Mental Health Professionals' Perception of Respect for Human Rights and Organizational Well-Being in Three Countries of South America.

The respect for human rights in mental health care services significantly contributes to organizational well-being and is evolving into an actual benchmark of quality standards. This study assesses the perception of the respect for human rights for users and staff, as well as organizational and job satisfaction among mental health professionals in three South American countries, through the well-being at work and respect for human rights (WWRR) questionnaire and assesses whether there are significant differences. Seven mental health facilities in Argentina, Colombia, and Peru were involved in this observational study. The sample comprised 310 mental health professionals. The three countries exhibited differences in WWRR, particularly in the staff's satisfaction with resources for care (η2 = 0.166) and staff's satisfaction with organizational aspects (η2 = 0.113). Colombia had the lowest scores in these factors but the highest in the perception of the respect for human rights for users and staff, although this difference did not reach a statistical significance. Despite the progress made in recent years towards coercion-free medical standards and an increased focus on mental health polices in Latin American countries, there is a need to enhance the quality standards of mental health services, recognizing the value that the respect for human rights holds for the organizational well-being of both mental health users and professionals.

Assessing Multi-Site rs-fMRI-Based Connectomic Harmonization Using Information Theory.

Several harmonization techniques have recently been proposed for connectomics/networks derived from resting-state functional magnetic resonance imaging (rs-fMRI) acquired at multiple sites. These techniques have the objective of mitigating site-specific biases that complicate its subsequent analysis and, therefore, compromise the quality of the results when these images are analyzed together. Thus, harmonization is indispensable when large cohorts are required in which the data obtained must be independent of the particular condition of each resonator, its make and model, its calibration, and other features or artifacts that may affect the significance of the acquisition. To date, no assessment of the actual efficacy of these harmonization techniques has been proposed. In this work, we apply recently introduced Information Theory tools to analyze the effectiveness of these techniques, developing a methodology that allows us to compare different harmonization models. We demonstrate the usefulness of this methodology by applying it to some of the most widespread harmonization frameworks and datasets. As a result, we are able to show that some of these techniques are indeed ineffective since the acquisition site can still be determined from the fMRI data after the processing.

Association of hydrogen peroxide with commercial fungicide formulations in the control of asian soybean rust / Associação de peróxido de hidrogênio com misturas comerciais fungicidas no controle da ferrugem asiática da soja

In recent years, there have been reductions in the efficacy of the fungicidal control of Phakopsora pachyrhizi, thereby hindering the management of soybean rust and compromising crop yield. This study evaluated the effects of incorporating hydrogen peroxide (H2O2) in commercial fungicide formulations on the control of soybean rust. We conducted two experiments, one of which was performed in a greenhouse environment and the other under field conditions. In both environments, we examined the following four control programs using commercial fungicide formulations: (I) azoxystrobin + cyproconazole (quinone outside inhibitor [QoI] + demethylation inhibitor [DMI]); (II) picoxystrobin + cyproconazole (QoI + DMI); (III) pyraclostrobin + epoxiconazole + fluxapyroxad (QoI + DMI + succinate dehydrogenase inhibitor); and (IV) water (H2O) (program without fungicide application), combined with the incorporation of (i) H2O2; (ii) mancozeb (positive control I); (iii) chlorothalonil (positive control II); or (iv) water (H2O) alone. Analyses of infected leaf area and grain yield revealed that the addition of H2O2 to the formulations of DMI and QoI fungicides led to a reduction in disease severity of between 33% and 44% relative to the effects of these products used alone, as well as an increase in yield and SPAD values. The use of H2O2 and multi-site fungicides alone failed to provide effective control of soybean rust. In addition to enhancing the efficacy of disease control, the use of H2O2 associated with commercial fungicide mixtures was shown to be a potential tool for the management of fungicide resistance and reduction in losses from Asian soybean rust.

Nos últimos anos, a eficiência do controle de Phakopsora pachyrhizi por fungicidas tem sido reduzida, dificultando o manejo da ferrugem asiática da soja, o que ocasiona o comprometimento da produtividade. O objetivo deste estudo foi avaliar o efeito da adição do peróxido de hidrogênio (H2O2) em misturas comerciais fungicidas no controle da ferrugem da soja. Foram realizados dois ensaios, um em ambiente de casa de vegetação e outro em condições de campo. Em ambos ambientes foram estudados quatro programas de controle com formulações comerciais: I) azoxistrobina + ciproconazole (IQe + IDM); II) picoxistrobina + ciproconazole (IQe + IDM); III) piraclostrobina + epoxiconazole + fluxapiroxade (IQe + IDM + ISDH); IV) água - H2O (sem aplicação fungicida) associados à: i) peróxido de hidrogênio - H2O2, ii) mancozebe (controle positivo I), iii) clorotalonil (controle positivo II) e iv) água - H2O (sem associação). Análises de área foliar lesionada e de rendimento de grãos revelaram que a adição de peróxido de hidrogênio nas misturas de fungicidas IDMs e IQes proporcionou uma redução na severidade da doença entre 33 a 44% comparado aos produtos isolados, incremento na produtividade e maiores índices SPAD. O uso isolado do peróxido de hidrogênio e dos fungicidas multissítios não resultou em controle da ferrugem da soja. A utilização do H2O2 associado a misturas comerciais fungicidas, além de aprimorar a eficiência de controle, demonstra possibilidade de uso como ferramenta para manejo da resistência e redução dos prejuízos provenientes da ferrugem asiática da soja.

Striking a Balance between Program-Specific and Portfolio-Level Evaluation: Lessons Learned from a Multi-Site Evaluation on the Texas-Mexico Border.

Funders are increasingly making strategic investments across multiple grantees, aiming for their portfolio to improve targeted outcomes in a specific issue area. To this end, funders might use multi-site evaluation (MSE) approaches to examine the impact of their collective investments. However, it is important to recognize that each program-and its own program evaluation-must be tailored to its setting, population, and local context to best meet the needs of its target population. Therefore, multi-site evaluations need to account for this complexity. This paper describes the Sí Texas project, a large initiative of eight grantees implementing different integrated behavioral health models to improve physical and mental health outcomes along the Texas-Mexico border. With over 4,200 MSE study participants, the evaluation for Sí Texas used a partnership-centered approach to both enhance the evidence base and build local organizational capacity. This paper describes this approach, the process of tailoring evaluation practices to the grantees' context, and the challenge of balancing consistency at the grantee-level for the portfolio multi-site evaluation. Successes, challenges, and lessons learned related to study design, data collection, grantee partnership, and capacity building are discussed.

Persuasive messaging for human papillomavirus vaccination by adolescent providers in a five-country multi-site study.

OBJECTIVE: Strong persuasive messaging by providers is a key predictor for patient acceptance of prophylactic human papillomavirus vaccination. We aimed to determine optimal messaging to promote human papillomavirus adolescent vaccination across different geographical sites. METHODS: Adolescent providers (n = 151) from Argentina, Malaysia, South Africa, South Korea, and Spain were surveyed on messages, family decision makers, and sources of communication to best motivate parents to vaccinate their adolescent daughters overall, and against human papillomavirus. Multivariate logistic regression assessed the likelihood of recommending messages specifically targeted at cervical cancer with providers' characteristics: gender, medical specialization, and previous administration of human papillomavirus vaccination. RESULTS: Mothers were considered the most important human papillomavirus vaccination decision makers for their daughters (range 93%-100%). Television was cited as the best source of information on human papillomavirus vaccination in surveyed countries (range 56.5%-87.1%), except Spain where one-on-one discussions were most common (73.3%). Prevention messages were considered the most likely to motivate parents to vaccinate their daughters overall, and against human papillomavirus, in all five countries (range 30.8%-55.9%). Optimal messages emphasized cervical cancer prevention, and included strong provider recommendation to vaccinate, vaccine safety and efficacy, timely vaccination, and national policy for human papillomavirus vaccination. Pediatricians and obstetricians/gynecologists were more likely to cite that the best prevention messages should focus on cervical cancer (OR: 4.2, 95% CI: 1.17 to 15.02 vs other medical specialists). CONCLUSIONS: Provider communication messages that would motivate parents to vaccinate against human papillomavirus were based on strong recommendation emphasizing prevention of cervical cancer. To frame convincing messages to increase vaccination uptake, adolescent providers should receive updated training on human papillomavirus and associated cancers, while clearly addressing human papillomavirus vaccination safety and efficacy.

Respuesta a la estimulación multisitio del ventrículo izquierdo en un paciente con terapia de resincronización y fibrilación auricular permanente / Multi-site stimulation of the left ventricle in a patient with dilated cardiomyopathy and permanent atrial fibrillation on resynchronization therapy

Resumen: Se presenta el caso de un hombre de 79 años con miocardiopatía dilatada severa, disfunción ventricular izquierda, fibrilación auricular permanente y portador de un resincronizador ventricular. Al efectuar un recambio del resincronizador se implantó un electrodo adicional para estimulación multisitio del ventrículo izquierdo. Ello condujo a significativa mejoría clínica y de la fracción de eyección del ventrículo izquierdo.

Abstract: A 79-year-old man with dilated cardiomyopathy and atrial fibrillation undergoing resynchronization therapy had and additional electrode implanted in the left ventricle. Multi-site stimulation led to an improved functional class and left ventricular ejection fraction.

Anthropometric indices for non-pregnant women of childbearing age differ widely among four low-middle income populations.

BACKGROUND: Maternal stature and body mass indices (BMI) of non-pregnant women (NPW) of child bearing age are relevant to maternal and offspring health. The objective was to compare anthropometric indices of NPW in four rural communities in low- to low-middle income countries (LMIC). METHODS: Anthropometry and maternal characteristics/household wealth questionnaires were obtained for NPW enrolled in the Women First Preconception Maternal Nutrition Trial. Body mass index (BMI, kg/m2) was calculated. Z-scores were determined using WHO reference data. RESULTS: A total of 7268 NPW participated in Equateur, DRC (n = 1741); Chimaltenango, Guatemala (n = 1695); North Karnataka, India (n = 1823); and Thatta, Sindh, Pakistan (n = 2009). Mean age was 23 y and mean parity 1.5. Median (P25-P75) height (cm) ranged from 145.5 (142.2-148.9) in Guatemala to 156.0 (152.0-160.0) in DRC. Median weight (kg) ranged from 44.7 (39.9-50.3) in India to 52.7 (46.9-59.8) in Guatemala. Median BMI ranged from 19.4 (17.6-21.9) in India to 24.9 (22.3-28.0) in Guatemala. Percent stunted (<-2SD height for age z-score) ranged from 13.9% in DRC to 80.5% in Guatemala; % underweight (BMI <18.5) ranged from 1.2% in Guatemala to 37.1% in India; % overweight/obese (OW, BMI ≥25.0) ranged from 5.7% in DRC to 49.3% in Guatemala. For all sites, indicators for higher SES and higher age were associated with BMI. Lower SES women were underweight more frequently and higher SES women were OW more frequently at all sites. Younger women tended to be underweight, while older women tended to be OW. CONCLUSIONS: Anthropometric data for NPW varied widely among low-income rural populations in four countries located on three different continents. Global comparisons of anthropometric measurements across sites using standard reference data serve to highlight major differences among populations of low-income rural NPW and assist in evaluating the rationale for and the design of optimal intervention trials. TRIAL REGISTRATION: ClinicalTrials.gov # NCT01883193 (18 June 2013, retrospectively registered).

The concurrence of musculoskeletal pain and associated work-related factors: a cross sectional study.

BACKGROUND: Several recent studies have described the presence of musculoskeletal complaints, presenting evidence that multisite musculoskeletal pain (MP) is more often present than single-site musculoskeletal pain. However, less is known about determinants of this multimorbidity, particularly, concerning the role of occupational factors and, mainly, what determines single or multisite pain. This study described the associations between pain in different body sites and investigated related factors to MP in workers from Brazil. METHODS: A total of 1070 workers (228 women and 842 men), from urban cleaning services and from shoe manufacturers, participated in this cross sectional study (response 97 %). Interviewer-administered questionnaire included sociodemographic factors, physical and psychosocial work demands, leisure-time activities and musculoskeletal pain which was presence of pain in previous seven days, considering eight body sites and MP, the sum score of all painful sites, varying 0-8. A factor analysis was performed that captured the nine variables of physical exposure into two latent factors. Associations of pain between different body sites were assessed. Cox regression analyses, presenting the prevalence ratio (PR), showed the related factors to MP. RESULTS: In the previous seven days, 30 % of workers had MP. For all body sites, comorbidity ranged from 72 % to 91 %. Having pain in one body site is associated with pain in other site and the associations between proximal sites were stronger than between more distal sites. High exposure to manual material handling and awkward postures (PR = 1.5, 95 % CI 1.1-2.0), job strain (PR = 1.2, 95 % CI 1.0-1.6), and low social support (PR = 1.3, 95 % CI 1.0-1.7) and being woman (PR = 1.7, 95 % CI 1.3-2.3) were associated with MP. Risk factors for single-site pain and for subsequent musculoskeletal comorbidity were very similar, suggesting an additive effect of risk factors. CONCLUSIONS: Most workers reported MP that was associated with several work-related factors. The findings support the idea that multisite pain is a continuum of single-site pain, maintained by exposure to several risk factors, rather than the result of a specific risk factor that initiates the multisite pain but not single-site pain. Workplace interventions are needed to decrease the number of pain sites, in order to improve the worker's health.