Supporting Vulnerable People During Challenging Transitions: A Systematic Review of Critical Time Intervention.

Critical Time Intervention (CTI) is designed to reduce the risk of homelessness and other adverse outcomes by providing support to individuals during challenging life course transitions. While several narrative reviews suggest the benefit of CTI, the evidence on the model's effectiveness has not been systematically reviewed. This article systematically reviews studies of CTI applied to a variety of populations and transition types. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis for protocols (PRISMA-P) guidelines, we reviewed 13 eligible experimental and quasi-experimental studies. Findings were summarized by individual outcome domains, including housing, service engagement use, hospitalization or emergency services, mental health, substance use, family and social support, and quality of life. CTI had a consistent positive impact on two primary outcomes-reduced homelessness and increased service engagement use-among different populations and contexts. Despite the effectiveness of CTI, the specific mechanisms of the model's positive impacts remain unclear. Implications for practice, policy and research are addressed.

Virulence of native isolates of entomopathogenic fungi (Hypocreales) against the "sweetpotato whitefly" Bemisia tabaci (Hemiptera: Aleyrodidae), including the effects of temperature and fungicides.

Hypocrella, Moelleriella and related species in the Hypocreales (Ascomycota, Sordariomycetes) cause epizootics of whiteflies and scale insects in nature. However, studies on their host specificity, virulence, infection cycles, optimal development under laboratory conditions, and compatibility with other control methods, are unexplored for most species. Under laboratory conditions, the virulence of several isolates of field-collected hypocrealean fungi (Hypocrella, Moelleriella, Regiocrella, and Verticillium) was determined on Bemisia tabaci eggs and 4th instar nymphs. In addition to virulence, the effect of temperature and two commercial fungicides on growth rates and germination of the isolates was evaluated. None of the isolates infected the eggs, while M. libera, M. ochracea, and M. turbinata caused high nymphal mortality. Moelleriella libera was the most virulent isolate. At all temperatures, M. libera, Regiocrella sp. (P17H20), and Verticillium cf. pseudohemipterigenum had the highest germination and growth rates. The optimal growth temperature depended on the isolate, but at 23 °C and 25 °C, the probability of spore germination was higher for most isolates. Finally, the fungicides azoxystrobin and chlorothalonil inhibited growth rates and conidial germination at 24 and 48 h of exposure. This research produces vital knowledge on the virulence and infection cycles of poorly studied native species of entomopathogenic fungi. In addition, the results provide information on the optimal temperature for development in laboratory conditions and susceptibility to fungicides, which could contribute to future biological control strategies.

New world goat populations are a genetically diverse reservoir for future use.

Western hemisphere goats have European, African and Central Asian origins, and some local or rare breeds are reported to be adapted to their environments and economically important. By-in-large these genetic resources have not been quantified. Using 50 K SNP genotypes of 244 animals from 12 goat populations in United States, Costa Rica, Brazil and Argentina, we evaluated the genetic diversity, population structure and selective sweeps documenting goat migration to the "New World". Our findings suggest the concept of breed, particularly among "locally adapted" breeds, is not a meaningful way to characterize goat populations. The USA Spanish goats were found to be an important genetic reservoir, sharing genomic composition with the wild ancestor and with specialized breeds (e.g. Angora, Lamancha and Saanen). Results suggest goats in the Americas have substantial genetic diversity to use in selection and promote environmental adaptation or product driven specialization. These findings highlight the importance of maintaining goat conservation programs and suggest an awaiting reservoir of genetic diversity for breeding and research while simultaneously discarding concerns about breed designations.

[[Anti-leishmanial activity in plants from a Biological Reserve of Costa Rica]. / Actividad contra Leishmania sp. (Kinetoplastida: Trypanosomatidae) de plantas en una Reserva Biológica de Costa Rica.

Leishmaniosis is an important human disease very difficult to treat. For this reason, many researchers in the world have been look- ing for anti-leishmanial chemical components present in several plant species. In Costa Rica, since no studies have been done in this field, this work aimed at the search of active chemical components in local plants that may have an activity against Leishmania sp. A total of 67 plants were selected from the Alberto Manuel Brenes Biological Reserve (REBAMB). For these collected plants, fresh or dried hidroalcoholic extracts of root, stem, mature or young leaves, flowers, and immature or mature fruits, were prepared under conventional methods. All extracts were tested for their effect against a strain of Leishmania (OCR with known characteristics). Firstly, by presumptive tests, we selected only those with some activity, and then, more specific studies were done to determine the IC50 in µg/mL; a promising plant was considered only if at least one of its parts presented an IC50 < 100 µg/mL. Under this parameter, the following active plants were obtained and their lowest and highest IC50 obtained values presented (µg/mL): Bocconia frutescens (0.6 and 66.7), Clematis dioica (27.5 and 44.4), Cordia megalantha (80.0), Eugenia austin-smithi (90.6), Guarea bullata (98.8), Guateria tonduzii (44.4 and 66.3), Mikania holwayana (45.0 and 95.6), Nectandra membranacea (44.5 and 58.6), Neurolaena lobata (25.0 and 100.0), Persea povedae (76.9), Piper auritum (60.0), Rollinia pittieri (43.1), Solanum arboreum (25.8 and 72.5), Tetrorchidiumn eurphyllum (53.8 and 95.0), Witheringia solanacea (15.9 and 98.1) and Zanthoxylum juniperinum (23.4 and 97.5). Although the parasitic effect of fresh or dried extracts were almost similar, the fresh material slightly showed better results. That anti-parasitic effect occurred in one or more than four parts of the plant. Most of the active extracts did not produce lysis and aglutination which indicates a low toxicity. Since the species studied are different from those analyzed by other authors, we discuss the importance of these new findings, in relation to the new scientific knowledge, and the possible use of these plants as a leishmaniosis treatment.

Actividad contra Leishmania sp. (Kinetoplastida: Trypanosomatidae) de plantas en una Reserva Biológica de Costa Rica / Anti-leishmanial activity in plants from a Biological Reserve of Costa Rica

Leishmaniosis is an important human disease very difficult to treat. For this reason, many researchers in the world have been looking for anti-leishmanial chemical components present in several plant species. In Costa Rica, since no studies have been done in this field, this work aimed at the search of active chemical components in local plants that may have an activity against Leishmania sp. A total of 67 plants were selected from the Alberto Manuel Brenes Biological Reserve (REBAMB). For these collected plants, fresh or dried hidroalcoholic extracts of root, stem, mature or young leaves, flowers, and immature or mature fruits, were prepared under conventional methods. All extracts were tested for their effectagainst a strain of Leishmania (OCR with known characteristics). Firstly, by presumptive tests, we selected only those with some activity, and then, more specific studies were done to determine the IC50 in µg/mL; a promising plant was considered only if at least one of its parts presented an IC50<100µg/mL. Under this parameter, the following active plants were obtained and their lowest and highest IC50 obtained values presented (µg/mL): Bocconia frutescens (0.6 and 66.7), Clematis dioica (27.5 and 44.4), Cordia megalantha (80.0), Eugenia austin-smithi (90.6), Guarea bullata (98.8), Guateria tonduzii (44.4 and 66.3), Mikania holwayana (45.0 and 95.6), Nectandra membranacea (44.5 and 58.6), Neurolaena lobata (25.0 and 100.0), Persea povedae (76.9), Piper auritum (60.0), Rollinia pittieri (43.1), Solanum arboreum (25.8 and 72.5), Tetrorchidium euryphyllum (53.8 and 95.0), Witheringia solanacea (15.9 and 98.1) and Zanthoxylum juniperinum (23.4 and 97.5). Although the parasitic effect of fresh or dried extracts were almost similar, the fresh material slightly showed better results. That anti-parasitic effect occurred in one or more than four parts of the plant.Most of the active extracts did not produce lysis and aglutination which indicates a low toxicity. Since the species studied are different from those analyzed by other authors, we discuss the importance of these new findings, in relation to the new scientific knowledge, and the possible use of these plants as a leishmaniosis treatment. Rev. Biol. Trop. 62 (3): 1229-1240. Epub 2014 September 01.

La leishmaniosis es una enfermedad muy importante para el ser humano pero su tratamiento es bastante difícil. Por esta razón muchos investigadores han venido buscando plantas que contengan componentes químicos activos contra esta parasitosis. En Costa Rica no se tienen estudios al respecto y por eso el objetivo de este estudio fue la búsqueda de componentes activos contra Leishmania sp. en plantas de Costa Rica; 67 especies de la Reserva Biológica Alberto Manuel Brenes (REBAMB) fueron seleccionadas para realizar este trabajo. Para ello se prepararon extractos crudos hidro-alcohólicos de material fresco o desecado de raíz, tallo, hojas maduras o tiernas, flores y frutos inmaduros o maduros. Usando pruebas presuntivas y luego específicas, se analizó el efecto de tales extractos sobre una cepa de Leishmania (OCR). Se consideraron plantas promisorias solamente aquellas en que al menos una de sus partes presentara un CI50<100µg/mL. Las plantas seleccionadas fueron: Bocconia frutescens, Clematis dioica,Cordia megalantha, Eugenia austin-smithii, Guarea bullata, Guateria tonduzii, Mikania holwayana, Nectandra membranacea,Neurolaena lobata, Persea povedae, Piper auritum, Rollinia pittieri, Solanum arboreum, Tetrorchidium euryphyllum, Witheringia solanacea y Zanthoxylum juniperinum. Existió una ligera tendencia de positividad mayor para los extractos frescos y la actividad se presentó en una y hasta más de cuatro partes de la planta. La mayoría de los extractos activos no fueron tóxicos. Se discute la importancia de estos nuevos hallazgos, en relación con el nuevo conocimiento científico y su proyección en el tratamiento de la leishmaniosis.

Autopercepción de los residentes de la relación con su tutor de medicina familiar durante el proceso de tutoría en investigación / Residents' selfperception of their relationship with their family medicine tutor during the research mentoring process

Introducción: Durante el proceso de tutoría en investigación se presenta una relación personal entre el residente y su tutor que tiene gran importancia para el desarrollo del trabajo de tesis. En este trabajo se presenta la autopercepción que el residente experimentó sobre los aspectos positivos y negativos durante el proceso del trabajo de tesis de su especialidad. Objetivo: Identificar las características generales de la auto-percepción de los residentes en la relación con su tutor de medicina familiar durante el proceso de tutoría en investigación. Material y métodos: Estudio descriptivo, transversal y observacional. Participaron 77 residentes del Curso de Especialización en Medicina Familiar. Se diseñó un cuestionario para evaluar la autopercepción de la relación de los residentes con su tutor durante el proceso de tutoría de sus tesis. El cuestionario formó parte de un instrumento de 45 preguntas, 15 de ellas para evaluar las características de la autopercepción de los residentes de la relación con su tutor de medicina familiar durante el proceso de tutoría en investigación. Las preguntas fueron diseñadas en escala ordinal tipo diferencial semántico de seis opciones de respuesta con valores entre 1 y 6. El análisis estadístico se realizó mediante estadística descriptiva e inferencial (prueba binomial y x²). La confiabilidad fue determinada mediante el coeficiente alfa de Cronbach. Resultados: El promedio de evaluación de la autopercepción de los residentes en la escala positiva (8 items) fue de 42.81 ± 5.09, el coeficiente de confiabilidad alfa de Cronbach = 0.833. El promedio en la escala negativa (7 ítems) fue de 16.70 ± 6.523, el coeficiente de confiabilidad alfa de Cronbach = 0.645. Conclusiones: Los residentes se autoperciben con puntuaciones altas en los aspectos de interés, puntualidad, honestidad, compromiso, satisfacción, cumplimiento, motivación y capacidad; manifestaron puntuaciones bajas en actitud negativa e intolerancia durante el proceso de tutoría. Sin embargo no mostraron una tendencia clara (puntuaciones medias) en su autopercepción en los aspectos de irresponsabilidad, fastidio, frustración y preferencia por no realizar el trabajo de tesis y usar el tiempo en otras actividades. Los resultados conducen a analizar la validez de constructo de los elementos que integraron el contenido teórico del cuestionario utilizado.

Introduction: During research mentoring process, a relationship between resident and tutor is developed which is of great importance for thesis development. This paper presents the self-perception on positive and negative aspects that residents experienced during their thesis development. Objective: To identify the general characteristics of residents' self-perception in their relationship with family medicine tutor during the research mentoring process. Material and methods: A descriptive, cross sectional, and observational study was performed. Seventy seven residents from Specialization Course in Family Medicine participated in this study. A questionnaire to assess self-perception of the relationship of residents with their tutor during the thesis tutoring process was designed. The questionnaire was part of a 45 item instrument, 15 to evaluate the characteristics of self-perception of their relationship with the Family Medicine tutor during the research mentoring process. The questions were designed on an ordinal scale of six semantic differential-type response choices with values between 1 and 6. Statistical analysis was performed using descriptive and inferential statistics (binomial test and x2). Reliability was determined using Cronbach's alpha coefficient. Results: The average of residents'self-perception assessment in the positive scale (8 items) was 42.81 ± 5.09, Cronbach's alpha reliability coefficient = 0.833. Average in the negative scale (7 items) was 16.70 ± 6523, Cronbach's alpha reliability coefficient = 0.645. Conclusions: Residents perceive themselves with high scores on: interest, punctuality, honesty, commitment, satisfaction, compliance, motivation and ability, they showed low scores on negative attitudes and intolerance during the mentoring process. No clear trend (mean scores) in their self-perception in aspects such as irresponsibility, boredom, frustration and preference for not doing the thesis work and using the time in other activities however was showed. Results lead to analyze construct validity of the elements that formed the theoretical content of the questionnaire used.

La privación social y afectiva de la madre se asocia a alteraciones anatómicas y funcionales en el feto y recién nacido / Social and emotial deprivation in the mother is associated with anatomical and functional alterations in the fetus and newborn

Objetivo: Demostrar que la privación social y afectiva en la madre se asocia a restricción del crecimiento fetal, muerte fetal, parto pretérmino, alteraciones anatómicas y funcionales en el feto y recién nacido. Materiales y Métodos: Estudio retrospectivo en el que se analizó la base de datos materno-perinatal del Hospital San Bartolomé. Se examinó tres grupos de gestantes con privación social y afectiva: 1) madres solteras (n=6561), 2) gestantes adolescentes con ausencia de control prenatal (n=2131) y 3) primigestas con talla menor de 160 cm (n=35722). Se comparó las complicaciones maternas y perinatales con las gestantes : 1) madres con unión estable (n=40629), 2) gestantes adolescentes con control prenatal (n=7644) y 3) primigestas con talla mayor de 159 cm (n=5264). Se empleó el odds ratio (OR) y el intervalo de confianza al 95 por ciento (IC). Resultados: Las madres solteras presentaron mayor riesgo de falla en la función placentaria (OR 1,92, IC95 por ciento 1,51-2,44), restricción del crecimiento fetal (OR 2,02, IC95 por ciento 1,45-2,82), rotura prematura de membranas fetales (OR 1,28, IC95 por ciento 1,00-1,63) comparadas con las madres con unión de pareja estable. Las gestantes adolescentes con ausencia de control prenatal presentaron mayor riesgo de muerte fetal (OR 2,89, CI95 por ciento 1,85-4,50), rotura prematura de membranas fetales (OR 1,38, CI95 por ciento 1,18-1,62), parto pretérmino (OR 1,63, CI95 por ciento 1,39-1,91), neonato pequeño para la edad (OR 1,25, IC95 por ciento 1,08-1,44), morbilidad neonatal (OR 1,23, IC95 por ciento 1,07-1,41), asfixia perinatal (OR 2,73, IC95 por ciento 1,33-5,58), neonato con Ápgar bajo en minuto 1 (OR 1,26, IC95 por ciento 1,05-1,52), dificultad respiratoria (OR 1,51, IC95 por ciento 1,10-2,06), sepsis neonatal (OR 1,54, IC95 por ciento 1,19-1,99), prematuridad (OR 1,50, IC95 por ciento 1,27-1,78), muerte neonatal (OR 2,56, IC95 por ciento 1,88-3,48) y muerte perinatal (OR 3,02, IC95 por cie...