Feasibility of an mobile application as a tool for multidrug-resistant tuberculosis contact monitoring in Peru. / Factibilidad de una aplicación móvil para el monitoreo de contactos de tuberculosis multidrogorresistente en Perú.

This study aimed to validate an ODK digital mobile application (ODK-DMA) in contacts exposed to multidrug-resistant tuberculosis (MDR-TB) in Lima, Peru. Using a questionnaire in an application on a mobile device, we registered 129 household contacts of 29 index cases of MDR-TB under treatment in 10 health facilities in South Lima in August 2018. The mean time of registration per contact was found to be 4 minutes. The prevalence of active TB symptoms among MDR-TB contacts was 3.1%. An acceptability questionnaire was completed by 31 respondents; all reported feeling comfortable or very comfortable with recording their data in the ODK-DMA, although 10% expressed concerns about confidentiality. We concluded that the ODK-DMA was a feasible and acceptable tool for registering household contacts exposed to cases with MDR-TB. Future studies should consider the use of mobile platforms for the monitoring of MDR-TB contacts.

El presente estudio tuvo como objetivo realizar una validación de un aplicativo móvil Open Data Kit (AM-ODK) en contactos expuestos a tuberculosis multidrogorresistente (TB-MDR) en Lima. Utilizando un cuestionario en una aplicación en un dispositivo móvil Android, se registraron 129 contactos intradomiciliarios de 29 casos índice de TB-MDR en tratamiento, en diez establecimientos de salud de Lima Sur en agosto de 2018. Se encontró un tiempo medio de registro por contacto de cuatro minutos. La frecuencia de síntomas de TB activa entre los contactos de TB-MDR fue 3,1%. Treinta y un encuestados completaron un cuestionario de aceptabilidad; todos manifestaron sentirse cómodos o muy cómodos con el registro de sus datos en AM-ODK, aunque 10% expresó inquietudes sobre la confidencialidad. Se concluye que el AM-ODK fue una herramienta viable y aceptable para registrar contactos intradomiciliarios expuestos a casos con TB-MDR. Estudios futuros deberían considerar el uso de plataformas móviles para el monitoreo de contactos de TB-MDR.

Factibilidad de una aplicación móvil para el monitoreo de contactos de tuberculosis multidrogorresistente en Perú

El presente estudio tuvo como objetivo realizar una validación de un aplicativo móvil Open Data Kit (AM-ODK) en contactos expuestos a tuberculosis multidrogorresistente (TB-MDR) en Lima. Utilizando un cuestionario en una aplicación en un dispositivo móvil Android, se registraron 129 contactos intradomiciliarios de 29 casos índice de TB-MDR en tratamiento, en diez establecimientos de salud de Lima Sur en agosto de 2018. Se encontró un tiempo medio de registro por contacto de cuatro minutos. La frecuencia de síntomas de TB activa entre los contactos de TB-MDR fue 3,1%. Treinta y un encuestados completaron un cuestionario de aceptabilidad; todos manifestaron sentirse cómodos o muy cómodos con el registro de sus datos en AM-ODK, aunque 10% expresó inquietudes sobre la confidencialidad. Se concluye que el AM-ODK fue una herramienta viable y aceptable para registrar contactos intradomiciliarios expuestos a casos con TB-MDR. Estudios futuros deberían considerar el uso de plataformas móviles para el monitoreo de contactos de TB-MDR.

This study aimed to validate an ODK digital mobile application (ODK-DMA) in contacts exposed to multidrug-resistant tuberculosis (MDR-TB) in Lima, Peru. Using a questionnaire in an application on a mobile device, we registered 129 household contacts of 29 index cases of MDR-TB under treatment in 10 health facilities in South Lima in August 2018. The mean time of registration per contact was found to be 4 minutes. The prevalence of active TB symptoms among MDR-TB contacts was 3.1%. An acceptability questionnaire was completed by 31 respondents; all reported feeling comfortable or very comfortable with recording their data in the ODK-DMA, although 10% expressed concerns about confidentiality. We concluded that the ODK-DMA was a feasible and acceptable tool for registering household contacts exposed to cases with MDR-TB. Future studies should consider the use of mobile platforms for the monitoring of MDR-TB contacts.

Exposed! Management of MDR-TB household contacts in an evidence light era.

Until the three ongoing randomised controlled trials of preventive therapy are completed, there remains a large knowledge gap about how individuals known to have been exposed to multidrug-resistant TB (MDR-TB) should be managed. The evolving paradigms and improving outcomes from treatment of active MDR-TB disease play in to discussions about the relative merits and importance of intensive surveillance and/or preventive therapy for MDR-TB contacts.

Determining optimal therapy of dogs with chronic enteropathy by measurement of serum citrulline.

BACKGROUND: Serum concentration of citrulline is a useful biomarker in human intestinal disease and indicates globally reduced enterocyte mass and absorptive function in various disease states. OBJECTIVES: To determine whether serum citrulline concentration is a biomarker in chronic enteropathy (CE) in dogs, to provide useful information regarding optimal treatment or to predict outcome. ANIMALS: Seventy-four dogs with CE and 83 breed- and age-matched hospital controls with no clinical signs of intestinal disease. METHODS: Retrospective study. Outcome was determined and dogs were categorized by response to treatment as having food-responsive enteropathy (FRE), antibiotic-responsive diarrhea (ARD), or idiopathic inflammatory bowel disease (IBD). Disease severity was quantified by the CIBDAI scoring index. RESULTS: Serum citrulline concentration did not differ between dogs with CE (median, 8.4 µg/mL, 5th-95th percentile 2.0-19.6) and controls (median, 8.1 µg/mL, 5th-95th percentile 2.2-19.7, P = .91). Serum citrulline concentration was similar between dogs with FRE (median, 9.1 µg/mL, 5th-95th percentile 2.0-18.9), ARD (median, 13.0 µg/mL, 5th-95th percentile 1.6-19.2), IBD (median, 8.4 µg/mL, 5th-95th percentile 2.1-21.0; P = .91). Serum citrulline did not correlate to CIBDAI or to serum albumin concentration. CONCLUSIONS AND CLINICAL IMPORTANCE: In our study, serum citrulline concentration was not associated with efficacy of treatment or outcome in dogs with CE.

Examining the role of trauma, personality, and meaning in young prolonged grievers.

PURPOSE: Younger spouses or partners have been understudied in the prolonged grief literature. The purpose of this study was to determine rates of prolonged grief in young spouses or partners and the associations between prolonged grief and personality styles (specifically, narcissistic, histrionic, and obsessive), trauma history, and the perceived meaning of the loss in the young conjugally bereaved. PARTICIPANTS AND METHOD: Participants between 20 and 50 years old who lost a spouse/partner to cancer 6 months-3 years prior to the study completed the following measures during one time point (via phone or in person interviews): Prolonged Grief-13, traumatic life events questionnaire, Millon clinical multiaxial inventory-III, and grief meaning reconstruction inventory. RESULTS: Fifty-six spouses and partners (51.8% women) completed the interviews (mean age: 44.54 ± 4.20 years). The participants (49.1%) reported elevated rates of prolonged grief and 12.3% of the participants were diagnosed with prolonged grief with the recently published diagnostic algorithm. Bivariate analyses demonstrated an association between prolonged grief and negative meaning of the loss (r = 0.73; p < 0.01) and the frequency of the traumatic events (r = 0.23; p < 0.05). Multivariate analyses revealed that negative meaning of the loss was the only significant predictor of prolonged grief (Beta = 0.71; p = 0.0001). CONCLUSION: Elevated levels of prolonged grief were found in this population, suggesting a need for further research into young spousal grief. Young bereaved spouses may lack flexibility in reconstructing their view of the world as the death may invalidate their previously held world beliefs.

Prenatal predictors of infant temperament.

Emerging data suggest that prenatal factors influence children's temperament. In 50 dyads, we examined fetal heart rate (FHR) activity and women's antenatal psychiatric illness as predictors of infant temperament at 4 months (response to novelty and the Infant Behavior Checklist). FHR change during maternal challenge was positively associated with observed infant motor reactivity to novelty (p = .02). The odds of being classified as high versus low motor among fetuses who had an increase in FHR during maternal stress was 11 times those who had a decrease in FHR (p = .0006). Antenatal psychiatric diagnosis was associated with an almost fourfold greater odds of having a high cry reactivity classification (p = .03). There also were modest associations between baseline FHR and maternal reports of infant temperament and between observed temperament and that based on mothers' reports. All of the infant results were found independent of the influence of women's postnatal anxiety. These data indicate that physiological markers of individual differences in infant temperament are identifiable in the fetal period, and possibly shaped by the prenatal environment.

Childhood physical abuse and differential development of paranormal belief systems.

This study compared paranormal belief systems in individuals with and without childhood physical abuse histories. The Revised Paranormal Belief Scale and the Assessing Environments III Questionnaire were completed by 107 University students. Psi, precognition, and spiritualism, which are thought to provide a sense of personal efficacy and control, were among the most strongly held beliefs in abused subjects, and were significantly higher in abused versus nonabused subjects. Superstition and extraordinary life forms, thought to have an inverse or no relation to felt control, were the least strongly held beliefs in abused subjects, and, along with religious beliefs, did not differ between the two abuse groups. Witchcraft was unexpectedly found to be the most strongly held belief among those with abuse histories. Results suggest that by providing a sense of control, certain paranormal beliefs may offer a powerful emotional refuge to individuals who endured the stress of physical abuse in childhood.