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Late-life depression, falls, and fall worry are public health problems. While previous research confirms the cross-sectional relationship between depression and fall worry, few longitudinal studies have examined whether changes in fall worry are associated with changes in depressive illness and vice versa. This study examined longitudinal relationships between probable major depression (PMD) and activity-limiting fall worry (ALW).
Design, Setting, Participants, Measurements:
This longitudinal panel observational study used data from the National Health and Aging Trends Study (NHATS) waves 5 (referred to as T1 in this study) and 6 (T2), conducted in 2015 and 2016, respectively (N = 6,299, aged 65 and older). We examined associations of new and continued ALW between T1 and T2 with T2 PMD, controlling for T1 PMD; and associations of new and continued PMD between T1 and T2 with T2 ALW, controlling for T1 ALW. We used χ2 and t tests for descriptive statistics and logistic regression for multivariable analysis.
Those with new ALW at T2 had significantly greater odds of T2 PMD compared to those without ALW at both time points (AOR = 2.64, 95% CI = 1.98−3.51), and those with new PMD at T2 had significantly greater odds of T2 ALW (AOR = 2.42, 95% CI = 1.66−3.52). Those with continued PMD also had greater odds of T2 ALW compared to those without PMD at either time point (AOR = 2.31, 95% CI = 1.62−3.29).
The findings add to knowledge about bidirectional (mutually reinforcing) relationships between depression and activity-limiting fall worry. Innovative interventions are needed to reduce both late-life depression and activity-limiting fall worry.
Clinical Enterobacteriacae isolates with a colistin minimum inhibitory concentration (MIC) ≥4 mg/L from a United States hospital were screened for the mcr-1 gene using real-time polymerase chain reaction (RT-PCR) and confirmed by whole-genome sequencing. Four colistin-resistant Escherichia coli isolates contained mcr-1. Two isolates belonged to the same sequence type (ST-632). All subjects had prior international travel and antimicrobial exposure.
More and more attention is paid nowadays to the human health concerns, associated with environmental problems arising from the fossil fuel use. The world scientific community offers new alternatives that, despite being more environmentally friendly, require an analysis of their potential environmental impacts. For example, biorefineries are becoming increasingly widespread nowadays offering a large gamma of bio-based products. However, it is necessary to take into account what potential effects such facility may have on the human health, depending on its geographical location since different territories may be more or less sensitive to its installation. Our study describes a new bioprocess implementation in terms of impact on human health through three countries: France, Belgium or China. In order to understand what territory can be more appropriate to the industrial process installation in terms of its effects on the human health, we propose to use the spatialized life-cycle analysis methodology.
Pre-Variscan basement rocks from the Pyrenees provide evidence of several magmatic episodes with complex geodynamic histories from late Neoproterozoic to Palaeozoic times. One of the most significant episodes, consisting of several granitic and granodioritic bodies and volcanic rocks, mostly pyroclastic in nature, dates from the Late Ordovician period. In the Eastern Pyrenees, this magmatism is well represented in the Ribes de Freser and Núria areas; here, the Núria orthogneiss and the Ribes granophyre, both dated at c. 457–460 Ma, seem to form a calc-alkaline plutonic suite emplaced at different crustal levels. The presence of numerous pyroclastic deposits and lavas interbedded with Upper Ordovician (Sandbian–lower Katian, formerly Caradoc) sediments, intruded by the Ribes granophyre, suggests that this magmatic episode also generated significant volcanism. Moreover, the area hosts an important volume of rhyolitic ignimbrites and andesitic lavas affected by Alpine deformation. These volcanic rocks were previously attributed to late Variscan volcanism, extensively represented in other areas of the Pyrenees. Here we present the first five laser-ablation U–Pb zircon dates for this ignimbritic succession and two new ages for the Ribes granophyre. The ages of the ignimbrites, overlapping within error, are all 460 Ma, suggesting a genetic relationship between the plutonic and volcanic rocks and indicating that the Sandbian–Katian magmatism is much more voluminous than reported in previous studies, and possibly includes mega-eruptions linked to the formation of collapse calderas.
The recent development of value frameworks to inform healthcare resource allocation responds to a demand to make the decision-making process more inclusive and explicit. The objectives of the 2018 Latin American (LAtam) Health Technology Assessment International (HTAi) Policy Forum were to explore the current international experiences and to discuss the potential application of value frameworks in Latin America.
A background paper, presentations, and group discussions of Policy Forum members (43 participants, 12 LAtam countries represented) at the 2018 HTAi Policy Forum meeting informed this paper.
Participants agreed that HTA and decision making based on more comprehensive and inclusive value frameworks could improve health system effectiveness, efficiency, sustainability, and equity; promote transparency in the decision process; sustain a more comprehensive assessment of technologies; and facilitate stakeholder participation as well as accountability of decisions. Criteria that were identified as essential to be included in a value framework for LAtam were burden of illness and severity of the disease, effectiveness and safety of the technology, quality of the evidence, cost-effectiveness, and budget impact. Potential challenges identified for the application of value frameworks in LAtam, included scarcity of human resources and delays in the assessment process.
Forum participants agreed that the next steps should be to identify appropriate processes and methodologies, adapted to the context of each country, regarding the application of value frameworks to improve the link between HTA and decision making.
El reciente desarrollo de marcos de valor responde a una demanda por hacer más explícito e inclusivo el proceso de toma de decisiones sobre asignación de recursos sanitarios. El objetivo del Foro de Políticas en Latino América 2018 de Health Technology Assessment International fue explorar las experiencias internacionales y discutir la potencial aplicación de marcos de valor en la región.
Este manuscrito está basado en un documento base y en las presentaciones y discusiones mantenidas por los miembros del Foro (43 participantes, 12 países) durante el Foro del 2018.
Los participantes coincidieron en que un proceso de evaluación y toma de decisión basado en marcos de valor más inclusivos y abarcativos podría mejorar la efectividad, eficiencia, sustentabilidad y equidad; promover la transparencia y una evaluación más completa de las tecnologías, mejorar la rendición de cuentas de las decisiones y la participación de actores. Se identificaron como criterios esenciales para ser incluidos en marcos de valor en la región a la carga de enfermedad y severidad de la condición, la efectividad y seguridad de la tecnología, la calidad de la evidencia, la costo-efectividad e impacto presupuestario. Los potenciales desafíos para su implementación identificados incluyeron la escasez de recursos humanos y las demoras en el proceso de evaluación que se podrían producir.
Los participantes remarcaron que los próximos pasos deberían ser identificar procesos y metodologías apropiadas, adaptadas al contexto de cada país, para facilitar la aplicación de marcos de valor y mejorar el vínculo entre la evaluación y la toma de decisiones.
In 1989, after ten years of research, François Delalande presented for the first time the idea of ‘listening behaviours’, distinguishing several ways to listen to the same piece of music. The methods did not allow for many conclusions, but the approach started a new field of research, where diverse listening behaviours could serve as a basis for diverse, exclusive (or even contradictory) analyses of the same work. Furthermore, Delalande’s preliminary research based on an extract from Pierre Henry’s music is still one of the few instances of research into acousmatic music listening that addresses actual listeners. The last 20 years have seen the reproduction and extension of Delalande’s results, as well as a growing interest in listening in musicological circles. For this reason, it seemed necessary to review research about listening behaviours to evaluate their operational validity and to propose a robust theoretical framework for their study and description. This paper addresses this problem using the elicitation interview for the description and interpretation of listeners’ testimonies. Drawing on testimonies from five listeners about a single extract of acousmatic music, it seems that, for Delalande’s model to be able to describe various listening experiences, it should be further detailed and completed with attention management processes. Further investigation is needed to allow the model to include some listening behaviours which were not recurrent enough here to make sense of them.
We present here the results from a full polarisation study, an important VLBI capability, of a selected set of bright Active Galactic Nuclei (AGNs), along with the steps required to fully calibrate the Australian Long Baseline Array. We compare strategies for high-precision polarisation measurements using two polarisation correction methods: (1) Linear model and (2) Ellipticity-Orientation model and two data-recording techniques: recording (1) nominally circular polarisation at all stations and (2) mixed polarisation, where all but one station record circular polarisation and the other recorded linear polarisation. The latter is corrected post-correlation. We explored these possible solution to discover which will best accommodate the heterogeneous nature of the Australian Long Baseline Array without impacting on the science results. The targets, all compact and of low polarisation fraction, allow us to compare multiple independent solutions for polarisation characteristics. The results show that the agreement between the two polarisation correction models is excellent. However, the values from Mopra with nominally circular polarisation are larger than would be acceptable. However, we also demonstrate that recording mixed polarisation modes and correcting post-correlation provide a high quality polarisation product. We report on the detailed tests of these strategies and assess that the array is ready for full polarisation operation.
In Spain, the establishment of ethnomusicology as a discipline fully conscious of its methods and objectives is relatively recent. Procursors can be seen in early studies of folk song which were catalyzed in European society by Herder and other scholars. It is obvious that 19th century research into Spanish folk song has little to do with current ethnomusicology, although there exists a common denominator: in both cases, scholars center their attention on those musics which are on the margin of “great musical art.” However, we could hardly understand the development and current state of the discipline in Spain if we did not take its beginnings in folk music studies into account. Comparative musicology of old, which concentrated on music of non-occidental origins and which laid the foundations of current ethnomusicology, was practically absent in the Spanish state. We do not find in Spain at that time a consolidated method or a satisfactory concretization of goals, but we can already encounter an object of study — denominated “folk music” — and social attitudes toward this object which allow us to consider those early collectors the predecessors of Spanish ethnomusicology.
In this article I intend to describe some of the social processes that have led to the development of the sardana, a Catalan dance, to its present form. This is not meant to be a thorough description of the dance itself but rather a treatment of it as an expression of certain social and cultural processes which, although not of a strictly musical nature, have strongly influenced, and even determined, this dance and its music. My objective here is first to review the differentiated social perceptions of sardana in the course of its history and then to clarify the relationship between that dance and the phenomenon of folklorism. As a result, the interdependence of musical morphology, social customs, function and ideology in relation to the sardana should become apparent. Through this example, we can observe the function of music and dance as socially articulated elements within society.
OBJECTIVES/SPECIFIC AIMS: The objective of this project is to determine whether HRV, collected peri-operatively, is predictive of cognitive decline among older adults who undergo elective surgery/anesthesia. METHODS/STUDY POPULATION: This project is a part of the ongoing INTUIT/PRIME study, which is collecting pre- and post-operative cognitive testing, fMRI imaging, CSF samples, and EEG recordings from 200 older adults (age ≥ 60) undergoing elective non-cardiac/non-neurologic surgery scheduled to last > 2 hours at Duke University Medical Center and Duke Regional Hospital. This project utilizes data from the first 60 INTUIT participants who contributed continuous heart rate data before and during surgery. Participants undergo cognitive testing prior to surgery (baseline) and at 6 weeks after surgery. Our primary dependent variable is the change in the composite score from baseline to 6-weeks. Delirium is assessed in the hospital with the twice daily 3D-CAM tool, so we will report the proportion of individuals with 6-week cognitive decline who exhibited delirium in the days following surgery. Participants’ echocardiogram (ECG) recordings are extracted pre- and intraoperatively from B650/B850 patient monitors with VSCapture software. HRV is defined as the variability between successive R-spikes or inter-beat-intervals on ECG. RESULTS/ANTICIPATED RESULTS: We anticipate that lower intraoperative HRV is associated with worse cognitive decline at 6 weeks after surgery. As secondary objectives, we will determine whether pre-operative HRV or change in HRV (from pre-operative to intra-operative measures) are predictive of cognitive decline after surgery. We expect that in-hospital delirium will be detected in a higher proportion of those with 6-week cognitive decline, compared to those with stable or improved cognition at 6 weeks. DISCUSSION/SIGNIFICANCE OF IMPACT: HRV may address the present need for pre- and intra-operative cognitive risk stratification in the elderly. Physiological indices like HRV have the potential to dramatically change our understanding of CI in older adults undergoing surgery, as they offer an accessible, cost-effective, and non-invasive means whereby clinicians, particularly those unfamiliar with the nuances of geriatric and CI/dementia-related care, can monitor patients and refer those at high-risk of CI after surgery for early intervention.
The crystal structure of tlapallite has been determined using single-crystal X-ray diffraction and supported by electron probe micro-analysis, powder diffraction and Raman spectroscopy. Tlapallite is trigonal, space group P321, with a = 9.1219(17) Å, c = 11.9320(9) Å and V = 859.8(3) Å3, and was refined to R1 = 0.0296 for 786 reflections with I > 2σ(I). This study resulted from the discovery of well-crystallised tlapallite at the Wildcat prospect, Utah, USA. The chemical formula of tlapallite has been revised to (Ca,Pb)3CaCu6[Te4+3Te6+O12]2(Te4+O3)2(SO4)2·3H2O, or more simply (Ca,Pb)3CaCu6Te4+8Te6+2O30(SO4)2·3H2O, from H6(Ca,Pb)2(Cu,Zn)3(TeO3)4(TeO6)(SO4). The tlapallite structure consists of layers containing distorted Cu2+O6 octahedra, Te6+O6 octahedra and Te4+O4 disphenoids (which together form the new mixed-valence phyllotellurate anion [Te4+3Te6+O12]12−), Te4+O3 trigonal pyramids and CaO8 polyhedra. SO4 tetrahedra, Ca(H2O)3O6 polyhedra and H2O groups fill the space between the layers. Tlapallite is only the second naturally occurring compound containing tellurium in both the 4+ and 6+ oxidation states with a known crystal structure, the other being carlfriesite, CaTe4+2Te6+O8. Carlfriesite is the predominant secondary tellurium mineral at the Wildcat prospect. We also present an updated structure for carlfriesite, which has been refined to R1 = 0.0230 for 874 reflections with I > 2σ(I). This updated structural refinement improves upon the one reported previously by refining all atoms anisotropically and presenting models of bond valence and Te4+ secondary bonding.