Developmental plasticity has been suggested to facilitate phenotypic diversity, but the molecular mechanisms underlying this relationship are little understood. We analyzed a feeding dimorphism in Pristionchus nematodes whereby one of two alternative adult mouth forms is executed after an irreversible developmental decision. By integrating developmental genetics with functional tests in phenotypically divergent populations and species, we identified a regulator of plasticity, eud-1, that acts in a developmental switch. eud-1 mutations eliminate one mouth form, whereas overexpression of eud-1 fixes it. EUD-1 is a sulfatase that acts dosage dependently, is necessary and sufficient to control the sexual dimorphism of feeding forms, and has a conserved function in Pristionchus evolution. It is epistatic to known signaling cascades and results from lineage-specific gene duplications. EUD-1 thus executes a developmental switch for morphological plasticity in the adult stage, showing that regulatory pathways can evolve by terminal addition of new genes.

The increasing evidence for a role of developmental plasticity in evolution offers exciting prospects for testing interactions between ecological and developmental genetic processes. Recent advances with the model organism Pristionchus pacificus have provided inroads to a mechanistic understanding of a developmental plasticity. The developmental plasticity of P. pacificus comprises two discontinuous adult mouth-forms, a stenostomatous ("narrow mouthed") and a eurystomatous ("wide mouthed") form, the latter of which is structurally more complex and associated with predatory feeding. Both forms are consistently present in populations, but fundamental properties guiding fluctuations in their appearance have been poorly understood. Here, we provide a systematic characterization of the mouth plasticity in P. pacificus, quantifying a strong sexual dimorphism and revealing that, in an inbred genetic background, maternal phenotype is linked to that of male offspring. Furthermore, cues from conspecifics influenced the developmental decision in juvenile nematodes. Separating individuals from a population resulted in a lower eurystomatous frequency, which decreased incrementally with earlier isolation. Finally, the time to the reproductively mature stage was, in the presence of an abundant bacterial food supply, less for stenostomatous than for eurystomatous individuals, suggesting the potential for a fitness trade-off between developmental time and breadth of diet. This study provides a baseline understanding of the mouth dimorphism in P. pacificus as a necessary reference point for comparative analysis.

Social interaction is impaired in schizophrenia, including the use of hand gestures, which is linked to poor social perception and outcome. Brain imaging suggests reduced neural activity in a left-lateralized frontoparietal network during gesture preparation; therefore, gesturing might be improved through facilitation of left hemispheric brain areas or via disruption of interhemispheric inhibition from the right homolog. This study tested whether repetitive transcranial magnetic stimulation (rTMS) protocols would improve gesture performance in schizophrenia. This randomized, placebo-controlled, double-blind, crossover trial applied 3 different protocols of rTMS separated by 48 h. Twenty right-handed schizophrenia patients and 20 matched healthy controls received facilitatory intermittent theta burst stimulation (iTBS) over the left inferior frontal gyrus (IFG), inhibitory continuous theta burst stimulation (cTBS) over right inferior parietal lobe (IPL), and placebo over left IPL in randomized order. Primary outcome was change in the test of upper limb apraxia (TULIA), rated from video recordings of hand gesture performance. Secondary outcome was change in manual dexterity using the coin rotation task. Participants improved on both tasks following rTMS compared with baseline. Only patients improved gesture performance following right IPL cTBS compared with placebo (P = .013). The results of the coin rotation parallel those of the TULIA, with improvements following right IPL cTBS in patients (P = .001). Single sessions of cTBS on the right IPL substantially improved both gesture performance accuracy and manual dexterity. The findings point toward an inhibition of interhemispheric rivalry as a potential mechanism of action.

This research project is the first phase of a larger study aimed at describing and exploring the cost-effective utilisation of nursing personnel in old age homes in South Africa. The aim in the first phase was to describe the composition of the residents and nursing personnel of old age homes in South Africa. An exploratory and descriptive survey was conducted and the data was collected by means of a questionnaire. The questionnaire also included data on the financial implications of utilising professional nursing personnel to manage the care of the frail residents/older persons in old age homes in South Africa. The questionnaires were mailed to 612 old age homes published in the Hospital and Nursing Yearbook of 1997 (100% sample). A total of 145 (23.69%) questionnaires were returned and included in the descriptive data analysis. The residents are mainly female (77%), older than 85 years of age, belong to the white race group (83,74%) and are highly dependent on nursing care and supervision (69,7%). Old age homes are mainly managed/ controlled by welfare organisations and lay health care workers are utilised to a large extent (42,22% of the nursing workforce) to render nursing care to the frail residents. The cost-effective utilisation of nursing personnel (registered and enrolled), as well as the utilisation of lay health workers in old age homes, needs to be critically examined

A Saúde Mental Global é um campo de ensino, pesquisa e prática, cuja prioridade é melhorar o acesso e assegurar a equidade no cuidado em saúde mental para todas as pessoas do mundo, propondo ações especialmente em países de média e baixa renda, como o Brasil. Diante desse panorama mundial e considerando o avanço local dos processos das reformas sanitária e psiquiátrica, torna-se importante investigar o estado atual da literatura brasileira e sua relação com a Saúde Mental Global, descrevendo como a produção nacional aborda assuntos enfatizados nesse campo. Assim, adotando abordagem qualitativa e perspectiva descritiva, foi realizada revisão integrativa da literatura do período de 2014-2015, por meio de pesquisa bibliográfica em português e inglês, utilizando os termos saúde mental e Brasil combinados a palavras-chave correspondentes aos principais tópicos discutidos por autores da Saúde Mental Global. Foram encontrados 88 artigos apreciados segundo sua autoria, periódicos e regiões de publicação, metodologia e de acordo com as categorias de análise e acesso; atenção primária; atenção psicossocial; determinantes sociais da saúde; direitos humanos; e equidade. Constatou-se haver na produção científica nacional um conjunto de estudos muito rico e diversificado com paralelos com a literatura da Saúde Mental Global, mas apresenta um baixo índice de sistematização. Esses achados revelam, portanto, que, apesar dos esforços para a geração de conhecimento local, existem barreiras que, possivelmente, comprometem a participação brasileira no debate internacional.

We analyzed germline mutations of the BRCA1 gene in 20 German breast/ovarian-cancer families. BRCA1 mutations co-segregating with breast-cancer susceptibility were identified in 3 of these families. All mutations were found to generate a premature stop codon leading to the synthesis of truncated BRCA1 proteins of different length. Nine polymorphisms were detected in BRCA1, 4 of which have not been described previously. Analysis of familial tumors for LOH revealed that only the disease-related allele of BRCA1 was present.

Global Mental Health (GMH) is the field of study, research, and intervention, which aims at improving access to mental health worldwide. It is based on the global burden of disease research program and on the existence of a large “treatment gap” between the need and availability of mental health services, displaying individual and social costs of undiagnosed and untreated mental disorders, especially in low- and middle-income countries (LMIC). Few academic publications in Brazil dialogue directly with the field of GMH, although several issues drawn from its agenda have been the subject of mental health policies in the country. Brazil can be classified as a middle-income country with a well-structured national health system. This system is oriented toward primary health care, which integrates both community mental health services and the broader health care network. The debate between GMH advocates and critics has unearthed old controversies in psychiatry such as universality or cultural specificity of mental disorders, their expressions, and their relationship with social and economic factors. We intend to examine how these controversies reverberate in the Brazilian mental health scenario, taking as an illustration the debates around Attention Deficit Hyperactivity Disorder (ADHD) in the country. ADHD discussions oppose those who argue that the condition is underdiagnosed and undertreated, and those who claim that there is overdiagnosis and overtreatment and thus, medicalization of childhood. This article presents the current status of the Brazilian mental health literature on ADHD, with emphasis on tensions around diagnosis, prevalence and interventions. Our aim is to highlight how the differential in discourse shapes the debate on ADHD in Brazil and how this may contribute to the GMH agenda. This goal will be undertaken in three steps. First, we will briefly examine studies around GMH and ADHD. Secondly, we address Brazilian studies on this theme, considering the specificities regarding the constitution of the mental health field. Finally, we will examine the debate of treatment gap vs. medicalization in the country in order to underscore the potentials and limitations of each perspective.

A formação médica esteve centrada nas disciplinas técnico-científicas, privilegiando o raciocínio científico e as intervenções clínico-cirúrgicas. Ainda que as inovações curriculares denotem a necessidade de reformulação deste modelo, reorientando-o para uma formação mais generalista e humanista, perpetua-se um ensino pautado pelas tecnologias duras. O desenvolvimento das aptidões propedêuticas pouco valoriza o despertar da sensibilidade para aspectos subjetivos e relacionais. Este trabalho pretende evidenciar a importância da sensibilidade na formação médica pela inclusão da competência narrativa nos currículos médicos. Argumentamos que o cuidado integral, ampliado, se constrói pela integração da sensibilidade para os elementos biológicos, subjetivos e relacionais do processo saúde-doença-busca de cuidado, num enredo que dá sentido à experiência do adoecimento. Quanto melhor os clínicos souberem ouvir, absorver e interpretar os relatos que lhes trazem, melhor poderão estabelecer uma conexão que promova a mudança, cumprindo o cuidado.