Extinction in multiple contexts reduces the return of extinguished responses: A multilevel meta-analysis.

Extinguished responses have been shown to reappear under several circumstances, and this reappearance is considered to model behaviors such as relapse after exposure therapy. Conducting extinction in multiple contexts has been explored as a technique to decrease the recovery of extinguished responses. The present meta-analysis aimed to examine whether extinction in multiple contexts can consistently reduce the recovery of extinguished responses. After searching in several databases, experiments were included in the analysis if they presented extinction in multiple contexts, an experimental design, and an adequate statistical report. Cohen's d was obtained for each critical comparison and weighted to obtain the sample's average weighted effect size. Analyses were then performed using a multilevel meta-analytic approach. Twenty-five studies were included, with a total sample of 37 experiments or critical comparisons. The analyses showed a large effect size for the sample, moderated by the length of conditioned stimulus exposure, type of experimental subject, and type of recovery. The robust effect of extinction in multiple contexts on relapse should encourage clinicians to consider extinction in multiple contexts as a useful technique in therapy and research.

TRYPANOSOMA CRUZI INFECTION IN THREE SLENDER-TAILED MEERKATS (SURICATA SURICATTA).

Trypanosoma cruzi is a protozoan parasite primarily transmitted by triatomine insects (Hemiptera: subfamily Reduviidae) and is the cause of Chagas disease (CD). This report describes three cases of CD in a mob of five slender-tailed meerkats (Suricata suricatta) living in an outdoor exhibit at one zoological institution in Texas. The index case was a 9.5-yr-old female that presented with ataxia, lethargy, and pleural effusion. This case was diagnosed with CD postmortem via cytology, T. cruzi PCR of whole blood and lung fluid, and histology. Blood was opportunistically collected from the remaining four meerkats 28 d after the death of the index case and tested by PCR and serology. The second case was a clinically normal 7.5-yr-old male that tested PCR and antibody positive and the third case was a clinically normal 9-yr-old female that tested PCR positive. The second animal presented depressed, with pneumonia, and with continuous shivering 53 d after blood collection, and clinically improved after treatment with antibiotics and supportive care. Fifteen days later, the animal was found minimally responsive and died shortly thereafter. Histologic examination revealed Trypanosoma sp. amastigotes in the myocardium and the tissue was positive for T. cruzi DNA. The third meerkat, which received two separate courses of benznidazole over a span of almost 2 yr, was monitored routinely by PCR and serology and appeared clinically normal until found dead on exhibit 93 d after completion of the second treatment. Myocardium was positive for T. cruzi DNA. To the authors' knowledge, this case series is the first to document Chagas disease in meerkats and features associated cytologic and histologic findings.

Evaluación de características de personalidad psicopática en adolescentes según complejidades delictuales / Evaluation of psychopathic personality characteristics in adolescents according to criminal complexities

El objetivo de este estudio es determinar si existen diferencias en características psicopáticas según complejidades delictivas en adolescentes. Se utiliza un diseño de encuesta transversal correlacional y un muestro intencional. La muestra está constituida por 49 adolescentes de entre 14 y 18 años (M = 16,08, DE = 1,06) caracterizados por complejidades delictuales por criterios de experto, utilizando los lineamientos MMIDA (Perez-Luco et al., 2014). Una vez caracterizados son evaluados a través del Youth Psychopathic Traits Inventory (YPI, Andershed et al., 2002). Los resultados arrojan diferencias estadísticamente significativas en características psicopáticas entre los grupos persistentes y control (F (2, 40) = 3,45, p = ,04). Específicamente, en el Factor 2 Dureza/Insensibilidad (F (2, 41) = 4,41, p = ,02) en la sub escala Falta de Remordimiento (F (2, 41) = 8,17, p = ,001) y en Irresponsabilidad (F (2, 44) = 5,69, p = ,01). Se concluye que los adolescentes vinculados a una delincuencia persistente pertenecen a una población distintiva en su afectividad, en contraste con adolescentes que no reportan delitos; se discuten sus posibles implicancias

Perceptions of professionals regarding interventions involving family members responsible for justice-involved youth with substance use disorders in Santiago, Chile.

BACKGROUND: Eliciting professionals' experiences of current drug treatment programmes can lead to improvements of these youth-centred programmes through the involvement of the concerned youths' families. We explored perceived barriers amongst professionals concerning interventions incorporating parents or guardians responsible for justice-involved youth with substance use disorders. METHODS: We conducted semi-structured in-depth interviews with fourteen female and four male professionals, each representing one of eighteen programmes under the Chilean National Drug Treatment Programme (2016-2017), who were tasked with contacting and/or intervening in the families of justice-involved youth. Subsequently, we performed traditional content analysis. RESULTS: The professionals identified four key barriers impeding interventions: (1) parents' non-adherence to the treatment and issues relating to their role fulfilment; (2) tensions within the programme design that constrain the families' involvement in the interventions; (3) the lack of a supportive professional network offering interventions that complement drug treatment; (4) the problematic and dangerous living contexts of these families that discourage family involvement. Additionally, professionals identified intervention needs for improving treatment outcomes. CONCLUSIONS: The negative perceptions of professionals regarding the interventions as well as families and family contexts of justice-involved youth, and the lack of support from other programmes, induced feelings of hopelessness and pessimism amongst the professionals regarding the effectiveness of the Chilean National Drug Treatment Programme. It is essential to consider professionals' perspectives not only to benefit from their expertise, but also to assess whether their perspectives may hinder the implementation of changes when attempting to innovate drug treatment modalities aimed at improving their outcomes.

A Case Report on the Use of Pharmacological Intervention in the Treatment of Diffuse Axonal Injury From Road Traffic Accidents.

We report a case of traumatic brain injury treated with Cerebrolysin, a neurorecovery stimulating agent. Our therapeutic approach was based on the pathophysiology of traumatic brain injury and, in particular, of diffuse axonal injury. The patient registered marked improvement in mood and cognitive performance, indicating the effectiveness of multimodal and multidisciplinary interventions after traumatic brain injury.

Point-of-use Unit Based on Gravity Ultrafiltration Removes Waterborne Gastrointestinal Pathogens from Untreated Water Sources in Rural Communities.

OBJECTIVE: In developing countries, rural communities often face the lack of potable water infrastructure and must rely on untreated sources for drinking, which are often contaminated with waterborne pathogens. The use of home water treatment devices is seen as one means of reducing the risk of exposure to waterborne pathogens. The aim of this study was to evaluate the microbiological and physicochemical performance of a simple in-home point-of-use device based on gravity ultrafiltration through an ultrafilter membrane. METHODS: Twenty-five randomly selected households from 2 rural communities in Culiacán, Mexico, were enrolled. Water samples were collected before and after treatment and during storage for a period of 8 weeks. Heterotrophic bacteria, total coliforms, fecal coliforms, Escherichia coli, and Giardia spp were quantified, as well as various physicochemical parameters. RESULTS: All of the untreated water samples contained high levels of indicator bacteria, but none were detected in the treated water fulfilling the requirements set by the Mexican Norm (NOM-127-SSA1-1994) and the World Health Organization guidelines for drinking water. However, indicator bacteria (fecal coliforms and E coli) were detected in every sample from water stored 24 hours after treatment. CONCLUSION: This study demonstrated that point-of-use filters using gravity-fed ultrafilters are a low-cost, effective water treatment technology for water of poor microbial quality. However, further identification of the sources and mechanisms by which water is contaminated when stored after treatment will help with designing and implementing better strategies for keeping water safe for domestic use.

Valoración de la capacidad funcional del adulto mayor residente en casa hogar / Assessment of functional capacity of older adults living in nursing homes

Resumen:

Introducción: el envejecimiento es un proceso de cambios progresivos que repercuten en la funcionalidad física y esta, a su vez, es el mejor indicador de salud en la población adulta mayor. Objetivo: realizar un diagnóstico de la capacidad funcional del adulto mayor residente de casas hogar del sur de Jalisco.

Metodología: se llevó a cabo un estudio transversal descriptivo prospectivo en adultos mayores, en quienes se aplicó la Escala de Barthel para evaluar su capacidad para realizar 10 actividades básicas de la vida diaria. La muestra fue no aleatoria por conveniencia. Se obtuvo el consentimiento informado. Se utilizó estadística descriptiva, X2 para comparaciones entre los sexos. Las diferencias se consideraron estadísticamente significativas con una p < 0.05.

Resultados: la muestra estuvo conformada por 111 adultos mayores. El promedio de edad fue de 81 años, 27.9 % mostró independencia total, 28.8 % dependencia leve, 14.4 % moderada, 18 % severa y 10.8 % total. Estadísticamente no hubo diferencia significativa según el sexo (p = 0.36). Las actividades básicas con mayor número de sujetos independientes totales fueron comer, arreglarse, vestirse, control en la micción y evacuación, trasladarse y deambulación; subir y bajar escaleras y lavarse fueron actividades en las que más sujetos mostraron dependencia total.

Conclusiones: 72.1 % de los adultos mayores presentó algún grado de dependencia funcional, lo que representa una oportunidad para el cuidado de enfermería.

Abstract:

Introduction: Aging is a process of progressive changes that affect physical functioning, and this is the best health indicator of the adult population.

Objective: To make a diagnosis of the functional capacity of elderly residents of nursing homes in southern Jalisco.

Methodology: A cross sectional, descriptive, prospective study in older adults was conducted, in whom Barthel scale was used to assess their ability to perform ten basic activities of daily living. The sample was not random for convenience. Informed consent was obtained. Descriptive statistics were used, X2 for comparisons between sexes. Differences were considered statistically significant at p < 0.05.

Results: The sample consisted of 111 elderly. The mean age was 81 years, 27.9 % showed complete independence, 28.8 % mild dependence, 14.4 % moderate, 18 % severe and 10.8 % total dependence. There was no statistically significant sex differences (p = 0.36). The basic activities with the highest number of total independent subjects were eating, grooming, dressing, micturition and defecation continence, moving and walking; going up and down stairs and bathing were activities in which subjects showed more total dependence.

Conclusions: 72.1 % of elderly had some degree of functional dependence, which represents an opportunity for nursing care.

Intolerancia a la lactosa / Lactose intolerance

La lactosa es un disacárido de amplia distribución en la dieta y productos farmacéuticos, es el hidrato de carbono de la leche de los mamíferos. La intolerancia a la lactosa puede presentarse como congénita, hipolactasia del desarrollo, primaria y secundaria. Frente a la sospecha de ésta patología la clínica es lo principal, pudiendo investigarla a través de la prueba contraprueba, la prueba de hidrógeno espirado, la biopsia y por estudio de polimorfismos a través biología molecular (aún en estudio). Su tratamiento consiste en la disminución o exclusión de lactosa, uso de suplementos lácteos, sin olvidar la ingesta mínima requerida de calcio y vitamina D importantes en el desarrollo óseo.

Drinking water microbiological survey of the Northwestern State of Sinaloa, Mexico.

A potable water survey, in two important municipalities of the state of Sinaloa, Mexico was conducted. Culiacan, capital city of Sinaloa and its neighboring municipality, Navolato were selected to enumerate Aeromonas hydrophila, Escherichia coli, fecal and total coliforms, Pseudomonas aeruginosa, and Heterotrophic plate count bacteria from 100 households' taps. Manganese; residual chlorine; pH; temperature and turbidity were also examined. Overall, Aeromonas hydrophila was not detected in any of the samples, 3% contained Escherichia coli, 28% had fecal and 46 total coliforms, P. aeruginosa was present in 15% of the samples. HPC bacteria were found in all of the samples but 43% had numbers greater than 500 CFU per ml. The average numbers obtained for the physico-chemical parameters were 0.15 mg/L; 0.32 mg/L; 6.5; 28.7 degrees C and 2.92 NTU for manganese, residual chlorine, pH, temperature and turbidity, respectively. The findings of the current study demonstrate that potable water from both municipalities can harbor substantial numbers of indicator and opportunistic pathogens suggesting that additional treatment in the household may be needed.

Internalization of Salmonella typhimurium into mango pulp and prevention of fruit pulp contamination by chlorine and copper ions.

Outbreaks of Salmonella infections associated with fresh mango consumption have occurred in recent years. The study's objective was to assess the effectiveness of chlorine and copper ions to reduce Salmonella typhimurium from hydro-cooling water and prevent fruit pulp contamination of heat-treated mangos. Mature green Tommy Atkins' mangos were immersed in water at 46.1 degrees C for 100 min. Heat-treated mangos were then introduced, during 30 min, in 25 degrees C water containing 6 Log(10) CFU/ml of Salmonella with or without disinfectants (5 and 8 mg/l of either chlorine or copper ions). Chlorine at 5 and 8 mg/l reduced 6 Log(10) CFU/ml of Salmonella. Copper ions at 5 and 8 mg/l reduced 3.26 and 4.3 Log(10) CFU/ml, respectively. 2 Log(10) of Salmonella penetrated into mango pulp when disinfectants were not applied to 25 degrees C water. Both chlorine and copper ions were effective in preventing fruit pulp contamination by Salmonella typhimurium. Of residual chlorine, 2.37 and 3.54 mg/kg were detected in mango pulp after the treatment of 5 and 8 mg/l, respectively. Copper ions at 5 and 8 mg/l showed a residual content of 0.1 and 0.6 mg/kg on mango pulp, respectively. The chloride and copper residual levels in the pulp did not exceed the daily ingestion rates recommended by the National Academy of Sciences. Salmonella entered mango pulp by vascular elements and lenticels, both natural structures measuring an average diameter of 21 and 112 microm, respectively. The results illustrate the potential for pathogen penetration if heat-treated mangos are cooled in non-disinfected water. Also, appropriate chlorine or copper ion concentration prevents fruit pulp contamination.

Effect of water suspended particles on the recovery of Cryptosporidium parvum from tomato surfaces.

An increase in the number of outbreaks of foodborne disease associated with fresh produce consumption has been described. The objective of the present study was to evaluate the effect of water suspended particles during immersing/spraying disinfection processes and the recovery of Cryptosporidium parvum oocysts from tomato surfaces. Tomatoes (Lycopersicum esculetum Mill.) were immersed/sprayed with chlorinated water with low and high suspended particle content (10 and 1,000 mg/l) containing 100, 1,000 or 10,000 oocysts/l. Tomatoes were evaluated after a contact time of 120 seconds and 30 seconds for immersing and spraying procedures, respectively. The immersing procedure showed a high recovery of C. parvum oocysts from the tomato surface when the concentration was 10,000 oocysts/l and 10 mg/l suspended particles (295+/-94 [mean+/-standard deviation]). High particle content affected oocyst recovery and dissolved particles exerted a chlorine demand reducing the disinfectant residual. In the spraying procedure, the highest recovery was observed with 10,000 oocysts/l (225+/-72). Our understanding is that the association of C. parvum oocysts with suspended particles might promote the oocyst deposition in the wash water tanks and that this interaction should be considered when evaluating the quality of the water.

Occurrence of Cryptosporidium and Giardia in irrigation water and its impact on the fresh produce industry.

In Mexico, relatively few studies have examined the presence of protozoan parasites from surface waters with irrigation and wash-water applications in the fresh produce industry. In this study, the presence of Cryptosporidium oocysts and Giardia cysts in surface water for irrigation, washing and disinfecting applications was evaluated. In addition, the occurrence of Cryptosporidium oocysts and Giardia cysts was determined in wash-water tanks at selected packinghouses. The occurrence of both Cryptosporidium and Giardia was determined by an immunofluorescent technique. Forty-eight percent of the surface water samples tested positive for Cryptosporidium oocysts and 50% tested positive for Giardia cysts. Concentration ranges for Cryptosporidium oocysts and Giardia cysts were 17-200 and 17-1633 per 100 litres, respectively. Sixteen percent of the wash-water tanks tested positive for Cryptosporidium oocysts and 83% were positive for Giardia cysts with concentrations ranging from 1-133 oocysts and 100-533 cysts per 100 litres, respectively. The presence of protozoan parasites in surface water for irrigation and packinghouse operations suggests that there may be a risk of contamination of fresh produce as protozoan oocysts/cysts might come in contact with and attach to crop surfaces posing a risk of infection to consumers who eat these products.

Información y conocimientos que posee la población del municipio de Temuco y de otros municipios de la IX Región de Chile sobre cáncer cérvicouterino y su prevención / Information and knowldges about cancer of the uterine cervix and its prevention amog the population of Temuco, Chile and another municipalities of the IX Región

El objetivo de este trabajo es el de determinar los conocimientos y grado de información sobre los métodos preventivos y de diagnóstico precoz, que posee la población de nuestra región (la IX) sobre el cáncer cervicouterino, una patología con alta incidencia y morbimortalidad en nuestro medio. En el marco de unas charlas que realizamos sobre el tema aplicamos una autoencuesta a grupos comunitarios pertenecientes a la municipalidad de Temuco y otras 5 municipalidades de la región. Se constató desinformación sobre la enfermedad misma, así como también sobre los métodos de prevención y diagnóstico precoz. Esto crea la necesidad de continuar realizando planes masivos de prevención, aumentando la cobertura y la calidad de la información para así lograr el compromiso de mujeres en edades de riesgo haciendo que ellas tomen conciencia del PAP como una forma de cuidar su salud