Coordination of international multicenter studies: Governance and administrative structure

A well-conducted multicenter study needs to assure standardization, uniformity of procedures, high data quality, and collaboration across sites. This manuscript describes the organization and dynamics of multicenter studies, focusing on governance and administrative structures among countries of diverse cultures. the organizational structure of a multicenter study is described, and a system for oversight and coordination, along with roles and responsibilities of participants in the multicenter study, are presented. the elements of a governance document are also reviewed, along with guidelines and policies for effective collaboration. the experience of an ongoing multi-country collaboration, the World Studies of Abuse in the Family Environment (World-SAFE), illustrates the implementation of these guidelines. It is essential that multicenter studies have an objective coordinating center and that the investigators jointly develop a written governance document to enable collaboration and preserve collegiality among participating investigators. the English version of this paper is available too at: http://www.insp.mx/salud/index.html.Univ N Carolina, Chapel Hill, NC USAUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, BrazilUniv Philippines, Manila, PhilippinesUniv La Frontera, Temuco, ChileUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, BrazilWeb of Scienc

White dwarf and subdwarf stars in the Sloan Digital Sky Survey Data Release 14

White dwarfs carry information on the structure and evolution of the Galaxy, especially through their luminosity function and initial-to-final mass relation. Very cool white dwarfs provide insight into the early ages of each population. Examining the spectra of all stars with $3\sigma$ proper motion in the Sloan Digital Sky Survey Data Release 14, we report the classification for 20 088 spectroscopically confirmed white dwarfs, plus 415 hot subdwarfs, and 311 cataclysmic variables. We obtain Teff, log g and mass for hydrogen atmosphere white dwarf stars (DAs), warm helium atmosphere white dwarfs (DBs), hot subdwarfs (sdBs and sdOs), and estimate photometric Teff for white dwarf stars with continuum spectra (DCs). We find 15793 sdAs and 447 dCs between the white dwarf cooling sequence and the main sequence, especially below Teff= 10000 K; most are likely low-mass metal-poor main sequence stars, but some could be the result of interacting binary evolution.Comment: 18 pages, 13 figure

Barriers to early identification of autism in Brazil

Objective: Parents of children with autism spectrum disorders (ASD) seem to perceive that their child's development is not following the normal pattern as early as the first year of life. However, ASD children may not receive a diagnosis until they are of preschool age, especially in low- and middle-income countries. The objective of this study was to evaluate the pathway between initial parental concerns about atypical child development and ASD diagnosis in Brazil. Methods: Nineteen mothers whose children had been diagnosed with ASD participated and were interviewed. The ASD group consisted of two girls and 17 boys, with a mean age of 93.0 months (SD 48.4 monthsrange 39-197 months). Results: Mothers had their first concerns regarding ASD when children were 23.6 +/- 11.6 months old, but formal diagnosis occurred at a mean +/- SD age of 59.6 +/- 40.5 months, corresponding to a 3-year delay. Most mothers felt discouraged to address their concerns due to negative experiences with health professionals. Conclusion: In Brazil, mothers perceived the first signs of ASD in their children at an age similar to that reported in other countries, but the diagnosis of ASD seemed to be delayed. Consistent with the literature, mothers reported negative experiences with health professionals during the pathway to achieving ASD diagnosis.Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES)Univ Fed Sao Paulo UNIFESP, Dept Psiquiatria, Ambulatorio Cognicao Social Marcos Tomanik Mercad, Sao Paulo, SP, BrazilUniv Presbiteriana Mackenzie, Programa Posgrad Disturbios Desenvolvimento, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Dept Psiquiatria, Ambulatorio Cognicao Social Marcos Tomanik Mercad, Sao Paulo, SP, BrazilWeb of Scienc

Mental health and violence among sixth grade students from a city in the state of São Paulo

OBJECTIVE: To analyze risk and protective factors for mental health problems among adolescents. METHODS: Cross-sectional study with a random sample (N=327; attrition rate=6.9%) of sixth grade students from all public and private schools in the city of Barretos, Southeastern Brazil, conducted in 2004. The factors studied were: exposure to intrafamilial and urban violence, family socioeconomic level, sex, motherless household, participation in social activities (protective factor). All the independent risk and protective factors were included in the initial logistic regression model. Only the variable with a significance level of p<0.05 remained in the model. RESULTS: It was observed that exposure to violence was the only factor associated with mental health problems in the final logistic regression model (p=0.02, 95% CI: 1.12;4.22). In addition, adolescents exposed to intrafamilial violence were three times more likely to have problems than those exposed to urban violence (p=0.04; 95% CI: 1.03;7.55). CONCLUSIONS: Intrafamilial violence was associated with mental heath problems among adolescents studied and it could be more important than urban violence in medium-sized cities.OBJETIVO: Analisar fatores de proteção e de risco para problemas de saúde mental entre adolescentes. MÉTODOS: Estudo transversal realizado com amostra aleatória (N=327; perda=6,9%) de estudantes da sexta série de todas as escolas públicas e privadas de Barretos, SP, em 2004. Os fatores examinados foram: exposição à violência doméstica e urbana, nível socioeconômico familiar, sexo, morar sem a mãe, participar de atividades sociais (fator de proteção). As associações entre esses fatores e problemas de saúde mental foram analisadas por meio de modelos de regressão logística. Todos os fatores de risco e proteção independentes foram incluídos no modelo inicial de regressão logística, permanecendo no modelo final apenas a variável com nível de significância inferior a 0,05. RESULTADOS: Verificou-se que apenas exposição à violência permaneceu no modelo final como fator associado a problemas de saúde mental (p=0,02; IC 95%: 1,12;4,22). Crianças expostas à violência doméstica tinham três vezes mais chances de apresentarem estes problemas do que aquelas expostas à violência urbana (p=0,04; IC 95%: 1,03;7,55). CONCLUSÕES: A violência doméstica associou-se a problemas de saúde mental nos adolescentes do estudo, podendo ser mais importante que a violência urbana em cidades de médio porte.Universidade Presbiteriana Mackenzie Programa de Pós-graduação em Distúrbios do DesenvolvimentoUniversidade Federal de São Paulo (UNIFESP) Departamento de Psiquiatria Setor de Psiquiatria SocialUNIFESP Departamento de Psiquiatria Unidade de Psiquiatria da Infância e AdolescênciaUNIFESP, Depto. de Psiquiatria Setor de Psiquiatria SocialUNIFESP, Depto. de Psiquiatria Unidade de Psiquiatria da Infância e AdolescênciaSciEL

Fatores de Risco para Problemas de Saúde Mental na Infância/Adolescência

A cross-sectional study was conducted in an urban low-income community in the municipality of Embu-SP with the objective of identifying factors associated with mental health problems of children and adolescents (MHPCA) in a probabilistic sample (N=67, aged 4-17 years). Standardized instruments were applied to mothers: Child Behavior Checklist; WorldSAFE Core Questionnaire (demographics, domestic violence, father/stepfather drunkenness); Self-Report Questionnaire (maternal mental health problems and suicide ideation). The results of this study identified factors statistically related to MPHCA: child/adolescent of male gender and severe physical punishment; maternal suicide ideation and severe physical marital violence; father/stepfather drunkenness. As a result, vulnerable groups with individual/family characteristics identified in this study should have priority in prevention/treatment programs. &nbsp;Estudo de corte transversal conduzido em comunidade urbana de baixa renda do município de Embu-SP com objetivo de identificar fatores associados a problemas de saúde mental em crianças/adolescentes (PSMCA) em amostra probabilística (N=67, faixa etária 4-17 anos). Foram aplicados instrumentos estruturados às mães: Child Behavior Checklist (PSMCA); WorldSAFE Core Questionnaire (dados sociodemográficos; violência doméstica; embriaguez do pai/padrasto); Self-Report Questionnaire (problemas de saúde mental maternos, ideação suicida materna). Os resultados do estudo apontaram fatores estatisticamente associados aos PSMCA: criança/adolescente ser do sexo masculino e sofrer punição física grave; ideação suicida da mãe e violência conjugal física grave contra a mãe; embriaguez do pai/padrasto. Concluindo, grupos vulneráveis com características individuais/familiares identificadas neste estudo devem ser considerados prioritários em propostas de prevenção/tratamento. &nbsp

Survey for Caregivers of People with Autism Spectrum in Chile: Access to Health and Education Services, Satisfaction, Quality of Life And Stigma [Encuesta para Cuidadores de Personas del Espectro Autista en Chile. Acceso a Servicios de Salud y Educación, Satisfacción, Calidad de Vida y Estigma]

People on the Autism Spectrum (AS) face multiple health, education, social, and economic problems. There is limited available information in Chile. \ Objective: To describe the access and satisfaction with health and education services, family and economic impact, stigma, and quality of life of people with AS and their families in Chile. Subjects and Method: Parents/caregivers of AS persons completed the Caregiver Needs Survey, developed by Autism Speaks, which includes demographic information, characteristics of AS persons (previously published), use of health and education services, parents/caregivers\u27 perceptions of satisfaction, impact, stigma, and quality of life. Results: 291 caregivers (86% mothers) of 291 AS persons participated, 89% were male, aged 1-40 years (X:10.4 SD:6.1). Limited and unspecific access to health services is reported. 77% are regularly attending a standard or special school system. Families pay for over 60% of therapies/medical care and over 40% of specific educational support, and 25% report difficulties in accessing services. The family income is affected by resignation (35%) or reduced working hours (46%). Stigma is associated with possible discrimination and feelings of helplessness. The main priorities mentioned for a better quality of life are support for inclusive schooling, better adjustment at home, and improved socialization. Conclusions: This survey provides relevant information about the needs, barriers, and challenges of AS people in Chile and highlights the difficulties in accessing health services and the severe impact on family income. Feelings of stigma, discrimination, and helplessness are reported. Collaborative strategies are needed to improve the quality and access to services and to reduce the economic and mental health burden on the family. - Introducción: Las personas del Espectro Autista (EA) enfrentan múltiples necesidades de salud, educación, problemas sociales y económicos. La información disponible en Chile es insuficiente. Objetivo: Conocer el acceso y satisfacción con servicios de salud y educación, el impacto familiar y económico, estigma y calidad de vida de personas EA y sus familias en Chile. Sujetos y Método: Padres/cuidadores de perso nas EA respondieron la Encuesta de Necesidades de Cuidadores, desarrollada por Autism Speaks, que comprende: información demográfica, características de las personas EA (publicado previamente), utilización de servicios de salud y educación, percepciones de padres/cuidadores en satisfacción, im pacto, estigma y calidad de vida (que presenta esta publicación). Resultados: Participaron 291 cuida dores (86% madres), de 291 personas EA, 89% varones, de 1-40 años (X:10,4 DE:6,1). Se reporta un acceso insuficiente y poco específico a servicios de salud. Un 77% asiste regularmente a algún sistema escolar regular o especial. Las familias financian sobre 60% de terapias/atención médica y sobre 40% de apoyos educacionales específicos; un 25% refiere dificultades de acceso a servicios. La economía familiar se afecta por renuncia (35%) o reducción de jornadas laborales de los cuidadores (46%). El estigma se asocia a posible discriminación y sentimientos de impotencia. Las principales prioridades mencionadas para una mejor calidad de vida son apoyos para escolaridad inclusiva, mejor adaptación en el hogar y mejorar la socialización. Conclusiones: Esta encuesta aporta información relevante acerca de las necesidades, barreras y desafíos de las personas EA en Chile. Destacan las dificultades de acceso a servicios de salud y el severo impacto sobre el ingreso económico familiar. Existe estigma, discriminación e impotencia. Se requiere elaborar estrategias colaborativas para mejorar la calidad y acceso a servicios y reducir la carga económica y de salud mental familiar

Influence of psychosocial risk factors on the trajectory of mental health problems from childhood to adolescence: a longitudinal study

Background\ud Longitudinal epidemiological studies involving child/adolescent mental health problems are scarce in developing countries, particularly in regions characterized by adverse living conditions. We examined the influence of psychosocial factors on the trajectory of child/adolescent mental health problems (CAMHP) over time.\ud \ud Methods\ud A population-based sample of 6- to 13-year-olds with CAMHP was followed-up from 2002–2003 (Time 1/T1) to 2007–2008 (Time 2/T2), with 86 out of 124 eligible children/adolescents at T1 being reassessed at T2 (sample loss: 30.6%). Outcome: CAMHP at T2 according to the Child Behavior Checklist/CBCL’s total problem scale. Psychosocial factors: T1 variables (child/adolescent’s age, family socioeconomic status); trajectory of variables from T1 to T2 (child/adolescent exposure to severe physical punishment, mother exposure to severe physical marital violence, maternal anxiety/depression); and T2 variables (maternal education, child/adolescent’s social support and pro-social activities).\ud \ud Results\ud Multivariate analysis identified two risk factors for child/adolescent MHP at T2: aggravation of child/adolescent physical punishment and aggravation of maternal anxiety/depression.\ud \ud Conclusions\ud The current study shows the importance of considering child/adolescent physical punishment and maternal anxiety/depression in intervention models and mental health care policies.We thank all study participants, professionals and employees from the health centre where data were collected, Embu Health Secretariat and Mental Health Coordination, and all research team members of the Brazilian Studies of Abuse in the Family Environment (BrazilSAFE) and it’s Follow-Up Study for the valuable collaboration.The study was financially supported by the São Paulo State Research Foundation (Fundação de Amparo à Pesquisa do Estado de São Paulo/FAPESP – Process no. 00/14555-4) in 2002/2003 and by Mackpesquisa of the Mackenzie Presbyterian University in 2007

Photobacterium sanctipauli sp nov isolated from bleached Madracis decactis (Scleractinia) in the St Peter & St Paul Archipelago, Mid-Atlantic Ridge, Brazil

Five novel strains of Photobacterium (A-394T, A-373, A-379, A-397 and A-398) were isolated from bleached coralMadracis decactis (scleractinian) in the remote St Peter & St Archipelago (SPSPA), Mid-Atlantic Ridge, Brazil. Healthy M. decactis specimens were also surveyed, but no strains were related to them. The novel isolates formed a distinct lineage based on the 16S rRNA, recA, and rpoA gene sequences analysis. Their closest phylogenetic neighbours were Photobacterium rosenbergii, P. gaetbulicola, and P. lutimaris, sharing 96.6 to 95.8% 16S rRNA gene sequence similarity. The novel species can be differentiated from the closest neighbours by several phenotypic and chemotaxonomic markers. It grows at pH 11, produces tryptophane deaminase, presents the fatty acid C-18:0, but lacks C-16:0 iso. The whole cell protein profile, based in MALDI-TOF MS, distinguished the strains of the novel species among each other and from the closest neighbors. In addition, we are releasing the whole genome sequence of the type strain. The name Photobacterium sanctipauli sp. nov. is proposed for this taxon. The G + C content of the type strain A-394(T) (=LMG27910(T) = CAIM1892(T)) is 48.2 mol%