Improving Depression Screening for Clinical Staff in a Psychiatric Rehabilitation Facility: A Quality Improvement Project

Abstract Background: Depression is the most common of mental disorders in the United States affecting a significant portion of the population. Despite the serious consequences of untreated depression, depression screening remains a challenge across healthcare settings prompting the United States Prevention Task Services to develop strong recommendations to improve screening and treatment. Yet, despite those recommendations, lack of knowledge about depression screening continues to impede this process. The presence of substance use in individuals affected by depression worsens the severity of either condition alone. Considering the frequency of co-occurring substance use and depression, it becomes vital that staff working at substance abuse facilities receive adequate training to improve depression screening skills in this sub-population. Purpose: The purpose of this quality improvement project was to increase knowledge of depression screening skills for clinical staff working at a psychiatric rehabilitation facility. Methods: A total of 15 participants completed an online pretest survey to assess their baseline knowledge on depression screening. This was followed by a virtual education module delivered online via PowerPoint presentation. Then, 4 weeks after, participants completed an online posttest survey to evaluate knowledge gained. Results: Pretest survey results revealed knowledge deficit regarding guidelines about depression screening, depression screening skills, and a misguided attitude and negative perception regarding depression. Posttest shows significant improvement in all categories with an overall improvement of 41%. Conclusion: The overwhelming improvement in scores shows the effectiveness of educational interventions to improve depression screening skills and competence and the impact of evidence based training overall in improving patient care

Seasonality and prevalence of respiratory syncytial virus in Kinshasa, Democratic Republic of Congo

The Democratic Republic of Congo (DRC) with its tropical climate in the past was thought not to house many respiratory viruses, with time and after many outbreaks began researches and surveillance on respiratory viruses circulating in the country. The first was influenza sentinel surveillance which showed that around 10% of suspected samples received were positive for influenza and 90% were negative, therefore a research was needed to find which other virus was present and causing infection in the remaining 90%. This study aimed to screen Respiratory Syncytial Virus (RSV) among those remaining samples in Kinshasa in order to determine the proportion and seasonal factors influencing the virus. The samples used were nasopharyngeal swabs collected from different Influenza surveillance sites in Kinshasa: Kalembelembe, Boyambi, Kinshasa General Hospital, Kingasani Hospital Centre and RVA clinic during the period of January to September 2016. 169 Samples were randomly selected for the research and were chosen regardless of the patient’s age, sex, geographic group and symptoms. Molecular analysis was done to determine if the samples were RSV positive or negative at the National Reference Laboratory (NRL) in Kinshasa using real time reverse transcription-polymerase chain reaction (rRT-PCR). 13.6% were positive for RSV. The prevalence was higher in female 65.2% than in male 34.8%, over 95% of RSV infection occurred during the rainy season and among the positive cases 60.9% were from hospitalized patients with severe acute respiratory infection and 39.1% were from influenza-like illness or infection. The largest proportion (78.3%) of RSV positives was found in children under the age of 2 years. This study showed that RSV is found in Kinshasa, DRC at most during the rainy season and tend to fade away during the dry season. Children are the most affected especially those younger than 2 years and RSV was more prevalent in female than in male.open석

Effect of the enzymatic inhibitor of Kunitz on the gastric lesions from reserpine, from phenylbutazone, from pyloric ligation and by restraint in the rat

The protective effects of certain polypeptides on gastric ulcerations caused from reserpine and phenylbutazone in the rate were studied. It was found that the Kunitz enzymatic inhibitor exerts a protective action in regard to gastric lesions. However, the inhibitor did not change the development of Shay ulcers and stress ulcers from restraint

D2.6 Compiled proceedings of Annual Conferences

This document collects the proceedings of the 3 Annual Conferences and the Final Conference as organised under SHERPA. It brings together the main contributions from interventions and keynote speeches during these conferences, as well as from the interactive sessions

Cascaded multitask U-Net using topological loss for vessel segmentation and centerline extraction

Vessel segmentation and centerline extraction are two crucial preliminary tasks for many computer-aided diagnosis tools dealing with vascular diseases. Recently, deep-learning based methods have been widely applied to these tasks. However, classic deep-learning approaches struggle to capture the complex geometry and specific topology of vascular networks, which is of the utmost importance in most applications. To overcome these limitations, the clDice loss, a topological loss that focuses on the vessel centerlines, has been recently proposed. This loss requires computing, with a proposed soft-skeleton algorithm, the skeletons of both the ground truth and the predicted segmentation. However, the soft-skeleton algorithm provides suboptimal results on 3D images, which makes the clDice hardly suitable on 3D images. In this paper, we propose to replace the soft-skeleton algorithm by a U-Net which computes the vascular skeleton directly from the segmentation. We show that our method provides more accurate skeletons than the soft-skeleton algorithm. We then build upon this network a cascaded U-Net trained with the clDice loss to embed topological constraints during the segmentation. The resulting model is able to predict both the vessel segmentation and centerlines with a more accurate topology.Comment: 13 pages, 4 figure

Représentations de leur rôle d'acteur politique chez des personnalités politiques issues de la communauté haïtienne du Québec

Depuis plusieurs années le Québec devient une société de plus en plus diversifiée avec un nombre grandissant de ressortissants en provenance de l'étranger venant s'y établir. Pourtant cette diversité fait défaut dans de nombreux espaces de la vie publique. En effet, les communautés ethnoculturelles minoritaires font face à un déficit de représentation dans les instances politiques et décisionnelles. Or, la participation politique de ces communautés soulève pour celles-ci des enjeux sociaux et identitaires. Ceci nous a porté à nous interroger sur la manière dont des personnalités politiques issues de la communauté haïtienne, une minorité visible, perçoivent leur rôle dans le milieu politique. Pour répondre à cette question, les concepts de minorité ethnique, d'identité sociale et de représentation sociale ont servi de cadre de référence pour comprendre le sens des actions de nos répondants dans l'univers social. La recherche est ancrée dans une perspective interactionniste en mariant contexte, vécu et représentation du rôle. La méthode de recherche qualitative nous a permis à travers des entretiens semi-directifs de brosser un portrait du rôle d'acteur politique tel que perçu par nos répondants. Nos résultats indiquent un fort intérêt communautaire chez les personnalités politiques issues de la communauté haïtienne dans leur manière d'envisager leur rôle politique. Leur rôle d'acteur politique est vu comme une stratégie de revendications sociales et de revendications identitaires principalement au bénéfice des groupes défavorisés et de la communauté d'origine. Ils ont également un souci de transformation de la société québécoise pour en faire un espace auquel tous ses fils et filles peuvent non seulement s'identifier mais aussi avoir les mêmes chances. Cependant, il est difficile de détacher aspects sociaux et aspects identitaires des rôles, ceux-ci évoluant de préférence sur un axe où ils s'interpénètrent. En nous référant à l'approche théorique des minorités actives de Moscovici (1996) nous constatons que leurs actions tendent principalement vers la normalisation et l'innovation sociale.\ud ______________________________________________________________________________ \ud MOTS-CLÉS DE L’AUTEUR : minorité, communauté haïtienne, participation politique, représentation sociale, identité, reconnaissance social

Les Forêts Sacrées Dans Les Hautes Terres De l’OuestCameroun : Intérêt Dans La Conservation De La Biodiversité

La végétation des Hauts plateaux de l’Ouest-Cameroun est pratiquement domestiquée, les espèces originales sont réfugiées dans des reliques de forêts, dans des zones à accès difficile dans des forêts ripicoles le long des cours d’eau ou dans des forêts dites forêt sacrées. Le présent travail vise à évaluer la diversité floristique et à faire une analyse qualitative et quantitative de la flore de quelques forêts sacrées dans l’Ouest du Cameroun. Le statut de conservation des espèces a été également déterminé. Le recensement des individus s’est fait dans 41 placettes de 25 m x 25 m établies dans les forêts sacrées de Bafou, Baleveng, Bamendou, Mbing Mekoup, Bamendjinda et de Bamendjo. Le nombre de placettes par forêt dépendait de la taille de la forêt. À l’intérieur de chaque placette, tous les individus de diamètre supérieur ou égal à 10 cm à hauteur de poitrine (1,30 m) ont été considérés. Les indices de diversité de Shannon et de Simpson ont été utilisés pour évaluer la phytodiversité ; les valeurs d’importance des espèces et des familles ont été calculées. Le test d’ANOVA a été utilisé pour comparer statistiquement les données. Globalement, 2 829 individus de diamètre ≥ 10 cm appartenant à 91 espèces, 85 genres et 47 familles ont été inventoriés. Les valeurs des indices de diversité sont faibles (de 0,73 et 2,49 bits par placette pour l’indice de Shannon ; de 0,02 à 0,89 par placette pour l’indice de Simpson). Elles traduisent la faible diversité floristique de la zone. La surface terrière varie de 14,44 m2.ha-1 à 65,6 m2. ha-1 par forêt. L’analyse factorielle des correspondances individualise la flore en trois grands groupes suivant un gradient topographique, hydrologique et anthropique. La classification ascendante hiérarchique confirme les résultats de l’analyse factorielle des correspondances en individualisant trois grandes classes de flore. Le facteur altitude semble être le facteur principal qui influence l’individualisation de ces groupes déterminés par les analyses multivariées. D’après la liste rouge des espèces menacées de l'Union Internationale pour la Conservation de la Nature ; six espèces du total enregistré sont en situation de vulnérabilité (Prunus africana, Podocarpus mannii, Entandrophragma utile, Entandrophragma candollei, Cordia platythyrsa, Antidesma venosium). Cette étude souligne l’importance de la flore des forêts sacrées, les données obtenues pourront servir de bases pour une gestion durable de ces forêts. The vegetation of the Western Highlands is almost domesticated, and the original species are found in forest relics called sacred forest. These sacred forests also have an important number of floristic species. This work aims to assess the floristic diversity and to make a qualitative and quantitative analysis of the flora of some sacred forests in West Cameroon. The conservation status of the species was also determined using IUCN redlist. The census of individuals was carried out on 41 plots of 25 m x 25 m established in the selected forests. The number of plots per forest depended on the size of the forest. Within each plot, all individuals with a diameter greater or equal to 10 cm at breast height (1.30 m) were considered. The Shannon and Simpson diversity index were used to assess phytodiversity; importance values for species and families were calculated. The ANOVA test was used to compare the data. Overall, 2829 individuals with a diameter of ≥ 10 cm belonging to 91 species, 85 genera and 47 families were inventoried. Diversity index values are low (0.73 and 2.49 bits per plot for the Shannon index; 0.02 to 0.89 bits per plot for the Simpson index). These reflect the low floristic diversity of the area. The basal area varies from 14,44 m2. ha-1 to 65.6 m2. ha-1 per zone. Correspondence factor analysis individualizes the flora into three major groups following a topographic, hydrological, and anthropogenic gradient. Clustering hierarchical analysis confirms the results of the AFC by grouping the flora into three main classes according to the altitude. Amongst the species recorded, six others are in a vulnerable situation (Prunus africana, Podocarpus mannii, Entandrophragma utile, Entandrophragma candollei, Cordia platythyrsa, Antidesma venosium). This study highlights the importance of sacred forest vegetation as a basis for sustainable management of these forests

Comparison of Focused Cardiac Ultrasound Findings in Lateral Versus Sternal Recumbency in Cats

peer reviewe

Addressing the Social Aspects of a Circular Economy: A Systematic Literature Review

ABSTRACT: Circular Economy (CE) is a growing topic among scholars, industries, and governments, and is aimed at decoupling economic growth and development from the consumption of finite resources. CE incorporates different meanings, from reduce, reuse, and recycle activities, to environmental degradation or resource scarcity, and is supported by specific indicators to attain sustainable development. However, so far, there has been no agreement to measure how effective an industry/product is in making the transition from linear to circular approaches, particularly those that affect society. This research work aims to perform a systematic literature review (n = 60) to analyze and discuss how social aspects have been considered and integrated in CE research so far. Moreover, this review provides an overview of the literature on social impact within the CE, which results in three main outputs: a knowledge map of the CE, an analysis of social aspects within CE, and the theories/frameworks used to evaluate social impact of CE. Finally, this study brings to light how CE implementation can affect society and highlights the importance of social dimension in the domains of CE and a policy-making community, which could help move CE towards a sustainable development

Focused Cardiac Ultrasound to Detect Pre-capillary Pulmonary Hypertension

peer reviewedBackgroundEarly recognition of pre-capillary (PC) pulmonary hypertension (PH) benefits dogs, allowing earlier treatment and improving prognosis. The value of focused cardiac ultrasound (FCU) to diagnose PH and assess its severity has not been investigated yet.HypothesisA subjective 10-point FCU pulmonary hypertension score (PHS) allows diagnosis and assessment of severity of PCPH.AnimalsThis study involved fifty client-owned dogs.MethodsDogs, recruited between September 2017 and February 2020, were classified into four categories (no, mild, moderate, and severe PH; C1 to C4, respectively). C1 and C2, and C3 and C4 were regrouped as group 1 and group 2, respectively. A blinded general practitioner assessed four FCU cineloops. Five echocardiographic parameters were subjectively scored, resulting in a total score of 0–10. Non-parametric tests compared global scores between categories and groups. A receiver operating characteristic (ROC) curve determined the cutoff value to differentiate group 1 and group 2. A gray zone approach allowed diagnosing or excluding moderate to severe PH with 90% certitude.ResultsGlobal scores were significantly higher for C4 than for C1, C2, and C3. Global scores of G2 were significantly higher than G1. The ROC curve indicated a cutoff value of 5, discriminating group 1 from group 2 with a sensitivity of 77% and a specificity of 100%. A score of ≥5/10 allowed diagnosing moderate to severe PH with ≥90% certainty while a score of ≤2/10 excluded PH with ≥90% certainty.Conclusions and Clinical SignificanceModerate to severe PCPH can be accurately detected by non-cardiologists using a 10-point FCU PHS score