Economic context analysis in mental health care. Usability of health financing and cost of illness studies for international comparisons

This paper discusses an integrated approach to mental health studies on Financing of Illness (FoI) and health accounting, Cost of Illness (CoI) and Burden of Disease (BoD). In order to expand the mental health policies, the following are suggested: (a) an international consensus on the standard scope, methods to collect and to analyse mental health data, as well as to report comparative information; (b) mathematical models are also to be validated and tested in an integrated approach, (c) a better knowledge transfer between clinicians and knowledge engineers, and between researchers and policy makers to translate economic analysis into practice and health plannin

Recent Technological Developments on LGAD and iLGAD Detectors for Tracking and Timing Applications

This paper reports the last technological development on the Low Gain Avalanche Detector (LGAD) and introduces a new architecture of these detectors called inverse-LGAD (iLGAD). Both approaches are based on the standard Avalanche Photo Diodes (APD) concept, commonly used in optical and X-ray detection applications, including an internal multiplication of the charge generated by radiation. The multiplication is inherent to the basic n++-p+-p structure, where the doping profile of the p+ layer is optimized to achieve high field and high impact ionization at the junction. The LGAD structures are optimized for applications such as tracking or timing detectors for high energy physics experiments or medical applications where time resolution lower than 30 ps is required. Detailed TCAD device simulations together with the electrical and charge collection measurements are presented through this work.Comment: Keywords: silicon detectors, avalanche multiplication, timing detectors, tracking detectors. 8 pages. 8 Figure

Gain and time resolution of 45 μ\mum thin Low Gain Avalanche Detectors before and after irradiation up to a fluence of 101510^{15} neq_{eq}/cm2^2

Low Gain Avalanche Detectors (LGADs) are silicon sensors with a built-in charge multiplication layer providing a gain of typically 10 to 50. Due to the combination of high signal-to-noise ratio and short rise time, thin LGADs provide good time resolutions. LGADs with an active thickness of about 45 $\mu$m were produced at CNM Barcelona. Their gains and time resolutions were studied in beam tests for two different multiplication layer implantation doses, as well as before and after irradiation with neutrons up to $10^{15}$ n$_{eq}$/cm$^2$. The gain showed the expected decrease at a fixed voltage for a lower initial implantation dose, as well as for a higher fluence due to effective acceptor removal in the multiplication layer. Time resolutions below 30 ps were obtained at the highest applied voltages for both implantation doses before irradiation. Also after an intermediate fluence of $3\times10^{14}$ n$_{eq}$/cm$^2$, similar values were measured since a higher applicable reverse bias voltage could recover most of the pre-irradiation gain. At $10^{15}$ n$_{eq}$/cm$^2$, the time resolution at the maximum applicable voltage of 620 V during the beam test was measured to be 57 ps since the voltage stability was not good enough to compensate for the gain layer loss. The time resolutions were found to follow approximately a universal function of gain for all implantation doses and fluences.Comment: 17 page

Involvement of PrPC in kainate-induced excitotoxicity in several mouse strains

The cellular prion protein (PrPC) has been associated with a plethora of cellular functions ranging from cell cycle to neuroprotection. Mice lacking PrPC show an increased susceptibility to epileptic seizures; the protein, then, is neuroprotective. However, lack of experimental reproducibility has led to considering the possibility that other factors besides PrPC deletion, such as the genetic background of mice or the presence of so-called "Prnp flanking genes", might contribute to the reported susceptibility. Here, we performed a comparative analysis of seizure-susceptibility using characterized Prnp(+/+) and Prnp(0/0) mice of B6129, B6.129, 129/Ola or FVB/N genetic backgrounds. Our study indicates that PrPC plays a role in neuroprotection in KA-treated cells and mice. For this function, PrPC should contain the aa32-93 region and needs to be linked to the membrane. In addition, some unidentified "Prnp-flanking genes" play a role parallel to PrPC in the KA-mediated responses in B6129 and B6.129 Prnp(0/0) mice

Estudio quimico preliminar de los fenoles y polifenoles de dos accesiones de calliandra calothyrsus (mimosaceae)

El objetivo de este estudio comparativo es conocer la composición química cualitativa y la concentración relativa de los fenoles y de los taninos condensados en dos accesiones de la especie forrajera Calliandra calothyrsus (Fabaceae Mimosaceae) cultivada y clasificada por el CIAT. El análisis por técnicas cromatográficas y métodos espectroscópicos permitió establecer claras diferencias en las dos muestras, no solo en cantidades sino en el número de derivados fenólicos observados. Entre los componentes fenólicos de bajo peso molecular identificados en las dos muestras sobresalen las isoflavonas: genisteína, prunetina y 7-O-glucosil-genisteína; catequinas, quercetina, miricetina y sus dihidroderivados, epigaloilcatequina, y galatos de epigaloilcatequinas. Entre los oligómeros, por MALDI-TOF y ESI en modo negativo se detectaron hasta pentámeros de catequinas en series de distintas combinaciones de monómeros según la regla Krueger

Virtual reality body exposure therapy for anorexia nervosa. A case report with follow-up results

Objective: Exposure-based therapies such as mirror exposure may help to improve the results of classic cognitive behavioral therapy in anorexia nervosa (AN). Virtual reality (VR)-based procedures provide interesting novelties for targeting body-related concerns. This study aimed to provide preliminary evidence of the usefulness of a VR body exposure therapy in a patient diagnosed with AN. Method: Fear of gaining weight (FGW), body anxiety, drive for thinness, body image disturbances, body mass index and body-related attentional bias were assessed before and after the intervention, as well as five months later. Five sessions of VR body exposure therapy were included within the standard course of cognitive behavioral therapy. The sessions involved a systematic and hierarchical exposure of the patient to a virtual representation of her own silhouette, with the body mass index of the avatar progressively increasing in subsequent sessions. Results: After the intervention, there was a clear reduction in AN symptoms such as the FGW, drive for thinness, body-related anxiety and dissatisfaction. Body mass index values rose continuously during the intervention and reached healthy levels. Finally, there was a notable change in the dysfunctional body-related attentional bias. Almost all these improvements were maintained after five months, except for the FGW. Conclusion: To the best of our knowledge, this study is the first to focus on treating the FGW and body-related concerns in AN using a VR-based paradigm. To pursue this study further and assess the effectiveness of this new VR software, larger controlled clinical trials are needed

Magnitude of terminological bias in international health services research: a disambiguation analysis in mental health

Aims Health services research (HSR) is affected by a widespread problem related to service terminology including non-commensurability (using different units of analysis for comparisons) and terminological unclarity due to ambiguity and vagueness of terms. The aim of this study was to identify the magnitude of the terminological bias in health and social services research and health economics by applying an international classification system. Methods This study, that was part of the PECUNIA project, followed an ontoterminology approach (disambiguation of technical and scientific terms using a taxonomy and a glossary of terms). A listing of 56 types of health and social services relevant for mental health was compiled from a systematic review of the literature and feedback provided by 29 experts in six European countries. The disambiguation of terms was performed using an ontology-based classification of services (Description and Evaluation of Services and DirectoriEs – DESDE), and its glossary of terms. The analysis focused on the commensurability and the clarity of definitions according to the reference classification system. Interrater reliability was analysed using κ. Results The disambiguation revealed that only 13 terms (23%) of the 56 services selected were accurate. Six terms (11%) were confusing as they did not correspond to services as defined in the reference classification system (non-commensurability bias), 27 (48%) did not include a clear definition of the target population for which the service was intended, and the definition of types of services was unclear in 59% of the terms: 15 were ambiguous and 11 vague. The κ analyses were significant for agreements in unit of analysis and assignment of DESDE codes and very high in definition of target population. Conclusions Service terminology is a source of systematic bias in health service research, and certainly in mental healthcare. The magnitude of the problem is substantial. This finding has major implications for the international comparability of resource use in health economics, quality and equality research. The approach presented in this paper contributes to minimise differentiation between services by taking into account key features such as target population, care setting, main activities and type and number of professionals among others. This approach also contributes to support financial incentives for effective health promotion and disease prevention. A detailed analysis of services in terms of cost measurement for economic evaluations reveals the necessity and usefulness of defining services using a coding system and taxonomical criteria rather than by ‘text-based descriptions’