En 1988, el Centro Oceanográfico de Vigo del Instituto Español de Oceanografía (COV-IEO) inició un proyecto de investigación dirigido al estudio y seguimiento de las pesquerías que la flota española ...de pesca había comenzado a desarrollar de forma sostenida en aguas de la Plataforma Patagónica, a partir de 1983. El punto de partida fue la puesta en marcha de un programa de observadores científicos a bordo de buques comerciales, con el objetivo de recoger y validar la información científica y comercial necesaria para evaluar el estado de las poblaciones de peces y cefalópodos objetivo de la flota y el impacto de las actividades pesqueras sobre esas poblaciones. Más recientemente, y en vista de las recomendaciones de la Asamblea General de Naciones Unidas referentes al impacto del arrastre de fondo sobre los Ecosistemas Marinos Vulnerables (Resoluciones AGNU 59/251 y 61/1052) y las Directrices Internacionales para la Ordenación de las Pesquerías de Aguas Profundas en Alta Mar (FAO, 20083), se añadió a las tareas de los observadores la recogida de información relacionada con estos temas. El estudio de las pesquerías explotadas exige el conocimiento profundo de la biología de las especies capturadas, de las actividades de pesca a que son sometidas y la determinación de índices de la abundancia de las especies de interés, ya sea a través de datos que proceden de las pesquerías o de datos independientes de las pesquerías (campañas de investigación). Además, es necesario el estudio de las relaciones de las pesquerías con el medio ambiente y los ecosistemas. Para conseguir todos estos objetivos es indispensable disponer de información fiable sobre la actividad pesquera, además de una serie de datos y muestras biológicas que permitan conocer las zonas y épocas de puesta, crecimiento, fecundidad, migraciones, etc, de las especies estudiadas. En una pesquería en las que las capturas no sufren ningún tipo de procesamiento (como por ejemplo las pesquerías de tipo artesanal o la pesquería de altura en el Gran Sol), los muestreos se pueden realizar en los distintos puertos o en el laboratorio; esto no es posible en el caso de pesquerías de larga distancia o gran altura como las del Atlántico Sudoccidental (ATSW), ya que las capturas son procesadas a bordo y llegan a puerto descabezadas, en forma de filete, etc. Cuando no es posible obtener en tierra la información hay que recurrir a otros métodos para conseguirla. Uno de los métodos utilizados es mediante observadores embarcados en pesqueros comerciales. El fin de un programa de observadores es, por tanto, la recogida de la información necesaria para el estudio de las pesquerías y del impacto de las actividades pesqueras sobre los ecosistemas y organismos marinos sensibles o vulnerables.
In 2013, the diagnosis of somatic symptom disorder (SSD) was introduced into the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This review aims to comprehensively synthesize ...contemporary evidence related to SSD.
A scoping review was conducted using PubMed, PsycINFO, and Cochrane Library. The main inclusion criteria were SSD and publication in the English language between 01/2009 and 05/2020. Systematic search terms also included subheadings for the DSM-5 text sections; i.e., diagnostic features, prevalence, development and course, risk and prognostic factors, culture, gender, suicide risk, functional consequences, differential diagnosis, and comorbidity.
Eight hundred and eighty-two articles were identified, of which 59 full texts were included for analysis. Empirical evidence supports the reliability, validity, and clinical utility of SSD diagnostic criteria, but the further specification of the psychological SSD B-criteria criteria seems necessary. General population studies using self-report questionnaires reported mean frequencies for SSD of 12.9% 95% confidence interval (CI) 12.5-13.3%, while prevalence studies based on criterion standard interviews are lacking. SSD was associated with increased functional impairment, decreased quality of life, and high comorbidity with anxiety and depressive disorders. Relevant research gaps remain regarding developmental aspects, risk and prognostic factors, suicide risk as well as culture- and gender-associated issues.
Strengths of the SSD diagnosis are its good reliability, validity, and clinical utility, which substantially improved on its predecessors. SSD characterizes a specific patient population that is significantly impaired both physically and psychologically. However, substantial research gaps exist, e.g., regarding SSD prevalence assessed with criterion standard diagnostic interviews.
The Clinician-Administered PTSD Scale (CAPS) is an extensively validated and widely used structured diagnostic interview for posttraumatic stress disorder (PTSD). The CAPS was recently revised to ...correspond with PTSD criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). This article describes the development of the CAPS for DSM-5 (CAPS-5) and presents the results of an initial psychometric evaluation of CAPS-5 scores in 2 samples of military veterans (Ns = 165 and 207). CAPS-5 diagnosis demonstrated strong interrater reliability (к = .78 to 1.00, depending on the scoring rule) and test-retest reliability (к = .83), as well as strong correspondence with a diagnosis based on the CAPS for DSM-IV (CAPS-IV; к = .84 when optimally calibrated). CAPS-5 total severity score demonstrated high internal consistency (α = .88) and interrater reliability (ICC = .91) and good test-retest reliability (ICC = .78). It also demonstrated good convergent validity with total severity score on the CAPS-IV (r = .83) and PTSD Checklist for DSM-5 (r = .66) and good discriminant validity with measures of anxiety, depression, somatization, functional impairment, psychopathy, and alcohol abuse (rs = .02 to .54). Overall, these results indicate that the CAPS-5 is a psychometrically sound measure of DSM-5 PTSD diagnosis and symptom severity. Importantly, the CAPS-5 strongly corresponds with the CAPS-IV, which suggests that backward compatibility with the CAPS-IV was maintained and that the CAPS-5 provides continuity in evidence-based assessment of PTSD in the transition from DSM-IV to DSM-5 criteria.
Public Significance Statement
This study evaluated the DSM-5 version of the Clinician-Administered PTSD Scale (CAPS-5), a widely used structured interview for posttraumatic stress disorder, in 2 samples of military veterans. Results indicated that the CAPS-5 is psychometrically sound and corresponds closely with the previous DSM-IV version of the CAPS.
This study examined the psychometric properties of the posttraumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5; Weathers, Litz, ...et al., 2013b) in 2 independent samples of veterans receiving care at a Veterans Affairs Medical Center (N = 468). A subsample of these participants (n = 140) was used to define a valid diagnostic cutoff score for the instrument using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5; Weathers, Blake, et al., 2013) as the reference standard. The PCL-5 test scores demonstrated good internal consistency (α = .96), test-retest reliability (r = .84), and convergent and discriminant validity. Consistent with previous studies (Armour et al., 2015; Liu et al., 2014), confirmatory factor analysis revealed that the data were best explained by a 6-factor anhedonia model and a 7-factor hybrid model. Signal detection analyses using the CAPS-5 revealed that PCL-5 scores of 31 to 33 were optimally efficient for diagnosing PTSD (κ(.5) = .58). Overall, the findings suggest that the PCL-5 is a psychometrically sound instrument that can be used effectively with veterans. Further, by determining a valid cutoff score using the CAPS-5, the PCL-5 can now be used to identify veterans with probable PTSD. However, findings also suggest the need for research to evaluate cluster structure of DSM-5.
Instrumented gloves are motion capture systems that are widely used due to the simplicity of the setup required and the absence of occlusion problems when manipulating objects. Nevertheless, the ...effect of their use on manipulation capabilities has not been studied to date. Therefore, the aim of this work is to quantify the effect of wearing CyberGlove instrumented gloves on these capabilities when different levels of precision are required. Thirty healthy subjects were asked to perform three standardised dexterity tests twice: bare-handed and wearing instrumented gloves. The tests were the Sollerman Hand Function Test (to evaluate capability of performing activities of daily living), the Box and Block Test (to evaluate gross motor skills) and the Purdue Pegboard Test (to evaluate fine motor skills). Scores obtained in the test evaluating fine motor skills decreased by an average of 29% when wearing gloves, while scores obtained on those evaluating gross motor skills and capability to perform activities of daily living were reduced by an average of 8% and 3%, respectively. The use of instrumented gloves to record hand kinematics is only recommended when performing tasks requiring medium and gross motor skills.
The Posttraumatic Stress Disorder Checklist (PCL-5; Weathers et al., 2013) was recently revised to reflect the changed diagnostic criteria for posttraumatic stress disorder (PTSD) in the fifth ...edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). We investigated the psychometric properties of PCL-5 scores in a large cohort (N = 912) of military service members seeking PTSD treatment while stationed in garrison. We examined the internal consistency, convergent and discriminant validity, and DSM-5 factor structure of PCL-5 scores, their sensitivity to clinical change relative to PTSD Symptom Scale-Interview (PSS-I; Foa, Riggs, Dancu, & Rothbaum, 1993) scores, and their diagnostic utility for predicting a PTSD diagnosis based on various measures and scoring rules. PCL-5 scores exhibited high internal consistency. There was strong agreement between the order of hypothesized and observed correlations among PCL-5 and criterion measure scores. The best-fitting structural model was a 7-factor hybrid model (Armour et al., 2015), which demonstrated closer fit than all other models evaluated, including the DSM-5 model. The PCL-5's sensitivity to clinical change, pre- to posttreatment, was comparable with that of the PSS-I. Optimally efficient cut scores for predicting PTSD diagnosis were consistent with prior research with service members (Hoge, Riviere, Wilk, Herrell, & Weathers, 2014). The results indicate that the PCL-5 is a psychometrically sound measure of DSM-5 PTSD symptoms that is useful for identifying provisional PTSD diagnostic status, quantifying PTSD symptom severity, and detecting clinical change over time in PTSD symptoms among service members seeking treatment.
Abstract
Introduction
Delirium is associated with a wide range of adverse patient safety outcomes, yet it remains consistently under-diagnosed. We undertook a systematic review of studies describing ...delirium in adult medical patients in secondary care. We investigated if changes in healthcare complexity were associated with trends in reported delirium over the last four decades.
Methods
We used identical criteria to a previous systematic review, only including studies using internationally accepted diagnostic criteria for delirium (the Diagnostic and Statistical Manual of Mental Disorders and the International Statistical Classification of Diseases). Estimates were pooled across studies using random effects meta-analysis, and we estimated temporal changes using meta-regression. We investigated publication bias with funnel plots.
Results
We identified 15 further studies to add to 18 studies from the original review. Overall delirium occurrence was 23% (95% CI 19–26%) (33 studies) though this varied according to diagnostic criteria used (highest in DSM-IV, lowest in DSM-5). There was no change from 1980 to 2019, nor was case-mix (average age of sample, proportion with dementia) different. Overall, risk of bias was moderate or low, though there was evidence of increasing publication bias over time.
Discussion
The incidence and prevalence of delirium in hospitals appears to be stable, though publication bias may have masked true changes. Nonetheless, delirium remains a challenging and urgent priority for clinical diagnosis and care pathways.
PDF
