Diagnostic Efficiency of the Child and Adolescent Symptom Inventory (CASI-4R) Depression Subscales for identifying Youth Mood Disorders

This study examined the diagnostic and clinical utility of the Child and Adolescent Symptom Inventory (CASI-4R) depression and dysthymia subscales (caregiver and teacher report) for detecting youth mood disorders in outpatient mental health clinics (N=700). Semi-structured interviews (KSADS) with youth participants and their caregivers determined psychiatric diagnoses. CASI-4R depressive symptom severity and symptom count scores predicted mood disorder diagnoses. Both caregiver versions of the CASI-4R subscales significantly identified youth mood disorders (AUCs = .78 - .79, ps .05). Caregiver subscale cutoff scores were calculated to assist in ruling in (DLR = 3.39) or ruling out (DLR = 0.36) presence of a mood disorder. The CASI-4R depression subscales caregiver report can help identify youth mood disorders. Using DLRs may help clinicians to identify youth mood disorders and improve diagnostic accuracy via these brief subscales.Master of Art

Differences in Depressive Symptom Presentation between Latino and non-Latino White Youths on the Center for Epidemiologic Studies Depression Scale (CES-D): A Moderated Nonlinear Factor Analysis (MNLFA) Approach

Most mental health measures have been validated with English speaking and majority White samples (Guillemin et al., 1993; Vega & Rumbaut, 1991). Despite guidelines recommending formal cultural adaptation to ensure that scale content still measures what it intended and provide accurate group comparisons, such adaption is rare (Borsboom, 2006; Chen, 2008). Latinos are the largest minority in the US, making it imperative to understand how cultural factors can influence mood symptom endorsement and conceptualization. This study examined the Center for Epidemiologic Studies Depression Scale (CES-D) for differential item functioning (DIF). Secondary analyses of Latino (n=3,208) and non-Latino White youths (n=9,919) from the National Longitudinal Study of Adolescent Health (Add Health). Moderated nonlinear factor analysis (MNLFA) examined ethnicity DIF, while accounting for other covariates (gender, age, parental education, acculturation). An exploratory aim compared Latino subgroups separately (Mexicans, Puerto Ricans, and Cubans) to assess subgroup differences in the item intercepts and factor loadings. In the initial model (only incorporating ethnicity), at similar levels of depression, Latinos were more likely to score higher on being bothered by things, feeling unable to shake the blues, talking less, and feeling like a failure. However, Latinos were less likely to endorse having sleep problems, feeling like others were unfriendly, having crying spells, or difficulty getting started on things. There were also significant differences in the factor loadings for the blues and crying items. In the second model incorporating covariates (e.g., gender, age, parental education), nine items showed Latino-White DIF (ps<.05), but two items (being bothered by things, crying spells) no longer showed ethnicity DIF. However, graphical analyses showed that DIF effects on the overall measure appear small and unlikely to affect total scores between groups. Given that the magnitude of DIF observed on the CES-D between Latinos and non-Latinos in this sample was small, the CES-D measured depressive symptoms similarly between Latino and White youths. Using MNLFA to examine DIF provided a more comprehensive picture of how demographic characteristics influenced symptom reporting. MNLFA modeled covariates simultaneously when assessing DIF, avoiding potentially confounding that might otherwise cloud our understanding of cultural differences.Doctor of Philosoph

Permeabilidad de los guantes de uso frecuente en la manipulación de Iodo 131. Servicio de medicina nuclear del Hospital Nacional Edgardo Rebagliati Martins. Noviembre 2017

Identifica la permeabilidad de los guantes de uso frecuente en la manipulación de Iodo 131, en el servicio de medicina nuclear del Hospital Nacional Edgardo Rebagliati Martins en el mes de noviembre del 2017. Es un estudio observacional, descriptivo, prospectivo, transversal, de enfoque cuantitativo. El tamaño muestral está conformada por 30 guantes de uso frecuente en la manipulación de Iodo 131 en el servicio de medicina nuclear del Hospital Nacional Edgardo Rebagliati Martins en el mes de noviembre del 2017. Para el análisis descriptivo se estima el promedio y la desviación estándar. Los resultados de la investigación son hallados buscando simular una situación real, encontrándose que en el 100% de los guantes de uso frecuente en la manipulación de Iodo 131, utilizados, hubo permeabilidad. Por otro lado se halla que la actividad del fondo del activimetro en la solución de Iodo 131, en las jeringas con solución de Iodo 131, en los guantes y en cada uno de los guantes es de 0 μCi. Así mismo la actividad en la prueba de frotis de la superficie interna de los guantes es de 0.26 μCi +/- 0.45, con una mínima de 0.01 μCi y un máximo de 2.4 μCi. Existe permeabilidad de los guantes de uso frecuente en la manipulación de Iodo 131 del servicio de medicina nuclear del Hospital Nacional Edgardo Rebagliati Martins en el mes de noviembre del 2017, dado que en el 100% del total de los guantes se determina que la actividad presentada en el frotis supera la actividad del fondo del activímetro, teniendo que la mayoría osciló entre 0.01 a 0.05 μCi (86.7%).Tesi

Nutrition, Exercise, and Wellness Treatment in bipolar disorder: proof of concept for a consolidated intervention

Background: This pilot study examines the proof of concept of a consolidated Nutrition, Exercise, and Wellness Treatment (NEW Tx) for overweight individuals with bipolar disorder. Findings: Five participants completed NEW Tx, a 20-week individual cognitive behavioral therapy-based treatment comprising three modules: Nutrition teaches appropriate serving sizes and balanced diet; Exercise emphasizes increasing weekly physical activity; Wellness focuses on skills for healthy decision-making. Participants attended most sessions and reported high satisfaction with the treatment. Participants’ weight, cholesterol and trigyclerides decreased over the study duration as well as number of daily calories and sugar intake. We found that weekly exercise duration more than tripled over the study duration and depressive symptoms and functioning have improved. Conclusions: These results offer proof of concept that consolidated NEW Tx is feasible and acceptable and has the potential to improve nutrition, exercise, wellness, and mood symptoms in bipolar disorder. Future iterations of NEW Tx will reflect the strengths and lessons learned from this study

Propuesta de implementación de un sistema de control interno en la sociedad Acuatec S.A.S de la ciudad de Girardot

Formular una propuesta de sistema de control interno para la sociedad ACUATEC S.A.S. de la ciudad de GirardotUn sistema de control interno es una herramienta importante en una organización, promueve el cumplimiento de los objetivos institucionales basados en la seguridad de sus operaciones y protegiendo los activos de una manera razonable. El presente trabajo fue elaborado en base a diferentes libros de Contabilidad, Auditoría Financiera y el reporte solo COSO (más adelante se ampliara la información sobre este tema), para esto se obtuvo información directa de la Empresa ACUATEC S.A.S. para conocer los factores internos y externos en los cuales se desenvuelve la misma, también fue necesario entrevistar y aplicar cuestionarios de control interno a los responsables de los cinco ciclos analizados en el trabajo, con el fin de conocer la situación actual de la Empresa. Una vez reconocido aquellas debilidades, se evalúa la probabilidad de ocurrencia y el impacto que tienen sobre los objetivos organizacionales. Se concluye primordialmente que debido a que la pequeña y medianas empresas no cuentan con un control adecuado que se ajuste a sus necesidades, es de vital importancia para evitar riesgos y fraudes, en aras de cuidar los activos y los intereses de la empresa; también para evaluar la eficiencia de la misma en cuanto a su organización.The internal control has become more important in recent years in the process of transformation and growth of the company, because it becomes a mechanism that allows the address of a company to measure and test the efficiency of management as to achievement of the objectives, providing a prudent level of security to achieve them. From here in this paper intends to show some concepts of internal control and its role in the process of organizational change, allowing demonstrate the added value generated in this process by providing and preparing the company for its own transformation and chang

Propuesta de implementación de un sistema de control interno en la sociedad Acuatec S.A.S de la ciudad de Girardot

Formular una propuesta de sistema de control interno para la sociedad ACUATEC S.A.S. de la ciudad de GirardotUn sistema de control interno es una herramienta importante en una organización, promueve el cumplimiento de los objetivos institucionales basados en la seguridad de sus operaciones y protegiendo los activos de una manera razonable. El presente trabajo fue elaborado en base a diferentes libros de Contabilidad, Auditoría Financiera y el reporte solo COSO (más adelante se ampliara la información sobre este tema), para esto se obtuvo información directa de la Empresa ACUATEC S.A.S. para conocer los factores internos y externos en los cuales se desenvuelve la misma, también fue necesario entrevistar y aplicar cuestionarios de control interno a los responsables de los cinco ciclos analizados en el trabajo, con el fin de conocer la situación actual de la Empresa. Una vez reconocido aquellas debilidades, se evalúa la probabilidad de ocurrencia y el impacto que tienen sobre los objetivos organizacionales. Se concluye primordialmente que debido a que la pequeña y medianas empresas no cuentan con un control adecuado que se ajuste a sus necesidades, es de vital importancia para evitar riesgos y fraudes, en aras de cuidar los activos y los intereses de la empresa; también para evaluar la eficiencia de la misma en cuanto a su organización.The internal control has become more important in recent years in the process of transformation and growth of the company, because it becomes a mechanism that allows the address of a company to measure and test the efficiency of management as to achievement of the objectives, providing a prudent level of security to achieve them. From here in this paper intends to show some concepts of internal control and its role in the process of organizational change, allowing demonstrate the added value generated in this process by providing and preparing the company for its own transformation and chang

Intranasal Oxytocin Modulates Decision-Making Depending on Outcome Predictability-A Randomized Within-Subject Controlled Trial in Healthy Males.

Oxytocin (OT) has been extensively studied with regard to its socio-cognitive and -behavioral effects. Its potential as a therapeutic agent is being discussed for a range of neuropsychiatric conditions. However, there is limited evidence of its effects on non-social cognition in general and decision-making in particular, despite the importance of these functions in neuropsychiatry. Using a crossover/within-subject, blinded, randomized design, we investigated for the first time if intranasal OT (24 IU) affects decision-making differently depending on outcome predictability/ambiguity in healthy males. The Iowa Gambling Task (IGT) and the Cambridge Risk Task (CRT) were used to assess decision-making under low outcome predictability/high ambiguity and under high outcome probability/low ambiguity, respectively. After administration of OT, subjects performed worse and exhibited riskier performance in the IGT (low outcome predictability/high ambiguity), whereas they made borderline-significant less risky decisions in the CRT (high outcome probability/low ambiguity) as compared to the control condition. Decision-making in healthy males may therefore be influenced by OT and adjusted as a function of contextual information, with implications for clinical trials investigating OT in neuropsychiatric conditions

Do Sleep Disturbances Predict or Moderate the Response to Psychotherapy in Bipolar Disorder?

This study examined whether sleep disturbance predicted or moderated responses to psychotherapy in participants who participated in STEP-BD, a national, multi-site study that examined the effectiveness of different treatment combinations for bipolar disorder. Participants received either a brief psychosocial intervention called collaborative care (CC; n=130), or intensive psychotherapy (IP; n=163), with study-based pharmacotherapy. Participants (N=243) were defined as current (past week) short sleepers (<6 hours/night), normal sleepers (6.5-8.5 hours/night), and long sleepers (≥9 hours/night), according to reported average nightly sleep duration the week before randomization. Sleep disturbances did not predict the likelihood of recovery nor time until recovery from a depressive episode. There was no difference in recovery rates between IP versus CC for normal sleepers, and medium effect sizes were observed for differences in short and long sleepers. In this study, sleep did not play a major role in predicting or moderating response to psychotherapy in bipolar disorder

Brucella Control of Dendritic Cell Maturation Is Dependent on the TIR-Containing Protein Btp1

Brucella is an intracellular pathogen able to persist for long periods of time within the host and establish a chronic disease. We show that soon after Brucella inoculation in intestinal loops, dendritic cells from ileal Peyer's patches become infected and constitute a cell target for this pathogen. In vitro, we found that Brucella replicates within dendritic cells and hinders their functional activation. In addition, we identified a new Brucella protein Btp1, which down-modulates maturation of infected dendritic cells by interfering with the TLR2 signaling pathway. These results show that intracellular Brucella is able to control dendritic cell function, which may have important consequences in the development of chronic brucellosis

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London