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While medication is hugely important in treating bipolar disorders, an integrated approach which utilizes psychological treatments can target some aspects that medication alone cannot reach. A comprehensive review of evidence-based psychological treatments is provided, followed by practical information on psychoeducation for patients and family members, healthy lifestyle promotion, mindfulness-based interventions and cognitive and functional remediation, as they represent the basis on which the integrative approach is developed. The second half of the book provides examples of sessions of integrative therapy, which can be shared with patients themselves, enhancing the effectiveness of applying the treatment. Psychotherapy for Bipolar Disorders: An Integrative Approach offers a brief but multi-component treatment framework that can also be implemented in non-specialized health centres. This approach may greatly improve the well-being and quality of life of people with bipolar disorders. This accessible text is an essential resource for psychiatrists, clinical psychologists and any healthcare provider working in mental healthcare.
The purpose of this study was to analyse the reliability and validity of a semi-quantitative FFQ to assess food group consumption in South American children and adolescents.
The SAYCARE (South American Youth/Child cARdiovascular and Environmental) study is an observational, multicentre, feasibility study performed in a sample of 3- to 18-year-old children and adolescents attending private and public schools from six South American countries. Participants answered the FFQ twice with a two-week interval and three 24-h dietary recalls. Intraclass and Spearman’s correlations, weighted Cohen’s kappa (κw), percentage of agreement and energy-adjusted Pearson’s correlation coefficients were calculated.
Seven cities in South America (Buenos Aires, Lima, Medelin, Montevideo, Santiago, Sao Paulo and Teresina).
A sample of 200 children and 244 adolescents for reliability analyses and 252 children and 244 adolescents for validity analyses were included.
Depending on the food group, for children and adolescents, reliability analyses resulted in Spearman’s coefficients from 0·47 to 0·73, intraclass correlation coefficients from 0·66 to 0·99, κw coefficients from 0·35 to 0·63, and percentage of agreement between 72·75 and 83·52 %. In the same way, validity analyses resulted in Spearman’s coefficients from 0·17 to 0·37, energy-adjusted Pearson’s coefficients from 0·17 to 0·61, κw coefficients from 0·09 to 0·24, and percentages of agreement between 45·79 and 67·06 %.
The SAYCARE FFQ achieved reasonable reliability and slight-moderate validity for almost all food groups intakes. Accordingly, it can be used for the purpose of ranking the intake of individuals within a population.
The purpose of this paper 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.
The Murcia Twin Registry (MTR) is the only population-based registry in Spain. Created in 2006, the registry has been growing more than a decade to become one of the references for twin research in the Mediterranean region. The MTR database currently comprises 3545 adult participants born between 1940 and 1977. It also holds a recently launched satellite registry of university students (N = 204). Along five waves of data collection, the registry has gathered questionnaire and anthropometric data, as well as biological samples. The MTR keeps its main research focus on health and health-related behaviors from a public health perspective. This includes lifestyle, health promotion, quality of life or environmental conditions. Future short-term development points to the expansion of the biobank and the continuation of the collection of longitudinal data.
Predation by Engytatus varians (Distant) adults on different development stages of the prey species Bactericera cockerelli (Sulcer) (egg, second, and third nymphal instars), Spodoptera exigua (Hübner) and Spodoptera frugiperda (J. E. Smith) (egg, first, and second larval instars) was evaluated using tomato (Solanum lycopersicum L.) leaflets or plants. These insects are the primary pest of several agriculturally important crops. The influence of E. varians age on the predation capacity was also analysed. Engytatus varians females consumed significantly more B. cockerelli eggs and nymphs than males. Additionally, female predators consumed significantly more second than third instar prey at two predator ages, while males consumed significantly more the second instar than third instar prey at all predator ages. In most of the cases, females also consumed significantly more S. exigua and S. frugiperda eggs than males; however, in terms of larvae consumption, this difference was observed only in some predator ages. Females consumed more the first than second instar S. exigua than males, whereas this behaviour was only observed in males when the predators were 15 and 17 days old. No significant differences were observed in the consumption of first and second instar of S. frugiperda for both sexes of the predators. Predator age did not cause any systematic effects on the predation rates of any prey species. Based on these results, we confirmed that E. varians has potential as a biological control agent for B. cockerelli and also for the Spodoptera species bioassayed.
Morphological characterization and quantification of gold particles by optical image analysis (OIA) and by compositional analysis of microprobes using scanning electron microscope and electron microprobe analysis techniques were carried out on gold grains from the Minvoul area (Archean greenstone belt in Gabon). Large grains of almost pure gold were found throughout a weathering profile, which consisted of saprolite, mottled clay zone, iron duricrust, pisolitic gravels and yellow latosol. In the deeper horizons, gold was dissolved as shown by corrosion features on the surface of particles with average sizes of 2.6Φ and 2.35Φ in the saprolite and mottled clay zones, respectively. The occurrence of secondary gold in the duricrust was indicated by the larger size of the nuggets (average, 1.8Φ), the high fineness (> 995 in average) and the close textural relationship between gold and neoformed iron oxyhydroxides. The uppermost horizons composed of yellow latosol and pisolitic gravels were interpreted as transported materials based on their size distribution (average 0.85Φ and 1.34Φ), sorting and shape parameters. The best morphological parameter to describe the whole weathering profile was found to be the perimeter/area ratio. The highest ratios were recorded in the saprolite (average 0.192 μm−1), and decreased towards the surface (average 0.057 μm−1). The combination of the OIA technique and the microchemical analysis of gold grains allowed us to define specific morphological and compositional characteristics of the gold particles for each horizon. Both methods proved to be of great utility to understand gold concentration, dissolution and dispersion processes in supergene environments.
Cancer during pregnancy has an incidence of 1/1,000, and when diagnosed, the most common ones are breast cancer (1/10,000), Hodgkin’s lymphoma (1/6,000), and head and neck cancer (1/10,000). If a diagnosis is made during pregnancy, the treatment cannot wait until delivery, and there is concern about the effects that radiotherapy may have on the foetus. The multidisciplinary group has to assess and ethically make decisions with regard to the mother and foetus.
A 35-year-old female, a carrier of Behcet’s disease, underwent 5 years of treatment with hydroxychloroquine, prednisone and low-molecular-weight heparin (the patient being a carrier of Behcet’s disease, there is a high risk for cancer of the oral cavity and oropharynx with an HR of 2·11, so the cancer could be related to the tonsil). The patient’s oncological situation started on December 2017 with a volume increase in preauricular, parotid and right mandibular angle, with a progressive growth. At this time, the foetus was of 17·5 weeks of gestation. An oral cavity tumour that invaded the right retromolar triangle was observed, and upon biopsy, a basaloid squamous cell carcinoma was diagnosed.
Radiotherapy treatment was started at 22 weeks of gestation; intensity-modulated radiation therapy (IMRT) was planned with a dose of 69·96 Gy to the primary tumour and 59·4 Gy to ganglion levels II, III and IV, bilaterally in 33 fractions. At fraction 27 a significant decrease in tumour volume was noted, so adaptive radiotherapy was performed to complete the treatment. Currently the patient has no clinical evidence of tumour pathology.
The risk of radiation exposure in pregnant women (after 20 weeks of gestation), being treated for cancers of the tonsil, reaching the foetus is minimal, with a reduced risk of a few or no effects.
Radiotherapy in tonsil cancer has been shown to be effective in combination with chemotherapy for local control of the disease. In the case of this pregnant patient, radiotherapy, as the only modality, provided local control and little exposure of radiation to the foetus.
Babysbreath or perennial babysbreath (Gypsophila paniculata L.) is an aggressive invasive plant in large parts of southern Canada and the northern and western United States. It reproduces and disperses by seed, so the phenology of seed maturation is important in designing management programs. The present study provides the first quantitative assessment of G. paniculata seed-maturation phenology in a field population, as well as the first quantitative assessment of how the efficacy of herbicide treatment in preventing production of germinable seeds depends on the timing of treatment in relation to this phenology. Seeds were collected from untreated plants on five dates during July and August in both 2016 and 2017 and tested for germinability. Percent germination increased from 20% to 81% between July 22 and 28 and exceeded 90% by August 4, 2016. The seed-maturation phenology in 2017 was similar but delayed by about 4 d. On a growing degree-day scale, seed-maturation phenologies for the 2 yr were nearly identical. We also tested germinability of seeds from plants sprayed with glyphosate (23.4 ml ae L−1) on July 11, 18, and 25, 2016 (one date per plant). Percent germination increased from 0% to 13% to 20% over successive treatment dates, highlighting the importance of completing treatment early in the growing season.
Tick-borne diseases (TBDs) can sometimes cause severe symptoms and lead to hospitalisation, but they often go unnoticed in the Emergency Department (ED). The aim of this study was twofold: (i) to describe the profile of patients hospitalised by TBDs; and (ii) to evaluate the data collected in the medical records from the ED in order to analyse their potential clinical consequences. A total of 84 cases that included all TBD diagnoses registered in the ED records were identified and analysed. These corresponded to all the hospitalisations by TBDs in the last 10 years (2009–2019) in two tertiary hospitals in Granada, Spain. Statistical analyses were made using RStudio. Coinciding with the absence of patient's report of exposure to ticks, 64.3% of TBDs were not suspected in the ED. Intensive care unit admission was required in 8.3% of cases, and the mortality rate was 2.4%. Non-suspected cases showed longer hospital stay (P < 0.001), treatment duration (P = 0.02) and delay in the initiation of antibiotic treatment (P < 0.001). Our findings indicate that symptoms associated with TBDs are highly non-specific. In the absence of explicit information related to potential tick exposure, TBDs are not initially suspected. As a consequence, elective treatment administration is delayed and hospitalisation time is prolonged. In conclusion, our results highlight the importance of addressing potential exposure to ticks during the ED contact with patients presenting with febrile syndrome.
Individuals with Williams syndrome (WS) present prosodic impairments. They are also interested in musical activities. In typical development, a body of research has shown that the linguistic prosodic skills of musically trained individuals are enhanced. However, it is not known whether, in WS, musical training is also associated with enhanced prosodic performance, a question this study sought to answer. We compared the performance on linguistic prosodic tasks among seven musically trained and fourteen musically untrained individuals with WS, and typically developing peers. Among those with WS, musically trained participants outperformed their musically untrained counterparts on the perception of acoustic parameters involved in prosody, the understanding of questioning and declarative intonation, and the comprehension of prefinal contrastive stress. The results suggest that musical training facilitates prosodic performance in WS. Our findings also suggest common processing mechanisms for acoustic parameters involved in both prosody and music, and that positive music-to-language transfer effects could take place in WS. We discuss the implications of these results for intervention purposes.
Recent excavations at the Early–Middle Formative period site of Altica in the southern piedmont of the Teotihuacan Valley, Mexico, provide evidence for early agriculture and plant use in a rural community in the northern Basin of Mexico. In the Basin of Mexico, settled agricultural communities were present in the southern sector of the region from at least 1200 cal b.c. Initial expansion into the semiarid northern sector of the Basin, however, appears to have taken place towards the end of the Early Formative, during the transition to the Middle Formative when agricultural economies based on maize cultivation became firmly established, setting the scene for increased population density and concomitant social complexity.
Altica is currently the only community in the Teotihuacan Valley spanning this transitional period that has survived in the face of intensive changes in land use over the last three millennia. Macro- and microbotanical evidence recovered from radiocarbon-dated excavated contexts at Altica provide evidence for maize cultivation and suggest a subsistence economy in transition, prior to the establishment of intensive dependence upon a broader range of domesticated and cultivated plants.
Breastfeeding is the ideal nutrition for a newborn’s integral necessities. It seems crucial therefore to know its composition in order to provide suitable infant formula when required. Of these, polyamines (with lactation and the microbiota being its intestinal source) are involved in the development of gut epithelium and immunity. Safety concerns limit human intervention studies. Therefore, we have studied whether the different amounts of polyamines supplied by breast milk (varying among mothers) or infant formulas feeding, up to day 30 postpartum, determine the polyamine content in newborn faeces. Independent samples (68) of breast milk from 59 healthy Caucasian woman (day 0, 1, 3, 5, 7, 15 and 30 postpartum) who had natural deliveries after week 38, same day newborn faeces, when available (81 from breast milk and 55 from infant formula fed) and 6 infant formulas were determined by HPLC. In breast milk, polyamines and isoamylamine (a primary amine), with interindividual variations, increased over time with a higher content of spermidine (no other amines were present). Overall, they were much higher than in infant formula. By the 2nd week after birth the content of polyamines, cadaverine and tyramine, but not isoamylamine, in the faeces of infant formula were higher than in breast milk fed. Cadaverine and tyramine could be used to predict the type of newborns feeding used. The differences in the content may be related to distinct colonisation of amines-producer bacteria, to which polyamines could help establish. Further studies are required to determine the clinical utility of these findings.
In recent years, tissue engineering has helped to reduce hospital stays and deaths caused by skin wounds. Scaffolds are one of the main factors that influence the success of any tissue graft. Collagen is one of the main components of the extracellular matrix, and there has been much interest in new sources for application as a biomaterial. In this work, a tissue engineering scaffold was developed using the electrospinning technique. The chicken skin was used as an alternative source to obtain collagen. The combination of this collagen with elastin was successfully electrospun, and a distribution of diameters was obtained, less than 100 nm. In vitro tests showed the adhesion and proliferation of the cells, as well as an absence of cytotoxicity from non–cross-linked scaffolds and scaffolds that were cross-linked with carbonyldiimidazole. The structure and composition of the developed scaffolding provide a favorable environment for cell growth and generating a skin substitute.