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The use of social networks is an integral part of our daily life as a means of communication. Patients manage information mostly from the internet, that strongly influence their beliefs and behaviors toward illness. Scientific dissemination through these kinds of platforms has expanded enormously in recent years, varying between them in style, contents and type of interaction with the users, that make necessary an individualized analysis. The use of Instagram goes beyond sharing photos and free comments, and it has been used extensively in different fields of medicine, such as mental health. This tool has enormous potential as a means of more effective communication and prevention and it is very valuable as a tool for psychoeducation and prevention in mental health. However, in the era where “information is easy to get but knowledge is difficult to find”, professionals of mental health should get involved and adapt to new scenarios of communication.
The use of social networks is an integral part of our daily life as a means of communication. Scientific dissemination through these kind of platforms has expanded enormously in recent years, for example in networks such as Instagram, a free photo, text messaging and video sharing social media application. Instagram has been used extensively in different fields of medicine. Initially it was limited to visually rich fields but it has been extended to others such as mental health. This tool has enormous potential as a means of more effective communication and prevention.
To analyze the role of Instagram as a tool of psychoeducation and prevention in mental health
An analysis of different mental health profiles was carried based on different items: publications, interactions, likes, commentaries, shares, accounts reached, accounts engaged and hashtags.
Mental health has become one of the sanitary fields generating more traffic on social media reaching a great number of publications per day. Topics that generated more interaction were: depression, anxiety, trauma, sleep and emotion regulation difficulties among others. However most mental health information available in social media had not been provided by proffessinals of the mental health but by many others.
Instagram is presented as a valuable mental health prevention tool and professionals should engage and adapt to new scenarios of communication. In the era where information is easy to get but knowledge is difficult to find, experts of mental health should more involved.
The extent to which social media contributes to body image dissatisfaction and lower self-esteem is currently under debate
This research seeks to study the relationship between the use of Instagram (one of the main platforms used by young people nowadays) and the degree of dissatisfaction with body image and the level of self-esteem among their younger users
A sample of 585 Spanish adults between 18 and 40 years old was used, to whom the Body Shape Questionnaire (BSQ), the Rosenberg Self-esteem Scale and the Social Comparison of Appearance Scale (PACS) were applied.
A positive correlation was observed between the frequency of use of the social network and dissatisfaction with body image and low self-esteem. In addition, it was found that content observation time significantly predicts body dissatisfaction and low self-esteem. On the other hand, the type of content both published and observed, showed no effect on any of these variables, although it has been found that the relationship between the use of the platform and the study variables seems to be mediated by the tendency of their users to compare their appearance with others.
These results invite us to reflect on the use of social networks and their impact on constructs as relevant to the person as self-esteem and body image and on how different policies should be taken into account to prevent a negative impact on the mental health of their users
Functional magnetic resonance imaging (fMRI) is a neuroimaging technique increasingly used for both patient care and clinical research. This techniche provides a space-time high-resolution able to detect small changes in regional brain activation.Ojbectives: the aim of this study was to compare patterns of regional brain activation in patients with eating disorders (ED) and healthy volunteers during emotional stimulation.
Materials and methods
A group of 13 young female ED outpatients was selected using DSM-IV criteria and 13 young healthy female volunteers with no significant differences in sociodemographic or environmental data. fMRI was used to examine the neural responses after visual stimulation with neutral and fearful images, taken from the IAPS (International Affective Picture System) and selected a region of interest (ROI) aproach to examine the function of the amygdala in emotional processing.Data processing and higher level analysis were carried out using FSL (fMRI's Software Library).
ED patients showed significantly greater rigth amygdala activation to the fearful images versus neutral images than healthy control subjects (p < 0.02)
A higher right amygdala response to processing of fearful stimuli was observed in ED patients compared to healthy volunteers. This emotional dysregulation in the affective response to unpleasant stimuli would correlate with a maladaptative response and therefore justify disruptive behaviours in this patients.
Diffusion tensor imaging (DTI) is a relatively new imaging technique that is being increasingly used in different types of psychiatric patologies to characterize white matter microstructural organization in this kind of disorders. In the present study we use DTI to explore the structure of the white matter of borderline personality disorder (BPD) patients, using a novel voxel-based approach, tract-based spatial statistics (TBSS), to analyze the data.
Methods and materials
DTI was performed in a 1.5T MRI unit in 9 young male patients with a DSM-IV defined BPD and 14 healthy male control subjects (no significant age difference between groups).Voxel wise analysis was performed using TBSS (diffusion toolbox of FSL- functional MRI Software Library) to localize regions of white matter showing significant changes of fractional anisotropy (FA). Additional high resolution three dimensional datasets were also acquired and normalised white matter volume was estimated with SIENAX (part of FSL).
The TBSS analysis revealed a statistically significant decrease in FA at the anterior part of the body and the genu of the corpus callosum and frontal white matter. This finding is consistent with previously reported findings of subtle prefrontal white matter abnormalities in BPD.
Significant white matter tract alterations in patients with BPD where observed in frontal regions involved in emotional, behavioural and cognitive regulation, and these abnormalities may be linked to key aspects of psychopatology in these patients.
There is a shortage of psychiatrists worldwide. Within Europe, psychiatric trainees can move between countries, which increases the problem in some countries and alleviates it in others. However, little is known about the reasons psychiatric trainees move to another country.
Survey of psychiatric trainees in 33 European countries, exploring how frequently psychiatric trainees have migrated or want to migrate, their reasons to stay and leave the country, and the countries where they come from and where they move to. A 61-item self-report questionnaire was developed, covering questions about their demographics, experiences of short-term mobility (from 3 months up to 1 year), experiences of long-term migration (of more than 1 year) and their attitudes towards migration.
A total of 2281 psychiatric trainees in Europe participated in the survey, of which 72.0% have ‘ever’ considered to move to a different country in their future, 53.5% were considering it ‘now’, at the time of the survey, and 13.3% had already moved country. For these immigrant trainees, academic was the main reason they gave to move from their country of origin. For all trainees, the overall main reason for which they would leave was financial (34.4%), especially in those with lower (<500€) incomes (58.1%), whereas in those with higher (>2500€) incomes, personal reasons were paramount (44.5%).
A high number of psychiatric trainees considered moving to another country, and their motivation largely reflects the substantial salary differences. These findings suggest tackling financial conditions and academic opportunities.
Treatment strategies in bipolar disorder (BPD) has changed in the last decades and polypharmacy including antipsychotics has become extremely common compared to monotherapy with mood stabilisers. Clinicians tend to use 2 or more atypical antipsychotics despite the lack of evidence to support safety, tolerability and efficacy of this practice.
To determine most frequently used treatment strategies in a sample of bipolar disorder patients and review of the literature.
Analysis of a sample of 35 patients with BPD from Madrid and review of recent literature for evidence arising from international guidelines recommendations and meta-analyses.
Most frequently used treatment approach in our sample was polytherapy, including at least 1 atypical antipsychotic (31%) and polytherapy, including at least 2 antipsychotics (47%) together with mood stabilisers. Only 11% were in monotherapy with mood stabilisers and another 11%were in monotherapy with one atypical antipsychotic but without mood stabilisers. Aripiprazol and olanzapine were among the most preferred atypical antipsychotics. Efficacy and safety of such combinations have not been systematically compared with monotherapy in the literature. Previous data indicate that polytherapy in BPD may incur in important disadvantages .
Treatment of BPD remains challenging. Polytherapy seem to have replaced monotherapy due to less relapses and better results in treatment of affective symptoms. However, compliance and secondary long-term effects should be taken into account. Superiority in terms of efficacy in polytherapy needs to be balanced with tolerability issues. More studies on combination therapy, long-term efficacy and safety are needed.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Dietary interventions are a common practice in the poultry industry to promote optimal performance and health of animals. Here, we aim at assessing the influence of supplementing broiler diets with dry whey powder (DWP) and whey protein concentrate (WPC) on nutrient coefficient of apparent ileal digestibility (CAID) and productive performance. Cecal microbiota composition was also determined using Illumina amplicon sequencing. Dietary treatments were control diet (no supplementation of DWP or WPC), 60-DWP (60 g/kg of DWP), and 80-WPC (80 g/kg of WPC). One-day-old male broilers were randomly assigned to one of three treatments, and housed in floor pens. In Trial 1, 90 1-day-old chicks were allocated to three pens/treatment, with 10 birds/pen, during 21 days for CAID evaluation. Diet 60-DWP increased Ca CAID (P=0.041), while diet 80-WPC improved Ca and P CAID (P<0.001 and 0.002, respectively) when compared with control diet. In Trial 2, 810 one-day-old chicks were allocated to nine pens/treatment, with 30 birds/pen, during 42 days. Feeding chickens with 60-DWP and 80-WPC increased their BW, average daily gain (ADG) and feed intake (FI) during the starter (P<0.001 for all variables) and grower-finisher periods (P<0.001 for BW and FI, and P=0.048 for ADG), and during the entire feeding period (P<0.05), when compared with control diet. Diets 60-DWP and 80-WPC reduced the feed conversion ratio of chickens during the starter period (P<0.001 and 0.003, respectively), while 60-DWP reduced this parameter during the entire feeding period (P=0.048), when compared to control diet. At day 42, cecal microbial communities of chickens that were fed with 60-DWP and 80-WPC differed from those fed with control diet (R=0.776, P=0.008; and R=0.740, P=0.008, respectively). The abundance of Bacteroides fragilis, Bacteroides spp., Escherichia coli/Shigella flexneri and Megamonas furniformis increased when 60-DWP and 80-WPC diets were offered, while the presence of Helicobacter pullorum decreased. Lactobacillus salivarius consistently increased in chickens with better feed conversion ratio, which were those fed with 60-DWP. The results obtained in the present study indicate that growth of chickens is improved by DWP and WPC supplementation because of a higher mineral digestibility, increased feed intake and modulation of cecal microbiota communities.
Daytime restricted feeding (2 h of food access from 12.00 to 14.00 hours for 3 weeks) is an experimental protocol that modifies the relationship between metabolic networks and the circadian molecular clock. The precise anatomical locus that controls the biochemical and physiological adaptations to optimise nutrient use is unknown. We explored the changes in liver oxidative lipid handling, such as β-oxidation and its regulation, as well as adaptations in the lipoprotein profile. It was found that daytime restricted feeding promoted an elevation of circulating ketone bodies before mealtime, an altered hepatic daily rhythmicity of 14CO2 production from radioactive palmitic acid, and an up-regulation of the fatty acid oxidation activators, the α-subunit of AMP-activated protein kinase (AMPK), the deacetylase silent mating type information regulation homolog 1, and the transcriptional factor PPARγ-1α coactivator. An increased localisation of phosphorylated α-subunit of AMPK in the periportal hepatocytes was also observed. Liver hepatic lipase C, important for lipoprotein transformation, showed a change of daily phase with a peak at the time of food access. In serum, there was an increase of LDL, which was responsible for a net elevation of circulating cholesterol. We conclude that our results indicate an enhanced fasting response in the liver during daily synchronisation to food access, which involves altered metabolic and cellular control of fatty acid oxidation as well a significant elevation of serum LDL. These adaptations could be part of the metabolic input that underlies the expression of the food-entrained oscillator.
We simulated the frequency of tuberculosis infection in healthcare workers in order to classify the risk of TB transmission for nine hospitals in Medellín, Colombia. We used a risk assessment approach to estimate the average number of infections in three risk groups of a cohort of 1082 workers exposed to potentially infectious patients over 10- and 20-day periods. The risk level of the hospitals was classified according to TB prevalence: two of the hospitals were ranked as being of very high priority, six as high priority and one as low priority. Consistent results were obtained when the simulation was validated in two hospitals by studying 408 healthcare workers using interferon gamma release assays and tuberculin skin testing. The latent infection prevalence using laboratory tests was 41% [95% confidence interval (CI) 34·3–47·7] and 44% (95% CI 36·4–51·0) in those hospitals, and in the simulation, it was 40·7% (95% CI 32·3–49·0) and 36% (95% CI 27·9–44·0), respectively. Simulation of risk may be useful as a tool to classify local and regional hospitals according to their risk of nosocomial TB transmission, and to facilitate the design of hospital infection control plans.
Two in vitro experiments were conducted to analyse the effects of replacing dietary barley grain with wastes of tomato and cucumber fruits and a 1 : 1 tomato : cucumber mixture on rumen fermentation characteristics and microbial abundance. The control (CON) substrate contained 250 g/kg of barley grain on a dry matter (DM) basis, and another 15 substrates were formulated by replacing 50, 100, 150, 200 or 250 g of barley grain/kg with the same amount (DM basis) of tomato or cucumber fruits or 1 : 1 tomato : cucumber mixture. In Expt 1, all substrates were incubated in batch cultures with rumen micro-organisms from goats for 24 h. Increasing amounts of tomato, cucumber and the mixture of both fruits in the substrate increased final pH and gas production, without changes in final ammonia-nitrogen (NH3-N) concentrations, substrate degradability and total volatile fatty acid (VFA) production, indicating that there were no detrimental effects of any waste fruits on rumen fermentation. Therefore, in Expt 2 the substrates including 250 g of waste fruits (T250, C250 and M250 for tomato, cucumber and the mixture of both fruits, respectively) and the CON substrate were incubated in single-flow continuous-culture fermenters for 8 days. Total VFA production did not differ among substrates, but there were differences in VFA profile. Molar proportions of propionate, isobutyrate and isovalerate were lower and acetate : propionate ratio was greater for T250 compared with CON substrate. Fermentation of substrates containing cucumber (C250 and M250) resulted in lower proportions of acetate, isobutyrate and isovalerate and acetate : propionate ratio, but greater butyrate proportions than the CON substrate. Carbohydrate degradability and microbial N synthesis tended to be lower for substrates containing cucumber than for the CON substrate, but there were no differences between CON and T250 substrates. Abundance of total bacteria, Fibrobacter succinogenes and Ruminococcus flavefaciens, fungi, methanogenic archaea and protozoa were similar in fermenters fed T250 and CON substrates, but fermenters fed C250 and M250 substrates had lower abundances of R. flavefaciens, fungi and protozoa than those fed the CON substrate. Results indicated that tomato fruits could replace dietary barley grain up to 250 g/kg of substrate DM without noticeable effects on rumen fermentation and microbial populations, but the inclusion of cucumber fruits at 250 g/kg of substrate DM negatively affected some microbial populations as it tended to reduce microbial N synthesis and changed the VFA profile. More studies are needed to identify the dietary inclusion level of cucumber which produces no detrimental effects on rumen fermentation and microbial growth.
Two in vitro and one in vivo experiments were conducted to investigate the effects of a selection of plant compounds on rumen fermentation, microbial concentration and methane emissions in goats. Treatments were: control (no additive), carvacrol (CAR), cinnamaldehyde (CIN), eugenol (EUG), propyl propane thiosulfinate (PTS), propyl propane thiosulfonate (PTSO), diallyl disulfide (DDS), a mixture (40 : 60) of PTS and PTSO (PTS+PTSO), and bromochloromethane (BCM) as positive control with proven antimethanogenic effectiveness. Four doses (40, 80, 160 and 320 µl/l) of the different compounds were incubated in vitro for 24 h in diluted rumen fluid from goats using two diets differing in starch and protein source within the concentrate (Experiment 1).The total gas production was linearly decreased (P<0.012) by all compounds, with the exception of EUG and PTS+PTSO (P⩾0.366). Total volatile fatty-acid (VFA) concentration decreased (P⩽0.018) only with PTS, PTSO and CAR, whereas the acetate:propionate ratio decreased (P⩽0.002) with PTS, PTSO and BCM, and a tendency (P=0.064) was observed for DDS. On the basis of results from Experiment 1, two doses of PTS, CAR, CIN, BCM (160 and 320 µl/l), PTSO (40 and 160 µl/l) and DDS (80 and 320 µl/l) were further tested in vitro for 72 h (Experiment 2). The gas production kinetics were affected (P⩽0.045) by all compounds, and digested NDF (DNDF) after 72 h of incubation was only linearly decreased (P⩽0.004) by CAR and PTS. The addition of all compounds linearly decreased (P⩽0.009) methane production, although the greatest reductions were observed for PTS (up to 96%), DDS (62%) and BCM (95%). No diet–dose interaction was observed. To further test the results obtained in vitro, two groups of 16 adult non-pregnant goats were used to study in vivo the effect of adding PTS (50, 100 and 200 mg/l rumen content per day) and BCM (50, 100 and 160 mg/l rumen content per day) during the 9 days on methane emissions (Experiment 3). The addition of PTS and BCM resulted in linear reductions (33% and 64%, respectively, P⩽0.002) of methane production per unit of dry matter intake, which were lower than the maximum inhibition observed in vitro (87% and 96%, respectively). We conclude that applying the same doses in vivo as in vitro resulted in a proportional lower extent of methane decrease, and that PTS at 200 mg/l rumen content per day has the potential to reduce methane emissions in goats. Whether the reduction in methane emission observed in vivo persists over longer periods of treatments and improves feed conversion efficiency requires further research.
The Asian citrus psyllid Diaphorina citri Kuwayama is a destructive insect pest in citriculture, because it is an efficient vector of the proteobacteria ‘Candidatus Liberibacter asiaticus’ (Las), ‘Ca. L. africanus’ (Laf) and ‘Ca. L. americanus’ (Lam). These bacteria cause the ‘huanglongbing’ disease or ‘greening’ or ‘yellow dragon’ disease. The disease kills the plant and reduces fruit production. This insect pest is susceptible to entomopathogenic fungi, and we report the use of different strains of Metarhizium anisopliae, Cordyceps bassiana and Isaria fumosorosea against the nymphs and adults of D. citri under field conditions. The fungi were applied four times using a concentration of 2 × 1013 conidia/ha with a time interval of 15 days between applications. The percentage of control of Cb 108, Ma 65, Ma 14 and Ifr 4 was 60, 50, 40 and 35% in nymphs, and 50, 50, 42 and 22% in adults, respectively. Metarhizium anisopliae, C. bassiana and I. fumosorosea applied on Persian lime groves are more effective in reducing higher density of nymphs than adults of D. citri.
This work was conducted to evaluate the effect of tannins, contained in a by-product derived from olive oil extraction (two-stage olive cake), on nutrient digestibility, nitrogen (N) losses and liver and kidney functions in goats and wethers. Six Segureña wethers and six Granadina goats were fed three experimental diets: alfalfa hay (AH); alfalfa hay and a concentrate (formulated with two-stage olive cake, barley and a mineral-vitamin mixture) without (AHCO) or with polyethylene glycol (PEG) addition (AHCOP). The inclusion of two-stage olive cake increased condensed tannins content of the diet and led to a decrease ( P < 0.001) in dry matter, organic matter, neutral-detergent fibre, acid-detergent fibre and crude protein (CP) digestibility. PEG supply increased ( P < 0.001) CP digestibility and N losses in urine and faeces only in wethers. Concentrations of creatinine and alkaline phosphatase activity, measured in the serum of animals, were not modified either by olive cake inclusion or by PEG supply. Results from this work indicate a higher sensitivity of sheep to diets containing condensed tannins, compared with goats, and reveal no toxic effect of tannins from two-stage olive cake at the concentration used in the experimental diets.
To increase the existent genetic variability in cysteine proteases, a polymorphism study was performed in Haemonchus contortus by comparing 2 different strains of the parasite: North American (NA) and Spanish (SP) strains. For this purpose, the polymorphism of 5 previously reported genes (AC-1, AC-3, AC-4, AC-5 and GCP-7) were analysed by PCR–SSCP and sequencing procedures. Based on the SSCP results, a total of 20 different alleles were identified for the 5 loci assessed. Except locus AC-5, all the loci were polymorphic. Loci AC-1, AC-3, AC-4 and GCP-7 showed 5, 8, 2 and 4 alleles, respectively. The allelic frequencies ranged from 0·0070 to 0·8560 and were significantly different between strains. In addition, nucleotide diversity analyses showed a significant variation within and between strains. The variations in the nucleotide sequence of the different alleles were translated in some cases into changes in the amino acid sequence. Evidence of genetic variability in cysteine proteases from two different strains of H. contortus for the same set of genes had not been previously reported.
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