Background An automated web-based assessment and monitoring system (www.psynary.com) has been developed to assist non-specialist clinicians in managing common mood and anxiety disorders. Psynary promotes the use of standardised outcome measures to assess symptom severity and optimise treatments with the aim of improving outcomes and enabling faster recovery. This paper analyses the results from two parallel studies in New Zealand and Japan (OptiMA-1 NZ and Japan) to assess the validity of the R8 Depression scale, one of the system’s core outcome measures. Methods Clinical samples were recruited from a public secondary care and a private psychiatry clinic. Participants completed the outcome measures for the study via the online Psynary system. The R8 Depression scale is a 30-item questionnaire which includes all symptom domains covered in the ICD-10 classification of depression. The Patient Health Questionnaire (PHQ-9) was completed at the same time points as the R8 Depression, with a smaller sample also completing a paper-based Quick Inventory of Depressive Symptomatology (QIDS-SR16). Internal validity was quantified via Cronbach’s alpha and Guttman lower bounds method. External validation against the PHQ-9 and QIDS used the Pearson’s and Kendall’s correlation coefficients. Severity categories were set using a multivariate regression model. Results 270 patients participated in the study and completed a maximum of 1 baseline and 5 reviews within a 90-day period, giving a total of 1124 assessments with the PHQ-9 also being completed in 1053 of these assessments. R8 Depression normative data was also collected from 204 non-clinical volunteers with 187 of these also completing the PHQ9. Internal reliability scores were all higher than 0.9 (n = 1328). There was overall good external validity when comparing the R8 Depression to the PHQ-9, with a correlation of 0.91 for the combined normative and clinical samples (n = 1240). Conclusions The R8 Depression has been developed as a patient-rated outcome measure for depression for administration on an online system called “Psynary”. It has high internal and external validity against current widely used scales. Further work is underway to determine the sensitivity to change of the R8 Depression.
Atmospheric turbulence is usually simulated at the laboratory by generating convective free flows with hot surfaces, or heaters. It is tacitly assumed that propagation experiments in this environment are comparable to those usually found outdoors. Nevertheless, it is unclear under which conditions the analogy between convective and isotropic turbulence is valid; that is, obeying Kolmogorov isotropic models. For instance, near-ground-level turbulence often is driven by shear ratchets deviating from established inertial models. In this case, a value for the structure constant can be obtained but it would be unable to distinguish between both classes of turbulence. We have performed a conceptually simple experiment of laser beam propagation through two types of artificial turbulence: isotropic turbulence generated by a turbulator [Proc. SPIE 8535, 853508 (2012)], and convective turbulence by controlling the temperature of electric heaters. In both cases, a thin laser beam propagates across the turbulent path, and its wandering is registered by a position sensor detector. The strength of the optical turbulence, in terms of the structure constant, is obtained from the wandering variance. It is expressed as a function of the temperature difference between cold and hot sources in each setup. We compare the time series behaviour for each turbulence with increasing turbulence strength by estimating the Hurst exponent, H, through detrended fluctuation analysis (DFA). Refractive index fluctuations are inherently fractal; this characteristic is reflected in their spectra power-law dependence-in the inertial range. This fractal behaviour is inherited by time series of optical quantities, such as the wandering, by the occurrence of long-range correlations. By analyzing the wandering time series with this technique, we are able to correlate the turbulence strength to the value of the Hurt exponent. Ultimately, we characterize both types of turbulence.
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Objectives: To determine the possibility of performing complete resections of rhinosinusal hemangiomas greater than 2cm treated by an endonasal approach assisted with endoscopes. Study design: Descriptive, retrospective Methods: We analyzed the clinical histories of all adult patients who underwent an endonasal approach with endoscopes, for having hemangiomas of the nasal cavity and paranasal sinuses in the Italian Hospital of Buenos Aires, between June 2006 and December 2016. We excluded patients with hemangiomas who were less than 18 years old, with small tumors (less than 2 cm), vascular malformations, and those who underwent surgical procedures performed externally. The surgeries were performed under general anesthesia, with endoscopes of 0° and 30°, conventional surgical instruments were used for rhinosinusal endoscopic surgery. The follow-up was performed by nasal endoscopy, computed tomography and/or magnetic resonance with contrast. Results: Four patients were treated for nasal cavity (1/4) and paranasal sinuses (3/4) hemangiomas through an endonasal approach with endoscopes. There were no complications. The follow-up was greater than 5 years in two, 2 years in one and 1 year in another patient. No recurrences were detected. Conclusión: Trans-nasal surgery assisted with endoscopes of paranasal sinus and nasal cavity hemangiomas greater than 2 cm in adults, allowed perform complete resections in 100% of treated patients. In extensive hemangiomas and when it was not possible to detect the site of vascular tumor implantation, it was important to previously devascularize the lesion by preoperative embolization and cauterization of the vascular pedicles before resecting the tumor.
Este artículo se centra en el análisis del proceso histórico que sirvió de contexto a las ideas y movimientos de secularización durante el período de emancipación en Chile y América del Sur. Incluye las relaciones con la modernidad y el liberalismo de la época y también parte del pensamiento de las familias tradicionales de período colonial y sus definiciones de una secularización positiva. Todo ello dentro del problema central: las discusiones entre Estado e Iglesia respecto a sus ámbitos de poder. Abstract This article deals with historical facts underlying the current secularization process including its relationships with modernity and liberalism. It also analyses part of the thought of a colonial family about the process, with an emphasis of its definition of «positive secularity». The main point focuses into State-Church discussion on power scopes.
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