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Cercarial dermatitis (‘swimmer's itch’; SI), characterized by small itchy bumps caused by schistosome parasites of birds and mammals, is a common problem in Michigan. Research on avian schistosomes began nearly 100 years ago in Michigan inland lakes, yet scientists are still uncovering basic biological information including the identification of local snail and parasite species that cause SI. Previous research primarily focused on lakes in the northern half of Michigan's lower peninsula, although SI occurs throughout the state. We surveyed snails and snail-borne trematodes in lakes across Michigan's lower peninsula and used quantitative polymerase chain reaction analysis of filtered water samples to identify parasites to the species level, including a recently discovered parasite species that uses the snail Planorbella (Helisoma) trivolvis as its intermediate host. Most SI mitigation efforts have focused on a parasite species hosted by the snail Lymnaea catescopium ( = Stagnicola emarginata); however, lymnaeid snails and their associated schistosome species were largely restricted to northern lakes. In contrast, P. trivolvis and its associated parasite species were common in both northern and southern Michigan lakes. A third schistosome species associated with physid snails was also present at low levels in both northern and southern lakes. These results indicate that the recently discovered parasite species and its planorbid snail intermediate host may be more important drivers of Michigan SI than previously thought, possibly due to increased definitive host abundance in recent decades. These results have potentially important implications for SI mitigation and control efforts.
The Interpersonal Needs Questionnaire (INQ-15) and the Acquired Capability for Suicide Scale - Fearlessness About Death (ACSS-FAD) have been introduced to evaluate the theoretical constructs posit by Joiner’s Interpersonal Psychological Theory of Suicide (IPTS).
The present study aimed to evaluate the psychometric properties of the INQ-15 (which measures Thwarted Belongingness, TB, and Perceived Burdensomeness, PB) and the ACSS-FAD (measurement of Fearlessness About Death, FAD, dimension of the acquired capability) in a population of Italian university students.
Since there was no Italian version of the ACSS-FAD, we have translated it through an accurate multistage procedure. ACSS-FAD and INQ-15 have been administered to a sample of 1,665 Italian university students. We analyzed the factorial structure of the INQ-15 and the ACSS-FAD, their reliability, criterion, convergent and discriminant validity.
Principal Component Analysis confirmed a two-dimensional structure for INQ-15 and a one-factor structure for ACSS-FAD. Internal consistency reliability of the scales was good, respectively TB: α = .85; PB: α = .90; and FAD: α = .85. The INQ-15 demonstrated concurrent associations with suicidal ideation, while the ACSS-FAD with a history of suicidal planning/suicide attempt. Convergent and discriminant validity were also in line with previous studies.
Both INQ-15 and ACSS-FAD appropriately capture the respective constructs, proving to be valid measures for the assessment of suicide risk factors among Italian university students according to the IPTS. The valuable psychometric properties of the two scales established with this study in the Italian context encourages their use to advance the clinical understanding and prevention of suicide.
Cesare P.R. Romano begins by noting the distinction between the “right to benefit from advancements in science and technology” (i.e. the Right to Science) and the so-called “rights of science” (e.g. right to academic freedom, to conduct research, to reap the fruits of one’s own inventions etc.). Romano proceeds to discuss the roots of these two sets of rights. The roots of the rights of science run deep, all the way to Bacon and Galileo, and intertwine with other more well-known rights, such as the right to education and freedom of expression. The roots of the Right to Science are relatively more recent and can be traced to the work of the Inter-American (I-A) Juridical Committee, the expert body that drafted the American Declaration of Human Rights. This chapter tells the story of the debates between the members of the I-A Committee on the right to science, the various wordings they considered, and the influences and considerations that shaped their choices. Finally, it explains how and why the wording of Art. XIII of the American declaration morphed into Art. 27 of the Universal Declaration and, later, Art. 15.1.b, 15.2-4 of the ICESCR.
This article summarizes recent transformations in the field of performing arts in Brazil, with attention to feminist theatrical production. It provides a description of the context of this branch of Brazilian political theatre, between the civil–military coup of 1964 and the present, focusing on 2015, a period named the Brazilian ‘Feminist Spring’. This historical arc of almost sixty years celebrates groups and artists which represent the dissemination of feminist discussion and poetics in all kinds of performative events in the theatrical field, as well as revealing the backlash represented by the anti-feminist policies of the Bolsonaro government, elected in late 2018.
One of the central debates in the psychiatric community is the difficulty in distinguishing Dissociative Identity Disorder (DID) from Borderline Personality Disorder (BPD). The fact that core symptoms of these pathologies such as emotional dysregulation, alterations in sense of Self, amnesia, depersonalization, self harm, hearing voices, difficulties in maintaining relationships, are symptoms that feature in both disorders can lead physicians to a misdiagnosis, thus depriving patients with DID of adequate treatment.
To report a complex clinical case of a DID patient initially misdiagnosed as BPD.
Clinical case report.
A 45-year-old Caucasian woman with a history of childhood intrafamilial sexual abuse and domestic violence, substance use disorder, autolesionistic and suicidal behaviour with an active diagnosis of BPD presented to our ambulatory mental health care service. A more thorough examination revealed a history of emotional and affect dysregulation, depersonalization, amnesia, intrusive traumatic memories and nightmares with affective, cognitive, and sensorimotor aspects, persistent negative Self-perception. Auditory verbal hallucinations were also present described as inner space with commentary and derogatory nature with one of them being a child voice. The diagnosis of tertiary structural dissociation and DID was finally made when three Apparently Normal Personalities emerged with several Emotional Personalities, authorising for cautious partial pharmacological washout and initiation of three phase-orientated treatment approach.
DID is more common than is assumed and the overlap of core symptoms with other disorders can lead to a misdiagnosis. A careful clinical interview and evaluation of symptoms is mandatory to a correct DID diagnosis with a consequent appropriate therapy.
Understanding the impact of the COVID-19 pandemic on paediatric non-COVID-19-related care, as well as patient and caregiver concerns and stressors, is critical for informing healthcare delivery. It was hypothesised that high care disruptions and psychological stress would be observed among paediatric and adult CHD patients in the early phase of the pandemic.
A cross-sectional, international, electronic survey study was completed. Eligible participants included parents of children with acquired or CHD, adults with CHD, or caregivers of adults with CHD.
A total of 1220 participants from 25 countries completed the survey from 16 April to 4 May, 2020. Cardiac care disruption was significant with 38% reporting delays in pre-pandemic scheduled cardiac surgeries and 46% experiencing postponed cardiac clinic visits. The majority of respondents (75%) endorsed moderate to high concern about the patient with heart disease becoming ill from COVID-19. Worry about returning for in-person care was significantly greater than worry of harm to patient due to postponed care. Clinically significant psychological stress was high across the sample including children (50%), adults with CHD (42%), and caregivers (42%).
The early phase of the COVID-19 pandemic contributed to considerable disruptions in cardiac care for patients with paediatric and adult CHD. COVID-19-related fears are notable with potential to impact willingness to return to in-person care. Psychological stress is also very high necessitating intervention. Further study of the impact of delays in care on clinical outcomes is warranted.
The presence of panic disorder (PD) [1,2,3] is associated with numerous of cardiovascular, respiratory, gastroenterologic and neuro-otologic symptoms. PD is an anxiety disorder with a good outcome and prognosis, but if it isn't recognized cause a worse quality of life and a reduction of global functioning. The aim of our study is to put the attention on this delayed form of PD that are very good treated with duloxetine.
GV, a 29-year-old caucasian woman affected by PD with agoraphobia referred for recurrent gastroenteric symptoms (heartburn, chest tightness). PA, a 64-year-old caucasian woman affected by PD without agoraphobia referred for recurrent gastroenteric symptoms (heartburn). TB, a 45-year-old caucasian man affected by PD without agoraphobia referred for recurrent gastroenteric symptoms (heartburn, tightness, eructation). All patients are evaluated by gastroenterologist to excluded fisical gastroenterological problems. After 6 months all patients treated with duloxetine 60 mg/day, showed a complete remission of gastric and panic related symptoms.
Three case report positive treated with duloxetine, without particular adverse effects and litterature review.
Discussion and conclusion
Others authors hypothesized the duloxetine, a serotonin-norepinephrine inhibitor that has greater initial noradrenergic effects than venlafaxine, would have broad efficacy for individuals with PD. Descending serotonin and norepinephrine pathways are modulators of pain perception, and duloxetine have an analgesic effect on painful physical symptoms. Further research is warranted to replicate our clinical observations.
Our world is becoming more urban. More than fifty percent of the global population now lives in cities, which poses new challenges for sustainable development. This book integrates theory and methods of sustainability assessment with concepts from systems science to provide guidelines for assessing the sustainability of urban systems. It discusses different aspects of urban sustainability, from energy and housing, to mobility and health, covering social, economic and environmental factors, as well as the various stakeholders and actors involved. The book argues for the need to find models and solutions in order to design sustainable cities of the future in light of the complexity of urban social life. Including diverse case studies from the developed and developing world, this book provides a useful reference for researchers and students from a broad range of disciplines working in the field of sustainability, as well as for environmental consultants and policy makers.
Sustainability as a key principle that guides the development of our societies requires fundamental transitions if we are to attain a more liveable planet. Concomitantly, the question of how to assess sustainability not only with respect to specific system states, but also regarding transition processes as a whole, has gained greater importance. In this chapter, we propose to extend established sustainability assessment practices with an approach informed by resilience thinking. In particular, we apply a systemic angle to develop three analytical perspectives which focus on the progress, the stability, as well as the adaptability of transition processes. These perspectives make it possible to reflect on the history, current state, and (potential) future development of the system in transition. We illustrate how these analytical perspectives can complement existing sustainability assessment approaches with regard to the description, interpretation, and evaluation of the transition process.
The sustainability of urban systems is a pressing topic now, and will be even more so in the future. Currently, more that 50 percent of the world’s population (74 percent in the EU) lives in cities, and this share is expected to keep increasing, posing new challenges for sustainable development. Although cities only cover 3 percent of the earth’s surface, they account for 75 percent of global CO2 emissions, and consume about 75 percent of resources and produce 50 percent of the waste worldwide. However, cities also provide income (80 percent of global GDP) and education, and are hotspots for innovation (Acuto & Panel 2016; Wigginton, et al., 2016). The ambiguous role of cities poses large challenges and renders it necessary to develop tools to assess urban strategies and developments from a sustainability perspective.
The conceptualisation of urban systems is a crucial step in their assessment. It not only involves identifying the constituent parts of an urban system, but also directly influences the definition of appropriate measurement tools, evaluation criteria, and stakeholders for the assessment. Choices related to conceptualisation therefore have strong normative implications. Hence, there is a need to develop ways to analyse and compare different approaches in terms of their relative emphases, strengths, and weaknesses. The purpose of this chapter is to respond to this need by developing analytical tools that build on four contrasting metaphors commonly used for describing cities. The set of four metaphors (machine, organism, network, and melting pot) used for this purpose were selected based their ability to capture different existing scientific perspectives on cities. Through elaborating the implications that each of the four metaphors carries for the different aspects of an urban system, our work produced two frameworks, one for analysing approaches to conceptualising urban systems in general, and another directed more specifically at analysing approaches to the assessment of urban systems. In addition to their analytical functions, these frameworks can also provide the language that enables communication between different scientific approaches to urban systems.