Mental health problems in youths committed to juvenile institutions: prevalences and treatment needs

Many international studies show that adolescents in coercive institutional care display high prevalences of mental disorders, especially in the form of disruptive behavior disorders [including attention-deficit/hyperactivity disorder (AD/HD), oppositional defiant disorder, and conduct disorder], anxiety disorders, and mood disorders. High degrees of overlap across mental disorders have also been reported. In addition, institutionalized adolescents are often traumatized. Despite this well-documented psychiatric morbidity, the mental health care needs of detained adolescents are often overlooked. The main objective of this study is to assess prevalences of psychiatric disorders, results of intelligence tests, and previous contacts with child and adolescent psychiatric services among adolescents in institutional care. DSM-IV diagnoses, mental health contacts, substance abuse, neurocognitive abilities, and school performance were registered in 100 adolescents (92 boys, 8 girls) aged 12–19 years (mean age 16.0; SD ± 1.5) consecutively committed to Swedish juvenile institutions between 2004 and 2007. At least one psychiatric disorder was diagnosed in 73% of the subjects: 48% met DSM-IV diagnostic criteria for AD/HD, 17% for an autism spectrum disorder, and 10% for a mental retardation. The collapsed prevalence for psychiatric disorders requiring specialist attention was 63%. Our data indicate that systematic diagnostic procedures are crucial in the treatment planning for institutionalized adolescents. Adequate treatment strategies need to be designed and implemented to meet the extensive mental health care needs of this vulnerable population

Stage-Specific Effects of Candidate Heterochronic Genes on Variation in Developmental Time along an Altitudinal Cline of Drosophila melanogaster

Background: Previously, we have shown there is clinal variation for egg-to-adult developmental time along geographic gradients in Drosophila melanogaster. Further, we also have identified mutations in genes involved in metabolic and neurogenic pathways that affect development time (heterochronic genes). However, we do not know whether these loci affect variation in developmental time in natural populations. Methodology/Principal Findings: Here, we constructed second chromosome substitution lines from natural populations of Drosophila melanogaster from an altitudinal cline, and measured egg-adult development time for each line. We found not only a large amount of genetic variation for developmental time, but also positive associations of the development time with thermal amplitude and altitude. We performed genetic complementation tests using substitution lines with the longest and shortest developmental times and heterochronic mutations. We identified segregating variation for neurogenic and metabolic genes that largely affected the duration of the larval stages but had no impact on the timing of metamorphosis. Conclusions/Significance: Altitudinal clinal variation in developmental time for natural chromosome substitution lines provides a unique opportunity to dissect the response of heterochronic genes to environmental gradients. Ontogenetic stage-specific variation in invected, mastermind, cricklet and CG14591 may affect natural variation in development time an

Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.

Abstract BACKGROUND: The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. METHODS: We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The coprimary hypotheses were that exenatide, administered once weekly, would be noninferior to placebo with respect to safety and superior to placebo with respect to efficacy. RESULTS: In all, 14,752 patients (of whom 10,782 [73.1%] had previous cardiovascular disease) were followed for a median of 3.2 years (interquartile range, 2.2 to 4.4). A primary composite outcome event occurred in 839 of 7356 patients (11.4%; 3.7 events per 100 person-years) in the exenatide group and in 905 of 7396 patients (12.2%; 4.0 events per 100 person-years) in the placebo group (hazard ratio, 0.91; 95% confidence interval [CI], 0.83 to 1.00), with the intention-to-treat analysis indicating that exenatide, administered once weekly, was noninferior to placebo with respect to safety (P<0.001 for noninferiority) but was not superior to placebo with respect to efficacy (P=0.06 for superiority). The rates of death from cardiovascular causes, fatal or nonfatal myocardial infarction, fatal or nonfatal stroke, hospitalization for heart failure, and hospitalization for acute coronary syndrome, and the incidence of acute pancreatitis, pancreatic cancer, medullary thyroid carcinoma, and serious adverse events did not differ significantly between the two groups. CONCLUSIONS: Among patients with type 2 diabetes with or without previous cardiovascular disease, the incidence of major adverse cardiovascular events did not differ significantly between patients who received exenatide and those who received placebo. (Funded by Amylin Pharmaceuticals; EXSCEL ClinicalTrials.gov number, NCT01144338 .)

Petrography of gypsum-bearing facies of the Codó Formation (Late Aptian), Northern Brazil

An original and detailed study focusing the petrography of evaporites from the Late Aptian deposits exposed in the eastern and southern São Luís-Grajaú Basin is presented herein, with the attempt of distinguishing between primary and secondary evaporites, and reconstructing their post-depositional evolution. Seven evaporites phases were recognized: 1. chevron gypsum; 2. nodular to lensoidal gypsum or anhydrite; 3. fibrous to acicular gypsum; 4. mosaic gypsum; 5. brecciated gypsum or gypsarenite; 6. pseudo-nodular anhydrite or gypsum; and 7. rosettes of gypsum. The three first phases of gypsum display petrographic characteristics that conform to a primary nature. The fibrous to acicular and mosaic gypsum were formed by replacement of primary gypsum, but their origin took place during the eodiagenesis, still under influence of the depositional setting. These gypsum morphologies are closely related to the laminated evaporites, serving to demonstrate that their formation was related to replacements that did not affect the primary sedimentary structures. The pseudo-nodular anhydrite or gypsum seems to have originated by mobilization of sulfate-rich fluids during burial, probably related to halokinesis. The rosettes of gypsum, which intercept all the other gypsum varieties, represent the latest phase of evaporite formation in the study area, resulting from either intrastratal waters or surface waters during weathering.<br>Neste trabalho, é apresentado um estudo original e detalhado enfocando os aspectos petrográficos dos evaporitos de depósitos aptianos superiores expostos no sul e leste da Bacia de São Luís-Grajaú. O objetivo é o estabelecimento de critérios que permitam distinguir entre evaporitos primários e secundários, além da reconstrução de sua evolução pós-deposicional. Sete fases de evaporitos foram reconhecidas: 1. gipsita em chevron; 2. gipsita ou anidrita nodular a lenticular; 3. gipsita fibrosa a acicular; 4. gipsita em mosaico; 5. gipsita brechada a gipsarenito; 6. anidrita ou gipsita pseudo-nodular; e 7. gipsita em rosetas. As três primeiras fases apresentam características petrográficas condizentes com origem primária. Agipsita fibrosa a acicular e a gipsita em mosaico foramformadas por substituições de gipsita primária, com origem provável nos estágios iniciais da diagenêse, portanto ainda sob influência do ambiente deposicional. Estas morfologias de gipsita estão relacionadas com a fáciesde evaporito laminado, tendo sido formadas por substituição, porém sem afetar a estruturação primária. A gipsita ou anidrita pseudo-nodular originou-se pela mobilização de soluções sulfatadas durante ou após soterramento, provavelmente associada à halocinese. A gipsita em rosetas, que intercepta todas as outras variedades de gipsita, representa o ultimo estágio de formação de evaporitos na área de estudo, tendo resultado de soluções intraestratais ou de águas superficiais durante intemperismo