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Although Latinos are now the largest non-majority group in the United States, existing research on white attitudes toward Latinos has focused almost exclusively on attitudes toward immigration. This book changes that. It argues that such accounts fundamentally underestimate the political power of whites' animus toward Latinos and thus miss how conflict extends well beyond immigration to issues such as voting rights, criminal punishment, policing, and which candidates to support. Providing historical and cultural context and drawing on rich survey and experimental evidence, the authors show that Latino racism-ethnicism is a coherent belief system about Latinos that is conceptually and empirically distinct from other forms of out-group hostility, and from partisanship and ideology. Moreover, animus toward Latinos has become a powerful force in contemporary American politics, shaping white public opinion in elections and across a number of important issue areas - and resulting in policies that harm Latinos disproportionately.
Peripheral gene expression of several molecular pathways has been studied in major depression (MDD) with promising results. We sought to investigate some of these genes in a treatment-free Latino sample of Mexican-descent.
Material and Methods:
The sample consisted of 50 MDD treatment-free cases and 50 sex and age-matched controls. Gene expression of candidate genes of neuroplasticity (BDNF, p11, VGF), inflammation (IL1A, IL1B, IL4, IL6, IL7, IL8, IL10, MIF, TNFA), the canonical Wnt signaling pathway (TCF7L2, APC, GSK3B), and mTOR, was compared in cases and controls. RNA was obtained from blood samples. We used bivariate analyses to compare subjects vs. control mean mRNA quantification of target genes and lineal regression modeling to test for effects of age and BMI on gene expression.
Most subjects were female (66%) with a mean age of 26.7 (SD 7.9) years. Only GSK3B was differentially expressed between cases and controls at a statistically significant level (p = 0.048). TCF7L-2 showed the highest number of correlations with MDD-related traits, yet these were modest in size.
GSK3B encodes a moderator of the canonical Wnt signaling pathway. It has a role in neuroplasticity, neuroprotection, depression and other psychiatric phenotypes. We found that adding population diversity has the potential to elicit distinct peripheral gene expression markers in MDD and MDD-related traits. However, our results should only be considered as hypothesis-generating research that merits further replication in larger cohorts of similar ancestry.
Life originated on Earth possibly as a physicochemical process; thus, geological environments and their hypothetical characteristics on early Earth are essential for chemical evolution studies. Also, it is necessary to consider the energy sources that were available in the past and the components that could have contributed to promote chemical reactions. It has been proposed that the components could have been mineral surfaces. The aim of this work is to determine the possible role of mineral surfaces on chemical evolution, and to study of the stability of relevant molecules for metabolism, such as α-ketoglutaric acid (α-keto acid, Krebs cycle participant), using ionizing radiation and thermal energy as energy sources and mineral surfaces to promote chemical reactions. Preliminary results show α-ketoglutaric acid can be relatively stable at the simulated conditions of an impact-generated hydrothermal system; thus, those systems might have been plausible environments for chemical evolution on Earth.
The purpose of this article is to describe the process of developing and implementing a transdisciplinary community-based research center, the Center for Health Equity Research (CHER) Chicago, to offer a model for designing and implementing research centers that aim to address structural causes of health inequality.
Scholars from diverse backgrounds and disciplines formed a multidisciplinary team for the Center and adopted the structural violence framework as the organizing conceptual model. All Center activities were based on community partnership. The Center activities were organized within three cores: administrative, investigator development, and community engagement and dissemination cores. The key activities during the first year were to develop a pilot grant program for early-stage investigators (ESIs) and to establish community partnership mechanisms.
CHER provided more than 60 consultations for ESIs, which resulted in 31 pilot applications over the three application cycles. Over 200 academic and community partners attended the community symposium and discussed community priority. Some challenges encountered were to improve communication among investigators, to clarify roles and responsibilities of the three cores, and to build consensus on the definition and operationalization of the concept of structural violence.
There is an increasing need for local hubs to facilitate transdisciplinary collaboration and community engagement to effectively address health inequity. Building consensus around a shared vision among partners is a difficult and yet important step toward achieving equity.
Nonventilator hospital-acquired pneumonia (NV-HAP) is one of the most common healthcare-associated infections, but most hospitals do not track it. We created a pilot electronic definition for NV-HAP and compared its accuracy to Centers for Disease Control and Prevention (CDC) criteria. Kappa values for the electronic definition and CDC criteria versus “true” pneumonia were similar: 0.40 and 0.47, respectively.
When people interact, aspects of their speech and language patterns often converge in interactions involving one or more languages. Most studies of speech convergence in conversations have examined monolingual interactions, whereas most studies of bilingual speech convergence have examined spoken responses to prompts. However, it is not uncommon in multilingual communities to converse in two languages, where each speaker primarily produces only one of the two languages. The present study examined complexity matching and lexical matching as two measures of speech convergence in conversations spoken in English, Spanish, or both languages. Complexity matching measured convergence in the hierarchical timing of speech, and lexical matching measured convergence in the frequency distributions of lemmas produced. Both types of matching were found equally in all three language conditions. Taken together, the results indicate that convergence is robust to monolingual and bilingual interactions because it stems from basic mechanisms of coordination and communication.
Meaning-centered psychotherapy (MCP) is a structured psychotherapeutic intervention that aims to improve existential and spiritual well-being in patients with advanced cancer. To validate it, several efficacy studies with predominantly non-Hispanic white patients have been done. Puerto Ricans residing on the island are a largely overlooked segment of the US Latinx population. They have a strong national identity and are embedded in a collectivist culture which shares the Spanish language, cultural traditions, and an emphasis on familism, a cultural factor that values the role of the family in ensuring the well-being of its members.
The purpose of this study is to present a case study focused on a Puerto Rican advanced cancer patient who underwent MCP to assess the comprehension and acceptance of the MCP intervention.
We used a mixed-methods study design that included the taking of ethnographic notes, and pre- and post-test assessments of the scores the patient received on all the measures (using validated scales). The ethnographic notes were analyzed to determine the participant's comprehension and acceptance of the MCP intervention. Content analysis was performed on the ethnographic notes by three independent coders using a deductive coding approach. Pre- and post-interview assessments were conducted to explore changes in distress, spiritual well-being, and self-perceived quality of life.
A Latino patient with stage III cancer, low income, and low literacy skills showed low comprehension of the concepts of meaning, the finite, legacy, and moderate comprehension and acceptance of the concepts of the search for hope, purpose in life, connecting with life, courage, life's limitations, and sources of meaning. However, the patient showed high comprehension of death and dying (i.e., meaningful death). The patient showed low acceptance of death and dying concepts and high acceptance of the integration of family members into the therapy.
Significance of Results
Additional studies are needed to address cultural themes and to improve the comprehensibility and acceptance of the manual's content and the central MCP concepts. The findings suggest that MCP has the potential of being a feasible form of psychotherapy for Latinx patients suffering from distress, low spiritual well-being, and low self-perceived QOL.
Encephalitis due to anti-N-methyl-D-aspartate receptor antibodies (ANMDARE) is the most frequent immune-mediated encephalitis. It is distinguished by the subacute onset of neuropsychiatric symptoms.
To evaluate the characteristic neuropsychiatric symptoms and their outcome in patients diagnosed with ANMDARE.
This was a prospective, longitudinal study in patients with a diagnostic suspicion of ANMDARE that presented to the National Institute of Neurology from March 2018 to February 2019. A comparative analysis of two groups (positive N-methyl-D-aspartate receptor [NMDAR] vs. negative NMDAR antibodies in cerebrospinal fluid [CSF]) was done on admission and at discharge. Neuropsychiatric systematic assessments included the Neuropsychiatric Inventory Questionnaire, the Bush Francis Catatonia Rating Scale, the Confusion Assessment Method Severity, the Montreal Cognitive Assessment, and the Overt Agitation Severity Scale.
24 individuals were analysed: 14 had positive NMDAR antibodies, and 10 had negative NMDAR antibodies in CSF. On admission, agitation/aggression, euphoria/exaltation, and disinhibition were more common in patients with positive antibodies. Excited catatonia and delirium were diagnosed more frequently in patients with positive antibodies. At discharge, there was an important decrease in neuropsychiatric symptoms, but substantial cognitive impairment remained. The mean hospitalisation length was 41.71 (SD 39.33) days for patients with definitive ANMDARE (p 0.259).
Neuropsychiatric symptoms profile in ANMDARE was associated with the early onset of euphoria/exaltation and disinhibition, accompanied by marked psychomotor agitation. When ANMDARE was suspected, the presence of excited-type catatonia and delirium showed a tendency to predict definitive ANMDARE. At discharged, most patients recovered from catatonia, delirium, and psychosis, but marked cognitive symptoms, anxiety, and depression persisted at discharge.
The aim of the current study was to examine the heterogeneity of functional outcomes in first episode psychosis (FEP) patients and related clinical, neurocognitive and sociodemographic factors using a cluster analytic approach.
A large sample of FEP patients (N = 209) was functionally reassessed 10 years after the first contact with an early intervention service. Multiple baseline, 3-year and 10-year follow-up variables were explored.
The cluster analysis emphasized the existence of six independent clusters of functioning: one cluster was normal overall (42.16%), two clusters showed moderate interpersonal (9.63%) or instrumental (12.65%) deficits, two clusters showed more severe interpersonal (12.05%) or interpersonal and instrumental (13.85%) deficits and there was a significantly overall impaired cluster (9.63%). Cluster comparisons showed that several baseline and follow-up factors were differentially involved in functional outcomes.
The current study demonstrated that distinct clusters of functioning in FEP patients can be identified. The fact that a variety of profiles was observed contributes to a better understanding of the nature of the heterogeneity characterizing FEP patients and has clinical implications for developing individualized treatment plans.
Scaffolds based on two different geometries were constructed by additive manufacturing: one based on a triply periodic minimal surface, the Schwarz D surface, and the other based on a rectangular geometry with orthogonal through-holes. For construction of the scaffolds, two different materials were used: polylactic acid (PLA) in filament form and alumina in printable paste form. The structure of the resulting scaffolds was characterized via X-ray diffraction and scanning electron microscopy, and cell proliferation was assessed for each geometry and material, using fluorescence microscopy and DNA quantification via NanoDrop. Additive manufacturing allowed us to obtain scaffolds with the assessed materials while guaranteeing the interconnectivity of the pores in each one. The curved surfaces constructed with PLA were more favorable for cell attachment and proliferation of the CHO-K1 cell line.
Describe and validate the CHROME (CHemical Restraints avOidance MEthodology) criteria.
Observational prospective longitudinal study.
Single nursing home in Las Palmas de Gran Canaria, Spain.
288 residents; mean age: 81.6 (SD 10.6). 77.4% had dementia.
Multicomponent training and consultancy program to eliminate physical and chemical restraints and promote overall quality care. Clinicians were trained in stringent diagnostic criteria of neuropsychiatric syndromes and adequate psychotropic prescription.
Psychotropic prescription (primary study target), neuropsychiatric syndromes, physical restraints, falls, and emergency room visits were semi-annually collected from December 2015 to December 2017. Results are presented for all residents and for those who had dementia and participated in the five study waves (completer analysis, n=107).
For the study completers, atypical neuroleptic prescription dropped from 42.7% to 18.7%, long half-life benzodiazepines dropped from 25.2% to 6.5%, and hypnotic medications from 47.7% to 12.1% (p<0.0005). Any kind of fall evolved from 67.3 to 32.7 (number of falls by 100 residents per year). Physicians’ diagnostic confidence increased, while the frequency of diagnoses of neuropsychiatric syndromes decreased (p<0.0005).
Implementing the CHROME criteria reduced the prescription of the most dangerous medications in institutionalized people with dementia. Two independent audits found no physical or chemical restraint and confirmed prescription quality of psychotropic drugs. Adequate diagnosis and independent audits appear to be the keys to help and motivate professionals to optimize and reduce the use of psychotropic medication. The CHROME criteria unify, in a single compendium, neuropsychiatric diagnostic criteria, prescription guidelines, independent audit methodology, and minimum legal standards. These criteria can be easily adapted to other countries.
Although both obesity and ageing are risk factors for cognitive impairment, there is no evidence in Chile on how obesity levels are associated with cognitive function. Therefore, the aim of the present study was to investigate the association between adiposity levels and cognitive impairment in older Chilean adults. This cross-sectional study includes 1384 participants, over 60 years of age, from the Chilean National Health Survey 2009–2010. Cognitive impairment was evaluated using the Mini-Mental State Examination. BMI and waist circumference (WC) were used as measures of adiposity. Compared with people with a normal BMI, the odds of cognitive impairment were higher in participants who were underweight (OR 4·44; 95 % CI 2·43, 6·45; P < 0·0001), overweight (OR 1·86; 95 % CI 1·06, 2·66; P = 0·031) and obese (OR 2·26; 95 % CI 1·31, 3·21; P = 0·003). The associations were robust after adjustment for confounding variables. Similar results were observed for WC. Low and high levels of adiposity are associated with an increased likelihood of cognitive impairment in older adults in Chile.
To analyse disparities of malnutrition in all its forms by socio-economic indicators in children aged <5 years, adolescent girls and women of reproductive age (WRA).
We defined wasting/underweight, stunting/short stature, overweight and obesity following the WHO criteria for children aged <5 years, adolescents and WRA. We evaluated the prevalence of malnutrition by wealth status, education level and ethnicity (indigenous/non-indigenous).
Guatemalan 2014–2015 National Maternal and Child Health Survey.
Children aged <5 years (n 11 962), adolescent girls aged 15–19 years (n 1086) and WRA aged 20–49 years (n 11 354).
Stunting/short stature prevalence among children, adolescents and WRA was 2·8, 2·1 and 2·0 times higher in the poorest compared with the richest; 2·9, 2·9 and 2·1 times higher in the lower educational level than in the highest; and 1·7, 1·7 and 1·6 times higher in the indigenous than in the non-indigenous population. In contrast, overweight/obesity prevalence among children, adolescents and WRA was 1·6, 2·1 and 1·8 times higher in the richest compared with the poorest; 1·6, 1·3 and 1·3 times higher in the higher educational level than in the lowest; and 1·3, 1·7 and 1·3 times higher in the non-indigenous than in the indigenous population.
Stunting/short stature is more prevalent among low-income, low-education and indigenous populations in all age groups. In contrast, overweight/obesity is more prevalent in high-income, high-education and non-indigenous populations in all age groups. These outcomes demonstrate socio-economic and ethnic disparities for malnutrition in all its forms.
The first record of the ophiuroid family Ophiohelidae from the Mediterranean Sea is reported. It consists of the description of the new record of Ophiomyces grandis from the Mallorca Channel seamounts in the Balearic Islands, western Mediterranean, where it shows high abundances. We present both the morphological description of the individuals collected and, for the first time, the cytochrome oxidase subunit I (COI) sequence of this species. The morphological traits of our specimens match the available descriptions of O. grandis. On the other hand, molecular analyses show a large genetic distance between O. grandis and Ophiomyces delata, the two species being very similar morphologically. Despite the high abundances of O. grandis reported here, previous surveys in the Mallorca Channel seamounts using ROV did not detect it, emphasizing the importance of beam trawl sampling to improving the biodiversity description of these geomorphological sea bottom features.
To describe and quantify the magnitude and distribution of stunting, wasting, anaemia, overweight and obesity by wealth, level of education and ethnicity in Ecuador.
We used nationally representative data from the 2012 Ecuadorian National Health and Nutrition Survey. We used the Multidimensional Poverty Index (MPI) as a proxy of wealth. The MPI identifies deprivations across three dimensions (health, education and standard of living). We defined education by years of schooling and ethnicity as a social construct, based on shared social, cultural and historical experiences, using Ecuadorian census categories.
Urban and rural Ecuador, including the Amazon rainforest and the Galapagos Islands.
Children aged <5 years (n 8580), adolescent women aged 11–19 years (n 4043) and adult women aged 20–49 years (n 15 203).
Among children <5 years, stunting and anaemia disproportionately affected low-wealth, low-education and indigenous groups. Among adolescent and adult women, higher rates of stunting, overweight and obesity were observed in the low-education and low-wealth groups. Stunting and short stature rates were higher in indigenous women, whereas overweight and obesity rates were higher in Afro-Ecuadorian women.
Malnutrition differs significantly across sociodemographic groups, disproportionately affecting those in the low wealth tertile and ethnic minorities. Rates of stunting remain high compared with other countries in the region with similar economic development. The effective implementation of double-duty actions with the potential to impact both sides of the double burden is urgently required.
Disasters, such as cyclones, create conditions that increase the risk of infectious disease outbreaks. Epidemic forecasts can be valuable for targeting highest risk populations before an outbreak. The two main barriers to routine use of real-time forecasts include scientific and operational challenges. First, accuracy may be limited by availability of data and the uncertainty associated with the inherently stochastic processes that determine when and where outbreaks happen and spread. Second, even if data are available, the appropriate channels of communication may prevent their use for decision making.
In April 2019, only six weeks after Cyclone Idai devastated Mozambique’s central region and sparked a cholera outbreak, Cyclone Kenneth severely damaged northern areas of the country. By June 10, a total of 267 cases of cholera were confirmed, sparking a vaccination campaign. Prior to Kenneth’s landfall, a team of academic researchers, humanitarian responders, and health agencies developed a simple model to forecast areas at highest risk of a cholera outbreak. The model created risk indices for each district using combinations of four metrics: (1) flooding data; (2) previous annual cholera incidence; (3) sensitivity of previous outbreaks to the El Niño-Southern Oscillation cycle; and (4) a diffusion (gravity) model to simulate movement of infected travelers. As information on cases became available, the risk model was continuously updated. A web-based tool was produced, which identified highest risk populations prior to the cyclone and the districts at-risk following the start of the outbreak.
The model prior to Kenneth’s arrival using the metrics of previous incidence, projected flood, and El Niño sensitivity accurately predicted areas at highest risk for cholera. Despite this success, not all data were available at the scale at which the vaccination campaign took place, limiting the model’s utility, and the extent to which the forecasts were used remains unclear. Here, the science behind these forecasts and the organizational structure of this collaborative effort are discussed. The barriers to the routine use of forecasts in crisis settings are highlighted, as well as the potential for flexible teams to rapidly produce actionable insights for decision making using simple modeling tools, both before and during an outbreak.