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Children exposed to prenatal maternal psychological distress are at elevated risk for a range of adverse outcomes; however, it remains poorly understood whether postnatal influences can ameliorate impairments related to prenatal distress. The current study evaluated if sensitivematernal care during the first postnatal year could mitigate child cognitive and emotional impairments associated with prenatal psychological distress. Prenatal maternal psychological distress was assessed via self-reports of anxiety, depression, and perceived stress for 136 mothers at five prenatal and four postpartum time points. Quality of maternal care (sensitivity to nondistress, positive regard, and intrusiveness reverse-scored) were assessed during a mother–child play interaction at 6 and 12 months. Child cognitive function and negative emotionality were assessed at 2 years, using The Bayley Scales and the Early Childhood Behavior Questionnaire. Elevated prenatal distress was associated with poorer child cognitive function and elevated negative emotionality. Children exposed to elevated prenatal maternal distress did not, however, display these outcomes if they received high-quality caregiving. Specifically, maternal care moderated the relation between prenatal psychological distress and child cognitive function and negative emotionality. This association remained after consideration of postnatal maternal psychological distress and relevant covariates. Sensitive maternal care was associated with altered offspring developmental trajectories, supporting child resilience following prenatal distress exposure.
Cardiovascular side effects of antipsychotics are been studied both in typical and atypical antipsychotics but, in particular, with clozapine few systematic studies of these effects have been performed. In this study, we reviewed electrocardiographic (ECG) data from patients treated with clozapine.
Observational, retrospective study in our Clozapine Day Clinic from 2000 to 2008. We recluted 197 patients (70% men) with mean age 31,75 ± 9,0 years who began treatment with clozapine. All of them had an electrocardiogram taken before starting treatment and after 18 weeks of follow-up. None suffered from heart diseases. QTc was evaluated by Bazett formula (QT/ (R-R’)1/2). Treatment prescribed was taken down and drug serum levels were detected. Statistical analysis was executed by SPSS 17.0.
There was significant correlation between doses prescribed and levels of clozapine and norclozapine (r=.304, p=.023; r=.354 p=.007), between levels of clozapine, norclozapine and QTc enlargement (r=.348, p=.008; r=.268 p=.046) and between levels of clozapine, norclozapine and heart rate (r=.390, p=.003; r=.326 p=.014). There were no differences between QTc and treatment with clozapine or other antipsychotic (p=0.902), between sex or if polypharmacy existed. ECG alterations were a case of supraventricular extrasystoles, another of Wolf-Parkinson -White Syndrome and other inespecific alterations like repolarizations or left hypertrophy.
We did not find either major incidence on cardiological effects or significative QTc enlargement during treatment with clozapine in contrast to other antipsychotic previously prescribed. Therefore clozapine may be in the same cardiologic safety rank than other antipsychotics.
The DSM-IV-TR category “brief psychotic disorder” includes different concepts that have been defined before like bouffée délirante, cycloid psychosis and “acute and transient psychosis” in the last ICD-10. Limited prospective studies have been done, and they all show a marked diagnostic instability during follow-up. According to that, its independent nosologic entity is still uncertain.
To determine the diagnostic stability of the brief psychotic disorders as well as their distinct clinical features.
Observational, retrospective, longitudinal study of 80 consecutive patients admitted at the acute psychiatric inpatient service of a general hospital between 2000 and 2006. at discharge, all of them fulfilled diagnostic criteria for “brief psychotic disorder” according to DSM-IV. Demographic and psychopathological data were analysed.
Mean age (SD) was 31.3 (9.5), most of them women (63%). the most frequent previous stressor was related to labour, while up to 45% didn't report any. 51% had no psychiatric family history. 15 (19%) patients previously had a brief psychotic episode. Psychopathological disturbances identified were: thought disorder 69%, anxiety 66.6%, insomnia 57.7%, suspiciousness 53.5%, rapidly changing delusions 53.3% (paranoid contents 75.3%), perplexity 46.5%, auditory hallucinations 45.1%, mood lability 36.6%, elation 23.9%, depressed mood 22.5% and irritability 12.7%. in the 24 month follow-up, 32.5% changed diagnosis to schizophrenia, 3"9% to schizoaffective, 10% to bipolar disorder and 16.9% achieved clinical remission. 28.5% were lost to follow-up.
“Brief psychotic disorder” category is still uncertain and more data may be necessary to clarify if it should remain as a distinct nosologic entity.
Asenapine is the most recent compound that hasbeen FDA- and EMA-approved for treatment of mania. Its efficacy and safety havebeen assessed in placebo-controlled trials, but little is known about itsperformance in routine clinical conditions. The MANACOR study assessed costsassociated with treatment of mania in several hospital settings acrossCatalonia, Spain. As part of the protocol, we compared cost-effectiveness ofasenapine versus other treatment options.
A combined prospective and retrospective datacollection and analysis was conducted from January 2011 to December 2013following a clinical interview and assessment of manic and depressive symptoms(YMRS, HDRS-17), clinical state (CGI-BP-M), psychosocial functioning (FAST),sexual dysfunction (PRSexDQ) and health resource costs associated withtreatment with asenapine versus other antipsychotics.
152 patients from different university hospitalswere included. 53 patients received asenapine and 99 received otherantipsychotics. Considering inpatients (N=117), those treated with asenapinepresented a significantly less severe manic episode (p=0.001), less psychoticsymptoms (p=0.030) and, more comorbid personality disorder (p=0.002). Regardingoutpatients, those treated with asenapine showed significantly less severemanic episode (p=0.046), more previous mixed episodes (p= 0.013) and, moresexual dysfunction at baseline (p=0.036). No significant differences were foundin mean total costs per day.
Non-randomized study design.
Clinicians tended to use asenapine in patientswith less severe manic symptoms but more complex clinical profile, includingmore mixed episodes in the past, concomitant personality disorder, and sexualproblems. Treatment with asenapine was not associated with higher costs when comparedto other options.
Asenapine is the most recent compound that has been FDA- and EMA-approved for treatment of mania. Its efficacy and safety have been assessed in placebo-controlled trials, but little is known about its performance in routine clinical conditions. In this study, we compared features of patients treated with adjunctive asenapine or other adjunctive antipsychotics and the costs of the treatment.
A combined prospective and retrospective data collection and analysis was conducted from January 2011 to December 2013 following a clinical interview and assessment of manic and depressive symptoms (YMRS, HDRS-17), clinical state (CGI-BP-M), psychosocial functioning (FAST), sexual dysfunction (PRSexDQ) and health resource costs associated with treatment with adjunctive asenapine versus other adjunctive antipsychotics.
Hundred and fifty-two patients from different university hospitals were included. Fifty-three patients received adjunctive asenapine and 99 received other adjunctive antipsychotics concomitantly to mood stabilizers. Considering inpatients, those treated with adjunctive asenapine presented a significantly less severe manic episode (P = 0.001), less psychotic symptoms (P = 0.030) and more comorbid personality disorder (P = 0.002). Regarding outpatients, those treated with adjunctive asenapine showed significantly less severe manic episode (P = 0.046), more previous mixed episodes (P = 0.013) and more sexual dysfunction at baseline (P = 0.036). No significant differences were found in mean total costs per day.
Clinicians tended to use adjunctive asenapine in patients with less severe manic symptoms but more complex clinical profile, including more mixed episodes in the past, concomitant personality disorder, and sexual problems. Treatment with adjunctive asenapine was not associated with higher costs when compared to other options.
In young rabbit, digestive disorders are frequently observed around weaning. Stimulating the onset of feed intake in the suckling rabbit might be a way to promote gut health. The aim of this study was to determine the rabbit’s acceptability for different feed presentations and its preferences for flavours at an early stage of life. Two trials were conducted to evaluate the effects of physical form and flavouring on creep feed attractiveness. All the diets tested were provided in the nest from 3 to 17 days, and the daily intake per litter was recorded as of 8 days of age. In the first trial, five feed presentations were tested separately (n = 60 litters). Three dry presentations were chosen: commercial pellet (P), crumb from commercial pellet (cP) and crumb from beet pulp pellet (cBP). Hydrated feeds were also provided with either raw fodder beetroot (B) or a semi-solid feed in agar gel form produced with fodder beetroot juice and pulp (gB). In the second trial, double-choice tests were performed on four feed gels (n = 72 litters), leading to six comparison treatments. These agar gels were made of pellet mash without or with a sensory additive: one non-odorised control gel and three gels with 0.20% banana flavour, 0.06% red berry flavour and 0.10% vanilla flavour, respectively. In the first trial, kits ate more gB in fresh matter than other feed presentations (P < 0.001), with a total intake of 7.0 ± 1.8 g/rabbit from 8 to 17 days. In DM, the total consumption of pellets P (1.6 ± 0.4 g of DM/rabbit) was the highest together with the gB form (1.4 ± 0.4 g of DM/rabbit), whereas cBP was barely consumed (0.3 ± 0.1 g of DM/rabbit). Gel feed supplemented with vanilla was slightly more consumed than other flavoured and non-odorised gels (relative consumption of 57% when compared to control gel; P = 0.001). The gel feed intake was independent of the milk intake but was correlated with the litter weight at 3 days (r = 0.40, P < 0.001). In both trials, rabbit growth before and after weaning was not affected by the type of creep feed provided. Our results confirmed that providing creep feed promotes the solid intake of rabbits at early stages. Gel feed form motivated rabbits to eat and vanilla flavour supplementation increased the feed palatability. Those creep feed characteristics should be explored further for seeking effective stimulation of the onset of the feed intake in suckling rabbit.
Credibility and trustworthiness are the bedrock upon which any science is built. The strength of these foundations has been increasingly questioned across the sciences as instances of research misconduct and mounting concerns over the prevalence of detrimental research practices have been identified. Consequently, the purpose of this article is to encourage our scientific community to positively and proactively engage in efforts that foster a healthy and robust industrial and organizational (I-O) psychology. We begin by advancing six defining principles that we believe reflect the values of robust science and offer criteria for evaluating proposed efforts to change scientific practices. Recognizing that the contemporary scientific enterprise is a complex and diverse network of actors and institutions, we then conclude by identifying 12 stakeholders who play important roles in achieving a culture of robust science in I-O psychology and offer recommendations for actions we can take as members of these groups to strengthen our science.
The use of a catalyst is required to synthesize poly(D,L-lactide) (PLA) and tin (II) 2-ethylhexanoate could be highlighted among them. However, this kind of catalysts can produce bio-dangerous compounds limiting the PLA in medical applications, therefore there is a need to investigate novel bio-safe catalysts. Taking into account this problem, this communication reports the use of micro- and nano-ZnO particles as catalysts for the microwave-assisted polymerization of D,L-lactide. By microwave heating a high monomer conversion (higher than 95%) was achieved in a relatively short reaction time (3 hours). Morphology/size and concentration of ZnO particles presented a strong effect on the production of PLA, star-like microparticles leaded to conversion ca. 25%, well below to the values achieved with the nanoparticles. Furthermore, the formation of a ZnO-PLA hybrid was evidenced by spectroscopic and thermal characterization techniques. The methodology herein developed represents a new pathway for the green synthesis of PLA.
We compare the stellar motion around a spiral arm created in two different scenarios, transient/co-rotating spiral arms and density-wave-like spiral arms. We generate Gaia mock data from snapshots of the simulations following these two scenarios using our stellar population code, SNAPDRAGONS, which takes into account dust extinction and the expected Gaia errors. We compare the observed rotation velocity around a spiral arm similar in position to the Perseus arm, and find that there is a clear difference in the velocity features around the spiral arm between the co-rotating spiral arm and the density-wave-like spiral arm. Our result demonstrates that the volume and accuracy of the Gaia data are sufficient to clearly distinguish these two scenarios of the spiral arms.
Improved understanding of the pattern of white matter changes in early and prodromal Alzheimer's disease (AD) states such as mild cognitive impairment (MCI) is necessary to support earlier preclinical detection of AD, and debate remains whether white matter changes in MCI are secondary to gray matter changes. We applied neuropsychologically based MCI criteria to a sample of normally aging older adults; 32 participants met criteria for MCI and 81 participants were classified as normal control (NC) subjects. Whole-head high resolution T1 and diffusion tensor imaging scans were completed. Tract-Based Spatial Statistics was applied and a priori selected regions of interest were extracted. Hippocampal volume and cortical thickness averaged across regions with known vulnerability to AD were derived. Controlling for cortical thickness, the MCI group showed decreased average fractional anisotropy (FA) and decreased FA in parietal white matter and in white matter underlying the entorhinal and posterior cingulate cortices relative to the NC group. Statistically controlling for cortical thickness, medial temporal FA was related to memory and parietal FA was related to executive functioning. These results provide further support for the potential role of white matter integrity as an early biomarker for individuals at risk for AD and highlight that changes in white matter may be independent of gray matter changes. (JINS, 2013, 19, 1–13)
Foraminiferal analyses of 404 contiguous samples, supported by diatom, lithologic, geochronologic and seismic data, reveal both rapid and gradual Holocene paleoenvironmental changes in an 8.21-m vibracore taken from southern Pamlico Sound, North Carolina. Data record initial flooding of a latest Pleistocene river drainage and the formation of an estuary 9000 yr ago. Estuarine conditions were punctuated by two intervals of marine influence from approximately 4100 to 3700 and 1150 to 500 cal yr BP. Foraminiferal assemblages in the muddy sand facies that accumulated during these intervals contain many well-preserved benthic foraminiferal species, which occur today in open marine settings as deep as the mid shelf, and significant numbers of well-preserved planktonic foraminifera, some typical of Gulf Stream waters. We postulate that these marine-influenced units resulted from temporary destruction of the southern Outer Banks barrier islands by hurricanes. The second increase in marine influence is coeval with increased rate of sea-level rise and a peak in Atlantic tropical cyclone activity during the Medieval Climate Anomaly. This high-resolution analysis demonstrates the range of environmental variability and the rapidity of coastal change that can result from the interplay of changing climate, sea level and geomorphology in an estuarine setting.
In this study we investigated the development of the hypothalamic–pituitary–adrenal (HPA) axis in 21 group-living rhesus monkeys infants that were physically abused by their mothers in the first few months of life and in 21 nonabused controls. Cortisol and adrenocorticotropin hormone (ACTH) responses to a corticotropin-releasing hormone (CRH) challenge were assessed at 6-month intervals during the subjects' first 3 years of life. Abused infants exhibited greater cortisol responses to CRH than controls across the 3 years. Abused infants also exhibited blunted ACTH secretion in response to CRH, especially at 6 months of age. Although there were no significant sex differences in abuse experienced early in life, females showed a greater cortisol response to CRH than males at all ages. There were no significant sex differences in the ACTH response to CRH, or significant interactions between sex and abuse in the ACTH or cortisol response. Our findings suggest that early parental maltreatment results in greater adrenocortical, and possibly also pituitary, responsiveness to challenges later in life. These long-term alterations in neuroendocrine function may be one the mechanisms through which infant abuse results in later psychopathologies. Our study also suggests that there are developmental sex differences in adrenal function that occur irrespective of early stressful experience. The results of this study can enhance our understanding of the long-term effects of child maltreatment as well as our knowledge of the development of the HPA axis in human and nonhuman primates.
Pedro Barbieri, Department of Anesthesia, Hospital Britanico de Buenos Aires, University of El Salvador School of Medicine, Buenos Aires, Argentina,
Daniel H. Gomez, Department of Anesthesia, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina,
Peter F. Mahoney, Military Critical Care, Royal Centre for Defence Medicine, Birmingham, United Kingdom,
Pablo Pratesi, Department of Emergency Medicine, Austral University Hospital, Pilar, Buenos Aires, Argentina,
Christopher M. Grande, Department of Anesthesiology, University of Pittsburgh School of Medicine, Pennsylvania, and International TraumaCare (ITACCS), Baltimore, Maryland
The aim of this chapter is to put trauma in context as a major health issue and give practitioners an understanding of the underlying causes and mechanisms.
Injury is the leading cause of death in people aged between 1 and 44 years in the United States and a leading cause of death worldwide . It can be defined as a “physical harm or damage to the structure or function of the body, caused by an acute exchange of energy (mechanical, chemical, thermal, radioactive, or biological) that exceeds the body's tolerance” [2, 3].
In 2002, 33 million patients were processed by emergency departments in the United States, and 161,269 died by traumatic injury . Trauma is the leading cause of years of potential life lost for people younger than 75 years and this implies a huge expense to the health care system and massive amounts of resources used for care and rehabilitation .
Demographics is the statistical study of human populations, especially with reference to size and density, distribution, and vital statistics. Data on the demographics of trauma in the United States have been obtained from a number of sources listed in the references to this chapter.
In a recent report from the Federal Bureau of Investigation's (FBI) Uniform Crime Reporting Program, the FBI estimated that more than 1.4 million drivers were arrested for driving under the influence of alcohol or narcotics, and an estimated 254,000 persons were injured in crashes where police reported that alcohol was present – an average of one person injured approximately every two minutes.
Candidates for coronary artery bypass graft surgery have been found to
exhibit reduced cognitive function prior to surgery. However, little is
known regarding the factors that are associated with pre-bypass cognitive
function. A battery of neuropsychological tests was administered to a
group of patients listed for bypass surgery (n = 109). Medical,
sociodemographic and emotional predictors of cognitive function were
investigated using structural equation modeling. Medical factors, namely
history of hypertension and low ejection fraction, significantly predicted
reduced cognitive function, as did several sociodemographic
characteristics, namely older age, less education, non-English speaking
background, manual occupation, and male gender. One emotional variable,
confusion and bewilderment, was also a significant predictor whereas
anxiety and depression were not. When significant predictors from the
three sets of variables were included in a combined model, three of the
five sociodemographic characteristics, namely age, non-English speaking
background and occupation, and the two medical factors remained
significant. Apart from sociodemographic characteristics, medical factors
such as a history of hypertension and low ejection fraction significantly
predicted reduced cognitive function in bypass candidates prior to
surgery. (JINS, 2007, 13, 257–266.)
Background. Somatizing patients are a challenge to general practitioners (GPs). A cluster randomized controlled trial was conducted to asses the effect of specific communication techniques delivered by GPs on somatizing patients' self-perceived health.
Method. Thirty-nine GPs were assigned randomly to two parallel groups. GPs in the intervention group treated somatic patients according to specific communication techniques focused on offering a physical explanation – release of hormones – and approaching sensitive topics in the patient's experience indirectly. Control GPs used the standard Goldberg reattribution technique. A total of 156 patients, aged 18–65 years, were selected randomly from a list of 468 patients with six or more active symptoms for women and four or more for men. All patients had six programmed 30-min consultations. Health-related quality of life (assessed with the 36-item Short-Form Health Survey, SF-36) and a summary utility index were used as outcome measures. Patients were interviewed at home at baseline and at 3, 8 and 12 months after the beginning of the intervention.
Results. Patients in both groups improved in all dimensions of the SF-36. The time course of the quality of life was significantly better for the intervention group in five of the eight scales of the SF-36 (bodily pain, mental health, physical functioning, vitality, and social functioning) and in the utility index (p<0·039).
Conclusions. Communication techniques were found to have a clinically relevant impact on body pain. This finding, together with a trend towards better scores in the remaining scales, justifies the use of these techniques in psychosocial interventions delivered to patients with medically unexplained symptoms.
Patients with unilateral, right frontal lobe damage (N = 13)
and matched controls (N = 20) performed a task of lexical
ambiguity resolution in order to explore the contribution of right frontal
regions to lexical-semantic priming. Word triplets consisting of balanced
homographs were presented to participants in four conditions:
concordant, discordant, neutral, and
unrelated. Controls demonstrated facilitation for concordant
meanings of homographs, as evidenced by their faster reaction times in the
concordant relative to the unrelated (baseline) condition, as well as a
lack of facilitation for the discordant meaning relative to the neutral
and concordant conditions. Results in patients with right frontal lobe
damage differed depending on the site of the lesion. Patients with lesions
restricted to the right medial frontal lobe only showed facilitation in
the neutral condition, while those with lesions encroaching upon the right
dorsolateral region demonstrated facilitation of both discordant and
concordant meanings relative to the baseline condition. These results
support a role for the right frontal lobe in semantic priming and suggest
possible specialization within the right prefrontal cortex for the
processing of lexical-semantic information. (JINS, 2005,
In order to enable low cost roll-to-roll or sheet-processing of organic light-emitting diode (OLED) devices, completely new deposition methods for both polymer and smallmolecule layers are being developed in place of the classic semiconductor manufacturing methods. In evaluating the utility of such methods, it is advantageous to have a robust and fast method to measure the thickness uniformity of the deposited organic layers. Non-uniformities at all spatial length scales from sub-mm to several cm can occur and so need to be understood as a function of the relevant parameters for each deposition method. Here we demonstrate a simple and fast method to quantify non-uniformities in thin films over arbitrarily large length scales. Our method utilizes the color of light reflected from the coated substrate and its variation with polymer layer thickness. This concept of color change is well known, and is due to constructive interference of light of particular wavelengths related to polymer layer thickness and optical constants. In our modification, a digital camera is used to capture images of the coated substrates, and hue is extracted from the image data files. We show that hue can be linearly correlated with polymer thickness. We demonstrate this for polymer based OLEDs using poly(3,4-ethylenedioxythiophene) poly(styrenesulfonate) (PEDOT:PSS) and a light-emitting polymer (LEP) deposited on transparent substrate. The correlations were successfully used for 40-140nm PEDOT:PSS layers and 20-110nm LEP layers over length scales greater than 1 inch. The method sensitivity is estimated to be better than 5 nm. We show examples of non-uniformity analysis and how it relates to OLED performance.
The Botswana Composite Breed (BCB) was developed by Dept. of Agricultural Research to mitigate problems of small herds that could not sustain crossbreeding programs. The breed has 47.5% Sanga, 22.6% Zebu and 29.9% Bos taurus blood. Indigenous Tswana cattle are 40% of the national herd (Masilo and Podisi 2001), indicating an erosion of local genetic material. Tswana cattle are small framed and are prejudiced by the Botswana Meat Commission (BMC) weight-based pricing system in favour of large-framed cattle. Lack of carcass characterization of indigenous cattle contributes to the above situation. The aim of this study was to evaluate performance of BCB and other indigenous breeds under feedlot and grazing conditions in order to promote their attributes.