Examining the relationship between psychosis and immigration in Spain: The effect of cannabis use and language barrier in a large psychosis sample.

The main aim of this study is to examine the association between psychosis and immigration, independent of the language barrier, drug consumption, and the social support index. The second aim is to explore the clinical and demographic characteristics of the immigrants in the catchment area, compared with the native Spanish population suffering from psychosis. All consecutive patients admitted to a hospital in Spain during 2018 and 2019 (n = 1484) were identified through the hospital's clinical records. The general representative sample (n=1484) was divided into two groups: immigrants (n=131) and non-immigrants (n=1353). Demographic, clinical, and social variables were then obtained and included in a logistic regression model. A subsample with all consecutive cases with psychosis (93 immigrants and 543 no immigrants) was also analysed to describe the diagnosis and evolution after admission. Our results show that there is higher significant prevalence of admissions due to psychosis in the immigrant population than in the non-immigrant population. This association is prominent in the population of Sub-Saharans, and is independent of cannabis use, a low social support index, or a language barrier. Understanding the specificities not only in the social context of this population but also the clinical needs is determinant for being able to shape the therapeutic intervention.

Cement technique correlates with tuberosity healing in hemiarthroplasty for proximal humeral fracture.

BACKGROUND: Tuberosity healing correlates with clinical outcomes after hemiarthroplasty for 4-part proximal humeral fractures (4PHFs). We seek to examine variables that affect tuberosity healing. METHODS: This was a retrospective comparative study. At 1 year postoperatively, patients who underwent hemiarthroplasty for 4PHFs were divided into 2 groups: those with anatomically healed tuberosities and those with tuberosity nonunion. The primary variables included time between injury and surgery, prosthesis fenestration, cement mantle classification, and both vertical and horizontal tuberosity reduction. Secondary demographic factors included age, gender, osteoporosis status, diabetes status, and smoking status. RESULTS: There were 84 individuals who met the inclusion criteria: 37 (44%) had anatomically healed tuberosities, and 47 (56%) did not. Individuals with anatomic healing had cement near or under the tuberosities 32% of the time, whereas individuals with nonunion or resorption had cement near the tuberosities 66% of the time (P = .002). There was no association between tuberosity healing and fenestration of the humeral stem (P = .84). Anatomic reduction between tuberosities was associated with healing (P <.001), whereas greater tuberosity-to-head height was not (P = .25). There were no significant differences in age, osteoporosis status, smoking status, diabetes status, or time to surgery between groups. Male patients had nearly double the rate of healing (P = .03). DISCUSSION AND CONCLUSION: The classification and effect of cement technique on tuberosity healing have not previously been described. We suggest limiting cementation to a minimum of 5 mm below the level of the tuberosity fracture. The ideal candidate for hemiarthroplasty for a 4PHF is a male patient with anatomic tuberosity reduction and limited use of cement.

The changing face of public education: the process of "revisioning" elementary teacher preparation programs.

Three years ago the elementary education department at Clemson University recognized the need for curricular change in the way we prepare teachers. The current program was not reflective of the changing demographics of multilingual and multicultural students in the public/ private school population. The challenge from the university provost was to create an enhanced elementary curriculum that would be unique in training students to meet these new demands. The purpose of this article is to share the revisioning process that led to redesigning the teacher preparation program. Promoting positive conversations about the richness of viewing diversity through a new lens will provide deeper insights into these issues.

Noninvasive Measurements of Pressure for Detecting Compartment Syndromes.

BACKGROUND: We tested a noninvasive ultrasound, Pulse Phase Locked Loop (PPLL) technique for estimating Intramuscular Pressure (IMP) in a model Acute Compartment Syndrome (ACS); and compared it to a Near-Infrared Spectroscopy (NIRS) method. QUESTIONS: We wanted to validate our model compartment syndrome, and to compare and validate the PPLL and NIRS methods of detecting compartment syndrome. METHODS: To simulate the tamponade of an ACS, external-pressure levels from 10 to 70 mm Hg were applied to the legs of 15 healthy adult subjects to raise their IMP. Receiver Operator Characteristic (ROC) curves were used to determine the sensitivity and specificity of diagnosing elevated IMP by the two noninvasive techniques. RESULTS: NIRS data varied significantly with compression (p=0.003) with large subject-to-subject variability (p<0.001). PPLL data also varied significantly with compression (p=0.004), but subject-to-subject variation was not significant (p=0.47), suggesting that individual variation does not affect the diagnostic accuracy of the PPLL technique. Sensitivity and specificity for diagnosing normal IMP by the PPLL (<30 mm Hg from a slit catheter reading) from elevated IMP (>30 mm Hg) were 0.75 and 0.75, respectively, and the area under the curve (AUC) was 0.78. For the NIRS, the sensitivity and specificity were 0.65 and 0.65, respectively, and the AUC was 0.68. CONCLUSIONS: Both NIRS and PPLL recordings are able to differentiate a simulated ACS up to 70 mm Hg. However, the PPLL technique is a slightly better diagnostic predictor than NIRS with less subject-to-subject variability and slightly better sensitivity and specificity. LEVEL OF EVIDENCE: Level II, Diagnostic test.

Increased microvascular flow and foot sensation with mild continuous external compression.

Intermittent pneumatic compression of the calf and foot increases inflow to the popliteal artery and skin. We hypothesize that mild, continuous pneumatic compression of the lower extremities of type 2 diabetic patients increases microvascular blood flow to skin (SBF) and muscle (MBF) and improves sensation in feet. Data were collected on 19 healthy volunteers and 16 type 2 diabetic patients. Baseline values of SBF, MBF, and foot sensation were recorded in one leg. The lower extremity was then subjected to 30 mmHg of continuous external air pressure for 30 min, whereas SBF and MBF were continuously monitored. Sensation was reassessed after pressure was released. During 30 mmHg continuous external compression, the healthy control group significantly increased MBF by 39.8% (P < 0.01). Sensation of the foot in this group improved significantly by 49.8% (P < 0.01). In the diabetic group, there was a significant increase in MBF of 17.7% (P = 0.03). Also sensation improved statistically by 40.2% (P = 0.03). Importantly and counterintuitively, MBF and foot sensation both increase after 30 min of leg compression at 30 mmHg. Therefore, mild, continuous pneumatic compression may be a new approach for treating diabetic patients with compromised leg perfusion and sensation.

A detailed analysis of open-field habituation and behavioral and neurochemical antidepressant-like effects in postweaning enriched rats.

Our previous work has shown that male Sprague-Dawley rats reared in social isolation, standard housing and environmental enrichment differ in their spontaneous open-field activity and in some neurobehavioral depressive-like parameters. Here, we extended this evidence by using a shorter postweaning rearing period (1 month) and including additional evaluations. First, in order to obtain a better characterization of the exploratory strategies among rearing conditions we analyzed in detail the spontaneous activity at the first minute and during the 10-min session. Second, we asked whether the changes in open-field activity were related with basal anxiety levels in the elevated plus-maze. Third, behavior in the forced-swimming test was analyzed and afterward, the tissue levels of hippocampal norepinephrine and serotonin were assessed. The possible relationship between neurotransmitters and forced-swimming behavior were explored through correlation analyses. We found that rearing conditions (i) differed on locomotor habituation and on sensory-motor exploration at the first minute and during the 10-min session without modifying the plus-maze behavior; (ii) affected differentially the grooming time, its sequential components, and the relationship between grooming and locomotor parameters; (iii) modified forced-swimming behavior and the hippocampal concentration of norepinephrine, serotonin, and its turnover; and (iv) produced different correlation patterns between both neurotransmitters and forced-swimming behaviors. Overall, environmental enrichment accelerated open-field habituation and led to behavioral and neurochemical antidepressant-like effects. In contract, isolation rearing strongly impaired habituation and simple information processing, but showed marginal effects on depressive-like behavior and on hippocampal neurochemistry. The current results suggest that differential rearing is not only a useful procedure to study behavioral plasticity or rigidity in response to early experience, but also to modeling some developmental protective or risk factors underlying depressive disorders.