Clinical features of obsessive-compulsive disorder with hoarding symptoms: A multicenter study

Background: Factor analyses indicate that hoarding symptoms constitute a distinctive dimension of obsessive-compulsive disorder (OCD), usually associated with higher severity and limited insight. The aim was to compare demographic and clinical features of OCD patients with and without hoarding symptoms. Method: A cross sectional study was conducted with 1001 DSM-IV OCD patients from the Brazilian Research Consortium of Obsessive-Compulsive Spectrum Disorders (CTOC), using several instruments. The presence and severity of hoarding symptoms were determined using the Dimensional Yale-Brown Obsessive-Compulsive Scale. Statistical univariate analyses comparing factors possibly associated with hoarding symptoms were conducted, followed by logistic regression to adjust the results for possible confounders. Results: Approximately half of the sample (52.7%, n = 528) presented hoarding symptoms, but only four patients presented solely the hoarding dimension. Hoarding was the least severe dimension in the total sample (mean score: 3.89). The most common lifetime hoarding symptom was the obsessive thought of needing to collect and keep things for the future (44.0%, n = 440). After logistic regression, the following variables remained independently associated with hoarding symptoms: being older, living alone, earlier age of symptoms onset, insidious onset of obsessions, higher anxiety scores, poorer insight and higher frequency of the symmetry-ordering symptom dimension. Concerning comorbidities, major depressive, posttraumatic stress and attention deficit/hyperactivity disorders, compulsive buying and tic disorders remained associated with the hoarding dimension. Conclusion: OCD hoarding patients are more likely to present certain clinical features, but further studies are needed to determine whether OCD patients with hoarding symptoms constitute an etiologically discrete subgroup. (C) 2012 Elsevier Ltd. All rights reserved.

Obsessive-compulsive symptom dimensions correlate to specific gray matter volumes in treatment-naive patients

Background: Clinical and sociodemographic findings have supported that OCD is heterogeneous and composed of multiple potentially overlapping and stable symptom dimensions. Previous neuroimaging investigations have correlated different patterns of OCD dimension scores and gray matter (GM) volumes. Despite their relevant contribution, some methodological limitations, such as patient's previous medication intake, may have contributed to inconsistent findings. Method: Voxel-based morphometry was used to investigate correlations between regional GM volumes and symptom dimensions severity scores in a sample of 38 treatment-naive OCD patients. Several standardized instruments were applied, including an interview exclusively developed for assessing symptom dimensions severity (DY-BOCS). Results: Scores on the "aggression" dimension were positively correlated with GM volumes in lateral parietal cortex in both hemispheres and negatively correlated with bilateral insula, left putamen and left inferior OFC. Scores on the "sexual/religious" dimension were positively correlated with GM volumes within the right middle lateral OFC and right DLPFC and negatively correlated with bilateral ACC. Scores on the "hoarding" dimension were positively correlated with GM volumes in the left superior lateral OFC and negatively correlated in the right parahippocampal gyrus. No significant correlations between GM volumes and the "contamination" or "symmetry" dimensions were found. Conclusions: Building upon preexisting findings, our data with treatment-naive OCD patients have demonstrated distinct GM substrates implicated in both cognitive and emotion processing across different OCS dimensions. (C) 2012 Elsevier Ltd. All rights reserved.

THE KNOWLEDGE ABOUT COMMUNICATION STRATEGIES WHEN TAKING CARE OF THE EMOTIONAL DIMENSION IN PALLIATIVE CARE

The aim of this qualitative study was to investigate existing knowledge and the use of communication strategies in emotional care for patients receiving palliative care in Brazil. It was performed from August, 2008, to July, 2009, with 303 health professionals who worked or had frequent contact with patients receiving palliative care, using a questionnaire. Data was submitted to descriptive and analytical statistical treatment. The professionals reported not knowing about communication strategies, showing a significant difference (p-value 0.0011) in comparing subjects with and without previous training in palliative care, showing that those who had received proper training know/use more communication strategies when providing care for their patients on an emotional level. The strategies most often cited were: careful listening, verbal reaffirmation of care, using open questions, and affective touch. We conclude that there is little knowledge and poor use of communication strategies among health professionals in towards the emotional care of patients receiving palliative care.

12 item Allodynia Symptom Checklist/Brasil: cross-cultural adaptation, internal consistency and reproducibility

Since there was no Portuguese questionnaire to evaluate cutaneous allodynia, which has been pointed out as a risk factor of migraine, we aimed to perform the cross-cultural adaptation of the 12 item Allodynia Symptom Checklist for the Brazilian population and to test its measurement properties. It consisted in six stages: translation, synthesis, back translation, revision by a specialist committee, pretest and submission the documents to the committee. In the pretest stage, the questionnaire was applied to 30 migraineurs of both sexes, who had some difficulty in understanding it. Thus, a second version was applied to 30 additional subjects, with no difficulties being reported. The mean filling out time was 3'36", and the internal consistency was 0.76. To test reproducibility, 15 other subjects filled out the questionnaire at two different times, it was classified as moderate (weighted kappa=0.58). We made available to Brazilian population an easy, quick and reliable questionnaire.

Shape analysis using fractal dimension: A curvature based approach

The present work shows a novel fractal dimension method for shape analysis. The proposed technique extracts descriptors from a shape by applying a multi-scale approach to the calculus of the fractal dimension. The fractal dimension is estimated by applying the curvature scale-space technique to the original shape. By applying a multi-scale transform to the calculus, we obtain a set of descriptors which is capable of describing the shape under investigation with high precision. We validate the computed descriptors in a classification process. The results demonstrate that the novel technique provides highly reliable descriptors, confirming the efficiency of the proposed method. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4757226]

An estimate on the fractal dimension of attractors of gradient-like dynamical systems

This paper is dedicated to estimate the fractal dimension of exponential global attractors of some generalized gradient-like semigroups in a general Banach space in terms of the maximum of the dimension of the local unstable manifolds of the isolated invariant sets, Lipschitz properties of the semigroup and the rate of exponential attraction. We also generalize this result for some special evolution processes, introducing a concept of Morse decomposition with pullback attractivity. Under suitable assumptions, if (A, A*) is an attractor-repeller pair for the attractor A of a semigroup {T(t) : t >= 0}, then the fractal dimension of A can be estimated in terms of the fractal dimension of the local unstable manifold of A*, the fractal dimension of A, the Lipschitz properties of the semigroup and the rate of the exponential attraction. The ingredients of the proof are the notion of generalized gradient-like semigroups and their regular attractors, Morse decomposition and a fine analysis of the structure of the attractors. As we said previously, we generalize this result for some evolution processes using the same basic ideas. (C) 2012 Elsevier Ltd. All rights reserved.

The ethical dimension f analyst's interventions facing institutional demands of CAPS

(The ethical dimension f analyst's interventions facing institutional demands of CAPS) Considering the complexities involved in setting up clinical work in the psychosocial field, analyst must question their own contributions toward improvements in this area. This issue is presented here as a considerable challenge, due to the limitations of psychoanalytic practice and, especially, the differences between conventional clinical practice and that carried out in institutional and political settings. From this perspective, we call attention to the notion of ethics as a differentiating and guiding concept for psychoanalytic practice in its contribution toward the treatment provided at CAPS.

Circuit board accident - organizational dimension hidden by prescribed safety

This study analyzes an accident in which two maintenance workers suffered severe burns while replacing a circuit breaker panel in a steel mill, following model of analysis and prevention of accidents (MAPA) developed with the objective of enlarging the perimeter of interventions and contributing to deconstruction of blame attribution practices. The study was based on materials produced by a health service team in an in-depth analysis of the accident. The analysis shows that decisions related to system modernization were taken without considering their implications in maintenance scheduling and creating conflicts of priorities and of interests between production and safety; and also reveals that the lack of a systemic perspective in safety management was its principal failure. To explain the accident as merely non-fulfillment of idealized formal safety rules feeds practices of blame attribution supported by alibi norms and inhibits possible prevention. In contrast, accident analyses undertaken in worker health surveillance services show potential to reveal origins of these events incubated in the history of the system ignored in practices guided by the traditional paradigm.

Modeling the gluon propagator in Landau gauge: Lattice estimates of pole masses and dimension-two condensates

We present an analytic description of numerical results for the Landau-gauge SU(2) gluon propagator D(p(2)), obtained from lattice simulations (in the scaling region) for the largest lattice sizes to date, in d = 2, 3 and 4 space-time dimensions. Fits to the gluon data in 3d and in 4d show very good agreement with the tree-level prediction of the refined Gribov-Zwanziger (RGZ) framework, supporting a massive behavior for D(p(2)) in the infrared limit. In particular, we investigate the propagator's pole structure and provide estimates of the dynamical mass scales that can be associated with dimension-two condensates in the theory. In the 2d case, fitting the data requires a noninteger power of the momentum p in the numerator of the expression for D(p(2)). In this case, an infinite-volume-limit extrapolation gives D(0) = 0. Our analysis suggests that this result is related to a particular symmetry in the complex-pole structure of the propagator and not to purely imaginary poles, as would be expected in the original Gribov-Zwanziger scenario.

Axioms for the coincidence index of maps between manifolds of the same dimension

We study the coincidence theory of maps between two manifolds of the same dimension from an axiomatic viewpoint. First we look at coincidences of maps between manifolds where one of the maps is orientation true, and give a set of axioms such that characterizes the local index (which is an integer valued function). Then we consider coincidence theory for arbitrary pairs of maps between two manifolds. Similarly we provide a set of axioms which characterize the local index, which in this case is a function with values in Z circle plus Z(2). We also show in each setting that the group of values for the index (either Z or Z circle plus Z(2)) is determined by the axioms. Finally, for the general case of coincidence theory for arbitrary pairs of maps between two manifolds we provide a set of axioms which characterize the local Reidemeister trace which is an element of an abelian group which depends on the pair of functions. These results extend known results for coincidences between orientable differentiable manifolds. (C) 2012 Elsevier B.V. All rights reserved.

Structural properties and energetics of diffuse Rb-87 clusters in three-dimension

A correlated two-body basis function is used to describe the three-dimensional bosonic clusters interacting via two-body van der Waals potential. We calculate the ground state and the zero orbital angular momentum excited states for Rb-N clusters with up to N = 40. We solve the many-particle Schrodinger equation by potential harmonics expansion method, which keeps all possible two-body correlations in the calculation and determines the lowest effective many-body potential. We study energetics and structural properties for such diffuse clusters both at dimer and tuned scattering length. The motivation of the present study is to investigate the possibility of formation of N-body clusters interacting through the van der Waals interaction. We also compare the system with the well studied He, Ne, and Ar clusters. We also calculate correlation properties and observe the generalised Tjon line for large cluster. We test the validity of the shape-independent potential in the calculation of the ground state energy of such diffuse cluster. These are the first such calculations reported for Rb clusters. (C) 2012 American Institute of Physics. [http://dx.doi.org/10.1063/1.4730972]

A comparative study on multiscale fractal dimension descriptors

Fractal theory presents a large number of applications to image and signal analysis. Although the fractal dimension can be used as an image object descriptor, a multiscale approach, such as multiscale fractal dimension (MFD), increases the amount of information extracted from an object. MFD provides a curve which describes object complexity along the scale. However, this curve presents much redundant information, which could be discarded without loss in performance. Thus, it is necessary the use of a descriptor technique to analyze this curve and also to reduce the dimensionality of these data by selecting its meaningful descriptors. This paper shows a comparative study among different techniques for MFD descriptors generation. It compares the use of well-known and state-of-the-art descriptors, such as Fourier, Wavelet, Polynomial Approximation (PA), Functional Data Analysis (FDA), Principal Component Analysis (PCA), Symbolic Aggregate Approximation (SAX), kernel PCA, Independent Component Analysis (ICA), geometrical and statistical features. The descriptors are evaluated in a classification experiment using Linear Discriminant Analysis over the descriptors computed from MFD curves from two data sets: generic shapes and rotated fish contours. Results indicate that PCA, FDA, PA and Wavelet Approximation provide the best MFD descriptors for recognition and classification tasks. (C) 2012 Elsevier B.V. All rights reserved.

Strategy and model building in the fourth dimension: a null model for genotype × age interaction as a Gaussian stationary stochastic process

Abstract Background Using univariate and multivariate variance components linkage analysis methods, we studied possible genotype × age interaction in cardiovascular phenotypes related to the aging process from the Framingham Heart Study. Results We found evidence for genotype × age interaction for fasting glucose and systolic blood pressure. Conclusions There is polygenic genotype × age interaction for fasting glucose and systolic blood pressure and quantitative trait locus × age interaction for a linkage signal for systolic blood pressure phenotypes located on chromosome 17 at 67 cM.

Quantification of fractal dimension and Shannon’s entropy in histological diagnosis of prostate cancer

Background: Prostate cancer is a serious public health problem that affects quality of life and has a significant mortality rate. The aim of the present study was to quantify the fractal dimension and Shannon’s entropy in the histological diagnosis of prostate cancer. Methods: Thirty-four patients with prostate cancer aged 50 to 75 years having been submitted to radical prostatectomy participated in the study. Histological slides of normal (N), hyperplastic (H) and tumor (T) areas of the prostate were digitally photographed with three different magnifications (40x, 100x and 400x) and analyzed. The fractal dimension (FD), Shannon’s entropy (SE) and number of cell nuclei (NCN) in these areas were compared. Results: FD analysis demonstrated the following significant differences between groups: T vs. N and H vs. N groups (p < 0.05) at a magnification of 40x; T vs. N (p < 0.01) at 100x and H vs. N (p < 0.01) at 400x. SE analysis revealed the following significant differences groups: T vs. H and T vs. N (p < 0.05) at 100x; and T vs. H and T vs. N (p < 0.001) at 400x. NCN analysis demonstrated the following significant differences between groups: T vs. H and T vs. N (p < 0.05) at 40x; T vs. H and T vs. N (p < 0.0001) at 100x; and T vs. H and T vs. N (p < 0.01) at 400x. Conclusions: The quantification of the FD and SE, together with the number of cell nuclei, has potential clinical applications in the histological diagnosis of prostate cancer.

Spiritual dimension of children and adolescents with cancer: an integrative review

OBJECTIVE: To review scientific literature relating to the spiritual dimension of children and adolescents with cancer. METHODS: We conducted an integrative literature review in the LILACS, SciELO, PsycINFO and MEDLINE databases in the period between 1990 to 2011. RESULTS: Twenty-one studies were analyzed and grouped into thematic categories: quality of life and elements of spirituality; alternative and complementary therapies: spirituality as a therapeutic resource; spirituality as a coping strategy and spirituality as an attribute of existential transformations. It was found that spirituality is present at different stages of the disease experience and that its forms of expression may vary, according to age and cognitive development. CONCLUSION: There is a scarcity of specific scales for this age range and a need for scientific production relating to the spiritual dimension of children and adolescents with cancer. Descriptors: Neoplasms; Children; Adolescents; Spirituality