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Artificial neural networks (ANNs) are powerful nonparametric tools for estimating genomic breeding values (GEBVs) in genetic breeding. One significant advantage of ANNs is their ability to make predictions without requiring prior assumptions about data distribution or the relationship between genotype and phenotype. However, ANNs come with a high computational cost, and their predictions may be underestimated when including all molecular markers. This study proposes a two-step genomic prediction procedure using ANNs to address these challenges. Initially, molecular markers were selected either directly through Multivariate Adaptive Regression Splines (MARS) or indirectly based on their importance, identified through Boosting, considering the top 5, 20, and 50% of markers with the highest significance. Subsequently, the selected markers were employed for genomic prediction using ANNs. This approach was applied to two simulated traits: one with ten trait-controlling loci and heritability of 0.4 (Scenario SC1) and the other with 100 trait-controlling loci and a heritability of 0.2 (Scenario SC2). Comparisons were made between ANN predictions using marker selection and those without any marker selection. Reducing the number of markers proved to be an efficient strategy, resulting in improved accuracy, reduced mean squared error (MSE), and shorter adjustment times. The best ANN predictions were obtained with ten markers selected by MARS in SC1, and the top 5% most relevant markers selected using Boosting in SC2. As a result, in SC1, predictions using MARS achieved over a 31% increase in accuracy and a 90% reduction in MSE. In SC2, predictions using Boosting resulted in more than a 15% increase in accuracy and an 83% reduction in MSE. For both scenarios, computational time was up to ten times shorter with marker selection. Overall, the two-step prediction procedure emerged as an effective strategy for enhancing the computational and predictive performance of ANN models.

Objectives: To test the association of 45 single nucleotide polymorphisms (SNPs) with transition to psychiatric disorders in a cohort of individuals at ultrahigh risk (UHR) mental state for psychosis. Methods: Through general population screening, 88 non-help-seeking UHR subjects and 130 healthy control individuals were genotyped for 45 SNPs related to psychosis. They were followed for a mean of 2.5 years, and conversion to psychotic and to general psychiatric disorders was assessed. Genotype frequencies between controls, converters, and non-converters were analyzed. Results: There were no differences in sociodemographics between controls and UHR. Also, UHR converters and non-converters had no differences in their baseline symptoms scores. The dopamine receptor D2 gene (DRD2) SNP rs6277 was significantly more common among UHR who transitioned to psychosis (p < 0.001) and to UHR who transitioned to any psychiatric disorders (p = 0.001) when compared to UHR who did not transition. The rs6277 T allele was related to psychiatric morbidity in a dose-response fashion, being significantly more frequent in UHR converters than UHR non-converters and control subjects (p = 0.003). Conclusion: Our findings suggest that rs6277 could potentially constitute a genetic marker of transition to psychiatric disorders in subjects with at-risk mental states, warranting further investigation in larger samples.

ABSTRACT: The present study evaluated, through physical and physiological tests, the seed quality of a landrace fava bean variety in different packaging materials and storage periods, aiming to guarantee the conservation of their quality in seed banks and facilities. The methodology used was the one recommended by the Rules for Seed Analysis (RAS - Brasil, 2009) and minimum descriptors for Phaseolus lunatus L. The data were subjected to analysis of variance by the F-test at 5% signififance to verify the presence of significant interactions and the individual effects of each treatment. The test of multiple comparison of means was performed by the Tukey test at 5% significance between common treatments. The Dunnett test was used at 5% significance to compare the control means with the means of the treatments. Regression analysis was performed to study the effect of storage on the variables evaluated. All analyses were performed using the R software. From the results, it can be concluded that the storage of fava bean seeds is viable in small rural properties in impermeable packaging materials and aluminized polyethylene bags. The germination and vigor of the seeds analyzed in this study decreased throughout the storage period regardless of the type of packaging used. It is not recommended to store fava bean seeds in permeable paper packaging as they have the lowest quality indices (germination and vigor) at the end of the storage period.

IntroductionTranscranial magnetic stimulation (TMS) is a consolidated procedure for the treatment of depression, with several meta-analyses demonstrating its efficacy. Theta-burst stimulation (TBS) is a modification of TMS with similar efficacy and shorter session duration. The geriatric population has many comorbidities and a high prevalence of depression, but few clinical trials are conducted specifically for this age group. TBS could be an option in this population, offering the advantages of few side effects and no pharmacological interactions. Therefore, our aim is to investigate the efficacy of TBS in geriatric depression.Clinical trial registration[https://clinicaltrials.gov/ct2/], identifier [NCT04842929].

ABSTRACT Purpose: Despite high success rates in the treatment of urinary incontinence, complications related to the use of polypropylene (PP) meshes are still a concern, especially in vaginal prolapses surgeries. The objective of this study was to assess the effect of autologous platelet-rich plasma (PRP) coating on the integration of PP meshes implanted in the vaginal submucosa of rabbits. Materials and Methods: Thirty adult New Zealand rabbits were randomly divided into two groups (n=15): PP, implanted with conventional PP meshes; and PRP, implanted with autologous PRP coated PP meshes. Animals in both groups (n=5) were euthanized at 7, 30 and 90 days postoperatively, the vaginas extracted and sent to immunohistochemical analysis for the assessment of the pro-inflammatory agent TNF-α, anti-inflammatory agents TGF-β and IL-13, collagen metabolism marker MMP-2, and angiogenesis marker CD-31. AxioVision™ image analysis was used for the calculation of the immunoreactive area and density. Statistical analysis was performed with ANOVA followed by Tukey test (p

Abstract Hemoplasmas are epierythrocytic bacteria that infect mammals. ‘Candidatus Mycoplasma haemoalbiventris’ was detected in white-eared opossums (Didelphis albiventris) from southern and central-western Brazil. The present study aimed at: i) screening opossums for tick-borne (TBP) pathogens (Piroplasmida and Anaplasmataceae) and ii) detecting and characterizing hemoplasma species infecting opossums from Curitiba and Foz do Iguaçu cities in the Paraná State, southern Brazil. Thirty blood samples from white-eared opossums were evaluated by PCR assays. Animals were not infested by ectoparasites. The mammalian endogenous gapdh gene was consistently amplified in all samples. All opossums tested negative for Theileria/Babesia spp. and Ehrlichia/Anaplasma spp. by PCR based on 18S rRNA and 16S rRNA genes, respectively. A genus-specific PCR assay based on the 16S rRNA gene of hemoplasmas showed that three/13 (23.08%; CI 95%: 8.18-50.26%) opossums from Foz do Iguaçu were positive for hemotropic Mycoplasma sp. All opossums from Curitiba tested negative for hemoplasmas. Sequencing of both the 16S and 23S rRNA genes revealed that the animals were infected by ‘Ca. M. haemoalbiventris’. Although ‘Ca. M. haemoalbiventris’ is prevalent in opossums in Brazil, clinical signs associated with its infection and its putative vectors remain unknown.

Rhodnius prolixus is the principal vector of Trypanosoma cruzi, the aetiological agent of Chagas disease in American countries. This insect is haematophagous during all life cycles and, to antagonize its haemostatic, inflammatory and immune systems, it secretes saliva while feeding on the vertebrate host's blood. Here, we investigated characteristic changes of the salivary glands (SG) that occur during insect development. Two pairs of lobules and ducts comprise the SG of R. prolixus. The organ's size increases over time, but the microanatomical structures are preserved during insect development. Both lobules have a single layer epithelium formed by binucleated cells, which surrounds the saliva reservoir. The principal lobule presents higher polysaccharide and total protein contents than the accessory lobe. A network of external muscle layers is responsible for organ contraction and saliva release. Apocrine, merocrine and holocrine secretion types occur in the secretory epithelium. Dopamine, serotonin and tyrosine-hydroxylase are neural-related molecules that regulate SG function both during and after feeding.

Introduction: The public stigma and self-stigma contribute to the dilemma of disclosing or not one's own mental illness diagnosis. Studies suggest that revealing it diminishes stress, besides helping with self-esteem. Honest, Open, Proud (HOP) is a group program that aids in the process of deciding on it, reducing its impact. Considering the relevance of this issue, the present study aimed to apply a HOP-based intervention in a group of patients diagnosed with mood disorders.Methods: A randomized controlled clinical trial was used, including 61 patients with mood disorders, of whom 31 were diagnosed with depression and 30 were diagnosed with bipolar disorder. They were randomly placed on the intervention (HOP) or the control group (unstructured psychoeducation). The evaluations occurred before (T0) and after (T1) the sessions. We administered eight scales, from which three presented relevant results: Coming Out with Mental Illness Scale (COMIS), Cognitive Appraisal of Stigma as a Stressor (CogApp), and Authenticity Scale.Results: The intervention groups (depression and bipolar) did not present a significant change regarding the decision to disclose their diagnostics. However, the depression group showed a decrease on the perception of stigma as a stressor (T0 = 0.50 vs. T1 = −1.45; p = 0.058). Improvements in post-intervention results were seen for both groups (depression and bipolar) on the Authenticity Scale—self-alienation subscale (T0 = 10.40 vs. T1 = 12.37, p = 0.058).Conclusion: Our HOP-based intervention appeared to be an important program to aid patients in facing stigma stress, showing positive effects, whether helping to diminish stress or to improve self-conscience, both of which have indirect effects on self-stigma. As it is a compact program, it can bring benefits when applying to public health institutions.

Introduction: We extend prior reports about the risk of dependence on specific drugs by providing developmental-specific risk estimates for progression from first use to meeting criteria for DSM-III-R dependence upon cannabis, cocaine, or alcohol, as well as male-female differences.Methods: The data are from the National Comorbidity Survey, with a national probability sample of persons 15-44 years old in the United States, which included many respondents who used cannabis, cocaine and alcohol on at least one occasion (n=3558, 1337, and 6149, for cannabis, cocaine, and alcohol, respectively). Survival analysis procedures provided cumulative risk estimates of progression from first use to dependence upon each drug.Results: The estimated risk of cannabis dependence among male cannabis users was 1% in the first year after first use, and reached a peak at 4% per year 2 years later, before declining. In contrast, the estimated risk of cannabis dependence among female cannabis users remained at 1% per year for 3 years, without the peak. For both male and female cocaine users, the estimated risk for developing cocaine dependence was 5 to 6% within the first year after first use. Thereafter, the estimated risk declined from the peak value, with a somewhat faster decline for females in the next 3 years after first use. For alcohol, the estimated risk period extended for many years after the first drink, with female drinkers becoming alcohol dependent at a rate of about 1% per year; with somewhat higher risk for male drinkers. For both male and female drinkers, the period of risk for developing alcohol dependence extended for a span of more than 20 years since first use; for cannabis and cocaine, the estimated period of risk was much shorter.Comment: There are male-female differences in the risk of becoming cannabis dependent during the first several years after initiation of cannabis use, less pronounced male-female differences for alcohol, and relatively smaller male-female differences for cocaine. These results should interest scientists whose focus is upon the origins of male-female differences in the occurrence of drug dependence. [ABSTRACT FROM AUTHOR]

BACKGROUND: While an association between cigarette smoking and depression has been established in Anglo populations, replication of tobacco-depression associations in countries where smoking is growing may provide important new insights. The objectives of this study were to estimate the association of depressive symptomatology with tobacco smoking, number of cigarettes smoked daily, and smoking cessation in a representative sample of the Mexican population. METHOD: The data come from the Third National Addictions Survey (1998) conducted by the Mexican Ministry of Health, representative of Mexico's civilian population residing in cities and towns with 2500+ inhabitants, aged 18-64. Part of a multi-stage, stratified, probability sample, 1935 men and women answered a version of the survey that also included the CES-D depression scale. Analyses addressed the survey's complex design and controlled for income and educational evel. RESULTS: Among women only, current smokers had twice the odds of elevated depressive symptomatology than never smokers (OR 2.1, 95% CI 1.3-3.5, p = 0.002). For men, only those smoking a pack or more a day had greater odds of depressive symptomatology (OR 5.9, 95% CI 1.6-21.9, p = 0.008). Overall, former smokers who ceased smoking within 6 months had lower odds of depressive symptomatology than current smokers (OR 0.4, 95% CI 0.1-1.0, p = 0.042). CONCLUSIONS: These findings add to the accumulating evidence for the association between smoking and depression in different cultures and populations. [ABSTRACT FROM AUTHOR]

Introduction: Very little research has heen done in Mexico to estimate drug-related treatment needs or service utilization. There is also scarce epidemiological research on the influence of parents on drug-related service utilization by adolescents in Mexico. In this paper, we use advanced epidemiologic strategies to provide population-based estimates of the association between parental involvement and treatment needs and service utilization, by level of drug use, with and without adjustment for sociodemographic characteristics. Methods: We used data from the latest survey on drug use, representative of all middle and high school students in the Federal District of Mexico (Mexico City). A standardized, self-administered questionnaire was given to 10,173 students aged 12-22 (mean = 1-1.6, SE=0.08), especially designed to assess use of several drugs and risk/protective factors, including a sub-scale on parental involvement. All analyses used procedures that account for the complex sample design. Results: Students with lower parental involvement (lowest quartile) were found to be more likely to have used drugs in their lifetime, in the past year, as well as in the past month. Moreover, students with the lowest quartile of parental involvement were more likely to have used two or more drugs in their lifetime, and this association was estimated to be independent of sex, age, school enrollment in the past year as well as history of working part or full time in the prior year. About 20% of the students who ever used two or more drugs received some drug-related help, however 50-SST reported they would like to use drugs less. Service utilization was associated with higher numbers of drugs ever used, but not with higher levels of parental involvement. Discussion: Parental involvement seems to play a major role as a protective factor against drug use initiation among students, but does not differentiate drug users who seek help from those who do not. Further research is needed to answer whether this is due to students with higher levels of parental involvement having less problematic patterns of drug use. The discrepancy between wanting to use drugs less and service utilization points to the need for further research into the factors that may influence service utilization and, ultimately, recovery. [ABSTRACT FROM AUTHOR]

Three philosophies have different proposals and pathways in the ethical field of the study and the solution of problems relating to justice: liberalism, liberal egalitarianism and communitarianism. His representatives are called respectively liberal, liberal-egalitarian and communitarian. In this paper, we intend to evaluate each of these philosophical lines, presenting their strengths and weaknesses, and to demonstrate that liberalism must be rejected at the expense of liberal egalitarianism and of communitarianism. These philosophies have more plausible ways of problem solving than the liberal way. Accordingly, the liberal egalitarianism and communitarianism not necessarily repel. On the contrary, they can be applied jointly, which will be demonstrated in this paper. This hypothesis is developed and confirmed in this paper through the survey and study of the relevant doctrine.

Background: Experimental evidence supports the neuroprotective properties of lithium, with implications for the treatment and prevention of dementia and other neurodegenerative disorders. Lithium modulates critical intracellular pathways related to neurotrophic support, inflammatory response, autophagy and apoptosis. There is additional evidence indicating that lithium may also affect membrane homeostasis. Objective: To investigate the effect of lithium on cytosolic phospholipase A2 (PLA2) activity, a key player on membrane phospholipid turnover which has been found to be reduced in blood and brain tissue of patients with Alzheimer’s disease (AD). Methods: Primary cultures of cortical and hippocampal neurons were treated for 7 days with different concentrations of lithium chloride (0.02 mM, 0.2 mM and 2 mM). A radio-enzymatic assay was used to determine the total activity of PLA2 and two PLA2 subtypes: cytosolic calcium-dependent (cPLA2); and calcium-independent (iPLA2). Results: cPLA2 activity increased by 82% (0.02 mM; p = 0.05) and 26% (0.2 mM; p = 0.04) in cortical neurons and by 61% (0.2 mM; p = 0.03) and 57% (2 mM; p = 0.04) in hippocampal neurons. iPLA2 activity was increased by 7% (0.2 mM; p = 0.04) and 13% (2 mM; p = 0.05) in cortical neurons and by 141% (0.02 mM; p = 0.0198) in hippocampal neurons. Conclusion: long-term lithium treatment increases membrane phospholipid metabolism in neurons through the activation of total, c- and iPLA2. This effect is more prominent at sub-therapeutic concentrations of lithium, and the activation of distinct cytosolic PLA2 subtypes is tissue specific, i.e., iPLA2 in hippocampal neurons, and cPLA2 in cortical neurons. Because PLA2 activities are reported to be reduced in Alzheimer’s disease (AD) and bipolar disorder (BD), the present findings provide a possible mechanism by which long-term lithium treatment may be useful in the prevention of the disease.

Schizophrenia is a psychiatric illness in which disorders of thought content are a prominent feature. The disruption of normal flow of thought, or “Formal Thought Disorder” (FTD), has been traditionally assessed through the content and form of patients’ speech, and speech abnormalities in schizophrenia were considered as a by-product of the disruption in conceptual structures and associative processes related to psychosis. This view has been changed due to increasing evidence that language per se is impaired in schizophrenia, especially its semantic, discursive, and pragmatic aspects. Schizophrenia is currently considered by some authors as a “language related human specific disease” or “logopathy”, and the neuroanatomical and genetic correlates of the language impairment in these patients are under investigation. Such efforts may lead to a better understanding about the pathophysiology of this devastating mental disease. We present some current concepts related to FTD as opposed to primary neurolinguistic abnormalities in schizophrenia.

OBJECTIVE: To evaluate fatty acid plasma levels, phospholipase A2 activity, and the developmental profiles of children with autism vs. control subjects. METHODS: Twenty four children with autism underwent laboratory analysis for fatty acid quantification using gas chromatography and PLA2 activity determination by fluorometric assay. RESULTS: No correlation was observed between the developmental quotient and fatty acid plasma levels. Phospholipase A2 activity was significantly higher among autistic children compared with controls. CONCLUSION: The study did not show a correlation between fatty acid and phospholipase A2 plasma levels and the developmental profile of children with autism.OBJETIVO: Avaliar os níveis plasmáticos de ácidos graxos, a atividade da fosfolipase A2 e o perfil de desenvolvimento de crianças com autismo versus controles. MÉTODOS: Vinte e quatro crianças com autismo foram submetidas a exames laboratoriais para quantificação plasmática de ácidos graxos por cromatografia gasosa e para determinação da atividade de fosfolipase A2 por ensaio fluorimétrico. RESULTADOS: Nenhuma correlação foi observada entre o coeficiente de desenvolvimento e os níveis plasmáticos dos ácidos graxos quantificados. A atividade da fosfolipase A2 foi significativamente maior no grupo de crianças com autismo quando comparado ao grupo controle. CONCLUSÃO: O estudo não demonstrou correlação entre os níveis plasmáticos de ácidos graxos e fosfolipase A2 e o perfil de desenvolvimento de crianças com autismo.

A simple, rapid and selective method using high-performance liquid chromatography with ultraviolet detection (267 nm) was applied for the determination of tryptophan in plasma. Separation was carried out on a C18 column (150 x 4.6 mm internal diameter) in 6 min. The mobile phase consisted of 5 mM the sodium acetate and acetonitrile (92:8, v/v). The method was shown to be precise and accurate, and good recovery of analyte was achieved, characterizing the method as efficient and reliable for use in laboratory analysis.

This paper aimed to investigate the influence organizational values at bank branches have on bank branchperformance. The research was undertaken at branches of a Brazilian publicly held bank. The questionnairecalled Inventário de Perfis de Valores Organizacionais (IPVO, or Inventory of Organizational Values Profiles)was adapted to measure the organizational values of bank branches. Bank branch performance was measuredobjectively, using the percentage of goals accomplished during the year 2009. The sample is non-probabilisticand is formed by 271 bank branches and the data about the organizational values of bank branches was providedby 720 respondents. Data analysis revealed that the organizational values of bank branches are organized intofour factors: respect for stakeholders, employee entertainment, competent performance, and prestige. Prestige ispositively correlated with bank branch performance, and respect for stakeholders and employee entertainmentare negatively correlated with the dependent variable. The multiple regression analysis yielded an equation thataccounts for 9.5% of the variance in performance and contains two factors as independent variables whichpositively influence bank branch performance: prestige and competent performance. The results showed thatorganizational values are one of the variables that can impact bank branch performance.

As brocas-das-cucurbitáceas Diaphania spp. são as principais pragas das cucurbitáceas, podendo ocasionar perdas de até 100% na produção. A fim de reduzir o uso de inseticidas, o controle biológico, aplicado com parasitoides do gênero Trichogramma, tem-se destacado. Objetivou-se avaliar a seletividade dos ingredientes ativos abamectina, tiacloprido e clorfenapir, para Trichogramma atopovirilia Oatman & Platner (Hymenoptera: Trichogrammatidae). Para isso, 20 fêmeas recém-emergidas de T. atopovirilla foram individualizadas, em tubos de vidro (2,5 cm de diâmetro x 8,5 cm de comprimento), e oferecidas cartelas com 30 ovos de Diaphania hyalinata (Linnaeus) (Lepidoptera: Pyralidae), previamente imersas por cinco segundos em calda química. Os ingredientes ativos abamectina, tiacloprido e clorfenapir não afetaram o parasitismo de T. atopovirilia. Clorfenapir reduziu a emergência. Abamectina e tiacloprido são os mais recomendados no manejo integrado de pragas, pois foram os que se mostraram mais seletivos a T. atopovirilia em ovos de D. hyalinata.

OBJECTIVE: To investigate spectral analysis of electroencephalograms (EEG) for the alpha frequency band during rest and cognitive stimulation in healthy adults and individuals with mild cognitive impairment. METHOD: We analyzed 56 EEGs from 28 patients, 7 men and 21 women, 12 of whom (40%) were controls, 16 patients with mild cognitive impairment (60%). Ages ranged from 61 to 83 years. All individuals were patients in the Psycho-geriatric Out-patients Clinic of LIM-27, of the Psychiatric Institute of the Clinicas Hospital of the Faculty of Medicine of the University of São Paulo, IPq-HCFMUSP, between 2004 and 2007. Each patient underwent two exams with an interval of at least six months between them. During the exam, performed after a period of wakefulness and rest, the patients memorized series of pictures. RESULTS: Analysis of spectral potential both at rest and during the memorizing task showed no statistical differences between baseline and final recordings. CONCLUSION: Spectral analysis of EEGs showed coherent results with the clinical stability of the patients evaluated but was unable to distinguish between the control group and patients with MCI. Future studies should include a larger sample and a longer follow up.OBJETIVO: Realizar a análise espectral da banda de frequência alfa do EEG em adultos saudáveis, com comprometimento cognitivo leve (CCL), durante o repouso e a estimulação cognitiva. MÉTODO: Analisamos 56 EEGs de 28 pacientes, 7 homens e 21 mulheres, 12 dos quais (40%) controles, 16 pacientes com CCL (60%), com idades entre 61 a 83 anos.Todos os pacientes foram atendidos no serviço de psicogeriatria do LIM 27, do Instituto de Psiquiatria da Faculdade de Medicina da USP,entre os anos de 2004 a 2007, sendo que cada paciente realizou 2 exames com intervalo de 6 meses entre eles. Os registros dos EEGs foram realizados em repouso e durante a realização de atividade de memorização de figuras. RESULTADOS: A analise espectral durante o repouso e a tarefa de memorização não mostraram diferenças estatísticas entre os EEGs iniciais e finais. CONCLUSÃO: A análise espectral dos EEGs mostrou-se coerente com a estabilidade clínica dos dois grupos, no entanto não foi capaz de distinguir o grupo controle do grupo CCL. Estudos futuros deverão incluir um maior número de indivíduos por um tempo maior de seguimento.

OBJECTIVE: To investigate the recognition of depressive symptoms of major depressive disorder (MDD) by general practitioners. INTRODUCTION: MDD is underdiagnosed in medical settings, possibly because of difficulties in the recognition of specific depressive symptoms. METHODS: A cross-sectional study of 316 outpatients at their first visit to a teaching general hospital. We evaluated the performance of 19 general practitioners using Primary Care Evaluation of Mental Disorders (PRIME-MD) to detect depressive symptoms and compared them to 11 psychiatrists using Structured Clinical Interview Axis I Disorders, Patient Version (SCID I/P). We measured likelihood ratios, sensitivity, specificity, and false positive and false negative frequencies. RESULTS: The lowest positive likelihood ratios were for psychomotor agitation/retardation (1.6) and fatigue (1.7), mostly because of a high rate of false positive results. The highest positive likelihood ratio was found for thoughts of suicide (8.5). The lowest sensitivity, 61.8%, was found for impaired concentration. The sensitivity for worthlessness or guilt in patients with medical illness was 67.2% (95% CI, 57.4-76.9%), which is significantly lower than that found in patients without medical illness, 91.3% (95% CI, 83.2-99.4%). DISCUSSION: Less adequately identified depressive symptoms were both psychological and somatic in nature. The presence of a medical illness may decrease the sensitivity of recognizing specific depressive symptoms. CONCLUSIONS: Programs for training physicians in the use of diagnostic tools should consider their performance in recognizing specific depressive symptoms. Such procedures could allow for the development of specific training to aid in the detection of the most misrecognized depressive symptoms.

Although aromatic anticonvulsants are usually well tolerated, they can cause cutaneous adverse drug reactions in up to 10% of patients. The clinical manifestations of the antiepileptics-induced hypersensitivity reactions (AHR) vary from mild skin rashes to severe cutaneous drug adverse reactions which are related to high mortality and significant morbidity. Genetic polymorphisms in cytochrome P450 genes are associated with altered enzymatic activity and may contribute to the risk of AHR. Here we present a case-control study in which we genotyped SNPs of CYP2C19, 2C9 and 3A5 of 55 individuals with varying severities of AHR, 83 tolerant, and 366 healthy control subjects from São Paulo, Brazil. Clinical characterization was based on standardized scoring systems and drug patch test. All in vivo investigation followed the ENDA (European Network of Drug Allergy) recommendations. Genotype was determined by real time PCR using peripheral blood DNA as a template. Of all 504 subjects, 65% were females, 45% self-identified as Afro-American, 38% as Caucasian and 17% as having non-African mixed ascendancy. Amongst 55 subjects with AHR, 44 had severe cutaneous drug adverse reactions. Of the 46 drug patch tests performed, 29 (63%) were positive. We found a strong association between the absence of CYP3A5*3 and tolerant subjects when compared to AHR (p = 0.0002, OR = 5.28 [CI95% 2.09-14.84]). None of our groups presented positive association with CYP2C19 and 2C9 polymorphisms, however, both SNPs contributed to separation of cases and tolerants in a Classification and Regression Tree. Our findings indicate that drug metabolism genes can contribute in the tolerability of antiepileptics. CYP3A5*3 is the most prevalent CYP3A5 allele associated with reduced enzymatic function. The current study provides evidence that normal CYP3A5 activity might be a protective factor to aromatic antiepileptics-induced hypersensitivity reactions in Brazilian subjects.

Estudamos, em 10 indivíduos adultos normais, o comportamento de cinco artefatos biológicos do eletrencefalograma (EEG): piscamento palpebral, fechamento forçado dos olhos, fechamento forçado da mandíbula, movimentos de língua e varredura horizontal dos olhos - tanto por análise visual como espectral - tanto com objetivo de verificar como esses artefatos são visualizados quando apresentados em mapas de potência da amplitude espectral. Observamos que os potenciais do espectro respeitavam a mesma disposição topográfica que os encontrados à análise visual do traçado. A análise visual do EEG é superior à quantitativa, para o reconhecimento de artefatos, porque preserva a visualização morfológica dos grafoelementos que deve ser feita obrigatoriamente no domínio do tempo, pois a sua correta identificação se perde no domínio da frequência. Devido a grande dificuldade de excluirmos totalmente os artefatos durante o registro do EEG e, por conseguinte, serem incluídos na análise quantitativa, é fundamental conhecermos como estes potenciais serão representados nos mapas quantitativos, para podermos identifica-los, evitando confundí-los com atividades patológicas do EEG.We studied the influence of five biologic artifacts sources on quantitative EEG (blinking, forced eyes closure, forced jaw closure, tongue movements and pursuit eyes movements) through both visual and spectral analysis, with the purpose of verifying how do these artifacts can be seen in a cartographic way. We found that the spectrum’s potencials showed the same topographic display that was found through visual analysis. Visual analysis was superior than the quantitative evaluation to recognise the artifacts, as the former preserved the morphological display of the paroxisms. However it is important know how do the potencials are represented in quantitative maps, so that they can be identified as artifacts and not as pathologic EEG activity.

Objective: To confirm previous evidence suggesting an association between autism and low vitamin D serum levels. Methods: This preliminary exploratory study assessed the circulating levels of 25-hydroxyvitamin D (25-OHD) in pediatric patients with autism and in typically developing controls from Juiz de Fora, Brazil. Results: Serum levels of 25-OHD were lower in children with autism (26.48 ± 3.48 ng mL-1) when compared to typically developing subjects (40.52 ± 3.13 ng mL-1) (p < 0.001). Conclusion: Our findings attest to the importance of vitamin supplementation during pregnancy and in the treatment of children with autism, who tend to present low vitamin D consumption rates.Objetivo: Confirmar evidências prévias indicando uma associação entre autismo e baixos níveis séricos de vitamina D. Métodos: Este estudo preliminar avaliou os níveis circulantes de 25-hidroxivitamina D (25-OHD) em pacientes pediátricos com autismo e em controles apresentando desenvolvimento típico em Juiz de Fora, Brasil. Resultados: Os níveis séricos de 25-OHD foram menores em crianças com autismo (26,48 ± 3,48 ng mL-1) em comparação com indivíduos com desenvolvimento típico (40,52 ± 3,13 ng mL-1) (p < 0,001). Conclusão: Nossos resultados confirmam a importância da suplementação de vitamina durante a gravidez e no tratamento de crianças com autismo, que costumam apresentar um baixo consumo de vitamina D.

Occurrence of Faustinus sp. (Coleoptera: Curculionidae) in tomato (Solanum lycopersicum L.) plantations in the State of Espirito Santo, Brazil, was confirmed through field observations carried out between April 2006 and March 2008. Larvae of Faustinus sp. bore the stems of tomato plants, whereas adults feed on the leaves. Bored stems are then easily broken by the wind, by manual handling or by plant weight itself. Crop rotation and removal of crop residues may help reduce pest population levels.

World population growth is projected to be concentrated in megacities, with increases in social inequality and urbanization-associated stress. São Paulo Metropolitan Area (SPMA) provides a forewarning of the burden of mental disorders in urban settings in developing world. The aim of this study is to estimate prevalence, severity, and treatment of recently active DSM-IV mental disorders. We examined socio-demographic correlates, aspects of urban living such as internal migration, exposure to violence, and neighborhood-level social deprivation with 12-month mental disorders.A representative cross-sectional household sample of 5,037 adults was interviewed face-to-face using the WHO Composite International Diagnostic Interview (CIDI), to generate diagnoses of DSM-IV mental disorders within 12 months of interview, disorder severity, and treatment. Administrative data on neighborhood social deprivation were gathered. Multiple logistic regression was used to evaluate individual and contextual correlates of disorders, severity, and treatment. Around thirty percent of respondents reported a 12-month disorder, with an even distribution across severity levels. Anxiety disorders were the most common disorders (affecting 19.9%), followed by mood (11%), impulse-control (4.3%), and substance use (3.6%) disorders. Exposure to crime was associated with all four types of disorder. Migrants had low prevalence of all four types compared to stable residents. High urbanicity was associated with impulse-control disorders and high social deprivation with substance use disorders. Vulnerable subgroups were observed: women and migrant men living in most deprived areas. Only one-third of serious cases had received treatment in the previous year.Adults living in São Paulo megacity had prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world. Integration of mental health promotion and care into the rapidly expanding Brazilian primary health system should be strengthened. This strategy might become a model for poorly resourced and highly populated developing countries.

Schizophrenia is a psychiatric illness in which disorders of thought content are a prominent feature. The disruption of normal flow of thought, or “Formal Thought Disorder” (FTD), has been traditionally assessed through the content and form of patients’ speech, and speech abnormalities in schizophrenia were considered as a by-product of the disruption in conceptual structures and associative processes related to psychosis. This view has been changed due to increasing evidence that language per se is impaired in schizophrenia, especially its semantic, discursive, and pragmatic aspects. Schizophrenia is currently considered by some authors as a “language related human specific disease” or “logopathy”, and the neuroanatomical and genetic correlates of the language impairment in these patients are under investigation. Such efforts may lead to a better understanding about the pathophysiology of this devastating mental disease. We present some current concepts related to FTD as opposed to primary neurolinguistic abnormalities in schizophrenia.A esquizofrenia é uma doença psiquiátrica na qual as alterações do conteúdo do pensamento são uma característica marcante. A ruptura do fluxo normal de pensamentos, ou “Alteração Formal do Pensamento” (AFP) é acessada através da forma e conteúdo da fala do paciente. Alterações de fala e linguagem em esquizofrênicos eram consideradas como consequentes à ruptura de seus sistemas conceituais e processos associativos relacionados à psicose. Esta visão alterou-se pelo aumento nas evidências de comprometimento primário da linguagem na esquizofrenia, especialmente em seus aspectos semânticos, discursivos e pragmáticos. A esquizofrenia é atualmente considerada por alguns autores como uma “doença humana específica relacionada à linguagem”, ou “logopatia”. Os correlatos neuroanatômicos e genéticos do prejuízo linguístico nestes pacientes estão sendo investigados. Estes esforços podem levar à maior compreensão da fisiopatologia desta grave doença mental. Nesta revisão, apresentamos conceitos atuais sobre AFP e sua diferenciação das anormalidades linguísticas primárias na esquizofrenia.

Abstract Introduction Schizophrenia is a severe mental disorder. While some antipsychotic medications have demonstrated efficacy in treating positive symptoms, there is no widely recognized treatment for negative symptoms, which can cause significant distress and impairment for patients with schizophrenia. Here we describe the rationale and design of the STARTS study (Schizophrenia TreAtment with electRic Transcranial Stimulation), a clinical trial aimed to test the efficacy of a non-pharmacological treatment known as transcranial direct current stimulation (tDCS) for treating the negative symptoms of schizophrenia Methods The STARTS study is designed as a randomized, sham-controlled, double-blinded trial evaluating tDCS for the treatment of the negative symptoms of schizophrenia. One-hundred patients will be enrolled and submitted to 10 tDCS sessions over the left dorsolateral prefrontal cortex (anodal stimulation) and left temporoparietal junction (cathodal stimulation) over 5 consecutive days. Participants will be assessed using clinical and neuropsychological tests before and after the intervention. The primary outcome is change in the Positive and Negative Syndrome Scale (PANSS) negative subscale score over time and across groups. Biological markers, including blood neurotrophins and interleukins, genetic polymorphisms, and motor cortical excitability, will also be assessed. Results The clinical results will provide insights about tDCS as a treatment for the negative symptoms of schizophrenia, and the biomarker investigation will contribute towards an improved understanding of the tDCS mechanisms of action. Conclusion Our results could introduce a novel therapeutic technique for the negative symptoms of schizophrenia. Clinical trial registration: ClinicalTrials.gov, NCT02535676 .

Introduction: Technology advancements have enhanced artificial intelligence, leading to a user shift towards virtual assistants, but a human-centered approach is needed to assess for acceptability and effectiveness. The AGILE chatbot is designed in Kenya with features to redefine the response towards gender-based violence (GBV) among vulnerable populations, including adolescents, young women and men, and sexual and gender minorities, to offer accurate and reliable information among users., Methods: We conducted an exploratory qualitative study through focus group discussions (FGDs) targeting 150 participants sampled from vulnerable categories; adolescent girls and boys, young women, young men, and sexual and gender minorities. The FGDs included multiple inquiries to assess knowledge and prior interaction with intelligent conversational assistants to inform the user-centric development of a decision-supportive chatbot and a pilot of the chatbot prototype. Each focus group comprised 9-10 members, and the discussions lasted about two hours to gain qualitative user insights and experiences. We used thematic analysis and drew on grounded theory to analyze the data., Results: The analysis resulted in 14 salient themes composed of sexual violence, physical violence, emotional violence, intimate partner violence, female genital mutilation, sexual reproductive health, mental health, help-seeking behaviors/where to seek support, who to talk to, and what information they would like, features of the chatbot, access of chatbot, abuse and HIV, family and community conflicts, and information for self-care., Conclusion: Adopting a human-centered approach in designing an effective chatbot with as many human features as possible is crucial in increasing utilization, addressing the gaps presented by marginalized/vulnerable populations, and reducing the current GBV epidemic by moving prevention and response services closer to people in need.

Introduction: Over one million people in the U.S. received residential treatment for a substance use disorder (SUD) in 2020. Longer treatment retention is associated with better outcomes (e.g., reduced substance use). Entering treatment with higher stress may be associated with shorter retention. This paper examines the impact of perceived stress at admission on SUD treatment retention in short-term residential treatment., Methods: A sample of 271 treatment episodes with admissions between October 2019 and February 2020 were collected from de-identified records of an urban mid-Atlantic adult 28-day short-term residential SUD treatment facility. Treatment completion involved finishing 28 days. Sociodemographic, substance use, perceived stress, and treatment discharge variables were analyzed. Bivariate analyses examined differences between treatment completion and early discharge, and Cox regression investigated the effect of perceived stress on treatment retention with covariates., Results: The sample was primarily male (73.8%) and non-Hispanic Black (71.6%). A majority used heroin as their primary substance (54.6%) and reported polysubstance use (72.3%). About half (51.3%) completed treatment, and completed an average of 18.7 ( SD  = 10.7) days. Those who prematurely discharged from treatment stayed an average of 8.9 ( SD  = 7.0) days. The Cox regression model found that higher perceived stress (adjusted hazard ratio (AHR) = 1.028; 95% CI = [1.005, 1.053], p  =.019) and a race/ethnicity other than non-Hispanic Black (AHR = 1.546, 95% CI = [1.037, 2.305], p  =.033) predicted premature discharge., Conclusions: Perceived stress at admission is associated with shorter treatment retention. Early stress management interventions may help increase treatment retention., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Studies including adolescents and young people (AYP) enhance the relevance of research results, benefit stakeholders, and inform future research. There exists a mental health gap in services for AYP living in low and middle-income countries. This study aims to identify mental health challenges faced by adolescents and young people in Kenya, develop practical recommendations to mitigate these issues, and reduce the mental health burden among this population. We convened an AYP-led meeting that involved 41 participants. The meeting objectives were to (1) identify efforts to support existing national and regional strategic priorities and review goals for addressing mental health needs among AYPs, (2) develop immediate action plans for strengthened mental health services, (3) review and strengthen country-level coordination mechanisms, and (4) identify how participating county experiences can inform mental health services in Kenya. Ministry of Health (MoH) officials from national and county levels, academic experts, and implementing partner agencies involved in mental health services participated in the meeting. The team, including AYP representatives, identified various mental health challenges among the AYA and recommended interventions aimed towards improving their mental health situation in the country. The challenges were clustered into three themes and comprehensively reviewed to establish the precipitating factors to mental health outcomes among AYPs in Kenya and provide recommendations. The themes included (1) legislative, (2) service provider/Ministry of Health, and (3) adolescent/individual-level factors. To bridge the mental health gap in the country and scale up mental health outcomes, the stakeholders recommended interventions within the context of the three clusters. The key suggestions included an increase in insurance financing, acceleration of community health interventions, the establishment of adolescent-friendly spaces, the training of adolescent youth champions, interactive service provision models, implementation of the existing mental health policies and structures, the development of comprehensive assessment tools, well equipped mental health departments in health facilities, the enhancement of telehealth services and digital villages, the mobilization of a functional mental health response team, and the development of a mental health database.

Suicidal behavior is a serious health issue that affects the adolescent population and that may be prevented through evidence-based approaches. There are many risk factors involved in suicidal behavior, but there are few studies encompassing the complex relationships between them. This study tested the similarity between two latent class models from two different epidemiological samples of middle-school students and evaluated if the multinomial regression model replicated the associations between the classes and the psychosocial variables. Data of 4013 adolescents from the Mexican states of Campeche and Querétaro were included in LCA to characterize suicide behavior and associated factors. The most likely latent class membership was used as the outcome in multinomial regression models. The model with data from Querétaro was consistent with the previous LC model from Campeche. The four latent classes were nearly identical for both populations and can be defined as follows: 1) "No Problems," included 73% of the adolescents; 2) "Drug Use Only," comprised 7% of the adolescents; 3) "Suicidal Behavior, No Depression," captured 8% of the adolescents (25% reported binge drinking in the past month, 50% self-inflicted injuries, and 43% low-lethality suicide attempt); 4) "Depression and Suicidal Behavior," comprised 12% of the sample (66% met criteria for Major Depressive Episode, 28% reported binge drinking in the past month, and 11% had a high-lethality suicide attempt). The congruence between the models and the consistency with identified factors highlight the need for appropriate and effective prevention strategies to minimize risk factors and reinforce protective factors in the adolescent population., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: We are currently in a period of transition, from the pre-COVID-19 (coronavirus disease 2019) era and the initial reactive lockdowns, to now the ongoing living with and potentially the after COVID-19 period. Each country is at its own individual stage of this transition, but many have gone through a period of feeling adrift; disconnected from normal lives, habits and routines, finding oneself betwixt and between stages, similar to that of liminality. Children and young people have been particularly affected. Aim: To increase the understanding of home and community-based strategies that contribute to children and young people's capacity to adjust to societal changes, both during and after pandemics. Moreover, to identify ways in which children's actions contribute to the capacity of others to adjust to the changes arising from the pandemic. The potential for these activities to influence and contribute to broader social mobilisation will be examined and promoted. Research design: To achieve the aim of this study, a participatory health research approach will be taken. The overarching theoretical framework of the COVISION study is that of liminality. The study design includes four work packages: two syntheses of literature (a rapid realist review and scoping review) to gain an overview of the emerging international context of evidence of psychosocial mitigations and community resilience in pandemics, and more specifically COVID-19; qualitative exploration of children and young people's perspective of COVID-19 via creative outlets and reflections; and participatory learning and action through co-production., Competing Interests: No competing interests were disclosed., (Copyright: © 2022 McAneney H et al.)

Background: There is serious concern over the increase in mental health problems during the coronavirus disease 2019 (Covid-19) pandemic., Methods: Based on data from two Mexican National Health and Nutrition Surveys conducted in 2018-2019 and 2020 (n = 17,925 and 4,913, respectively), we estimated the prevalence of suicide attempts among adolescents 10-19 years old in the previous year. We constructed a multivariate logistic regression model adjusted by sociodemographic characteristics and contextual variables for the Covid-19 pandemic., Results: The prevalence of suicide attempts in the previous year was similar in both surveys. We found that women, youth in urban localities and individuals living in households where a family member had lost her/his job as a result of the Covid-19 contingency were more likely to attempt suicide compared to their counterparts. On the other hand, attending classes online proved to be a protective factor (aOR=0.3, 95% CI=0.1, 0.8, p = 0.022)., Limitations: The principal limitation of our study concerned the restricted size of our sample for the 2020 survey wave., Conclusions: Population-level policies aimed at providing economic protection and helping youth to return to school would exert a favorable impact on the mental health and suicidal behavior of youths., (Copyright © 2021. Published by Elsevier B.V.)

Forming equity-based community-academic partnerships focused on recovery research is a time- consuming and challenging endeavor, but one well worth the care and effort required. Through building trusting relationships, vital research collaborations emerge, which are driven by expressed community needs and supported with university resources. This article describes the stakeholder engagement process utilized by a university-based and opioid-focused initiative entitled Innovations in Recovery through Infrastructure Support (IRIS). IRIS developed a diverse and representative network of clinical providers, peer recovery workers, academics, and other behavioral health leaders. The process was informed by community-based participatory research (CBPR) practices and principles aimed at creating equitable partnerships. Lessons learned include the need to reshape the relationship between research and the community through an acknowledgment of harms committed by academia, as well as the importance of maintaining an approach of humility, accountability, and patience with the partnership process. Concrete benefits that go beyond the long-term promise of change, including compensating partners financially for their time, help ensure equity. A commitment to always asking "Who's missing?" and then filling those gaps builds a broad network inclusive of the various constituencies that make up the recovery support system. As IRIS builds on these lessons learned and plans next steps, we share our experience to support others engaged in forming community-academic partnerships through deep stakeholder engagement and use of participatory approaches within and outside of recovery research.

Background: We are currently in a period of transition, from the pre-COVID-19 (coronavirus disease 2019) era and the initial reactive lockdowns, to now the ongoing living with and potentially the after COVID-19 period. Each country is at its own individual stage of this transition, but many have gone through a period of feeling adrift; disconnected from normal lives, habits and routines, finding oneself betwixt and between stages, similar to that of liminality. Children and young people have been particularly affected. Aim: To increase the understanding of home and community-based strategies that contribute to children and young people's capacity to adjust to societal changes, both during and after pandemics. Moreover, to identify ways in which children's actions contribute to the capacity of others to adjust to the changes arising from the pandemic. The potential for these activities to influence and contribute to broader social mobilisation will be examined and promoted. Research design: To achieve the aim of this study, a participatory health research approach will be taken. The overarching theoretical framework of the COVISION study is that of liminality. The study design includes four work packages: two syntheses of literature (a rapid realist review and scoping review) to gain an overview of the emerging international context of evidence of psychosocial mitigations and community resilience in pandemics, and more specifically COVID-19; qualitative exploration of children and young people's perspective of COVID-19 via creative outlets and reflections; and participatory learning and action through co-production., Competing Interests: No competing interests were disclosed., (Copyright: © 2021 McAneney H et al.)

Objective: To compare the occurrence of suicide attempts across nationally representative samples of the Mexican adolescent population over the past 12 years, and to analyze its association with sociodemographic, lifestyle and mental-health indicators., Methodology: Data were drawn from the 2006, 2012 and 2018 National Health and Nutrition Surveys ( n = 25,056; 21,509; and 17,925 adolescents, respectively). Estimates were based on standardized measurements., Results: The estimated lifetime prevalence rates of suicide attempts were 1.1% in 2006, 2.7% in 2012, and 3.9% in 2018, indicating a 3.4-fold increase. Across the three survey periods, women yielded rates nearly three times higher than men. Lifetime prevalence grew the most among adolescents aged 13-15 years. Compared to the other respondents, the odds of lifetime suicide attempts proved seven times as high for those who had been sexually abused during their childhood, five times as high for those who had been diagnosed with a depressive disorder, three times as high for those who had suffered physical aggression and twice as high for those who had smoked 100+ cigarettes in their lifetimes and those who consumed alcohol., Conclusion: The sharp increase in suicide attempts in Mexico calls for an urgent public-health response via universal and targeted interventions supported by national policy and sustained federal funding.

Background : Suicide and suicidal behaviors were already a global public health problem, producing preventable injuries and deaths. This issue may worsen due to the COVID-19 pandemic and may differentially affect vulnerable groups in the population, including children, adolescents, and young adults. The current study evaluated the association of affective variables (depression, hopelessness, and anxiety), drug use (alcohol, tobacco, and others), emotional intelligence, and attachment with suicidal behaviors. Methods : A state-wide survey included 8033 students (51% female, 49% male; mean age of 16 years) from science and technology high-schools using a standardized questionnaire that was distributed online. Multinomial logistic regression models tested associations between suicidal behaviors and several covariates. The analyses accommodated the complex structure of the sample. Results : Approximately 21% of all students reported a suicidal behavior (11% with a low-lethality suicide attempt, 6% with self-injuries, and 4% with a high-lethality suicide attempt). Variables associated with higher odds of suicidal behavior included: female sex, depression, hopelessness, anxiety, alcohol and tobacco use, childhood trauma, and having to self-rely as issues affecting attachment, and low self-esteem. Security of attachment was associated with lower odds of suicidal behavior. Conclusions : The complexity of suicidal behavior makes it clear that comprehensive programs need to be implemented.

Suicide rates in Mexico have increased and have more than doubled in the state of Aguascalientes over the past 10 years. Few studies have been able to control for family, neighborhood, and occupational environment factors that may confound the association between psychosocial characteristics and suicidal behavior. We study suicidal behavior among adolescents and young adults in Mexico utilizing epidemiologic research strategies to overcome prior research deficiencies. In a case-control study with youth and adults 14-42 years of age, recent cases of severe suicidal behavior (n = 150) were individually matched with up to three controls who had never had a suicidal attempt by age and sex, as well as within familial, neighborhood, and occupational contexts (n = 353). Data were collected through standardized face-to-face interviews to measure suicidal behavior and several covariates, including family relations, psychological resources, hopelessness, depression, self-esteem, stress, impulsivity, anxiety, and substance use. All measures demonstrated good to excellent precision and accuracy. Compared with their matched controls, cases perceived life events as more stressful and had worse depression and familial relationships; poorer development of affective, religious, and social resources; higher levels of hopelessness and impulsive behavior; and lower self-esteem. Evidence from multivariate analysis suggests highly probable MDE combined with low self-esteem and the use of two or more drugs in the past month more clearly differentiate cases and controls and, therefore, may best predict suicidal attempt among adolescents and young adults in Aguascalientes, Mexico., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: While research suggests that chronic childhood adversities may be predictors of alcohol use disorders, little is known of their influence on accelerated transitions through stages of alcohol involvement. We estimated the speed of transition from first opportunity (to first drink, regular drinking) to alcohol use disorder, by type and number of childhood adversities experienced., Methods: Nine-hundred-and-fifteen individuals participated in the Mexican Adolescent Mental Health Survey (a stratified multistage probabilistic sample), first as adolescents (12-17 years of age) and again eight years later as young adults (19-26 years of age). The WHO World Mental Health Composite International Diagnostic Interview (WMH-CIDI) assessed DSM-IV alcohol use disorders and twelve chronic childhood adversities. We calculated random coefficient models to estimate the association of childhood adversities with speed through stages of alcohol use involvement., Results: Mean time from opportunity to disorder was 4.08 years and the average growth rate was 1.36 years between each stage of involvement. Some, but not all, childhood adversities accelerated the growth rate, decreasing latency between each stage of alcohol use involvement from 1.36 to 0.93 years for witnessing family violence, 0.87 years for having a life-threatening illness, 0.79 years for sexual abuse to 0.77 years for physical abuse (p < 0.01)., Conclusions: There is a narrower window of opportunity to prevent progression through stages of alcohol involvement in youth who have experienced certain childhood adversities. Our findings are consistent with the dimensional approach of childhood adversity that distinguishes between experiences of threat and deprivation that might differentially influence neurological development., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Communities Engaged and Advocating for a Smoke-Free Environment (CEASE) is a long-standing research partnership between a university and the neighboring community that was established to reduce tobacco use among poor and underserved residents. The CEASE tobacco cessation program was implemented in four phases, with each new phase applying lessons learned from the previous phases to improve outcomes. This study describes CEASE's community-based approach and reports results from implementing the second phase of the intervention which, among other things, varied in the type of incentives, setting, and providers used. CEASE implemented a mixed-methods study following the Community-Based Participatory Research (CBPR) approach. During Phase II, a total of 398 smokers were recruited into two 12-session group counseling interventions facilitated by trained peers in community venues, which differed in the type of incentives used to increase participation and reward the achievement of milestones. At 12-week follow-up, 21% of all participants reported not smoking, with a retention rate (i.e., attendance at six or more of the 12 cessation classes offered) of 51.9%. No significant differences in cessation outcomes were found between the two study arms. Using a CBPR approach resulted in a peer-led model of care with improved outcomes compared to Phase I, which was provided by clinicians. The combined use of monetary and non-monetary incentives was helpful in increasing participation in the program but did not significantly impact smoking cessation. A CBPR approach can increase the acceptability and effectiveness of cessation services for underserved populations.

Aim: To determine the prevalence of drug and substance abuse among high school students in Jalisco and its association with the severity of health, behavior and psychosocial problems in order to provide evidence for possible prevention and treatment needs., Methods: A multi-stage random sample of Jalisco high school students was given a paper-and-pencil survey based upon an adapted version of the drug use screening inventory (DUSI) ( n = 24699; n = 2832). The DUSI showed adequate psychometric characteristics in this population. The statistical analyses accommodated the complex survey design with attention to unequal probability of selection and clustering of participants within schools and regions., Results: An estimated 44% of the students had smoked tobacco, one in five students was a current smoker, and one in four students used to smoke but had not smoked for one year or more. By contrast, 6.8% of the students reported having used marijuana, cocaine, or both. Behavioral problems, deviant peer affiliation, and troubled families were independently associated with drug use. One in two students who used tobacco or alcohol had used these drugs in the past year (46% and 54%, respectively), and one in four students who used marijuana or cocaine in their lifetime had used those drugs in the past year (28% in both cases)., Conclusion: The rates of cocaine use as well as the proportion of current users were higher than expected among high school students and indicate changing patterns of drug use in Mexico. These results corroborate that the general trend of drug use by youth in Mexico is increasing. Results from this study help us better understand the needs of at-risk youth and the need for new treatment and prevention strategies., Competing Interests: Conflict-of-interest statement: There are no conflicts of interest arising from this work.

Suicide is an important public health problem that requires a preventive approach. The present study aimed at assessing suicidal behaviors and their relations with other psychosocial factors in Campeche, Mexico, in order to inform the design of potential preventive interventions. A multistage probability sample of 2386 students representative of all middle schools of the state of Campeche, Mexico, took a standardized, paper-and-pencil survey covering selected psychosocial constructs including suicide behavior, depression, drug use, familial relationships, locus of control, impulsivity, and self-esteem, among others. Latent classes were identified and multinomial logistic regression was used to analyze associations between class membership and psychosocial covariates. An estimated 8% of the middle school population in Campeche had three or more psychosocial problems in the past month including drug use, major depression episode symptoms, as well as suicidal problems like attempts and self-inflicted injuries. Four latent classes were identified, one with lowest risk and three with varying characteristics in terms of binge alcohol and other drug use, depression, and suicide behaviors. Associations between psychosocial covariates and latent class were observed, as predicted based on a multi-dimensional theoretical framework. Heterogeneity across "High-Risk" groups and their potential determinants highlight the need for differentiated, specialized efforts ranging from universal to indicated interventions. Given the high level of risk factors in this population, universal preventive interventions should aim at building resiliency among youth by helping them develop an array of coping resources, as well as by creating a more nurturing psychosocial environment., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Tobacco use remains a major public health problem in the U.S. disproportionately affecting underserved communities. The Communities Engaged and Advocating for a Smoke-free Environment (CEASE) initiative is an intervention to address the problem using a community-based participatory research (CBPR) approach. This study compares quit rates in a peer-led community-based intervention with those achieved in a clinical setting. The intervention consisted of three Phases. Phase I (n = 404) was a clinic-based trial comparing two types of counseling. Phase II (n = 398) and Phase III (n = 163) interventions were conducted in community venues by trained Peer Motivators. Quit rates at 12-week follow-up increased from 9.4 % in Phase I (clinic-based) to an average of 23.7 % in Phases II and III combined (community-based). The main predictor of smoking cessation was delivery of services in community settings (OR 2.6, 95 % CI 1.7-4.2) while controlling for possible confounders. A community-based approach can significantly guide and improve effectiveness and acceptability of smoking cessation services designed for low-income urban populations. In addition, CBPR can result in better recruitment and retention of the participants.

Using a modified social ecological model, we conducted a review of the literature and nationwide statistics on African American health. We discuss the main social determinants of health and main health disparities, risk factors, the leading causes of morbidity and mortality, and access to health services for blacks in the USA. The mechanisms through which social determinants, including racism, exert their deleterious effects on black health are discussed at the macro and individual levels. Incarceration and mental health care issues are highlighted as priorities to be addressed. African Americans remain the least healthy ethnic group in the USA, a somber legacy of years of racial and social injustice and a formidable challenge to equitable health care for all. Systemic causes of suboptimal black health require equally systemic solutions; positive trends in black health indicators seem to be driven by social development programs, economic investment in education, participation of African Americans in policy, and decision-making and expansion of access to health care.

Male-female variations in health-behavior continue to be of national and international significance with men generally being more likely to be engaged in behaviors that enhance risk across an array of preventable diseases and injuries as well as premature deaths. The literature has identified non-medical use of prescription drugs (NMUPD) as a developing and particularly dangerous substance use behavior among college students. The literature has reported sex differences (male; female) in NMUPD but has yet to explain how gender-orientation (e.g., masculine, feminine) might impact NMUPD. The purpose of this study is to address this gap by examining the influence of gender-orientation on NMUPD. Using survey data collected during the 2013-2014 academic year from a convenience sample of college students at a mid-sized Midwestern university, we examine the association of gender-orientation with NMUPD (N=796). To do this, we separate masculine and feminine scales from the BEM Sex Role Inventory and use logistic regression to test whether masculine or feminine gender characteristics influence the likelihood of NMUPD (lifetime measure of any use and by category). This analysis shows that self-identified characteristics associated with masculinity increase the odds of NMUPD while femininity is associated with lower odds of NMUPD. Findings from this study increase our knowledge of gender-orientation and sex interactions as factors that might influence NMUPD thus demonstrating the importance of differentiating sex from gender-orientation.