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The purpose of this study was to document the development of a Community Advisory Board (CAB) to enhance equitable dissemination of research findings within an implementation mapping study to enhance equitable impact of Universal School Meals (USM) through the Designing for Dissemination and Sustainability (D4DS) process.
Methods
The D4DS process comprises 7 key elements to facilitate meaningful dissemination. To accomplish Step 1: Identify Partners, the research team conducted snowball recruitment methods within the local Philadelphia community and with existing connections. To Empathize and Outline the Problem (Step 2) and Understand the Context (Step 3), an interest meeting was held followed by monthly meetings. Our team Confirmed and Co-designed the Product (Step 4) and Developed the Dissemination Plan (Step 5) through collaborative brainstorming sessions. Finally, we started the Iterative Evaluation (Step 6) and Plan for Sustainability (Step 7) by administering a baseline and follow-up survey measuring CAB members’ perceived utility, effectiveness, and sustainability of the board.
Results
The final CAB included 8 members. The co-created dissemination products and plan comprised a 2-page infographic, social media toolkits, and a webinar slide deck, which were disseminated locally by the research team via presentations, websites, and email communication, in spring 2024. Initial findings from baseline and follow-up surveys indicated that CAB members benefited from skill development, compensation, writing credit, and autonomy in dissemination designing.
Conclusions
Sharing power and decision-making enhanced the capacity for local-level dissemination, which is much needed to advance the science of community partnerships.
In this article, a genetic algorithm (GA) is proposed as a solution for the path planning of unmanned aerial vehicles (UAVs) in 3D, both static and dynamic environments. In most cases, genetic algorithms are utilised for optimisation in offline applications; however, this work proposes an approach that performs real-time path planning with the capability to avoid dynamic obstacles. The proposed method is based on applying a genetic algorithm to find optimised trajectories in changing static and dynamic environments. The genetic algorithm considers genetic operators that are employed for path planning, along with high mutation criteria, the population of convergence, repopulation criteria and the incorporation of the destination point within the population. The effectiveness of this approach is validated through results obtained from both simulations and experiments, demonstrating that the genetic algorithm ensures efficient path planning and the ability to effectively avoid static and dynamic obstacles. A genetic algorithm for path planning of UAVs is proposed, achieving optimised paths in both static and dynamic environments for real-time tasks. In addition, this path planning algorithm has the properties to avoid static and moving obstacles in real-time environments.
Delirium is common in hospital settings, with approximately 3% to 45% of older patients in hospitals developing delirium during their stay. Among the elderly and those with severe or advanced medical conditions, the reported percentage of patients with delirium is over 56%. The three motor subtypes of delirium are hyperactive, hypoactive, and mixed. Another way to characterize delirium is based on whether it is reversible, irreversible, or terminal.
Objectives
Identifying appropriate pharmacological treatment options among antipsychotics and their correlation with various precipitating and predisposing factors in the in-hospital context
Methods
This was a retrospective, cross-sectional, observational study that utilized a database created by the psychiatry department at the National Medical Center 20 de Noviembre, with data collected from April 2021 to April 2022. The database contains anonymized administrative and clinical data of patients who were seen in the psychiatry department for the diagnosis of any type of delirium, using the CAM scale for classification. The database includes records and data of hospitalized patients, encompassing all specialties at this medical center
Results
A total of 139 patients were included in the study, of which 39% were female and 61% were male, with a mean age of 67 and a median age of 68 years. It was observed that the average duration of delirium symptoms, from receiving the consultation to remission, was approximately 6 days (p <0.005) (OR 5.12-6.62), and the average length of hospital stay was approximately 20 days (OR 17.3-22.09). Among the patients, 50.39% were overweight, 63% had hypertension (HTA), 29% had chronic kidney injury, 24% had a history of delirium, and 73% had recent surgical interventions. Patients with diabetes mellitus had a 3.1 times higher risk, those with HTA had a 2.8 times higher risk, and those with kidney injury had a 3.8 times higher risk of having a positive CAM result. It was observed that haloperidol, used in 84% of the patients, showed the highest percentage reduction in CAM scores
Image:
Image 2:
Conclusions
The results of this study emphasize the importance of identifying risk factors associated with delirium and implementing effective treatment for this condition. It was observed that the average duration of delirium symptoms was approximately 6 days, which is relevant for understanding the course and management of this illness. Furthermore, it was found that the average hospital stay was 20 days, underscoring the burden that delirium can place on healthcare systems.
In conclusion, this study highlights the importance of identifying risk factors and providing appropriate treatment, such as the use of haloperidol, to improve outcomes in patients with delirium.
The Positive and Negative Syndrome Scale (PANSS) has been used as a universal instrument for clinical assessment of psychopathology in schizophrenia. Different studies have analyzed the factorial structure of this scale and have suggested a five-factor model: positive, negative, excited, depressive, and cognitive/disorganized factors. Two of the most used models are the Marder´s solution and the Wallwork´s one.
Objectives
The aim of this work was to study the correlations of the two cognitive factors (Marder and Wallwork) with a cognitive assessment performed with a standard cognitive battery, in a sample of patients with first psychotic episode of schizophrenia.
Methods
Seventy four patients with first psychotic episode of schizophrenia (26.9, SD:7.8 years old; 70.3% male) were included. The cognitive assessment was performed with the MATRICS Consensus Cognitive Battery (MCCB). The MCCB present seven cognitive domains: Speed of processing, Working memory, Attention/Vigilance, Verbal Learning, Visual Learning, Reasoning and Problem Solving, and Social cognition). Pearson correlations were performed between MCCB scores and Marder´s PANSS cognitive factor (P2, N5, G5, G10, G11, G13, G15) and Wallwork´s one (P2, N5, G11).
Results
Correlation between MCCB scores and cognitive factors of Marder and Wallwork can be seen in the table.
Marder´s cognitive factor
Wallwork´s cognitive factor
Speed of processing
r = -0.461; p<0.001
r = -0.455; p<0.001
Attention/Vigilance
r = -0.414; p<0.001
r = -0.415; p<0.001
Working memory
r = -0.449; p<0.001
r = -0.468; p<0.001
Verbal Learning
r = -0.511; p<0.001
r = -0.405; p<0.001
Visual Learning
r = -0.252; p=0.024
r = -0.254; p=0.029
Reasoning and Problem Solving
r = -0.244; p=0.036
r = -0.272; p=0.019
Social cognition
r = -0.268; p=0.024
r = -0.202; p=0.091
Conclusions
Both PANSS cognition factors show a moderate correlations with Speed of processing, Working memory, Attention/Vigilance and Verbal Learning assessed by MCCB. More discrete correlations were found with Visual Learning, Reasoning and Problem Solving, and with Social cognition (in fact, non-significant correlation with Wallwork´s cognitive factor was found).
Acknowledgements. This study has been funded by Instituto de Salud Carlos III (ISCIII) through the project PI19/00766 and co-funded by the European Union.
Health Psychology is aggregated to clinical studies providing physicians, nurses, and psychotherapists with psychodynamics of sick persons, facilitating interpersonal relationships and greater adherence to treatments. How do people deal with illness and treatment from what they symbolize in experiences of becoming ill? Watch & Wait Protocol for patients with rectal cancer is an active surveillance as an alternative approach in surgical medical management. Patients are followed with physical examinations, endoscopy, and imaging. Observation carried out through periodic examinations aims to avoid surgery stage while rectal cancer is maintained.
Objectives
To interpret emotional meanings attributed by patients, after adhering to the W&W protocol for rectal cancer, to life experiences of watching and waiting for the disease course.
Methods
Clinical-Qualitative Method (Turato. Portuguese Psychos. J, 2000 2(1): 93-108). For data collection, the first author used Semi-Directed Interview with Open-ended Questions In-Depth and Field Notes, after acculturation. Sample closed by information saturation (Fontanella et al. Cad Saude Publica. 2008; 24(1): 17-27). Interviews conducted by the first author, a female psychologist. We employed the Seven Steps of the Clinical-Qualitative Content Analysis (Faria-Schützer et al. Cien Saude Colet. 2021; 26(1): 265-274) to construct categories. Theoretical framework was the Balintian Medical Psychology. Findings were validated by peer reviewers from Lab of Clinical-Qualitative Research.
Results
Sample had 10 patients, 3 female and 7 male, from 52 to 77 years. Interviews carried out from October 2022 to March 2023. We constructed 03 categories: 1) Fate out of hands - “I get sick just coming in here.” There is an apprehension experienced in each medical evaluation to check the clinical condition because the symbol of waiting is not having the own destiny in the hands. 2) Psychic defence - “Sometimes I even thought if I had to live on a grant for the rest of my life or die!” Imagining the worst is a psychic defence because if this probability occurs, the mind has already begun its elaboration. 3) Life upside down - “I was going to have the surgery, use a bag, my life was going to be upside down.” Anxiety generated by waiting is a mental disorganizing.
Conclusions
Attitudes of observing and waiting carry different symbolisms to those who work with scientific thinking and who experience the observation of their own disease and the wait for what conduct they will receive. Observing oneself in illness requires acceleration of changes in ego identity. Waiting in front of illness asks the ego to think the worst. It is not a volitional choice. Preparing for the worst is a defensive necessity in the emotional sphere to avoid surprises that take to mental rupture.
Schizotypal personality is a condition suffered by 4% of the population. It is defined by presenting interpersonal, behavioral and perceptual features similar to the clinical features of psychotic disorders, such as schizophrenia, in less intensity and dysfunctionality, but at risk of reaching psychosis.
Objectives
Presentation of a clinical case about a patient with premorbid schizotypal personality traits presenting with an acute psychotic episode.
Methods
Literature review on association between schizotypal personality and psychosis.
Results
A 57-year-old woman with a history of adaptive disorder due to work problems 13 years ago, currently without psychopharmacological treatment, goes to the emergency room brought by the emergency services due to behavioral alteration. She reports that “her husband and son wanted to sexually abuse her”, so she had to run away from home and has been running through the streets of the town without clothes and barefoot.
Her husband relates attitude alterations and extravagant behaviors of years of evolution, such as going on diets of eating only bread for 40 days or talking about exoteric and religious subjects, as believing that the devil got inside her husband through a dental implant. He reports that these behaviors have been accentuated during the last month. She has also created a tarot website, and has even had discussions with several users. She is increasingly suspicious of him, has stopped talking to him and stays in his room all day long, with unmotivated laughter and soliloquies.
It was decided to admit him to Psychiatry and risperidone 4 mg was started. At the beginning, she was suspicious and reticent in the interview. As the days went by, communication improved, she showed a relaxed gesture and distanced herself from the delirious ideation, criticizing the episode.
Conclusions
In recent years, there has been increasing interest in understanding the association between schizotypy and serious mental disorder. Several theories understand schizotypy as a natural continuum of personality that reveals genetic vulnerability and that can lead to psychotic disorder when added to precipitating factors. Other theories define schizotypy as a “latent schizophrenia” where symptoms are contained and expressed in less intensity.
Around 20% evolves to paranoid schizophrenia or other serious mental disorders. It is complex to distinguish between those individuals in whom schizotypy is a prodrome and those in whom it is a stable personality trait. To date, studies applying early psychotherapeutic or pharmacological interventions have had insufficient and contradictory results, and the follow-up and treatment of these individuals could be a stress factor and a stigma. Some studies are looking for reliable markers of evolution to schizophrenia in order to establish adequate protocols for detention, follow-up and treatment.
We present the case of a 48-year-old woman, a nurse, referred from the Internal Medicine department for evaluation of depressive symptoms and accompanying somatic presentation following COVID-19. The aim is to highlight a recently emerging condition that we are increasingly encountering in our clinics, which can complicate the diagnosis of an underlying affective disorder
Objectives
Diagnosed with COVID-19, confirmed by a positive PCR test, 6 months ago following an infection in the workplace. The clinical picture consisted of mild symptoms, with a ten-day course and apparent resolution at the time of hospitalization. She returned to her work activities and gradually began to report fluctuating symptoms, including headaches, mild shortness of breath, fatigue, as well as a tingling sensation in the upper extremities, especially in the hands. Additionally, she described feelings of restlessness, depressive mood, and intense fatigue. In additional tests: (CT-Scan) there are signs of mild bilateral lower lung fibrosis.
Methods
Treatment with Duloxetine was initiated for a case of depressive symptoms with accompanying physical symptoms. The differential diagnosis considered Major Depressive Disorder, Single Episode, and Adjustment Disorder with Depressed Mood.”
Results
We are facing a clear case of depressive clinic that may have endogenous features, if we adhere to criteria such as those in the DSM-5, as it would meet the criteria for Major Depressive Disorder, Single Episode. However, we have a clearly identified trigger, so we also need to perform a differential diagnosis, primarily with Adjustment Disorder with Depressed Mood: here, the symptoms appear within 3 months following the stressful agent (in this case, SARS-CoV-2 infection). Unlike Major Depressive Episode, once the agent has ceased, the symptoms do not persist beyond 6 months (which we do not know because the physical symptoms causing disability have not disappeared).In addition to purely psychiatric diagnoses that we are accustomed to, we must consider a new diagnostic entity that is becoming more prevalent as the pandemic progresses, namely “long-covid” or persistent COVID.These are generally middle-aged women who, several months after infection, continue to manifest a multifactorial complex of symptoms. These symptoms persist over time, not only the classical ones but also many others that can appear during the ongoing course of the disease.
Conclusions
Beyond the purely psychiatric diagnoses we are accustomed to, we must also consider a new diagnostic entity that is becoming more prevalent as the pandemic continues to advance: Persistent COVID or ‘long-COVID.’ Generally, this condition affects middle-aged women who, several months after contracting the virus, continue to exhibit a multifactorial complex of symptoms. The most common symptoms include fatigue/asthenia (95.91%); general discomfort (95.47%); headaches (86.53%); and low mood (86.21%)
Pregnancy is a high-risk period for major affective disorders and can lead to a destabilizing period for our patients. Standard pharmacological strategies must be carefully evaluated due to potential teratogenic or side effects. We present a case of bipolar disorder type I with challenging-to-control maniac episodes during pregnancy, which has required Electroconvulsive Therapy for its management.
Objectives
Presenting maintenance electroconvulsive therapy (ECT) as a safe and effective therapeutic strategy during pregnancy, with the presentation of a case in which it has been administered every 3 weeks from the second trimester until the baby’s birth at 37 weeks
Methods
This concerns a 28-year-old immigrant woman, married, with a 10-year-old child. She was diagnosed with bipolar disorder type I at the age of 16 when she experienced her first manic episode in her country of origin. Subsequently, during her first pregnancy, she required hospitalization for electroconvulsive therapy (ECT) treatment, with a positive response after a single session. She remained stable for several years without maintenance pharmacological treatment or follow-up until the ninth week of her second pregnancy when she experienced a manic episode requiring hospitalization.
Results
She was initially treated with Olanzapine and Lorazepam with a positive response, but three weeks later, she was readmitted with a similar episode. These decompensations occurred almost monthly, leading to the consideration of introducing mood stabilizers after the first trimester. However, due to the patient’s severe hyperemesis gravidarum, this stabilizing treatment was ruled out due to the difficulty in controlling its blood levels and the associated risk of intoxication. During the fifth admission at the 20th week of gestation, the decision was made to initiate ECT treatment, which yielded an excellent response and subsequent maintenance.
Conclusions
The indications for electroconvulsive therapy (ECT) during pregnancy are the same as in the rest of adult patients. In individuals with a psychiatric history, it is possible for a relapse of mental illness to occur during pregnancy, although the risk is considerably higher during the postpartum period. ECT is considered an effective and safe treatment option in all three trimesters of pregnancy and the postpartum period. During the informed consent process, patients should be informed about the potential impact of ECT as well as alternative treatment options.
Delusional parasitosis, also known as delusional infestation or Ekbom’s syndrome, is a rare psychotic disorder characterized by the false belief that a parasitic skin infestation exists, despite the absence of any medical evidence to support this claim. These patients often see many physicians, so a multidisciplinary approach among clinicians is important. Many patients refuse any treatment due to their firm belief that they suffer from an infestation, not a psychiatric condition, so it is crucial to gain the trust of these patients.
Objectives
The comprehensive review of this clinical case aims to investigate Ekbom syndrome, from a historical, clinical and therapeutic perspective.
Methods
Literature review based on delusional parasitosis.
Results
A 65-year-old woman comes to the psychiatry consultation referred by her primary care physician concerned about being infested by insects that she perceives through scales on her skin for the last three months. She recognizes important impact on her functionality. She is also convinced that her family is being infected too. As psychiatric history she recognizes alcohol abuse in the past (no current consumption) and an episode of persecutory characteristics with a neighbor, more than ten years ago. On psychopathological examination, she shows delusional ideation of parasitosis, with high behavioral repercussions, cenesthetic and cotariform hallucinations, as well as feelings of helplessness and anger. Treatment with Pimozide was started and the patient was referred to dermatology for evaluation, a plan she accepted. Her primary care physician and dermatology specialist were informed about the case and the treatment plan. In the recent reviews, the patient is calmer, however, despite the corroboration of dermatology and in the absence of organic lesions in cranial CT, she is still unsatisfied with the results, remaining firm in her conviction of infestation. It was decided to start treatment with atypical neuroleptics (Aripiprazole), with progressive recovery of her previous functionality.
Conclusions
Despite the increase in the number of studies in recent years, there are still few studies on this type of delirium. The female:male ratio varies in the bibiliography (between 2:1 and 3:1). The onset is usually insidious, generally appearing as a patient who comes to his primary care physician convinced of having parasites in different skin locations. It is usual to observe scratching lesions or even wounds in search of the parasite. In the past, the most used and studied treatment was Pimozide. Currently the treatment of choice is atypical neuroleptics due to their lower side effects. The latest reviews on the prognosis of this disorder show data with percentages of complete recovery between 51% and 70%, and partial responses between 16.5% and 20%. Finally, for a good diagnosis and therapeutic management, it is important to achieve a multidisciplinary approach.
The action of mixed salts of copper and zinc (basic and neutral) on Hisex chickens experimentally infected with Ascaridia galli has been studied. The data show that the lowest host mortality and decrease in body weight gain and the highest reduction in nematode loading occurs in infected chickens treated with basic salts (in comparison with infected chickens, untreated or treated with neutral salts). A mathematical model has been proposed to provide a quantitative interpretation of the observed results. The model solutions of the kinetics of parasite numbers and of the gain in body weight are in a good agreement with the experimental data. One of the kinetic parameters in the model is defined as a phenomenological constant of the host immune response. Its value is determined in the case of infected and untreated chickens.
Large kaolin deposits developed by weathering on Precambrian granitic rocks have been discovered in the Caluquembe area, Huíla province, Angola. To determine accuracy of analysis and to evaluate the kaolinite grade, a full-profile Rietveld refinement by X-ray Powder Diffraction (XRPD) and Thermal Gravimetric Analysis (TGA) was used. Caluquembe kaolin is composed mainly of kaolinite (44–93 wt.%), quartz (0–23 wt.%), and feldspar (4–14 wt.%). The Aparicio-Galán-Ferrell index (AGFI), calculated by XRPD profile refinement, indicates low- and medium-defect kaolinite. Kaolinite particles show a platy habit and they stack together forming ‘booklets’ or radial aggregates; they also occur as small anhedral particles in a finer-grained mass. Muscovite-kaolinite intergrowths have also been found. Whole-rock chemical analysis included major, trace, and Rare Earth Elements (REE). Chondrite-normalized REE patterns show the same tendency for all samples, with a significant enrichment in Light Rare Earth Elements (LREE). Mineralogical and compositional features of the Caluquembe kaolin indicate that it is a suitable material for the manufacture of structural products, such as bricks, paving stones, and roofing tiles. In addition, the significant REE contents of the Caluquembe kaolin can be considered as a potential future target of mining exploration.
The coronavirus disease 2019 (COVID-19) has serious physiological and psychological consequences. The long-term (>12 weeks post-infection) impact of COVID-19 on mental health, specifically in older adults, is unclear. We longitudinally assessed the association of COVID-19 with depression symptomatology in community-dwelling older adults with metabolic syndrome within the framework of the PREDIMED-Plus cohort.
Methods
Participants (n = 5486) aged 55–75 years were included in this longitudinal cohort. COVID-19 status (positive/negative) determined by tests (e.g. polymerase chain reaction severe acute respiratory syndrome coronavirus 2, IgG) was confirmed via event adjudication (410 cases). Pre- and post-COVID-19 depressive symptomatology was ascertained from annual assessments conducted using a validated 21-item Spanish Beck Depression Inventory-II (BDI-II). Multivariable linear and logistic regression models assessed the association between COVID-19 and depression symptomatology.
Results
COVID-19 in older adults was associated with higher post-COVID-19 BDI-II scores measured at a median (interquartile range) of 29 (15–40) weeks post-infection [fully adjusted β = 0.65 points, 95% confidence interval (CI) 0.15–1.15; p = 0.011]. This association was particularly prominent in women (β = 1.38 points, 95% CI 0.44–2.33, p = 0.004). COVID-19 was associated with 62% increased odds of elevated depression risk (BDI-II ≥ 14) post-COVID-19 when adjusted for confounders (odds ratio; 95% CI 1.13–2.30, p = 0.008).
Conclusions
COVID-19 was associated with long-term depression risk in older adults with overweight/obesity and metabolic syndrome, particularly in women. Thus, long-term evaluations of the impact of COVID-19 on mental health and preventive public health initiatives are warranted in older adults.
Maintenance electroconvulsive therapy (mECT) is an option in the treatment of affective disorders which progress is not satisfactory. It is certainly neglected and underused during the clinical practice.
Objectives
To evaluate the efficacy of mECT in reducing recurrence and relapse in recurrent depression within a sample of three patients.
Methods
We followed up these patients among two years since they received the first set of electroconvulsive sessions. We applied the Beck Depression Inventory (BDI) in the succesives consultations for evaluating the progress.
Results
The three patients were diagnosed with Recurrent Depressive Disorder (RDD). One of them is a 60 year old man that received initially a cycle of 12 sessions; since then he received 10 maintenance sessions. Other one is a 70 year old woman that received initially a cycle of 10 sessions; since then she received 6 maintenance sessions. The last one is a 55 year old woman that received initially a cycle of 14 sessions; since then she received 20 maintenance sessions.
All of them showed a significant reduction in depressive symptoms evaluated through BDI and clinical examination. In the first case, we found a reduction in the BDI from the first consultation to the last that goes from 60 to 12 points; in the second case, from 58 to 8 points; and in the last case, from 55 to 10 points. The main sections that improved were emotional, physical and delusional.
As side-effects of the treatment, we found anterograde amnesia, lack of concentration and loss of focus at all of them.
Conclusions
We find mECT as a very useful treatment for resistant cases of affective disorders like RDD.
It should be considered as a real therapeutic option when the first option drugs have been proved without success.
Chronic psychiatric patients admitted to subacute and long-stay hospital units are especially vulnerable to the situation of confinement due to the pandemic. Throughout 2020 and 2021 they have suffered the consequences of multiple strict confinements given the differences in isolation protocols in hospitalized patients compared to the general population. This has repercussions on the increase in anxious symptomatology, which influences a more torpid and prolonged evolution of mental disorders in this subpopulation.
Objectives
The objective of this study is to study the anxiety levels of patients admitted to a sub-acute and long-stay mental health unit in a situation of confinement due to covid-19.
Methods
We have carried out a cross-sectional descriptive observational study in 25 patients admitted to the subacute and long-stay unit of the Barcelona Forum Center between December 8 and 23, 2021 in the context of confinement due to a covid-19 outbreak. Sociodemographic and clinical variables are collected. We have used the self-administered STAI scale to assess clinical anxiety.
Results
The mean age is 47.7 years; women 60%. 80% with single marital status. 90% of the patients presented active tobacco consumption, with an average of 21.2 cigarettes/day. The mean score on the STAI scale was 58.8 for state anxiety and 46.7 for trait anxiety, both levels above the 75th percentile for adults, both men (state anxiety 28, trait anxiety 25) and women (state anxiety 31, trait anxiety 32).
Conclusions
The state and trait anxiety scores of the STAI scale of hospitalized patients are higher than the average of the general population, which could be due to the situation of confinement due to the covid pandemic.
Negative symptoms has been classically associated with cognition, psychosocial functioning and quality of life in patients with schizophrenia. But negative symptoms are not a unitary construct, encompassing two different factors: diminished expression, and motivation and pleasure. Few works have studied the relationship between these two different negative symptoms factors and cognition (neuro and social cognition), psychosocial functioning and quality of life, jointly, in patients with a first psychotic episode of schizophrenia.
Objectives
The objective of the present work was to study, in a sample of patients with a first psychotic episode of schizophrenia, the relationship between the negative symptoms (diminished expression and motivation and pleasure) and neurocognition, social cognition, functioning and quality of life.
Methods
The study was carried out with 82 outpatients with a first psychotic episode of schizophrenia from two Spanish hospitals (“12 de Octubre” University Hospital, Madrid and “Virgen de la Luz” Hospital, Cuenca). The patients were assessed with the Clinical Assessment Interview for Negative Symptoms (CAINS) for evaluating diminished expression (EXP) and motivation and pleasure (MAP) symptoms, the MATRICS Consensus Cognitive Battery (MCCB) for evaluating neurocognition and social cognition, the Social and Occupational Functioning Assessment Scale (SOFAS), and the Quality of Life Scale (QLS).
Results
A negative correlation was found between neurocognition and the two negative symptoms subscales: CAINS-EXP (r=-0.458, p<0.001) and CAINS-MAP (r=-0.374, p<0.001); but with social cognition only CAINS-EXP was correlated (r=-0.236, p=0.033). Also, it was found a high negative correlation between SOFAS scores and CAINS-MAP (r=-0.717, p<0.001); and a medium negative correlation with CAINS-EXP (r=-0.394, p<0.001). Finally, QLS score was high correlated with both CAINS subscales: CAINS-EXP (r=-0.681, p<0.001) and CAINS-MAP (r=-0.770, p<0.001).
Conclusions
This study found a relationship between negative symptoms and neurocognition, social cognition, functioning and quality of life in a sample of patients with a first psychotic episode of schizophrenia. But the two different negative symptom factors, diminished expression, and motivation and pleasure, are associated differently with psychosocial functioning, but especially with social cognition where the relationship was only found with diminished expression symptoms.
Patients with an alcohol use disorder frequently relapse after various efforts to quit. Admission to hospital units is a possible start to stop drinking alcohol and reach abstinence. Among the pharmacological strategies to quit this addiction are specific drugs, such as disulfiram or namelfen, which are widely studied. Hospitalized patients frequently initiate these medications to control addiction, but little is known about their efficacy after discharge in this group.
Objectives
The aim is to determine whether the initiation of treatment with specific drugs for alcohol use disorder could help to maintain alcohol abstinence after admission to a General Hospital Psychiatric Ward. In addition, we want to check those factors associated with a higher rate of relapse in consumption.
Methods
We conducted a retrospective cross-sectional study of a group of patients admitted in 2018 to a psychiatric hospitalization ward due to alcohol use disorder and who expressed their desire to stop drinking. At the time of admission, we recorded sociodemographic data, consumption of other substances and alcohol family history. Patients initialized specific treatments to reduce and control alcohol consumption if they wanted. Twenty-four months after discharge, we acquired the number of relapses through new admissions, emergency room visits or outpatient follow-up data.
Results
A sample of 36 patients (28 men) admitted to a psychiatric hospitalization ward was analyzed. At discharge, 17 accepted specific pharmacological treatments to reduce alcohol consumption. After a follow-up period of 24 months, 70.8% relapsed compared to 94.7% who did not accept treatment (χ2=4.001, DF=1, p=0.045, OR=0.13). There were no differences between the two groups in age, gender, amount of alcohol consumed, follow-up modality at discharge or if it was their first detoxification attempt. However, those who did not accept the specific pharmacological treatment consumed other drugs (41.1% vs 5.8%, χ2= 5.888, DF=1, p=0.015), had other history of mental disorder (64.7% vs 23.5%, χ2= 5.845, FD=1, p=0.015) and a higher proportion of relatives with alcohol consumption (81.8% vs 42.8%, χ2= 3.896, FD=1, p=0.048) more frequently. The time (in days) to relapse was faster in this group of patients (200.8 vs 402.7 , Z=-2.5413, p=0.005).
Conclusions
Accepting drug-specific treatment for alcohol use can be helpful for many patients who want to achieve alcohol abstinence. Among the factors that prevent the acceptance of this treatment is the consumption of other substances, comorbidity with another mental pathology and family history, which may involve genetic factors that favour addiction. This group of patients could benefit from a specific pharmacological treatment, although other psychosocial factors may also help.
Dysthymia is a chronic mood disorder with similar but less severe features than major depressive disorder. Compared to the latter, major depressive episodes of dysthymic disorder are more spaced, less intense, and more persistent.
The most effective treatment is usually the combination of serotonin reuptake inhibitor antidepressant drugs with behavioral, cognitive, interpersonal and group psychotherapies.
The reality is that there are few clearly effective treatments to treat this disorder which makes the symptoms even more chronic which has a negative impact on the functionality of patients with clear influence at a personal and work level. Without treatment, dysthymia sometimes progresses to major depression, called “double depression” what can be a most serious problem.
Objectives
Finding new lines of treatment or management in these patients seems to be essential because of the inability that can occur in some of them and the high demand they can produce.
Methods
A 45-year-old woman diagnosed of dysthymia has been followed for more than 10 years. Multiple visits to the emergency room and several outpatient mental health services. absenteeism and great repercussion in the family environment. Many side effects to antidepressants and a benzodiazepine overuse tendency. She has been receiving psychotherapeutic treatment for many years with little effectiveness. Worsening of the symptoms with the appearance of obsessiveness around what is happening to her
Results
Several alternative treatments are tested for the management of anxious depressive and obsessive symptoms being Aripiprazole 10mg the only effective one with almost complete recovery of symptoms. The patient returns to work and significantly improves her family situation.
Conclusions
Dysthyma is a disorder with difficult pharmacological and psychological management. Trying different little-used treatments can open up a different view about the disorder.
The use of serotonin reuptake inhibitor antidepressant drugs is not always effective and the risk posed by using benzodiazepines for long time forces us to look for other treatments for the control of the main symptoms The use of aripiprazole at moderate doses may be a good new way to control symptoms.
We report direct numerical simulations of the flow around a spanwise-flexible wing in forward flight. The simulations were performed at $Re=1000$ for wings of aspect ratio 2 and 4 undergoing a heaving and pitching motion at Strouhal number $St_c\approx 0.5$. We have varied the effective stiffness of the wing $\varPi _1$ while keeping the effective inertia constant, $\varPi _0=0.1$. It has been found that there is an optimal aerodynamic performance of the wing linked to a damped resonance phenomenon, that occurs when the imposed frequency of oscillation approaches the first natural frequency of the structure in the fluid, $\omega _{n,f}/\omega \approx 1$. In that situation, the time-averaged thrust is maximum, increasing by factor 2 with respect to the rigid case with an increase in propulsive efficiency of approximately 15 %. This enhanced aerodynamic performance results from the combination of larger effective angles of attack of the outboard wing sections and a delayed development of the leading edge vortex. With increasing flexibility beyond the resonant frequency, the aerodynamic performance drops significantly, in terms of both thrust production and propulsive efficiency. The cause of this drop lies in the increasing phase lag between the deflection of the wing and the heaving/pitching motion, which results in weaker leading edge vortices, negative effective angles of attack in the outboard sections of the wing, and drag generation in the first half of the stroke. Our results also show that flexible wings with the same $\omega _{n,f}/\omega$ but different aspect ratio have the same aerodynamic performance, emphasizing the importance of the structural properties of the wing for its aerodynamic performance.
Sixty-two 14C dates are analyzed in combination with a recently established local floating tree-ring sequence for the Early Neolithic site of La Draga (Banyoles, northeast Iberian Peninsula). Archaeological data, radiometric and dendrochronological dates, as well as sedimentary and micro-stratigraphical information are used to build a Bayesian chronological model, using the ChronoModel 2.0 and OxCal 4.4 computer programs, and IntCal 2020 calibration curve. The dendrochronological sequence is analyzed, and partially fixed to the calendrical scale using a wiggle-matching approach. Depositional events and the general stratigraphic sequence are expressed in expanded Harris Matrix diagrams and ordered in a temporal sequence using Allen Algebra. Post-depositional processes affecting the stratigraphic sequence are related both to the phreatic water level and the contemporaneous lakeshore. The most probable chronological model suggests two main Neolithic occupations, that can be divided into no less than three different “phases,” including the construction, use and repair of the foundational wooden platforms, as well as evidence for later constructions after the reorganization of the ground surface using travertine slabs. The chronological model is discussed considering both the modern debate on the Climatic oscillations during the period 8000–4800 cal BC, and the origins of the Early Neolithic in the western Mediterranean region.
Ultra-processed food (UPF) consumption is increasing exponentially, becoming a matter of concern for Public Health, given its adverse health effects.
Objective:
To identify individual and faGmily factors predicting UPF consumption in childhood.
Design:
The SENDO project is an ongoing prospective dynamic cohort of Spanish children. In this study, we used baseline information of participants recruited between January 2015 and June 2021. Dietary information was collected with a validated semi-quantitative FFQ, and food items were classified using the NOVA classification. Individual and family factors associated with UPF consumption (P < 0·20) in univariate analyses were introduced in a model of generalised estimating equations which accounted for intra-cluster correlations between siblings.
Setting:
The SENDO project (Spain), 2015–2021.
Participants:
Spanish children are recruited at the age of 4–5 years and followed yearly through online questionnaires completed by parents.
Results:
In this sample of 806 participants (49 % girls; mean age 5 years (sd: 0·90)), the mean UPF consumption was 37·64 % of total energy intake (sd: 9·59). Large family size and longer exposure to screens predicted higher consumption of UPF. On the other hand, better knowledge of children’s dietary recommendations, healthy dietary attitudes towards child’s eating habits and longer breastfeeding were associated with lower consumption of UPF. All these factors accounted for approximately 16 % of the variability on the consumption of UPF in childhood.
Conclusion:
Since most of the factors identified in this study are modifiable, they should be considered in public health strategies aimed at promoting healthy dietary habits in early life.