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Standardization of operating guidelines for veterinary care in evacuation and emergency animal shelters is imperative for an organized response and to facilitate treatment and prevention of medical conditions stemming from the effects of a disaster and the associated outcomes of sheltering. Safeguarding animal welfare through creating guidelines should expedite care, assure consistency, and provide appropriate safety measures for animals and veterinary medical providers. Veterinary integration into an incident command system (ICS) and response training allows for proper allocation of roles and responsibilities, as well as coordination of veterinary supplies and personnel. Central components of the operational model include guidelines for animal identification, triage, medical records, medical treatments, and discharge instructions. An outline for communication with disaster response agencies, as well as animal owners, is aimed to inform appropriate conduct. Improving the animal component of disaster response is integral in meeting societal needs and improving animal welfare in the face of a disaster.
Cutaneous leishmaniasis (CL) is a major health problem in many countries and its current treatment involves multiple parenteral injections with toxic drugs and requires intensive health services. Previously, the efficacy of a single subcutaneous injection with a slow-release formulation consisting of poly(lactide-co-glycolide) (PLGA) microparticles loaded with an antileishmanial 3-nitro-2-hydroxy-4,6-dimethoxychalcone (CH8) was demonstrated in mice model. In the search for more easily synthesized active chalcone derivatives, and improved microparticle loading, CH8 analogues were synthesized and tested for antileishmanial activity in vitro and in vivo. The 3-nitro-2′,4′,6′-trimethoxychalcone (NAT22) analogue was chosen for its higher selectivity against intracellular amastigotes (selectivity index = 1489, as compared with 317 for CH8) and more efficient synthesis (89% yield, as compared with 18% for CH8). NAT22 was loaded into PLGA / polyvinylpyrrolidone (PVP) polymeric blend microspheres (NAT22-PLGAk) with average diameter of 1.9 μm. Although NAT22-PLGAk showed similar activity to free NAT22 in killing intracellular parasites in vitro (IC50 ~ 0.2 μm), in vivo studies in Leishmania amazonensis – infected mice demonstrated the significant superior efficacy of NAT22-PLGAk to reduce the parasite load. A single intralesional injection with NAT22-PLGAk was more effective than eight injections with free NAT22. Together, these results show that NAT22-PLGAk is a promising alternative for single-dose localized treatment of CL.
It is a consummate fact that the youths occupy, during the adolescence most of the day in the school, being that many prominent behaviours for the health are initiated in this phase of the life. It is for that fundamental that the schools be health promoters spaces.Objectives : to know the age of initiation to the consumption of alcoholic beverages, tobacco and illicit drugs in this sample; to calculate the prevalence rate of these consumption; to identify priority areas to approach in the Health Education process.
This is a descriptive and cross-sectional study, that is going to identify behaviours of risk for the health of High School students of Douro Region. The sample is constituted by 466 students of seven schools. The data were collected through a questionnaire on line, of Janeiro to March of 2007, disposed in the site http://jovemsaudavel.com.sapo.pt, designed for the effect. In the data treatment we utilize the statistical descriptive and the qui-square test.
The ages average of initiation to the consumption of alcoholic beverages, tobacco and illicit drugs is 12,5, 12,3 and 13,6 years, whereas the prevalence's of these consumption are 38,9%, 16,9% and 6,0%, respectively. Highlights-itself the sporadic consumption of alcoholic beverages (28,4%), the abusive consumption of tobacco (9,4%) and of illicit drugs (1,8%). The boys swallow beverages and smoke with bigger frequency than the girls ((c2: p = 0,006 and 0,001). They had intercourse relations already 27,7% of the students of this sample, of the which 11,9% did not use protection.
Bipolar disorder (BD) is a highly heterogeneous and heritable psychiatric illness. Age at onset has been shown to be a powerful tool for dissecting both the phenotypic and genetic complexity of BD. In this article, we present findings from an association study between the DRD2 TaqIA polymorphism and age at onset, showing that both alleles and genotypes at this locus associate with early onset BD.
The World Health Organization (WHO) Somatoform Disorders Schedule (SDS) is a highly standardized instrument for the assessment of somatoform disorders according to the tenth revision of the International Classification of Diseases (ICD-10) and the fourth edition of the Diagnostic and Statistical Manual (DSM-IV). The SDS was produced in the framework of the WHO International Study of Somatoform Disorders and tested for its reliability in Brazil, India, Italy, the USA and Zimbabwe. A sample of 180 patients from general psychiatry, primary care and general medical settings were interviewed with the SDS within a three-day interval by nonclinician and clinician interviewers. The agreement between the two interviews was tested using the intraclass correlation coefficients (ICC) and kappa statistic. The test-retest reliability of the SDS was found to be very good (the ICC for all the centres was 0.76; overall kappa value for SDS questions was 0.58; one-third of SDS questions had a kappa value of 0.60 or higher). The field test results of the SDS indicated that the instrument may be administered in larger studies by non-clinician interviewers without compromising the ability to document the prevalence of somatoform disorders in different cultures.
Non-specific chronic low back pain is one of common causes of disability and a recurrent medical complaint with high costs. From rehabilitative medicine, physiotherapy programs and general postural recommendations are offered. Although this treatment is aimed to reduce disability, severity of pain and anxiety-depressive symptoms, many patients report partial improvements and recurrence of pain. Therefore, a new approach to treat this pathology with a broaden focus on psychososocial issues that might modulate pain and its evolution is required.
Aims and hypothesis
To assess the effectiveness of two complementary interventions to physiotherapy, such as relaxation techniques (specifically, sophrology) and cognitive behavioral intervention. It is hypothesized that intervention groups will significantly improve their adherence to physiotherapy and will gain control over their pain. Ultimately, this will foster better quality of life.
Longitudinal design with pre-post intervention measures and follow-up appointments (at 6 and 12 months) carried out in a sample of 66 participants. The sample will be divided into three groups: control (physiotherapy), intervention group 1 (physiotherapy & sophrology) and intervention group 2 (physiotherapy & cognitive behavioral intervention). In all groups biomedical aspects regarding type, evolution and characterization of pain as well as several psychosocial factors will be assessed.
Preliminary results are expected by December 2013.
If hypotheses are confirmed, we will be able to provide empirical evidences to justify a multidisciplinary care model for chronic low back pain, which will favor a significant cost reduction in terms of health care and human suffering.
A group of intercompany job is constituted from the DSMs of the ASLs of Biella (BI), Novara (NO), VCO, Vercelli (VC) and of the Psychiatric Clinic of the AOU of Novara (NO) finalized to the definition of relief runs for the patients with Eating Disorders (ED). Currently they result active 2 ambulatory devoted to the ED near NO and VCO. In the AOU NO a collaboration is active with the dietology and a daily DH with activity of group for patient with different diagnoses. To Borgosesia (VC) a project of promotion and prevention it is active in the secondary (course of formation for teachers, job with the students) schools. In the DSM NO it is active a program of food education in the schools. Patients affections from ED currently in load: AOU NO 47 (2 AN Purging, 5 AN Restrictive, 2 BED, 20 Bulimia, 18 EDNOS); DSM NO 15 (7 AN, 5 Bulimia, 3 EDNOS); DSM VCO 27 (10 AN, 5 Bulimia, 12 EDNOS); DSM VC 21 (5 AN Purging, 1 AN Restrictive, 6 Bulimia, 9 EDNOS); DSM Arona (NO) 13 (4 AN, 9 Bulimia); DSM BI 20 (8 AN, 8 Bulimia, 4 EDNOS). In the last two years the followings have been effected refuges in Therapeutics Community specific (CT) for ED: 3 near the CT to Moncrivello (VC) and 1 near the CT to Cuasso al Monte (VA). Besides the structures of the DSM they are present associations of relatives and volunteers (informative counter).
The authors intend to analyse through a historical and philosophical perspective, the relationship between nihilistic delusions content and ideas expressed in remarkable literary works addressing the Nihilism theme.
Report of two clinical cases of patients with nihilistic delusions. Review of relevant literature collected from PubMed and other medical internet databases under key-words “nihilistic delusions”, “nihilism”, “Cotard syndrome” and “psychotic depression”. Review of relevant historical and philosophical literature.
First descriptions of nihilistic delusions were made by Jules Cotard, who described a syndrome with his name in middle nineteenth century. First references to the Nihilistic philosophy are contemporary to that, initially by Jacobi and later on by other philosophers, including Nietzsche, who was its main propeller. Some literature propose that Nietzsche suffered from migraine and mental illness, namely bipolar disorder.
Cotard's Syndrome refers to the delusional belief held by patients that they are dead, do not exist, are putrefying or have lost their blood or internal organs. Nihilistic philosophy posed great influence to world's thinking of XIX and XX centuries. Analysis of Nihilistic philosophy works show ideas that resemble the ones reported by patients with nihilistic delusions.
Cardinal ideas expressed by Nietzsche in some of his works, relating to the nihilistic thematic, may have been influenced by an altered mental state, with manifestations compatible with Cotard syndrome which can be associated with bipolar disorder, migraine or organic cerebral pathologies.
Migration of mental health professionals is an important phenomenon influencing mental health services of host and donor countries. Data on medical migration in Europe is very limited, particularly in the field of young doctors and psychiatry. To research this hot topic, the European Federation of Psychiatric Trainees (EFPT) conducted the EFPT Brain Drain Survey.
To identify the impact of previous short-term mobility on international migration and to understand characteristics, patterns and reasons of migration.
In this cross-sectional European multicentre study, data were collected from 2281 psychiatric trainees across 33 countries. All participants answered to the EFPT Brain Drain Survey reporting their attitudes and experiences on migration.
Two-thirds of the trainees had not had a short-mobility experience in their lifetime, but those that went abroad were satisfied with their experiences, reporting that these influenced their attitude towards migration positively. However, the majority of the trainees had not had a migratory experience of more than 1 year. Flows showed that Switzerland and United Kingdom have the greatest number of immigrant trainees, whereas Germany and Greece have the greatest number of trainees leaving. ‘'Pull factors'’ were mostly academic and personal reasons, whereas ‘'push factors'’ were mainly: academic and financial reasons. Trainees that wanted to leave the country were significantly more dissatisfied with their income.
The majority of the trainees has considered leaving the country they currently lived in, but a lower percentage has taken steps towards migration.
blepharospasm is a focal dystonia of the orbicularis oculi muscles, provoking intermittent or sustained eye closure, sometimes severe enough to cause functional blindness. Basal ganglia connections seem to have a major role in its still largely unknown physiopathology. Though usually idiopathic, in the last decades many authors have been linking it to neuropsychiatric diseases, such as obsessive-compulsive disorder. Hemifacial spasm (HFS) consists in unilateral, sudden and intermittent contraction of muscles innervated by the facial nerve. Unlike blepharospasm, an identifiable etiology is frequent. Current best treatment for both diseases consists in botulinum neurotoxin type A application (BoNT/A).
to characterize psychological profile of patients with idiopathic blepharospasm or HFS and analyze significant differences.
consecutive patients diagnosed with one of the above mentioned diseases, visiting an outpatient clinic of BoNT/A application, were evaluated regarding the existence of stress, depression, and obsessive-compulsive behavior. Personality traits, quality of sleep and quality of life were also analyzed. Validated scales were used to assess these domains.
eighty patients were included, 43 with HFS and 37 with idiopathic blepharospasm. After explanation and agreement, demographic, social and clinical data was collected, in addition to questionnaires. Statistical analysis focuses on group differences and correlation with clinical and psychological parameters.
the proposed involvement of basal ganglia in motor and affective domains of blepharospasm must lead to a comprehensive approach of these patients, including a psychological evaluation and pharmacological treatment directed not only to motor spectrum, as it is currently usual, but also matching coincident psychopathology.
Trazodone is a 5-HT(2) antagonist and 5-HT reuptake inhibitor (SARI), and an antidepressant with therapeutic effects on its target symptoms depressed mood, anxiety and insomnia [1,2]. The aim of our study is to present a possible line of treatment of a depressive episode in bipolar disorder type II with three case report.
BT is a 35-year-old Caucasian lady affected by bipolar disorder type II with a depressive episode. CA is a 40-year-old Caucasian lady affected by bipolar disorder type II with recurrent depressive episode with atypical symptoms. FR is a 38-year-old Caucasian gentleman affected by bipolar disorder type II with recurrent depressive episode. All patients are treated with trazodone immediate release subsequently increased up to 50-75 mg/day. After 6 months of treatment the patients showed a good outcome.
Discussion and conclusion
These case reports underscore the possibility of tailoring therapeutic strategies for the treatment of depressive episode in bipolar disorder type II. Our interest in trazodone lies in the possibility of treatment of depressive episode with the added benefit of resolution of affective symptoms, with fewer adverse effects and a well done effect in this patients. Moreover our opinions is that a therapy like trazodone with this particular profile of action, could represent a new strategy of tratment this patients. Further research is warranted to confirm the efficacy of this treatment.
The authors intend to review clinical features, epidemiology and management of bipolar disorder in elderly patients, and discuss the possibility of a sub-classification as late-onset bipolar disorder, concerning a clinical case.
Relevant literature was collected from PubMed database under keywords “bipolar disorder”, “late-onset”; “old age” and “age of onset”; the authors reviewed selected articles, publishing dates ranging from 1994 to 2011. Report of a clinical case of a 72 y.o. female patient without previous psychiatric history, admitted for the first time on psychiatric wards, for affective symptoms.
The clinical presentation initially led to the diagnosis of psychotic depression. After treated with antidepressant and atypical antipsychotic, the patient developed mania symptoms and is currently on mood stabilizer.
Although peak incidence of bipolar disorder is around 30 y.o., several studies have suggested a second peak of elderly-presenting cases. Data shows that the later have a greater proportion of medical comorbidities, especially neurological, and of cases with no familial history, which may suggest that these patients belong to a different aetiological sub-group.
Patients with bipolar disorder with onset at older age differ clinically from younger patients, probably due to different aetiological factors. When an elderly patient without previous history of psychiatric disease is admitted for first episode, late-onset bipolar disorder diagnosis must be considered, concerning therapeutic and prognostic implications.
Pearl millet (Pennisetum glaucum (L.) R.) is an important crop for rainfed production systems and can play a significant role as a feed source for ruminants owing to its high yield and drought tolerance. It is well-established that the maturity stage can influence the chemical composition as well as the nutritional value of crops traditionally used for silage production, although quantitative evidence that this occurs with pearl millet under rainfed conditions is lacking. The current research assessed the agronomic characteristics, ensilability, intake and digestibility of a Brazilian pearl millet cultivar (IPA BULK1-BF) harvested at four different growth stages. Forage was harvested at 35, 50, 65 and 80 days after sowing and ensiled under laboratory and farm conditions. Apparent digestibility of the silages was determined using 24 male lambs. The results showed that dry matter (DM) and panicle and stem proportions increased with the advancement maturity. The silage evaluations showed that DM, total and non-fibrous carbohydrates and lignin concentrations increased, while crude protein, ADF and in vitro DM digestibility decreased with the increase in plant maturity. Additionally, the fermentation characteristics were improved with the increasing maturity. The digestion study showed that intake of DM and N as well as digestibility of DM and fibre fractions decreased, while lignin intake increased. The results obtained for the production of dry and digestible DM, the ratio of plant fractions and fermentation parameters indicate the possibility of harvesting pearl millet forage after 50 days after sowing for silage production in the Brazilian semi-arid region.
It is known that the level of dietary protein modulates the enzymatic activity of the digestive tract of fish; however, its effect at the molecular level on these enzymes and the hormones regulating appetite has not been well characterised. The objective of this study was to evaluate the effect of CP on the activity of proteases and the expression of genes related to the ingestion and protein digestion of juveniles of red tilapia (Oreochromis sp.), as well as the effects on performance, protein retention and body composition of tilapia. A total of 240 juveniles (29.32 ± 5.19 g) were used, distributed across 20 tanks of 100 l in a closed recirculation system. The fish were fed to apparent satiety for 42 days using four isoenergetic diets with different CP levels (24%, 30%, 36% and 42%). The results indicate that fish fed the 30% CP diet exhibited a higher growth performance compared to those on the 42% CP diet (P < 0.05). Feed intake in fish fed 24% and 30% CP diets was significantly higher than that in fish fed 36% and 42% CP diets (P < 0.05). A significant elevation of protein retention was observed in fish fed with 24% and 30% CP diets. Fish fed with 24% CP exhibited a significant increase in lipid deposition in the whole body. The diet with 42% CP was associated with the highest expression of pepsinogen and the lowest activity of acid protease (P < 0.05). The expression of hepatopancreatic trypsinogen increased as CP levels in the diet increased (P < 0.05) up to 36%, whereas trypsin activity showed a significant reduction with 42% CP (P < 0.05). The diet with 42% CP was associated with the lowest intestinal chymotrypsinogen expression and the lowest chymotrypsin activity (P < 0.05). α-amylase expression decreased with increasing (P < 0.05) CP levels up to 36%. No significant differences were observed in the expression of procarboxypeptidase, lipase or leptin among all the groups (P > 0.05). In addition, the diet with 42% CP resulted in a decrease (P < 0.05) in the expression of ghrelin and insulin and an increase (P < 0.05) in the expression of cholecystokinin and peptide yy. It is concluded that variation in dietary protein promoted changes in the metabolism of the red tilapia, which was reflected in proteolytic activity and expression of digestion and appetite-regulating genes.
False Memory Syndrome (FMS) is caused by memories of a traumatic episode, most commonly childhood sexual abuse, which are objectively false, but in which the person strongly believes. These pseudomemories usually arise in the context of adult psychotherapy and are often quite vivid and emotionally charged. FMS is rare and sometimes could be confused with psychotic disorder and malingering. The infrequency with which it is encountered makes this syndrome a diagnostic challenge. Failure to diagnose can lead to significant morbidity.
We studied a 26-year-old female with no prior Psychiatric history who started to recall vivid memories of sexual abuse perpetrated by her father, following few sessions of clinical hypnosis. She presented a low mood, disorganized behaviour and aggressivity towards her father when she was admitted to our ward. After a normal CT brain scan and lab tests and a meticulous clinical history, the clinical diagnosis was made. She was successfully managed with supportive psychotherapy combined with mood stabilizer medications.
This case illustrates the unknown field between memory and confabulation and the value of a complete history. Physicians should be alert and keep an open mind about this iatrogenic disorder. Research is needed on the identification of memory mechanisms, specific situations and personality factors involved in this syndrome.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The screen for cognitive impairment in psychiatry (SCIP) is a brief, accessible scale designed for detecting cognitive deficits in psychiatric disorders.
The objective of this study is to test the SCIP's validity as a cognitive test by comparison with standard neuropsychological scale using the Pearson's correlation.
Aims Test the convergent and discriminant validity of the SCIP within the Italian SCIP validation project.
Patients between 18 and 65 years who are in a stable phase of the disease, diagnosed with schizophrenia, schizoaffective disorder or bipolar I disorder were enrolled in this study, from the community mental health department of Ferrara.
The tests were administered to 110 patients (mean age: 45 ± 11,4) and to 86 controls (mean age: 35 ± 12,6) of both sex. SCIP presents high correlation with the R-BANS total score (P < 0.01) and the subscales (verbal learning test-immediate, working memory, verbal fluency test, verbal learning test-delayed, processing speed test, P < 0.01). There are significant differences (P < 0.01) in all SCIP dimensions between patient and control group (Table 1).
Our analysis confirm the results of the English, French and Spanish version of the SCIP regarding convergent and discriminant validity. The SCIP represents a valid, simple and brief screening tool for the cognitive evaluation of patients with schizophrenia-spectrum disorders.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Unemployment is common in persons with severe mental illness (SMI) and more in Latino population. Department of Mental Health and Addiction Services (DMHAS) of Connecticut offers a supported employment (SE) Program to help clients get competitive work in integrated settings with nondisabled workers in the community.
Capture perspectives of key informant groups to describe barriers for linking Latinos with SMI to employment and adapt SE Services for subpopulations.
Four focus groups were conducted (employment specialists, case managers and peer support counselors/employers/two with clients-one in Spanish and other in English). They were conducted during January-February 2015, 70–90 minutes each one. A question guide was developed for each group. Participants per focus group ranged from 3–10, voluntarily. Two new questionnaires to the baseline pack were developed: challenges to Employment Assessment–provider and client version.
Thirty individuals participated. Several barriers to employment were reported. Clients and staff reported criminal record, lack of employment history and lack of motivation. Staff described client hygiene, mental status, physical health, substance abuse and discrimination. Clients, staff and employers reported language barrier for Latinos who don’t speak English. Non-adherence to medication was reported by clients and employers. About Spanish-Speaking Latinos with mental illness, medication, discrimination, previous abuse by employers, inappropriate employment, difficulties of the job interview and computer skills appeared as challenges. English-Speaking Latinos with mental illness identified transport, stability, support, keeping apartment and financial needs.
Focus groups can help in knowledge about the diversity of Latino communities to improve SE Services and outcomes for Latinos.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Single nucleotide polymorphism (SNP) genotyping tools, which can analyse thousands of SNPs covering the whole genome, have opened new opportunities to estimate the inbreeding level of animals directly using genome information. One of the most commonly used genomic inbreeding measures considers the proportion of the autosomal genome covered by runs of homozygosity (ROH), which are defined as continuous and uninterrupted chromosome portions showing homozygosity at all loci. In this study, we analysed the distribution of ROH in three commercial pig breeds (Italian Large White, n = 1968; Italian Duroc, n = 573; and Italian Landrace, n = 46) and four autochthonous breeds (Apulo-Calabrese, n = 90; Casertana, n = 90; Cinta Senese, n = 38; and Nero Siciliano, n = 48) raised in Italy, using SNP data generated from Illumina PorcineSNP60 BeadChip. We calculated ROH-based inbreeding coefficients (FROH) using ROH of different minimum length (1, 2, 4, 8, 16 Mbp) and compared them with several other genomic inbreeding coefficients (including the difference between observed and expected number of homozygous genotypes (FHOM)) and correlated all these genomic-based measures with the pedigree inbreeding coefficient (FPED) calculated for the pigs of some of these breeds. Autochthonous breeds had larger mean size of ROH than all three commercial breeds. FHOM was highly correlated (0.671 to 0.985) with FROH measures in all breeds. Apulo-Calabrese and Casertana had the highest FROH values considering all ROH minimum lengths (ranging from 0.273 to 0.189 and from 0.226 to 0.152, moving from ROH of minimum size of 1 Mbp (FROH1) to 16 Mbp (FROH16)), whereas the lowest FROH values were for Nero Siciliano (from 0.072 to 0.051) and Italian Large White (from 0.117 to 0.042). FROH decreased as the minimum length of ROH increased for all breeds. Italian Duroc had the highest correlations between all FROH measures and FPED (from 0.514 to 0.523) and between FHOM and FPED (0.485). Among all analysed breeds, Cinta Senese had the lowest correlation between FROH and FPED. This might be due to the imperfect measure of FPED, which, mainly in local breeds raised in extensive production systems, cannot consider a higher level of pedigree errors and a potential higher relatedness of the founder population. It appeared that ROH better captured inbreeding information in the analysed breeds and could complement pedigree-based inbreeding coefficients for the management of these genetic resources.
The stable isotope ratios of carbon (δ13C) and nitrogen (δ15N) and total mercury concentrations (THg) of the three marine catfish species Aspistor luniscutis, Bagre bagre and Genidens genidens were evaluated to understand their trophic relationship in northern Rio de Janeiro state, south-eastern Brazil. The δ13C was similar among the three marine catfishes, whereas δ15N was similar in A. luniscutis and B. bagre and lower in G. genidens. THg was higher in G. genidens and lower in B. bagre. The greater assimilation of Sciaenidae fishes and squids by A. luniscutis and B. bagre resulted in smaller isotopic niche areas and trophic diversity but higher isotopic niche overlap, trophic redundancy and evenness. For G. genidens, the similar assimilation of all prey items resulted in the broadest isotopic niche among the marine catfishes. The higher mercury content in G. genidens is consistent with an increased important contribution of prey with a higher Hg burden. The bioaccumulation process was indicated by significant correlations of δ15N and THg with total length and total mass. Additionally, a significant correlation between THg and δ15N reflected the biomagnification process through the food web.