We posit the Personal Style of the Therapist (PST) construct. It is defined as 'the set of characteristics that each therapist applies in every psychotherapeutic situation, thus shaping the main attributes of the therapeutic act'. Its background is examined and its main traits are described. It includes five bipolar dimensions: Instructional, Expressive, Engagement, Attentional and Operative. It may be assessed through a self-descriptive inventory. We list the psychometric properties found when the instrument was applied to a sample of N = 189 therapists in Argentina. We calculated descriptive statistics of the sample (means and standard deviations) and reliability coefficients (test-retest and Cronbach's alpha). To examine the dimension of the data a factor analysis of the main components was carried out using Varimax rotation. Results and potential applications of the instrument are discussed.
This study aimed to assess the molecular basis of the resistance to carbapenems in clinical isolates of Pseudomonas aeruginosa recovered from a tertiary-level health facility in San José , Costa Rica. A total of 198 non-duplicated isolates were evaluated for their susceptibility to b-lactams, aminoglycosides and fluoroquinolones. The production of metallo-b-lactamases (MBLs), the presence of MBL encoding genes (bla IMP , bla VIM and bla GIM-1 ) and the occurrence of these genes within class 1 integrons were investigated. In addition, an ERIC2 PCR fingerprinting method was used to elucidate the distribution of the detected MBL genes within the strain collection. Of the 198 isolates tested, 125 (63.1 %) were categorized as carbapenem-resistant. The majority (88.8 %) of the carbapemen-resistant isolates also showed resistance to ceftazidime, cefepime, aztreonam, ticarcillin/clavulanic acid, amikacin, gentamicin, tobramycin, ciprofloxacin and gatifloxacin. Among the carbapenem-resistant isolates, 102 (81.6 %) showed MBL activity. Strikingly, both bla IMP and bla VIM genes were simultaneously detected in most (94.1 %) of the 102 MBL producers. Five carbapenem-resistant MBL producers were positive only for bla IMP genes. Almost 70 % of the isolates examined harboured the intI1 gene, accompanied by the sul1 and qacED1 genes in 136 (99 %) and 122 (89 %) isolates, respectively. The majority (94.4 %) of the carbapenem-resistant isolates carried the intI1 gene, in contrast to 26 % of the carbapenem-susceptible isolates. Ninety-three out of 96 (96.9 %) isolates carrying both bla IMP and bla VIM genes also harboured the intI1, sul1 and qacED1 genes. Gene cassettes from carbapenem-susceptible and MBL-negative carbapenem-resistant isolates encoded aminoglycoside-resistance enzymes (aadA2, aadA4 and aadA6) as well as orfD and qacF genes. RAPD analysis distributed 126 of the isolates in 29 clusters. Eighty of the 90 bla IMP + bla VIM + isolates were sorted into 16 different clusters, suggesting that the bla IMP and bla VIM genes detected were located within a genetic element capable of lateral transfer. Carbapenem-resistant MBL-positive isolates were recovered from almost all hospital wards and were over-represented in samples obtained from the surgical emergency and intensive care therapy units. Remarkably, three carbapenem-resistant isolates, exhibiting MBL activity and carrying both bla IMP and bla VIM genes, were recovered from outpatients. Sequence analysis of both bla genes in various isolates revealed that they correspond to the alleles bla IMP-18 and bla VIM-2 . To our knowledge, this is the first report of the combination of two metallo-b-lactamases encoded by the bla IMP-18 and bla VIM-2 genes in P. aeruginosa.
The aim of this article is to share our experience at the Aiglé Foundation in fostering research that can conducted by (or in collaboration with) clinicians within a specific type of naturalistic setting-one that not only provides psychological services but also trains psychotherapists. After presenting the structure of Aiglé and the implementation of its scientific-practitioner philosophy, we describe some of the research that has been conducted with our network of clinicians and the benefits of connecting clinical practice and academic work. We then discuss some of the obstacles that we have encountered in conducting such studies, as well as a number of strategies that we adopted in attempting to address these challenges. We end this article by briefly describing the current state of our practice-research network, and by offering some recommendations to facilitate the conduct of research by and for clinicians.
Genotyping methods and genome sequencing are indispensable to reveal genomic structure of bacterial species displaying high level of genome plasticity. However, reconstruction of genome or assembly is not straightforward due to data complexity, including repeats, mobile and accessory genetic elements of bacterial genomes. Moreover, since the solution to this problem is strongly influenced by sequencing technology, bioinformatics pipelines, and selection criteria to assess assemblers, there is no systematic way to select a priori the optimal assembler and parameter settings. to assembly the genome of Pseudomonas aeruginosa strain AG1 (PaeAG1), short reads (Illumina) and long reads (Oxford Nanopore) sequencing data were used in 13 different non-hybrid and hybrid approaches. PaeAG1 is a multiresistant high-risk sequence type 111 (ST-111) clone that was isolated from a Costa Rican hospital and it was the first report of an isolate of P. aeruginosa carrying both blaVIM-2 and blaIMP-18 genes encoding for metallo-β-lactamases (MBL) enzymes. To assess the assemblies, multiple metrics regard to contiguity, correctness and completeness (3C criterion, as we define here) were used for benchmarking the 13 approaches and select a definitive assembly. In addition, annotation was done to identify genes (coding and RNA regions) and to describe the genomic content of PaeAG1. Whereas long reads and hybrid approaches showed better performances in terms of contiguity, higher correctness and completeness metrics were obtained for short read only and hybrid approaches. A manually curated and polished hybrid assembly gave rise to a single circular sequence with 100% of core genes and known regions identified, >98% of reads mapped back, no gaps, and uniform coverage. The strategy followed to obtain this high-quality 3C assembly is detailed in the manuscript and we provide readers with an all-in-one script to replicate our results or to apply it to other troublesome cases. The final 3C assembly revealed that the PaeAG1 genome has 7,190,208 bp, a 65.7% GC content and 6,709 genes (6,620 coding sequences), many of which are included in multiple mobile genomic elements, such as 57 genomic islands, six prophages, and two complete integrons with blaVIM-2 and blaIMP-18 MBL genes. Up to 250 and 60 of the predicted genes are anticipated to play a role in virulence (adherence, quorum sensing and secretion) or antibiotic resistance (β-lactamases, efflux pumps, etc). Altogether, the assembly and annotation of the PaeAG1 genome provide new perspectives to continue studying the genomic diversity and gene content of this important human pathogen. Genotyping methods and genome sequencing are indispensable to reveal genomic structure and evolution of bacterial clones with high resolution 1. In this sense, production of large amounts of short sequencing data from genomes (reads) has been facilitated by continuous advances in Next Generation Sequencing (NGS) technologies.
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