Challenges Veterans Encounter Receiving or Seeking Mental Health Services

The goal of this research was to identify the challenges U.S. Veterans faced when accessing mental health services within the Veterans Affairs (V.A.) Healthcare System. The V.A. serves approximately six million U.S. military veterans annually and is considered a leader in providing high-quality care in the USA. Despite the V.A.\u27s efforts to improve its patient care system, many veterans do not seek treatment or follow through with mental health services. The study found that participants had difficulty getting appointments with V.A. mental health services. When they did, the appointments were usually convenient and took place as scheduled. While some participants were satisfied with V.A. services, others preferred outside providers because they were easier to access. Participants who did not seek mental health services felt they did not need them but would be more likely to seek them if the process were simplified. The main challenges preventing participants from seeking services were appointments being scheduled too far in advance, societal stigma, and potential obstacles from leadership. Many participants believed that seeking help would make them appear weak and that their peers would have less confidence. Talking about mental health was difficult for many, and they feared it could negatively impact their careers

Com uma lupa e um binóculo: uma investigação sobre a inadimplência de um banco de desenvolvimento através de análise de sobrevivência

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Sócio-Econômico, Programa de Pós-Graduação em Economia, Florianópolis, 2016.O objetivo desse trabalho foi investigar os condicionantes da inadimplência de um banco de desenvolvimento, através da Análise de Sobrevivência. Em virtude da disponibilidade dos dados dessa instituição, que atua na Região Sul do Brasil, bem como às suas peculiaridades no mercado de crédito e sua relevância para a região, tomou-se-a como objeto de estudo. A Análise de Sobrevivência foi empregada em função de sua capacidade de incorporar o tempo à análise de risco de inadimplência, além de ser uma técnica relativamente recente em estudos como esse. A partir da literatura consultada sobre crédito de longo prazo, bancos de desenvolvimento, risco de crédito e análise de sobrevivência, constituiu-se 3 modelos e 3 ensaios, a partir de 11.251 observações entre outubro de 2013 e abril de 2015. Os modelos estimados foram o Exponencial, o Weibull e o Cox, apresentando resultados favoráveis quanto à significância. No principal ensaio, o ensaio 1, as variáveis explicativas significantes e que colaboraram para a redução da probabilidade de falha foram: pertencer à agência 1; pertencer à agência 2; o aumento dos juros do contrato; ser um pequeno produtor rural; provir da região metropolitana de Porto Alegre; provir da região Nordeste e Noroeste do Rio Grande do Sul; o aumento do PIB; o aumento do índice de emprego; o aumento da TJLP; o aumento das expectativas de inflação e aumento da desvalorização cambial. Colaborando para o aumento da probabilidade de inadimplência estavam: provir do Oeste de Santa Catarina e provir do Oeste e do Centro paranaense. No teste de razão de verossimilhança, verificou-se que os modelos irrestritos tiveram um desempenho superior comparado aos modelos restritos. Isso indica que para a investigação proposta, tanto variáveis macroeconômicas como microeconômicas colaboraram no diagnóstico da inadimplência desse banco. Propõe-se para um próximo trabalho que ferramentas de seleção de variáveis sejam aplicadas, como o método Stepwise, assim como o diagnóstico evolua para um problema de Credit Scoring.Abstract : Investigating the determinants of default of a development bank, through Survival Analysis was the aim of this study. Because of the availability of data in this institution, which operates in southern Brazil, as well as its peculiarities in the credit market and its relevance to the region, it took up it as an object of study. Survival analysis was used because of its ability to embody time to the analysis of default risk as well as being a relatively new technique in studies like this. From the literature revisited on long-term credit, development banks, credit risk and survival analysis, it had run up 3 models and 3 essays, from 11.251 observations between October 2013 and April 2015. The estimated models were the Exponential, Weibull and Cox, with favorable results in terms of significance. In the main essay, or essay 1, the significant covariates and that helped to reduce the probability of failure were: belonging to the agency 1; belonging to the agency 2; the rise in contract interest; being a small farmer; come from the metropolitan area of Porto Alegre; come from the Northeast and North West Rio Grande do Sul state region ; GDP growth; increasing the employment rate; the increase in TJLP; the increase in inflation expectations and an increase in currency devaluation. Collaborating with the increase in the default probability were: come from the West of Santa Catarina state and come from the West and Center of the Paraná state. In the likelihood ratio test, it was found that the unrestricted models have higher performance compared to the restricted models. This indicates that for the proposed research, both macroeconomic and microeconomic variables cooperated with the diagnosis of the default. It is proposed for further studies the application of covariate selection, as the Stepwise method, as well as the evolving of this diagnosis to a problem of credit scoring

Identificación y caracterización de integrones asociados a la resistencia antimicrobiana, en aislados de escherichia coli provenientes de niños menores de dos años con diarrea y bacteremia de Lima, Perú

Permite la diseminación de bacterias multidrogorresistentes (MDR). Los integrones incorporan cassette de genes de resistencia garantizando su expresión. Este estudio describe la resistencia antimicrobiana, detecta y caracteriza los integrones de clase 1 y 2 en aislados de Escherichia coli provenientes de niños menores de dos años con diarrea y bacteremia. Para ello, se obtuvieron 355 aislados de E. coli de diarrea y bacteremia de pacientes pediátricos de dos estudios previos recolectados aleatoriamente: 129 E. coli enteropatogénica (EPEC), 90 E. coli enteroagregativa (EAEC), 66 E. coli enterotoxigénica (ETEC) y 70 E. coli de bacteremia. La presencia de genes de integrasa (intI) e integrones de clase 1 (IntI1) y 2 (IntI2) fue detectada mediante la reacción en cadena de polimerasa, los cassettes génicos fueron caracterizados por RFLP y secuenciamiento. Los integrones solo de clase 1 fueron más frecuentes y asociados significativamente con los aislados de bacteremia 31 % (22/70), en E. coli diarreogénicas, EAEC fue la más frecuente con 24% (22/90), seguido de EPEC con 9% (11/129) y ETEC con 6% (4/66). La presencia de solo integrasa 2 fue similar en EPEC 4% (5/129), EAEC 3% (3/90) y bacteremia 6% (4/70). Solo ETEC presentó un aislado con ambos tipos de integrones. En total se detectaron 15 cassettes génicos, 12 de clase 1 y 3 de clase 2, que confieren resistencia a los aminoglucósidos (aadA1, aadA2, aadA5), a gentamicina / tobramicina / kanamicina (aadB), a trimetoprima (dfrA1, dfrA5, dfrA7, dfrA12, dfrA15, dfrA17), a cloranfenicol (catB3) y 1 ORF (marco de lectura abierta). Solo en integrones de clase 2 se identificaron tres cassettes génicos de estreptotricina acetiltransferasa (sat 1, 2 y 3) que confieren resistencia a la estreptotricina. La mayoría de aislados con integrones 1 y 2 fueron mutiresistentes. Aislados de bacteremia con integrones de tipo 1 presentaron β-Lactamasas de Espectro Extendido en 59% (13/33). Por lo tanto E. coli provenientes de heces y sangre en niños peruanos presentan multiresistencia y albergan integrones de clase 1 y 2 con una variedad de genes cassette.Tesi

Potencialidades Turísticas del distrito de Callahuanca, provincia de Huarochirí, 2019

El presente trabajo de investigación tuvo como objetivo general analizar las Potencialidades Turísticas con las que cuenta el distrito de Callahuanca, provincia de Huarochirí 2019. El trabajo de investigación es de enfoque cualitativo, se usó un diseño etnográfico, la población objeto de estudio fueron los residentes del distrito de Callahuanca, la muestra constó de cinco personas, la técnica de muestreo que se utilizó para elegir a nuestros entrevistados fue la llamada cadena por redes o también llamada “bola de nieve”, el instrumento que se usó para recolectar los datos fue la entrevista semiestructurada, así como la técnica de la observación, la cual permitió conocer y analizar la situación actual del distrito de Callahuanca. La conclusión que se obtuvo al realizar este trabajo fue que Callahuanca cuenta con potencial turístico, que es un distrito capaz de atraer turistas internacionales, nacionales y locales, en dónde sus recursos permiten realizar un turismo de naturaleza, aventura, deportivo, vivencial, cultural y que además cuenta con festividades y con productos estrella como lo es la chirimoya, que tan sólo con este fruto es capaz de atraer a una gran cantidad de turistas al distrito, además de que cuenta con una adecuada planta turística y con variedad de alojamientos y restaurantes

Efecto sinérgico hipotensor del extracto acuoso de Hibiscus sabdariffa (flor de jamaica) con losartán en Ratus ratus albinus con hipertensión inducida.

En este estudio se planteó como objetivo evaluar el efecto sinérgico hipotensor del extracto acuoso de Hibiscus sabdariffa (flor de Jamaica) con losartán, en Rattus rattus var. albinus, hipertensas. Se evaluó el extracto acuoso de flor de Jamaica a la concentración de 125 mg/ml, y en combinación con losartán 0,07 mg/100g, en 1 dosis diaria por 2 días, utilizando control positivo (losartán) y control negativo (solución salina de NaCl al 0,9%), en 7 ratas por grupo. Se observó que la sinergia entre el extracto de rosa de Jamaica y losartán produjo mayor efecto hipotensor que el losartán, bajando la presión arterial sistólica en 29,57 mmHg (DE = 4,89 ± 1,85; [IC 95% = 25,05 – 34,10]) y 23,86 mmHg (DE = 6,67 ± 2,52; [IC 95% = 17,69 – 30,02]), respectivamente; y la presión arterial diastólica en 27,14 mmHg (DE = 4,81 ± 1,82; [IC 95% = 22,69 – 31,59]) y 25,57 mmHg (DE = 3,21 ± 1,21; [IC 95% = 22,61 – 28,54]), respectivamente. Se concluye que el extracto acuoso de Hibiscus sabdariffa asociado a losartán tiene efecto sinérgico hipotensor en Rattus rattus var, albinus, en estudio in vivo

Economic Assessment of Post-2012 Global Climate Policies - Analysis of Gas Greenhouse Gas Emission Reduction Scenarios with the POLES and GEM-E3 models

This report documents the JRC/IPTS modelling activities of the 2009 European Commission Communication "Towards a comprehensive climate change agreement in Copenhagen", which establishes the EU's position in the Copenhagen negotiations. According to the POLES model, the estimated global direct abatement costs of an emission reduction scenario compatible with the EU 2 degrees target are ¿175 billion by 2020. The report also highlights the crucial importance of energy efficiency improvements in achieving the overall emission reduction targets. Finally, the analyses with the POLES and GEM-E3 models underline the fundamental role that a global carbon market can play in implementing climate policies in a cost-efficient way.JRC.J.2-Competitiveness and Sustainabilit

A Comparability Analysis of Global Burden Sharing GHG Reduction Scenarios

The distribution of the mitigation burden across countries is a key issue regarding the post-2012 global climate policies. This article explores the economic implications of alternative allocation rules, an assessment made in the run-up to the COP15 in Copenhagen (December 2009). We analyse the comparability of the allocations across countries based on four single indicators: GDP per capita, GHG emissions per GDP, population growth, and the GHG emission trend in the recent past. The multi-sectoral computable general equilibrium model of the global economy, GEM-E3, is used for that purpose. Further, the article also compares a perfect carbon market without transaction costs with the case of a gradually developing carbon market, i.e. a carbon market with (gradually diminishing) transaction costs.JRC.J.1-Economics of Climate Change, Energy and Transpor

Reelin Mobilizes a VAMP7-Dependent Synaptic Vesicle Pool and Selectively Augments Spontaneous Neurotransmission

SummaryReelin is a glycoprotein that is critical for proper layering of neocortex during development as well as dynamic regulation of glutamatergic postsynaptic signaling in mature synapses. Here, we show that Reelin also acts presynaptically, resulting in robust rapid enhancement of spontaneous neurotransmitter release without affecting properties of evoked neurotransmission. This effect of Reelin requires a modest but significant increase in presynaptic Ca2+ initiated via ApoER2 signaling. The specificity of Reelin action on spontaneous neurotransmitter release is encoded at the level of vesicular SNARE machinery as it requires VAMP7 and SNAP-25 but not synaptobrevin2, VAMP4, or vti1a. These results uncover a presynaptic regulatory pathway that utilizes the heterogeneity of synaptic vesicle-associated SNAREs and selectively augments action potential-independent neurotransmission