Trauma, risk, and resilience: A qualitative study of mental health in post-conflict Liberia.

The Liberian civil wars led to widespread destruction and devastation for its individuals, communities, and economy. However, individuals' subjective trauma experiences and long-term psychological impact remain relatively understudied. This study aims to explore context-specific traumatic events and examine how risk and protective factors combine with traumas to influence trajectories of suffering and recovery over time. We conducted 43 semi-structured interviews with Liberian adults who were present during the Liberian civil wars, and we used line-by-line open coding, thematic analysis, and axial coding to analyze and contextualize the data. Eight key trauma themes emerged: Abuse (emotional, physical, and sexual), Captivity, Combat, Killings, Physical Illness, Resource Loss, Family Separation, and War Environment. The risk and protective factors that were reported as salient were: Age, Biological Sex, Socioeconomic Status, and Community Support. Further, key patterns emerged across interviews that indicated greater risk for long-term suffering: 1) exposure to multiple traumatic events, 2) certain types of traumatic events (like killing of a close family member), and 3) the combination of specific traumatic events and risk and protective factors (like older women witnessing the killing of their children). This study provides culturally relevant information on trauma, suffering, and resilience in post-conflict Liberia, with the aim of guiding the development of screening tools and targeted psychological interventions that improve well-being over time.

Software de Biología Molecular como herramienta educativa en el primer año de la carrera demedicina

Introducción: La asignatura Biología Molecular constituye un gran desafío para los estudiantes del primer año de Medicina, pues se imparte en la etapa de adaptación a la Educación Superior. El objetivo de esta investigación consistió en confeccionar un software educativo offline de la asignatura Biología Molecular como instrumento de trabajo que permitiera aplicar una nueva estrategia metodológica del proceso de enseñanza-aprendizaje de los profesores y estudiantes del primer año de la carrera de Medicina. Método: Se programó en HTML y se distribuyó a todos los estudiantes y profesores de la asignatura Biología Molecular del curso 2021. Se aplicó una nueva estrategia metodológica altamente participativa de los estudiantes. Se analizaron los resultados académicos de 279 estudiantes que examinaron en las tres convocatorias de exámenes finales de la asignatura, midiendo y graduando el rendimiento académico obtenido con el empleo del software educativo. Resultados: El software educativo diseñado con apariencia de un sitio Web presenta un menú principal con opciones de presentación, instrucciones, plan calendario, conferencias, guías de estudio para las clases talleres, autoevaluaciones y una biblioteca. Funciona en cualquier dispositivo que posea un navegador de internet. Se alcanzó un elevado rendimiento académico acompañado de una alta calidad del mismo. Conclusiones: El software educativo fue empleado exitosamente por estudiantes y profesores; constituyó la herramienta fundamental para el cambio metodológico aplicado en la impartición de la asignatura y se obtuvo un elevado rendimiento académico por parte de los estudiantes.

Introduction: The subject Molecular Biology constitutes a great challenge for the students of the first year of Medicine, since it is taught in the stage of adaptation to Higher Education. The objective of this research was to develop an educational software for the subject of Molecular Biology as a working tool that would allow the application of a new methodological strategy for the teaching-learning process of teachers and students of the first year of Medicine. Method: The educational software was programmed in HTML and distributed to all students and teachers of the subject Molecular Biology of the 2021 course. A new methodological highly participative strategy of students was applied. The academic results of 279 students who took the three final exams of the course were analyzed, measuring and grading the academic performance obtained with the use of the educational software. Results: The educational software designed to look like a website presents a main menu with presentation options, instructions, calendar plan, lectures, study guides for classes, workshops, self-evaluations and a library. It works on any device with a web browser. High academic performance accompanied by high academic quality was achieved. Conclusions: The educational software was successfully employed by students and teachers, which was fundamental for the methodological change applied in the teaching of the subject with a high academic performance.

Software educativo de Metabolismo-Nutrición para el proceso docente del primer año de medicina en la facultad "Victoria de Girón"

Introducción: La asignatura Metabolismo-Nutrición es una asignatura que los estudiantes del primer año de Medicina asimilan con mayor facilidad que su predecesora Biología Molecular. Esto se debe al intenso entrenamiento en esta última y al haber pasado la adaptación del primer periodo. El objetivo de esta investigación consistió en confeccionar un software educativo offline de la asignatura de Metabolismo-Nutrición como instrumento de trabajo que permitiera continuar aplicando otra nueva estrategia metodológica del proceso de enseñanza-aprendizaje de los profesores y estudiantes del primer año de la carrera de Medicina, basada en las esencialidades de los procesos metabólicos a estudiar en la misma. Materiales y métodos: El software educativo se programó en HTML y se distribuyó a todos los estudiantes y profesores de la asignatura Metabolismo-Nutrición del curso 2021. Se aplicó una nueva estrategia metodológica altamente participativa de los estudiantes y se implementó un algoritmo como estrategia metodológica de las "invariantes para el estudio de una vía o proceso metabólico". Se analizaron los resultados académicos de 227 estudiantes que examinaron en las tres convocatorias de exámenes finales de la asignatura, midiendo y graduando el rendimiento académico obtenido con el empleo del software educativo. Resultados: El software educativo diseñado con apariencia a un sitio web presenta un menú principal con opciones de presentación, orientaciones, plan calendario, trabajo extraclase, conferencias, guías de estudio para las clases talleres, autoevaluaciones y una biblioteca. Funciona en cualquier dispositivo que posea un navegador de internet. Se alcanzó un elevado rendimiento académico acompañado de una alta calidad del mismo. Conclusiones: El software educativo fue empleado exitosamente por estudiantes y profesores, lo que fue fundamental para el cambio metodológico aplicado en la impartición de la asignatura con un elevado rendimiento académico.

Introduction: Metabolism-Nutrition is a subject that first-year medical students assimilate more easily than its predecessor Molecular Biology. This is due to the intense training in the latter and to having passed the adaptation of the first period. The objective of this research was to develop an offline educational software for the Metabolism-Nutrition subject as a working tool that would allow the continued application of another new methodological strategy for the teaching-learning process of teachers and students in the first year of the Medicine course, based on the essential aspects of the metabolic processes to be studied. Materials and methods: The educational software was programmed in HTML and distributed to all students and teachers of the Metabolism-Nutrition course of the 2021 course. A new highly participative methodological strategy was applied to the students and an algorithm was implemented as a methodological strategy of the "invariants for the study of a metabolic pathway or process". The academic results of 227 students who examined in the three final exams of the subject were analyzed, measuring and grading the academic performance obtained with the use of the educational software. Results: The educational software designed with the appearance of a website presents a main menu with presentation options, orientations, calendar plan, extra-class work, conferences, study guides for the classes, workshops, self-evaluations and a library. It works on any device with a web browser. High academic performance accompanied by high academic quality was achieved. Conclusions: The educational software which was fundamental for the methodological change applied in the teaching of the subject was successfully employed by students and teachers, with a high academic performance.

Gender differences in eating disorder psychopathology across DSM-5 severity categories of anorexia nervosa and bulimia nervosa.

OBJECTIVE: This study examined whether patterns of eating-disorder (ED) psychopathology differed by gender across DSM-5 severity specifiers in anorexia nervosa (AN) and bulimia nervosa (BN). METHOD: We tested whether ED psychopathology differed across DSM-5 severity specifiers among 532 adults (76% female) in a residential treatment center with AN or BN. We hypothesized that severity of ED psychopathology would increase in tandem with increasing severity classifications for both males and females with AN and BN. RESULTS: Among females with BN, DSM-5 severity categories were significantly associated with increasing ED psychopathology, including Eating Disorder Examination-Questionnaire dietary restraint, eating concern, shape concern, and weight concern; and Eating Disorder Inventory drive for thinness and bulimia. ED psychopathology did not differ across DSM-5 severity levels for males with BN. For both males and females with AN, there were no differences in ED psychopathology across severity levels. DISCUSSION: Results demonstrate that DSM-5 severity specifiers may function differently for males versus females with BN. Taken together, data suggest DSM-5 severity specifiers may not adequately capture severity, as intended, for males with BN and all with AN. Future research should evaluate additional clinical validators of DSM-5 severity categories (e.g., chronicity, treatment non-response), and consider alternate classification schemes.

Global/local processing style: Explaining the relationship between trait anxiety and binge eating.

OBJECTIVE: Anxiety is a risk factor for disordered eating, but the mechanisms by which anxiety promotes disordered eating are poorly understood. One possibility is local versus global cognitive processing style, defined as a relative tendency to attend to details at the expense of the "big picture." Anxiety may narrow attention, in turn, enhancing local and/or compromising global processing. We examined relationships between global/local processing style, anxiety, and disordered eating behaviors in a transdiagnostic outpatient clinical sample. We hypothesized that local (vs. global) processing bias would mediate the relationship between anxiety and disordered eating behaviors. METHOD: Ninety-three participants completed the eating disorder examination-questionnaire (EDE-Q), State-Trait Anxiety Inventory (STAI)-trait subscale, and the Navon task (a test of processing style in which large letters are composed of smaller letters both congruent and incongruent with the large letter). The sample was predominantly female (95%) with a mean age of 27.4 years (SD = 12.1 years). RESULTS: Binge eating, but not fasting, purging, or excessive exercise, was correlated with lower levels of global processing style. There was a significant indirect effect between anxiety and binge eating via reduced global level global/local processing. DISCUSSION: In individuals with disordered eating, being more generally anxious may encourage a detailed-oriented bias, preventing individuals from maintaining the bigger picture and making them more likely to engage in maladaptive behaviors (e.g., binge eating).

Won't stop or can't stop? Food restriction as a habitual behavior among individuals with anorexia nervosa or atypical anorexia nervosa.

Food restriction among individuals with anorexia nervosa (AN) is regarded as a goal-directed behavior. However, Walsh (2013) theorized that, although restriction is initially maintained by operant conditioning (with successful weight loss and external praise as salient rewards), it ultimately becomes a classically conditioned habit, persisting regardless of the presence of these once-salient rewards. Understanding food restriction as a well-ingrained habit may provide insight into treatment resistance. Further, it is not clear whether habitual food restriction is present among individuals with atypical AN (i.e. who engage in food restriction but are not low-weight). This study evaluated whether strength of habit predicted self-reported restriction above and beyond cognitive restraint. Seventy-eight individuals with AN or atypical AN completed the Eating Pathology Symptoms Inventory Restriction (EPSI-R) and Cognitive Restraint (EPSI-CR) subscales and the Self-Report Habit Index (SRHI) adapted for food restriction. We used a hierarchical multiple regression model to test whether habit strength predicted food restriction above and beyond cognitive restraint. After adding illness duration (step 1) and diagnosis (step 2) to the model, cognitive restraint (step 3) was not significant in explaining variation in restriction, whereas adding habit strength to the model (step 4) explained 27.9% of the variance in restriction (p<0.001). This is the first study to test a key component of Walsh's theory. Results provide support for food restriction maintenance through habit, rather than through effortful cognitive restraint. Because current models of AN characterize food restriction as purposeful, further research is needed to better understand habitual restriction in AN.

Can unipolar and bipolar pediatric major depression be differentiated from each other? A systematic review of cross-sectional studies examining differences in unipolar and bipolar depression.

INTRODUCTION: While pediatric mania and depression can be distinguished from each other, differentiating between unipolar major depressive disorder (unipolar MDD) and bipolar major depression (bipolar MDD) poses unique clinical and therapeutic challenges. Our aim was to examine the current body of knowledge on whether unipolar MDD and bipolar MDD in youth could be distinguished from one another in terms of clinical features and correlates. METHODS: A systematic literature search was conducted on studies assessing the clinical characteristics and correlates of unipolar MDD and bipolar MDD in youth. RESULTS: Four scientific papers that met our priori inclusion and exclusion criteria were identified. These papers reported that bipolar MDD is distinct from unipolar MDD in its higher levels of depression severity, associated impairment, psychiatric co-morbidity with oppositional defiant disorder, conduct disorder and anxiety disorders, and family history of mood and disruptive behavior disorders in first-degree relatives. LIMITATIONS: Though we examined a sizeable and diverse sample, we were only able to identify four cross sectional informative studies in our review. Therefore, our conclusions should be viewed as preliminary. CONCLUSIONS: These findings can aid clinicians in differentiating the two forms of MDD in youth.

Can manic switches be predicted in pediatric major depression? A systematic literature review.

BACKGROUND: The rate of switching from major depression to bipolar disorder is high in children. Predicting who is at risk for switching poses unique challenges and is of high clinical relevance. Our aim was to examine the existing scientific literature elucidating if certain clinical correlates predict ultimate bipolar switches in children initially presenting with a depressive episode. METHODS: We conducted a systematic literature search of studies assessing the risk factors for bipolar switching in youth. In all, seven studies fit our a priori criteria and were thus included in our qualitative review. RESULTS: Together, these papers found that manic switches in pediatric depression can be predicted by several risk factors, including positive family history of mood disorders, emotional and behavioral dysregulation, subthreshold mania, and psychosis. LIMITATIONS: We identified only seven prospective informative studies for our review. The majority of subjects included in these studies were referred and Caucasian. Thus, the results may not generalize to other community samples and other ethnicities. CONCLUSIONS: These findings can help alert clinicians of the risk of manic switches.

Lipoproteína (a): estructura, metabolismo, genética y mecanismos patogénicos / Lipoprotein (a): structure, metabolism, genetics and pathogenic mechanisms

Se establecieron las características más sobresalientes de la lipoproteína (a), así como los mecanismos patogénicos de esta partícula lipoproteínica relacionados con la aterotrombogénesis. La lipoproteína (a) [Lp (a)], descubierta por Kare Berg en 1963, posee una composición similar a la de la lipoproteína de baja densidad (LDL). En su estructura también presenta a la apolipoproteína (a) [apo (a)], la cual está unida a la apo B100 mediante un enlace disulfuro. El aspecto más interesante de la biología de la Lp (a) lo constituye, sin dudas, la sorprendente homología estructural que existe entre el plasminógeno y la apo (a); esta apolipoproteína, además, es la responsable de las propiedades metabólicas y bioquímicas de la lipoproteína (a). Por su estructura peculiar y la correlación existente entre los niveles elevados de la Lp (a) y el desarrollo de complicaciones aterotrombóticas, esta lipoproteína se ha convertido en el objeto de numerosas investigaciones

Papel del estrés oxidativo en la infertilidad masculina / Role of the oxidative stress in male infertility

Resulta incuestionable la participación del estrés oxidativo en la patogenia de la infertilidad masculina. Una buena parte de los pacientes que sufren de este padecimiento presentan niveles elevados de especies reactivas del oxígeno, cuya presencia en el semen constituye un reflejo del desbalance entre su producción por los elementos celulares y su degradación por los sistemas antioxidantes. Como consecuencia de este desequilibrio, los lipoperóxidos generados dan al traste con la capacidad fertilizante de los espermatozoides. La determinación de indicadores de daño oxidativo y defensa antioxidante proporciona una información muy útil sobre la calidad de la espermatogénesis y resulta de gran valor para el diagnóstico de la infertilidad que involucra al estrés oxidativo y en la selección de los pacientes para la terapia antioxidante

Sídrome de Melkersson Rosenthal: presentación de un caso / Melkersson Rosenthal syndrome: case report

Se presenta el caso de una mujer de 24 años de raza negra que consultó al médico por aumento de volumen del labio superior , desde hacia dos años , con periodos de remisión incompletos sin relacion causal aparente y lengua plicata, que no logró mejoria con los medicaqmentos , incluidos los esteroides. Los exámenes com0plementarios fueron negativos, excepto la biopsia co9mpatible con quielitis granulomatosa. se concluye que el síndrome de melkerson Rosenthal debe tenerse en cuenta ante cualquier paciente con aumento de volumen recurrente de los labios y lengua plicata, acompañado o no de manifestaciones neurológicas como la parálisis facial.

Estado de anergia en pacientes neoplásicos / The state of anergy in neoplastic patients

A una muestra de 121 casos de neoplasias malignas no tratadas de diferentes localizaciones. Etapa clínica e histología se les realizó una bateria de pruebas de hipersensibilidad cutanea tardía con antígenos primarios (DNCB) y de memoria (PPD, candidina, tricofitina), se evaluaron 3 tipos de respuestas: anergicos, hiporreactivos y normales, y se investigó si variables como etapa clínica y tipo histológico ejercian influencias en las respuestas halladas. Estos resultados se comparan con un grupo control de individuos sanos, ajustados en cuanto a edad y sexo con la muestra. La incidencia de respuestas anormales fue significativamente más elevada (p < 0,005) en el grupo neoplásico a expensas de los estadios más avanzados. No hubo diferencias significativas en nuestra serie entre los los diferentes tipos histológicos. En cuanto a valor pronóstico, los casos incluidos en este trabajo serán seguidos cuidadosamente para determinar la relación entre respuesta inmune, recurrencia, sobrevida y progresión de la enfermedad