To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To identify sex-specific cut-off points for waist circumference (WC) in the definition of metabolic syndrome (MetS) for the Chilean adult population.
MetS was defined as the presence of at least two out of four of the following criteria: TAG ≥1·7 mmol/l; HDL-cholesterol: <1·3 mmol/l in women and <1·0 mmol/l in men; systolic blood pressure ≥130 mmHg and/or diastolic blood pressure ≥85 mmHg; and fasting glucose ≥ 5·6 mmol/l or current treatment for diabetes. The receiver operating characteristics curve and the AUC were computed to derive the specificity and sensitivity using bootstrapping (10 000 iterations restricted to have at least between 40 and 60 % of the original population). The optimal cut-off point for the Chilean population was computed by sex.
A representative sample of the Chilean population aged ≥15 years.
8182 participants (60 % women) from the three available Chilean National Health Surveys conducted in 2003, 2009–2010 and 2016–2017.
WC had a good predictive ability for MetS (AUC for men 0·74 (95 % CI 0·72, 0·76); AUC for women 0·71 (95 % CI 0·68, 0·73)). The optimal cut-off points for WC, in the definition of MetS, were 92·3 cm (95 % CI 90·5, 94·4) and 87·6 cm (95 % CI 85·8, 92·1) for men and women, respectively.
The mentioned cut-off points should be used for WC in the definition of MetS in Chile. As a result, the current recommendation (WHO/International Diabetes Federation) for WC, in the identification of MetS, is not supported by these findings in a representative sample of the Chilean adult population.
The objective of this study was to identify attitudes towards the scientific search for extraterrestrial life among students from public and private universities in Peru. This research was inspired by similar studies, realized in Sweden, which used the same instrument adapting it to our reality. The process consisted of a survey of the Peruvian student population by targeting it in different regions of Peru. The sample consisted of 1237 students from different academic areas. The findings show that 92% of the students believe in the existence of life outside our planet, with differences between the subgroups surveyed.
Mesoamerica is the world's third largest biodiversity hotspot and has c. 4,000 wildlife species protected under CITES. Despite the high biodiversity in the region, there is limited global attention, data and funding for conservation. The continued exploitation of wildlife species for the trade requires a more proactive approach to address emerging trends, and low-cost and effective solutions to prevent species decline. Over a 5-month period in 2017, we used expert-driven horizon scanning, facilitated online, to identify emerging trends of the illegal wildlife trade in Mesoamerica. We found that the main emerging trends included digital and technological advancements, greater regional access to the global community, developments in trafficking techniques and growing demand for certain species. Our findings demonstrate that horizon scanning can be used as a tool for identifying emerging trends of illegal wildlife trade in data-poor contexts. We recommend that horizon scanning is used regularly for systematic monitoring of trends and to prioritize resources for immediate and emerging trends in illegal wildlife trade.
The passage of a shock wave through a metal is particularly conducive to the production of point defects in the form of vacancies behind the shock front. Vacancies in the metal can be considered a form of relief for the high stresses associated with the shock wave. The amount of data covering the effect of high strain rates on lattice defects (vacancies) is small. Although previous research work has supported the existence of vacancies in shock loaded metals, vacancies have not actually been observed, nor have the concentrations of vacancies or vacancy clusters been studied quantitatively in relation to shock deformation.
In the present investigation, annealed molybdenum wires (3 mil diameter)(1250°C for 10 min. in high vacuum) and molybdenum foils (1 mil thick)(1250°C for 15 hrs. in high vacuum) were prepared and placed in sandwich assemblies for shock loading.
The work reported in this research communication investigated the occurrence of Mycoplasma bovis (M. bovis) in milk samples from cows with clinical mastitis on dairy farms from seven Brazilian states. We hypothesized that M. bovis was present in bovine clinical mastitis milk in Brazil. A total of 561 milk samples were cultured on Hayflick agar and incubated in a microaerophilic atmosphere at 5% CO2. Polymerase chain reaction (PCR) was performed for the detection of Mycoplasma spp. and Mycoplasma bovis in milk samples. Mycoplasma spp. were isolated in 2% of the milk samples, and Mycoplasma bovis was verified in 3% of the milk samples by PCR. The results showed that Mycoplasma bovis is involved in clinical mastitis in Brazilian dairy herds. We emphasize the need for further studies to investigate the infection by this agent in clinical mastitis cases, particularly in Brazil, due to the lack of knowledge about its prevalence.
The objective was to evaluate maternal Mediterranean diet (MD) pattern adherence during pregnancy and its association with small for gestational age (SGA) and preterm birth. A secondary objective of the current study was to describe the sociodemographic, lifestyle and obstetric profile of the mothers studied as well as the most relevant paternal and newborn characteristics.
The current study is a two-phase retrospective population-based study of maternal dietary habits during pregnancy and their effect on newborn size and prematurity. The descriptive first phase examined maternal dietary habits during pregnancy along with the maternal sociodemographic, lifestyle and obstetric profile in a cross-sectional period study. In the second phase, newborn outcomes were evaluated in a nested case–control study. Adherence to MD during pregnancy was measured with the Spanish version of Kidmed index.
Obstetrics ward of the La Fe Hospital in Valencia.
All mother–child pairs admitted after delivery during a 12-month period starting from January 2018 were assessed for eligibility. A total of 1118 provided complete outcome data after signing informed consent.
14·5 % met the criteria of poor adherence (PA); 34·8 %, medium adherence (MA); and 50·7 %, optimal adherence (OA). Medium adherence to MD was associated in the adjusted scenarios with a higher risk of giving birth to a preterm newborn. No association was found between MD adherence and SGA.
Early intervention programmes geared towards pregnant women, where women were aided in reaching OA to MD, might reduce the risk of preterm newborn.
It means quality of life according to WHO (1993) “The perception of an individual of his situation in life, within the cultural context and values in which they live and in relation to their objectives, expectations, values and interests”.The aim of the present study is to know the subjective perception of the schizophrenics on their health.
A sample of 67 patients receiving care in community mental health services (day hospital) has been evaluated using the SF-36 scale.
The results were compared with the population national values of reference to the same scale.
We found statistically significant differences between groups for the following items: General Health (t =-2,81; p=0,004), Vitality (t =-3,37; P=0,000; Social Functioning t =-4.11; p = 0,000); Emotional Role (t =-2,269; p=0,023) and Mental Health (T =-2,67; p = 0,007).
The studied patients have a worse perception it brings over of his general health that the rest of the Spanish population; likewise they perceive a major detriment as for his social functioning that is a rest of the Spanish population. This way, the physical health of the patients with schizophrenia needs a control and a specific follow-up to guarantee that his life expectancy, his quality of life and his social functioning are similar to those of the general population.
Assess clinical and functioning treatment outcomes of risperidone long-acting injection (RLAI) versus oral antipsychotics for patients participating in the electronic Schizophrenia Treatment Adherence Registry (e-STAR) in Spain.
e-STAR is a 2-year, multi-national, prospective, observational study of patients with schizophrenia who were initiated on RLAI or an oral antipsychotic. Data were collected retrospectively (1-year) and prospectively every three months (2 years). Outcomes included clinical effectiveness measured by Clinical Global Impression of Illness Severity (CGI-S) and patient functioning assessed by Global Assessment of Functioning (GAF) scale. Clinical and functional outcomes are analyzed using a linear mixed model controlling for age, gender, disease duration, baseline hospitalization status and antipsychotic treatment patterns. Results presented are based on the complete e-STAR data from Spain.
1,622 patients (63.6% male, mean age 38.4±11.2 years) participated in e-STAR from Spain, 1,345 were initiated on RLAI and 277 on oral antipsychotics. RLAI treated patients had significantly longer disease duration (12.6±9.5 years vs. 10.9±9.7, p<0.01) than those treated with oral antipsychotics. During the 2-year study, clinical symptoms and functioning improved in both groups. As revealed by the mixed-model regression, RLAI patients, compared to oral patients, had significantly greater improvement on CGI-S scores (-1.10 vs. -0.88, p<0.02) and GAF scores (16.4 vs. 14.6, p<0.03). Baseline hospitalization status and disease duration were significant explanatory variables in the mixed model regression.
This 2-year, prospective, observational study showed that compared to oral antipsychotics, RLAI treatment was associated with greater improvement in clinical symptoms and functioning in patients with schizophrenia.
Antipsychotic therapy is the cornerstone of the treatment of psychotic disorders. Although clinical guidelines recommend the use of antipsychotics in monotherapy, the combination of two or more antipsychotics is a common habit in clinical practice, especially in cases resistant to treatment with one antipsychotic, although there are few controlled trials that support this treatment modality.
To analyze the characteristics of antipsychotic therapy in patients admitted to hospitalization with diagnoses of schizophrenia and other psychoses, to determine if there are differences between diagnostic groups.
We analyzed a sample of 241 patients admitted during 2009, 97 women and 144 men, with schizophrenia and other psychoses.
We designed a protocol of collecting data based on clinical histories of patients, reflecting the gender, age, diagnosis and treatment regimen (monotherapy or combination therapy), and performed a statistical analysis using SPSS.
Of the sample, 40.2% were females and 59.8% were males. The mean age was 39.7 years old.
The diagnosis of schizophrenia was obtained in 60.2% of patients, while the remaining 39.8% were diagnosed with other psychoses (schizoaffective disorder, chronic delusional disorder, schizophreniform disorder, brief psychotic disorder, psychotic disorder not otherwise specified and other.)
The combination therapy was used in 62.2% of patients, while the remaining 37.8% were treated with monotherapy.
Combination therapy is used more often in male patients and in patients diagnosed with schizophrenia, while monotherapy is used more in women and patients with other psychoses.
Clozapine is an atypical dibenzodiazepine antipsychotic used for resistant schizophrenia. Myocarditis and cardiomyopathy are rarely reported complications of clozapine treatment. The incidence of clozapine-related myocarditis has been variably reported at between 0.03% and 0.19% Myocarditis is a potentially life-threatening complication of clozapine.
We reported a case of a 30-year-old female patient who developed reversible myocarditis a few weeks after we began the treatment with clozapine for chronic resistant schizophrenia (as specified in DSM-IVTR), characterized by severe left ventricular systolic dysfunction that resulted in congestive heart failure.
After the immediate discontinuation of the clozapine, along with aggressive supportive care, resulted in almost complete recovery to baseline.
Patients taking clozapine who develop dyspnoea, fatigue, chest pain or collapse should be screened for myocarditis, especially during the first weeks of treatment. Health professionals should be aware of this uncommon but serious side effect of clozapine since failure to recognize the association may result in adverse clinical outcome. Myocarditis should be suspected when cardiac dysfunction appears suddenly, and appropriate diagnostic and therapeutic strategies must be undertaken promptly.
Antipsychotic therapy is the cornerstone of the treatment of schizophrenia and other psychoses. Although clinical guidelines tend to recommend the use of antipsychotics in monotherapy, combination of two or more antipsychotics (that is, polytherapy) is a common habit in clinical practice.
To assess differences in antipsychotic combination profile between patients with schizophrenia and patients with other psychoses.
A total of 241 patients (40.2% females, mean age 39.7+/−13.0 years) consecutively admitted during 2009 to a psychiatric inpatient ward with diagnosis of schizophrenia and other psychoses were assessed.
145 (60.2%) patients were diagnosed with schizophrenia while 96 patients (39.8%) were diagnosed with other psychoses (schizoaffective disorder n = 35, delusional disorder n = 8, schizophreniform disorder n = 8, brief psychotic disorder n = 13, psychotic disorder not otherwise specified n = 27, and other psychoses n = 5). Out of the total sample, polytherapy was used in 150 (62.2%) patients. A total of 100 (69.0%) patients with schizophrenia were on polytherapy, compared to 52.1% of those with other psychoses (p = 0.008). After controlling for age and gender, the association between a diagnosis of schizophrenia and being in polytherapy remained significant (p = 0.046).
Patients diagnosed with schizophrenia are more prone to be in polytherapy than those with other psychoses.
Self-perceived health is a well-recognised predictor of later health outcomes and mortality, but its relationship to incident dementia has been scarcely explored.
To analyze self- perceived health as a risk factor for dementia and Alzheimer disease (AD) in a population- based survey of the elderly (NEDICES) Study.
Participants were evaluated at baseline (1994-1995) with a standardized questionnaire that included subjective and objective (chronic disorders) health status and screening questions for depression and neurologic disorders. At follow-up (a median of 3.2 years later in 1997-1998) an analogous protocol and neurological assessment were performed.
Of 5,278 participants evaluated at baseline there were 306 prevalent dementia cases, and 161 incident dementia cases were identified among 3,891 individuals assessed at follow-up (D: 115).
Cox hazard ratio analyses showed that age, stroke and illiteracy were independent risk factors for dementia and AD. Aggregation of vascular risk factors was related to a higher risk of both dementia and AD. Good (and very good) versus less than good (fair, bad and very bad) self-perceived health was an independent risk factor for dementia (CI 95% 1.13- 2.16; p= .006) and AD (CI 95% 1.02- 2.18; p= .038) after adjusting by age, sex education and vascular risk factors.
Self-perceived health increased the risk for incident dementia and AD in the NEDICES cohort as it was previously described in the United Kindom MRC- CFA Study of dementia incidence. Global health measurements (self-perceived health, quality of life) needs farther studies as risk for dementia and AD.
During gestation and maternal behavior, some physiological events can protect the dam and offspring, but explanations for such phenomena are partially unknown. The effects of stress during prenatal development and infancy can be studied in controlled laboratory conditions.
To determine the pre- and postnatal effects of stress on coping strategies in weanling rats subjected to the open field and forced swim tests after their dams are subjected to stress during gestation.
Rats aged 21 postnatal days (PND) were assigned to either a Control group (n = 36; offspring from intact dams during gestation) or a Prenatal stress group (n = 36; offspring from dams forced to swim during 5 min sessions on gestational days 1, 7, 14, and 19). Both groups were tested in the open field to evaluate locomotor activity and rearing. In another experiment, PND21 intact rats assigned to a Control group (n = 26) or Postnatal stress group (n = 35) were subjected to restraint stress for 6 min prior to the tests and were later evaluated in the forced swim test.
Locomotor activity (p < 0.026) and rearing (p < 0.001) were lower in the Prenatal stress group compared with the Control group. The latency to first immobility was shorter (p < 0.008), and the total immobility time was longer (p < 0.005) in the Postnatal stress group than Control group.
Stress exposure during gestation produces detectable changes during weanling, consisting of reduced exploratory activity and susceptibility to despair.
Clinical trials (CT) are the main scientific support of the recommendations of pharmacological treatment of patients with schizophrenia. However, CT tend to strengthen the internal validity at the expense of external validity and the ability to generalize the results to the clinical population. For this reason, in recent years have developed large practical clinical trials that expand the inclusion criteria to incorporate as many real patients as possible. The first and most significant of these trials was the CATIE study (Lieberman et al, 2005).
To analyze eligibility for participation in CATIE of patients admitted during 2009 in a psychiatric inpatient unit with a diagnosis of schizophrenia.
A total of 145 patients (27.6% females, mean age 39.6+/−12.8 years), consecutively admitted to an inpatient psychiatric ward with a clinical diagnosis of schizophrenia were assessed to test if they would fulfill criteria for participation in CATIE.
60 (41.4%) patients did not fulfill CATIE inclusion criteria. Mental retardation (n = 22, p < 0.001), absence of informed consent (n = 15, p < 0.001) and refusal to take oral medication (n = 12, p < 0.001) were the main factors responsible for not meeting inclusion criteria.
Meeting the criteria was not significantly related to gender or specific diagnosis.
41.4% of patients admitted to a psychiatric inpatient unit with a diagnosis of schizophrenia did not meet criteria for participation in the CATIE study.
Researching from a symptom approach avoids possible spurious associations, given the co-occurrence of symptoms in a disorder (Costello, 1992). Here, we deepen the evidenced relationships among anxiety, delusions and hallucinations.
We intended to assess differences in Anxiety Sensitivity dimensions between patients with psychosis depending on presence/absence of hallucinations and/or delusions.
49 patients with DSM psychosis diagnosis (42 men and 7 women; mean age: 40), who attended a Mental Health Rehabilitation Service in 2008, of whom 7 only deluded, 6 only hallucinated, 11 deluded-hallucinated and the remaining 25 neither hallucinated nor deluded.
Design, materials and procedure
A Cross-sectional design (one measurement) for a co-relational method of comparison between groups.
We used the Spanish validated Anxiety Sensitivity lndex-3 -ASI 3- (Sandín et al., 2007), a 18-item Likert self-report that assesses fears of anxious symptoms. It presents a hierarchical structure (a general factor and three subscales -Physical, Cognitive and Social Concerns-). It's also used the first and third items (delusions and hallucinatory behaviour) of The Positive and Negative Syndrome Scale -PANSS- (Kay, Opler and Lindenmayer, 1988) to detect positive symptoms.
All analysis were accepted at p < .05. Patients only hallucinators showed a higher anxiety sensitivity in Social Subscale than non-hallucinative/non-delusional patients; the former presented lower punctuations in ASI-total and ASI-cognitive than patients with hallucinations and delusions. The latter showed a higher anxiety sensitivity in Cognitive Subscale than patients who only deluded.
It's hypothetized that both delusional and hallucinative activity is necessary for emergence of cognitive anxiety sensitivity.
An important corpus of scientist evidence is linking psychotic activity and anxiety-related processes (Freeman and Garety, 2003).
We intended to assess differences in Anxiety Sensitivity dimensions between patients diagnosed by psychosis with and without positive symptoms.
Participants: 49 patients with DSM psychosis diagnosis (42 men and 7 women; mean age: 40), who attended a Mental Health Rehabilitation Service in 2008, of whom 24 patients had positive symptomatology.
Design, materials and procedure: A Cross-sectional design (one measurement) for a co-relational method of comparison between groups.
We used the Spanish validated Anxiety Sensitivity lndex-3 -ASI 3- (Sandîn et al, 2007), a 18-item Likert self-report that assesses fears of anxious symptoms. It presents a hierarchical structure (a general factor and three subscales -Physical, Cognitive and Social Concerns-). It's also used the first and third items (delusions and hallucinatory behaviour) of The Positive and Negative Syndrome Scale -PANSS- (Kay, Opler and Lindenmayer, 1988) to detect positive symptoms.
Patients with positive symptoms showed a higher sensitivity to cognitive (z = -3.22, p < 0.01) and social anxiety (z = -2.66, p < 0.01), as well as higher punctuations in ASI-total (z = -2.91, p < 0.01), than patients without positive symptoms.
Patients with positive symptoms show significant fears of symptoms of different anxious domains (ASI-total) with regard to patients without this kind of symptomatology. Specially, they are worried about the possibility that concentration difficulties and restlessness lead to mental incapacitation (ASI-cognitive) and about social reactions before their own publicly observable anxiety manifestations (ASI-social).