The psychosis high-risk state: a comprehensive state-of-the-art review

Context During the past 2 decades, a major transition in the clinical characterization of psychotic disorders has occurred. The construct of a clinical high-risk (HR) state for psychosis has evolved to capture the prepsychotic phase, describing people presenting with potentially prodromal symptoms. The importance of this HR state has been increasingly recognized to such an extent that a new syndrome is being considered as a diagnostic category in the DSM-5. Objective To reframe the HR state in a comprehensive state-of-the-art review on the progress that has been made while also recognizing the challenges that remain. Data Sources Available HR research of the past 20 years from PubMed, books, meetings, abstracts, and international conferences. Study Selection and Data Extraction Critical review of HR studies addressing historical development, inclusion criteria, epidemiologic research, transition criteria, outcomes, clinical and functional characteristics, neurocognition, neuroimaging, predictors of psychosis development, treatment trials, socioeconomic aspects, nosography, and future challenges in the field. Data Synthesis Relevant articles retrieved in the literature search were discussed by a large group of leading worldwide experts in the field. The core results are presented after consensus and are summarized in illustrative tables and figures. Conclusions The relatively new field of HR research in psychosis is exciting. It has the potential to shed light on the development of major psychotic disorders and to alter their course. It also provides a rationale for service provision to those in need of help who could not previously access it and the possibility of changing trajectories for those with vulnerability to psychotic illnesses.

Productive Diversification and Sustainable Use of Complex Social-Ecological Systems: A Comparative Study of Indigenous and Settler Communities in the Bolivian Amazon

Agricultural and forest productive diversification depends on multiple socioeconomic drivers—like knowledge, migration, productive capacity, and market—that shape productive strategies and influence their ecological impacts. Our comparison of indigenous and settlers allows a better understanding of how societies develop different diversification strategies in similar ecological contexts and how the related socioeconomic aspects of diversification are associated with land cover change. Our results suggest that although indigenous people cause less deforestation and diversify more, diversification is not a direct driver of deforestation reduction. A multidimensional approach linking sociocognitive, economic, and ecological patterns of diversification helps explain this contradiction.

Modelling the Impact of Built Environment, Geographical Scales and Latent Constructs On Individual Travel Behaviour

La relación entre la estructura urbana y la movilidad ha sido estudiada desde hace más de 70 años. El entorno urbano incluye múltiples dimensiones como por ejemplo: la estructura urbana, los usos de suelo, la distribución de instalaciones diversas (comercios, escuelas y zonas de restauración, parking, etc.). Al realizar una revisión de la literatura existente en este contexto, se encuentran distintos análisis, metodologías, escalas geográficas y dimensiones, tanto de la movilidad como de la estructura urbana. En este sentido, se trata de una relación muy estudiada pero muy compleja, sobre la que no existe hasta el momento un consenso sobre qué dimensión del entorno urbano influye sobre qué dimensión de la movilidad, y cuál es la manera apropiada de representar esta relación. Con el propósito de contestar estas preguntas investigación, la presente tesis tiene los siguientes objetivos generales: (1) Contribuir al mejor entendimiento de la compleja relación estructura urbana y movilidad. y (2) Entender el rol de los atributos latentes en la relación entorno urbano y movilidad. El objetivo específico de la tesis es analizar la influencia del entorno urbano sobre dos dimensiones de la movilidad: número de viajes y tipo de tour. Vista la complejidad de la relación entorno urbano y movilidad, se pretende contribuir al mejor entendimiento de la relación a través de la utilización de 3 escalas geográficas de las variables y del análisis de la influencia de efectos inobservados en la movilidad. Para el análisis se utiliza una base de datos conformada por tres tipos de datos: (1) Una encuesta de movilidad realizada durante los años 2006 y 2007. Se obtuvo un total de 943 encuestas, en 3 barrios de Madrid: Chamberí, Pozuelo y Algete. (2) Información municipal del Instituto Nacional de Estadística: dicha información se encuentra enlazada con los orígenes y destinos de los viajes recogidos en la encuesta. Y (3) Información georeferenciada en Arc-GIS de los hogares participantes en la encuesta: la base de datos contiene información respecto a la estructura de las calles, localización de escuelas, parking, centros médicos y lugares de restauración. Se analizó la correlación entre e intra-grupos y se modelizaron 4 casos de atributos bajo la estructura ordinal logit. Posteriormente se evalúa la auto-selección a través de la estimación conjunta de las elecciones de tipo de barrio y número de viajes. La elección del tipo de barrio consta de 3 alternativas: CBD, Urban y Suburban, según la zona de residencia recogida en las encuestas. Mientras que la elección del número de viajes consta de 4 categorías ordinales: 0 viajes, 1-2 viajes, 3-4 viajes y 5 o más viajes. A partir de la mejor especificación del modelo ordinal logit. Se desarrolló un modelo joint mixed-ordinal conjunto. Los resultados indican que las variables exógenas requieren un análisis exhaustivo de correlaciones con el fin de evitar resultados sesgados. ha determinado que es importante medir los atributos del BE donde se realiza el viaje, pero también la información municipal es muy explicativa de la movilidad individual. Por tanto, la percepción de las zonas de destino a nivel municipal es considerada importante. En el contexto de la Auto-selección (self-selection) es importante modelizar conjuntamente las decisiones. La Auto-selección existe, puesto que los parámetros estimados conjuntamente son significativos. Sin embargo, sólo ciertos atributos del entorno urbano son igualmente importantes sobre la elección de la zona de residencia y frecuencia de viajes. Para analizar la Propensión al Viaje, se desarrolló un modelo híbrido, formado por: una variable latente, un indicador y un modelo de elección discreta. La variable latente se denomina “Propensión al Viaje”, cuyo indicador en ecuación de medida es el número de viajes; la elección discreta es el tipo de tour. El modelo de elección consiste en 5 alternativas, según la jerarquía de actividades establecida en la tesis: HOME, no realiza viajes durante el día de estudio, HWH tour cuya actividad principal es el trabajo o estudios, y no se realizan paradas intermedias; HWHs tour si el individuo reaiza paradas intermedias; HOH tour cuya actividad principal es distinta a trabajo y estudios, y no se realizan paradas intermedias; HOHs donde se realizan paradas intermedias. Para llegar a la mejor especificación del modelo, se realizó un trabajo importante considerando diferentes estructuras de modelos y tres tipos de estimaciones. De tal manera, se obtuvieron parámetros consistentes y eficientes. Los resultados muestran que la modelización de los tours, representa una ventaja sobre la modelización de los viajes, puesto que supera las limitaciones de espacio y tiempo, enlazando los viajes realizados por la misma persona en el día de estudio. La propensión al viaje (PT) existe y es específica para cada tipo de tour. Los parámetros estimados en el modelo híbrido resultaron significativos y distintos para cada alternativa de tipo de tour. Por último, en la tesis se verifica que los modelos híbridos representan una mejora sobre los modelos tradicionales de elección discreta, dando como resultado parámetros consistentes y más robustos. En cuanto a políticas de transporte, se ha demostrado que los atributos del entorno urbano son más importantes que los LOS (Level of Service) en la generación de tours multi-etapas. la presente tesis representa el primer análisis empírico de la relación entre los tipos de tours y la propensión al viaje. El concepto Propensity to Travel ha sido desarrollado exclusivamente para la tesis. Igualmente, el desarrollo de un modelo conjunto RC-Number of trips basado en tres escalas de medida representa innovación en cuanto a la comparación de las escalas geográficas, que no había sido hecha en la modelización de la self-selection. The relationship between built environment (BE) and travel behaviour (TB) has been studied in a number of cases, using several methods - aggregate and disaggregate approaches - and different focuses – trip frequency, automobile use, and vehicle miles travelled and so on. Definitely, travel is generated by the need to undertake activities and obtain services, and there is a general consensus that urban components affect TB. However researches are still needed to better understand which components of the travel behaviour are affected most and by which of the urban components. In order to fill the gap in the research, the present dissertation faced two main objectives: (1) To contribute to the better understanding of the relationship between travel demand and urban environment. And (2) To develop an econometric model for estimating travel demand with urban environment attributes. With this purpose, the present thesis faced an exhaustive research and computation of land-use variables in order to find the best representation of BE for modelling trip frequency. In particular two empirical analyses are carried out: 1. Estimation of three dimensions of travel demand using dimensions of urban environment. We compare different travel dimensions and geographical scales, and we measure self-selection contribution following the joint models. 2. Develop a hybrid model, integrated latent variable and discrete choice model. The implementation of hybrid models is new in the analysis of land-use and travel behaviour. BE and TB explicitly interact and allow richness information about a specific individual decision process For all empirical analysis is used a data-base from a survey conducted in 2006 and 2007 in Madrid. Spatial attributes describing neighbourhood environment are derived from different data sources: National Institute of Statistics-INE (Administrative: municipality and district) and GIS (circular units). INE provides raw data for such spatial units as: municipality and district. The construction of census units is trivial as the census bureau provides tables that readily define districts and municipalities. The construction of circular units requires us to determine the radius and associate the spatial information to our households. The first empirical part analyzes trip frequency by applying an ordered logit model. In this part is studied the effect of socio-economic, transport and land use characteristics on two travel dimensions: trip frequency and type of tour. In particular the land use is defined in terms of type of neighbourhoods and types of dwellers. Three neighbourhood representations are explored, and described three for constructing neighbourhood attributes. In particular administrative units are examined to represent neighbourhood and circular – unit representation. Ordered logit models are applied, while ordinal logit models are well-known, an intensive work for constructing a spatial attributes was carried out. On the other hand, the second empirical analysis consists of the development of an innovative econometric model that considers a latent variable called “propensity to travel”, and choice model is the choice of type of tour. The first two specifications of ordinal models help to estimate this latent variable. The latent variable is unobserved but the manifestation is called “indicators”, then the probability of choosing an alternative of tour is conditional to the probability of latent variable and type of tour. Since latent variable is unknown we fit the integral over its distribution. Four “sets of best variables” are specified, following the specification obtained from the correlation analysis. The results evidence that the relative importance of SE variables versus BE variables depends on how BE variables are measured. We found that each of these three spatial scales has its intangible qualities and drawbacks. Spatial scales play an important role on predicting travel demand due to the variability in measures at trip origin/destinations within the same administrative unit (municipality, district and so on). Larger units will produce less variation in data; but it does not affect certain variables, such as public transport supply, that are more significant at municipality level. By contrast, land-use measures are more efficient at district level. Self-selection in this context, is weak. Thus, the influence of BE attributes is true. The results of the hybrid model show that unobserved factors affect the choice of tour complexity. The latent variable used in this model is propensity to travel that is explained by socioeconomic aspects and neighbourhood attributes. The results show that neighbourhood attributes have indeed a significant impact on the choice of the type of tours either directly and through the propensity to travel. The propensity to travel has a different impact depending on the structure of each tour and increases the probability of choosing more complex tours, such as tours with many intermediate stops. The integration of choice and latent variable model shows that omitting important perception and attitudes leads to inconsistent estimates. The results also indicate that goodness of fit improves by adding the latent variable in both sequential and simultaneous estimation. There are significant differences in the sensitivity to the latent variable across alternatives. In general, as expected, the hybrid models show a major improvement into the goodness of fit of the model, compared to a classical discrete choice model that does not incorporate latent effects. The integrated model leads to a more detailed analysis of the behavioural process. Summarizing, the effect that built environment characteristics on trip frequency studied is deeply analyzed. In particular we tried to better understand how land use characteristics can be defined and measured and which of these measures do have really an impact on trip frequency. We also tried to test the superiority of HCM on this field. We can concluded that HCM shows a major improvement into the goodness of fit of the model, compared to classical discrete choice model that does not incorporate latent effects. And consequently, the application of HCM shows the importance of LV on the decision of tour complexity. People are more elastic to built environment attributes than level of services. Thus, policy implications must take place to develop more mixed areas, work-places in combination with commercial retails.

The Iron Age landscape of Alcoi Valley, eastern Iberia: Agricultural intensification and sociopolitical dynamics

New archaeological survey data are combined with previous evidence to examine the rural landscape during the Iberian Iron Age in the Valencia region of eastern Spain. One goal was to understand the settlement pattern and agricultural intensification through manuring. The second objective was to address the socioeconomic aspects of changes in the landscape. It is possible to trace the emergence of a hierarchical settlement pattern in the Iberian Iron Age in which large fortified settlements carried out the most important functions of control and exploitation of the territory, extending their authority over small rural villages and farmsteads. This pattern is associated with the complex socioeconomic structures and political organization of early Iberian states.

Los bienes raíces de los moriscos expulsados

La expulsión de los moriscos fue un proceso complejo, a pesar de los innumerables trabajos que se han realizado hasta el día de hoy aún quedan aspectos por dilucidar. La confiscación y venta de los bienes raíces de los moriscos generó una inmensa documentación, cuyo estudio nos puede ayudar a comprender la vertiente económica de la expulsión, así como aspectos socioeconómicos de la minoría. En este artículo se presentan los primeros datos globales sobre la tasación de todos los bienes raíces de los moriscos en Castilla, Extremadura, Murcia y Andalucía, tanto en lugares de realengo como en lugares de señorío.

Toll facilities in the United States: bridges, roads, tunnels, ferries.

Mode of access: Internet.

Evaluation of California's safety belt law change to primary enforcement. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Department of Transportation's Intelligent Vehicle Highway Systems Institutional and Legal Issues Program.

Mode of access: Internet.

SUPORTE SOCIAL E QUALIDADE DE VIDA EM IDOSOS PARTICIPANTES DE UM PROGRAMA DE EDUCAÇÃO PERMANENTE

Este estudo objetivou identificar e descrever uma possível relação entre suporte social e qualidade de vida, em pessoas idosas participantes de um programa de educação permanente, o qual é promovido por órgão público em parceria com uma universidade, instalada em um dos municípios que integram a região do ABC Paulista, em São Paulo. A amostra consistiu de 106 idosos, com idade a partir de 60 anos, de ambos os sexos, e que efetivamente participam do referido programa. Para a coleta de dados, a amostra foi dividida em dois subgrupos, onde o primeiro grupo constou de 54 idosos que freqüentam o programa há menos de 1 ano, e o outro grupo foi formado por 52 idosos que freqüentam o programa há mais de 1 ano, com isso objetivamos identificar uma possível existência de diferentes percepções entre os grupos, das variáveis estudadas, em função do tempo de participação no programa, o que não foi confirmado, com os resultados apontando para uma homogeneidade entre os grupos, tanto nos aspectos socioeconômicos quanto nas percepções de suporte social e qualidade de vida, independente do tempo de participação no programa. Este estudo utilizou método descritivo exploratório, de caráter quantitativo e comparativo. Para a coleta de dados foram utilizadas a Escala de Percepção de Suporte Social (EPSS), que avalia percepção de suporte social em suas dimensões emocional e prático; o instrumento de avaliação da qualidade de vida: WHOQOL Bref e Old, e um questionário com dados socioeconômicos que auxiliaram na caracterização do perfil da amostra e na análise estatística dos resultados. Os resultados apontaram que a amostra pesquisada caracteriza-se por possuir um perfil socioeconômico diferenciado, no que se refere a uma maior escolaridade e rendimento mensal, quando comparado a media nacional que mostra o perfil do idoso brasileiro mais vulnerável, com baixa escolaridade e rendimento. Os resultados das avaliações das percepções de suporte social e da qualidade de vida demonstraram tratar-se de idosos que se sentem satisfeitos com seu momento de vida; que percebem apoio emocional, sentindo-se objeto de afeto em sua rede social. Com relação a percepção de suporte prático, os resultados demonstraram que os idosos possuem uma percepção relativa, apontando dúvidas e incertezas quanto ao recebimento deste tipo de apoio de sua rede social. Diante deste resultado, percepção de dúvidas e incertezas em receber suporte prático, e a característica socioeconômica diferenciada da amostra, podemos supor que esses idosos possuem estas percepções, por se sentirem ou por serem de fato provedores e não dependentes da sua rede social. Não foi evidenciada correlação entre as variáveis suporte social e qualidade de vida, sugerindo que o construto suporte social talvez seja percebido pelos idosos da amostra como fator de diminuição da funcionalidade biopsicossocial ou da competência comportamental; ou ainda, pode-se supor que diante dos sentimentos de satisfação com a vida atual, a amostra de idosos volta-se menos aos aspectos protetores do suporte social.

Um estudo sobre o perfil sexual e reprodutivo das adolescentes de um serviço de referência no município de Natal/RN

Adolescence is seen as a phase of life marked by a series of physical and behavioral changes, which leads to certain risk situations, such as early sexual activity, pregnancy and the occurrence of sexually transmitted diseases. Based on this statement, this research aimed generally: meet the sexual and reproductive adolescents of a reference service in Natal profile. Specifically describe the socioeconomic, sexual and reproductive individual and family characteristics of the population in question, but also verify possible association between pregnancy and age of onset of sexual activity with the socioeconomic aspects. The sectional study conducted in the database from the records of 463 adolescents seeking care in a referral center in Sexual and Reproductive Health in the period March 2011 to June 2012. The data collected were subjected to analysis by Excel 2007 and Statistical Package for Social Sciences (SPSS) 17.0. For data analysis, descriptive statistics, with absolute numbers and percentages was used, and its presentation by means of distribution and frequency tables. Results showed that the parents of these adolescents (65.7% - father; 57.8% - mother), had primary education; family income less than two minimum wages (66.2%); any type of chemical dependency in the family (33.5%) and presence of domestic violence (20.6%). A higher probability of pregnancy was verified when the mother had only primary education (26.3%), persons other than the father or mother contributed to family income (33.3%) and (26%) when there was substance abuse in the family early onset of sexual activity was observed when the mother had primary education (57.3%), persons other than the father or mother contributed to family income (63.1%) and the use of drugs / alcohol as a problem family (67.6%). It was concluded that such vulnerabilities appear as a reflection of the low social status of these young people, aggravated by emotional inheritance that is offered to every individual from birth. These findings may perhaps, support public health surveillance policies for adolescents in several areas

EVALUACIÓN SOCIOAMBIENTAL DE UNA ZONA DE AMORTIGUAMIENTO: CASO DEL PARQUE PIEDRAS BLANCAS Y LA RESERVA DE VIDA SILVESTRE GOLFITO, COSTA RICA

Este  artículo  analiza  las  políticas  ambientales,  relacionadas  directamente  con  el establecimiento y el manejo de  los espacios protegidos, y muy especialmente, con  las zonas de amortiguamiento  en  Costa  Rica,  como  un  elemento  esencial  para  comprender  la  dinámica  en áreas  de  conservación  reciente  creación,  por  ejemplo  el  Parque Nacional  Piedras Blancas  y  la Reserva  de Vida Silvestre Golfito.   Se  analiza  en  esta  área,  de  forma  cualitativa,  los  procesos socioambientales, como componentes fundamentales en  la determinación del nivel de alcance de la conservación de estas áreas protegidas.   Finalmente, este artículo concluye  la  importancia de abordar la gestión de los espacios protegidos desde perspectivas sistemáticas, que permita no sólo articular  diferentes  áreas,  sino  que  realice  una  gestión  que  considere  tanto  los  aspectos socioeconómicos  para  la  conservación  como  los  ecológicos,  debido  a  que  las  condiciones  de pobreza  imperantes  en  el  área  de  estudio  han  limitado  fuertemente  la  consolidación  de  estas áreas. Abstracts:This article analyzes the environmental policies related directly with the creation and management of protected areas, especially the buffer zones  in Costa Rica, as crucial elements  in the  comprehension  of  different  dynamics  in  the  recently  created  conservation  areas,  like  the Piedras Blancas National Park  and  the Golfito Wildlife Refuge. There  is  a  qualitative  analysis regarding  the  socio-environmental  processes,  as  key  elements  in  determining  the  conservation level  in  these  protected  areas.  Finally,  the  article  details  the  importance  of  approaching  the management  of  protected  areas  from  systematic  points  of  view  that  allow  the  articulation  of different areas, as well as considering the basic and socioeconomic aspects of the area, due to the fact that critic poverty conditions have strongly limited the consolidation of these protected areas.

Socioeconomic status, parental support, motivation and self-confidence in youth competitive sport

World Conference on Psychology and Sociology 2012

Economic aspects of pharmacotherapy for chronic constipation

Constipation is one of the most common digestive complaints. It is a symptom, not a disease. The subjectivity that this involves means that assessments of clinical epidemiology, socioeconomic costs and pharmacotherapy are difficult, since there is no definition of 'normal' bowel habit. Although constipation can affect all ages, the problem increases with age, and is of particular concern for those who are frail and in long term care. Cultural influences may affect the prevalence in older people. Drug therapy of constipation cannot be considered in isolation, since there are issues in the prevention of constipation and the principles of good management that also apply. Furthermore, some consideration of the pathophysiology and diagnosis is important. This is because a number of remediable causes can be identified, and the diagnostic process involves patient education, which in turn may be effective in reducing costs. It is the complaint of constipation which leads either to self-medication or to consultation with the medical profession. Both of these courses of action have a significant influence on utilisation of laxatives (cathartics), obtained both over-the-counter and by prescription. Although there are a large number of laxative preparations available, therapy has changed little in half a century. Costs may vary considerably, and with such a significant problem there is a need for comparative studies. However, study methodologies are difficult, and a significant placebo response may be found. Education and preventive measures have been shown to reduce laxative use and costs in institutions. Unfortunately, there are few comparative studies of individual laxatives and even fewer cost-effectiveness studies. Those that there are have been based in institutions, and so extrapolation to other situations may be difficult. In general, little attention is given to constipation. It is, however, an area with significant resource implications in which education and preventive measures have been shown to be beneficial. Even so, there is still a need for good comparative studies, particularly where cost effectiveness is concerned.

Relative importance of body composition, osteoporosis- related behaviours and socioeconomic status on bone SOS in adolescent females

The purpose of this study was to examine the associations between bone speed of sound (SOS) and body composition, osteoporosis-related health behaviours, and socioeconomic status (SES) in adolescent females. A total of 442 adolescent females in grades 9-11 participated. Anthropometric measures of height, body mass, and percent body fat were taken, and osteo-protective behaviours such as oral contraceptive use (OC), physical activity and daily calcium intake were evaluated using self-report questionnaires. Bone SOS was measured by transaxial quantitative ultrasound (QUS) at the distal radius and mid-tibia. The results suggest that fat mass is a significant negative predictor of tibial SOS, while lean mass is positively associated with radial SOS scores and calcium intake was positively associated with tibial SOS scores (p

Trends in rheumatic fever: clinical aspects and perspectives in prophylactic treatments

Introduction: Rheumatic fever (RF), a systemic illness that may occur following Group A beta-hemolytic streptococcal (GABHS) pharyngitis in children, is a major problem in countries with limited resources. Because of its long track record and low cost, an injection of benzathine penicillin G (BPG) suspension every 3 or 4 weeks has been used as secondary prophylaxis. Despite its excellent in vitro efficacy, the inability of BPG to eradicate GABHS has been frequently reported.Areas covered: This work reviews the possible causes of failure, as well as the inconvenience of the current prophylactic treatment of acute RF and suggests a new pharmacotherapeutic system that could replace the current one.Expert opinion: RF is a major problem concerning only countries with limited resources and could be considered as a neglected disease. The dose regimen using BPG suspension results in failures, which could be avoided by the use of nanocarrier-based systems. To meet this ultimate goal, the research should be transposed from the laboratory scale to an industrial and clinical application level. This research should be conducted to produce a pharmaceutical dosage form that will be commercially available, consumed by and affordable for patients. However, health, environmental and socioeconomic hazards should be considered.