Knowledge Awareness on Practice Sensitivity of LGBTQ Children and Adolescents with Psychiatric Disorders among Healthcare Providers at an Outpatient Clinic in Miami, Florida: A Quality Improvement Project

Compared to heterosexual youth, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) children and adolescents face a disproportionate burden of negative mental health outcomes. LGBTQ youth health disparities and inequalities are in part due to a lack of cultural competence and gender-sensitivity training among healthcare providers in mental health settings. The purpose of this quality improvement project was to increase knowledge awareness among healthcare providers at an outpatient clinic in Miami, Florida, regarding practice sensitivity of LGBTQ children and adolescents with psychiatric disorders. A descriptive, cross-sectional, pre- and posttest study design was employed to conduct this project. A convenience sampling method was used to recruit N = 9 participants and access data at an outpatient psychiatric-mental health specialty clinic in Miami, Florida. The project was conducted wholly remotely, including the delivery of the educational intervention and the administration of the pre- and posttests of a modified Queer Youth Cultural Competency (QYCC) scale, that measured knowledge awareness on practice competency and sensitivity of LGTBQ youth. Results revealed a significant large difference between pretest and posttest mean scores, with participants achieving higher scores on the posttest after the educational intervention, t(8) = 4.46, with a p = 0.002, (p \u3c 0.05). Healthcare providers should be educated on practice sensitivity of LGBTQ children and adolescents with psychiatric disorders to increase this vulnerable population’s mental healthcare access, utilization, and outcomes

Thermodynamics of Small Magnetic Particles

In the present paper, we discuss the interpretation of some of the results of the thermodynamics in the case of very small systems. Most of the usual statistical physics is done for systems with a huge number of elements in what is called the thermodynamic limit, but not all of the approximations done for those conditions can be extended to all properties in the case of objects with less than a thousand elements. The starting point is the Ising model in two dimensions (2D) where an analytic solution exits, which allows validating the numerical techniques used in the present article. From there on, we introduce several variations bearing in mind the small systems such as the nanoscopic or even subnanoscopic particles, which are nowadays produced for several applications. Magnetization is the main property investigated aimed for two singular possible devices. The size of the systems (number of magnetic sites) is decreased so as to appreciate the departure from the results valid in the thermodynamic limit; periodic boundary conditions are eliminated to approach the reality of small particles; 1D, 2D and 3D systems are examined to appreciate the differences established by dimensionality is this small world; upon diluting the lattices, the effect of coordination number (bonding) is also explored; since the 2D Ising model is equivalent to the clock model with q=2 degrees of freedom, we combine previous results with the supplementary degrees of freedom coming from the variation of q up to q=20. Most of the previous results are numeric; however, for the case of a very small system, we obtain the exact partition function to compare with the conclusions coming from our numerical results. Conclusions can be summarized in the following way: the laws of thermodynamics remain the same, but the interpretation of the results, averages and numerical treatments need special care for systems with less than about a thousand constituents, and this might need to be adapted for different properties or devices.Fil: Vogel, Eugenio. Universidad de La Frontera; Chile. Center for the Development of Nanoscience and Nanotechnology; ChileFil: Vargas, Patricio. Center for the Development of Nanoscience and Nanotechnology; Chile. Universidad Técnica Federico Santa María; ChileFil: Saravia, Gonzalo. Universidad de La Frontera; ChileFil: Valdes, Julio. Universidad de La Frontera; ChileFil: Ramirez Pastor, Antonio Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Física Aplicada "Dr. Jorge Andrés Zgrablich". Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto de Física Aplicada "Dr. Jorge Andrés Zgrablich"; ArgentinaFil: Centres, Paulo Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto de Física Aplicada "Dr. Jorge Andrés Zgrablich". Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto de Física Aplicada "Dr. Jorge Andrés Zgrablich"; Argentin

Prueba de habilidades practicas CISCO CCNP

En el siguiente trabajo se realizará el paso a paso de dos configuraciones en packet tracer los cuales corresponde a la prueba de habilidades practicas del diplomado CISCO CCNP, cada uno de los pasos anteriormente mencionados constara de tres escenarios que abarcan en gran parte los conocimientos adquiridos y permiten reforzar lo aplicado durante el programa. Está conformado en gran parte por el código aplicado a la configuración de cada escenario y únicamente se presentan imágenes para demostrar el funcionamiento a través de show ip route, show vlan, show ip bgp, etc.In the following work we will carry out the step by step of two configurations in packet tracer which corresponds to the practical skills test of the CISCO CCNP Diplomat, each of the steps mentioned above will consist of three scenarios that largely cover the knowledge acquired and allow to reinforce what was applied during the program. It is shaped in large part by the code applied to the configuration of each scenario and only images are presented to demonstrate the operation through show ip route, show vlan, show ip bgp, etc

Exploratory analysis using machine learning to predict for chest wall pain in patients with stage I non-small-cell lung cancer treated with stereotactic body radiation therapy.

Background and purposeChest wall toxicity is observed after stereotactic body radiation therapy (SBRT) for peripherally located lung tumors. We utilize machine learning algorithms to identify toxicity predictors to develop dose-volume constraints.Materials and methodsTwenty-five patient, tumor, and dosimetric features were recorded for 197 consecutive patients with Stage I NSCLC treated with SBRT, 11 of whom (5.6%) developed CTCAEv4 grade ≥2 chest wall pain. Decision tree modeling was used to determine chest wall syndrome (CWS) thresholds for individual features. Significant features were determined using independent multivariate methods. These methods incorporate out-of-bag estimation using Random forests (RF) and bootstrapping (100 iterations) using decision trees.ResultsUnivariate analysis identified rib dose to 1 cc < 4000 cGy (P = 0.01), chest wall dose to 30 cc < 1900 cGy (P = 0.035), rib Dmax < 5100 cGy (P = 0.05) and lung dose to 1000 cc < 70 cGy (P = 0.039) to be statistically significant thresholds for avoiding CWS. Subsequent multivariate analysis confirmed the importance of rib dose to 1 cc, chest wall dose to 30 cc, and rib Dmax. Using learning-curve experiments, the dataset proved to be self-consistent and provides a realistic model for CWS analysis.ConclusionsUsing machine learning algorithms in this first of its kind study, we identify robust features and cutoffs predictive for the rare clinical event of CWS. Additional data in planned subsequent multicenter studies will help increase the accuracy of multivariate analysis

PREÇOS DA TERRA NO BRASIL

Este trabalho analisa o preço da terra no período 1975 a 2006, mas ocupa-se principalmente com o período mais recente, de 2000 a 2006. Para que o leitor tenha uma melhor dimensão dos preços de terras no Brasil, comparações serão realizadas com os preços de terras nos Estados Unidos em anos recentes. As principais fontes de informação são a Fundação Getúlio Vargas – FGV que fornece as informações sobre preço de venda de terras de lavouras, pastagens e preços de arrendamentos por estados, Regiões e Brasil e o Departamento de Agricultura dos Estados Unidos (USDA) que publica os preços de terras por regiões e estados. Complementarmente, são utilizadas outras fontes como a Secretaria da Agricultura e do Abastecimento do Paraná - Seab, através de seu Departamento de Economia Rural - Deral.-------------------------------------------------------------------- ----------------The paper analyses price land in Brazil during the 1975 – 2006 period. To best information, we compare prices in Brazil and in United States. We used the following information sources: Fundação Getúlio Vargas – FGV, that publishes price land and cash rents by state, region and Brazil. United States information are from United States Department of Agriculture - USDA. Another information source is Departamento de Economia Rural do estado do Paraná – Deral.Preço de Terra, Lavouras, Pastagens, Brasil, Price, Land, Crops, Pasture, Brazil, Land Economics/Use,

La fijacion del quantum de la indemnizacion pecuniaria del dano moral extracontractual en el ordenamiento juridico chileno

60 p.El daño moral es una de las materias más controvertidas del Derecho Civil, debido a la inexistencia de un concepto unánime, como también, por la escasa normativa sobre daño moral en nuestro Derecho Civil. En este sentido, la labor del juez se ve dificultada, en virtud de esta carencia; logrando desarrollar su tarea, a base de criterios de la jurisprudencia y de la regla de la sana crítica. La protección que otorga la constitución en su artículo 19, en los incisos1º y 4º, a los derechos fundamentales, se ve debilitada por la discrecionalidad que tiene el juez al fijar el quantum del daño moral extracontractual; a diferencia de la contundente cobertura que otorga el recurso de protección a dichas garantías./ ABSTRACT: The moral damage is one of the most controversial areas of Civil Law, due to the lack of a unanimous concept as well, due to poor regulations on moral damage to our civil law. In this sense, the judge's task is made difficult by virtue of this lack, being able to develop their work, based on criteria of jurisprudence and the rule of sound criticism. The protection afforded by the Constitution in Article Nº19, numbers 1 and 4, of the fundamental rights, is undermined by the discretion that the judge have to determinate the quantum of moral damage, as opposed to the overwhelming coverage afforded by the resource protection to such guarantee

La responsabilidad civil medica. La responsabilidad del equipo medico y el consentimiento informado

57 p.La Responsabilidad médica ha sido objeto de numerosos estudios tanto en el Derecho comparado como en la doctrina nacional. El interés de esta es producto del aumento en los tribunales de Justicia de demandas donde se involucren médicos. El presente trabajo pretendemos analizar la naturaleza de la responsabilidad en general; la responsabilidad profesional; la responsabilidad médica y el ámbito de su aplicación. Luego se analizará las teorías al respecto,tanto la contractual como la extracontractual. Continuando con el equipo médico, revisando las teorías esgrimidas con respecto a su responsabilidad, para finalizar con el examen del principio del consentimiento informado