Locating and extracting the textual content from complex colour images using techniques inspired by human perception

Los sistemas de radio cognitivos son una solución a la deficiente distribución del espectro inalámbrico de frecuencias. Usando acceso dinámico al medio, los usuarios secundarios pueden comunicarse en canales de frecuencia disponibles, mientras los usuarios asignados no están usando dichos canales. Un buen sistema de mensajería de control es necesario para que los usuarios secundarios no interfieran con los usuarios primarios en las redes de radio cognitivas. Para redes en donde los usuarios son heterogéneos en frecuencia, es decir, no poseen los mismos canales de frecuencia para comunicarse, el grupo de canales utilizado para transmitir información de control debe elegirse cuidadosamente. Por esta razón, en esta tesis se estudian las ideas básicas de los esquemas de mensajería de control usados en las redes de radio cognitivas y se presenta un esquema adecuado para un control adecuado para usuarios heterogéneos en canales de frecuencia. Para ello, primero se presenta una nueva taxonomía para clasificar las estrategias de mensajería de control, identificando las principales características que debe cumplir un esquema de control para sistemas heterogéneos en frecuencia. Luego, se revisan diversas técnicas matemáticas para escoger el mínimo número de canales por los cuales se transmite la información de control. Después, se introduce un modelo de un esquema de mensajería de control que use el mínimo número de canales y que utilice las características de los sistemas heterogéneos en frecuencia. Por último, se comparan diversos esquemas de mensajería de control en términos de la eficiencia de transmisión.

Abriendo mentes, cerrando estigmas. Día mundial de la Salud Mental 2014

Boletín semanal para profesionales sanitarios de la Secretaría General de Calidad, Innovación y Salud Pública de la Consejería de Igualdad, Salud y Políticas Sociales

Efficacy of prescribed injectable diacetylmorphine in the Andalusian trial: Bayesian analysis of responders and non-responders according to a multi domain outcome index.

BACKGROUND The objective of this research was to evaluate data from a randomized clinical trial that tested injectable diacetylmorphine (DAM) and oral methadone (MMT) for substitution treatment, using a multi-domain dichotomous index, with a Bayesian approach. METHODS Sixty two long-term, socially-excluded heroin injectors, not benefiting from available treatments were randomized to receive either DAM or MMT for 9 months in Granada, Spain. Completers were 44 and data at the end of the study period was obtained for 50. Participants were determined to be responders or non responders using a multi-domain outcome index accounting for their physical and mental health and psychosocial integration, used in a previous trial. Data was analyzed with Bayesian methods, using information from a similar study conducted in The Netherlands to select a priori distributions. On adding the data from the present study to update the a priori information, the distribution of the difference in response rates were obtained and used to build credibility intervals and relevant probability computations. RESULTS In the experimental group (n = 27), the rate of responders to treatment was 70.4% (95% CI 53.287.6), and in the control group (n = 23), it was 34.8% (95% CI 15.354.3). The probability of success in the experimental group using the a posteriori distributions was higher after a proper sensitivity analysis. Almost the whole distribution of the rates difference (the one for diacetylmorphine minus methadone) was located to the right of the zero, indicating the superiority of the experimental treatment. CONCLUSION The present analysis suggests a clinical superiority of injectable diacetylmorphine compared to oral methadone in the treatment of severely affected heroin injectors not benefiting sufficiently from the available treatments. TRIAL REGISTRATION Current Controlled Trials ISRCTN52023186.

The administration of atomoxetine during alcohol deprivation induces a time-limited increase in alcohol consumption after relapse.

The administration of selective serotonin reuptake inhibitors (SSRIs) typically used as antidepressants increases alcohol consumption after an alcohol deprivation period in rats. However, the appearance of this effect after the treatment with selective noradrenaline reuptake inhibitors (SNRIs) has not been studied. In the present work we examined the effects of a 15-d treatment with the SNRI atomoxetine (1, 3 and 10 mg/kg, i.p.) in male rats trained to drink alcohol solutions in a 4-bottle choice test. The treatment with atomoxetine (10 mg/kg, i.p.) during an alcohol deprivation period increased alcohol consumption after relapse. This effect only lasted one week, disappearing thereafter. Treatment with atomoxetine did not cause a behavioral sensitized response to a challenge dose of amphetamine (1.5 mg/kg, i.p.), indicating the absence of a supersensitive dopaminergic transmission. This effect is markedly different from that of SSRI antidepressants that produced both long-lasting increases in alcohol consumption and behavioral sensitization. Clinical implications are discussed.

Oral and general health-related quality of life in patients treated for oral cancer compared to control group.

BACKGROUND Health-related quality of life (HRQoL) is gaining importance as a valuable outcome measure in oral cancer area. The aim of this study was to assess the general and oral HRQoL of oral and oropharyngeal cancer patients 6 or more months after treatment and compare them with a population free from this disease. METHODS A cross-sectional study was carried out with patients treated for oral cancer at least 6 months post-treatment and a gender and age group matched control group. HRQoL was measured with the 12-Item Short Form Health Survey (SF-12); oral HRQoL (OHRQoL) was evaluated using the Oral Health Impact Profile (OHIP-14) and the Oral Impacts on Daily Performances (OIDP). Multivariable regression models assessed the association between the outcomes (SF-12, OHIP-14 and OIDP) and the exposure (patients versus controls), adjusting for sex, age, social class, functional tooth units and presence of illness. RESULTS For patients (n = 142) and controls (n = 142), 64.1% were males. The mean age was 65.2 (standard deviation (sd): 12.9) years in patients and 67.5 (sd: 13.7) years in controls. Patients had worse SF-12 Physical Component Summary scores than controls even in fully the adjusted model [β-coefficient = -0.11 (95% CI: -5.12-(-0.16)]. The differences in SF-12 Mental Component Summary were not statistically significant. Regarding OHRQoL patients had 11.63 (95% CI: 6.77-20.01) higher odds for the OHIP-14 and 21.26 (95% CI: 11.54-39.13) higher odds for OIDP of being in a worse category of OHRQoL compared to controls in the fully adjusted model. CONCLUSION At least 6 months after treatment, oral cancer patients had worse OHRQoL, worse physical HRQoL and similar psychological HRQoL than the general population.

Examining the information content of time-lapse crosshole GPR data collected under different infiltration conditions to estimate unsaturated soil hydraulic properties

Time-lapse geophysical data acquired during transient hydrological experiments are being increasingly employed to estimate subsurface hydraulic properties at the field scale. In particular, crosshole ground-penetrating radar (GPR) data, collected while water infiltrates into the subsurface either by natural or artificial means, have been demonstrated in a number of studies to contain valuable information concerning the hydraulic properties of the unsaturated zone. Previous work in this domain has considered a variety of infiltration conditions and different amounts of time-lapse GPR data in the estimation procedure. However, the particular benefits and drawbacks of these different strategies as well as the impact of a variety of key and common assumptions remain unclear. Using a Bayesian Markov-chain-Monte-Carlo stochastic inversion methodology, we examine in this paper the information content of time-lapse zero-offset-profile (ZOP) GPR traveltime data, collected under three different infiltration conditions, for the estimation of van Genuchten-Mualem (VGM) parameters in a layered subsurface medium. Specifically, we systematically analyze synthetic and field GPR data acquired under natural loading and two rates of forced infiltration, and we consider the value of incorporating different amounts of time-lapse measurements into the estimation procedure. Our results confirm that, for all infiltration scenarios considered, the ZOP GPR traveltime data contain important information about subsurface hydraulic properties as a function of depth, with forced infiltration offering the greatest potential for VGM parameter refinement because of the higher stressing of the hydrological system. Considering greater amounts of time-lapse data in the inversion procedure is also found to help refine VGM parameter estimates. Quite importantly, however, inconsistencies observed in the field results point to the strong possibility that posterior uncertainties are being influenced by model structural errors, which in turn underlines the fundamental importance of a systematic analysis of such errors in future related studies.

A combination of ascorbic acid and α-tocopherol to test the effectiveness and safety in the fragile X syndrome: study protocol for a phase II, randomized, placebo-controlled trial.

BACKGROUND Fragile X syndrome (FXS) is an inherited neurodevelopmental condition characterised by behavioural, learning disabilities, physical and neurological symptoms. In addition, an important degree of comorbidity with autism is also present. Considered a rare disorder affecting both genders, it first becomes apparent during childhood with displays of language delay and behavioural symptoms.Main aim: To show whether the combination of 10 mg/kg/day of ascorbic acid (vitamin C) and 10 mg/kg/day of α-tocopherol (vitamin E) reduces FXS symptoms among male patients ages 6 to 18 years compared to placebo treatment, as measured on the standardized rating scales at baseline, and after 12 and 24 weeks of treatment.Secondary aims: To assess the safety of the treatment. To describe behavioural and cognitive changes revealed by the Developmental Behaviour Checklist Short Form (DBC-P24) and the Wechsler Intelligence Scale for Children-Revised. To describe metabolic changes revealed by blood analysis. To measure treatment impact at home and in an academic environment. METHODS/DESIGN A phase II randomized, double-blind pilot clinical trial. SCOPE male children and adolescents diagnosed with FXS, in accordance with a standardized molecular biology test, who met all the inclusion criteria and none of the exclusion criteria. INSTRUMENTATION clinical data, blood analysis, Wechsler Intelligence Scale for Children-Revised, Conners parent and teacher rating scale scores and the DBC-P24 results will be obtained at the baseline (t0). Follow up examinations will take place at 12 weeks (t1) and 24 weeks (t2) of treatment. DISCUSSION A limited number of clinical trials have been carried out on children with FXS, but more are necessary as current treatment possibilities are insufficient and often provoke side effects. In the present study, we sought to overcome possible methodological problems by conducting a phase II pilot study in order to calculate the relevant statistical parameters and determine the safety of the proposed treatment. The results will provide evidence to improve hyperactivity control and reduce behavioural and learning problems using ascorbic acid (vitamin C) and α-tocopherol (vitamin E). The study protocol was approved by the Regional Government Committee for Clinical Trials in Andalusia and the Spanish agency for drugs and health products. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01329770 (29 March 2011).

Quality of Web-based information on obsessive compulsive disorder.

BACKGROUND: The Internet is increasingly used as a source of information for mental health issues. The burden of obsessive compulsive disorder (OCD) may lead persons with diagnosed or undiagnosed OCD, and their relatives, to search for good quality information on the Web. This study aimed to evaluate the quality of Web-based information on English-language sites dealing with OCD and to compare the quality of websites found through a general and a medically specialized search engine. METHODS: Keywords related to OCD were entered into Google and OmniMedicalSearch. Websites were assessed on the basis of accountability, interactivity, readability, and content quality. The "Health on the Net" (HON) quality label and the Brief DISCERN scale score were used as possible content quality indicators. Of the 235 links identified, 53 websites were analyzed. RESULTS: The content quality of the OCD websites examined was relatively good. The use of a specialized search engine did not offer an advantage in finding websites with better content quality. A score ≥16 on the Brief DISCERN scale is associated with better content quality. CONCLUSION: This study shows the acceptability of the content quality of OCD websites. There is no advantage in searching for information with a specialized search engine rather than a general one. Practical implications: The Internet offers a number of high quality OCD websites. It remains critical, however, to have a provider-patient talk about the information found on the Web.

Assistência institucionalizada a indivíduos portadores de deficiência mental: dimensões esquecidas

O estudo foi realizado em uma instituição que existe indivíduos portadores de deficiência mental. Aqui denominada CASA GRANDE, a instituição abriga cerca de 900 internos. O cuidado direto aos internos é prestado por aproximadamente 400 pajens, formalmente subordinadas ao Serviço de Enfermagem. O propósito desse estudo foi conhecer e compreender como se dá o trabalho das pajens nesse contexto. Para tanto, partiu-se das representações que estas tem à respeito desse cuidar. A análise dessas representações propiciou a compreensão da dimensão simbólica desse trabalho, bem como da psicodinâmica aí compreendida, tanto ao nível da mulher trabalhadora, grupo e instituição.

Factor de riesgo cardiovascular en el trastorno mental severo

Antecedentes: Existe la percepción de que los pacientes con trastorno mental severo (TMS) presentan una mayor prevalencia de factores de riesgo cardiovascular (FRCV) y un menor control de los mismos en comparación con la población general. Objetivos: Conocer la prevalencia de los FRCV y hábitos tóxicos en pacientes con TMS y evaluar el seguimiento por la Atención Primaria (AP) en los que presentan un riesgo vascular elevado. Diseño y metodología: Se realizó un estudio descriptivo de prevalencia y de seguimiento en una muestra representativa de los pacientes con diagnóstico de TMS seguidos en el Centro de salud mental de Mataró. Se registraron los parámetros antropométricos, los FRCV, hábitos tóxicos, perfil lipídico y tratamientos farmacológicos. Se calculó el RCV mediante las tablas de REGICOR. Los pacientes con un RCV & 10% fueron derivados a AP para valorar la estrategia terapéutica. Se evaluó el seguimiento por parte de los especialistas a los 4 meses y en Atención Primaria a los 6-9 meses. Resultados: Se realizaron 112 entrevistas en el centro de Salud Mental de Mataró; 62% eran hombres y 38% mujeres, con una edad media de 43 ± 11,9 años. La obesidad abdominal fue el FRCV más prevalente (62%), le siguió el tabaquismo en un 58,9%, el sedentarismo con un 48,2% y la dislipemia 42%. El 66,8% de los pacientes eran portadores de tratamiento con antipsicóticos atípicos, lo que se asocia con un mayor RCV. Un total de 102 pacientes (91% de la muestra) presentaban uno o más FRCV, 98 de los mismos tenían un RCV & 10 y 4 presentaron un RCV & 10. Se derivaron 6 pacientes a la AP para control de los FRCV, de los que 3 nunca habían sido atendidos en AP. A los 9 meses fueron visitados el 50% de los derivados a AP, y se consiguió reducir el RCV & 10 en un 50% de los que se le hizo la recomendación de seguimiento. Conclusión: Los pacientes con TMS acuden habitualmente a las consultas de AP para el control de los FRCV. La prevalencia de FRCV en pacientes con TMS es superior a la población general. El porcentaje de pacientes con RCV elevado según el REGICOR es bajo.

El entorno terapéutico de los cuidados de enfermería desde una visión de la promoción de la salud mental

La promoción de la salud mental es una faceta importante de la promoción general de la salud. Teniendo en cuenta los niveles de estrés y de conflicto que soportan las personas y las comunidades, es preciso redoblar esfuerzos para promover la salud mental. Uno de los objetivos de la promoción de la salud en este ámbito es identificar las conductas inadaptadas de los pacientes y promover las actividades personales y psicológicas más eficaces para poder planificar los cuidados de enfermería en un entorno terapéutico favorable. La OMS está examinando los datos disponibles sobre la eficacia de las actividades de fomento de la salud mental y ha propuesto nuevas políticas y modelos de cambio de la asistencia: enfoque comunitario y desinstitucionalización, integración de la atención en salud mental con los servicios generales de salud, la colaboración intersectorial, enfoques multidisciplinarios, reorientar las funciones de los profesionales y evitar el estigma de las personas con problemas mentales. Así mismo también se han propuesto diez áreas de acción: Apoyo a los padres y a los primeros años de vida, promover la salud mental en las escuelas, promover la salud mental en el lugar de trabajo, apoyo en el envejecimiento mentalmente sano, en grupos de riesgo de trastornos mentales, prevenir la depresión y el suicidio, prevenir la violencia y el uso de sustancias nocivas, involucrar a la atención primaria y secundaria, reducir la situación de desventaja y evitar el estigma, trabajo intersectorial. Los profesionales de enfermería de salud mental han de proporcionar los cuidados teniendo en cuenta a los nuevos modelos de atención en salud mental y las acciones propuestas

Tentativas inovadoras na prática de ensino e assistência na área de saúde mental - I

RESUMO No atual contexto de transformações no campo da assistência à saúde mental no Brasil, a Universidade tem a responsabilidade de redirecionar a qualificação profissional da força de trabalho em saúde. Este artigo versa sobre a experiência de um Programa de Integração Docente-Assistencial envolvendo a Secretaria de Estado de Saúde e a Universidade de São Paulo. Particulariza a experiência de estudantes de enfermagem cursando a disciplina de enfermagem psiquiátrica. A análise da avaliação dos alunos do programa teórico-prático desenvolvido na unidade, ancorado nos pressupostos da Reabilitação Psicossocial indica, ao mesmo tempo, que o modelo de atenção interfere diretamente na qualificação das práticas e, simultaneamente, desenvolve nos alunos atitudes e conhecimentos que os qualificam para desempenhar de forma coerente suas funções.

Non-medical prescription drug and illicit street drug use among young Swiss men and associated mental health issues.

Non-medical use of prescription drugs (NMUPD) is increasing among the general population, particularly among teenagers and young adults. Although prescription drugs are considered safer than illicit street drugs, NMUPD can lead to detrimental consequences. The aim of the present study was to investigate the relationship between drug use (NMUPD on the one side, illicit street drugs on the other side) with mental health issues and then compare these associations. A representative sample of 5719 young Swiss men aged around 20 years filled in a questionnaire as part of the ongoing baseline Cohort Study on Substance Use Risk Factors (C-SURF). Drug use (16 illicit street drugs and 5 NMUPDs, including sleeping pills, sedatives, pain killers, antidepressants, stimulants) and mental health issues (depression, SF12) were assessed. Simple and multiple linear regressions were employed. In simple regressions, all illicit and prescription drugs were associated with poorer mental health. In multiple regressions, most of the NMUPDs, except for stimulants, were significantly associated with poorer mental health and with depression. On the contrary, the only associations that remained significant between illicit street drugs and mental health involved cannabis. NMUPD is of growing concern not only because of its increasing occurrence, but also because of its association with depression and mental health problems, which is stronger than the association observed between these problems and illicit street drug use, excepted for cannabis. Therefore, NMUPD must be considered in screening for substance use prevention purposes.

Reflexões sobre o processo de cuidar da enfermagem em saúde mental

Trata-se de um ensaio sobre o processo de trabalho da enfermagem em saúde mental. Diversas concepções têm fundamentado a assistência psiquiátrica, assim como as propostas de reorientação dessas práticas; a enfermagem tem suas práticas referidas a esse processo. É a visão de mundo dos profissionais que determina a escolha de uma determinada tendência e o entendimento do processo saúde-doença. A necessidade de rever o seu objeto de trabalho, assim como sua prática frente às transformações na assistência em saúde mental, tem apontado para novas posturas profissionais frente ao sujeito com transtornos psíquicos, assim como para a aquisição de conhecimento para além dos adquiridos nos cursos de graduação.

O atendimento do doente mental em pronto-socorro geral: sentimentos e ações dos membros da equipe de enfermagem

Estuda-se aqui o cotidiano de assistência ao doente mental apresentado pelos membros da equipe de enfermagem de um Pronto-Socorro Geral. Os objetivos foram descrever os sentimentos destes indivíduos em relação ao doente mental e seu atendimento naquele local e analisar como é oferecida esta assistência. A relação dinâmica entre pensar, sentir e agir, demonstrou que a maioria dos indivíduos estudados apresentava fortes concepções de senso comum. Os sentimentos variavam entre pena, medo e raiva, dependendo do tipo de comportamento apresentado pelos pacientes. O atendimento prestado foi quase exclusivamente voltado aos aspectos técnicos da profissão, em uma vertente organicista/biológica.