Association between chronic irritability and depressive symptoms in children and adolescents.

Association between chronic irritability and depressive symptoms in children and adolescents. Busto-Garrido, M.; Gutierrez-Castillo, D; Navas- Gonzalez, JR; Gutierrez-Bedmar, M; Gutierrez-Casares, JR; Martin-Lunar, MT; Rodríguez-Rosado, A; Pena-Andreu, JM. European Psychiatry 415(2017) 5221.Chronic irritability is the most frequently reported symptom in child and adolescent depression. The association of both has been linked with high rates of chronicity, comorbility and impairment. Objectives To study the association between chronic irritability and depressive symptoms in children and adolescents. Methods We have studied 857 participants recruited from the only Child and Adolescent Mental Health Clinic in a catchment area of 122968 people under 18 (2004-2010). A sample of 677 participants (57 controls and 620 patients) was included to carry out a cross-sectional study. Chronic irritability was measured by a Visual Analog Scale (VAS irritability) -scored from 0 to 10-, and depressive symptoms by the Children's Depression Inventory (CDI). The participants were categorized into controls and patients, and according to their chronic irritability (≤4 [I],5 [II] and ≥6 [III]). The mean of CDI score was calculated for each of the groups, adjusted by sex and age, and analyzed by ANCOVA. Results The following means were obtained from the controls: 13,71 (group I), 9,82 (group II) and 17,45 (group III). Regarding to the patients: 13,92 (group I), 11,54 (group II) and 15,64 (group III). A quadratic association (p <0,0015) was found between VAS irritability score and CDI score. Conclussions There is not a lineal association between chronic irritability and depressive symptoms in children and adolescent. High rates of depressive symptoms were associated both with high and low rates of irritability. Several questions remain unexplained about the status of irritability in psychiatry as Stringaris group has been pointed out. Disclosure statement I have no potential conflict of interest to discloseUniversidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Peritoneal carcinomatosis from a small bowel carcinoid tumour

BACKGROUND: Peritoneal carcinomatosis from a gastrointestinal carcinoid tumour is rare and the long-term management and prognosis have not been clearly defined. The natural history is different from gastrointestinal adenocarcinoma, although its capacity to invade regional lymph nodes and generate distal metastasis can make the management more complex. Whilst the development of carcinomatosis is uncommonly reported, it may be higher than expected. CASE PRESENTATION: A 63 years-old woman underwent emergency surgery in 1993 for right iliac fossa pain and a mass that was found to be an ileal carcinoid tumour. Over the next ten years, further surgery was required for disseminated disease with peritoneal carcinomatosis and liver metastasis. Systemic chemotherapy had little effect, although Somatostatin was used effectively to relieve symptoms caused by the disseminated disease (flushing and diarrhoea). CONCLUSION: Peritoneal carcinomatosis from carcinoid tumours is not well documented in the literature. Aggressive surgery must be performed in order to control the disease since chemotherapy has not been reported to be effective. With repeated surgery long-term survival can be achieved in these patients

Ignorancia consciente en el aprendizaje de las ciencias II : factores que influyen en lo que los alumnos saben que no saben

La investigación en la didáctica de las ciencias ha examinado en detalle procesos de adquisición de conocimiento y comprensión del contenido científico. Sin embargo, se ha prestado menos atención a los papeles positivos de la incomprensión o el desconocimiento consciente. Este artículo es el segundo de dos trabajos de revisión y síntesis en los que se analiza el desconocimiento y la incomprensión conscientes de contenidos científicos. El primero se centra en los componentes y estructura de la incomprensión y en este segundo se examinan las variables que afectan al desconocimiento y a la incomprensión conscientes. En particular se revisan y sintetizan estudios sobre el efecto que tienen el conocimiento, las tareas y los criterios de coherencia en la consciencia de la incomprensión, o el desconocimiento de la ciencia, que se manifiesta generalmente a través de preguntas. Finalmente se sintetizan algunas de las implicaciones que tienen los estudios revisados para la enseñanza y el aprendizaje de las ciencias.La recerca en la didàctica de les ciències ha examinat detalladament processos d'adquisició de coneixement i comprensió del contingut científic. No obstant això, s'ha prestat menys atenció als papers positius de la incomprensió o el desconeixement conscient. Aquest article és el segon de dos treballs de revisió i síntesi en els quals s'analitza el desconeixement i la incomprensió conscients de continguts científics. El primer se centra en els components i estructura de la incomprensió i en aquest segon s'examinen les variables que afecten al desconeixement i a la incomprensió conscients. En particular es revisen i sintetitzen estudis sobre l'efecte que tenen el coneixement, les tasques i els criteris de coherència en la consciència de la incomprensió, o el desconeixement de la ciència, que es manifesta generalment a través de preguntes. Finalment se sintetitzen algunes de les implicacions que tenen els estudis revisats per a l'ensenyament i l'aprenentatge de les ciències.Much research in science education has focused on the processes of knowledge building and comprehension of scientific content. However, the positive roles of what is unknown or not understood have received much less attention. This article is the second one of two reviews that analyze the nature of what is consciously unknown or not understood about science content. The first paper focused on the components and structure of incomprehension. This second paper examines the variables influencing what is consciously not known or not understood. In particular we review and synthesize studies about the influence of knowledge, tasks, and standards of coherence on the awareness of lack of knowledge or the incomprehension of science, that is made explicit through questioning. Finally, we synthesize some implications of the revised studies for science teaching and learning

MARCO GENERAL DE LA GESTIÓN ORGANIZACIONAL DE LAS PEQUEÑAS Y MEDIANAS EMPRESAS (PYMES): INCENTIVOS INSTITUCIONALES Y PALIATIVOS DEL MERCADO

La tendencia a formalizar el comportamiento empresarial a través de la definición de modelos de gestión organizacional en las PyMEs, implica analizar la estructura y fundamentación ex ante en que estos son basados. El análisis que debe rodear la constitución de un modelo, está siendo reducido por argumentos apriorísticos y evaluaciones dependientes del mecanismo, bajo el cual los datos y la información son obtenidos. El análisis sobre la estructuración de modelos debe guardar correspondencia desde las bases estadísticas, matemáticas y de programación sin distingo de alcance metodológico, que constituye el acervo del modelo y que en esencia no es visible. La modelación en cualquier escenario, requiere el trato propio al respecto y no una presentación semántica con la que se trata de ligar una idea

Dual-Drive Directional Couplers for Programmable Integrated Photonics

A novel class of photonic integrated circuits employs large-scale integration of combined beam splitters and waveguides loaded with phase actuators to provide complex linear processing functionalities that can be reconfigured dynamically. Here, we propose and experimentally demonstrate a thermally-actuated Dual-Drive Directional Coupler (DD-DC) design, integrated in a silicon nitride platform, functioning both as a standalone optical component providing arbitrary optical beam splitting and common phase as well as for its use in waveguide mesh arrangements. We analyze the experimental demonstration of the first integration of a triangular waveguide mesh arrangement, and the first DD-DC based arrangement along with an extended analysis of its performance and scalability