Psychometric properties of the Buss-Perry Aggression Questionnaire-short form among law enforcement officers.

Repeatedly capturing national headlines, excessive law enforcement officer (LEO) use of force in critical incident encounters is one of the most divisive human rights issues in the United States. Valid and reliable measures of potential precursors to LEO excessive use of force, such as aggression, are needed. The Buss-Perry Aggression Questionnaire-short form (BPAQ-SF) is a validated measure of aggression across various populations; however, evaluation of this easily administered measure in high-stress, frontline populations such as LEOs is limited. The primary goal of this study was to evaluate the validity, reliability, and sensitivity to change the BPAQ-SF in a sample of LEOs. A confirmatory factor analysis suggested that the hierarchical solution provides a mixed fit to the data: SBχ²(25.84) = 62.50, p = .0001; comparative fit index = .94, non-normed fit index = .92, root mean square error of approximation = .19 (90% confidence interval = .17-.21), standardized root mean squared residual = .08. The BPAQ-SF demonstrated good internal consistency (α = .84) and test-retest reliability (r = .86), correlations in the expected direction with predictors of and buffers against aggression, and sensitivity to change among LEOs who participated in an intervention targeting aggression. Results support and extend previous findings suggesting that the BPAQ-SF is a valid and reliable measure of aggression among LEOs.

The impact of ethnic discrimination on chronic pain: the role of sex and depression.

ABSTRACTPerceived ethnic discrimination (PED) is predictive of chronic pain-related outcomes. Less is known about pathways through which these constructs interact. The goal of this study was to test whether PED was predictive of chronic pain-related outcomes (pain interference, pain intensity, and symptoms related to central sensitization), whether depression mediated the relationship between PED and pain outcomes, and if these relationships were maintained across sex in a sample of racially and ethnically minoritized adults (n = 77). PED significantly predicted pain interference, pain intensity, and symptoms related to central sensitization. Sex accounted for a significant proportion of the variance in pain interference only. Depression explained the relationship between PED and pain interference and pain intensity. Sex moderated the indirect pathway, such that for men, the relationship between PED and pain interference and pain intensity was explained via depression. Depression partially explained the relationship between PED and symptoms related to central sensitization. Sex did not moderate this mediational effect. This study provided a unique contribution to the pain literature by providing a contextual analysis of PED and pain. Addressing and validating experiences of lifetime discrimination may be a clinically relevant tool in the management of chronic pain for of racially and ethnically minoritized adults.

The relevance of music therapy in paediatric and adolescent cancer patients: a scoping review.

BACKGROUND: Music therapy is an emerging and useful methodology to improve the quality of life of children and adolescents with cancer. OBJECTIVES: The objective of this scoping review was to examine the available literature and offer an analysis of the relevance of music therapy in paediatric oncology. We considered the effects of music therapy on children and adolescents with cancer as well as the perception of this population, their families, music therapists, and health professionals regarding the music therapy sessions conducted. Finally, we analysed the characteristics of the distinct types of music therapy interventions reported in the literature. METHODS: In this review, we applied the methodology proposed by Arksey and O'Malley. After performing a comprehensive academic literature database search, 522 articles were identified of which, 27 met the inclusion criteria. RESULTS: The results shed light on the use of music therapy as a means to facilitate self-esteem, to improve the physical, emotional, and cognitive aspects related to disease and, to a lesser extent, alleviate their physiological symptoms. Both children and adolescents with cancer were represented in the academic literature. The most prevalent findings described in these studies were the benefits of music therapy in terms of improved psychological well-being and social relationships in this population. CONCLUSIONS: Music therapy interventions are generally well received, not only by children and adolescents with cancer, but also by their families, music therapists, and health professionals. Nevertheless, several gaps were identified in some of the studies we considered, including a lack of specificity regarding the results obtained or music therapy intervention methods used.

Intestinal microbiota regulates tryptophan metabolism following oral infection with Toxoplasma gondii.

INTRODUCTION: The intestinal microbiota plays an important role in modulating host immune responses. Oral Toxoplasma gondii infection can promote intestinal inflammation in certain mice strains. The IDO-AhR axis may control tryptophan (Trp) metabolism constituting an important immune regulatory mechanism in inflammatory settings. AIMS: In the present study, we investigated the role of the intestinal microbiota on Trp metabolism during oral infection with T gondii. METHODS AND RESULTS: Mice were treated with antibiotics for four weeks and then infected with T gondii by gavage. Histopathology and immune responses were evaluated 8 days after infection. We found that depletion of intestinal microbiota by antibiotics contributed to resistance against T gondii infection and led to reduced expression of AhR on dendritic and Treg cells. Mice depleted of Gram-negative bacteria presented higher levels of systemic Trp, downregulation of AhR expression and increased resistance to infection whereas depletion of Gram-positive bacteria did not affect susceptibility or expression of AhR on immune cells. CONCLUSION: Our findings indicate that the intestinal microbiota can control Trp availability and provide a link between the AhR pathway and host-microbiota interaction in acute infection with T gondii.

Andes hantavirus variant in rodents, southern Amazon Basin, Peru.

We investigated hantaviruses in rodents in the southern Amazon Basin of Peru and identified an Andes virus variant from Neacomys spinosus mice. This finding extends the known range of this virus in South America and the range of recognized hantaviruses in Peru. Further studies of the epizoology of hantaviruses in this region are warranted.

Human rabies and rabies in vampire and nonvampire bat species, Southeastern Peru, 2007.

After a human rabies outbreak in southeastern Peru, we collected bats to estimate the prevalence of rabies in various species. Among 165 bats from 6 genera and 10 species, 10.3% were antibody positive; antibody prevalence was similar in vampire and nonvampire bats. Thus, nonvampire bats may also be a source for human rabies in Peru.

Uso de modelos simuladores como metodología docente para la carrera de medicina / Use of simulator models like educational methodology for the medicine carrer

Introduction: Usefulness of high tech clinical simulators as learning tools, are partially established. Objective: To determine utility of an Emergency Care Simulator (ECS) as a learning tool inmedicine. Methods: Study was conducted in 2007, during the respiratory diseases rotation of third year medical students. Informed consent was required to participants. They were divided in two groups: Study Group (SG) and Control group (CG). Both were submitted to the same regular respiratory diseases learning activities. Only the SG had a session with the ECS. The simulated scenario referred to a young man with severe community pneumonia. At the end of the activities every student from those groups answered a modified essay and a questionnaire about this disease problem (maximum score was 70 points). The SG also responded a list of12 statements to get their opinion on this experience. Results: 63 students participated in the study, 42 in the SG and 21 in the CG. All the SG answered the questionnaire and 31 answeredthe modified essay. All the CG answered the modified essay. The scores in the essay were (mean +/- SD) 44, 3 +/-12,9 and 35,5+/-14,7 for the SG and CG, respectively (p=0,026). 80 percent ofthe SG agreed that the experience was useful to learn; entertaining and allowing the application of previous knowledge. Less than 50 percent felt the simulation real enough. Conclusions: A learning activity about severe community acquired pneumonia with the METI ECS simulator apparently was useful for students learning and well evaluated by them.

Breastfeeding reduces immune activation in primary respiratory syncytial virus infection.

In epidemiological studies of respiratory syncytial virus (RSV) disease, breast milk has proven to be beneficial. However, a host mechanism that is associated with both disease severity and that is capable of being modulated by breast milk, has not yet been identified. Both the predominance of interleukin-10 (IL-10) over interferon-gamma (IFN-gamma), and high soluble interleukin-2 receptor antagonist (sCD25) concentrations have been associated with RSV severity. We explored if they were modulated by breastfeeding. Previously healthy Chilean infants from Santiago with RSV infection (n = 349) were consecutively enrolled in the study if they were term births, without underlying pathology. Breastfeeding was described as absent or present, and if partial or exclusive. Immune response was expressed through plasma concentrations of IFN-gamma, IL-10 and sCD25, obtained both in the acute and the recovery phase. The acute phase sCD25 concentrations were lower in the breastfed (13.8 ng/mL, n =133), compared with the non-breastfed infants (15.9 ng/mL, n 27, p = 0.015). The difference increased in infants below 3 months of age (p = 0.006) and with exclusive (p = 0.004), compared to partial breastfeeding (p = 0.025). When analyzed together with age, sex, severity and environment, breastfeeding was the only independent predictor of high sCD25 concentrations (above mean + 1SD, OR 4.6, 95% CI 1.8-11.9, p = 0.0015). The recovery phase IFN-gamma/IL-10 ratio was higher in the breastfed infants, but when analyzed with potential confounding factors, only female sex was associated with an increased ratio (OR 2.32, 95% CI 1.02-5.29, p = 0.045). High sCD25 concentrations during the acute phase of infection, previously associated with severe RSV disease, were significantly and independently reduced in association with breastfeeding, whereas the Th1/Th3 balance was only modified in the recovery phase.

Soluble interleukin-2 receptor (sCD25) and interleukin-10 plasma concentrations are associated with severity of primary respiratory syncytial virus (RSV) infection.

The role of the immune response in the severity of RSV infection was examined by determining plasma concentrations of interferon-gamma (IFN-gamma), interleukin-10 (IL-10), interleukin-2 receptor (sCD25) and soluble tumor necrosis factor receptor II (sTNFR-II) in 196, previously healthy infants, during acute and convalescence phases of primary RSV infection. The results were analyzed separately for days 1-4 (early) and days 5-7 (late) of symptoms before sample collection and according to disease severity (105 hypoxic, 91 non-hypoxic). Significant associations between plasma levels and severity were found in early samples only. IL-10 and sCD25 concentrations were higher (p=0.01, each) in hypoxic compared with non-hypoxic infants, whereas no differences were observed in IFN-gamma and sTNFR-II levels between the groups. Early sCD25 levels correlated positively with IL-10 concentrations (p= 0.0003; r= 0,401). Amongst the hypoxic infants, the number of days of oxygen supplementation correlated positively with early IL-10 levels (p=0.009; r=0.495) and negatively with the IFN-gamma/IL-10 ratio (p=0.007; r=0.495). IFN-gamma levels were significantly higher in the acute phase than during convalescence for hypoxic and non-hypoxic infants, while IL-10 levels were significantly higher in the acute phase only in hypoxic infants for days 1-4 (early; p=0.0007). sCD25 concentrations were elevated only in hypoxic infants at days 1-4 of the acute phase (p=0.002), whereas sTNFR-II levels did not vary between acute and convalescence phases, independent of severity and time point of sampling. We found no association between plasma levels during the convalescence phase and the severity of the RSV infection.

A report on student abuse during medical training.

The purpose of this study was to determine the incidence, and the consequences, of abusive situations as perceived by students during the course of their medical training. A descriptive study was carried out surveying the entire 2000 fifth-year class of 181 in the Medical School of the University of Chile. The questionnaire was answered by 144 students. Results showed that 91.7% of the students who responded had suffered at least one episode of abuse while enrolled in medical school. The main offenders were teachers and peers. Verbal abuse was the most common (85.4%), followed by psychological (79.9%), sexual(26.4%) and physical (23.6%) abuse. Students reported that abuse had effects on their mental health, social life and the image they had of physicians; 17% considered dropping out of school as a consequence of this experience. Efforts should be addressed to prompt educators to reflect on their role.

[Application of Objective Structured Clinical Examination (OSCE) for pediatric internship assessment in two schools of medicine]. / Aplicación del Examen Clínico Objetivo Estructurado (OSCE) en la evaluación final del internado de pediatría en dos escuelas de medicina.

BACKGROUND: The Objective Structured Clinical Examination (OSCE) has become a respected and widely used tool for the assessment of clinical competence in medical education. AIM: To describe the first experience of an OSCE as a summative assessment in undergraduate Pediatric Internship, in two universities. MATERIAL AND METHODS: The OSCE was structured by a committee of faculty members of the 5 campi of University of Chile and I campus of the Catholic University. A 21 station OSCE was administered simultaneously to 124 Pediatric Interns (University of Chile = 104, Catholic University = 20), in 3 centers. A total of 50 faculty members participated in the examination. The OSCE consisted of 20 clinical problems, including videotape recordings, photographs, x-rays and laboratory exams, phantoms and 7 simulated standardized parents. RESULTS: The average total OSCE score was 67.3% (range: 84.5%-43.5%). The maximum theoretic score was achieved in 19 stations. A significant correlation between station and total score, was found for 18 of the 20 clinical problems. CONCLUSIONS: The experience of using OSCE has been a success. The OSCE was an adequate procedure to assess a large number of interns simultaneously and it allowed us to measure the main objectives in all domains and a wide range of clinical competence of Pediatric Internship Programs.