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Educational practices are indicated to promote the health of people with fibromyalgia in primary health care. We aimed to develop an educative interdisciplinary program intended at the health promotion of individuals with fibromyalgia.
It is a study protocol that was developed following three phases in the city of São Paulo city, Brazil. Qualitative research was carried out, through a focal group, with 12 individuals with fibromyalgia and 10 health professionals. A thematic content analysis was made according to the content proposed by Bardin.
Fibro Friends is an interdisciplinary program with educational approaches that must be performed in 15 meetings, once a week for 1 h and 20 min. Participants were the following professionals: a Physiotherapist, a Doctor, a Psychologist, a Nutritionist, a Nurse, a Pharmacist/Druggist, a Speech Therapist, an Occupational Therapist, a Naturopath, and a Social Worker. A physical exercise program will also be carried out. The professionals must discuss in a lecture, conversation hearing, and/or group dynamic, about strategies to promote health and pain control in fibromyalgia.
Fibro Friends is a program presenting educational interdisciplinary information to individuals with fibromyalgia, being considered a trend to future care. Fibro Friends is a practical guide, logical, and efficient to patients with fibromyalgia at the basic attention to health.
Alişar-IV ware is one of the most characteristic ceramic productions of early first-millennium BC central Anatolia and the only one characterised by painted figurative motifs besides geometric decorations. The ongoing excavations at Niğde-Kınık Höyük have uncovered a collection of fragments belonging to 42 Alişar-IV vessels, and this systematic material study of these sherds contributes much to understanding aspects of their production, use and consumption. Petrographic and chemical evidence presented in this study indicates that two-thirds of them were produced locally. Conversely, the study of Alişar-IV fragments from other regions of the Anatolian plateau has shown that they are non-local productions. We thus suggest that Alişar-IV ware is a product of a few centres within south-central Anatolia and that, from there, it circulated among and beyond these centres. Radiocarbon dating indicates that the main period of production of this ware covers the tenth and ninth centuries BC, in agreement with the evidence from Polatlı Yassı Höyük, Kaman-Kalehöyük and Böğazköy-Büyükkaya. The small number of Alişar-IV vessels found at each site is indicative of a limited, exclusive production. A combined study of their shapes and iconography might support the hypothesis that the Alişar-IV ware was primarily associated with wine circulation and consumption.
This paper investigates the origin of flow-induced instabilities and their sensitivities in a flow over a rotationally flexible circular cylinder with a rigid splitter plate. A linear stability and sensitivity problem is formulated in the Eulerian frame by considering the geometric nonlinearity arising from the rotational motion of the cylinder which is not present in the stationary or purely translating stability methodology. This nonlinearity needs careful and consistent treatment in the linearised problem particularly when considering the Eulerian frame or reference adopted in this study that is not so widely considered. Two types of instabilities arising from the fluid–structure interaction are found. The first type of instabilities is the stationary symmetry breaking mode, which was well reported in previous studies. This instability exhibits a strong correlation with the length of the recirculation zone. A detailed analysis of the instability mode and its sensitivity reveals the importance of the flow near the tip region of the plate for the generation and control of this instability mode. The second type is an oscillatory torsional flapping mode, which has not been well reported. This instability typically emerges when the length of the splitter plate is sufficiently long. Unlike the symmetry breaking mode, it is not so closely correlated with the length of the recirculation zone. The sensitivity analysis however also reveals the crucial role played by the flow near the tip region in this instability. Finally, it is found that many physical features of this instability are reminiscent of those of the flapping (or flutter instability) observed in a flow over a flexible plate or a flag, suggesting that these instabilities share the same physical origin.
In First Episode Psychosis (FEP), Suicidal Behaviours (SB), Violent Behaviours (VB) and substance use are frequent respectively 10% to 30%, 34.5% and 50% (Pompili et al., 2011), (Tournier et al., 2013). The role of substance use in facilitating SB and VB is described (Large et al., 2011).
We aim to evaluate the impact of substance use in FEP patients. Our hypothesis is that substance use is associated with more SB or VB before first admission.
First admission files of 45 patients diagnosed ICD10 F20 to F29 during the 2013-2018 period were retrospectively studied. SB, VB and substance use (Cannabis, alcohol and opiate/cocaine) before admission were collected. Correlation between SB and VB were tested with cannabis, alcohol, opiate/cocaine use with chi2 Pearson independance test.
The frequencies of suicidal behaviours and violent behaviours were 25 % and 22.7 %. The frequencies of cannabis use, alcohol use, opiate/cocaine use were 56.1 %, 10 % and 16.3 %. A strong significant correlation was found between opiate/cocaine use and violent behaviour, p = 0.011 Chi2 was 6.471 DF 1. No other significant correlations were found.
Suicidal behaviours and violent behaviours are known to be more frequent in psychotic patients with addictive comorbidity. Our french rural hospital retrospective study confirms that violent behaviours in first admission psychotic patients are strongly associated with opiate/cocaine substance use comorbidity.
According to Childe, the Bronze Age in Europe is thought to be the first ‘golden age’ in European history. The development of metallurgy, clearly associated with the production of weapons, and the expansion of exchange networks covering all types of goods are considered essential in the process of consolidation of social elites, and, by extension, of social inequalities. The significance of textile production has, however, been undervalued as a specialized craft and as a manufacturing process that creates cultural differences and signals social inequalities. Being associated with domestic contexts rather than with specialized workshops, textile production in the eastern Iberian Peninsula has been underestimated; it is addressed here, as is its potential importance in societies immersed in a process of social stratification.
Family carers (FCs) of nursing home (NH) residents are best placed to notice deteriorations that signal impending death in their relative, which can open a conversation with healthcare professionals (HCPs) about adjusting the care plan. We explored contributors to bereaved FCs’ decision to transition towards palliative-oriented care for their relatives in NHs.
This qualitative descriptive study used a phenomenological design. Thirty-two bereaved FCs across 13 Italian NHs completed semi-structured interviews. Additional data were collected on NH referrals to palliative care services (PCS) in the 6 months before study start and treatments provided in the last week of life. Content analysis with a combined inductive and deductive approach was applied to identify codes and fit them into an a priori framework. When codes did not fit, they were grouped into new categories, which were finally gathered into themes.
FCs reported four types of “trigger events” that made them doubt that their relative would recover: (1) physical deterioration (e.g., stopping eating/walking or swallowing problems); (2) social confirmation (e.g., confirming their relative's condition with friends); (3) multiple hospitalizations; and (4) external indicators (e.g., medical examinations by external consultants). A “resident-centered environment” helped FCs recognize trigger events and “raise awareness of the possibility of death”; however, the “need for reassurance” was pivotal to a “gradual transition towards palliative-oriented care”. When participants did not recognize the trigger event, their relative continued to receive curative-oriented care. NHs that referred residents to PCS discussed palliative-oriented care more frequently with FCs, had a lower nurse-to-resident and nurse aide-to-resident ratio, and administered more palliative-oriented care.
Significance of results
Trigger events represent an opportunity to discuss residents’ prognosis and are the starting point for a gradual transition towards palliative-oriented care. Adequate staffing, teamwork, and communication between FCs and healthcare professionals contribute to a sensitive, timely shift in care goals.
On the question of migration – and it was not the only one – Friedrich Engels got there before Karl Marx. In The Condition of the Working Class in England he dealt widely with the Irish immigration in Britain (over one million by 1845). He presented it there as an essential reserve of labour power for the take-off of British industry and the permanent existence of a ‘surplus population’ of unemployed workers. Borrowing from Thomas Carlyle (1795–1881) a frankly ethnicist characterization of Irish immigrants (‘but little above the savage’), Engels highlighted the downward moral and material spiral of competition into which they forced English workers. At the same time, however, as Eric Hobsbawm (1917–2012) noted, he described the political radicalization that developed in the Irish immigration, as well as the ardour and generosity that the Irish brought to the ‘cold, rational’ English workers through the mixing of temperaments and ‘races’. Engels thus also anticipated the key theoretical issue of the industrial reserve army, which Marx would later expound in Capital, and the key political issue of the relationship between Irish and English workers (or, more generally, between immigrant and indigenous workers), which would confront the International Working Men’s Association (IWMA).
Eating Disorders concern a growing number of people. Several instruments were created to assess symptomatology of Anorexia Nervosa and Bulimia Nervosa. Our aim is to create and validate a short questionnaire about all the eating symptoms of Eating Disorders, including Binge Eating Disorder.
The Questionnaire of Eating Behaviours (Scheda dei Comportamenti Alimentari, SCA) is a self-administered questionnaire composed of 13 items regarding all the eating symptoms of Eating Disorders. Items are divided into 3 scales: Restrictive Eating, Weight Control Practices and Binge Eating. The SCA was given to 200 female outpatients with Eating Disorders and to 218 non-clinical adult women. Student's t test was performed to compare clinical and non-clinical subjects, one-way ANOVA was performed to compare three diagnostic subtypes (Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder). Cronbach's Alpha and factor analysis were used to validate the questionnaire.
Clinical and non-clinical subjects get significantly different scores in all the three subscales. Besides, the three diagnostic subtypes scores significantly differ on each scale. Cronbach's Alpha values show a significant inner consistency in the subscales of Restrictive Eating and Binge Eating, while the Weight Control Practices one is not very homogeneous, as expected. The factor analysis has shown the presence of three factors, corresponding to the 3 scales.
The SCA has shown to be effective in distinguishing people with Eating Disorders from non-clinical subjects. For its characteristics of being short, easy to fill in and to interpret, the SCA seems to be an instrument suitable for screening purposes.
Several studies have demonstrated that Mood Disorders are threatening, widespread disorders characterized by poor outcome and chronic development. This study was undertaken to examine the features of affective patients in long-term residential care.
The study group consisted of 162 patients with a principal diagnosis of Major Depression (MDD), Bipolar Disorder I (BD-I) or Dysthymic Disorder (Dy), according to DSM IV criteria, assessed by the SCID I and II. Patients were also assessed with the HAM-D, the YMRS, the DDERS and the GAF. Current and prior medical health problems were documented also using the CIRS.
The most frequent diagnosis in our sample was found to be MDD (50.6%), followed by BD-I (35.8%) and Dy (13.6%). Psychotic symptoms were detected in 12.9% of the patients. MDD presented the higher level of depressive symptoms followed by BD-I and Dy. The latter showed the longer duration of illness and the longer untreated period compared with those of BD-I and MDD, and also presented the greater number of comorbid conditions, both medical and psychiatric. In addiction, the mean CIRS severity index for Dysthymia was significantly higher than that of MDD and BD-I. All affective patients showed a low level of global functioning, with no significant differences between the three diagnostic groups.
Affective patients in long-term residential facilities show significant impairment probably due to the complexity and severity of the psychopathology and in particular to the high rates of comorbidity, thus calling for a greater awareness in diagnosing and treating these patients in a residential setting.
As we know antipsychotic drugs are associated with the presence of side effects thar impair adherence, the course of the disease and the patient's functionality. Besides drug efficacy, tolerability is a factor which we consider in the choice of treatment.
Materials and Methods
Descriptive cross-sectional study of inpatients between June and September 2014 in treatment with paliperidone and with any psychiatric diagnosis according to the diagnostic criteria Statistical Manual of Mental Disorders (DSM-IV). To evaluate the presence of side effects we use the UKU (Udvalg für Kliniske Undersogelser), which is a comprehensive measure of side effects of psychotropic drugs. It consist of 54 items grouped into psychological, neurological, autonomic and other symptoms.
18 patients (12 men and 6 women) were included. The average age was 37 years. 16 patients (88.8%) had a diagnosis of Tr. psychotic and 2 of them (11.1%) Tr. personality. 8 patients had started treatment with oral paliperdione two weeks before evaluation, while the remaining 10 patients had longer treatment (mean 9.4 months).
Symptoms found in the psychic area were astenia, lassitude, fatigability, decreased sleep duration and emotional indifference. No symptoms were described in the neurological area. Among the autonomic effects: increased sweating and inside the area “others”: decreased sexual desire, erectile dysfunction and weight loss. All of them were obtained as slight maximum score.
These data give us guidance on the tolerability profile of oral paliperidone short to medium term. The values obtained in the UKU scale indicate good tolerability of the treatment.
To demonstrate the complex correlation existing in patients with eating disorders between hormonal alterations and psychopathological symptomatology, that has been little studied until now.
60 women aged between 16 and 35 years and diagnosed with Anorexia Nervosa and Bulimia Nervosa according to the DSM-IV were assessed using the SCL-90-R, EDI, BAT and DES II. A blood sample was taken from each patient in the morning, on the seventh day of the menstrual cycle or on the corresponding day from the women with amenorrhea; the following hormone levels were measured: TSH, FT3, FT4, LH, FSH, 17-beta-estradiol, cortisol, DHEAS. Pearson's Correlation Coefficient has been used to test the correlation between hormonal level and test scores.
Positive correlations exist between BMI and FT3 and LH, which decrease when BMI decreases. We can observe positively significant correlations between LH and FSH levels and the BAT scale scores.No one significant correlation was found between hormonal levels and dissociative symptoms as measured by DES. With regard to EDI, the following psychopathological features correlate with hormonal assessment: the wish to be thin, body dissatisfaction and perfectionism.
Our findings suggest a significant correlation between psychopathological features we considered and hormonal readings, especially LH, FSH, TSH, FT3. When these hormonal readings decrease, the patients’ self-ratings and their body dissatisfaction decrease. That attributes a protective meaning to the dietary symptom akin to an effective measure that relieves the person's feelings of inadequacy.
Even if obesity isn’t a psychiatric disorder included in the DSM IV-TR, it is associated with a high prevalence of psychopatological features. Mainly obese patients on a waiting list for bariatric surgery are affected by psychiatric disorders more often than non-obese individuals.
To estimate the prevalence of psychopatology in obese patients on a waiting list for weight loss surgery.
To demonstrate the importance of a multidisciplinary approach to bariatric surgery that includes a psychodiagnostic evaluation.
Forty-seven patients on a waiting list for bariatric surgery were assessed using the SCL-90-R.
In a high rate of patients (83%) was identified a significantly altered value at least in one of the SCL-90-R subscales. Mainly the 80.85% has expressed a psychological distress through physical symptoms (SOM), the 63.82% had a deflection of mood (DEP), the 61.7% had a higher ability to perceive both internal and external stimuli (IS); suspiciousness (PAR) occurred in 59.57% of patients (PAR).
Our results suggest a high rate of psychopatological alterations in patients on a waiting list for weight loss. These individuals try to manage their emotions through the relationship with food, and the body become a way to express themselves. Therefore the early detection and the treatment of the psychopatological features associated with obesity could have a role to improve the therapeutic outcome, and a multidisciplinary approach could represent an essential element to reach a global resolution of both clinical and mental features of patients.
Since the end of the nineteenth century, many paleontological studies have been developed on the Middle Triassic localities of the Monte San Giorgio area (Canton Ticino, Switzerland, and Lombardy, Italy). These localities were inscribed in 2003 and 2010 in the UNESCO World Heritage List due to their paleontological relevance. New crustaceans are here described from the Kalkschieferzone member of the upper Ladinian Meride Limestone, outcropping near Besnasca-Cà del Frate (Viggiù, Italy) and Meride (Mendrisio, Switzerland). Several hundred specimens of a new genus and new species of Lophogastrida, named here Vicluvia lombardoae, improve information on Triassic mysidaceans (sensu lato), a group of shrimp-like crustaceans presently including hundreds of species worldwide distributed in marine and freshwater environments. The paper discusses the relations between Vicluvia n. gen. and the other fossil genera belonging to the same family. Vicluvia lombardoae n. gen. n. sp. exhibits two dorsally vanishing transverse grooves with their branches regularly bending toward the posterior margin of the shield and a telson with a rounded and setose apex. It was probably a euryhaline species living in a transitional environment affected by frequent and ephemeral salinity variations. Middle Triassic taphonomic windows have preserved specimens of lophogastrids in shallow basins along the Tethys, from the present Alps to China as well as in the German Basin.
Plant nitrogen (N) links with many physiological progresses of crop growth and yield formation. Accurate simulation is key to predict crop growth and yield correctly. The aim of the current study was to improve the estimation of N uptake and translocation processes in the whole rice plant as well as within plant organs in the RiceGrow model by using plant and organ maximum, critical and minimum N dilution curves. The maximum and critical N (Nc) demand (obtained from the maximum and critical curves) of shoot and root and Nc demand of organs (leaf, stem and panicle) are calculated by N concentration and biomass. Nitrogen distribution among organs is computed differently pre- and post-anthesis. Pre-anthesis distribution is determined by maximum N demand with no priority among organs. In post-anthesis distribution, panicle demands are met first and then the remaining N is allocated to other organs without priority. The amount of plant N uptake depends on plant N demand and N supplied by the soil. Calibration and validation of the established model were performed on field experiments conducted in China and the Philippines with varied N rates and N split applications; results showed that this improved model can simulate the processes of N uptake and translocation well.
OBJECTIVES/SPECIFIC AIMS: Incomplete spinal cord injury typically results in life-long disability, often in the form of profound loss of locomotion capability. Individuals who have experienced incomplete spinal cord injury exhibit persistent eccentric motor deficits, which are particularly prevalent in the weight acceptance phase of gait and emphasized in sagittal plane knee motion and frontal plane hip motion. METHODS/STUDY POPULATION: Motion analysis can capture the kinematic and joint-level deficits of these individuals, but it is impossible to directly calculate the contributions of individual muscles to weight acceptance due to the complexity of the musculoskeletal system. Instead, those muscle contributions must be simulated in order to approximate muscle power during locomotion. RESULTS/ANTICIPATED RESULTS: The traditional method for driving these simulations with electromyography readings is unavailable for individuals who have neuromuscular deficits (e.g., spasticity or paralysis), due to the need to generate reliable maximum voluntary isometric contractions for baseline purposes. Instead, this research develops a novel method for using resting electromyography data to drive musculoskeletal simulations using a muscle activation threshold paradigm. DISCUSSION/SIGNIFICANCE OF IMPACT: The simulation results of this method more closely resemble experimental results, but further simulation refinement is needed to fully capture the true muscle activity.
Whole-crop maize forage was ensiled without inoculant (control), inoculated with Lactobacillus buchneri and L. plantarum at a rate of 1 × 105 cfu/g fresh forage per bacterium (LBLP), or inoculated with Bacillus subtilis and L. plantarum at a rate 1 × 105 cfu/g fresh forage per bacterium (BSLP) with the goal to investigate the growth performance of finishing feedlot lambs. Thirty Dorper × Santa Ines lambs (29 ± 3.5 kg initial body weight) were used in the feedlot programme and assigned (n = 10) to one of three diets containing control, LBLP or BSLP silages in a 60:40 forage:concentrate ratio. Inoculation of maize silage did not alter dry matter intake (overall mean = 1.16 kg/day) and average daily gain (overall mean = 0.217 kg/day) of lambs. Consequently, feed efficiency remained unchanged. Inoculation of maize silage did not alter carcass and meat traits of lambs, with the exception of meat colour, wherein yellowness (b*) decreased by feeding LBLP and BSLP diets compared with the untreated diet. Regarding ruminal fermentation, there was an interaction between diets and the interval at which ruminal fluid was sampled for determining total volatile fatty acid concentration, but inoculation yielded no obvious results. In conclusion, the use of diets based on maize silage inoculated with L. plantarum combined with either L. buchneri or B. subtilis did not display relevant effects on growth performance of lambs; this response might be related to the limited impact of these bacterial inoculants on silage composition.
In the southern Gulf of Mexico, the spotted eagle ray (Aetobatus narinari) is the second most frequently caught batoid in small-scale fisheries off Campeche. Ecological aspects of this ray are unknown in this region, hampering the understanding of the relationship between its distribution and prey availability in the fishing area. In order to study the feeding habits of this batoid and characterize its potential prey in the study area, stomachs and intestines of 154 specimens (68 females and 86 males) were analysed. The results indicated that A. narinari near Campeche is a specialist and selective predator that feeds mainly on gastropods (92.7% IRI), with no significant differences in the diet found between sexes, size groups, or between stomach and intestine contents. In addition, the results indicated that the most important prey species in the diet were among the most common benthic species in three of the four sampling transects positioned in or adjacent to fishing areas for rays. These most important prey species were Strombus pugilis (53.33% IRI) and Americoliva reticularis (25.6% IRI). Other prey species included Lobatus costatus (5.6% IRI) and Petrochirus diogenes (3.6% IRI). This study suggests that this widely distributed ray species feeds in Campeche's coastal waters and that the study of its potential prey increases the understanding of ecological aspects of the species, which emphasizes the added importance of monitoring fishery impacts on prey species (e.g. the conch fishery off Campeche) to help support integrated assessment and management of fisheries.