good tolerance (only 4 drop-outs associated to indesirable effects). The most frequent drug use disorder was tobacco followed by alcohol and cannabis.The results on number and frequency of drug use shows a slow tendency to reduce at the end of the evaluation as well the craving measures but no significant differences were found.
Our exploratory study with Zyprasidone, althougt metodological limitations, suggests that clinical schizofrenic symptoms can improve but also drug pattern use. Naturalistic studies of schizofrenia with comorbid substance use disorder can be useful to show the efficacy of antipsychotics in real clinical practice
A prospective study in treatment-resistant schizophrenic patients was performed over 10 years to evaluate the therapeutic response to clozapine and the variables related to this treatment. Eighty schizophrenic and schizoaffective patients (according to Diagnostic and Statistical Manual [DSM]-IIIR criteria), considered as refractory (previously resistant to at least two different typical neuroleptics), were studied. The average dose of clozapine was 267 mg/d. The clinical variables considered were: Brief Psychiatric Rating Scale (BPRS), number of admissions before and after clozapine treatment and the Strauss-Carpenter scale as measures of efficacy; Premorbid Adjustment Scale (PAS), to assess personal and social adjustment before illness; Karolinska Personality Scale (KPS) to assess stable traits of personality; and the Simpson-Angus scale as a measure of extrapyramidal symptoms. Sixty percent of patients showed a significant improvement after clozapine treatment. Side-effects were mild and well tolerated, with no cases of haematological disturbance and only five withdrawals because of adverse events. The severity of the episode, according to BPRS score and anxiety as a personal trait, are related to good prognosis. Other relationships between improvement and clinical and demographic variables are discussed.
Previous studies reported that music therapy (MT) exerts a positive effect on many medical and neuropsychiatric disorders. The use of MT has been proposed also for patients with severe mental illnesse (SMI), altrough further studies are still needed. The aim of the present study was to evaluate the effects on a structured MT program on clinical and social functioning indices of patient with SMI, hospitalized in an psychiatric emergency ward.
The MT intervention followed the Benenzon model of MT and was delivered biweekly to 61 patients consecutively admittted to the psychiatric emergency ward. Subjects who did not complete the two-week MT intervention (N=45) were considered as the control group. all subjects were administred the Brief Psychiatric Rating Scale (BPRS) to evaluate the general psychopatology, the Hospital Anxiety And Depression Scale (HADS) for affective symptomatology, the Clinical Global Impression Scale (CGI-S) for severity of symptoms and the Global Assestment of Functioning (GAF) for psychosocial functioning.
A repeated measures analysis of variance revealed that patients who unerwent the MT intervention had a statistically significant reduction of general and affective psychopatology scores and of symptoms severity with respect to the control group, after observation period.
Our result are in line with previous studies confirming that MT may exert positive effects on psychopatology (in particular, on affective symptomatology) of patient with SMI, and extend this observation to an emergency setting, with short period of hospital stay.
Discrimination towards people with schizophrenia (PWS) by healthcare professionals is responsible of underdiagnosis and undertreatment of these patients. Negative attitudes toward PSW in health care professionals tend to be present since their university studies and are related to their knowledge and experience about the disease.
Objectives and aims
To assess opinion towards PSW in medical, nursing and psychology students and to investigate the relation with their knowledge of schizophrenia and its causes.
The study involved 133 medical, 200 nursing and 296 psychology undergraduate students. The opinion on mental illness questionnaire, the Devaluation Consumers Scale, and the Devaluation of Consumer Families Scale were administered to the sample. ANOVA and ANCOVA were used to test differences between groups and the relation between causal explanation of schizophrenia and discrimination towards PWS.
Psychology students were more aware than the other student of public stigma towards PWS and their families (F 12.57, P < 0.001; F 32.69, P < 0.001) and expressed a more positive view on treatments’ effectiveness (F 30.74, P < 0.001). Psychology (OR 0.48, 95% CI 0.26–0.88) and nursing (OR 0.29, 95% CI 0.15–0.55) students were more likely to identify psychological and social risk factors as more frequent causes of schizophrenia (vs. biogenetics) and these, in turn, were related to a better opinion towards social equality of PWS.
These preliminary findings underline the relevance of biopsychosocial model of schizophrenia within stigma-reduction programs for health science students.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
QTc interval prolongation is considered a risk factor for fatal polymorphic ventricular tachycardia, which can result in sudden cardiac death. Most psychotropic drugs have a dose-dependent potential to prolong the QTc interval. However, other factors require appropriate consideration, including: age; gender; other medications; electrolyte abnormalities; severe comorbid conditions, such as co-occurring alcohol or substances abuse/dependence.
The objective was to study the potential mediating roles of alcohol/substances abuse on QTc prolongation.
The Italian research group STAR Network, in collaboration with the Young Italian Psychiatrists Association, aimed to evaluate the frequency of QTc interval prolongation in a sample of patients under treatment with psychotropic drugs through a cross-sectional national survey.
A sample of 2411 unselected patients were enrolled after performing an ECG during the recruitment period. Sociodemographic and clinical characteristics were collected from medical records. Collected data underwent statistical analysis.
A total of 11.2% of patients reported alcohol abuse, and only 8.9% psychotropic substances. According to the threshold, less than 20% of patients had a borderline value of QTc, and 1% a pathological value. Patients with co-occurring alcohol misuse and drug abuse were more likely to have longer QTc interval.
The present study describes the frequency of QTc prolongation in real-world clinical practice. Before prescribing a psychotropic drug, the physician should carefully assess its risks and benefits to avoid this type of adverse reaction, particularly when additional risk factors are present. The potential role of alcohol and substances on QTc length could be particularly useful in emergency settings.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
We present very detailed images of the photosphere of an AGB star obtained with the PIONIER instrument, installed at the Very Large Telescope Interferometer (VLTI). The images show a well defined stellar disc populated by a few convective patterns. Thanks to the high precision of the observations we are able to derive the contrast and granulation horizontal scale of the convective pattern for the first time in a direct way. Such quantities are then compared with scaling relations between granule size, effective temperature, and surface gravity that are predicted by simulations of stellar surface convection.
The synthesis of clay minerals has been studied for decades in an attempt to better understand their formation in natural environments and more recently to obtain clay minerals with controlled compositions and properties. Even though nontronite has been synthesized successfully since 1935, the process is not a straightforward and has been poorly documented. In the present review concerning the synthesis of nontronite and other Fe-rich smectites, the experiments attempted in the past are discussed critically in light of the most recent data. Most notably, the application of relationships established recently, thanks to synthetic smectitic series, have allowed us to refine the chemical compositions of some nontronites synthesized previously.
The prevalence of depression in rural Ugandan communities is high and yet detection and treatment of depression in the primary care setting is suboptimal. Short valid depression screening measures may improve detection of depression. We describe the validation of the Luganda translated nine- and two-item Patient Health Questionnaires (PHQ-9 and PHQ-2) as screening tools for depression in two rural primary care facilities in Eastern Uganda.
A total of 1407 adult respondents were screened consecutively using the nine-item Luganda PHQ. Of these 212 were randomly selected to respond to the Mini International Neuropsychiatric Interview diagnostic questionnaire. Descriptive statistics for respondents’ demographic characteristics and PHQ scores were generated. The sensitivity, specificity and positive predictive values (PPVs), and area under the ROC curve were determined for both the PHQ-9 and PHQ-2.
The optimum trade-off between sensitivity and PPV was at a cut-off of ≧5. The weighted area under the receiver Operating Characteristic curve was 0.74 (95% CI 0.60–0.89) and 0.68 (95% CI 0.54–0.82) for PHQ-9 and PHQ-2, respectively.
The Luganda translation of the PHQ-9 was found to be modestly useful in detecting depression. The PHQ-9 performed only slightly better than the PHQ-2 in this rural Ugandan Primary care setting. Future research could improve on diagnostic accuracy by considering the idioms of distress among Luganda speakers, and revising the PHQ-9 accordingly. The usefulness of the PHQ-2 in this rural population should be viewed with caution.
The effects of different dietary levels of maize silage (10% v. 36% DM) and group size (7 v. 14 animals) were assessed on growth performance and in vivo digestibility of 28 male fattening buffaloes. In addition, the effects of diet on meat quality and group size on behaviour and immune response were separately evaluated. Animals were weighed and assigned to three groups. The high silage – low size group (HL) was fed a total mixed ration (TMR) containing 36% DM of maize silage and consisted of seven animals (age 12.7±2.6 months; BW 382.2±67.7 kg at the start of the study). The low silage – low size group (LL) was fed a TMR containing 10% DM of maize silage and consisted of seven animals (age 13.0±2.7 months; BW 389.4±72.3 kg). The high silage – high size group (HH) was fed the 36% maize silage DM diet and consisted of 14 animals (age 13.9±3.25 months; BW 416.5±73.9 kg). Total space allowance (3.2 indoor+3.2 outdoor m2/animal) was kept constant in the three groups, as well as the ratio of animals to drinkers (seven animals per water bowl) and the manger space (70 cm per animal). Growth performance, carcass characteristics and digestibility were influenced neither by dietary treatment nor by group size, even if the group fed 36% maize silage diet showed a higher fibre digestibility. No effect of diet was found on meat quality. Group size did not affect the behavioural activities with the exception of drinking (1.04±0.35% v. 2.60±0.35%; P<0.01 for groups HL and HH, respectively) and vigilance (2.58±0.46% v. 1.20±0.46%; P<0.05 for groups HL and HH, respectively). Immune responses were not affected by group size.
Immature bovine oocytes were vitrified using the cryotop method and their post-warming survivability and capability to undergo in vitro maturation, fertilization and subsequent embryonic development were evaluated. In addition throughout the embryonic 2-cell, 4-cell, morula and blastocyst stages, the expression of four developmentally important genes (Cx43, CDH1, DNMT1 and HSPA14) was analysed using the real-time polymerase chain reaction (PCR). Immature oocytes (n = 550) were randomly assigned to non-vitrified (fresh) or cryotop vitrification groups using ethylene glycol (EG) with 1,2 propanediol (PROH) or dimethylsulphoxide (DMSO). After warming, oocytes survivability, embryo cleavage and embryonic developmental rates were not statistically different between the two cryoprotectants groups. However, the DMSO group had a lower (P < 0.05) oocyte maturation rate compared with the fresh and PROH groups. For morula and blastocyst rates, the DMSO group achieved a lower (P < 0.05) morula rate compared with the fresh group, while at the blastocyst stage, there were no differences between fresh and both cryoprotectants groups. For molecular analysis, at the 4-cell stage, most studied genes showed an inconsistent pattern of expression either from the PROH or DMSO groups. Noteworthily, these differences were limited at the morula and blastocyst stages. In conclusion, the cryotop method is sufficient for vitrification of immature bovine oocytes, both for embryonic developmental competence and at the molecular level. Moreover, PROH showed some advantage over DMSO as a cryoprotectant.
Axial heterostructure nanowires with Si and SiGe segments have been grown using Au metal seed as catalyst by chemical vapor deposition (CVD) via vapor-liquid-solid process (VLS). We report on the effect of growth intervention on the droplet stability which in turn modifies NW morphology and interfacial abruptness. Growth stop of 2 minutes on transition from one material to another have been demonstrated to suppress reservoir effect by Au catalyst. The two SiGe/Si and Si/SiGe heterointerfaces are found to be assymetric. The former being diffused while the latter one is sharp. Furthermore, geometric phase analysis reports elastic deformation at the heterointerface. Nanowire undergoes rotation in both clock and anticlockwise direction at their sidewalls with an angle of 2.5° in order to accommodate this strain.
The aim of the study was the construction of risk maps for exposure to Phlebotomus sergenti, the main vector of Leishmania tropica, with a view to identifying hot spots for the potential establishment of this parasite in the southwest of Europe. Data were collected on the presence/absence of this vector and the ecological and climatic characteristics of 662 sampling sites located in the southeast, centre and northeast of the Iberian Peninsula (south-western Europe). The environmental factors associated with the distribution of P. sergenti were determined. The best predictors for the presence of this dipteran were ‘altitude’, ‘land use’, ‘land surface temperature’, ‘aspect’, ‘adjacent land cover’, ‘absence of vegetation in wall’ and the ‘absence of PVC pipes in the drainage holes of retaining walls’. Risk maps for exposure to the vector were drawn up based on these variables. The validation of the predictive risk model confirmed its usefulness in the detection of areas with a high risk of P. sergenti being present. These locations represent potential hot spots for an autochthonous focus of L. tropica becoming established. The risk maps produced for P. sergenti presence revealed several areas in the centre and south of the Iberian Peninsula to be the most prone to this process, which would make it possible for the disease to enter south-western Europe.
The close environment of Herbig stars starts to be revealed step by step and it appears to be quite complex. Many physical phenomena interplay: the dust sublimation causing a puffed-up inner rim, a dusty halo, a dusty wind or an inner gaseous component. To investigate more deeply these regions, getting images at the first Astronomical Unit scale is necessary. This has become possible with near infrared instruments on the VLTI. We have developed a new imaging method adapted to young stellar objects where we process separately the stellar component from the rest of the image to reveal the environment by using the spectral differences between these two components. We present the result of this method on the first imaging survey of Herbig stars carried out by PIONIER on the VLTI.
Light absorbed by chl. antenna is converted almost instantaneously into charge pairs in photochemical centres, which makes possible excitation by short flashes or modulated light thus generating various absorption, fluorescence or luminescence responses. The possibility of manipulating light excitation at will, together with the abundance of chromophores in the photosynthetic machinery, has favoured the development of optical monitoring of photosynthesis in vivo. The three complementary dimensions of optical methods, spectral, kinetic and imaging, provide unique tools to investigate the photosynthetic energy metabolism and, beyond, the bioenergetic status of the whole cell.
There is not a one-to-one correspondence between the measuring opportunities offered by various chromophores embedded in the thylakoid membranes and the aspects of the photosynthetic process they allow monitoring (Table 10.1). Starting from the mechanisms of light interactions with pigments, we will introduce the optical methods that have proved useful for studying leaf photosynthesis, using ‘intensive’ parameters (ratios such as Fv/Fm, kinetic amplitudes and time constants) that automatically compensate for variations of signal intensity between leaf samples. Other non-photosynthetic optical methods that can be used simultaneously (blue-green fluorescence (BGF), IR reflectance) will be briefly mentioned. Applications of leaf reflectance and fluorescence to remote sensing will be addressed in more detail in Chapter 15 and light absorption by leaves and canopies in Chapter 16.
Introduction, Mandeep K. Dhami, Anne Schlottmann, and Michael R. Waldmann
In conclusion, rather than present a summary of the preceding chapters, we invited nine eminent past presidents of the Society for Judgment and Decision Making (SJDM) to provide personal perspectives on the concept of JDM as a dynamic skill. These scholars were not asked to comment on the chapters in this book, but rather to highlight their personal points of contact with the notion of JDM as a dynamic skill. The following perspectives offer historical accounts, and also point to future lines of research.
Shanteau describes how over the years he has highlighted the importance of training and skill acquisition in JDM, but feels “blue” that this view has not been more popular. Wallsten remembers the benefits of learning for JDM performance found in a study that he conducted 30 years ago, and confesses that he has only recently begun to revisit this important finding. Fischhoff points out that a sound understanding of the normative implications of tasks has laid a better foundation for the study of dynamically changing skills, especially in development. Levin and colleagues provide useful examples of their research on the developmental and neurological bases of JDM skills. Reyna highlights how her fuzzy trace theory taps into JDM processes that develop over time and experience, has neurological correlates, and may be evolutionarily adaptive. Baron reveals how he now finds himself in search of the developmental origins of the types of moral heuristics and biases that he has studied during his career. Hogarth shares three steps he has developed during decades of teaching decision making that can help people make better decisions. Klayman reveals that despite decades of studying learning and development of JDM, he still seeks a greater understanding of how decision makers “get that way.” Finally, Birnbaum points to the methodological factors that have limited our understanding of JDM as a skill, and presents a challenge for future researchers: to explain how and why JDM skills change. Overall, the following perspectives provide a rare glimpse of the personalized views of those who have made significant contributions to the field of human JDM.
The aim of this study was to construct risk maps for the presence of the dominant Leishmania infantum vector, P. perniciosus, and check its usefulness (a) to predict the risk of canine leishmaniasis and (b) to define effective leishmaniasis control measures. We obtained data for the presence/absence of P. perniciosus at 167 sampling sites in southern Spain, from which we also took a series of ecological and climate-related data. The probability of P. perniciosus presence was estimated as a function of these environmental variables and generated spatial risk maps. Altitude, land use and drainage hole features (with or without PVC piping) were retained as the only predictors for the distribution of this vector species. Drainage hole features in retaining walls, with or without PVC piping, produce significant variations in the probability of P. perniciosus presence, varying from 2·3 to 91·8% if PVC piping is absent and from 0·4 to 66·5% if all holes have PVC piping. It was concluded that the use of PVC piping in drainage holes could help to reduce leishmaniasis transmission.
Autism is associated with intellectual disability. The strength and origin of this association is unclear.
To investigate the association between extreme autistic traits and intellectual disability in children from a community-based sample and to examine whether the association can be explained by genetic factors.
Children scoring in the extreme 5% on measures of autistic traits, IQ and academic achievement were selected from 7965 7/8-year-old and 3687 9-year-old twin pairs. Phenotypic associations between extreme autistic traits and intellectual disability were compared with associations among the full-range scores. Genetic correlations were estimated using bivariate DeFries–Fulker extremes analyses.
Extreme autistic traits were modestly related to intellectual disability; this association was driven by communication problems characteristic of autism. Although this association was largely explained by genetic factors, the genetic correlation between autistic traits and intellectual disability was only modest.
Extreme autistic traits are substantially genetically independent of intellectual disability.
Lipases (glycerol ester hydrolases, E.C. 18.104.22.168) are enzymes of
great industrial interest due to their ability to catalyze a broad range
of hydrolytic and synthetic reactions. They find applications in the
synthesis of compounds used in clinical, nutritional, environmental,
pharmaceutical and chemical fields. For example, lipases are used to
catalyze key intermediate steps in the synthesis of biologically active
compounds such as Naproxen, Ibuprofen and Atenolol . Depending on the
application, lipases may need to be purified and characterized
biochemically before they can be used. However, the purification of
microbial lipases is often made difficult by the presence of high
molecular weight aggregates. These aggregates can form due to the
presence, in the fermentation medium, of lipids used to induce the
production of the enzyme by the microorganism or simply due to
hydrophobic interactions amongst the enzyme molecules themselves . In
previous work, we characterized a new lipase produced by Bacillus
megaterium CCOC P2637. The enzyme eluted in the void volume during gel
filtration chromatography, indicating that it was present in the form of
a high molecular weight aggregate. This aggregate was dispersed when a
gradient of 60% (v/v) isopropanol was used, but formed again when the
enzyme was injected in a gel filtration column for further purification,
even when the elution buffer contained 20% (v/v) isopropanol. Further,
when the enzyme was diluted in buffer (phosphate pH 7.0 20 mM)
containing 30% isopropanol, its specific activity was double the
activity obtained by diluting in buffer without isopropanol .