Affective Instability, Childhood Trauma and Major Affective Disorders

Background and Aims Affective instability (AI), childhood trauma, and mental illness are linked, but evidence in affective disorders is limited, despite both AI and childhood trauma being associated with poorer outcomes. Aims were to compare AI levels in bipolar disorder I (BPI) and II (BPII), and major depressive disorder recurrent (MDDR), and to examine the association of AI and childhood trauma within each diagnostic group. Methods AI, measured using the Affective Lability Scale (ALS), was compared between people with DSM-IV BPI (n = 923), BPII (n = 363) and MDDR (n = 207) accounting for confounders and current mood. Regression modelling was used to examine the association between AI and childhood traumas in each diagnostic group. Results ALS scores in descending order were BPII, BPI, MDDR, and differences between groups were significant (p < 0.05). Within the BPI group any childhood abuse (p = 0.021), childhood physical abuse (p = 0.003) and the death of a close friend in childhood (p = 0.002) were significantly associated with higher ALS score but no association was found between childhood trauma and AI in BPII and MDDR. Conclusions AI is an important dimension in bipolar disorder independent of current mood state. There is a strong link between childhood traumatic events and AI levels in BPI and this may be one way in which exposure and disorder are linked. Clinical interventions targeting AI in people who have suffered significant childhood trauma could potentially change the clinical course of bipolar disorder.

Effects of age and body mass on development of diving capabilities of gray seal pups: costs and benefits of the postweaning fast

Development of adequate diving capabilities is crucial for survival of seal pups and may depend on age and body size. We tracked the diving behavior of 20 gray seal pups during their first 3 mo at sea using satellite relay data loggers. We employed quantile analysis to track upper limits of dive duration and percentage time spent diving, and lower limits of surface intervals. When pups first left the breeding colony, extreme (ninety-fifth percentile) dive duration and percentage time spent diving were positively correlated with age, but not mass, at departure. Extreme dive durations and percentage time spent diving peaked at [Formula: see text] d of age at values comparable with those of adults, but were not sustained. Greater peaks in extreme percentage time spent diving occurred in pups that had higher initial values, were older at their peak, and were heavier at departure. Pups that were smaller and less capable divers when they left the colony improved extreme dive durations and percentage time spent diving more rapidly, once they were at sea. Minimum survival time correlated positively with departure mass. Pups that were heavier at weaning thus benefitted from being both larger and older at departure, but smaller pups faced a trade-off. While age at departure had a positive effect on early dive performance, departure mass impacted on peak percentage time spent diving and longer-term survival. We speculate that once small pups have attained a minimum degree of physiological development to support diving, they would benefit by leaving the colony when younger but larger to maximize limited fuel reserves, rather than undergoing further maturation on land away from potential food resources, because poor divers may be able to "catch up" once at sea.

Panorama y tendencias de la telemática en salud, hablando de telemedicina

Este trabajo describe las experiencias internacionales en el área de la Telemedicina a través de los encuentros y conferencia internacional que desde el 2001 hasta el 2003 han sido realizadospor la Asociación Americana de Telemedicina y por la SociedadInternacional para Telemedicina, respectivamente. Las tendencias de la Telemedicina están orientadas para producir unefecto sinérgico de compartir, acompañar y colaborar en esfuerzos en un escenario mundial. América Latina y Colombia con el Centro de Telemedicina, han participado con experienciasen el área de servicios médicos de telemedicina, por ejemplo en teleoftalmología, tele-dermatología, teleotorrinolaringología,tele-simulación quirúrgica virtual y estrategias de aprendizaje a distancia. Telemedicina y la simulación médica son un desafío para América Latina y sus equipos de telemedicina.

Lucretius: the Wonderer

I seek to create a Lucretius text useful for a high school classroom including a commentary on four sections of the poem. The passages include 2.998 – 1047 which explains how the Epicurean atomic theory, 3.912—979 the famous passage that denies the underworld and its tortures, 5.855 – 923 the semi-Darwinian passage detailing the sorts of creatures that can exist in this world, and 5.1194– 1240 about the detrimental effects of humans fearing gods. In addition to writing a commentary on these passages, I will explore the perception of Lucretius though the present day, in hopes of discovering how and why this important and influential author has been so systematically excluded from secondary latin literary studies. My discussion will include an overview of how modern Latin textbooks do or do not mention Lucretius and how his presence in these textbooks compares to his role in university-level Latin course offerings. In addition to writing a commentary on these passages, I will explore the perception of Lucretius though the present day, in hopes of discovering how and why this important and influential author has been so systematically excluded from secondary latin literary studies. My discussion will include an overview of how modern Latin textbooks do or do not mention Lucretius and how his presence in these textbooks compares to his role in university-level Latin course offerings. I am hoping this research will be useful both pedagogically and for learning how decisions about literary content are made in American secondary and higher education in Latin.

Application of fuzzy logic for the evaluation of livestock slaughtering

A lógica fuzzy admite infinitos valores lógicos intermediários entre o falso e o verdadeiro. Com esse princípio, foi elaborado neste trabalho um sistema baseado em regras fuzzy, que indicam o índice de massa corporal de animais ruminantes com objetivo de obter o melhor momento para o abate. O sistema fuzzy desenvolvido teve como entradas as variáveis massa e altura, e a saída um novo índice de massa corporal, denominado Índice de Massa Corporal Fuzzy (IMC Fuzzy), que poderá servir como um sistema de detecção do momento de abate de bovinos, comparando-os entre si através das variáveis linguísticas )Muito BaixaM, ,BaixaB, ,MédiaM, ,AltaA e Muito AltaM. Para a demonstração e aplicação da utilização deste sistema fuzzy, foi feita uma análise de 147 vacas da raça Nelore, determinando os valores do IMC Fuzzy para cada animal e indicando a situação de massa corpórea de todo o rebanho. A validação realizada do sistema foi baseado em uma análise estatística, utilizando o coeficiente de correlação de Pearson 0,923, representando alta correlação positiva e indicando que o método proposto está adequado. Desta forma, o presente método possibilita a avaliação do rebanho, comparando cada animal do rebanho com seus pares do grupo, fornecendo desta forma um método quantitativo de tomada de decisão para o pecuarista. Também é possível concluir que o presente trabalho estabeleceu um método computacional baseado na lógica fuzzy capaz de imitar parte do raciocínio humano e interpretar o índice de massa corporal de qualquer tipo de espécie bovina e em qualquer região do País.

Hydration status using free water reserve in Portuguese adolescents

Introduction: Few data is available about the hydration status of active adolescents in free living conditions. Cell dehydration may be prevalent in healthy, free-living children at school and they could be in a state of chronic voluntary dehydration. Objective: This study aims to describe hydration status assessed by Free Water Reserve (FWR) in adolescents. Method: Two hundred participants (118 girls), aged 13-18 years completed the study. Urinary volume (ml/d) and urinary osmolality (mosm/kg) were measured by one 24h urinary collection, and coefficient of creatinine was used to validate completeness of urine collections. FWR (measured urine volume minus the obligatory urine volume) was used for characterization of hydration status. Positive values of FWR indicate euhydration, negative values the risk of hypo-hydration. Results: Median urinary volume excretion was 1100.0 ml/d for boys and 1025.0 ml/d for girls (p=0.923). Mean urinary osmolality was 715.7±172.3 mosm/kg for boys and 597.42±193.1 mosm/kg for girls (p=0.247). Median FWR (ml/24h) was positive in both sex groups (173.2 ml/d in boys and 373.2 ml/d in girls); however, 40.2% of boys and 31.4% of girls (p=0.195) were at risk of hypo-hydration status. Conclusions: In this sample of adolescents approximately one third was classified as at risk of hypo-hydration status. Preventive measures to increase the level of total water intake should be considered.

A MARKET-BASED APPROACH TO 3D PRINTING FOR ECONOMIC DEVELOPMENT IN GHANA

The purpose of this report is to create the foundation for further study of a market-based approach to 3D printing as an instrument for economic development in Ghana. The delivery of improved products and services to the most underserved markets is needed to spur economic activity and improve standards of living. The relationship between economic development and the advancement of technology is considered within the context of Ghana. An opportunity for market entry exists within both the bottom of the economic pyramid and the mid-segment market. 3D printing (additive manufacturing) has proven to be a disruptive technology that has demonstrated an ability to expedite the speed of innovations and create products that were previously not possible. An investigation of how 3D printers can be used to create improved products for the most underserved markets within Ghana is presented. Questions are asked to elucidate how and when adoption of 3D printers and 3D printed products may occur in the future. Based upon the existing barriers to adoption, 3D printing technology must improve before widespread adoption will occur in Ghana.

Wildfire Assessment Using FARSITE Fire Modeling: A Case Study in the Chihuahua Desert of Mexico

The Chihuahua desert is one of the most biologically diverse ecosystems in the world, but suffers serious degradation because of changes in fire regimes resulting in large catastrophic fires. My study was conducted in the Sierra La Mojonera (SLM) natural protected area in Mexico. The purpose of this study was to implement the use of FARSITE fire modeling as a fire management tool to develop an integrated fire management plan at SLM. Firebreaks proved to detain 100% of wildfire outbreaks. The rosetophilous scrub experienced the fastest rate of fire spread and lowland creosote bush scrub experienced the slowest rate of fire spread. March experienced the fastest rate of fire spread, while September experienced the slowest rate of fire spread. The results of my study provide a tool for wildfire management through the use geospatial technologies and, in particular, FARSITE fire modeling in SLM and Mexico.

Índice general de fuerza y adiposidad como medida de la condición relacionada con la salud en niños y adolescentes de Bogotá, Colombia: Estudio FUPRECOL

Objetivos: El presente estudio tuvo por objetivo general (1) determinar los valores de referencia de la condición muscular mediante el índice general de fuerza (IGF) y como objetivo específico, (2) estudiar si el IGF está relacionado con indicadores de adiposidad en niños y adolescentes escolares de Bogotá, Colombia. Métodos: Del total de 7.268 niños y adolescentes (9-17.9 años) evaluados en el estudio FUPRECOL, 4.139 (57%) fueron mujeres. Se evaluó el IGF como marcador del desempeño muscular a partir de la tipificación de las pruebas de fuerza prensil (FP) y salto longitud (SL). El IGF se recodificó en cuartiles (Q), siendo el Q4 la posición con mejor valor del IGF. El índice de masa corporal (IMC), la circunferencia de cintura (CC), el índice cintura/talla (ICT) y el porcentaje de grasa corporal (%GC) por Bioimpedancia eléctrica, se midieron como marcadores de adiposidad. Resultados: La edad media de los evaluados fue 12,8±2,3 años. Se aprecia una tendencia hacia un incremento del nivel de condición física muscular en los varones conforme aumenta la edad, y hacia la estabilidad o un ligero aumento en el caso de las mujeres. El IGF se relacionó inversamente con el ICT y %GC en los varones (r= -0,280, r= -0,327 p<0,01), respectivamente. Los escolares ubicados en el Q4 del IGF, presentaron menores valores en marcadores de adiposidad IMC, CC, ICT y %GC, p<0,01 que su contraparte del Q1. Conclusión: Se presentan valores de referencia del IGF a partir de la estandarización de los resultados obtenidos en la FP y SL. La evaluación de la fuerza muscular en edades tempranas permitirá implementar programas de prevención de riesgo cardiovascular y metabólico futuro

Luxación esternoclavicular posterior

Paciente masculino de 24 años, ingresa a urgencias por trauma contundente en clavícula derecha durante accidente de tránsito. Presenta dolor en articulación esternoclavicular que se exacerba con la movilización del hombro y disfagia. Al examen físico, leve depresión del extremo medial de la clavícula y limitación de los arcos de movimiento del hombro. Las imágenes confirmaron el diagnostico de LEC posterior. El paciente fue llevado a cirugía para reducción y cerclaje, sin complicaciones.

Propiedades psicométricas de los instrumentos para la medición de la actividad física en adultos con discapacidad física relacionada con lesión de médula espinal: una revisión sistemática

Objetivo: Evaluar las propiedades psicométricas de los instrumentos para la medición de la actividad física en adultos de 18-65 años con discapacidad física por lesión de médula espinal. Materiales y métodos: Revisión sistemática. Las bases de datos de Medline, Scopus, Web of Science y 19 revistas especializadas fueron consultadas durante once días entre abril de 2015 y febrero de 2016 para identificar estudios originales de validación, sin límite de tiempo y que estuvieran publicados en español, francés y/o inglés. La calidad metodológica de los instrumentos de medición se evaluó usando las diferentes cajas de propiedades de la lista COSMIN. Resultados: Se identificaron 9229 referencias, de las cuales sólo 12 cumplieron los criterios de inclusión, dando como resultado 13 instrumentos de medición. Se evaluaron seis propiedades psicométricas. La propiedad más común fue la confiabilidad, además se observó que la calidad metodológica de los estudios incluidos no representa los resultados de las propiedades psicométricas de los instrumentos de medición. La calidad metodológica de los instrumentos para la evaluación de la actividad física en población con lesión medular espinal es “baja” para propiedades como consistencia interna, error de medición, sensibilidad, validez de criterio (con excepción del WISCI II que tiene buena validez) y excelente para validez de contenido y fiabilidad. Conclusión: Se ha encontrado que instrumentos empleados hasta el presente en la medición de la actividad física en población con discapacidad física relacionada con lesión de médula espinal han sido creados para otros tipos de discapacidad y otros instrumentos deben ser validados en futuros estudios.

As bases da assistência psiquiátrica no Brasil

Este objeto aborda de início o a construção do Hospício de Pedro II em 1852 e as numerosas críticas que recebeu por parte dos médicos até 1890 quando passou a Hospital Nacional dos Alienados e dirigido pelo médico Juliano Moreira. Segue mostrando o Decreto de 1903 que estabelecia o recolhimento a estabelecimento de alienados e também o de 1934 que instituiu o Conselho de Proteção aos Psicopatas. Termina abordando a criação de hospícios-colônia nas capitais e grandes cidades e a tendência à privatização da saúde. Unidade 1 do módulo 9 que compõe o Curso de Especialização em Saúde da Família.