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Care strategies for older dependants are determined by not only individuals or network characteristics, but also contextual factors. The objective of this study is to determine whether urban contexts (neighbourhoods) are linked to the use of family care (informal), public services or private care at home (formal). We applied logistic regression analysis to data from the Survey of People in a Situation of Dependence 2018. The sample was composed of 530 older people (55 years old and over) living in two types of socio-economic groups of neighbourhoods in Barcelona, Spain. The type of neighbourhood is relevant in explaining the home care that older dependants receive. In neighbourhoods with a high socio-economic level, dependants are more likely to use private services and less likely to use informal care services and public services, even after controlling for household income, degree of dependency, sex, age and the number of people in the household. Understanding the factors that determine the use of public care services, private care services or family care-giving is important due to the increment in the number of older people in the population. Our results suggest that differences in urban socio-economic contexts determine some inequalities in the use of services even after controlling for socio-economic individual differences. The characteristics of neighbourhoods should be considered to adjust care policies for older dependants.
The purpose of this paper is to build on personal engagement and role theory to develop a conceptual definition of engagement to different organizational roles (job, organization, supervisor, and coworkers) and create and validate the Role-Based Engagement Scale (RBES). Data were collected from four samples (n = 1,302) of employees, including three from multiple organizations and one from an aircraft manufacturer. Results across three studies consistently support the four dimension structure of the RBES, its internal consistency, convergent, discriminant, and predictive validity based on a series of confirmatory factor analyses. The RBES is a psychometrically sound instrument that measures engagement to job, organization, supervisor, and coworkers. This instrument will provide more targeted information for human resource management (HRM) professionals tasked with developing training methods and processes to improve low-scoring dimensions of engagement, optimizing HRM interventions.
Heterogeneous nucleation is the most effective mechanism for the inception of phase transformation. Solid walls and impurities act as a catalyst for the formation of a new thermodynamic phase by reducing the activation energy required for a phase change, hence enhancing nucleation. The formation of vapour bubbles close to solid, ideally flat, walls is addressed here by exploiting a mesoscale description that couples diffuse interface modelling of the two-phase vapour–liquid system with fluctuating hydrodynamics, extending previous work by the authors on homogeneous nucleation. The technical focus of this work is to directly account for hydrophobic or hydrophilic walls through appropriate boundary conditions compliant with the fluctuation–dissipation balance, a crucial point in the context of fluctuating hydrodynamics theory. This methodology provides access to the complete dynamics of the nucleation process, from the inception of multiple bubbles up to their long-time macroscopic expansion, on time and spatial scales unaffordable by standard techniques for nucleation, such as molecular dynamics. The analysis mainly focuses on the effect of wall wettability on the nucleation rate, and, albeit qualitatively in agreement with classical nucleation theory predictions, it reveals several discrepancies to be ascribed to layering effects in the liquid close to the boundary and to bubble–bubble interactions. In particular, it is found that, close to moderately hydrophilic surfaces, the most probable nucleation events occur away from the wall through a homogeneous mechanism.
The current pandemic is defined by the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that can lead to coronavirus disease 2019 (COVID-19). How is SARS-CoV-2 transmitted? In this review, we use a global lens to examine the sociological contexts that are potentially and systematically involved in high rates of SARS-CoV-2 transmission, including lack of personal protective equipment, population density and confinement. Altogether, this review provides an in-depth conspectus of the current literature regarding how SARS-CoV-2 disproportionately impacts many minority communities. By contextualising and disambiguating transmission risks that are particularly prominent for disadvantaged populations, this review can assist public health efforts throughout and beyond the COVID-19 pandemic.
Dual/multiple language use has been shown to affect cognition and its neural substrate, although the replicability of such findings varies, partially due to neglecting the role of interindividual variability in bilingual experience. To address this, we operationalized the main bilingual experience factors as continuous variables, investigating their effects on executive control performance and neural substrate deploying a Flanker task and structural magnetic resonance imaging. First, higher L2 proficiency predicted better executive performance. Second, neuroimaging results indicated that bilingualism-related neuroplasticity may peak at a certain stage of bilingual experience and eventually revert, possibly following functional specialization. Importantly, experienced bilinguals optimized behavioral performance independently of volumetric variations, suggesting a degree of performance gain even with lower GMV. Hence, the effects of bilingualism on cognition may evolve with experience, with improvements in functional efficiency eventually replacing structural changes. We conclude that individual differences in bilingual experience modulate cognitive and neural consequences of bilingualism.
To elucidate mechanisms across family function, home environment and eating behaviours within sociocultural context among Hispanic youth.
Two models tested via path analysis (youth fruit and vegetable (FV) consumption; empty energy consumption) using data from the Study of Latino Youth (2011–2013).
Chicago, IL; Miami, FL; Bronx, NY; San Diego, CA.
Youth (8–16-year-olds), n 1466.
Youth ate 2·4 servings of FV per d and received 27 % of total energy from empty energies. Perceiving higher acculturative stress was indirectly associated with lower FV consumption via a pathway of low family function and family support for FV (β = −0·013, P < 0·001) and via lower family closeness and family support (β = −0·004, P = 0·004). Being >12-year-olds was indirectly associated with lower FV consumption via lower family closeness and family support (β = −0·006, P < 0·001). Household food security was indirectly associated with greater FV consumption via family closeness and family support (β = 0·005, P = 0·003). In contrast, perceiving higher acculturative stress was indirectly associated with higher empty energy consumption (via family closeness and family support: β = 0·003, P = 0·028 and via low family function and low family support: β = 0·008, P = 0·05). Being older was associated with higher consumption of empty energies via family closeness (related to family support: β = 0·04, P = 0·016; parenting strategies for eating: β = 0·002, P = 0·049).
Findings suggest pathways of influence across demographic and sociocultural context, family dynamics and home environment. The directionality of these associations needs confirmation using longitudinal data.
In December 2019, a novel human-infecting coronavirus, named Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), was recognised to cause a pneumonia epidemic outbreak with different degrees of severity in Wuhan, Hubei Province in China. Since then, this epidemic has spread worldwide; in Europe, Italy has been involved. Effective preventive and therapeutic strategies are absolutely required to block this serious public health concern. Unfortunately, few studies about SARS-CoV-2 concerning its immunopathogenesis and treatment are available. On the basis of the assumption that the SARS-CoV-2 is genetically related to SARS-CoV (about 82 % of genome homology) and that its characteristics, like the modality of transmission or the type of the immune response it may stimulate, are still poorly known, a literature search was performed to identify the reports assessing these elements in patients with SARS-CoV-induced infection. Therefore, we have analysed: (1) the structure of SARS-CoV-2 and SARS-CoV; (2) the clinical signs and symptoms and pathogenic mechanisms observed during the development of acute respiratory syndrome and the cytokine release syndrome; (3) the modification of the cell microRNome and of the immune response in patients with SARS infection; and (4) the possible role of some fat-soluble compounds (such as vitamins A, D and E) in modulating directly or indirectly the replication ability of SARS-CoV-2 and host immune response.
The use of modern prolific lines of rabbit does in intensive production systems leads to an increase in productivity but also causes a rise in several problems related to the does’ health status. Hence, the aim of this study was to investigate the effect of the litter size on the metabolic, inflammatory and plasma amino acid profile in rabbit does. The blood of 30 pregnant does was sampled on the 27th day of pregnancy. The does were retrospectively grouped according to the number of offspring into a high litter size group (HI, does with ≥ 12 kits; n = 16) and a low litter size group (LO, does with ≤ 11 kits; n = 14). Data were subjected to Pearson’s correlation analysis. Further, data were analysed in agreement to a completely randomized design in which the main tested effect was litter size. The linear or quadratic trends of litter size on parameters of interests were post hoc compared by using orthogonal contrasts. In addition, compared with the LO group, the HI group had lower levels of glucose (−5%; P < 0.01), zinc (−19%; P < 0.05), albumin (−6%; P < 0.05) and total cholesterol (−13%; P < 0.07), but the total bilirubin level was higher in the HI group (+14%; P < 0.05). Regarding the plasma amino acids, the HI group had lower concentrations of threonine (−15%), glycine (−16%), lysine (−16%) and tryptophan (−26%) and a higher level of glutamic acid (+43%; P < 0.05) compared with the LO group. The exclusively ketogenic amount of amino acids was lower (P < 0.06) in the HI (55.8 mg/100 ml) does compared with the LO does (56.8 mg/100 ml). These results show that a few days before delivery, rabbit does that gave birth to a higher number of offspring had a metabolic profile and an inflammatory status that was less favourable with respect to does who gave birth to a lower number of offspring. Moreover, the plasma amino acid profile points out that there was an enhanced catabolic condition in the rabbit does with a high number of gestated foetuses; it was likely related to the greater energy demand needed to support the pregnancy and an early inflammatory response.
Pseudoaneurysms are rare complications of Blalock–Taussig fistulas. We present the case of an abscessed right pulmonary aneurysm after a Blalock–Taussig fistula in the context of a Salmonella bacteremia.
Several factor analytic studies have shown than anhedonia and avolition are included in the same factor, suggesting that motivational deficits in schizophrenia are related to a reduced experience of pleasure; however other studies have not confirmed this hypothesis. More recently, it has been hypothesized that avolition is related to a difficulty in anticipating reward value and\or regulating behavior on the basis of the associations between value and action.
This study is aimed to verify an impairment of reward anticipation in patients with deficit schizophrenia (DS), but not in those with non-deficit schizophrenia (NDS) and its association with primary negative symptoms, using event-related potentials (ERPs).
ERPs were recorded in 11 patients with DS, 23 patients with NDS and 23 healthy controls (HC), during anticipation of five different outcomes, small (SR) or large (LR) reward, small (SP) or large (LP) punishment or no-outcome (NO), and during feedback processing.
Patients did not differ from HC on indices of anticipatory or consummatory anhedonia, but they showed reduced motivation. During reward anticipation, only patients with primary and persistent avolition showed ERPs abnormalities, with respect to HC, in the early processing stages and a reduced activity of cortical generators in the cingulate, in the temporal-occipital and fronto-parietal regions, that are involved in the attention modulation and visual perceptual processing.
Our data suggest that anhedonia and avolition are partially independent constructs and that avolition is related to the inability to modulate attention and amplify visual perceptual processing of reward stimuli.
Previous studies have reported that patient with schizophrenia have preserved hedonic capacity, but impaired ability to anticipate future reward (anticipatory anhedonia) that, according to some authors, may underlie other aspects of negative symptoms, such as avolition.
The aim of our study was to demonstrate an impairment of reward anticipation in patients with deficit schizophrenia (DS), characterized by primary and persistent negative symptoms, but not in those with non-deficit schizophrenia (NDS) with respect to healthy controls (HC), by means of functional magnetic resonance imaging (fMRI).
fMRI was recorded during the execution of the ’Monetary Incentive Delay’ task in 11 patients with DS, 23 patients with NDS and 23 HC, during the anticipation of five different outcomes, small (SR) or large (LR) reward, small (SP) or large (LP) punishment or no-outcome (NO).
The ventral striatum response to reward anticipation was preserved in subjects with schizophrenia. Only patients with DS, compared with HC, showed a significant reduction in the left caudate during the anticipation of reward. The reduced activity of the caudate correlated with the scores for avolition but not for anhedonia.
Our preliminary data suggest an involvement of the caudate in the abnormal processing of reward stimuli in patients with DS and show that avolition and anhedonia are subtended by different functional abnormalities.
Participation is a central requirement of ethical quality in Child Psychiatry. Target criteria are obtaining and maintaining parental informed consent (PIC) and child assent (CA) to hospital admission and treatment. Clinical practice of PIC and CA displays considerable variability and deficits. We report how an innovative implementation strategy through Clinical Ethics Support (CES) impacted on practice.
Approach: explorative, comparative analysis of 10 cases in a Child Psychiatric ward pre and post ‘implementation of ethical target criteria’ in inpatient routine.
Material: patient charts with documented admission, case conference and dismissal.
Research question: evaluating documented changes after the implementation.
CES strategy: a) screening for ethical problems in daily rounds; b) informing case conferences; c) ‘ethics consultations on demand’; d) education; e) ethics policy regarding isolation.
5 pre- and 5 post-implementation cases were analysed (retro-/prospectively) with pairs of cases matched for complexity, severity and patient age.
Analysis shows that daily practice changed after implementation: 1. heterogeneity in PIC and CA reduced; 2. overall quality of documentation raised with voids about ethical aspects of PIC and CA filled; 3. standardized documentation of PIC and CA realized.
The approach is innovative and addresses a research of PIC and CA; results are clinically relevant, let alone their contribution to make the patients’ and their parents’ wishes better heard. Explicit documentation of the target criteria PIC and CA gives clear, fast and consistent information on the ethical status and eventual needs for further intervention, valuable for inpatient care as well as follow-up.
The Mismatch Negativity (MMN) is an event-related potential (ERP) sensitive to early auditory deviance detection and has been shown to be reduced in patients with schizophrenia. Moreover, MMN amplitude reduction to duration deviant tones was found to be related to functional outcomes particularly, to social cognition and real-life functioning.
In the context of a multicentre study of the Italian Network for Research on Psychoses, our study focused on the investigation of early auditory discrimination components in relation to functioning in real-life in patients with schizophrenia.
ERPs were recorded in 64 chronic, stabilized patients with schizophrenia during the presentation of standard, duration deviants and frequency deviants tones while watching a cartoon. The Specific Level of Functioning (SLOF) scale was used to measure real-life functioning. Psychopathology, neurocognition and social cognition were measured by state of art instruments. Regression analyses were carried out using SLOF domains as dependent variables and MMN, psychopathology, neurocognition, extrapyramidal symptoms and social cognition as independent predictors.
Latency of MMN entered the regression equation only for the SLOF domain of common activities explaining less variance than social cognition and positive symptoms.
In stabilized patients with schizophrenia pre-attentive deficits, as indexed by MMN and P3a amplitude reduction, do not show any association with psychopathology or functioning. Latency of MMN was an independent predictor of some aspects of functioning with a smaller effect than social cognition and psychopathology domains.
Negative symptoms are the psychopathological domain most associated to poor outcome in patients with schizophrenia (SCZ). Insight into their pathophysiology might contribute to develop innovative treatments for the syndrome. Recently, it has been hypothesized that avolition is related to a difficulty in anticipating reward or integrating value and action.
Our study aimed to investigate abnormalities of reward anticipation in SCZ and evaluate associations of negative symptoms dimensions with the same abnormalities using electrophysiological indices.
ERPs were recorded during the execution of 'Monetary Incentive Delay' task in 30 SCZ patients stabilized on second generation antipsychotics and 23 and healthy controls (HC). Measures of anticipatory and consummatory pleasure, trait anhedonia and motivation were obtained in all subjects. A measure of avolition independent of anhedonia was obtained in patients.
Patients did not differ from HC with respect to trait anhedonia and experience of pleasure but showed a deficit of motivation. Unlike HC, P3 amplitude in patients did not discriminate stimuli relevance in the early interval and was higher for the anticipation of loss in the late interval. In SCZ, early P3 amplitude for loss and reward anticipation was inversely related to social anhedonia but not to avolition.
Patients with preserved experience and anticipation of reward seem unable to integrate the relevance and rewarding value of future events in the context of their ongoing task. Our results indicate that anhedonia and avolition are partially independent constructs and that SCZ might integrate better loss than reward.
P300 is an event-related potential (ERP) thought to reflect attention, working memory and context integration and has been shown to be consistently reduced in patients with Schizophrenia. Despite a possible relation between P300 components and cognitive deficits in Schizophrenia has been hypothesized, few studies addressed this hypothesis.
In the context of a multicenter study of the Italian Network for Research on Psychoses, our study focused on the investigation of auditory P300 component in relation to clinical and cognitive domains in patients with Schizophrenia.
ERPs were recorded in 64 chronic, stabilized patients with Schizophrenia during a standard oddball task. N1 and P3b latency and amplitude were assessed at Fz and Pz, respectively. State of art instruments was used for clinical assessment. Cognitive indices (from the seven cognitive domains of the Measurement and Treatment of Cognition in Schizophrenia, MATRICS) were expressed as Z-scores from an Italian normative sample.
Correlation analysis revealed associations of P3b latency with age, education, PANSS-DIS, processing speed, working memory, St. Hans parkinsonism subscale. In a multiple linear regression model, processing speed was an independent significant predictor of P3b latency.
For the first time, a strong relation between P3b latency and processing speed impairment was shown in Schizophrenia. Processing speed is considered a central factor in the relation between cognitive deficits and functional outcome in chronic schizophrenia. The association with P3b latency might shed lights in the neural basis of this complex construct.
Short stature caused by growth hormone (GH) deficiency is one of the causes of the “Failure to Thrive” (FTT) condition. In absence of clear organic causes, several different psychosocial conditions may play a role in explaining the FTT phenotype. Advances in developmental psychology have highlighted the role of emotions and caregiving behaviors in the organization of child's personality and psychobiology, with the mother–son attachment bond being considered a fundamental developmental experience. The objective of the present preliminary study was to assess whether there are significant correlations between attachment styles and GH levels in a sample of subjects with non-organic FTT.
We enrolled 27 children (mean age: 9.49 ± 2.63) with non-organic FTT. Perceived attachment security was assessed through the Security Scale (SS) and its subscales focused on maternal and paternal security. Pearson partial correlation was used to test associations between GH levels and SS measures adjusting for confounding factors (i.e. age, gender and BMI).
Across all subjects, GH was significantly positively correlated with general security (r = 0.425; P = 0.038) and maternal security (SSM) (r = –0.451; P = 0.027) and not significantly correlated with paternal security (SSP) (r = 0.237; P = 0.264).
These findings preliminarily suggest that perceived attachment security may play a role in the etiopathogenesis of non-organic GH deficiencies and add to the accumulating evidence that attachment styles are associated with specific psychoendocrine underpinnings.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Since the implementation of the Clinical Learning Environment Review by the Accreditation Council for Graduate Medical Education, there has been an emphasis on training residents in health care quality as well as patient safety. As such, psychiatry residency training programs have had to incorporate quality improvement (QI) projects into their training. We developed a QI curriculum, which not only included resident and faculty participation, but also encouraged other staff in our department to focus on patient safety as well as improving their performance and the quality of care provided to the patients.
In this poster, we present the development of our curriculum and will include a successful QI project to highlight this. This project focused on creating an algorithm to help assign patient risk level, which is based on evidence based risk factors. This project was created due to a survey conducted in our clinic which demonstrated that clinicians, and in residency training in particular, identifying and managing high risk patients can be anxiety provoking for trainees. We will present the specifics of this QI project, and additionally outline the steps that were taken to develop and integrate the QI project into clinical practice.
(1) Learn how to successfully incorporate a QI project and curriculum into a psychiatry residency training program.
(2) Understand both resident and faculty perspectives on what resources facilitated participation in QI.
(3) Present the development of a quality improvement project focused on risk assessment of outpatient psychiatric patients.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Although multiple studies have been conducted in the adult population, there is a vast knowledge gap regarding the epidemiologic characteristics of cardiomyopathies in the paediatric population. This issue is even more crucial when the precarious situation of medical research in Latin America is considered. Given the potential impact that these disorders could have on Latin American health systems, a comprehensive epidemiologic study regarding the clinical profile and sociodemographic characteristics of these patients will influence the way we approach paediatric cardiomyopathies.
An observational retrospective study was conducted at a tertiary referral centre for Colombian and Latin American paediatric cardiology. We analysed all cases of primary cardiomyopathies in children younger than 18 years of age who presented at our institution between 2010 and 2016. Cases of cardiomyopathies were classified according to World Health Organization guidelines.
From a total of 29,533 children who attended our institution during the study period, 89 new cases of primary cardiomyopathies were identified. The median age at diagnosis was 11 years (interquartile range 4–9). Dilated cardiomyopathy accounted for 57.3% (n = 51) of cases; hypertrophic cardiomyopathy, 12.3% (n = 11); restrictive cardiomyopathy, 8.9% (n = 8); non-compacted cardiomyopathy, 7.8% (n = 7); arrhythmogenic ventricular cardiomyopathy, 6.7% (n = 6); and unspecified cardiomyopathy, 6.7% (n = 6). Heart failure was observed in 53.93% of the patients. The overall mortality was 12.36% (n = 11), which included two of eight patients who underwent cardiac transplantation.
Single nucleotide polymorphism (SNP) genotyping tools, which can analyse thousands of SNPs covering the whole genome, have opened new opportunities to estimate the inbreeding level of animals directly using genome information. One of the most commonly used genomic inbreeding measures considers the proportion of the autosomal genome covered by runs of homozygosity (ROH), which are defined as continuous and uninterrupted chromosome portions showing homozygosity at all loci. In this study, we analysed the distribution of ROH in three commercial pig breeds (Italian Large White, n = 1968; Italian Duroc, n = 573; and Italian Landrace, n = 46) and four autochthonous breeds (Apulo-Calabrese, n = 90; Casertana, n = 90; Cinta Senese, n = 38; and Nero Siciliano, n = 48) raised in Italy, using SNP data generated from Illumina PorcineSNP60 BeadChip. We calculated ROH-based inbreeding coefficients (FROH) using ROH of different minimum length (1, 2, 4, 8, 16 Mbp) and compared them with several other genomic inbreeding coefficients (including the difference between observed and expected number of homozygous genotypes (FHOM)) and correlated all these genomic-based measures with the pedigree inbreeding coefficient (FPED) calculated for the pigs of some of these breeds. Autochthonous breeds had larger mean size of ROH than all three commercial breeds. FHOM was highly correlated (0.671 to 0.985) with FROH measures in all breeds. Apulo-Calabrese and Casertana had the highest FROH values considering all ROH minimum lengths (ranging from 0.273 to 0.189 and from 0.226 to 0.152, moving from ROH of minimum size of 1 Mbp (FROH1) to 16 Mbp (FROH16)), whereas the lowest FROH values were for Nero Siciliano (from 0.072 to 0.051) and Italian Large White (from 0.117 to 0.042). FROH decreased as the minimum length of ROH increased for all breeds. Italian Duroc had the highest correlations between all FROH measures and FPED (from 0.514 to 0.523) and between FHOM and FPED (0.485). Among all analysed breeds, Cinta Senese had the lowest correlation between FROH and FPED. This might be due to the imperfect measure of FPED, which, mainly in local breeds raised in extensive production systems, cannot consider a higher level of pedigree errors and a potential higher relatedness of the founder population. It appeared that ROH better captured inbreeding information in the analysed breeds and could complement pedigree-based inbreeding coefficients for the management of these genetic resources.
The growing prevalence of obesity worldwide poses a public health challenge in the current geological epoch, the Anthropocene. Global changes caused by urbanisation, loss of biodiversity, industrialisation, and land-use are happening alongside microbiota dysbiosis and increasing obesity prevalence. How alterations of the gut microbiota are associated with obesity and the epigenetic mechanism mediating this and other health outcome associations are in the process of being unveiled. Epigenetics is emerging as a key mechanism mediating the interaction between human body and the environment in producing disease. Evidence suggests that the gut microbiota plays a role in obesity as it contributes to different mechanisms, such as metabolism, body weight and composition, inflammatory responses, insulin signalling, and energy extraction from food. Consistently, obese people tend to have a different epigenetic profile compared to non-obese. However, evidence is usually scattered and there is a growing need for a structured framework to conceptualise this complexity and to help shaping complex solutions. In this paper, we propose a framework to analyse the observed associations between the alterations of microbiota and health outcomes and the role of epigenetic mechanisms underlying them using obesity as an example, in the current context of global changes within the Anthropocene.