The impact of pipeline changes and temperature increase in a hospital historically colonised with Legionella.

Healthcare-related Legionnaires' disease has a devastating impact on high risk patients, with a case fatality rate of 30-50%. Legionella prevention and control in hospitals is therefore crucial. To control Legionella water colonisation in a hospital setting we evaluated the effect of pipeline improvements and temperature increase, analysing 237 samples over a 2-year period (first year: 129, second year: 108). In the first year, 25.58% of samples were positive for Legionella and 16.67% for amoeba. Assessing the distance of the points analysed from the hot water tank, the most distal points presented higher proportion of Legionella colonisation and lower temperatures (nearest points: 6.4% colonised, and temperature 61.4 °C; most distal points: 50% and temperature 59.1 °C). After the first year, the hot water system was repaired and the temperature stabilised. This led to a dramatic reduction in Legionella colonisation, which was negative in all the samples analysed; however, amoeba colonisation remained stable. This study shows the importance of keeping the temperature stable throughout the circuit, at around 60 °C. Special attention should be paid to the most distal points of the circuit; a fall in temperature at these weak points would favour the colonisation and spread of Legionella, because amoeba (the main Legionella reservoir) are not affected by temperature.

Engaging Media for Mental Health Applications: the EMMA project.

EMMA project has been focused on how the sense of presence in virtual environments mediates or generates emotional responses, and how to use presence and emotional responses in virtual environments effectively in clinical and non clinical settings. EMMA project has developed two different virtual environments. The first one acts as a 'mood device' and is aimed to induce and enhance several moods on clinical and non clinical subjects. The second one is a virtual environment that acts as an adaptive display to treat emotional disorders (Post-traumatic Stress Disorder, Adjustment Disorder and Pathological Grief). This virtual world varies the contents that are presented depending on the emotions of the patient at each moment. The goal of this paper is to outline the main goals achieved by this project.

An Internet-based self-help treatment for fear of public speaking: a controlled trial.

This study offers data about the efficacy of "Talk to Me," an Internet-based telepsychology program for the treatment of fear of public speaking that includes the most active components in cognitive-behavior therapy (CBT) for social phobia (exposure and cognitive therapies). One hundred twenty-seven participants with social phobia were randomly assigned to three experimental conditions: (a) an Internet-based self-administered program; (b) the same program applied by a therapist; (c) a waiting-list control group. Results showed that both treatment conditions were equally efficacious. In addition, Talk to Me and the same treatment applied by a therapist were more efficacious than the waiting-list condition. Treatment gains were maintained at 1-year follow-up. The results from this study support the utility of Internet-delivered CBT programs in order to reach a higher number of people who could benefit from CBT. Internet-delivered CBT programs could also play a valuable role in the dissemination of CBT.

Virtual reality interoceptive exposure for the treatment of panic disorder and agoraphobia.

The efficacy of cognitive-behavioral therapy for panic disorder and agoraphobia (PDA) has been widely demonstrated. The exposure technique is the main component of these programs; interoceptive exposure also plays an important role. The virtual reality (VR) program for treating PDA developed by Botella's group can simulate physical sensations in a controlled manner while the user is immersed in the VR environments in the consultation room. These include audible effects, such as rapid heartbeat and panting, as well as visual effects, such as blurry vision, double vision and tunnel vision. This work examines the efficacy of the interoceptive exposure (IE) component in two treatment conditions: 1) VR Interoceptive Exposure Simultaneous Condition (VRIE-sim; N=14), and 2) Interoceptive Exposure Traditional Condition (IET; N=15). Results obtained showed that both treatment conditions significantly reduced the main clinical variables at post-treatment; these results were maintained or even improved at three month follow-up. Simultaneous VR interoceptive and VR external stimuli exposure is a new and effective way to apply PDA treatment.

Detection and distraction effects for threatening information in social phobia and change after treatment.

This work examines differences in the detection and distraction by social-threat-related information between a social phobia group (SP; N=33) and a normal control group (NC; N=32). The change obtained after psychological treatment is also studied for the SP group. A paper-and-pencil visual search task is used, in which the emotional valence of the "target" (social threat, physical threat, and neutral words) and "distractor" (social threat, physical threat, neutral, and nonsense words) verbal stimuli is manipulated. Results indicate that there are no differences in the detection of social-threat targets between SP and NC participants. However, the performance of SP individuals is more impaired when distractor stimuli related to social threat are presented, regardless of the target valence. This increased distraction by social-threat-related stimuli is reduced after psychological treatment, and this decrease is maintained at 6-month follow-up.

Optimizing the collection of used paper from small businesses through GIS techniques: the Leganés case (Madrid, Spain).

This article deals with a methodology for the design of routes for the "bin to bin" (BTB) collection of paper and cardboard waste (PCB) from small businesses, as well as with the new location and calculation of the number of containers needed in the streets for both commercial and non-commercial use due to the large amount of PCB deposited in them. This study was carried out in five shopping areas of the city of Leganés (Community of Madrid, Spain). One of the characteristics of the area is a high density of population and urban traffic. The tool used is the Geographical Information System (GIS-Arc-View). With it we can generate PCB points of high population density in commercial streets based on territorial analysis. We placed the special routes and the new container locations within a distance of 60 m of these collection points (CPT). The system calculates and optimizes six routes according to different urban restrictions. Finally, we provided service to 59% of the shops, which generate almost 82% of the PCB waste, using 160 min per day to collect 1027 kg of high quality PCB. If we compare the system with the system in place previously, we can conclude that the "bin to bin" (BTB) system improves the quality of the PCB in the containers, avoiding overflow and reducing the percentage of rejected material.

The social phobia and anxiety inventory: psychometric properties in a Spanish sample.

This study is a validation of the Spanish version of the Social Phobia and Anxiety Inventory using a nonclinical sample (198 participants) and a clinical sample (72 participants with social phobia). The factor structure and concurrent validity with Fear of Negative Evaluation and Social Avoidance and Distress scales were analyzed. The Social Phobia and Anxiety Inventory demonstrated good concurrent validity, showing statistically significant relationships with Fear of Negative Evaluation and Social Avoidance and Distress. Results confirmed the rationale for the division of the SPAI into two subscales. Results also demonstrated the utility of the Social Phobia and Anxiety Inventory for differentiating between a nonclinical sample and participants with a social phobia, and its adequate reliability.

Body image and virtual reality in eating disorders: is exposure to virtual reality more effective than the classical body image treatment?

Body image (BI) disturbances are considered to be central in eating disorders (ED) psychopathology. There are few studies focused on the treatment of BI disturbances in ED, and most of them have used "traditional methods." The purpose of the present study was to probe the effectiveness of one specific component in the assessment and treatment of BI in ED by means of virtual reality (VR). Two treatment conditions were applied: (a) The Standard Body Image Treatment Condition (SBIT) and (b) the VR Condition. Thirteen eating disordered patients were randomly assigned to one of those conditions. No differences between both conditions were found in general ED measures, but patients treated in the VR condition showed a greater significant improvement in specific BI measures. These results suggest that BI treatment with VR could be more targeted to its disturbances. than traditional techniques are.

The GABA(A) receptor complex in the developing chick optic tectum: characterization of benzodiazepine and ionophore-linked convulsant/barbiturate recognition sites.

By use of membrane preparations and incubation conditions optimized for each binding site, we have characterized the benzodiazepine and ionophore-linked-convulsant/barbiturate modulatory sites within the chick tectal GABA(A) receptor complex. Using [(3)H]flunitrazepam (FNZ) and [(35)S]t-butylbicyclophosphorothionate (TBPS), respectively, as specific radioligand probes for the two sites, we have found in each case one single population of high-affinity, saturable, specific binding sites. The apparent dissociation constants (K(d)) show no change during tectal development (9 nM for [(3)H]FNZ, and 25-28 nM for [(35)S]TBPS) while the respective densities of binding sites at saturation (B(max)) experience in both cases a twofold increase between embryonic day 16 and postnatal day 10. Ligand-specific pharmacological profiles and allosteric interactions between the transmitter and modulatory sites appear to be well preserved in the chick tectal membrane preparations employed in this study.