Problematic, absent and stigmatizing diagnoses in current mental disorders classifications: Results from the WHO-WPA and WHO-IUPsyS Global Surveys

This study examined English- and Spanish-speaking psychologists' and psychiatrists' opinions regarding problematic, absent and stigmatizing diagnoses in current mental disorders classifications (ICD-10 and DSM-IV), and their perceived need for a national classification of mental disorders. Answers to open-ended questions included in WHO-WPA and WHO-IUPsyS surveys were examined using an inductive content-analysis method. A total of 3,222 participants from 35 countries were included. The most problematic diagnostic group was personality disorders, especially among psychiatrists, because of poor validity and lack of specificity. Complex posttraumatic stress disorder was the most frequent diagnosis suggested for inclusion, mainly by psychologists, to better account for the distinct processes and consequences of complex trauma. Schizophrenia was the diagnosis most frequently identified as stigmatizing, particularly by psychiatrists, due to lack of public understanding or knowledge about the diagnosis. Of the 14.4% of participants who perceived a need for a national classification system, two-thirds were from Africa or Latin America. The rationales provided were that mental disorders classifications should consider cultural and socio-historical diversity in the expression of psychopathology, differences in the perception of what is and is not pathological in different nations, and the existence of culture-bound syndromes. Implications for ICD-11 development and dissemination are discussed. © 2014 Asociación Española de Psicología Conductual

Gamificación como estrategia didáctica en la asignatura de Estudios Sociales de décimo año de Educación Básica

Gamification and Information and Communication Technologies, given the resources and means at their disposal, are tools with a high possibility of success in achieving the activation and development of the teaching-learning process. The objective is to propose a didactic strategy for the use of gamification with the support of technologies that contributes to positive results in the motivation and performance of students in the Social Studies subject. It starts from the application of theoretical research methods by consulting previous research regarding the concept and characteristics of the use of gamification and the activation of the teaching-educational process to establish guidelines and variables to include in the diagnosis. This is developed with the use of methods such as: observation, documentary review, interview and the application of a survey to the students with two defined objectives: to evaluate the current situation from the perspective of the students and to verify the effect of the selected influential variables. The Kendall Method is applied to the instrument, which demonstrates the validity and reliability of the test; as well as the determination of the explanatory local variance and the sedimentation graph that verify the accuracy of the defined variables. The application of the strategy shows an improvement in the perception of students about the results of the teaching-learning process and the motivation in classes that use gamification supported by Information and Communication Technologies.La gamificación y las Tecnologías de la Información y las Comunicaciones dados los recursos y medios que poseen a su disposición resultan herramientas de alta posibilidad de éxito en el logro de la activación y desarrollo del proceso de enseñanza-aprendizaje. El objetivo es proponer una estrategia didáctica para el empleo de la gamificación con apoyo de las tecnologías que tribute a resultados positivos en la motivación y el desempeño de los estudiantes en asignatura de Estudios Sociales. Se parte de la aplicación de métodos teóricos de investigación al consultar investigaciones precedentes respecto al concepto y características del uso de la gamificación y la activación del proceso docente–educativo para establecer pautas y variables a incluir en el diagnóstico. Este se desarrolla con el empleo de métodos como: observación, revisión documental, entrevista y la aplicación de una encuesta a los estudiantes con dos objetivos definidos: evaluar la situación actual desde la perspectiva de los estudiantes y comprobar el efecto de las variables influyentes seleccionadas. Al instrumento se le aplica el Método Kendall lo que demuestra la validez y fiabilidad de la prueba; así como la determinación de la varianza local explicativa y el gráfico de sedimentación que comprueban la exactitud de las variables definidas. La aplicación de la estrategia muestra una mejora en la percepción de los alumnos acerca de los resultados del proceso de enseñanza-aprendizaje y la motivación en las clases que emplean la gamificación apoyada en las Tecnologías de la Información y las Comunicaciones

Intervention strategies to reduce the burden of non-communicable diseases in Mexico: cost effectiveness analysis

Objective To inform decision making regarding intervention strategies against non-communicable diseases in Mexico, in the context of health reform

Estructura dimensional de la Escala Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) en universitarios mexicanos

This work verifies the dimensional structure of the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM; Evans et al., 2000) through a quantitative-cross-sectional study in a sample of 466 university students who were selected by convenience sampling. 181 ages 18 to 30 who had requested psychological attention; and 285 ages 17 to 29 who were not seeking care. Through exploratory and confirmatory factor analyses,three dimensions for the instrument were identified, which presented adequate levels of internal consistency. This substantially replicates the previous results of the original version. Statistically significant differences were found in relation to sex, as well as of the consulting and non-consulting population. Differential item functioning (DIF) was carried out to explore these differences, and five items were found in the first category and three in the second. The internal structure of CORE-OM explores a wide range of symptoms of psychological distress and it is useful for evaluation in young university students.Este trabajo verifica la estructura dimensional del Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM; Evans et al., 2000) mediante un estudio cuantitativo-transversal en una muestra de 466 estudiantes universitarios elegidos por muestreo de conveniencia; 181 de 18 a 30 años que solicitaron atención psicológica, y 285 de 17 a 29 años que no estaban en búsqueda de atención. A través de los análisis factoriales exploratorio y confirmatorio se identificaron tres dimensiones para el instrumento con adecuados niveles de consistencia interna, lo cual replica sustancialmente los resultados previos de la versión original. Se hallaron diferencias estadísticamente significativas entre varones y mujeres y entre la población consultante y no consultante. Finalmente, se comprobó si existía funcionamiento diferencial del ítem por sexo y por población consultante. Cinco reactivos se hallaron en la primera categoría y tres en la segunda. La estructura interna del CORE-OM explora un amplio conjunto de síntomas de malestar psicológico y resulta útil para su evaluación en jóvenes universitarios.&nbsp

Adolescentes con diagnóstico de endocarditis infecciosa atendidos en el Hospital Infantil Norte de Santiago de Cuba

Introduction: infectious endocarditis is one of the main prototypes of cardiovascular diseases not only on a global scale, but also at a national level.Objective:to characterize clinically and epidemiologically the adolescents diagnosed with infectious endocarditis treated at North Pediatric Hospital of Santiago de Cuba from 2010 to 2017.Method: an observational, descriptive and cross-sectional study was carried out. The target group comprised 20 adolescents with the diagnosis of infectious endocarditis treated at Norte Pediatric Hospital of Santiago de Cuba during the period 2010 to 2017. The information was collected from the medical records.Results: the age group of 10 to 12 years (45 %) and male sex (65 %) predominated. Fever and tachycardia were the most frequent clinical manifestations, present in 100 % of adolescents. Ventricular septal defect constituted the most significant comorbidity with 30 %. Blood cultures were positive in 75 % of the cases; there was only one patient who died in the series (5 %) and 75 % progressed satisfactorily to health recovery.Conclusions: infectious endocarditis in adolescence is more frequent in males, having several forms of presentation; it is also directly associated with the presence of other diseases, having a low mortality in the series studied.Introducción: la endocarditis infecciosa constituye uno de los principales prototipos de las enfermedades cardiovasculares no solo a escala mundial, sino también en el ámbito nacional.Objetivo: caracterizar clínica y epidemiológicamente a los adolescentes con diagnóstico de endocarditis infecciosa atendidos en el Hospital Infantil Norte de Santiago de Cuba de 2010 a 2017.Método: se realizó un estudio observacional, descriptivo y transversal. El universo estuvo constituido por 20 adolescentes con diagnóstico de endocarditis infecciosa atendidos en el Hospital Infantil Norte de Santiago de Cuba en el período de 2010 a 2017. La información se obtuvo de las historias clínicas.Resultados: predominó el grupo de edades de 10 a 12 años (45 %) y el sexo masculino (65 %). La fiebre y la taquicardia fueron las manifestaciones clínicas más frecuentes, presentes en el 100 % de los adolescentes. La comunicación interventricular constituyó la comorbilidad más significativa con un 30 %. Los hemocultivos fueron positivos en el 75 % de los casos; solo hubo un paciente fallecido en la serie (5 %) y el 75 % evolucionó satisfactoriamente a la curación.Conclusiones: en la adolescencia la endocarditis infecciosa es más frecuente en el sexo masculino, teniendo varias formas de presentación; además se asocia directamente a la presencia de otras enfermedades, teniendo una baja mortalidad en la serie estudiada

Myeloid p38 activation maintains macrophage-liver crosstalk and BAT thermogenesis through IL-12-FGF21 axis.

Obesity features excessive fat accumulation in several body tissues and induces a state of chronic low-grade inflammation that contributes to the development of diabetes, steatosis, and insulin resistance. Recent research has shown that this chronic inflammation is crucially dependent on p38 pathway activity in macrophages, suggesting p38 inhibition as a possible treatment for obesity comorbidities. Nevertheless, we report here that lack of p38 activation in myeloid cells worsens high-fat diet-induced obesity, diabetes, and steatosis. Deficient p38 activation increases macrophage IL-12 production, leading to inhibition of hepatic FGF21 and reduction of thermogenesis in the brown fat. The implication of FGF21 in the phenotype was confirmed by its specific deletion in hepatocytes. We also found that IL-12 correlates with liver damage in human biopsies, indicating the translational potential of our results. Our findings suggest that myeloid p38 has a dual role in inflammation and that drugs targeting IL-12 might improve the homeostatic regulation of energy balance in response to metabolic stress.S

Global Collaborative Team Performance for the Revision of the International Classification of Diseases: A Case Study of the World Health Organization Field Studies Coordination Group

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.Background/Objective: Collaborative teamwork in global mental health presents unique challenges, including the formation and management of international teams composed of multicultural and multilingual professionals with different backgrounds in terms of their training, scientific expertise, and life experience. The purpose of the study was to analyze the performance of the World Health Organization (WHO) Field Studies Coordination Group (FSCG) using an input-processes-output (IPO) team science model to better understand the team's challenges, limitations, and successes in developing the eleventh revision of the International Classification of Diseases (ICD). Method: We thematically analyzed a collection of written texts, including FSCG documents and open-ended qualitative questionnaires, according to the conceptualization of the input-processes-output model of team performance. Results: The FSCG leadership and its members experienced and overcame numerous barriers to become an effective international team and to successfully achieve the goals set forth by WHO. Conclusions: Research is necessary regarding global mental health collaboration to understand and facilitate international collaborations with the goal of contributing to a deeper understanding of mental health and to reduce the global burden of mental disorders around the world

Mujeres que inspiran…Grandes historias de guerreras

Recopilación de historias propias o contadas por terceros de mujeres que han superado retos, dificultades, competencias y cómo han conseguido lograr hazañas inspiradoras.Collection of own or told stories by third parties of women who have overcome challenges, difficulties, competencies and how they have managed to achieve inspiring feats.Yamel Rodríguez -- Iber James Quiñones -- Diana Yamileth Velasquez Maldonado -- Nidia Karina Mora Londoño -- Aura María Rosero -- Catherine Caicedo -- David Alejandro Mera Benavides -- Elizabeth Cárdenas Berrío -- Jhon Jairo Leal F. -- Miguel Ángel Solís -- Milton Cesar Mera Osorio -- Elizabeth González Londoño -- Lorena Villegas -- Ana María Cortés Rosero -- Jhonathan Paul Obando Vera -- María Elena Realpe Delgado -- Carolina Medina Alcalde -- Yaneth Ariasna34 página

Validez de las categorías relacionadas con la identidad de genero en la CIE-11 y el DSM-5 entre personas transgenero que buscan procedimientos medicos que afirmen su genero

BACKGROUND/OBJECTIVE : The most recent versions of the two main mental disorders classifications-the World Health Organization's ICD-11 and the American Psychiatric Association's DSM-5-differ substantially in their diagnostic categories related to transgender identity. ICD-11 gender incongruence (GI), in contrast to DSM-5 gender dysphoria (GD), is explicitly not a mental disorder; neither distress nor dysfunction is a required feature. The objective was compared ICD-11 and DSM-5 diagnostic requirements in terms of their sensitivity, specificity, discriminability and ability to predict the use of gender-affirming medical procedures. METHOD : A total of 649 of transgender adults in six countries completed a retrospective structured interview. RESULTS : Using ROC analysis, sensitivity of the diagnostic requirements was equivalent for both systems, but ICD-11 showed greater specificity than DSM-5. Regression analyses indicated that history of hormones and/or surgery was predicted by variables that are an intrinsic aspect of GI/GD more than by distress and dysfunction. IRT analyses showed that the ICD-11 diagnostic formulation was more parsimonious and contained more information about caseness than the DSM-5 model. CONCLUSIONS : This study supports the ICD-11 position that GI/GD is not a mental disorder; additional diagnostic requirements of distress and/or dysfunction in DSM-5 reduce the predictive power of the diagnostic model.Partially funded by unrestricted grants by the World Health Organization Department of Mental Health and Substance Abuse to participating institutions in Brazil, India, Lebanon, Mexico, and South Africa for the development and implementation of ICD-11 field studies. Financial support for the French study was provided by the Direction Générale de la Santé (DGS), Ministry of Health, France.http://www.elsevier.es/ijchpam2023Psychiatr