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The efficacy is measured for a public health intervention related to community-based planning for population protection measures (PPMs; ie, shelter-in-place and evacuation).
This is a mixed (qualitative and quantitative) prospective study of intervention efficacy, measured in terms of usability related to effectiveness, efficiency, satisfaction, and degree of community engagement.
Two municipalities in the Commonwealth of Puerto Rico are included.
Community members consisting of individuals; traditional leaders; federal, territorial, and municipal emergency managers; municipal mayors; National Guard; territorial departments of education, health, housing, public works, and transportation; health care; police; Emergency Medical Services; faith-based organizations; nongovernmental organizations (NGOs); and the private sector.
The intervention included four community convenings: one for risk communication; two for plan-writing; and one tabletop exercise (TTX). This study analyzed data collected from the project work plan; participant rosters; participant surveys; workshop outputs; and focus group interviews.
Main Outcome Measures:
Efficacy was measured in terms of ISO 9241-11, an international standard for usability that includes effectiveness, efficiency, user satisfaction, and “freedom from risk” among users. Degree of engagement was considered an indicator of “freedom from risk,” measurable through workshop attendance.
Two separate communities drafted and exercised ~60-page-long population protection plans, each within 14.5 hours. Plan-writing workshops completed 100% of plan objectives and activities. Efficiency rates were nearly the same in both communities. Interviews and surveys indicated high degrees of community satisfaction. Engagement was consistent among community members and variable among governmental officials.
Frontline communities have successfully demonstrated the ability to understand the environmental health hazards in their own community; rapidly write consensus-based plans for PPMs; participate in an objective-based TTX; and perform these activities in a bi-lingual setting. This intervention appears to be efficacious for public use in the rapid development of community-based PPMs.
There is evidence that environmental and genetic risk factors for schizophrenia spectrum disorders are transdiagnostic and mediated in part through a generic pathway of affective dysregulation.
We analysed to what degree the impact of schizophrenia polygenic risk (PRS-SZ) and childhood adversity (CA) on psychosis outcomes was contingent on co-presence of affective dysregulation, defined as significant depressive symptoms, in (i) NEMESIS-2 (n = 6646), a representative general population sample, interviewed four times over nine years and (ii) EUGEI (n = 4068) a sample of patients with schizophrenia spectrum disorder, the siblings of these patients and controls.
The impact of PRS-SZ on psychosis showed significant dependence on co-presence of affective dysregulation in NEMESIS-2 [relative excess risk due to interaction (RERI): 1.01, p = 0.037] and in EUGEI (RERI = 3.39, p = 0.048). This was particularly evident for delusional ideation (NEMESIS-2: RERI = 1.74, p = 0.003; EUGEI: RERI = 4.16, p = 0.019) and not for hallucinatory experiences (NEMESIS-2: RERI = 0.65, p = 0.284; EUGEI: −0.37, p = 0.547). A similar and stronger pattern of results was evident for CA (RERI delusions and hallucinations: NEMESIS-2: 3.02, p < 0.001; EUGEI: 6.44, p < 0.001; RERI delusional ideation: NEMESIS-2: 3.79, p < 0.001; EUGEI: 5.43, p = 0.001; RERI hallucinatory experiences: NEMESIS-2: 2.46, p < 0.001; EUGEI: 0.54, p = 0.465).
The results, and internal replication, suggest that the effects of known genetic and non-genetic risk factors for psychosis are mediated in part through an affective pathway, from which early states of delusional meaning may arise.
This study attempted to replicate whether a bias in probabilistic reasoning, or ‘jumping to conclusions’(JTC) bias is associated with being a sibling of a patient with schizophrenia spectrum disorder; and if so, whether this association is contingent on subthreshold delusional ideation.
Data were derived from the EUGEI project, a 25-centre, 15-country effort to study psychosis spectrum disorder. The current analyses included 1261 patients with schizophrenia spectrum disorder, 1282 siblings of patients and 1525 healthy comparison subjects, recruited in Spain (five centres), Turkey (three centres) and Serbia (one centre). The beads task was used to assess JTC bias. Lifetime experience of delusional ideation and hallucinatory experiences was assessed using the Community Assessment of Psychic Experiences. General cognitive abilities were taken into account in the analyses.
JTC bias was positively associated not only with patient status but also with sibling status [adjusted relative risk (aRR) ratio : 4.23 CI 95% 3.46–5.17 for siblings and aRR: 5.07 CI 95% 4.13–6.23 for patients]. The association between JTC bias and sibling status was stronger in those with higher levels of delusional ideation (aRR interaction in siblings: 3.77 CI 95% 1.67–8.51, and in patients: 2.15 CI 95% 0.94–4.92). The association between JTC bias and sibling status was not stronger in those with higher levels of hallucinatory experiences.
These findings replicate earlier findings that JTC bias is associated with familial liability for psychosis and that this is contingent on the degree of delusional ideation but not hallucinations.
To assess whether higher adherence to the traditional Mediterranean diet (MedDiet) was associated with lower consumption of ultra-processed foods (UPF) and lower free sugar intake.
Cross-sectional analysis of baseline information among participants in the SENDO project, a Spanish paediatric cohort. Dietary information was collected through a semi-quantitative FFQ. Food items were classified according to the NOVA classification. Adherence to the MedDiet was evaluated through the KIDMED index.
Three hundred eight-six children (52 % boys) with a mean age of 5·3 years old (sd 1·0) were included in the analysis.
74·4 % of the children had moderate adherence to the MedDiet (mean KIDMED score: 5·9 points; sd 1·7) and overall, 32·2 % of the total energy intake came from UPF. Each two additional points in the KIDMED score was associated with 3·1 % (95 % CI 2·1, 4·0) lower energy intake from UPF. Compared to those with low adherence to the MedDiet, children with medium and high adherence reported 5·0 % (95 % CI 2·2, 7·7) and 8·5 % (95 % CI 5·2, 11·9) lower energy intake from UPF, respectively. We also found that 71·6 % of the variability in free sugar intake was explained by the variability in UPF consumption.
Adherence to the traditional MedDiet was inversely associated with energy intake from UPF. Furthermore, most of the variability in free sugar intake was explained by the variability of UPF consumption. Public health strategies are needed to strengthen the adherence to the MedDiet in pre-schoolers while regulating the production, marketing and advertising of UPF.
In recent years the availability of geolocation data has increased considerably and can be found in various portable devices such as smartphones. These devices are intended for navigation in general, but can be used to carry out topographical surveys that do not require high accuracy of the surveyed data. To verify the applicability and accuracy of these devices we conducted the topographic survey in an area of approximately 5 ha using a GPS with RTK technology as reference, a Commercial Navigation Receiver (RNC) and a popular brand smartphone with the mobile applications C7 GPS Data and GPS Essentials previously installed. The GPS RNC showed the best planimetric results and the Smartphone with C7 GPS Data obtained the best result altimetric. None of the receivers analyzed showed high accuracy in results obtained. However, they can be used for tasks where high precision is not required.
Failure to adjust doses may contribute to adverse events. We evaluated the effectiveness of providing the estimated glomerular filtration rate on appropriateness of dosing for antimicrobials. The approach increased appropriateness of dosing from 33.9% to 41.4% (P < .001). Nudging prescription behavior can boost strategies for adequate antimicrobial prescription.
The ‘jumping to conclusions’ (JTC) bias is associated with both psychosis and general cognition but their relationship is unclear. In this study, we set out to clarify the relationship between the JTC bias, IQ, psychosis and polygenic liability to schizophrenia and IQ.
A total of 817 first episode psychosis patients and 1294 population-based controls completed assessments of general intelligence (IQ), and JTC, and provided blood or saliva samples from which we extracted DNA and computed polygenic risk scores for IQ and schizophrenia.
The estimated proportion of the total effect of case/control differences on JTC mediated by IQ was 79%. Schizophrenia polygenic risk score was non-significantly associated with a higher number of beads drawn (B = 0.47, 95% CI −0.21 to 1.16, p = 0.17); whereas IQ PRS (B = 0.51, 95% CI 0.25–0.76, p < 0.001) significantly predicted the number of beads drawn, and was thus associated with reduced JTC bias. The JTC was more strongly associated with the higher level of psychotic-like experiences (PLEs) in controls, including after controlling for IQ (B = −1.7, 95% CI −2.8 to −0.5, p = 0.006), but did not relate to delusions in patients.
Our findings suggest that the JTC reasoning bias in psychosis might not be a specific cognitive deficit but rather a manifestation or consequence, of general cognitive impairment. Whereas, in the general population, the JTC bias is related to PLEs, independent of IQ. The work has the potential to inform interventions targeting cognitive biases in early psychosis.
To test the reliability and validity of the DIGS in Spanish population.
Inter-rater and test-retest reliability of the Spanish version of DIGS was tested in 95 inpatients and outpatients. The resultant diagnoses were compared with diagnoses obtained by the LEAD (Longitudinal Expert All Data) procedure as “gold standard”. The kappa statistic was used to measure concordance between blind inter-raters and between the diagnoses obtained by LEAD procedure and through the DIGS.
Overall kappa coefficient for inter-rater reliability was 0.956. The kappa value for individual diagnosis varied from major depression = 0.877 to schizophrenia = 1. Test-retest reliability was 0.926. Kappa for all individual target diagnoses ranged from 0.776 (major depression) to 1. Kappa between LEAD procedure and DIGS ranged from 0.704 (major depression) to 0.825 (bipolar I disorder).
Most of the DSM-IV major psychiatric disorders can be assessed with acceptable to excellent reliability with the Spanish version of the DIGS interview. The Spanish version of DIGS showed an acceptable to excellent concurrent validity. Giving the good reliability and validity of Spanish version of DIGS it should be considered to identify psychiatric phenotypes for genetics studies.
Fibromyalgia is a chronic disorder characterized by widespread and long-lasting pain, tenderness, and fatigue. It is associated with impaired quality of life, and significant social and health burden.
The etiopathogenesis of this condition is presently undefined, but is probably multifactorial. The hypothesis of a clinical endocannabinoid deficiency has been proposed. In fact, recent studies suggest that synthetic cannabinoids might be an effective therapy in patients with fibromyalgia.
Based on the clinical case of a female patient whose cannabis use was related to symptomatic relief of fibromyalgia, the authors review issues concerning the endocannabinoid system, its possible relation to this challenging pain disorder, and therapeutic possibilities with synthetic cannabinoids.
Psychosocial and psychiatric aspects influence adherence to treatment and, consequently, the prognosis of liver transplantation. Psychosocial and psychiatric pretransplant assessment helps physicians to make clinical and therapeutic decisions.
To describe psychosocial and psychiatric aspects of patients awaiting liver transplant at the Coimbra University Hospital Centre.
A psychosocial and clinical evaluation questionnaire developed for our study was responded by 31 patients referred for psychological/psychiatric assessment to the Liaison Psychiatry Consultation at Coimbra University Hospital Centre, during the year of 2012.
Mean age was 48 years. 52% of them were females and 71% were married. Mean years of shooling was 7 years. At the time of the evaluation 35% were working, 19% were not actively working due to their hepatic disease and 23% were unemployed. The main causes for transplant were alcoholic liver disease (55%) and familial amyloidotic polyneuropathy (26%). More than half of patients (58%) had psychiatric history, mostly alcoholism and depression. At the time of evaluation, 42% presented depressive and/or anxiety symptoms. 19% did not reveal full understanding about their liver disease, mainly related to transplant surgical complications and medication side effects. Social and medical satisfaction was reported by 58% and non and poor satisfaction was identified in 3% and 26%,respectively.
Results indicate that psychosocial and psychiatric risk factors of nonadherence behavior after transplant are frequent on patients awaiting liver transplant. Psychological/psychiatric assessment is very important for selection and orientation of these patients.
The Patient Dignity Question (PDQ) is a clinical tool developed with the aim of reinforcing the sense of personhood and dignity, enabling health care providers (HCPs) to see patients as people and not solely based on their illness.
To study the acceptability and feasibility of the Portuguese version of the PDQ (PDQ-PT) in a sample of palliative care patients cared for in primary care (PC).
A cross-sectional study using 20 palliative patients cared for in a PC unit. A post-PDQ satisfaction questionnaire was developed.
Twenty participants were included, 75% were male; average age was 70 years old. Patients found the summary accurate, precise, and complete; all said that they would recommend the PDQ to others and want a copy of the summary placed on their family physician's medical chart. They felt the summary heightened their sense of dignity, considered it important that HCPs have access to the summary and indicated that this information could affect the way HCPs see and care for them. The PDQ-PT's took 7 min on average to answer, and 10 min to complete the summary.
Significance of results
The PDQ-PT is well accepted and feasible to use with palliative patients in the context of PC and seems to be a promising tool to be implemented. Future trials are now warranted.
Ethnic minority groups in Western countries face an increased risk of psychotic disorders. Causes of this long-standing public health inequality remain poorly understood. We investigated whether social disadvantage, linguistic distance and discrimination contributed to these patterns.
We used case–control data from the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study, carried out in 16 centres in six countries. We recruited 1130 cases and 1497 population-based controls. Our main outcome measure was first-episode ICD-10 psychotic disorder (F20–F33), and exposures were ethnicity (white majority, black, mixed, Asian, North-African, white minority and other), generational status, social disadvantage, linguistic distance and discrimination. Age, sex, paternal age, cannabis use, childhood trauma and parental history of psychosis were included as a priori confounders. Exposures and confounders were added sequentially to multivariable logistic models, following multiple imputation for missing data.
Participants from any ethnic minority background had crude excess odds of psychosis [odds ratio (OR) 2.03, 95% confidence interval (CI) 1.69–2.43], which remained after adjustment for confounders (OR 1.61, 95% CI 1.31–1.98). This was progressively attenuated following further adjustment for social disadvantage (OR 1.52, 95% CI 1.22–1.89) and linguistic distance (OR 1.22, 95% CI 0.95–1.57), a pattern mirrored in several specific ethnic groups. Linguistic distance and social disadvantage had stronger effects for first- and later-generation groups, respectively.
Social disadvantage and linguistic distance, two potential markers of sociocultural exclusion, were associated with increased odds of psychotic disorder, and adjusting for these led to equivocal risk between several ethnic minority groups and the white majority.
There is scarce research on bone health in early stages due to the difficulties in accessing to bone health assessment methods in absence of pathology conditions. Consequently, there is no much information on the determinants of bone health. The aim of this study is to elucidate the association of moderate-vigorous physical activity (MVPA) and bone mineral density of children from Aragon accounting for socioeconomic, role parental modelling, dietary and sedentary behavior effects.
Material & Methods
The longitudinal cohort ‘Growth and Feeding during Lactation and Early Childhood in Children of Aragon (CALINA in Spanish)’ included 1,629 born children from Aragon (Spain) in 2009. From those, after 7 years, 339 children (176 boys and 163 girls) were assessed. Bone mineral density (BMD) using Dual X-ray absorciometry (–DXA-), diet quality index (DQI) using a food frequency questionnaire(-FFQ-), sedentary behaviors by questionnaire, and physical activity (using accelerometry-actigraph 3GTX-) were evaluated, as well as if they were or not rapid weight gainers during the first year of life.
From the 339 children, 116 boys (66.5%) and 63 girls (38.7%) met the current MVPA recommendations of at least? 1 hour/day. Boys meeting MVPA recommendations did a mean of 84.02 minutes of MVPA per day and had a BMD of 0.60 g/cm2, while those not meeting the recommendations, did a mean of 43.91 minutes of MVPA and had a BMD of 0.59 g/cm2. Girls meeting MVPA recommendation did 75.52 minutes and had a BMD of 0.59 g/cm2, and those not meeting, did 42.81 minutes of MVPA and had a BMD of 0.58. Models, include BMI z-score (age/sex adjusted based in Anthro standards from WHO), weekly sedentary time, DQI, BMI of the mother and whether or not they had been rapid weight gainers from 0–12months as confounders and were performed for BMD having MVPA as a predictor. A significant association was found only for boys between MVPA and BMD (β = 0.145, p-value = 0.02) while no association was found for girls (β = 0.06, p-value = 0.40).
There is still an important physical activity gap between boys and girls. In boys, physical activity is positively associated with BMD, whereas in girls, no significant associations seem to exist. More research is required to elucidated the effects of lifestyle behaviors on bone health in children.
Dignity therapy (DT) is well established in adult populations, and it is likely that it could benefit younger people. This study aimed to adapt the adult Portuguese DT question framework for adolescents (DT-QF-Adol) (ages 10–18).
Five stages were followed: (1) the Portuguese DT-QF for adults was adapted for adolescents with the original author's collaboration, (2) an expert committee provided feedback on the adapted version, (3) an initial consensus version of the DT-QF-Adol was created, (4) expert committee consult affirmed final consensus, and (5) validation stage with a sample of 17 adolescents followed in ambulatory psychology clinic.
DT's original author endorsed the final Portuguese DT-QF-Adol, reinforcing that it captures the fundamental dimensions of DT. There was 100% agreement on the final consensus version and defined age group (10–18 years old). Twenty adolescents were invited to participate, and 17 were included after informed consent was obtained; 53% were female. The average age was 12.7 years. The interviewed adolescents reported that the DT-QF-Adol was clear, and they did not identify any ambiguity or difficulty in answering any of the questions. They assumed that this information could positively affect the way parents and friends see and cared for them, permitting others to understand their concerns and preferences. Participants felt that the DT-QF-Adol could be a good starting point for a conversation with their loved ones. Although they did not consider vital for health professionals to access their answers, they strongly felt that the DT-QF-Adol might be essential to sick adolescents and they would recommend it to others.
Significance of results
We developed a DT-QF of nine questions for Portuguese adolescents (DT-QF-Adol), coined Protocolo de Perguntas da Terapia da Dignidade para Adolescentes — 10–18 anos. This tool can potentially be considered a good addition for pediatric palliative care.
First-degree relatives of patients with psychotic disorder have higher levels of polygenic risk (PRS) for schizophrenia and higher levels of intermediate phenotypes.
We conducted, using two different samples for discovery (n = 336 controls and 649 siblings of patients with psychotic disorder) and replication (n = 1208 controls and 1106 siblings), an analysis of association between PRS on the one hand and psychopathological and cognitive intermediate phenotypes of schizophrenia on the other in a sample at average genetic risk (healthy controls) and a sample at higher than average risk (healthy siblings of patients). Two subthreshold psychosis phenotypes, as well as a standardised measure of cognitive ability, based on a short version of the WAIS-III short form, were used. In addition, a measure of jumping to conclusion bias (replication sample only) was tested for association with PRS.
In both discovery and replication sample, evidence for an association between PRS and subthreshold psychosis phenotypes was observed in the relatives of patients, whereas in the controls no association was observed. Jumping to conclusion bias was similarly only associated with PRS in the sibling group. Cognitive ability was weakly negatively and non-significantly associated with PRS in both the sibling and the control group.
The degree of endophenotypic expression of schizophrenia polygenic risk depends on having a sibling with psychotic disorder, suggestive of underlying gene–environment interaction. Cognitive biases may better index genetic risk of disorder than traditional measures of neurocognition, which instead may reflect the population distribution of cognitive ability impacting the prognosis of psychotic disorder.
In this work, a new concentric circles detection method for object detection is proposed. It has been applied to the images of a commercial radar, captured with a Charge-Coupled Device (CCD) camera. The processing includes the detection of centres and concentric circles in the images and the identification of the radar scale. Several methods found in the literature have been applied and compared with our novel proposal for multiple concentric circles detection, called “Propagation Method based on Circular Regression”. This methodology has been validated with real radar images, proving its efficiency in obtaining the distance of any object to a marine vessel, with high accuracy and low computational cost, in real time. This system can not only be applied to most existing radars in the market by adjusting the parameters of each model but our proposal for concentric circle detection can be also applied to other sensing applications.
According to the UNEP, mercury pollution is one of the main contamination problems of the world. The UN showed that more than 1,870 tons of this metal are released into the environment annually. This material arrives to water bodies where fish consume it and then reaches humans, producing negative effects on their health. The hydroxyapatite is one of the main components of bones and has proven itself to be useful in the removal of mercury from polluted sources. The aim of this research project is to synthesize and characterize different formulations of this substance and to determine which is the best selective formulation to remove mercury in water. Currently, twenty-one formulations have been produced. The experimental variables examined are the pH, the temperature and the time of calcination. These variables are characterized with Infrared Spectrophotometry (IR), Scanning Electron Microscope (SEM) and X-ray diffraction (XRD). Before calcination the samples contained 70% of hydroxyapatite. This concentration increased in some of them after calcination. The analysis of the results allowed to test the efficiency of these formulations at removing mercury from water. These materials will also be combined, in future stages of the research, with other substances such as activated carbon and organic fibers to improve their performance. The material will be used to coat a filter so that it can become a piping accessory to remove mercury from polluted waters as it is being recirculated.
The aim of this research communication was to identify chromosome regions and genes that could be related to milk yield (MY), milk fat (%F) and protein percentage (%P) in Brazilian buffalo cows using information from genotyped and non-genotyped animals. We used the 90 K Axiom® Buffalo Genotyping array. A repeatability model was used. An iterative process was performed to calculate the weights of markers as a function of the squared effects of Single Nucleotide Polymorphism (SNP) and allele frequencies. The 10 SNPs with the largest effects for MY, %F and %P were studied and they explained 7·48, 9·94 and 6·56% of the genetic variance, respectively. These regions harbor genes with biological functions that could be related to the traits analyzed. The identification of such regions and genes will contribute to a better understanding of their influence on milk production and milk quality traits of buffaloes.