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Moonshine worms are a popular bait species used for fishing. The taxon was not detected during surveys of the macrobenthos conducted in Knysna in the 1940s and 1990s, and was first reported as a harvested bait species in the mid-2000s, suggesting that it appeared for the first time in the estuary in the last three decades. A previous molecular analysis identified the worms as Diopatra aciculata, a species first described from Australia. This study provides an updated detailed morphological description of D. aciculata in South Africa to facilitate future identifications and also investigates the species' distribution and population size in the Knysna Estuary. Specimens were examined by scanning electron, stereo- and compound microscopes. Diopatra aciculata has tubes that protrude from the sediment in sandy areas, often decorated with algae and shell fragments; a large body size, up to 600 mm long and 11.5 mm wide. It has 10–18 rings on ceratophores; 5–10 teeth on pectinate chaetae; uni- and bidentate pseudo-compound falcigers and dorsal cirri approximately as long as branchiae. Diopatra aciculata was detected up to 12 km from the mouth of the Knysna Estuary with densities measured at 18 sampled sites. Statistical analysis retrieved high and low density groups that were significantly different from one another (Kruskal-Wallis H(14, 800) = 376.55; P = 0.01), but distribution of high density sites was patchy. We estimate that the population comprises 20–24 million individuals. Given the size of individual worms and the population estimate, this species can be expected to have significant ecological impacts in the estuary.
In order to elucidate the physical connection between the propulsive performance and the unsteadiness of jet flow, the transient development of the impulse and thrust of laminar starting jets with finite fluid discharged is investigated numerically for cases with different velocity programmes and jet stroke ratios. The simulation quantitatively demonstrates that the impulse and thrust generated are highly sensitive to the jet kinematics and its near-wake dynamics. The momentum flux contribution to the jet impulse is found to be significant and is associated closely with the jet kinematics. On the other hand, although the over pressure effect at the jet initiation stage has been identified previously as the main reason for the enhanced propulsive performance of the starting jet, the current results indicate that its contribution is in fact weakened by the negative local pressure, induced by the formation of the leading vortex ring as well as jet development during the deceleration stage. Contrary to the effects of the leading vortex ring, the stopping vortex formed near the nozzle exit plane during the jet deceleration stage is found to contribute positively to the pressure impulse production, albeit it is relatively small. By augmenting the over pressure effect and mitigating the negative-pressure effect, the cases with the fast acceleration and slow deceleration velocity programme is capable of producing the maximum pressure impulse, leading to additional impulse production over what would be expected from the jet momentum flux alone.
We have previously shown that higher intake of cruciferous vegetables is inversely associated with carotid artery intima-media thickness. To further test the hypothesis that an increased consumption of cruciferous vegetables is associated with reduced indicators of structural vascular disease in other areas of the vascular tree, we aimed to investigate the cross-sectional association between cruciferous vegetable intake and extensive calcification in the abdominal aorta. Dietary intake was assessed, using a FFQ, in 684 older women from the Calcium Intake Fracture Outcome Study. Cruciferous vegetables included cabbage, Brussels sprouts, cauliflower and broccoli. Abdominal aortic calcification (AAC) was scored using the Kauppila AAC24 scale on dual-energy X-ray absorptiometry lateral spine images and was categorised as ‘not extensive’ (0–5) or ‘extensive’ (≥6). Mean age was 74·9 (sd 2·6) years, median cruciferous vegetable intake was 28·2 (interquartile range 15·0–44·7) g/d and 128/684 (18·7 %) women had extensive AAC scores. Those with higher intakes of cruciferous vegetables (>44·6 g/d) were associated with a 46 % lower odds of having extensive AAC in comparison with those with lower intakes (<15·0 g/d) after adjustment for lifestyle, dietary and CVD risk factors (ORQ4 v. Q1 0·54, 95 % CI 0·30, 0·97, P = 0·036). Total vegetable intake and each of the other vegetable types were not related to extensive AAC (P > 0·05 for all). This study strengthens the hypothesis that higher intake of cruciferous vegetables may protect against vascular calcification.
While medical nutrition therapy is an essential part of the care for critically ill patients, uncertainty exists about the right form, dosage, timing and route in relation to the phases of critical illness. As enteral nutrition (EN) is often withheld or interrupted during the intensive care unit (ICU) stay, combined EN and parenteral nutrition (PN) may represent an effective and safe option to achieve energy and protein goals as recommended by international guidelines. We hypothesise that critically ill patients at high nutritional risk may benefit from such a combined approach during their stay on the ICU. Therefore, we aim to test if an early combination of EN and high-protein PN (EN+PN) is effective in reaching energy and protein goals in patients at high nutritional risk, while avoiding overfeeding. This approach will be tested in the here-presented EFFORTcombo trial. Nutritionally high-risk ICU patients will be randomised to either high (≥2·2 g/kg per d) or low protein (≤1·2 g/kg per d). In the high protein group, the patients will receive EN+PN; in the low protein group, patients will be given EN alone. EN will be started in accordance with international guidelines in both groups. Efforts will be made to reach nutrition goals within 48–96 h. The efficacy of the proposed nutritional strategy will be tested as an innovative approach by functional outcomes at ICU and hospital discharge, as well as at a 6-month follow-up.
In this chapter, important issues which may be encountered when prescribing medications to older adults will be discussed. It must be remembered that medication is only one of several valuable approaches in treating psychiatric disorders in the elderly and it is often necessary to integrate expertise in drug prescribing with psychotherapy and social interventions, although discussion of these is beyond the scope of this review. The first part of the chapter reviews population demographics in relation to older age psychiatry and the fact that the evidence base for using many psychiatric medications in older people is more meagre than in younger adults. This is followed by a review of the pharmacodynamics and pharmacokinetic changes seen in older adults, which can impact on prescribing.
Africa is a diverse and changing continent with a rapidly growing population, and the mental health of mothers is a key health priority. Recent studies have shown that: perinatal common mental disorders (depression and anxiety) are at least as prevalent in Africa as in high-income and other low- and middle-income regions; key risk factors include intimate partner violence, food insecurity and physical illness; and poor maternal mental health is associated with impairment of infant health and development. Psychological interventions can be integrated into routine maternal and child healthcare in the African context, although the optimal model and intensity of intervention remain unclear and are likely to vary across settings. Future priorities include: extension of research to include neglected psychiatric conditions; large-scale mixed-method studies of the causes and consequences of perinatal common mental disorders; scaling up of locally appropriate evidence-based interventions, including prevention; and advocacy for the right of all women in Africa to safe holistic maternity care.
At present, analysis of diet and bladder cancer (BC) is mostly based on the intake of individual foods. The examination of food combinations provides a scope to deal with the complexity and unpredictability of the diet and aims to overcome the limitations of the study of nutrients and foods in isolation. This article aims to demonstrate the usability of supervised data mining methods to extract the food groups related to BC. In order to derive key food groups associated with BC risk, we applied the data mining technique C5.0 with 10-fold cross-validation in the BLadder cancer Epidemiology and Nutritional Determinants study, including data from eighteen case–control and one nested case–cohort study, compromising 8320 BC cases out of 31 551 participants. Dietary data, on the eleven main food groups of the Eurocode 2 Core classification codebook, and relevant non-diet data (i.e. sex, age and smoking status) were available. Primarily, five key food groups were extracted; in order of importance, beverages (non-milk); grains and grain products; vegetables and vegetable products; fats, oils and their products; meats and meat products were associated with BC risk. Since these food groups are corresponded with previously proposed BC-related dietary factors, data mining seems to be a promising technique in the field of nutritional epidemiology and deserves further examination.
Alexithymia is a term to describe a state of deficiency in understanding, processing, or describing emotions. It expresses the cognitive-emotional state of vulnerable subjects who prone to suffer from psychosomatic illnesses. It’s characterized by difficulties in relationship and emptiness of feelings. It has been incriminated in genesis and maintenance of various psychosomatic pathologies, included psoriasis. Psychological stress is important in onset and exacerbation of psoriasis. We assume hypothesis that emotions that cannot be expressed through the appropriate symbolic language will be expressed through a symbolic somatic symptom.
A case study of psoriasis in a woman of 27 years without a previous psychiatric history. She was treated jointly by the service of psychiatry and dermatology. Methodology: We performed a detailed history in the course of the disease, summarizing vital changes and outstanding events of her lifetime in the different vital areas (family, work, school and sex life).
From the comprehensive revision of the ailments and pathobiography we can establish a clear relationship between physical-psychological symptoms.
Skin is an envelope that represents the boundary line between body-psyche. Skin and psyche interact in many ways. The skin reacts to feelings and perceptions. Psychosomatic patients feel extreme anxiety when they have to cope with separation and merger situations. They experience these situations as if they were to lose their physical limit. Broadly speaking, because of their alexithymia, they cannot process a painful emotion properly, and though they will express it through somatisation disorders and the development of diseases. In the case of our patient, the skin verbalizes her emotional silence.
The present study addresses the empirical basis for alerting health professionals to potential risk factors for excessive gambling. On the basis of international and Swiss literature on gambling, an explanatory model for the development of gambling problems is developed.
This work is based on the hypothesis that the prediction rule for excessive gambling, based on a sample of the general population and for different types of frequent gambling preferences, differs from the prediction rule for disordered gambling in patients, seeking psychiatric treatment. The goal of this study is, therefore, to contribute to an early identification of disordered gambling behaviour in the general population, as well as in the target group of patients seeking psychiatric treatment.
Various sources of information were analysed separately, in order to develop and test a prediction rule for excessive gambling, namely the 2002 Swiss Health Survey, which is a survey of the general population, involving 19'706 participants, as well as the data of psychiatric patients of Lausanne/Geneva, recruited consecutively from 1996 to 2004 at the Psychiatric Hospital of the University of Lausanne. This patient population comprised a total of 886 patients. Further data from the Centre for Excessive Gambling are presented, covering 105 patients.
Results show that indicators of depressive behaviour as well as smoking are good candidates for the early identification of gambling problems. On the basis of these data it is safe to assume that signs of depressive behaviour should encourage health professionals to enquire about gambling problems.
Excessive gambling touch between 1 and 3% of the adult population (Shaffer et al. 1999).
Studies of treatment-seeking gamblers establish a relationship between gambling and suicide. We investigated clinical characteristics in excessive gamblers of a Swiss University Hospital(CHUV).
The aim of this study is to compare gamblers with prior suicide attempts (GPSA) with gamblers without prior suicide attempts (Non-GPSA) and with the international literature.
- GPSA are confronted with a higher problem load than Non-GPSA.
- GPSA lack social networks and family support as compared to Non-GPSA.
Patients treated for gambling disorders typically show a high level of co-morbidity. Bourget, Data are based on medical files of our treatment center. Among our consecutively admitted patients (2002-2006), we identified pathological gamblers who reported prior suicide attempts directly or not directly linked with gambling.
Results and discussion
– GPSA were more likely to be women, separated or divorced, referred by the forensic network.
– GPSA were more likely to be disabled and had a history of alcohol abuse. GPSA showed no difference with respect to age at intake or employment status as compared to NON-GPSA.
Further research is needed to find out whether the higher proportion of women with prior suicide attempts is due to the fact that men are more likely to complete suicide.
Known by many different names-culture broker, community interpreter, medical interpreter, and communication facilitator-the intercultural mediator has as a primary task the facilitation of communication and the therapeutic relationship in the presence of linguistic and/or cultural difference. The Immigration Plan of “la Caixa” Social and Cultural Outreach Projects has undertaken an ambitious project to train all of the cultural mediators in Spain, including both those currently working and those newly entering the field, to meet existing needs. In the first phase of the project, the training was developed in Catalunya, in collaboration with the the Catalan Department of Health, executed by the Psychiatry Department of the Vall d'Hebron University Hospital (Autonomous University of Barcelona) and certified by the Health Studies Institute of the Department of Health. Drawing from the four years experience of the NGO SURT and the Department of Psychiatry of the Vall d'Hebron University Hospital, the program provides 200 hours of theoretical and 1200 hours of practical training. 50 currently employed intercultural mediators and 30 novices are being trained. In subsequent phases the training will be adapted to needs of other autonomous regions of Spain. Modules include medical anthropology, Western biomedicine, community health, linguistic interpretation, cultural competence, professional identity, and ethics. Small group supervision provides a supportive environment to facilitate the application of theory to practice. Finally, high quality training materials were developed specifically for the course. Preliminary evaluations of the project are positive despite some unanticipated complications.
Depression is highly recurrent in Bipolar patients, causes more disability than other manifestations of the illness and depressive symptoms predominate over manic and hypomanic symptoms. Our aim is to describe whether in our sample we can find some specific differences from the early course of the illness.
33 patients meeting DSM-IV criteria of Bipolar Disorder I and II whose illness onset was less than 5 years from the first Manic/ hyponamic episode or/and less than 10years from the index depressive episode. Recorded variables included socio-demographic, clinical, treatment characteristics and scales (HRSD, YMRS, BPRS, GAF).Analysis was performed using SPSS Version 12.0.
57.6% were male, 42.4% female, mean age 34.42 years. 2 Patients (6.2%) were depressed when inclusion and 8.8% had had a depressive episode before were included in our Program.
The mean number of depressive episodes was 1.88 (SD 3.58). Only 1 patient had had self-harm intent. 15.2% has first degree family history of Unipolar depressive disorder and 20% of Bipolar disorder. 6.2% were hospitalized because a depressive episode.
We found less rates of depressive episodes than we found in the literature with less sub-syndromal and syndromal depressive symptoms than in routine bipolar population that could be explained by the short course of the illness in our sample. More research should be done to study bipolar depression in early phases to find predictors that help us to decrease the high impact it has in the disorder.
The aim of the study is to validate an enlarged version of the Lie/Bet questionnaire for screening pathological gambling behaviour (Johnson, Hamer & Nora, 1998) in French. This version of the Lie/Bet has the following features: it was enlarged with one item derived from de CAGE screening for alcoholism (Ewing, 1984) and items were rated on a 4-points scale ranging from ‘All the time’ to ‘Never’ instead of being rated on a ‘Yes/No’ scale. The addition of the third item meets the need for a measure of social irritability about gambling. The use of 4-options responses scales is motivated by the necessity to measure severity of problem gambling and allow parametric epidemiological analysis. The study was conducted on three samples: one group of people concerned with gambling who participated to an online survey about gambling (N= 36), one group of out patients (N=33) and one group of respondents to the Swiss Health Survey 2007 (N=75). Analyses were conducted to measure internal consistency and convergent validity of the instrument. Results show good internal consistency of the enlarged Lie/Bet as well as good convergent validity.
We recently found that, in mice, independently of orosensory input, sucrose consumption is sufficient to condition the development of spout preferences and dopamine release in the ventral striatum.
To clarify if the appetitive behavioral and dopaminergic responses to the postingestive effects of calorie-containing sugars reflect preabsorptive or postabsorptive events.
To understand if endovenous injection of glucose is sufficient to condition spout preferences and dopamine release.
Measurements of the behavioural, metabolic and neurochemical effects of the administration of glucose solutions, enterically, and in the jugular (JV) or hepatic-portal (HPV) veins of rats.
High concentration glucose solutions administered in the JV were sufficient to condition spout preferences in a two-bottle behavioral task. Additionally, a low concentration glucose solution conditioned robust behavioral responses when administered in the HPV, but not the JV. Finally, using fast-scan cyclic voltammetry we found that, in accordance to behavioral findings, a low concentration glucose solution caused an increase of spontaneous dopamine release events in the nucleus accumbens shell when administered in the HPV, but not the JV.
The postabsorptive effects of glucose are sufficient to mimic the behavioral and dopaminergic responses that result from sugar consumption. Furthermore, glycemia levels in the HPV contribute more significantly for this effect than systemic glycemia, arguing for the participation of an intra-abdominal visceral sensor for glucose.
Psoriasis is a multifactorial chronic infiammatory skin disease that often occurs in patients with overweight or obesity; obesity makes psoriasis less susceptible to therapy and a moderate weight loss improves drug response. Many studies shows connections between obesity and eating disorders, but few studies investigated the link between eating disorders and psoriasis.
To evaluate the presence of eating disorders and psychopathological traits in patients affected by psoriasis compared with a control population, and correlate this data with different features of cutaneous disease and BMI.
To suggest the importance of a psychological support that could reduce the occurrence of loss of control over food.
We enrolled 100 consecutive psoriatic outpatients and a control group of 100 selected non psoriatic outpatients, matched by BMI to the study group. The assessment battery was composed by the Psoriasis Area and Severity Index (PASI) score, the EDI and SCL-90R.
Most of EDI and SCL-90R subscales resulted more altered in psoriatic population compared to the controls (p < .001 for IA and ID, and p < .05 for GSI). Moreover, we noticed an association between the progressive weight gain and the impairment of most of EDI subscales, indicating the presence of an ED in only psoriasis group (p < .01).
Psoriasis is associated with psychopathological traits and symptoms commonly associated with eating disorders. A multidisciplinary approach could have an important role to reduce the loss of control over food, to loss weight and to improve the drug response.