Hopelessness and shame in relation to suicide attempts by Cuban adolescents.

Youth suicide rates in Cuba are very high compared with most other countries, despite considerable improvement in recent years. The purpose of our study was to determine whether hopelessness and shame distinguish adolescent suicide attempters from non-attempters, over and above the effects of depression and suicidal ideation. Participants were 844 Cuban adolescents from the province of Holguin in Eastern Cuba. The attempter groups included 38 participants being treated for suicide attempts in a day hospital and 82 participants in the community who self-reported a previous suicide attempt. The other participants were non-attempter controls. All participants were asked to complete measures of depression, hopelessness, shame and suicidal ideation. As expected, attempters scored higher than non-attempters on the control variables of depression and suicidal ideation. In addition, attempters self-reported greater shame, especially behavioral and characterological shame, than non-attempters. Contrary to our hypothesis, there was no significant difference in hopelessness between attempters and non-attempters. The results are inconsistent with the considerable narrative lore about hopelessness as a reason for suicide in Cuba and other socialist countries. However, some collective socialization practices may lead to shame.

Quantitative and Qualitative Behavioral Measurements to Assess Pain in Axolotls (Ambystoma mexicanum).

Effective pain relief in animals relies on the ability to discern pain and assess its severity. However, few objective measures exist to assess the presence and severity of pain in axolotls, and few resources are available regarding drugs and appropriate doses to provide pain relief in this species. This study evaluated behavioral tools for cageside pain assessment and validated a reproducible and reliable quantitative method to evaluate analgesic efficacy in axolotls. Animals were divided into control and treatment groups (n = 6 per group); treatment groups received buprenorphine through injection (50 mg/kg every 24 h for 48 h intracelomically) or butorphanol immersion (0.50 or 0.75 mg/L every 24 h for 48 h). Qualitative behavioral tests, adapted from other amphibian studies, included tapping on the home tank, directing water jets or physically touching specific anatomic points on the animal, and placing a novel object in the home tank. Quantitative methods used to produce noxious stimuli were the acetic acid test and von Frey aesthesiometers. Animals that were treated with analgesics did not demonstrate a significant difference compared with controls during behavioral assessment at 1, 6, 12, 25, 30, and 48 h after analgesia administration. The acetic acid test revealed a reproducible, concentration-dependent pain response. However, a significant difference in the AAT response was not observed between control and treated groups with the tested analgesics and doses.

The role of ClpX in erythropoietic protoporphyria.

Hemoglobin is an essential biological component of human physiology and its production in red blood cells relies upon proper biosynthesis of heme and globin protein. Disruption in the synthesis of these precursors accounts for a number of human blood disorders found in patients. Mutations in genes encoding heme biosynthesis enzymes are associated with a broad class of metabolic disorders called porphyrias. In particular, one subtype - erythropoietic protoporphyria - is caused by the accumulation of protoporphyrin IX. Erythropoietic protoporphyria patients suffer from photosensitivity and a higher risk of liver failure, which is the principle cause of morbidity and mortality. Approximately 90% of these patients carry loss-of-function mutations in the enzyme ferrochelatase (FECH), while 5% of cases are associated with activating mutations in the C-terminus of ALAS2. Recent work has begun to uncover novel mechanisms of heme regulation that may account for the remaining 5% of cases with previously unknown genetic basis. One erythropoietic protoporphyria family has been identified with inherited mutations in the AAA+ protease ClpXP that regulates ALAS activity. In this review article, recent findings on the role of ClpXP as both an activating unfoldase and degrading protease and its impact on heme synthesis will be discussed. This review will also highlight the role of ClpX dysfunction in erythropoietic protoporphyria.

The role of ClpX in erythropoietic protoporphyria

ABSTRACT Hemoglobin is an essential biological component of human physiology and its production in red blood cells relies upon proper biosynthesis of heme and globin protein. Disruption in the synthesis of these precursors accounts for a number of human blood disorders found in patients. Mutations in genes encoding heme biosynthesis enzymes are associated with a broad class of metabolic disorders called porphyrias. In particular, one subtype - erythropoietic protoporphyria - is caused by the accumulation of protoporphyrin IX. Erythropoietic protoporphyria patients suffer from photosensitivity and a higher risk of liver failure, which is the principle cause of morbidity and mortality. Approximately 90% of these patients carry loss-of-function mutations in the enzyme ferrochelatase (FECH), while 5% of cases are associated with activating mutations in the C-terminus of ALAS2. Recent work has begun to uncover novel mechanisms of heme regulation that may account for the remaining 5% of cases with previously unknown genetic basis. One erythropoietic protoporphyria family has been identified with inherited mutations in the AAA+ protease ClpXP that regulates ALAS activity. In this review article, recent findings on the role of ClpXP as both an activating unfoldase and degrading protease and its impact on heme synthesis will be discussed. This review will also highlight the role of ClpX dysfunction in erythropoietic protoporphyria.

Dysfunctional eating behaviors, anxiety, and depression in Italian boys and girls: the role of mass media

Objective: Extensive research has implicated identification with characters in mass media in the emergence of disordered eating behavior in adolescents. We explored the possible influence of the models offered by television (TV) on adolescents' body image, body uneasiness, eating-disordered behavior, depression, and anxiety. Methods: Three hundred and one adolescents (aged 14-19) from southern Italy participated. They completed a questionnaire on media exposure and body dissatisfaction, the Eating Disorder Inventory-2, the Body Uneasiness Test, the Beck Depression Inventory, and the State-Trait Anxiety Inventory - Form Y. Results: The main factors contributing to females' eating-disordered behaviors were their own desires to be similar to TV characters, the amount of reality and entertainment TV they watched, and the discrepancy between their perceptions of their bodies and those of TV characters. Friends' desire to be similar to TV characters contributed most to depression, anxiety, body uneasiness, and eating disorders for both males and females. Conclusion: Our data confirm that extensive watching of reality and entertainment TV correlates with eating-disordered behavior among females. Moreover, the well-known negative effects of the media on adolescents' eating-disordered behaviors may also be indirectly transmitted by friends who share identification with TV characters.

Dysfunctional eating behaviors, anxiety, and depression in Italian boys and girls: the role of mass media.

OBJECTIVE: Extensive research has implicated identification with characters in mass media in the emergence of disordered eating behavior in adolescents. We explored the possible influence of the models offered by television (TV) on adolescents' body image, body uneasiness, eating-disordered behavior, depression, and anxiety. METHODS: Three hundred and one adolescents (aged 14-19) from southern Italy participated. They completed a questionnaire on media exposure and body dissatisfaction, the Eating Disorder Inventory-2, the Body Uneasiness Test, the Beck Depression Inventory, and the State-Trait Anxiety Inventory - Form Y. RESULTS: The main factors contributing to females' eating-disordered behaviors were their own desires to be similar to TV characters, the amount of reality and entertainment TV they watched, and the discrepancy between their perceptions of their bodies and those of TV characters. Friends' desire to be similar to TV characters contributed most to depression, anxiety, body uneasiness, and eating disorders for both males and females. CONCLUSION: Our data confirm that extensive watching of reality and entertainment TV correlates with eating-disordered behavior among females. Moreover, the well-known negative effects of the media on adolescents' eating-disordered behaviors may also be indirectly transmitted by friends who share identification with TV characters.

Detection and Management of Geographic Disparities in the TOPCAT Trial: Lessons Learned and Derivative Recommendations.

TOPCAT was a multinational clinical trial of 3,445 heart failure with preserved ejection fraction (HFpEF) patients that enrolled in 233 sites in six countries in North America, Eastern Europe and South America. Patients with a heart failure hospitalization in the last 12 months or an elevated B-type natriuretic peptide (BNP) were randomized to the mineralocorticoid receptor antagonist spironolactone vs. placebo. Sites in Russia and the Republic of Georgia provided the majority of early enrollment, primarily based on the hospitalization criterion since BNP levels were initially unavailable there. With the emergence of country-specific aggregate event rate data indicating lower rates in Eastern Europe and differences in patient characteristics there, the DSMB recommended relatively increasing enrollment in North America plus other corrective measures. Although final enrollment reflected the increased contribution from North America, a plurality of the final cohort came from Russia and Georgia (49% vs. 43% in North America). BNP measurements from Russia and Georgia available later in the trial suggested no or a mild level of heart failure consistent with low event rates. The primary results showed no significant spironolactone treatment effect overall (primary endpoint hazard ratio 0.89 (0.77, 1.04)), with a significant hazard ratio in North and South America (0.82 (0.69, 0.98), p =0.026) but not in Russia and Georgia (1.10 (0.79, 1.51), interaction p = 0.12). This report describes the DSMB's detection and management recommendations for regional differences in patient characteristics in TOPCAT, and suggests methods of surveillance and corrective actions that may be useful for future trials.

Does Comorbid Anger Exacerbate the Rejection of Children with Depression by their School Peers?

Depression in childhood and adolescence is often accompanied with social rejection by peers, which accentuates the course of that emotion. Despite the documented association between anger and depression, little is known about the impact of the interaction of both emotions on peer relations. The main objective of this study is to explore the interpersonal implications of depression with comorbid anger in a pediatric sample. The sample consisted of 466 participants; the mean age was 11.45 (SD = 1.55). There were 231 females (49.6 %) and 235 males (50.4 %). ANOVAs revealed significant differences between boys and girls in depression, aggression, anger experience/explosive anger and internalized responses to anger. There were no significant differences between the correlations computed with the data from boys and girls for the hypothesized associations among anger, aggression, depression, and peer acceptance/rejection. Both Anger-Out and Depression were significantly associated with perceived unpopularity. Additionally, the interaction of Anger-Out and Depression added significantly to the prediction of perceived unpopularity.

Smoking-related idiopathic interstitial pneumonia.

Cigarette smoking is a key factor in the development of numerous pulmonary diseases. An international group of clinicians, radiologists and pathologists evaluated patients with previously identified idiopathic interstitial pneumonia (IIP) to determine unique features of cigarette smoking. Phase 1 (derivation group) identified smoking-related features in patients with a history of smoking (n=41). Phase 2 (validation group) determined if these features correctly predicted the smoking status of IIP patients (n=100) to participants blinded to smoking history. Finally, the investigators sought to determine if a new smoking-related interstitial lung disease phenotype could be defined. Phase 1 suggested that preserved forced vital capacity with disproportionately reduced diffusing capacity of the lung for carbon monoxide, and various radiographic and histopathological findings were smoking-related features. In phase 2, the kappa coefficient among clinicians was 0.16 (95% CI 0.11-0.21), among the pathologists 0.36 (95% CI 0.32-0.40) and among the radiologists 0.43 (95% CI 0.35-0.52) for smoking-related features. Eight of the 100 cases were felt to represent a potential smoking-related interstitial lung disease. Smoking-related features of interstitial lung disease were identified in a minority of smokers and were not specific for smoking. This study is limited by its retrospective design, the potential for recall bias in smoking history and lack of information on second-hand smoke exposure. Further research is needed to understand the relationship between smoking and interstitial lung disease.

Distinguishing Features of Cuban Children Referred for Professional Help Because of ADHD: Looking Beyond the Symptoms

Objective: To distinguish Cuban children clinically referred because of ADHD from an at-risk community sample and a community control group in terms of symptoms, associated difficulties and impairment of family and peer relations. Method: Parents and teachers of 1,036 children (6-8 years old) completed an established ADHD rating scale and a behavioral screening measure, including peer functioning. We also administered a structured clinical interview and measures of family impairment to the clinical sample and to an at-risk community-based subsample. Results: Although both clinical and at-risk groups displayed more externalizing and internalizing symptoms than controls, referred children were not only characterized by higher levels of ADHD symptoms, but also by greater impairment of family and peer relations than at-risk community children or community controls. Conclusion: The findings suggest that ADHD has major consequences on the family and peer functioning of Cuban children, which may lead to their referral for treatment(AU)

Distinguishing features of cuban children referred for professional help because of ADHD: looking beyond the symptoms.

OBJECTIVE: To distinguish Cuban children clinically referred because of ADHD from an at-risk community sample and a community control group in terms of symptoms, associated difficulties and impairment of family and peer relations. METHOD: Parents and teachers of 1,036 children (6-8 years old) completed an established ADHD rating scale and a behavioral screening measure, including peer functioning.We also administered a structured clinical interview and measures of family impairment to the clinical sample and to an at-risk community-based subsample. RESULTS: Although both clinical and at-risk groups displayed more externalizing and internalizing symptoms than controls, referred children were not only characterized by higher levels of ADHD symptoms, but also by greater impairment of family and peer relations than at-risk community children or community controls. CONCLUSION: The findings suggest that ADHD has major consequences on the family and peer functioning of Cuban children, which may lead to their referral for treatment.

Predicting species interactions from edge responses: mongoose predation on hawksbill sea turtle nests in fragmented beach habitat.

Because species respond differently to habitat boundaries and spatial overlap affects encounter rates, edge responses should be strong determinants of spatial patterns of species interactions. In the Caribbean, mongooses (Herpestes javanicus) prey on hawksbill sea turtle (Eretmochelys imbricata) eggs. Turtles nest in both open sand and vegetation patches, with a peak in nest abundance near the boundary between the two microhabitats; mongooses rarely leave vegetation. Using both artificial nests and hawksbill nesting data, we examined how the edge responses of these species predict the spatial patterns of nest mortality. Predation risk was strongly related to mongoose abundance but was not affected by nest density or habitat type. The product of predator and prey edge response functions accurately described the observed pattern of total prey mortality. Hawksbill preference for vegetation edge becomes an ecological trap in the presence of mongooses. This is the first study to predict patterns of predation directly from continuous edge response functions of interacting species, establishing a link between models of edge response and species interactions.

Indicadores de predicción evolutiva en la nefropatía primaria por inmunoglobulina A: estudio Cooperativo Cubano / Indicators in predicting the evolutionary primary immunoglobulin A nephropathy Cooperative Study Cubano

La nefropatía por inmunoglobulina A (NIgA) se reconoce como la forma más frecuente de enfermedad glomerular primaria (EGP) 1,2, .Su evolución variable3 y comúnmente prolongada, está asociada con un importante riesgo de progresión hacia la insuficiencia renal crónica terminal (IRCT) 3,4. Por este motivo se creo un grupo de colaboración entre tres hospitales de la capital cubana, con el propósito de identificar en esta entidad, marcadores de predicción evolutiva

The effect of an early Le Fort III surgery on permanent molar eruption.

The purpose of this retrospective study was to evaluate the extent to which an early Le Fort III osteotomy affects the position and eruption of the permanent maxillary first and second molars. To test the null hypothesis that there are no changes in eruption patterns, 31 patients diagnosed with craniosynostoses (13 with Crouzon's syndrome, nine with Apert's syndrome, eight with Pfeiffer's syndrome, and one with Carpenter's syndrome) with a mean age at the time of surgery of 5.3 +/- 1.3 years were studied. All patients underwent a Le Fort III osteotomy performed by a single surgeon to correct the anatomical deformity for functional and psychosocial reasons. Eighteen patients with craniosynostoses who had not been operated on (11 with Crouzon's syndrome, four with Apert's syndrome, and three with Pfeiffer's syndrome) served as controls; they had a mean age of 21.2 +/- 9.5 years. First and second molar positions and eruption patterns were assessed separately on panoramic radiographs by three observers. For the patients who underwent surgery, long-term evaluation showed that although 79 percent of all first molars erupted compared with 100 percent for the control group (p < 0.001), only 18 percent of all second permanent molars erupted compared with 89 percent for the control group (p < 0.0001). The authors conclude that in a significant minority of cases, early Le Fort III osteotomy affects first molar eruption, whereas the probability of second molar eruption is significantly decreased in the majority of cases. Therefore, Le Fort III osteotomy sites should be positioned distal to the second molar tooth buds. If this is not possible, patients, parents, and dental professionals should be made aware of these early postosteotomy sequelae so that later treatment planning can be enhanced.

De los niños a los padres: El inventario de percepción de conductas parentales / Childrens and parents: The perception of parent inventory

El presente estudio explora las propiedades psicométricas del Inventario de Percepción sobre los Padres (Hazzard et al., 1983), instrumento elaborado para describir, con un acercamiento global, las prácticas de crianza de los padres tal como son experimentadas y percibidas por los niños. En una muestra de 276 alumnos desde el segundo al sexto grados de primaria de un colegio no estatal, mediante el análisis de cluster se confirmó la estructura interna del inventario; por otro lado, el género de los estudiantes tanto como el grado escolar explicaron poco la varianza en las diferencias entre los puntajes. Estas diferencias resultaron, en general, no significativas. Considerando las propiedades psicométricas, (1) el análisis apoyó la validez de la asumida estructura bidimensional, y (2) la confiabilidad fue aceptable.