Collet-Sicard syndrome: a scoping review.

Collet-Sicard syndrome (CSS) is the unilateral palsy of the cranial nerves (CN) IX, X, XI, and XII. To our knowledge, no review describes the characteristics of patients diagnosed with CSS. Therefore, this review aims to collect and describe all cases in the literature labeled as CSS. We performed a scoping review of the literature and conducted a database search in Embase and PubMed. We included articles and abstracts with case reports or case series of patients with CSS diagnosis. We classified the cases into two groups: "CSS", referring to patients presenting exclusively with IX-XII nerve involvement, and "CSS-plus", which corresponds to cases with CSS and other neurological impairments. We included 135 patients from 126 articles, of which 84 (67.7%) were male. The most common clinical manifestations reported were dysphagia and dysphonia. The most common etiology was tumoral in 53 cases (39.6%) and vascular in 37 cases (27.6%). The majority of patients showed partial or total improvement, with just over half receiving conservative treatment. The most frequent anatomic space was the jugular foramen (44.4%) and the parapharyngeal retrostyloid space (28.9%). Approximately 21% of the patients had other CN impairments, with the seventh and eighth CN most frequently compromised. We conclude that although there is a need for greater rigor in CSS reporting, the syndrome has a clear utility in identifying the localization of jugular foramen and parapharyngeal retrostyloid space pathology.

Social Positioning Analysis as a Qualitative Methodology to Study Identity Construction in People Diagnosed With Severe Mental Illnesses.

Severe mental illnesses (SMI) in general, and schizophrenia in particular, have been characterized as alterations of the experience of self and identity. When first diagnosed with SMI, the subjective experiences and specific narrative challenges faced by this population are particularly important. Therefore, qualitative approaches which allow to analyze these subjective experiences should be developed. This article presents in detail a specific method, called Social Positioning Analysis, which makes the complexity of narratives and life stories with multiple turning points understandable. To develop this methodological proposal, it has been taken into account the performative aspects of social interaction in which narratives are constructed. The methodology has previously been used in other health contexts and is innovative in the field of mental health. Linguistic criteria, definitions, and multiple examples are included to facilitate its application, as well as some reflections about its potential and possible benefits.

Access of Mental Health Services by the Adult Population in Metropolitan Lima, Peru: Characteristics, Perceptions and Need for Care.

This study aimed to characterize mental health service access in metropolitan Lima, Peru. Between May and December 2012, we interviewed 4,445 Peruvian adults, applying the Mini-International Neuropsychiatric Interview (MINI); a modified version of the WHO Disability Assessment Schedule (WHODAS-S); and, a health services access questionnaire. In the prior year, 3.6% (95% CI 3.0-4.4) of respondents accessed mental health services. Care access was associated with female sex; being unemployed; and having a diagnosed psychiatric morbidity. Of those with psychiatric morbidity, 16.9% (95% CI 13.3-21.3) received clinical care. Care access was 25.8% (95% CI 19.9-32.8) for people with a depressive episode; 12.1% (95% CI 7.4-19.2) for any anxiety disorder; and, 5.9% (95% CI 1.7-18.6) for harmful alcohol consumption or dependence. Respondents with moderate to severe levels of disability were more likely to recognize the need for care, but this was not necessarily associated with higher care access. Reducing the mental, neurological and substance use disorders treatment gap in Peru are discussed in light of the findings.

Does Employment Promote Recovery? Meanings from Work Experience in People Diagnosed with Serious Mental Illness.

Employment has been highlighted as a determinant of health and as an essential milestone in the recovery process of people with serious mental illness. Different types of programs and public services have been designed to improve the employability of this population. However, there has not been much interest in the meanings attributed to these experiences and the negative aspects of work experience. In this research, we explored the meanings that participants attributed to their work experience and the impact of work on their recovery process. Research participants lived in Andalusia (Spain), a region in southern Europe with a high unemployment rate. Two versions of a semi-structured interview were designed: one for people who were working, and one for unemployed people. Participants' narratives were categorized according to grounded theory and the analyses were validated in group sessions. Apart from several positive effects for recovery, the analysis of the narratives about work experience outlined certain obstacles to recovery. For example, participants mentioned personal conflicts and stress, job insecurity and meaningless jobs. While valid, the idea that employment is beneficial for recovery must be qualified by the personal meanings attributed to these experiences, and the specific cultural and economic factors of each context.

Cognitive and Social Functioning Correlates of Employment Among People with Severe Mental Illness.

We assess how social and cognitive functioning is associated to gaining employment for 213 people diagnosed with severe mental illness taking part in employment programs in Andalusia (Spain). We used the Repeatable Battery for the Assessment of Neuropsychological Status and the Social Functioning Scale and conducted two binary logistical regression analyses. Response variables were: having a job or not, in ordinary companies (OCs) and social enterprises, and working in an OC or not. There were two variables with significant adjusted odds ratios for having a job: "attention" and "Educational level". There were five variables with significant odds ratios for having a job in an OC: "Sex", "Educational level", "Attention", "Communication", and "Independence-competence". The study looks at the possible benefits of combining employment with support and social enterprises in employment programs for these people and underlines how both social and cognitive functioning are central to developing employment models.

Psychosocial and vocational impact of an internship program for people diagnosed with severe mental illnesses.

PURPOSE: Unemployment is an obstacle in recovery for people with severe mental illnesses (SMI), both in reducing psychopathological symptoms and in achieving a high quality of life. The aim of this study was to explore the impact of an internship program for people diagnosed with SMI on psychosocial variables using a pre-test and post-test design. METHOD: Four scales were administered to a sample of 127 study participants, all of whom were diagnosed with SMI. The results of standard and sheltered employment outcomes were obtained by comparing the number and type of contracts gained by participants up to one year after program completion. A repeated measures ANOVA analysis was carried out with intervention being an independent intra-subject variable and type of participant diagnosis being a between-subjects variable. RESULTS: A limited increase in social functioning was found, as well as a significant decrease in psychiatric distress for users diagnosed with personality disorders. Participants in the internship program obtained a greater number of employment contracts than their peers who did not participate in the program, albeit with a low effect size. CONCLUSIONS: Though results were positive, extension of internship length and provision of more intensive counselling for participants may be useful.

An internship program for persons with severe mental illnesses yielded modest improvements in social functioning.A decrease in psychiatric distress in participants with personality disorders was found after the internships.Participants in the internship obtained a greater number of employment contracts.An extended internship programme with workplace support is likely to be beneficial.

Cost-effectiveness of pharmacogenetic screening in the management of major depressive disorder in the Spanish Healthcare System.

BACKGROUND: Major depressive disorder (MDD) represents a sizable economic burden in Spain. Pharmacogenetic (PGx) screening to guide the choice of antidepressant medication (ADM) in MDD patients yields higher response and remission rates, which could reduce both healthcare and indirect costs. METHODS: We built a cost-effectiveness probabilistic Markov model with microsimulation using Tree Age Pro 2022, simulating a patient cohort from the SNHS starting ADM for MDD, and comparing PGx screening before starting ADM versus no screening (No PGx). We carried out a probabilistic sensitivity analysis using the Monte Carlo simulation with microsimulation, set for 1000 iterations and 1000 microsimulation trials, both from societal and healthcare provider perspectives, for a time horizon of 3 years. RESULTS: From a societal perspective, the model estimated a mean cost of 3172.85€ and effectiveness of 2.64 quality-adjusted life years (QALYs) for the No PGx strategy, and a mean cost of 1687.02€ and effectiveness of 2.84 QALYs for the PGx strategy. The mean ICER was -7820.56 €/QALY. From a healthcare provider perspective (no indirect costs considered), the mean cost was 662.62€ for the No PGx strategy, and 446.60€ for the PGx strategy. The mean ICER was -1130.16 €/QALY. LIMITATIONS: The heterogeneity of input data from the literature, the need for assumptions of homogeneous distribution of variables and events across population and time, and the inherent limitations of cost-effectiveness analysis should be considered. The model omits combined therapies (ADMs with mood stabilizers, antipsychotics, cognitive behavioral therapy…). CONCLUSIONS: PGx screening in MDD prior to ADM start is a dominant strategy in the SNHS.

Navigated Anterior Full-Endoscopic Transcervical Approach Odontoidectomy for Traumatic Posterior Atlantoaxial Dislocation Without Odontoid Fracture.

BACKGROUND AND IMPORTANCE: Complete posterior atlantoaxial dislocation (PAAD) with an unfractured odontoid process is a rare condition where a dislocated but intact odontoid process is positioned ventrally to the anterior arch of C1. This lesion is related to transverse and alar ligament rupture secondary to hyperextension and rotatory traumatic injury and is often associated with neurological deficit. The treatment strategy remains controversial, and in many cases, odontoidectomy is required. Traditional approaches for odontoidectomy (transnasal and transoral) are technically demanding and are related to several complications. This article describes a 360° reduction and stabilization technique through a navigated anterior full-endoscopic transcervical approach (nAFETA) as a novel technique for odontoidectomy and C1-C2 anterior transarticular fixation supplemented with posterior fusion. CLINICAL PRESENTATION: A 21-year-old man presented to the emergency room by ambulance after a motorcycle accident. On evaluation, incomplete ASIA B spinal cord injury was documented. Imaging revealed a complete PAAD. We performed a two-staged procedure, a nAFETA odontoidectomy plus C1-C2 anterior transarticular fixation followed by posterior C1-C2 wired fusion. At a 2-year follow-up, the patient had a 10-point Oswestry Disability Index score and neurological improvement to ASIA E. CONCLUSION: PAAD can be successfully treated through minimally invasive nAFETA. Noteworthy, the risks of the transoral and endonasal routes were avoided through this approach. In addition, nAFETA allows anterior transarticular fixation during the same procedure providing spinal stability. Further studies are required to expand the use of nAFETA in this field.

Association between traumatic experiences and psychosis among incarcerated men.

The possible influence of traumatic experiences on subsequent manifestations of psychosis has been the subject of intense scientific debate in the last decade. Whereas some authors have found a clear association between trauma and psychosis, others have pointed out methodological deficiencies in the research or have found only weak associations. Others found no association between trauma and psychosis in exclusive samples of men and recommend the use of studies stratified by sex. This article uses the data from an epidemiological study of a random sample of 500 male inmates in two prisons in Andalusia (Spain) to analyze the association between psychosis and trauma. The inmates were diagnosed using The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) interviews by teams of experienced clinicians. The results show a clear association between traumatic events and some functional psychosis or some psychosis, including induced psychoses. These associations resist the possible effect of confusing variables such as the origin of the inmates, educational level, or having an addictive disorder. We discuss the need to pay special attention to traumatic experiences such as witnessing extreme violence against others or participating in acts of violence, particularly in men. Our results are compatible with different theories that defend the association between trauma and psychosis.

Quality of life and psychiatric distress in people with serious mental illness, the role of personal recovery.

OBJECTIVES: When considering the personal recovery of people with serious mental illness (SMI), it is essential to examine their reported psychiatric distress and quality of life (QoL). However, there is no consolidated model in the literature that clearly relates these variables. In this study we first analysed the relationships between QoL, psychiatric distress and recovery, and several sociodemographic variables. Second, we analysed the linear effects of psychiatric distress and recovery on QoL. Third, and most important, we tested two hypotheses that considered personal recovery as a moderator or mediator of the relationship between psychiatric distress and QoL. DESIGN AND METHODS: 234 volunteers with a diagnosis of SMI completed three self-report questionnaires, The Recovery Assessment Scale-24, The World Health Organization QoL and the Clinical Outcomes in Routine Evaluation-Outcome Measure, which showed very good levels of validity and reliability. The PROCESS macro for SPSS developed by Hayes (Introduction to mediation, moderation, and conditional process analysis: A regression-based approach, The Guilford Press, 2022) was applied using the Bootstrap method to verify our moderation and mediation hypotheses. RESULTS: We found a negative linear effect of psychiatric distress on QoL, as well as a positive effect of recovery on said variable. Our results do not confirm the moderating effect of recovery on the relationship between distress and QoL. However, we do confirm the second hypothesis; recovery functioned as a mediating variable between psychiatric distress and QoL. CONCLUSIONS: These findings allow us to reflect on how personal recovery affect the relationship between psychiatric distress and QoL and discuss its theoretical and practical implications as public policies.

Predicting rainfall and irrigation requirements of corn in Ecuador.

This work is a case study whose objective is prediction of irrigation needs of corn crops in different regions of Ecuador; being this a fundamental basic food for the country's economy, as in the remaining countries of the Andean area. The proposed methodology seeks to help improving the quality of corn crop. Specifically, we propose the application of regression models, within the framework of Functional Data Analysis (FDA), to predict the amount of rainfall (scalar response variable) in the places with the highest production of corn in Ecuador, as a function of functional covariates such as temperature and wind speed. From the estimation of the amount of rainfall, effective precipitation is calculated. This is the fraction of water used by the crops, from which the value of real evapotranspiration or ETc is obtained and, more importantly, the irrigation requirements at each stage of the corn crop, for its adequate physiological development. Application of regression models based on functional basis, Functional Principal Components (FPC) or Functional Partial Least Squares (FPLS) for scalar response variable, allows us to use the information of variables such as wind speed and temperature (of functional nature) in a better way than using multivariate models, for predicting the amount of rainfall, obtaining, as a result, very explicative models, defined by a high goodness of fit (R2=0.97, with 6 significant parameters and an error of 0.14) and practical utility. The model has been also applied to North Peru regions, obtaining rainfall prediction errors between 9% and 22%. Thus, the geographical limitations of the model could be the Andean regions with similar climate. In addition, this study proposes the application of FDA exploratory analysis and FDA outlier detection techniques as a common and useful practice in the specific domain of rainfall prediction studies, prior to applying the regression models.

TTS package: Computational tools for the application of the Time Temperature Superposition principle.

The TTS package has been developed in R software to predict the mechanical properties of viscoelastic materials, at short and long observation times/frequencies by applying the Time Temperature Superposition (TTS) principle. TTS is a physical principle used in material science to estimate mechanical properties beyond the experimental range of observed times/frequencies by shifting data curves obtained at other temperatures relative to a reference temperature in the dataset. It is a methodology related to accelerated life-tests and reliability, whereas the TTS library is one of the first open source computational tool to apply the TTS principle. This R package provides free computational tools to obtain master curves that characterize materials from a thermal-mechanical approach. The TTS package also proposes, implements and explains our own method to obtain the shift factors and the master curve in a TTS analysis, based on horizontal shifting of the first derivative function of viscoelastic properties. This procedure provides shift factors estimates and smooth master curve estimates using B-spline fitting, in a fully automatic way, without assuming any parametric expression. Williams-Landel-Ferry (WLF) and Arrhenius TTS parametric models are also implemented in the TTS package. They can be fitted from shifts obtained by the our first derivative based method.

Application of residuals from purification of bivalve molluscs in Galician to facilitate marine ecosystem resiliency through artificial reefs with shells - One generation.

The seas and oceans of the planet provide a wide range of essential resources. However, marine ecosystems are undergoing severe degradation due to the unsustainable exploitation and consumption patterns of the linear economy. On the other hand, many economic activities linked to the sea generate a large amount of waste, leading to negative impacts, such as the cost of treating or disposing of this waste. A case in point is bivalve mollusc production: a purification process is needed to avoid the risk of diseases through faecal contamination. The present work proposes an innovative procedure to convert this waste, calcium carbonate as calcite and aragonite allotropic types, into by-products. These by-products can be used to manufacture green artificial reefs, partially replacing concrete aggregates with a sustainable alternative to the geological sources of CaCO3. By installing these reefs, marine ecosystems could be created in a sustainable way and an innovative approach based on the circular economy could be taken towards protecting them. To this end, different concrete mixtures with bivalve shells are proposed. Although this study had been carried out for Galicia (NW Spain), the methodology followed could also be valid for other regions. A physicochemical characterisation of the waste from purifying the bivalves, including oysters, mussels, clams and scallops, was performed. Statistical and multi-criteria analyses were done in order to select the best dosage. Both have provided justification for using a mixture of shells with a predominance of calcite (oyster, scallop) instead of shells with a predominance of aragonite. The multi-criteria analysis served to identify the two best alternatives with dosages in which the medium aggregates were substituted with shells mainly from oysters, with a predominance of calcite. Finally, the statistical analysis played a role in estimating the compressive strength and water absorption of each mixture from the design parameter values.

Considerations on the programmed functional life (one generation) of a green artificial reef in terms of the sustainability of the modified ecosystem.

The installation of artificial reefs serves to enhance marine ecosystems, although it also modifies them. These changes do not have to be irreversible, since it is possible to treat the functional life of an artificial reef (AR) as a variable factor to be determined, with the objective of contributing to the sustainability of the ecosystem. The quest for sustainability does not end with the manufacture and installation of the AR units. It is also necessary to analyse the sustainability of the modified ecosystem, through the production of services. This leads to consider the medium-term return of the ecosystem to its initial state, once the functional life of the ARs expires. This paper presents and justifies an AR design/composition for limited functional life. It is the result of acting on the base material, the concrete, with the objective of limiting the useful life to one social generation. Four different dosages were proposed for such a purpose. They were subjected to mechanical tests (compressive strength and absorption after immersion), including an innovative abrasion-resistant one. The results allow estimating the functional life of the four types of concrete from the design variables (density, compactness, and quantity of water and cement as well as its relation). To this end linear regression models and clustering techniques were applied. The described procedure leads to an AR design for limited functional life.

Wastewater early warning system for SARS-CoV-2 outbreaks and variants in a Coruña, Spain.

Wastewater-based epidemiology has been widely used as a cost-effective method for tracking the COVID-19 pandemic at the community level. Here we describe COVIDBENS, a wastewater surveillance program running from June 2020 to March 2022 in the wastewater treatment plant of Bens in A Coruña (Spain). The main goal of this work was to provide an effective early warning tool based in wastewater epidemiology to help in decision-making at both the social and public health levels. RT-qPCR procedures and Illumina sequencing were used to weekly monitor the viral load and to detect SARS-CoV-2 mutations in wastewater, respectively. In addition, own statistical models were applied to estimate the real number of infected people and the frequency of each emerging variant circulating in the community, which considerable improved the surveillance strategy. Our analysis detected 6 viral load waves in A Coruña with concentrations between 103 and 106 SARS-CoV-2 RNA copies/L. Our system was able to anticipate community outbreaks during the pandemic with 8-36 days in advance with respect to clinical reports and, to detect the emergence of new SARS-CoV-2 variants in A Coruña such as Alpha (B.1.1.7), Delta (B.1.617.2), and Omicron (B.1.1.529 and BA.2) in wastewater with 42, 30, and 27 days, respectively, before the health system did. Data generated here helped local authorities and health managers to give a faster and more efficient response to the pandemic situation, and also allowed important industrial companies to adapt their production to each situation. The wastewater-based epidemiology program developed in our metropolitan area of A Coruña (Spain) during the SARS-CoV-2 pandemic served as a powerful early warning system combining statistical models with mutations and viral load monitoring in wastewater over time.

Everyday life, culture, and recovery: carer experiences in care homes for individuals with severe mental illness.

Supported homes or Care Homes (CHs) have become in-services that play a fundamental role in social-health systems, particularly in mental health systems in Europe and the United States. They provide settings where residents' day-to-day routines are supervised by in-house non-clinician professional carers. Ten semi-structured in-depth interviews were conducted by expert professional carers of persons with schizophrenia to explore interactions and activities between carers and users living in special "Care Homes". Analysis focused primarily on the functions of everyday life and daily routines in the recovery process. Social positioning analysis was used to investigate meanings and subjective experiences of professionals. The analysis revealed the importance of personal interactions in daily routines for recovery. We identified two main concerns guiding professionals' interactions with users: "Bring [users] to the here and now" and "give them the initiative to start actions". We suggest that CHs promote the construction of privileged identity in western urban societies, forming part of the process towards recovery and better social integration.

Designing and assessing of an art-based intervention for undocumented migrants.

BACKGROUND: Undocumented immigrants and refugees are more likely to suffer from psychosocial disorders. METHODOLOGY: In this pilot study, an art-based intervention is described and assessed, with a sample of 11undocumented immigrants who recently came to southern Spain on a small boat. The art-based intervention is assessed using a pre-post design and four questionnaires, which consist of The General Health Questionnaire, Beck's Depression Inventory, the Barcelona Immigrant Stress Scale and Carol Ryff's Psychological Well Being Scale. Furthermore, five participants were interviewed before and after the intervention and a thematic analysis of the transcriptions was carried out. RESULTS: A significant reduction of depressive symptoms with a large effect size was found. An increase of reflexive discourse and the feeling of belonging after the intervention was also observed. CONCLUSIONS: The study suggests that the art-based intervention decreased depressive symptoms and stress, redirecting the narratives of the participants towards the future and increasing the sense of community.

"I don't believe I'm going to recover from anything." Understanding recovery amongst people with severe mental illness attending community health services in Spain.

PURPOSE: The concept of recovery has become the backbone of mental health services and professional practices. However, research aimed at analysing the conceptualisation of recovery of people diagnosed with severe mental illness (SMI) has an obvious Anglo-Saxon bias. Our objective was to analyse what a sample of 51 users of mental health services diagnosed with SMI in Spain understand by recovery. METHOD: The participants were interviewed in depth about their concept of recovery, and their responses were thematically analysed by three observers. RESULTS: Four categories of definitions of the concept of recovery were found in the analysis: Socio-Behavioural, Biomedical, Resistance, and Wellbeing-Growth. Inter-rater reliability scores ranged from 0.7 to 0.84 according to Krippendorff's alpha. While the Biomedical category essentially corresponded to the idea of clinical recovery, the Wellbeing-Growth category reproduced the concept of personal recovery (PR) that is dominant in the literature. The most frequent categories were Socio-Behavioural and Biomedical. Assimilation of the PR concept by participants was quite limited. The markedly relational character of the most frequent categories challenges the individualistic core of the classic definition of PR. CONCLUSIONS: We advocate the need to make alternative recovery concepts and narratives visible to the mental health services' users and practitioners.IMPLICATIONS FOR REHABILITATIONThe concept of personal recovery is not common amongst mental health services' users as recovery is mainly understood in social and biomedical terms.Different conceptualizations of recovery can coexist in participants.Mental health services should consider alternative narratives to personal recovery.Mental health services should provide resources for creating community and sense of belonging as first strategies for promoting recovery.

Modeling the number of people infected with SARS-COV-2 from wastewater viral load in Northwest Spain.

The quantification of the SARS-CoV-2 RNA load in wastewater has emerged as a useful tool to monitor COVID-19 outbreaks in the community. This approach was implemented in the metropolitan area of A Coruña (NW Spain), where wastewater from a treatment plant was analyzed to track the epidemic dynamics in a population of 369,098 inhabitants. Viral load detected in the wastewater and the epidemiological data from A Coruña health system served as main sources for statistical models developing. Regression models described here allowed us to estimate the number of infected people (R2 = 0.9), including symptomatic and asymptomatic individuals. These models have helped to understand the real magnitude of the epidemic in a population at any given time and have been used as an effective early warning tool for predicting outbreaks in A Coruña municipality. The methodology of the present work could be used to develop a similar wastewater-based epidemiological model to track the evolution of the COVID-19 epidemic anywhere in the world where centralized water-based sanitation systems exist.