Psychometric properties of the Ndetei–Othieno–Kathuku (NOK) Scale: A mental health assessment tool for an African setting

Background: Research suggests that psychiatric conditions in children and adolescents are highly debilitating, with sparse resources for assessment and treatment in low- and middle-income countries (LMICs). Objectives: The primary aim of this study was to evaluate the reliability, validity, and latent factor structure of an ethnographically-grounded assessment instrument for detecting common mental health complaints among rural Kenyan children and adolescents. Methods: The Ndetei–Othieno–Kathuku Scale (NOK) was delivered to 2 282 children aged 10 to 18 years old. Exploratory factor analysis identified four latent factors. This structure was confirmed in subsequent confirmatory factor analyses. External validity was explored by investigating associations among NOK factors and Youth Self-Report DSM-oriented scales. Results: Findings suggest the NOK possesses good internal reliability and a four-factor latent structure corresponding to depression, anxiety, somatic complaints, and a mixed factor. Significant associations ranging from small to medium effect sizes were noted between NOK factors and YSR DSM-oriented scales. Conclusions: Exploratory findings suggest that the NOK possesses adequate psychometric properties among this population. This ethnographically-grounded instrument may be uniquely suited to screening for mental health complaints among Kenyan children and adolescents

The Lifetime Burden of Schizophrenia as Estimated by a Government-Centric Fiscal Analytic Framework

Objective: To estimate the fiscal consequences of schizophrenia compared to the general US population using a “government perspective” fiscal analytic modeling framework capturing lost tax revenue and broader government costs in 2021. Methods: Schizophrenia was modeled from age 23 using a cohort-based Markov chain with 6-week cycles, simulating the effect of antipsychotic treatment sequences on remission and relapse. Markov states were defined using efficacy and safety outcomes from short- and long-term clinical trials. Mortality was based on US lifetables, schizophrenia-related suicide, and cardiovascular risks. A semi-Markov model with annual cycles simulated the likelihood and costs of incarceration and homelessness in community-based individuals. Lifetime fiscal consequence were estimated conditionally to survival, remission/relapse status, and likelihood of socioeconomic outcomes. Costs and life years were discounted at 3.0% annually. Uncertainty was explored in 1-way and scenario analyses. Results: Unemployment, disability, incarceration, homelessness, health care use, and productivity losses were more common in people living with schizophrenia. Schizophrenia was associated with a $1,540,042 per person lifetime fiscal loss to the government, with$56,707 per life year lived with schizophrenia. Health care costs represented 41.9% of the fiscal losses, 39.4% were due to criminal and homelessness costs, and 17.5% related to foregone tax revenue. Considering a 1.19% prevalence of schizophrenia, the estimated annual fiscal burden in the US was $173.6 billion. Conclusions: The fiscal framework illustrates how schizophrenia influences taxation and government transfer payments over time. These findings can be used to augment cost-effectiveness analyses and inform stakeholders of the fiscal impact of schizophrenia to inform priority interventions.</p

MARKET AND ASSORTMENT OF RASPBERRY PRODUCTS IN THE REPUBLIC OF SERBIA AND IN THE WORLD

This paper analyses raspberry market dynamics in the world; importance and possibilities for getting raspberry products, such as juices, concentrates, syrups, pastes and raspberry juice powder, in the higher processing stages. Considerably higher economic effects (market prices even higher than 60 EUR per kg) could be reached if these products are offered in the internal market, and especially if these products are exported. This is the reason why the overall supply of these products, aimed at winning the adequate place in the internal market as well as in the external market, despite the ever increasing competition with regard to the quantity and quality, should be derived from the production/objects which are working in accordance with HACCP standards, and it should have a recognizable trade mark and an original packaging, as a symbol of its origin and quality

Los puertos perdidos del Tinto : un enfoque multidisciplinar

Estudio sobre los puertos fluviales del río Tinto. Causas de su desaparición. Propuesta de recuparación de uno de ellos.Study on the RioTinto viver ports. Reason for the disappearance. Recovery proposal port

Comparative Bioequivalence of Tablet and Capsule Formulations of Ulotaront and the Effect of Food on the Pharmacokinetics of the Tablet Form in Humans

Abstract Introduction Ulotaront (SEP-363856), a dual trace animeassociated receptor 1 (TAAR1) and 5-HT1A receptor agonist, is in phase 3 clinical development for the treatment of schizophrenia. This study evaluated the comparative bioequivalence (BE) between tablet and capsule formulations of ulotaront and the food effect (FE) on pharmacokinetics (PK) of tablet form in healthy adult human subjects. Methods The BE study applied an open-label two-period crossover design in 24 healthy volunteers. Subjects were randomly assigned (1:1) to dosing sequence AB or BA (A, 25 mg ulotaront tablet; B, 25 mg ulotaront capsule). The FE study also used an open-label randomized two-period crossover design in 20 healthy volunteers. Subjects were fasted overnight then randomly assigned (1:1) to dosing sequence AB or BA (A, fasted condition; B, fed condition). Dosing periods were separated by 1 week for both studies. Serial plasma samples from each period were collected and analyzed by LC–MS/MS. PK parameters were calculated using Phoenix WinNonlin® software. Results For the BE study, geometric mean ulotaront C max values were 93.28 and 86.98 ng/mL for tablet and capsule, respectively. C max ratio was 107.25% (90% CI 101.84–112.94%). Geometric mean ulotaront area under the plasma concentration–time curve from time 0 to infinity (AUC0–∞) values were 868.8 and 829.3 ng·h/mL for tablet and capsule, respectively. AUC0–∞ ratio was 104.76% (90% CI 100.68109.01%). For the FE study, geometric mean ulotaront C max was 157.89 and 157.95 ng/mL under fed and fasted conditions, respectively. Geometric mean ratio of C max was 99.96% (90% CI 94.48–105.77%). Geometric mean ulotaront AUC0–∞ was 1584.2 ng·h/mL fed and 1589.2 ng·h/mL fasted. Geometric mean ratio for AUC0–∞ was 99.69% (90% CI 95.02–104.58%). There was a delay in t max (median difference 1.47 h) in the fed condition. Conclusions The results showed geometric mean ratios and 90% CIs for both C max and AUC0–∞ for ulotaront were well within typical bioequivalence criteria of 80–125% for both the BE and FE studies, thereby confirming the bioequivalence of the two dosage forms and no significant food effect

Psychometric properties of the Ndetei–Othieno–Kathuku (NOK) Scale: A mental health assessment tool for an African setting

Background: Research suggests that psychiatric conditions in children and adolescents are highly debilitating, with sparse resources for assessment and treatment in low- and middle-income countries (LMICs). Objectives: The primary aim of this study was to evaluate the reliability, validity, and latent factor structure of an ethnographically-grounded assessment instrument for detecting common mental health complaints among rural Kenyan children and adolescents. Methods: The Ndetei–Othieno–Kathuku Scale (NOK) was delivered to 2 282 children aged 10 to 18 years old. Exploratory factor analysis identified four latent factors. This structure was confirmed in subsequent confirmatory factor analyses. External validity was explored by investigating associations among NOK factors and Youth Self-Report DSM-oriented scales. Results: Findings suggest the NOK possesses good internal reliability and a four-factor latent structure corresponding to depression, anxiety, somatic complaints, and a mixed factor. Significant associations ranging from small to medium effect sizes were noted between NOK factors and YSR DSM-oriented scales. Conclusions: Exploratory findings suggest that the NOK possesses adequate psychometric properties among this population. This ethnographically-grounded instrument may be uniquely suited to screening for mental health complaints among Kenyan children and adolescents