Executive dysfunction and memory impairment in schizoaffective disorder: a comparison with bipolar disorder, schizophrenia and healthy controls.

BACKGROUND: Deficits in memory and executive performance are well-established features of bipolar disorder and schizophrenia. By contrast, data on cognitive impairment in schizoaffective disorder are scarce and the findings are conflicting. METHOD: We used the Wechsler Memory Scale (WMS-III) and the Behavioural Assessment of the Dysexecutive Syndrome (BADS) to test memory and executive function in 45 schizophrenic patients, 26 schizomanic patients and 51 manic bipolar patients in comparison to 65 healthy controls. The patients were tested when acutely ill. RESULTS: All three patient groups performed significantly more poorly than the controls on global measures of memory and executive functioning, but there were no differences among the patient groups. There were few differences in memory and executive function subtest scores within the patient groups. There were no differences in any test scores between manic patients with and without psychotic symptoms. CONCLUSIONS: Schizophrenic, schizomanic and manic patients show a broadly similar degree of executive and memory deficits in the acute phase of illness. Our results do not support a categorical differentiation across different psychotic categories with regard to neuropsychological deficits.

Facing Structural Disadvantage: The Role of Ingroup Connectedness

This thesis focuses on the social-psychological factors that help coping with structural disadvantage, and specifically on the role of cohesive ingroups and the sense of connectedness and efficacy they entail in this process. It aims to complement existing group-based models of coping that are grounded in a categorization perspective to groups and consequently focus exclusively on the large-scale categories made salient in intergroup contexts of comparisons. The dissertation accomplishes this aim through a reconsideration of between-persons relational interdependence as a sufficient and independent antecedent of a sense of groupness, and the benefits that a sense of group connectedness in one's direct environment, regardless of the categorical or relational basis of groupness, might have in the everyday struggles of disadvantaged group members. The three empirical papers aim to validate this approach, outlined in the first theoretical introduction, by testing derived hypotheses. They are based on data collected with youth populations (15-30) from three institutions in French-speaking Switzerland within the context of a larger project on youth transitions. Methods of data collection are paper-pencil questionnaires and in-depth interviews with a selected sub-sample of participants. The key argument of the first paper is that members of socially disadvantaged categories face higher barriers to their life project and that a general sense of connectedness, either based on categorical identities or other proximal groups and relations, mitigates the feeling of powerlessness associated with this experience. The second paper develops and tests a model that defines individual needs satisfaction as antecedent of self-group bonds and the efficacy beliefs derived from these intragroup bonds as the mechanism underlining the role of ingroups in coping. The third paper highlights the complexities that might be associated with the construction of a sense of groupness directly from intergroup comparisons and categorization-based disadvantage, and points out a more subtle understanding of the processes underling the emergence of groupness out of the situation of structural disadvantage. Overall, the findings confirm the central role of ingroups in coping with structural disadvantage and the importance of an understanding of groupness and its role that goes beyond the dominant focus on intergroup contexts and categorization processes.

Identity, non-identity, and near-identity: Addressing the complexity of coreference

This article examines the mainstream categorical definition of coreference as "identity of reference." It argues that coreference is best handled when identity is treated as a continuum, ranging from full identity to non-identity, with room for near-identity relations to explain currently problematic cases. This middle ground is needed to account for those linguistic expressions in real text that stand in relations that are neither full coreference nor non-coreference, a situation that has led to contradictory treatment of cases in previous coreference annotation efforts. We discuss key issues for coreference such as conceptual categorization, individuation, criteria of identity, and the discourse model construct. We redefine coreference as a scalar relation between two (or more) linguistic expressions that refer to discourse entities considered to be at the same granularity level relevant to the linguistic and pragmatic context. We view coreference relations in terms of mental space theory and discuss a large number of real life examples that show near-identity at different degrees.

Patología Dual y rasgos de personalidad:situación actual y líneas futuras de trabajo

Dual diagnosis (DD) is the co-occurrence, in the same person, of a mental disorder (MD) and a substance use disorder (SUD). Nowadays, the study of the personality with DD is realized mainly from a categorical view, focusing on the detection of personality disorders and not on the traits associated to DD and the possible differential profile compared to those patients with only MD or SUD. Studies analyzing personality traits of patients with DD and their possible differential profile are very limited. However, existing data indicates that DD patients show higher levels of Sensation Seeking, Impulsivity, Harm Avoidance and Neuroticism; and lower levels of Persistence, Self-Direction, Self-Transcendence and Cooperation. Therefore, DD is associated to personality characteristics that suggest more disruptive behaviors, fewer resources for recovering and keeping abstinent and worse prognosis compared to those with only one disorder. Progress in the characterization of personality traits in DD, taking into consideration the methodological aspects to be improved could allow better adaptation of the integrated treatment of these patients in the future.

Operational Reliability Analysis of a Three-Tiered Thin-Client ERP-system in an International Corporate Environment

Internationalization and the following rapid growth have created the need to concentrate the IT systems of many small-to-medium-sized production companies. Enterprise Resource Planning systems are a common solution for such companies. Deployment of these ERP systems consists of many steps, one of which is the implementation of the same shared system at all international subsidiaries. This is also one of the most important steps in the internationalization strategy of the company from the IT point of view. The mechanical process of creating the required connections for the off-shore sites is the easiest and most well-documented step along the way, but the actual value of the system, once operational, is perceived in its operational reliability. The operational reliability of an ERP system is a combination of many factors. These factors vary from hardware- and connectivity-related issues to administrative tasks and communication between decentralized administrative units and sites. To accurately analyze the operational reliability of such system, one must take into consideration the full functionality of the system. This includes not only the mechanical and systematic processes but also the users and their administration. All operational reliability in an international environment relies heavily on hardware and telecommunication adequacy so it is imperative to have resources dimensioned with regard to planned usage. Still with poorly maintained communication/administration schemes no amount of bandwidth or memory will be enough to maintain a productive level of reliability. This thesis work analyzes the implementation of a shared ERP system to an international subsidiary of a Finnish production company. The system is Microsoft Dynamics Ax, currently being introduced to a Slovakian facility, a subsidiary of Peikko Finland Oy. The primary task is to create a feasible base of analysis against which the operational reliability of the system can be evaluated precisely. With a solid analysis the aim is to give recommendations on how future implementations are to be managed.

Safety and sustainability research for university schools of fine arts

Designing new teaching programs for both undergraduate and graduate university studies involves integrating concepts and methodologies regarding quality, work safety and hazard prevention, and environmental protection. One of the challenges facing Spanish research within the realm of European Higher Education concerns health and safety issues in the Arts.In the case of Fine Arts, student exploration is one of the fundamental pillars of the study program; therefore it is imperative that art studios be optimized. This optimization affects both designated resources (infrastructures, materials, equipment, etc.) and organization of the teaching force.In this context, the aim of our research is to improve educational practices by designing quality measures that are both friendly to the environment and hazardous free. The aim here is to assure adequate art studio and laboratory management, and provide students with hazard free health and environmentally safe concepts that can be incorporated in their professional lives.The school of Fine Arts at the University of Barcelona is part of a pilot program, where our experience in educational innovation and research is serving as a reference for the implantation of OSHAS 18001 norms.

Safety and sustainability research for university schools of fine arts

Designing new teaching programs for both undergraduate and graduate university studies involves integrating concepts and methodologies regarding quality, work safety and hazard prevention, and environmental protection. One of the challenges facing Spanish research within the realm of European Higher Education concerns health and safety issues in the Arts.In the case of Fine Arts, student exploration is one of the fundamental pillars of the study program; therefore it is imperative that art studios be optimized. This optimization affects both designated resources (infrastructures, materials, equipment, etc.) and organization of the teaching force.In this context, the aim of our research is to improve educational practices by designing quality measures that are both friendly to the environment and hazardous free. The aim here is to assure adequate art studio and laboratory management, and provide students with hazard free health and environmentally safe concepts that can be incorporated in their professional lives.The school of Fine Arts at the University of Barcelona is part of a pilot program, where our experience in educational innovation and research is serving as a reference for the implantation of OSHAS 18001 norms.

Safety and sustainability research for university schools of fine arts

Designing new teaching programs for both undergraduate and graduate university studies involves integrating concepts and methodologies regarding quality, work safety and hazard prevention, and environmental protection. One of the challenges facing Spanish research within the realm of European Higher Education concerns health and safety issues in the Arts.In the case of Fine Arts, student exploration is one of the fundamental pillars of the study program; therefore it is imperative that art studios be optimized. This optimization affects both designated resources (infrastructures, materials, equipment, etc.) and organization of the teaching force.In this context, the aim of our research is to improve educational practices by designing quality measures that are both friendly to the environment and hazardous free. The aim here is to assure adequate art studio and laboratory management, and provide students with hazard free health and environmentally safe concepts that can be incorporated in their professional lives.The school of Fine Arts at the University of Barcelona is part of a pilot program, where our experience in educational innovation and research is serving as a reference for the implantation of OSHAS 18001 norms.

Influence of PTPN2 and pre-existing immunity on the generation of effector and memory CD8 T cells

Notre système immunitaire joue un rôle important pour la protection envers les maladies infectieuses. Au cours d'une réponse à une infection primaire, des cellules B et des cellules T spécifiques, dirigées contre le pathogène en question, sont générées et certaines d'entre elles deviennent des cellules dites mémoires. Leur fonction est de nous protéger contre une nouvelle infection avec le même pathogène, une infection secondaire. Dans certaines situations, comme c'est par exemple le cas avec la grippe, les pathogènes ne sont pas toujours complètement identiques et les cellules mémoires ne sont pas à même d'assurer leur rôle protecteur et d'empêcher une réinfection. Pourtant, on ne sait à l'heure actuelle que très peu comment une immunité acquise, mais non protectrice, influence le développement d'une réponse immunitaire ultérieure. Dans la première partie de cette thèse, nous avons étudié comment les cellules T mémoires cytotoxiques altèrent la réponse de cellules T cytotoxiques nouvellement induites. Au cours d'une réaction immunitaire dirigée contre une infection primaire, un vaste répertoire de lymphocytes T est créé, constitué de cellules T possédant divers degrés d'affinité pour le pathogène. Lors d'une infection secondaire, seules les cellules T ayant une forte affinité pour le pathogène participent à la réponse. Nous avons pu démontrer que ce phénomène de restriction du répertoire des cellules T est principalement causé par les cellules T mémoires qui sont à même de reconnaître un antigène pathogénique présent dans les deux infections. Dans un deuxième projet, nous avons étudié comment l'absence de PTPN2 influence la réponse des cellules T. Chez l'homme, une mutation dans le gène de PTPN2 est associée à des maladies auto-immunes et résulte en une activité réduite de cette phosphatase dans les lymphocytes T. Nous avons montré que la baisse d'activité de la phosphatase PTNP2 conduit à une meilleure expansion des cellules T ayant une qualité comparable à des cellules T auto-antigène spécifiques. De plus, nous avons observé que la survie de ces cellules T effectues ayant une phosphatase diminuée est nettement améliorée. Cela peut conduire à une réponse immunitaire plus efficace ou, éventuellement, à une pathologie auto-immune plus grave. En outre, nos résultats montrent qu'en manipulant l'activité de cette phosphatase, il est possible d'augmenter l'efficacité du transfert des cellules T dans un hôte receveur. Un tel transfert de cellules T est pratiqué chez des patients atteints de tumeurs. Nos travaux suggèrent que la manipulation de la phosphatase PTPN2 pourrait donc représenter une approche thérapeutique novatrice et prometteuse. -- Notre système immunitaire joue un rôle important pour la protection contre les maladies. Les cellules T CD8+ ont une importance primordiale pour le contrôle d'infections primaires causées par des virus ou bactéries, mais également contre certaines tumeurs. Par conséquent, mieux comprendre les exigences nécessaires à l'induction de bonnes réponses des cellules T CD8 pourrait nous permettre de construire des vaccins contre les pathogènes contre lesquels nous n'avons pour l'instant pas de vaccins mais aussi d'améliorer les réactions immunitaires dirigées anti-tumorales. Dans la première partie de cette thèse, nous avons étudié l'influence qu'une immunité préexistante a sur la réponse des cellules T CD8. Nous sommes souvent exposés à des pathogènes qui sont similaires mais pas identiques à ceux que nous avons rencontrés auparavant. De telles infections hétérologues ne sont pas l'objet de beaucoup d'études et certains exemples indiquent même qu'une immunité préexistante partielle peut mener à une aggravation de la maladie. Nous avons étudié le répertoire des lymphocytes T CD8 qui sont générés lors d'une rencontre avec un nouvel antigène, et ce en comparant infection primaire et secondaire. En utilisant le modèle expérimental d'infections à Listeria monocytogenes, nous avons pu montrer que lors d'une infection primaire, un répertoire diversifié comprenant des cellules T CD8 de forte et faible affinité est constitué. Au contraire, dans le cas d'une infection secondaire, le répertoire des cellules T est fortement limité et seulement les lymphocytes T de forte affinité sont impliqués dans la réponse immunitaire. Nous avons pu démontrer que ces Rangements sont provoqués par des cellules T CD8 mémoires capables de reconnaître un antigène présent dans les deux infections. Cette augmentation du seuil d'activation des cellules effectrices est majoritairement causée par les lymphocytes T CD8 mémoires non transférables. Ces observations indiquent que les vaccins visant à induire des cellules T anti-tumorales de faible affinité seraient inefficaces si le vaccin contient des épitopes contre lesquels il existe une mémoire immunologique. Les réponses immunitaires conduites par les cellules T contre les antigènes tumoraux dépendent des cellules T CD8 de faible réactivité contre les antigènes tumoraux puisque les cellules à forte réactivité sont éliminées par les mécanismes de tolérance. Nous basant sur l'existence dans la littérature de preuves indiquant que PTPN2 influence la réponse des cellules T de faible affinité, nous nous sommes intéressés à comprendre comment PTPN2 impacte les réponses des cellules T CD8 en général. Nous avons remarqué que des cellules T CD8 déficientes en PTPN2 exhibent une meilleure capacité à proliférer suite à une faible ou courte stimulation du récepteur des lymphocytes T. La phase effectrice est prolongée et la contraction retardée résultant ainsi à globalement plus de cellules effectrices. Ce phénomène est également accompagné d'une meilleure survie des cellules effectrices de différentiation terminale. Une fois transférées dans un nouvel hôte receveur, les cellules effectrices terminales KLRG1+CD127- déficientes en phosphatase PTPN2 peuvent survivre et se transformer en cellules mémoires CD127+ fonctionnelles. De façon inattendue, nous avons découvert que l'élimination de PTPN2 améliore l'efficacité du transfert et la formation des cellules mémoires ainsi que leur capacité protectrice. Manipuler l'activité de cette phosphatase apparaît donc comme une approche intéressante et prometteuse pour la thérapie cellulaire par transfert adoptif de lymphocytes T. Nos observations montrent que la manipulation d'un facteur intrinsèque, l'absence de PTPN2, peut, dans certaines circonstances, améliorer la réponse des cellules T. Une meilleure connaissance des mécanismes contrôlant la réponse des lymphocytes T CD8 pourrait donc permettre la manipulation de ces derniers et conduire à des réponses immunitaires plus vigoureuses. Si ces réponses sont déclenchées par l'utilisation de vaccins, il est nécessaire de considérer l'historique d'une exposition préalable à des agents pathogènes ou à des vaccins puisque celle-ci peut, comme nous l'avons démontré, influencer le répertoire des cellules T recrutées dans la réponse immunitaire et, par conséquent, modifier l'aptitude de notre système immunitaire à faire face à une infection. -- Our immune system plays an important role in the protection from disease. CD8 T cells are critical for the control of primary infections with most viruses and certain bacteria as well as against some tumors. Therefore, better knowledge of CD8 T cell responses might enable us to generate vaccines against pathogens for which currently no vaccines are available or to improve anti-tumor immune responses. In the first part of this thesis we addressed the issue how previously acquired immunity impacts on the response of CD8 T cells. We are often exposed to pathogens that are related but not identical to the previously encountered ones. Such heterologous infections are not well studied and there are some indications that partial pre-existing immunity may in some cases even lead to an enhancement of disease. We specifically studied the T cell repertoire of CD8 T cells that are responding to a newly encountered antigen in secondary compared to primary infections. Using the experimental model of Listeria monocytogenes infections, we showed that in primary infections a wide repertoire including high and low affinity CD8 T cells is recruited into the immune response. In contrast to this, in secondary infections, the T cell repertoire is severely restricted and only T cells of high affinity are responding. We were able to pinpoint this difference to the presence of memory CD8 T cells that recognize an antigen that is shared between the two subsequent infections. This increase in the activation threshold was most effectively mediated via non-transferable memory CD8 T cells. This would argue that vaccines targeting low affinity tumor-specific T cells would fail if the vaccine contains previously encountered CD8 T cell epitopes. T cell mediated immune responses to tumor antigen rely often on T cells which weakly react to tumor antigen as high affinity T cells are eliminated by tolerance mechanisms. Following indication in the literature that PTPN2 impacts on the response of such weakly antigen-reactive T cells, we investigated how PTPN2 impacts in general the response of CD8 T cells. We observed that CD8 T cells lacking PTPN2 show an enhanced expansion following weak or short-term T cell receptor stimulation. The effector phase is prolonged and contraction delayed thus resulting in overall more effector cells. This is accompanied by a better survival of terminal effector cells. When transferred into new recipients, KLRG1+CD127- terminal effector cells lacking PTPN2 can survive and convert into CD127+ functional memory cells. Surprisingly, we discovered that elimination of PTPN2 enhances the transfer efficacy and formation of memory cells as well as the protective capacity. Targeting PTPN2 might thus be a promising approach for adoptive T cell therapy. Our observations show how the manipulation of an intrinsic factor, the absence of PTPN2, can enhance T cell responses under certain circumstances. A better understanding of underlying mechanisms for the control of CDS T cell responses might enable the manipulation of these and allow for more powerful responses. If these responses are induced through vaccines it is imperative that the previous history of exposure to pathogens or vaccines is considered as it can, as we have shown in this thesis, influence the recruited T cell repertoire and thus possibly the ability to handle the infection.

Emotion and Linguistic Diversity

In this paper we shall try to explain why speakers experience their languages so passionately. One explanation is based on the role language plays in the construction of the community and in the fact that it is a clear mark of belonging. Furthermore, we support another reason. Speakers experience their language as something received from their ancestors and that they are obliged to transmit to their descendents, an imperative which carries an extraordinary emotional charge. In fact, fear of the death of a language is experienced as an act of irreparable non-fulfilment. Why? We believe that language is one of the most evident signs of community, much more than the sum of the individuals of which it is composed. Indeed, it is a long-lasting entity projected into both the past and the future and which, moreover, accumulates within the language the whole of the culture. In the survival of the community and the language we find a response, even though it may be illusory, to the need for transcendence: our ancestors live on in our language and we, if we meet our obligations, live on in the language of our descendents

Ultrasound scan as a potential source of nosocomial and cross-infection: a literature review

AbstractThe authors review the main concepts regarding the importance of cleaning/disinfection of ultrasonography probes, aiming a better comprehension by practitioners and thus enabling strategies to establish a safe practice without compromising the quality of the examination and the operator productivity. In the context of biosafety, it is imperative to assume that contact with blood or body fluids represents a potential source of infection. Thus, in order to implement cleaning/disinfection practice, it is necessary to understand the principles of infection control, to consider the cost/benefit ratio of the measures to be implemented, and most importantly, to comprehend that such measures will not only benefit the health professional and the patient, but the society as a whole.

Au sortir de l'hôpital, comment renforcer la continuité de la prise en charge médicale [Discharge from hospital: how to improve continuity of medical care?].

Early readmission is the major success indicator of the transition between hospital and home. Patients admitted with heart failure reach a 20% rate. Potentially avoidable readmissions, defined as unpredictable and related to a known condition during index hospitalization, represent the improvement margin. For these latter, implementation of specific interventions can be effective. Complex interventions on transition, including several modalities and seeking to encourage patient autonomy seem more effective than others. We describe two models: a pragmatic one developed in a regional hospital, and a more complex one developed in a university hospital during the LEAR-HF study. In both cases, it is imperative to work on "medical liability": should it extend beyond discharge up to the threshold of the private practice?

Psychomotor Development of 18-Months Children With Orofacial Clefts

Objective - To describe the global and language development of children with cleft palate or cleft lip and palate at the age of 18 months, and to evaluate whether the type of cleft has an impact on psychomotor development. Study Design - Prospective cohort study. Settings - Tertiary care hospital Patients - All children born between December 2002 and November 2009 with an orofacial cleft, operated and seen at the developmental unit (UD) of the same hospital at the age of 18 months. Outcome Measures - Developmental quotients of the Griffiths Mental Development Scale and the French Communicative Development Inventory (IFDC) were used to assess the overall and language development of the children. Statistics- The population characteristics were described with means for continuous variables, and frequencies for binary or categorical variables. Chi-squared and regression analysis were used to analyse the results. Results - 69 children with clefts were examined at the age of 18 months with the IFDC and the Griffith test. The results showed that there was no significant difference in the test results of language development and global psychomotor development between the children with different types of clefts, and all were within the normal range. Conclusion - Psychomotor development is not affected by orofacial clefts, and there is no difference between children with cleft palate or cleft lip and palate.

Assessment of research competences using e-portfolio

The challenges posed by the assessment of distance learning is a topic that requires, on the one hand, evolution with new trends and, on the other improving evaluative processes, to promote good practices. This demand becomes more imperative when we are dealing with a formativescenario based on distance assessment of competence-based learning.The Open University of Catalonia has begun to work with these formative tools, promoting new practices for online education. A very clear example of these educational practices is the assessment of research competences using the e-portfolio system. To meet this aim a profound and solid process has been developed over recent years, with the intention of making this tool an assessment alternative, and providing the opportunity to use it in a formative context. The objective is to study its strengths and limitations keeping in mind the final goal of offering the higher education community a validated assessment system.

The Pelosi-type versus the modified Misgav-Ladach: a randomized trial of two surgical techniques for cesarean section

Cesarean section (CS) is now the most common major surgical procedure performed on women worldwide. A quarter of deliveries in Spain are performed by cesarean section. With the increasing rates of the operation, there is the need to use evidence-based techniques to optimize outcomes and minimize complications. The goal of this study is to employ a well-designed randomized controlled trial to evaluate the intraoperative blood loss of two surgical techniques for cesarean section, the Pelosi-type and the modified Misgav-Ladach. The trial will take place in Hospital Universitari de Girona Dr. Josep Trueta From 2014 to 2015, 512 pregnant women undergoing delivery by their first lower segment cesarean section in this center will be selected through a consecutive nonprobability sampling. We will collect the main obstetrical characteristics, intraoperative outcomes, short-term outcomes for the baby and postoperative outcomes. We will evaluate the intraoperative blood loss by comparing the changes in hemoglobin levels, pre and postoperatively. Patients will be followed during the postoperative period and in a two-week postoperative appointment. We will analyze the continuous variables, such as the differences in hemoglobin levels, using an unpaired two-sided Student’s t-test, while for the categorical variables Fischer’s exact test will be used