How Mental Health Interviews Conducted Alone, in the Presence of an Adult, a Child or Both Affects Adolescents' Reporting of Psychological Symptoms and Risky Behaviors.

The normative process of autonomy development in adolescence involves changes in adolescents' information management typically characterized by decreasing disclosure and increasing concealment. These changes may have an important impact on the early detection and timely treatment of mental health conditions and risky behavior. Therefore, the objective was to extend our understanding of how these developmental changes in adolescent disclosure might impact adolescent mental health interviews. Specifically, we estimated the effects of third party presence and type of third party presence (adult, child, or both) on adolescents' reports of psychiatric symptoms, substance use, suicidal behavior, and childhood adversity. In this representative sample of 3005 adolescents from Mexico City (52.1 % female), administered the World Mental Health Composite International Diagnostic Interview (WMH-CIDI-A), adult presence influenced reporting the most; in their presence, adolescents reported more ADHD, parental mental illness and economic adversity, but less panic disorder, PTSD, drug use and disorder, and suicidal behavior. The presence of children was associated with increased odds of reporting conduct disorder, opportunity for drug use, parental criminal behavior, neglect, and the death of a parent. While adolescent information management strategies are normative and even desirable as a means of gaining emotional autonomy, they may also interfere with timely detection and treatment or intervention for mental health conditions and risky behaviors. Research and practical implications of these findings are discussed.

Use of multiplex allele-specific polymerase chain reaction (MAS-PCR) to detect multidrug-resistant tuberculosis in Panama.

The frequency of individual genetic mutations conferring drug resistance (DR) to Mycobacterium tuberculosis has not been studied previously in Central America, the place of origin of many immigrants to the United States. The current gold standard for detecting multidrug-resistant tuberculosis (MDR-TB) is phenotypic drug susceptibility testing (DST), which is resource-intensive and slow, leading to increased MDR-TB transmission in the community. We evaluated multiplex allele-specific polymerase chain reaction (MAS-PCR) as a rapid molecular tool to detect MDR-TB in Panama. Based on DST, 67 MDR-TB and 31 drug-sensitive clinical isolates were identified and cultured from an archived collection. Primers were designed to target five mutation hotspots that confer resistance to the first-line drugs isoniazid and rifampin, and MAS-PCR was performed. Whole-genome sequencing confirmed DR mutations identified by MAS-PCR, and provided frequencies of genetic mutations. DNA sequencing revealed 70.1% of MDR strains to have point mutations at codon 315 of the katG gene, 19.4% within mabA-inhA promoter, and 98.5% at three hotspots within rpoB. MAS-PCR detected each of these mutations, yielding 82.8% sensitivity and 100% specificity for isoniazid resistance, and 98.4% sensitivity and 100% specificity for rifampin resistance relative to DST. The frequency of individual DR mutations among MDR strains in Panama parallels that of other TB-endemic countries. The performance of MAS-PCR suggests that it may be a relatively inexpensive and technically feasible method for rapid detection of MDR-TB in developing countries.