Antecedents of Borderline Personality Disorder and Antisocial Personality Disorder: An Examination of Gene X Environment Interactions

Current thinking suggests that genotypes associated with impulse-control disorders and negative emotionality, such as monoamine oxidase-a (MAOA), interact with negative early environmental factors like childhood maltreatment and develop into the disorders know as Borderline Personality Disorder (BPD) and Antisocial Personality Disorder (ASPD). Using existing data from a prospective cohort design study of the consequences of child abuse and neglect, participants (N = 896 represent individuals with documented histories of child abuse and neglect and a matched comparison group that were followed up into adulthood and interviewed. A subsample of 631 participants gave permission for DNA extraction and analyses during a follow-up medical status exam. The final sample used in this study consisted of 592 participants, as we restricted analyses to White, non-Hispanic and Black, non-Hispanic individuals. Official reports of child maltreatment were collected from court records during the years 1967 to 1971, while retrospective self-reports were collected at both the 1st and 2nd interviews. BPD, ASPD, BPD symptoms, and ASPD symptoms were measured with a structured interview of DSM-III-R BPD criteria. MAOA genotype was coded into two unique variables; DC1, which represented males with one 3-repeat and females with two 3-repeats (low MAOA activity) compared to all other genotypes and DC2 represented the heterozygous females with the 3,4-genotype compared to all other genotypes. Multiple logistic and ordinary least squares (OLS) were conducted to analyze the main effect of each independent variable and any interactions in the prediction of one of the six dichotomous dependent variables. All analyses controlled for age, sex, and race. We hypothesized that childhood maltreatment will predict increased risk for BPD, BPD symptoms, ASPD, ASPD symptoms, impulsivity, and suicide attempts. However, similar to Widom, Czaja, & Paris (2009), we expected that males but not females, would show an association between childhood abuse and neglect and BPD. We also did not expect that there will be any differences in these relationships by race (e.g., Whites & Blacks). However, in regard to MAOA genotype, based on a previous publication using this data (Widom & Brzustowicz, 2006), we hypothesized that MAOA genotype would moderate the relationship between childhood maltreatment and our six dependent variables. The results of the present study showed that childhood maltreatment predicted ASPD diagnosis, ASPD symptoms, a lifetime history of suicide attempts, and impulsivity. Unexpectedly, we did not observe a relationship between BPD diagnosis and childhood maltreatment, although there was a relationship between childhood abuse and neglect and number of BPD symptoms. Several differences by race and sex, which indicate that there may be other environmental and contextual factors that may be influential in the development of these disorders in disadvantaged groups. Furthermore, we only observed one significant 3-way interaction suggesting that the heterozygous MAOA genotype (3-,4-) was protective for Black females with a history of childhood maltreatment. Due to the limited nature of MAOA genotype studies in Black females, it is difficult to put these results into context and future research is needed to better understand the impact of MAOA genotype in this population. Overall, our results the significant relationship between childhood maltreatment and personality psychopathology in adulthood

Role Conception in New Graduate Nurses: A Secondary Analysis

Background: The new graduate transition to practice process affects retention, competency development, healthcare costs, quality, and assimilation into the profession. During the transition, new graduate nurses compare the way they have conceptualized nursing to what they actually experience in practice. If the observed reality is not congruent with their ideal perception, role conflict and a compromised socialization may occur. Residency programs have been instituted at some healthcare facilities to promote a positive organizational socialization process. Purpose: The purpose of the study is to examine the differences in role conception of new graduates. The relationship of role conception and various anticipatory socialization variables such as age, gender, type of education and previous healthcare experience are examined. Methods: This study is a secondary analysis of an existing national database of new graduate nurses who completed a residency program during the years 2011-2013. Results: New graduate nurses were found to have high role conception in professional, competence and service scenarios. There was no relationship between role conception and age, gender, educational level or previous healthcare experience. Role conception did not significantly impact job satisfaction. Conclusion: Adequate role socialization will aid in the new graduate nurse's assimilation into the role of the professional nurse. Continued study on role conception in new graduate nurses is warranted

Diseño de un sistema de gestión de seguridad y salud en el trabajo basado en la norma ISO 45001-2018, para minimizar riesgos en la empresa Multiservicios Punre S. R. L. Cajamarca 2022

Este trabajo presenta una investigación con el objetivo de diseñar un sistema de gestión de seguridad y salud en el trabajo para minimizar los riesgos bajo la norma ISO 45001-2018, en la empresa Multiservicios Punre S.R.L. en la ciudad de Cajamarca. Los instrumentos empleados para realizar el diagnóstico partieron de la observación directa y unas entrevistas realizadas a las cabezas de las áreas y seguidamente se procedió a medir cuantitativamente el estatus de la empresa mediante un check list; luego, se documentó y realizó un diagnóstico de la situación inicial del taller respecto a su sistema de gestión de seguridad y salud en el trabajo y sus riesgos; de estos se extrajeron respectivamente 10 indicadores de cumplimiento de la norma ISO 45001-2018 y tipos de riesgo. Este diagnóstico mostró que, en promedio, cerca del 98% de la norma no estuvo implementada; a causa de rotación constante de personal, desinformación en el área, falta de capacitaciones, documentación y de seguimiento de la gestión de seguridad. Se encontró que estos datos se reflejan en la cantidad descontrolada de 73 riesgos que ponen en peligro a los trabajadores. Finalmente se concluyó que diseñar un sistema de gestión de seguridad y salud en el trabajo basado en la norma ISO 45001-2018 para controlar y minimizar los riesgos, asegurando el bienestar constante y la posibilidad de una próxima certificación de la empresa

Participación efectiva de las mujeres en los medios de comunicación en Siuna, 2014

La presente investigación es de carácter cualitativo con un enfoque fenomenológico acerca de Participación efectiva de las mujeres en los medios de comunicación en Siuna, 2014. Los métodos que sustenta esta investigación fueron las entrevistas individuales, revisión documental y la observación, permitiéndonos recopilar, procesar y analizar los datos que fueron proporcionados por los sujetos de estudio. Se partió de preguntas directrices que guiaron la misma, lo que también consistió en estructurar un sistema de categorías utilizadas como elementos de análisis. Los hallazgos revelan que las tomas de decisión en los medios de comunicación estás en manos de los hombres y en el nivel de alta gerencia solo figuran los hombres, este es un comportamiento tanto para los medios de comunicación radial como televisivo. Los principales obstáculos se asocian a oportunidades de participación activa de las mujeres en los medios de comunicación, estabilidad económica, limitadas capacidades en los temas de comunicación, pocos recursos económicos de los medios, ausencia de incentivos de las mujeres, falta de programas estratégicos con perspectivas de género. Resultados que servirán de base para implementar estrategias de comunicación. Las estrategias para mejorar las relaciones de género dentro de los medios de comunicación se asocian al trabajo de intercambios, sensibilización, integración, liderazgo, empoderamiento y formación y creación de capacidades. Este esfuerzo permitirá articular propuestas que den pautas sobre la relación que debe darse entre Comunicadores/as y directores de radios y televisión para ser efectivo y exitosos en la comunicación intercultural

Associations between parenting strategies and BMI percentile among Latino children and youth with intellectual and developmental disabilities

Introduction: Maintaining healthy weight is a challenge for all children, and particularly for children with IDD compared to nondisabled children and for Latino children compared to non-Latino White children. Parenting practices related to food intake and physical activity have been found to be important in maintaining children\u27s weight. In this study, we describe the prevalence of overweight and obesity status among Latino children with IDD and their maternal caregivers and determine the relationship between food and physical activity parenting practices and childhood obesity among Latino children with IDD. Methods: We interviewed 94 Latino parent/child dyads and collected information about parenting practices, home environment, and parent and child height and weight using standardized measures. Parent body mass index (BMI) and child BMI percentile were calculated from height and weight. Results: The combined overweight/obesity status for children in our sample was high (60.3%) compared to national rates among nondisabled Latino children (56%) and non-Latino White children with autism (37%). Contrary to research on nondisabled children, we found that greater parental use of controlling dietary strategies was associated with lower BMI percentile in Latino children with IDD. These findings may be indicative of the fact that children with IDD tend to have unique dietary behaviors that warrant more disability and culturally sensitive strategies. Discussion: Our findings suggest that overweight and obesity is especially prevalent for Latino children with IDD and that more research is needed on family factors that promote health in Latino families of children with IDD

Report of the 2016-17 Academic Affairs Standing Committee: Entrustable Professional Activities Implementation Roadmap

The purpose of this report is to: 1) Identify linkages across the EPA statements, Center for the Advancement of Pharmacy Education 2013 Educational Outcomes (CAPE 2013) and the Joint Commission of Pharmacy Practitioners’ Pharmacist Patient Care Process (PPCP); 2) Provide ways EPA statements can be used to communicate core skills that are part of the entry-level pharmacist identity; 3) Suggest a potential roadmap for AACP members on how to implement EPA statements

Identification of CFTR variants in Latino patients with cystic fibrosis from the Dominican Republic and Puerto Rico

BackgroundIn cystic fibrosis (CF), the spectrum and frequency of CFTR variants differ by geography and race/ethnicity. CFTR variants in White patients are wellâ described compared with Latino patients. No studies of CFTR variants have been done in patients with CF in the Dominican Republic or Puerto Rico.MethodsCFTR was sequenced in 61 Dominican Republican patients and 21 Puerto Rican patients with CF and greater than â â â â 60â mmol/L sweat chloride. The spectrum of CFTR variants was identified and the proportion of patients with 0, 1, or 2 CFTR variants identified was determined. The functional effects of identified CFTR variants were investigated using clinical annotation databases and computational prediction tools.ResultsOur study found 10% of Dominican patients had two CFTR variants identified compared with 81% of Puerto Rican patients. No CFTR variants were identified in 69% of Dominican patients and 10% of Puerto Rican patients. In Dominican patients, there were 19 identified CFTR variants, accounting for 25 out of 122 disease alleles (20%). In Puerto Rican patients, there were 16 identified CFTR variants, accounting for 36 out of 42 disease alleles (86%) in Puerto Rican patients. Thirty CFTR variants were identified overall. The most frequent variants for Dominican patients were p.Phe508del and p.Ala559Thr and for Puerto Rican patients were p.Phe508del, p.Arg1066Cys, p.Arg334Trp, and p.I507del.ConclusionsIn this first description of the CFTR variants in patients with CF from the Dominican Republic and Puerto Rico, there was a low detection rate of two CFTR variants after full sequencing with the majority of patients from the Dominican Republic without identified variants.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/153634/1/ppul24549.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/153634/2/ppul24549_am.pd

Diagnostic utility of whole genome sequencing in adults with B-other acute lymphoblastic leukemia

Genomic profiling at diagnosis of B-cell precursor Acute Lymphoblastic Leukemia (BCP-ALL) in adults is used to guide disease classification, risk stratification and treatment decisions. Patients for which diagnostic screening fails to identify disease defining or risk stratifying lesions are classified as B-other ALL. We screened a cohort of 652 BCP-ALL cases enrolled in UKALL14 to identify and perform whole genome sequencing (WGS) on paired tumor-normal samples. For 52 B-other patients we compared WGS findings to data from clinical and research cytogenetics. WGS identifies a cancer associated event in 51/52 cases, this includes an established subtype defining genetic alteration in 5/52 that were previously missed by standard-of-care genetics. Of the 47 true B-other ALL we identified a recurrent driver in 87% (41). Complex karyotype by cytogenetics emerges as a heterogeneous group, including distinct genetic alterations associated with either favorable (DUX4-r) or poor outcomes (MEF2D-r, IGK::BCL2). For a subset of 31 cases, we integrate findings from RNA-sequencing (RNA-seq) analysis to include fusion gene detection, and classification by gene expression. Compared to RNA-seq, WGS was sufficient to detect and resolve recurrent genetic subtypes, however RNA-seq can provide orthogonal validation of findings. In conclusion, we demonstrate that WGS can identify clinically relevant genetic abnormalities missed by standard-of-care testing and identify leukemia driver events in virtually all cases of B-other ALL