Globally, large increases in older adult populations require that psychological assessments are tailored to evaluate psychopathology by considering both language and culture. In Mexico, there are little to no assessment tools which measure multiple areas of psychopathology specific to older adults. The current study tested the psychometric properties of the Spanish version of Older Adult Self Report (OASR) from Achenbach System of Empirically Based Assessment (ASEBA). The OASR was completed by 308 older adults in Mexico. Confirmatory factor analyses tested the fit of the 7-syndrome OASR model originally derived from a U.S. sample. The primary model fit index (Root Mean Square Error of Approximation) showed good fit for individuals from Mexico, while the secondary model fit indices (Comparative Fit Index/Tucker-Lewis Index) showed acceptable to good fit. The items loaded strongly on their respective syndrome factors, with a median loading of .57. By syndrome, the overall median loadings ranged from .414 (Worries) to .643 (Memory/Cognition Problems); and 98.23% of the loadings were statistically significant. The Latin American Spanish OASR demonstrated proper psychometric properties for the sample indicating that it is suitable for use with older adults in or from Mexico. The OASR offers 7 empirically based clinical constructs that are appropriate for older adults in or from Mexico. It provides a structure which can use to assess and communication issues of psychopathology and adaptive functioning improving overall care and research in geriatric psychiatry, notably when considering diverse populations.

Objectives: To conduct international comparisons of self-reports, collateral reports, and cross-informant agreement regarding older adult psychopathology. Participants: We compared self-ratings of problems (e.g. I cry a lot) and personal strengths (e.g. I like to help others) for 10,686 adults aged 60-102 years from 19 societies and collateral ratings for 7,065 of these adults from 12 societies. Measurements: Data were obtained via the Older Adult Self-Report (OASR) and the Older Adult Behavior Checklist (OABCL; Achenbach et al., 2004). Results: Cronbach's alphas were.76 (OASR) and.80 (OABCL) averaged across societies. Across societies, 27 of the 30 problem items with the highest mean ratings and 28 of the 30 items with the lowest mean ratings were the same on the OASR and theOABCL. Qcorrelations between the means of the 0-1-2 ratings for the 113 problem items averaged across all pairs of societies yielded means of.77 (OASR) and.78 (OABCL). For the OASR and OABCL, respectively, analyses of variance (ANOVAs) yielded effect sizes (ESs) for society of 15% and 18% for Total Problems and 42% and 31% for Personal Strengths, respectively. For 5,584 cross-informant dyads in 12 societies, cross-informant correlations averaged across societies were.68 for Total Problems and.58 for Personal Strengths. Mixed-model ANOVAs yielded large effects for society on both Total Problems (ES = 17%) and Personal Strengths (ES = 36%). Conclusions: The OASR and OABCL are efficient, low-cost, easily administered mental health assessments that can be used internationally to screen for many problems and strengths.

El objetivo de este estudio fue establecer la relación entre la adicción a las redes sociales, la autoestima y la ansiedad en estudiantes universitarios. Participaron 100 alumnos, 36 hombres y 64 mujeres, a quienes se les aplicó el Cuestionario de Adicción a Redes Sociales (ARS), la Escala de Ansiedad Manifiesta en Adultos (AMAS-A) y la Escala de Autoestima de Rosenberg. Los análisis de varianza efectuados muestran que la adicción a las redes sociales se relaciona de forma negativa con el nivel de autoestima, y de forma significativa con el nivel de ansiedad, de manera que los estudiantes con mayor adicción a dichas redes manifiestan también un mayor nivel de ansiedad.

Objectives As the world population ages, psychiatrists will increasingly need instruments for measuring constructs of psychopathology that are generalizable to diverse elders. The study tested whether syndromes of co-occurring problems derived from self-ratings of psychopathology by US elders would fit self-ratings by elders in 19 other societies. Methods/design The Older Adult Self-Report (OASR) was completed by 12 826 adults who were 60 to 102 years old in 19 societies from North and South America, Asia, and Eastern, Northern, Southern, and Western Europe, plus the United States. Individual and multigroup confirmatory factor analyses (CFAs) tested the fit of the seven-syndrome OASR model, consisting of the Anxious/Depressed, Worries, Somatic Complaints, Functional Impairment, Memory/Cognition Problems, Thought Problems, and Irritable/Disinhibited syndromes. Results In individual CFAs, the primary model fit index showed good fit for all societies, while the secondary model fit indices showed acceptable to good fit. The items loaded strongly on their respective factors, with a median item loading of .63 across 20 societies, and 98.7% of the loadings were statistically significant. In multigroup CFAs, 98% of items demonstrated approximate or full metric invariance. Fifteen percent of items demonstrated approximate or full scalar invariance, and another 59% demonstrated scalar invariance across more than half of societies. Conclusions The findings supported the generalizability of OASR syndromes across societies. The seven syndromes offer empirically based clinical constructs that are relevant for elders of different backgrounds. They can be used to assess diverse elders and as a taxonomic framework to facilitate communication, services, research, and training in geriatric psychiatry.

Prior research demonstrates that stress and coping strategies have a significant influence on development and wellbeing, however few studies focus on the impact of daily stressors and coping strategies on anxiety and resiliency in preadolescents living in Mexico. The current study aim is to determine the impact of coping strategies and daily stressors on anxiety and resilience. Daily stressors, coping strategy use, anxiety symptoms, and resilience were assessed in a sample of 98 students (age 9–13) from two schools serving similar socioeconomic areas in Ciudad Juarez, Mexico. The relationship was analyzed using structural equation modeling (SEM) to better account for the influence of coping daily stressors, gender, and age on both anxiety and resilience. The proposed model had excellent indices of model fit and revealed a positive relationship between daily stressors and levels of anxiety. Non-productive coping strategies were also associated with higher levels of anxiety while the relying on others strategy associated with less anxiety. Productive coping and non-productive coping strategies were associated with greater resiliency. Our findings parallel other findings from the literature, however, in a sample from Mexico. The findings suggest that preadolescents use different coping strategies to effectively manage daily stressors, and that anxiety may influence resiliency.

Abstract. LiDAR is a popular and accurate method for mapping that can be utilized for three-dimensional model analysis. However, the equipment set-up and usage can become tedious, and ultimately impractical when applied to locations that are remote and confined in nature. In this investigation, three-dimensional analysis was conducted within a cave system. With this, limitations of LiDAR technology in these conditions become prominent; mapping non-planar surfaces can cause a potential decrease of the quality of the point cloud data. In all, a LiDAR application would be an inefficient use of methodology to conduct this investigation. This prompted a need to set-up and conduct a photogrammetric based evaluation. With this, smartphone camera technology was used in conjunction with free-to-use software and three-dimensional modeling applications. Through the use of photogrammetric concepts and structure from motion software, a three-dimensional model of the cave can be generated. Long term, this model can also be utilized to document the impact and health of the cave system. For the methodology, the on-sight portion of the investigation relied heavily on smartphone camera technology. The procedure draws parallels to drone paths; specifically, two flight-plans were developed to evaluate different perspectives within a 15 by 15 meter space in the cave. Within each flight path, the use of photo overlapping techniques established a denser and more fluid point cloud model. Once the data was processed, two different three-dimensional models of the cave were created. From those models, the point cloud data was extracted in order to merge the two separate models. Afterwards, the models underwent several format conversions in order to import it into the Unity game engine. The final result is an accurate three-dimensional model of the cave that is viewable and playable in a simple video game platform.

Nutrition is known to influence the development and cognitive functioning throughout the lifespan, however early brain development during infancy and childhood represents an epoch where the impact of nutrition may be most important. Malnutrition during this period is seen to be associated with disruption of physiological mechanisms and cognitive deficits; this is especially true when considering the deficiency of omega-3 polyunsaturated fatty acids. This chapter discusses how cognition in early development is impacted by malnutrition, including undernutrition, over nutrition, and specific deficiencies of micronutrients, and how omega-3 consumption/supplementation can improve cognitive deficits associated in children with malnutrition. Although there are little studies, results suggest that supplementation of undernourished children results in improved cognitive functioning. Likewise, studies with children who are obese/overweight show similar results. However, there is a need for more high-quality studies to further verify and better differentiate mechanisms in which omega-3 is having an influence on cognition in malnourished children.

Community-acquired pneumonia is a common condition and 6–24% of patients will fail to improve as expected. We present a patient who was initially treated for community-acquired pneumonia but did not make the anticipated recovery. We explore potential differentials, and the investigation and management of the rare condition we subsequently diagnosed.

INTRODUCTIONobesity is a global health epidemic and understanding its causes is essential for successful treatment and prevention. Cravings have been associated with the excessive consumption of sugars and fats, and addictive eating behavior.OBJECTIVEto determine the strength of the relationship between cravings, the consumption of sugar and fat, and its impact on body composition as determined via body mass index (BMI), body fat percentage (BFP) and waist circumference (WC) in a sample of Mexicans who reside close to the México-U.S. border.METHODSthe sample was comprised of 159 young adults with a mean age of 27.96 ± 6.19, 45.9% of which were male, and all residents of Ciudad Juarez, Mexico. Cravings were measured using Trait and State Food Cravings Questionnaires. The consumption of sugars and fats was determined via a 24-hour recall of foods consumed and a food consumption frequency questionnaire.RESULTSit was demonstrated that BMI and BFP were positively associated with responses to the craving questionnaires and WC with fat consumption. Additionally, higher fat consumption was positively associated with higher rates of obesity.CONCLUSIONSthe results demonstrate the need to identify the presence of cravings and integrate such measures for effective prevention and treatment of obesity.

Introduction EBUS guided trans-bronchial needle aspiration with ROSE ensures adequacy of specimen samples and provides preliminary cytological diagnosis. Few studies have explored the utility of ROSE in granulomatous mediastinal lymphadenopathy. This retrospective study looks to further assess the validity of ROSE in the setting of non-malignant granulomatous disease. Methods We reviewed a prospectively maintained database of ROSE and laboratory cytology Results for all EBUS procedures performed during a 12 month period from 1 st January to 31 st December 2015 at our institute. We included all patients who had granuloma (including probable or possible granuloma) identified at ROSE or final cytology analysis, or both. We then reviewed clinico-radiological data to ascertain the final diagnosis and excluded those patients with malignant disease. Results During the study period, 366 EBUS were performed, with granuloma identified in 51 patients. Three patients were found to have malignancy and were excluded therefore 48 were included in the final analysis. The final diagnoses for the 48 patients are shown in Table 1. Patients with TB were more likely to have at least one granuloma at ROSE (84%) than patients with sarcoidosis (67%). Patients with granuloma identified at ROSE had a slightly lower number of nodes sampled per patient compared to those with no granuloma at ROSE (mean 1.8 vs 2.4 nodes per patient). The positive predictive value of ROSE for granuloma in our cohort was 100%, with a sensitivity of 71%. This is comparable to other studies. Conclusions In our cohort of patients, ROSE had a high positive predictive value and a sensitivity of over 70% for the diagnosis of granuloma in non-malignant disease. Our Results suggest that with the use of ROSE fewer nodes are sampled which may reduce procedure time and potential complications. This study is limited due to the small sample size but supports the use of ROSE in this context. We plan to carry out further work with larger data sets, and to look at the characteristics of those subsequently diagnosed with sarcoidosis or tuberculosis.

Introduction and objectives International guidelines suggest regular CT scan follow-up for non-small-cell lung cancer (NSCLC) that is surgically treated with curative intent.1,2 NICE guidance does not specify the type or frequency of imaging. Our aims were to assess current follow-up practice in such patients in our region, and estimate the potential impact of implementing international guidelines. Methods We surveyed a majority of hospitals (six NHS trusts) in our region about their current follow-up practice. A retrospective study was performed of patients in our trust who underwent curative surgery for NSCLC between March 2013 and December 2014. Results None of the surveyed trusts were following ESMO or ACCP guidelines. Only two had a local policy in place. The majority used chest X-ray (CXR) rather than CT follow-up, which reflected our practice. We identified 79 patients who had undergone surgery with curative intent in our trust. 5 patients were excluded, as notes were unavailable for 2, and 3 died before any follow-up. Amongst the remaining 74 patients, follow-up was for a mean of 19 months. During this time the mean number of CTs and CXRs per patient was 1.3 and 2.7 respectively. Following ESMO guidelines would reduce the number of CT scans compared to our overall current practice, to 1.1 per patient,1 whilst ACCP guidelines would result in an increase to 2.7 CTs per patient.2 Conclusions Most patients in our region are followed-up by CXR rather than CT. Most hospitals are not using follow-up guidelines, resulting in practice variation. Compared to current practice in our trust, following ESMO guidelines would not result in an increase in CT scans for this purpose, and no CXRs would be required for routine follow-up. Therefore it may be feasible to adopt this more uniform, evidence-based approach. References Vansteenkiste J, Crino L, Dooms C, et al. 2nd ESMO Consensus Conference on Lung Cancer: early-stage non-small-cell lung cancer consensus on diagnosis, treatment and follow-up. Annals of Oncology 2014;25:1462–1474. Colt H, Murgu S, Korst R, et al. Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2013;143(5 Suppl):e437S–e454S.

Objective: The purpose of this study was to determine the frequency of change in neuropsychological performance across time in deployed military personnel who experienced traumatic brain injury (TBI). The hypothesis was that frequency of changes would decrease as a function of time since injury. Method: Test-retest data was used to calculate reliable change index scores from 114 individuals over 10 neuropsychological tests. This data, part of a database of over 1, 000 evaluations of soldiers, was collected by a private practice in association with Camp Lejeune. These soldiers were deployed to Iraq/Afghanistan and were referred for comprehensive outpatient evaluation. The second testing session was on average 14 months, with a range of 2 to 34 months, following initial testing and was necessary for medical board policy compliance. Results: Mean percentage of the sample with significant increases for neuropsychological measures for < 6, 6–18, 19–29, and 30+ months since injury respectfully include; 13%, 16%, 7%, and 10%; significant decreases respectfully include 15%, 16%, 8%, and 10%. These mean changes include: CVLT-II, COWAT, Grooved Pegboard, TMT, Stroop, and WAIS-IV. Four tests were excluded due to suboptimal sample size. WAIS-IV working memory and similarities subtests supported the hypothesis with frequencies of changes decreasing as a function of time. Conclusion(s): The hypothesis was confirmed in subtests of the WAIS-IV, where changes decrease as a function of time since injury. Overall patterns seen in each group indicated highly variable neuropsychological performance following TBI up to 6 years following injury.

Objective: The purpose of this study is to examine two depression subscales as predictors of executive function (EF) performance by using multiple regression analyses. Method: The present study utilizes data from 368 Marines and sailors from Camp Lejeune, NC with traumatic brain injury (TBI) and were referred to Carolina Psychological Health Services (CPHS) for neuropsychological evaluation. Individuals were administered a battery comprised of 14 neuropsychological tests which included 4 measures of EF: the Trail-Making Tests A &B, Stroop, Hayling-Brixton, and COWA. Depression subscales from the MMPI-2 and the Trauma Symptoms Inventory (TSI) were used as predictors. Individuals were excluded from the original 1, 056 sample collected by CPHS for: suboptimal scores ( < 45) on the Test of Memory Malingering (n = 156), unspecified demographic data (n = 165), and not having scores on all measures of EF and depression (n = 367). Results: Regression analyses found that the two depression subscales were significantly predictive of performance of Letter Fluency on the COWA Test (R2 = .054, F(2, 365) = 10.41, p < .000), Trail A (R2 = .070, F(2, 365) = 13.794, p < .000), Trail B (R2 = .043, F(2, 365) = 8.219, p < .000), Sensible Sentence Completion from the Hayling Test (R2 = .034, F(2, 365) = 6.415, p < .002), and the Color-Word Stroop task (R2 = .066, F(2, 365) = 12.822, p < .000). Conclusion(s): These results suggest depression plays a minor role in predicting EF performance of combat veterans with TBI. Long-term EF recovery of military personnel with TBI and depression needs clinical consideration and further research. NEUROPSYCHOLOGICAL DOMAINS: OTHER

Objective: The purpose of this study was to analyze loss of consciousness (LOC) and number of times blasted (NOTB) as predictors on of processing speed with multiple regression and to conduct a one-way 8 factorial ANOVA of processing speed with LOC (yes or no) as the factor. Method: Marines and sailors from Camp Lejeune, NC were referred for neuropsychological evaluation to Carolina Psychological Heath Services. They were administered a neuropsychological battery comprised of 14 tests, including the processing speed measures used in this study: Grooved Pegboard dominant and non-dominant completion time, Trail making Test Parts A and B, and the WAIS-IV and WAIS-III Processing Speed and Symbol Search subtests. Exclusion criteria included obtaining sub-optimal scores on the CVLT Forced Choice (< 14, n = 39), or on TOMM Trial 2 and TOMM Retention (< 45, n = 60). A total of 635 individuals were included in the final sample. Results: Multiple regression analyses did not show LOC or NOTB to be significant predictors of the 8 processing speed criteria. However, NOTB was significantly correlated with WAIS-III Processing Speed, r = −.235, n = 71, p = .024, and LOC with Trails A, r = .128, n = 295, p = .014. No significant differences were found according to presence or absence of LOC on any of the eight processing speed measures. Conclusion(s): The results of this study suggest that, as number of times blasted increases, significant decreases on processing speed are not present. Furthermore, LOC does not seem to be a predictor of processing speed performance, nor does processing speed seem to be significantly different according to presence or absence of LOC in this military sample.

Introduction and Objectives Idiopathic pulmonary fibrosis (IPF) is associated with a reduced life expectancy of 2–3 years from diagnosis to death. In the CAPACITY1 study patients treated with pirfenidone had a slower decline in FVC (evident from 6 months), and showed a trend towards improved mortality. We investigated causes of death and factors influencing mortality in patients who have received pirfenidone on a Named Patient Programme. Method We retrospectively analysed the data from 25 patients with a minimum of 3 months follow-up who were treated with Pirfenidone between August 2011 and June 2012 in a tertiary ILD clinic. Results Mean age was 67±8 years and 19 (76%) were male. 8 of the 25 patients treated died. 4 had discontinued pirfenidone prior to death. 4 died due to an IPF exacerbation, 3 due to progressive disease and 1 due to a combination of progressive disease and congestive cardiac failure. Survivors had a greater DLCO % predicted at baseline (49±16 v 30±8; p=0.001) and were heavier (82.8±14.6kg v 71.0±11.2kg; p=0.032). A greater proportion of subjects who died (75%) had severe IPF (DLCO<35% predicted or FVC<50% predicted) compared with those who survived (18%; p=0.014). For survivors compared with those who had died, there was a trend towards greater BMI (28.7±4.4 v 25.4±3.9; p=0.065) and younger age (65±8.2 v 70±4.5; p=0.053). FVC % predicted, Chronic Respiratory Questionnaire Scores and the presence of significant co-morbidities at baseline did not predict survival. Conclusion In IPF patients who had been treated with pirfenidone, all died of IPF related causes, and those who died weighed less, and had more severe disease with a lower baseline DLCO% predicted. This may help to inform us about the most appropriate patients for whom pirfenidone treatment should be considered. Noble P, Albera C, Bradford W et al, for the CAPACITY Study Group. Pirfenidone in patients with idiopathic pulmonary fibrosis (CAPACITY): two randomised trials. Lancet 2011; 377: 1760–69.