Whole-genome sequence analysis of multidrug-resistant uropathogenic strains of Escherichia coli from Mexico.

Background : Escherichia coli is the main bacterium associated with urinary tract infections (UTIs), including cystitis and pyelonephritis. Uropathogenic E. coli (UPEC) harbors numerous genes that encode diverse virulence factors contributing to its pathogenicity. The treatment of UTIs has become complicated due to the natural selection of E. coli strains that are multiresistant to several groups of antibiotics regularly used in clinical settings such as hospitals. Genomic reports of the global composition and distribution of the antibiotic resistance and virulence genes of these pathogenic strains are lacking in the Mexican population. Purpose and methods : The aim of this study was to globally characterize the genomes of a group of UPEC strains by massive parallel sequencing to determine the prevalence and distribution of virulence and antibiotic resistance genes associated with different serotypes and phylogenetic groups. Results: The strains exhibited 138-197 virulence genes and 29 antibiotic resistance genes related to antibiotics that are commonly used in clinical practice.  Conclusions: These findings are relevant to the definition of new strategies for treating urinary tract infections in public hospitals and private practice. To further define the epidemiological distribution and composition of these virulence and antibiotic resistance genes, larger studies are needed.

Taenia solium: antioxidant metabolism enzymes as targets for cestocidal drugs and vaccines.

This review focuses in the role that antioxidant enzymes play in protection and other important physiological functions such as signal transduction, cell differentiation, growth and apoptosis. Parasites use these enzymes to evade ROS produced by the host immune response and for development inside the host. In the cestoda Taenia solium, three antioxidant enzymes have been studied: a cystosolic Cu,Zn superoxide dismutase that is a target of cestocidal drugs (bencimidazoles); a 2-Cys peroxiredoxin that is a regulatory enzyme of H(2)O(2), molecule essential for several physiological functions; and two isoforms of glutathione transferases that are immunological targets, since they protect immunized mice against cysticercosis. Moreover, all these enzymes are present in all stages of the parasite. These findings suggest that antioxidant enzymes have an important role in T. solium physiology and infection, therefore they might represent the Achilles' heel of the parasite.

Self-evaluation of unintended biases and prejudices.

A scale for measuring self-assessment of factors, which might lead to unintended biases and prejudices, was tested with 39 professionals working with adolescents on probation. The scale has 10 items (e.g., "Would feel comfortable providing clinical services to [e.g., African Americans]." Each item was rated on a 3-point scale so as summated scores increase across items the probability of unintended biases and prejudices against five culturally diverse groups (African American, American Indian, Asian, Hispanic, and White) would also increase. The coefficient alpha was .87. Participants' mean unintended bias and prejudices across items were always lower toward clients from their own racial or ethnic group. For example, Hispanic and White participants tended to be more prompt to display these attitudes against African Americans, relative to African-American participants. White participants, however, reported lower scores leading to unintended biases in the case of White clients, relative to African-American and Hispanic participants. Overall, participants' mean unintended bias and prejudices against American Indian and Asian clients tended to be higher with these groups, relative to clients from the African-American, Hispanic, and White communities. Results are discussed in terms of further development of the scale in the design of cross-cultural training in various working environments with culturally diverse clients.

Knowledge of laws regulating issues related to HIV and AIDS: development of the HIV/AIDS and the law scale.

42 middle-aged and older adults, ranging in age from 51 to 85 years, completed 10 items dealing with the assessment of knowledge regarding laws regulating issues related to HIV and AIDS. Participants also completed 40 items involving knowledge of risks for HIV infection. The Cronbach coefficient alpha and test-retest reliability coefficient on the HIV/AIDS and the Law Scale were .74 and .83, respectively. Over-all, the grand mean for correct answers was 46.9%, whereas the grand means for incorrect answers and "don't know" responses were 13.6% and 39.5%, suggesting substantial lack of knowledge of laws regulating issues related to HIV and AIDS. Women (50%) and younger participants (51 to 66 years old; 48.2%) showed more of this knowledge (50%) than men (43.0%) and older participants (46.2%). The sample reported a substantial amount of knowledge regarding HIV transmission assessed with factual (92.2% correct) and misconception (87.5% correct) items. The correlation between this knowledge and knowledge of laws regulating issues related to HIV and AIDS was .42 (p < .01). Research with this scale using adolescents and young adults as well as the utility of the scale in areas of clinical, legal, and policy development are discussed.

Commentary on the possibility that Viagra may contribute to transmission of HIV and other sexual diseases among older adults.

Many older male adults experiencing impotence are being treated with Viagra. Scientific and media reports indicate that this medication is effective in re-establishing sexual relationships among these men. Despite the benefits that Viagra may have in the treatment of impotence among older adults, increased sexual activities could also facilitate the spread of HIV infection and other sexually transmitted diseases. This holds for older adults who may lack factual knowledge of HIV transmission and perceive themselves as nonsusceptible to this disease. Prescription of Viagra in combination with HIV/AIDS prevention programs may be helpful.

HIV/AIDS education survey for mental health professionals.

A total of 6804 mental health professionals, e.g., licensed and certified psychologists, licensed professional counselors, in Arkansas, Louisiana, New Mexico, Oklahoma, and Texas were mailed a questionnaire regarding HIV/AIDS topics professionals might recommend for educational programs. Participants were asked to rate how strongly they would recommend each topic. The return rate was 31% (2121). The percentage of participants who did not recommend the topics was low (0.7%-10.9%). Most topics were either recommended (6.5%-50.2%) or strongly recommended (29.0%-92.8%). Topics with ratings of 80% of participants endorsing the strongly recommended rating included psychological crises associated with learning one is HIV positive, psychosocial issues, and counseling dying clients regarding grief, loss, and legal issues. The results are discussed in terms of continuing to develop educational programs targeting mental health professionals.

Students' perception of a difficult case in psychotherapy.

Paniagua, et al. suggested that the definition of a "difficult" case in psychotherapy implies a relational definition involving the characteristics of the patient, the case, and the therapist. This study concerned this hypothesis with 44 graduate students in social work who received the Difficult Case Questionnaire representing examples of variables across each domain, e.g., motivation of the client, nature of the disorder, generic factors, and orientation of the therapist. The results were compared with the 1993 findings reported by Paniagua, et al., for a group of professionals in mental health practice. As in the earlier study, the present sample also agreed that, although all such domains are important in the formulation of that definition, their importance is not equal. Whereas professionals rated patient's, case's, and therapist's characteristics as the most important order of domains in that definition, students in this study agreed on the order of therapist's, patient's, and case's characteristics.

Training health professionals in the recognition and treatment of depression.

A total of 423 health professionals, including physicians, psychologists, counselors, social workers, and nurses, attended a two-day program to increase awareness, recognition, and treatment of depression. In a preprogram opinion survey, nurses and social workers reported less perceived ability to recognize mood disorders compared with physicians and psychologists. In a group of 274 respondents who took a 20-item test of their knowledge about depression before and after attending the program, scores for all professions increased after the program and pretest differences in scores between professions decreased. The results suggest that training was successful in increasing knowledge about depression among a diverse group of health professionals.

Post-disaster malaria in Costa Rica.

INTRODUCTION: In recent years, controversy has surrounded the issue of whether infectious disease should be considered a serious potential consequence of natural disasters. This article contributes to this debate with evidence of a significant outbreak of malaria in Costa Rica's Atlantic region after the 1991 earthquake and subsequent floods. METHODS: This study is an epidemiologic investigation of the incidence of malaria for the periods of 22 months before the April 1991 Limón earthquake and for 13 months afterward. Data were obtained from the Costa Rican Ministry of Health's malaria control program. RESULTS: Some of the cantons in the region experienced increases in the incidence of malaria as high as 1,600% and 4,700% above the average monthly rate for the preearthquake period (p < or = 0.01). Causal mechanisms are postulated as relating to changes in human behavior (increased exposure to mosquitoes while sleeping outside, and a temporary pause in malaria control activities), changes in the habitat that were beneficial to mosquito breeding (landslide deforestation, river damming, and rerouting), and the floods of August 1991. CONCLUSIONS: It is recommended that there be enhanced awareness of the potential consequences of disaster-wrought environmental changes. Date of Event: 22 April 1991; Type: Earthquake, 7.4 Richter scale; LOCATION: Costa Rica; Number of deaths and casualties: 54 deaths and 505 moderate to severe injuries.

Anomalies in covert conditioning.

The covert conditioning approach has received much empirical support. Despite the utility of this approach, a number of anomalies (or methodological problems) have been considered in the past. This study describes three anomalies in covert conditioning which have received little attention: (1) the difficulty in assessing the application of the covert conditioning technique by the client, (2) the difficulty in explaining client's failures during use of the technique in terms of either problems with the therapist's instructions regarding the use of the technique or problems with the client's inability to imagine the scene, and (3) the use of single-case experimental designs in the evaluation of the effectiveness of covert conditioning techniques seems to violate the experimental format of such designs.

The role of a research seminar for child psychiatry residents.

A major problem confronting the field of child and adolescent psychiatry is the development of teaching strategies to stimulate research activities and an appreciation of research. A teaching approach is described which emphasizes major research concepts using a programmed instruction method and illustrating these concepts with clinical cases. Fourteen child psychiatry residents participated in the seminar during a 3-year period. Overall, trainees' evaluation of the seminar was positive, and they demonstrated a high level of understanding across major research topics. In addition, the seminar may have contributed to an increased preference for academic careers by graduating residents.

Comportamiento sexual en una población de pacientes psiquiatricos / Sexual behavior in a psychiatry population

Se estudiaron 116 pacientes psiquiátricos de la consulta externa del Hospital Dr. Luis E. Aybar de Santo Domingo, entre 18 y 60 años de edad, investigando la presencia de parafilia como forma de gratificación sexual o parafilia exclusiva durante un período de 3 meses, comprendido desde octubre 1989 hasta enero 1990. De la muestra 84 (72.41 por ciento ) de los pacientes investigados, correspondieron al sexo femenino y 32 (27.59 por ciento ) al sexo masculino. Encontramos una incidencia de parafilia en un 20.31 por ciento de los pacientes. Un paciente presentó Parafilia exclusiva para 0.86

Management of a hyperactive-conduct disordered child through correspondence training: a preliminary study.

This study examined the clinical effects of correspondence training procedures in the management of a hyperactive-conduct disordered boy. During the reinforcement of promise-do correspondence procedure, a toy (reinforcer) was given contingent upon the presence of a promise to inhibit target behaviors (e.g., inattention, overactivity, aggression) and the actual inhibition of such behaviors. This intervention was programmed in a multiple baseline design across settings. Consistently lower levels of hyperactivity and conduct disorders were noted during treatment, relative to baseline. A demonstration of the indirect effects of the procedures upon the child's academic performance was also seen.

A procedural analysis of correspondence training techniques.

A variety of names have been given to procedures used in correspondence training, some more descriptive than others. In this article I argue that a terminology more accurately describing actual procedures, rather than the conceptual function that those procedures are assumed to serve, would benefit the area of correspondence training. I identify two documented procedures during the reinforcement of verbalization phase and five procedures during the reinforcement of correspondence phase and suggest that those procedures can be classified, or grouped into nonoverlapping categories, by specifying the critical dimensions of those procedures belonging to a single category. I suggest that the names of such nonoverlapping categories should clearly specify the dimensions on which the classification is based in order to facilitate experimental comparison of procedures, and to be able to recognize when a new procedure (as opposed to a variant of one already in existence) is developed. Future research involving comparative analysis across and within procedures is discussed within the framework of the proposed classification.

Lying by children: why children say one thing, do another?

Lying constitutes a problematic behavior for parents and other social agents involved in children's development of effective behaviors. This analysis suggests that lying is, in part, the name for a lack of correspondence between saying and doing, and that effective correspondence training procedures can be designed to teach truthfulness in children through the teaching of either promise-then-do correspondence or do-then-report correspondence. This paper proposes a relational definition of lying and shows its applications in the area of correspondence training. The generalization and maintenance of truthfulness, advantages and disadvantages of correspondence training in the management of lying are also considered.

Teaching first-year students the interpersonal recall process for patient interviews.

The authors investigated how well 52 internal medical residents understood the four modes of the interpersonal process recall (IPR) system after the students had received training in this system, and also investigated whether the students taught by instructors trained in the IPR system had a greater understanding of the system than those taught by nontrained instructors. Students were tested before and after the course, which involved extensive use of videotapes of interviews. With some reservations, the data as a whole suggest that the IPR system can be taught effectively by an enhancement of the methods used for this study and that the instructors do not have to receive training in the system to teach it effectively.

A procedural distinction between elective and progressive mutism.

This paper introduces a procedural distinction between elective and progressive mutism. In elective mutism, a child elects to talk freely with intimates (e.g. family members); in progressive mutism a child does not communicate verbally with anyone (including intimates). This analysis argues that clinicians' therapeutic goals and parents' expectations of treatment outcomes for elective mutism would differ from those applied to a case of progressive mutism and that the selection of the appropriate concept (elective vs progressive) to name the type of mutism prior to intervention would enhance treatment outcomes.

Labeling and functional language in a case of psychological mutism.

Talking was increased in an 11-year-old girl who recently had stopped talking to anyone in any setting, despite the absence of biological factors, mental retardation, and autism. Productive labeling (correctly naming picture cards) and functional language (talking about picture cards in the absence of such pictures) were interspersed with a series of treatment packages (including verbal instructions, imitation, tokens, and praise). Interventions for productive labeling were programmed in a changing-criterion design. Interventions for functional language were programmed in an ABC design. Higher levels of productive labeling and functional language were noted with the introduction of the particular package, in comparison to baseline. The results also showed the generalization of the procedures to the shaping of functional language in the absence of picture cards.