Development of mental health first-aid guidelines for a person after a potentially traumatic event: A Delphi expert consensus study in Argentina and Chile.

BACKGROUND: Exposure to potentially traumatic events increases the risk of a person developing a mental disorder. Training community members to offer support to a person during and after a traumatic situation may help lower this risk. This study reports on the cultural adaptation of Australian mental health first aid guidelines for individuals exposed to a potentially traumatic event to the Chilean and Argentinian context. METHODS: A Delphi expert consensus study was conducted with two panels of experts, one of people with lived experience of trauma (either their own or as a carer; n = 26) and another one of health professionals (n = 41). A total of 158 items, drawn from guidelines developed by Australian experts in 2019, were translated to Spanish and evaluated in a two-round survey process. The panellists were asked to rate each item on a five-point Likert scale; statements were included in the final guidelines if 80% of both panels endorsed the item as "essential" or "important". RESULTS: Consensus was achieved on 142 statements over two survey rounds. A total of 102 statements were included from the English-language guidelines, and 40 locally generated statements were accepted in the second round. Local experts endorsed a larger number of items compared to their counterparts in Australia and emphasised the importance of acknowledging the first aider's limitations, both personally and as part of their helping role. Additional items about working as a team with other first responders and considering helping the person's significant others were endorsed by the local panellists. CONCLUSIONS: The study showed a high level of acceptance of the original actions suggested for inclusion in the guidelines for Australia, but also a significant number of new statements that highlight the importance of the adaptation process. Further research on the dissemination of these guidelines into a Mental Health First Aid training course for Chile and Argentina is still required.

Protein-Protein Binding Kinetics by Biolayer Interferometry.

The specific kinetics and thermodynamics of protein-protein interactions underlie the molecular mechanisms of cellular functions; hence the characterization of these interaction parameters is central to the quantitative understanding of physiological and pathological processes. Many methods have been developed to study protein-protein interactions, which differ in various features including the interaction detection principle, the sensitivity, whether the method operates in vivo, in vitro, or in silico, the temperature control, the use of labels, immobilization, the amount of sample required, the number of measurements that can be accomplished simultaneously, or the cost. Bio-Layer Interferometry (BLI) is a label-free biophysical method to measure the kinetics of protein-protein interactions. Label-free interaction assays are a broad family of methods that do not require protein modifications (other than immobilization) or labels such as fusions with fluorescent proteins or transactivating domains or chemical modifications like biotinylation or reaction with radionuclides. Besides BLI, other label-free techniques that are widely used for determining protein-protein interactions include surface plasmon resonance (SPR), thermophoresis, and isothermal titration calorimetry (ITC), among others.

Close-Up Look at Electronic Spectroscopic Signatures of Common Pharmaceuticals in Solution.

Simulating electronic properties and spectral signals requires robust computational approaches that need tuning with the system's peculiarities. In this paper, we test implicit and fully atomistic solvation models for the calculation of UV-vis and electronic circular dichroism (ECD) spectra of two pharmaceutically relevant molecules, namely, (2S)-captopril and (S)-naproxen, dissolved in aqueous solution. Room temperature molecular dynamics simulations reveal that these two drugs establish strong contacts with the surrounding solvent molecules via hydrogen bonds. Such specific interactions, which play a major role in the spectral response and are neglected in implicit approaches, are further characterized and quantified with natural bond orbital methods. Our calculations show that simulated spectra, and especially ECD, are in good agreement with experiments solely when conformational and configurational dynamics, mutual polarization, and solute-solvent repulsion effects are considered.

Protein deuteration via algal amino acids to circumvent proton back-exchange for 1H-detected solid-state NMR.

With perdeuteration, solid-state NMR spectroscopy of large proteins suffers from incomplete amide-proton back-exchange. Using a 72 kDa micro-crystalline protein, we show that deuteration exclusively via deuterated amino acids, well-established in solution to suppress sidechain protonation without proton back-exchange obstacles, provides spectral resolution comparable to perdeuterated preparations at intermediate spinning frequencies.

Development of mental health first-aid guidelines for psychosis: a Delphi expert consensus study in Argentina and Chile.

BACKGROUND: Psychotic symptoms may be less common than anxiety or affective symptoms, but they are still frequent and typically highly debilitating. Community members can have a role in helping to identify, offer initial help and facilitate access to mental health services of individuals experiencing psychosis. Mental health first aid guidelines for helping a person experiencing psychosis have been developed for the global north. This study aimed to adapt the English- language guidelines for Chile and Argentina. METHODS: A Delphi expert consensus study was conducted with two panels of experts, one of people with lived experience of psychosis (either their own or as a carer; n = 29) and another one of health professionals (n = 29). Overall, 249 survey items from the original English guidelines and 26 items suggested by the local team formed a total of 275 that were evaluated in the first round. Participants were invited to rate how essential or important those statements were for Chile and Argentina, and encouraged to suggest new statements if necessary. These were presented in a second round. Items with 80% of endorsement by both panels were included in the guidelines for Chile and Argentina. RESULTS: Data were obtained over two survey rounds. Consensus was achieved on 244 statements, including 26 statements locally generated for the second round. Almost 20% of the English statements were not endorsed (n = 50), showing the applicability of the original guidelines but also the importance of culturally adapting them. Attributions and tasks expected to be delivered by first aiders were shrunk in favour of a greater involvement of mental health professionals. Self-help strategies were mostly not endorsed and as were items relating to respecting the person's autonomy. CONCLUSIONS: While panellists agreed that first aiders should be aware of human rights principles, items based on recovery principles were only partially endorsed. Further research on the dissemination of these guidelines and development of a Mental Health First Aid training course for Chile and Argentina is still required.

Interactions and reactivity in crystalline intermediates of mechanochemical cyclorhodation reactions.

There is experimental evidence that solid mixtures of the rhodium dimer [Cp*RhCl2]2 and benzo[h] quinoline (BHQ) produce two different polymorphic molecular cocrystals called 4α and 4ß under ball milling conditions. The addition of NaOAc to the mixture leads to the formation of the rhodacycle [Cp*Rh-(BHQ)Cl], where the central Rh atom retains its tetracoordinate character. Isolate 4ß reacts with NaOAc leading to the same rhodacycle while isolate 4α does not under the same conditions. We show that the puzzling difference in reactivity between the two cocrystals can be traced back to fundamental aspects of the intermolecular interactions between the BHQ and [Cp*RhCl2]2 fragments in the crystalline environment. To support this view, we report a number of descriptors of the nature and strength of chemical bonds and intermolecular interactions in the extended solids and in a cluster model. We calculate formal quantum mechanical descriptors based on electronic structure, electron density, and binding and interaction energies including an energy decomposition analysis. Without exception, all descriptors point to 4ß being a transient structure higher in energy than 4α with larger local and global electrophilic and nucleophilic powers, a more favorable spatial and energetic distribution of the frontier orbitals, and a more fragile crystal structure.

Development of mental health first-aid guidelines for suicide risk: a Delphi expert consensus study in Argentina and Chile.

BACKGROUND: Suicide continues to pose a significant global public health challenge and ranks as one of the leading causes of death worldwide. Given the prevalence of suicide risk in the community, there is a significant likelihood of encountering individuals who may be experiencing suicidal thoughts or plans, creating an opening for non-health professionals to offer support. This study aims to culturally adapt the original Australian Mental Health First Aid Guidelines for suicide risk to the Chilean and Argentine context. METHODS: A two-round Delphi expert consensus study was conducted involving two panels, one comprising individuals with personal experience in suicide thoughts/attempts or caregiving for those with such experiences (n = 18), and the other consisting of professionals specialized in suicide assessment and support for individuals at risk (n = 25). They rated a total of 179 items mainly derived from guidelines developed by Australian experts and translated into Spanish (168), and new items included by the research team (11). The panel members were requested to assess each item utilizing a five-point Likert scale. During the second round, items that received moderate approval in the initial round were re-evaluated, and new items suggested by the local experts in the first round were also subjected to evaluation in the next round. Inclusion in the final guidelines required an 80% endorsement as "essential" or "important" from both panels. RESULTS: Consensus of approval was reached for 189 statements. Among these, 139 statements were derived from the English-language guidelines, while 50 locally generated statements were accepted during the second round. A significant difference from the original guideline was identified concerning the local experts' reluctance to discuss actions collaboratively with adolescents. Furthermore, the local experts proposed the inclusion of an entirely new section addressing suicide risk in older individuals, particularly focusing on suicide methods and warning signs. CONCLUSIONS: A Delphi expert consensus study was conducted to culturally adapt mental health first aid guidelines for assessing suicide risk in Chile and Argentina. This study involved professionals and individuals with lived experience. While many items were endorsed, some related to inquiring about suicide risk and autonomy, particularly for adolescents, were not. An additional section for older individuals was introduced. Future research should explore the implementation and impact of these adapted guidelines in training courses. This is vital for enhancing mental health support and implementing effective suicide prevention strategies in Chile and Argentina.

'We see they are abandoned': Social support between people discharged from long-term psychiatric hospitalizations and their neighbors in Argentina.

BACKGROUND: Neighbors are an important component of personal social network (PSN) and despite their peripheral role and being considered as familiar strangers, they typically provide instrumental support. For people who is discharged after long-term psychiatric hospitalizations, neighbors would offer other types of social support and play a different role fostering the process of becoming full member of a given community. AIMS: To analyze the effects of neighboring on both, those who have had long-term psychiatric hospitalizations and their neighbors. METHOD: Data was collected between 2020 and 2021, including interviews with formal care staff of three housing support experiences in Argentina, and short testimonies from formerly discharged mental health service users living in the community and their neighbors. We analyzed the data using the Framework Method with a focus on the different aspects of social support and equity and reciprocity theories. RESULTS: Results suggest that emotional support was a frequent function displayed by neighbors toward people with a history of long-term psychiatric hospitalizations, which differs from typical neighboring relationships. CONCLUSIONS: Despite reciprocity was observed, users and neighbors displayed an unbalanced helping relationship.

Paper promises: Peruvian frontline health workers' perspectives on mental health policies during COVID-19.

Governments globally deployed various non-pharmacological public health measures to respond to the COVID-19 pandemic (i.e. lockdowns and suspension of transportation, amongst others); some of these measures had an influence on society's mental health. Specific mental health policies were therefore implemented to mitigate the potential mental health impact of the pandemic. We aimed to explore the implementation of mental health regulations adopted by the Peruvian health system by focusing on the care services at Community Mental Health Centres (CMHCs), based on the experiences of health workers. We conducted a phenomenological qualitative study to understand the implementation of mental health policies launched in Peru during the COVID-19 pandemic. Data were obtained from a document review of 15 national policy measures implemented during the pandemic (March 2020 to September 2021), and 20 interviews with health workers from CMHCs (September 2021 to February 2022). The analysis was conducted using thematic content analysis. Most implemented policies adapted CMHC care services to a virtual modality during the COVID-19 pandemic; however, various challenges and barriers were evidenced in the process, which prevented effective adaptation of services. Workers perceived that ineffective telemedicine use was attributed to a gap in access to technology at the CMHCs and also by users, ranging from limited access to technological devices to a lack of technological skills. Further, although mental health promotion and prevention policies targeting the community were proposed, CMHC staff reported temporary interruption of these services during the first wave. The disparity between what is stated in the regulations and the experiences of health workers is evident. Policies that focus on mental health need to provide practical and flexible methods taking into consideration both the needs of CMHCs and socio-cultural characteristics that may affect their implementation.

Computational Insights into the Adsorption of Ligands on Gold Nanosurfaces.

We study the adsorption process of model peptides, nucleobases, and selected standard ligands on gold through the development of a computational protocol based on fully atomistic classical molecular dynamics (MD) simulations combined with umbrella sampling techniques. The specific features of the interface components, namely, the molecule, the metallic substrate, and the solvent, are taken into account through different combinations of force fields (FFs), which are found to strongly affect the results, especially changing absolute and relative adsorption free energies and trends. Overall, noncovalent interactions drive the process along the adsorption pathways. Our findings also show that a suitable choice of the FF combinations can shed light on the affinity, position, orientation, and dynamic fluctuations of the target molecule with respect to the surface. The proposed protocol may help the understanding of the adsorption process at the microscopic level and may drive the in-silico design of biosensors for detection purposes.

[Attitudes of neighbors about the treatment and community life of people with severe mental health disorders in Argentina]. / Actitudes de vecinos acerca del tratamiento y la vida en comunidad de personas con problemáticas severas de salud mental en Argentina.

A psychiatric reform is underway in Latin America and the Caribbean. Specifically in Argentina, a model of community mental health is being built, and prolonged psychiatric hospitalizations are still taking place, especially in neuropsychiatric hospitals. Therefore, it is necessary to closely monitor the psychiatric reform. One of the possible ways to monitor the reform is by analyzing society's attitudes towards prolonged psychiatric hospitalization as a mean of mental health treatment. Thus, an analytical observational study was conducted at the Buenos Aires Province, Argentina, in 2021, to analyze the behavior of neighbors of people who had prolonged psychiatric hospitalizations and who received housing support. Questionnaires were applied to neighbors and non-neighbors, addressing the behaviors toward prolonged psychiatric hospitalization as a mean of treatment, social distance toward people who were hospitalized, as well as specific interviews with key informants from neighborhoods where people with severe mental health disorders and who receive housing support live. Based on the answers of neighbors and non-neighbors, no statistically significant differences were identified in behaviors toward prolonged psychiatric hospitalization as a mean of treatment, nor for social distance in relation to people who were hospitalized. Key informants conditioned their assessment of prolonged hospitalization and valued the role of support teams in making community life viable.

La reforma psiquiátrica se encuentra en proceso en la región de América Latina y el Caribe. Específicamente en Argentina, el modelo de salud mental comunitaria está en construcción, siendo aún observable la presencia de internaciones psiquiátricas prolongadas, principalmente en hospitales neuropsiquiátricos. Resulta así necesario monitorear la reforma psiquiátrica, siendo una de las vías para ello el análisis de las actitudes de la sociedad hacia la internación psiquiátrica prolongada como modalidad de atención en salud mental. Así, se realizó un estudio observacional analítico en la Provincia de Buenos Aires, Argentina, en el año 2021, en donde se analizaron las actitudes de vecinos de personas que tuvieron internaciones psiquiátricas prolongadas y que recibían apoyos a la vivienda. Se hicieron cuestionarios a vecinos y no vecinos, indagándose por las actitudes hacia la internación psiquiátrica prolongada como modalidad de tratamiento, así como la distancia social hacia personas que tuvieron internaciones psiquiátricas, y también entrevistas a profundidad con informantes clave de barrios en donde habitan personas con problemáticas severas de salud mental y que reciben apoyos a la vivienda. No se identificaron diferencias estadísticamente significativas en las actitudes en relación a la internación psiquiátrica prolongada como modalidad de tratamiento de vecinos y no vecinos, ni tampoco respecto a la distancia social hacia personas que tuvieron internaciones psiquiátricas. Los informantes clave condicionaron su valoración sobre la internación prolongada, y valoraron el rol de los equipos de apoyo para posibilitar la vida en comunidad.

Uma reforma psiquiátrica está em curso na América Latina e Caribe. Especificamente na Argentina, um modelo de saúde mental comunitária está sendo construído, ainda acontecendo internações psiquiátricas prolongadas, principalmente em hospitais neuropsiquiátricos. Faz-se necessário, portanto, o acompanhamento da reforma psiquiátrica. Uma das formas de fazê-lo é analisando as atitudes da sociedade frente à internação psiquiátrica prolongada como forma de tratamento da saúde mental. Assim, foi realizado um estudo observacional analítico na Província de Buenos Aires, Argentina, no ano de 2021, onde foram analisadas as atitudes de vizinhos de pessoas que tiveram internações psiquiátricas prolongadas e que receberam apoio habitacional. Foram aplicados questionários a vizinhos e não vizinhos, questionando as atitudes em relação à internação psiquiátrica prolongada como forma de tratamento, bem como a distância social em relação às pessoas que foram internadas, e também entrevistas específicas com informantes-chave de bairros onde vivem pessoas com problemas graves de saúde mental e que recebem apoio habitacional. Com base nas respostas de vizinho e não vizinhos, não foram identificadas diferenças estatisticamente significantes nas atitudes em relação à internação psiquiátrica prolongada como forma de tratamento, nem em relação à distância social em relação às pessoas que foram internadas. Os informantes-chave condicionaram sua avaliação da hospitalização prolongada e valorizaram o papel das equipes de apoio na viabilização da vida comunitária.

The Role of Crystalline Intermediates in Mechanochemical Cyclorhodation Reactions Elucidated by in-Situ X-ray Powder Diffraction and Computation.

The occurrence of crystalline intermediates in mechanochemical reactions might be more widespread than previously assumed. For example, a recent study involving the acetate-assisted C-H activation of N-Heterocycles with [Cp*RhCl2 ]2 by ball milling revealed the formation of transient cocrystals between the reagents prior to the C-H activation step. However, such crystalline intermediates were only observed through stepwise intervallic ex-situ analysis, and their exact role in the C-H activation process remained unclear. In this study, we monitored the formation of discrete, stoichiometric cocrystals between benzo[h]quinoline and [Cp*RhCl2 ]2 by ball milling using in-situ synchrotron X-ray powder diffraction. This continuous analysis revealed an initial cocrystal that transformed into a second crystalline form. Computational studies showed that differences in noncovalent interactions made the [Cp*RhCl2 ]2 unit in the later-appearing cocrystal more reactive towards NaOAc. This demonstrated the advantage of cocrystal formation before the acetate-assisted metalation-deprotonation step, and how the net cooperative action of weak interactions between the reagents in mechanochemical experiments can lead to stable supramolecular assemblies, which can enhance substrate activation under ball-milling conditions. This could explain the superiority of some mechanochemical reactions, such as acetate-assisted C-H activation, compared to their solution-based counterparts.

Mortalidad por suicidio en la provincia de Buenos Aires: epidemiología y contexto pandémico por COVID-19 en perspectiva histórica 2009-2020 / Mortality due to suicide in the province of Buenos Aires: epidemiology and COVID-19 pandemic context in historical perspective, 2009-2020

RESUMEN INTRODUCCIÓN: El suicidio constituye una de las principales causas de muerte consideradas como violentas y evitables. El objetivo fue estimar la incidencia y modalidad de suicidios en la serie histórica 2009-2020, considerando este último año como contexto pandémico por COVID-19. MÉTODOS: Se realizó un estudio transversal, observacional y retrospectivo de línea histórica. Los datos fueron obtenidos de la Dirección de Estadística e Información en Salud del Ministerio de Salud de la Provincia de Buenos Aires. Se clasificaron según tres modalidades de suicidio: intervención de un agente invasivo, un agente externo o sin agente. Para evaluar la posible variación de la densidad poblacional sobre las tasas de incidencia, se distribuyeron las defunciones sobre la base del tamaño poblacional de residencia. Finalmente, se obtuvieron dos índices: escore p y estimación de mortalidad observada (MO). RESULTADOS: Entre 2009 y 2020 se produjeron 13 221 muertes por lesiones autoinfligidas, con un promedio de 1110 suicidios al año. Al comparar 2020 (916 suicidios) con el quinquenio inmediato anterior (2015-2019, con una media de 1139 suicidios ±26 en su error estándar), el escore p mostró una reducción del 23,1% (275 muertes menos de lo esperado) y la MO, un descenso de 19,6% (223 muertes por debajo del intervalo superior esperado). DISCUSIÓN: En 2020 se redujo la incidencia absoluta y relativa de suicidios, aunque se mantuvo la diferencia según modalidad y género observada en la línea histórica.

ABSTRACT INTRODUCTION: Suicide is one of the main causes of death classified as violent and preventable. The objective was to estimate the incidence and mode of suicide in the 2009-2020 historical series, considering year 2020 as COVID-19 pandemic context. METHODS: A cross-sectional, retrospective, observational, historical timeline study was conducted. Data were obtained from the Department of Health Statistics and Information of the Ministry of Health of the Province of Buenos Aires. They were classified according to three modes of suicide: intervention of an invasive agent, an external agent or no agent. In order to evaluate the possible variation of population density on suicide incidence rates, deaths were distributed based on the population size of residence. Finally, two indices were obtained: the p-score and the estimate of observed mortality (OM). RESULTS: During 2009-2020 there were 13221 deaths due to self-inflicted injuries, with an average of 1110 suicides per year. When comparing the year 2020 (916 suicides) with the previous five-year period (2015-2019, with a mean of 1139 suicides ±26 in its standard error), the p-score showed a reduction of 23.1% (275 deaths less than expected) and OM, a decrease of 19.6% (223 deaths below the expected upper interval). DISCUSSION: During 2020 there was a reduction in the absolute and relative incidence of suicides, while maintaining the difference according to mode and gender observed through the historical timeline.

Meanings and practices about work of women discharged from a psychiatric hospital of Buenos Aires province, Argentina / Significaciones y prácticas en torno al trabajo de mujeres externadas de un hospital neuropsiquiátrico de la provincia de Buenos Aires, Argentina.

Introduction: Work is central to the social inclusion of people who have had long-term psychiatric hospitalizations. In the context of the mental health care reform in Argentina, it is important to produce local knowledge about work inclusion of people discharged from psychiatric hospitals. The objective of this study was to describe the meanings and practices of women who had long-term psychiatric hospitalizations at the José A. Estéves Hospital in the Province of Buenos Aires, Argentina, regarding their inclusion in the labor market, once they return to live in the community. Methods and Materials: Descriptive mixed-methods study. The case of the Assisted Discharge and Rehabilitation Program of José A. Estéves Hospital, which accompanied 69 women in the year 2018, was analyzed. For quantitative analysis the data of the 69 women was analyzed, and for qualitative analysis a sample of nine women were interviewed. Results: 74% of women did some work after their discharge, although at the moment of the study only 33% were working. The jobs they carried out corresponded to elementary and low-competence occupational levels, mostly in a supported work program. After the psychiatric hospitalization, jobs obtained were less qualified, more informal and less exposed to the public than those held before the hospitalization. Discussion and Conclusionss: Prolonged psychiatric hospitalization is a significant break in people's work trajectories. Despite the value of work experiences after having a psychiatric hospitalization, those experiences mainly correspond to the informal sector of the economy.

Introducción: El trabajo es central para la inclusión social de personas que tuvieron internaciones psiquiátricas prolongadas. Por ello es necesario generar conocimientos locales sobre estos procesos en personas que han sido externadas, como parte de la reforma de la atención en salud mental en Argentina. Así, el objetivo de este estudio fue describir las significaciones y las prácticas de mujeres que tuvieron internaciones psiquiátricas prolongadas en el Hospital "José A. Estéves" de la Provincia de Buenos Aires, Argentina, acerca de su inclusión en el mercado laboral, a partir de su externación. Materiales y métodos: Estudio descriptivo de  tipo mixto, tomando como caso al grupo de mujeres que eran acompañadas por el Programa de Rehabilitación y Externación Asistida del Hospital "José A. Estéves", en el año 2018. Se analizaron datos cuantitativos de todo el grupo (n=69) y se realizaron entrevistas semiestructuradas con nueve señoras. Resultados: El 74% de las mujeres realizó algún trabajo desde su externación, aunque al momento del estudio, solo el 33% lo hacía. Los trabajos que desarrollaban correspondían a niveles ocupacionales elementales o de bajo nivel de competencia, mayoritariamente en un programa asistido de trabajo. Después de la internación, los trabajos obtenidos fueron menos calificados, más informales y menos expuestos al público que los desempeñados antes de la internación. Discusión y resultados: La internación psiquiátrica prolongada constituye un corte significativo en la trayectoria laboral de las personas. Pese al valor de las experiencias laborales de quienes logran conseguir un trabajo tras la internación, tales experiencias no implican, mayoritariamente, avances sobre el mercado formal.

Repercussions of COVID-19 on psychiatric inpatient care in Latin America and the Caribbean.

OBJETIVE: To characterise the impact of the COVID-19 pandemic on psychiatric hospitalisations in the Latin American and Caribbean (LAC) region. METHODS: Descriptive study. 85 semi-structured interviews were conducted with health workers involved with psychiatric hospitalisations in general hospitals (GHs) and specialised psychiatric hospitals (SHs) from 18 LAC countries. The interviews were done between 8 May and 30 June 2020. The data were analysed quantitatively and qualitatively. RESULTS: An initial decrease in the demand for hospitalisation is reported, attributed to the population's fear of approaching health services as well as restrictions on mobility. Stricter criteria for hospitalisation were reported with a double focus on the acute within the acute. The length of hospitalisations were mixed, with both increases and decreases in GHs and SHs. The therapeutic offer was drastically reduced, and interaction between hospitalised people and their support networks was restricted. CONCLUSIONS: In the COVID-19 context, hospitalisation seems to be not the last but the only alternative for psychiatric treatment. The decrease in the number of beds in SHs could be a positive aspect for the reform of psychiatric care, but it is questioned since this reduction also occurs in GHs.

Encapsulation of Astatide by a water cage.

A 512 cage of (H2O)20 consisting of 30 hydrogen bonds encapsulates Astatide with little geometrical distortion. The cage is marginally destabilized but the non-covalent interactions are actually strengthened. Host⋯cage interactions in the [At@(H2O)20]- cluster are anti-electrostatic, placing both negatively charged atoms in direct contact as in Atδ-⋯δ-O-Hδ+. An orbital interaction analysis reveals that explicit host⋯cage contacts are "inverted" hydrogen bonds. That is, the same type of donor→acceptor charge transfer as in hydrogen bonding, with no proton bridging the two negative charges.

Development of mental health first-aid guidelines for depression: a Delphi expert consensus study in Argentina and Chile.

BACKGROUND: Depression is one of the most common mental health problems worldwide and, while prevalence rates in Latin America are relatively high, most people who meet the criteria for diagnosis do not receive treatment. Family and friends of a person with depression can play an important role in supporting a person to seek and engage with treatment. However, many people do not have the necessary skills or confidence to help. English-language mental health first aid guidelines have been developed to support people to provide such help. The aim of this study was to culturally adapt these guidelines for Chile and Argentina. METHODS: A Delphi expert consensus study was conducted with two expert panels, one of people with lived experience of depression (either their own or as a carer; n = 26) and one of health professionals (n = 29). Overall, 172 statements from the English-language guidelines were translated and compiled into a questionnaire. Participants were asked to rate statements based on how essential or important those statements were for Chile and Argentina and to suggest new statements if necessary. RESULTS: Data were obtained over two survey rounds. Consensus was achieved on 172 statements. A total of 137 statements were adopted from the English-language guidelines, whereas 35 new endorsed statements were generated from panel suggestions. There were similarities between the English-language guidelines and those for Chile and Argentina. The adapted guidelines did not include some of the items from the English-language guidelines related to commenting on a person's strengths or making judgements about their character, and also incorporated new items related to the incorporation of sociocultural considerations as causes of depression and attention to inequities in mental health. CONCLUSIONS: The significant number of new items underscores the importance of undertaking a careful process of cultural adaptation. Further research on dissemination and incorporation of the guidelines into the Mental Health First Aid training course for Chile and Argentina is still required.

The transition state region in nonsynchronous concerted reactions.

The critical and vanishing points of the reaction force F(ξ) = -dV(ξ)/dξ yield five important coordinates (ξR, ξR* , ξTS, ξP* , ξP) along the intrinsic reaction coordinate (IRC) for a given concerted reaction or reaction step. These points partition the IRC into three well-defined regions, reactants (ξR→ξR* ), transition state (ξR* →ξP* ), and products (ξP* →ξP), with traditional roles of mostly structural changes associated with the reactants and products regions and mostly electronic activity associated with the transition state (TS) region. Following the evolution of chemical bonding along the IRC using formal descriptors of synchronicity, reaction electron flux, Wiberg bond orders, and their derivatives (or, more precisely, the intensity of the electron activity) unambiguously indicates that for nonsynchronous reactions, electron activity transcends the TS region and takes place well into the reactants and products regions. Under these circumstances, an extension of the TS region toward the reactants and products regions may occur.

Water Maintains the UV-Vis Spectral Features During the Insertion of Anionic Naproxen and Ibuprofen into Model Cell Membranes.

UV-vis spectra of anionic ibuprofen and naproxen in a model lipid bilayer of the cell membrane are investigated using computational techniques in combination with a comparative analysis of drug spectra in purely aqueous environments. The simulations aim at elucidating the intricacies behind the negligible changes in the maximum absorption wavelength in the experimental spectra. A set of configurations of the systems constituted by lipid, water, and drugs or just water and drugs are obtained from classical Molecular Dynamics simulations. UV-vis spectra are computed in the framework of atomistic Quantum Mechanical/Molecular Mechanics (QM/MM) approaches together with Time-Dependent Density Functional Theory (TD-DFT). Our results suggest that the molecular orbitals involved in the electronic transitions are the same, regardless of the chemical environment. A thorough analysis of the contacts between the drug and water molecules reveals that no significant changes in UV-vis spectra are a consequence of ibuprofen and naproxen molecules being permanently microsolvated by water molecules, despite the presence of lipid molecules. Water molecules microsolvate the charged carboxylate group as expected but also microsolvate the aromatic regions of the drugs.

Repercusiones de la COVID-19 en la Internación Psiquiátrica en América Latina y el Caribe

Objetivo: Caracterizar el impacto de la pandemia por COVID-19 en las internaciones psiquiátricas en la región de América Latina y el Caribe. Métodos: Estudio descriptivo. Se realizaron 85 entrevistas semiestructuradas con trabajadores de hospitales generales (HG) y hospitales especializados (HE) en salud mental en 18 países de la región de América Latina y el Caribe entre el 8 de mayo y el 30 de junio de 2020. Los datos se analizaron cuantitativa y cualitativamente. Resultados: Se reporta una disminución inicial en la demanda de internación, atribuida al temor de la población a acercarse a los servicios, así como a restricciones en la movilidad. Se indican criterios más estrictos para internar con una doble focalización de lo agudo dentro de lo agudo. Los tiempos de internación presentaron un comportamiento mixto, tanto de aumento como de disminución en HG y en HE. La oferta terapéutica durante la internación se vio drásticamente reducida, y se restringió la interacción de las personas internadas con sus redes de apoyo. Conclusiones: La internación pareciera estar siendo no la última, sino la única alternativa de tratamiento psiquiátrico en el contexto de la pandemia. La reducción de camas en los HE podría ser un aspecto positivo para la reforma de la atención, pero es puesto en duda, ya que dicha reducción también se produce en los HG.

Objetive: To characterise the impact of the COVID-19 pandemic on psychiatric hospitalisations in the Latin American and Caribbean (LAC) region. Methods: Descriptive study. 85 semi-structured interviews were conducted with health workers involved with psychiatric hospitalizations in general hospitals (GHs) and specialised psychiatric hospitals (SHs) from 18 LAC countries. The interviews were done between 8 May and 30 June 2020. The data were analysed quantitatively and qualitatively. Results: An initial decrease in the demand for hospitalization is reported, attributed to the population's fear of approaching health services as well as restrictions on mobility. Stricter criteria for hospitalization were reported with a double focus on the acute within the acute. The length of hospitalizations were mixed, with both increases and decreases in GHs and SHs. The therapeutic offer was drastically reduced, and interaction between hospitalised people and their support networks was restricted. Conclusions: In the COVID-19 context, hospitalization seems to be not the last but the only alternative for psychiatric treatment. The decrease in the number of beds in SHs could be a positive aspect for the reform of psychiatric care, but it is questioned since this reduction also occurs in GHs.