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The aim of this study was to (1) understand types and amounts of Ebola-related information that health organization employees wanted and obtained through formal, informal, internal, and external organizational communication channels; (2) determine potential discrepancies between information wanted and obtained; and (3) investigate how organizational structure might affect information wanted and obtained through these communication channels.
Primary data were collected from 526 health workers in 9 hospitals and 13 public health departments in Texas from June to November 2015. Survey data were collected for 7 types of Ebola-related information health organization employees wanted and obtained through various types of organizational communication channels. Descriptive statistical analyses, mixed design analysis of variance, regression analyses, and multilevel analyses were used to analyze the data.
Hospital employees (mostly nurses in our sample) received more self-care information than they wanted from every communication channel. However, they received less about all other types of information than they wanted from every communication channel separately and combined. Public health department employees wanted more information than they received from every communication channel separately and combined for all 7 types of information.
Discrepancies existed between the types of Ebola-related information wanted and obtained by employees of hospitals and public health departments.
The mechanisms underlying both depressive and anxiety disorders remain poorly understood. One of the reasons for this is the lack of a valid, evidence-based system to classify persons into specific subtypes based on their depressive and/or anxiety symptomatology. In order to do this without a priori assumptions, non-parametric statistical methods seem the optimal choice. Moreover, to define subtypes according to their symptom profiles and inter-relations between symptoms, network models may be very useful. This study aimed to evaluate the potential usefulness of this approach.
A large community sample from the Canadian general population (N = 254 443) was divided into data-driven clusters using non-parametric k-means clustering. Participants were clustered according to their (co)variation around the grand mean on each item of the Kessler Psychological Distress Scale (K10). Next, to evaluate cluster differences, semi-parametric network models were fitted in each cluster and node centrality indices and network density measures were compared.
A five-cluster model was obtained from the cluster analyses. Network density varied across clusters, and was highest for the cluster of people with the lowest K10 severity ratings. In three cluster networks, depressive symptoms (e.g. feeling depressed, restless, hopeless) had the highest centrality. In the remaining two clusters, symptom networks were characterised by a higher prominence of somatic symptoms (e.g. restlessness, nervousness).
Finding data-driven subtypes based on psychological distress using non-parametric methods can be a fruitful approach, yielding clusters of persons that differ in illness severity as well as in the structure and strengths of inter-symptom relationships.
The vulnerability hypothesis suggests that impairments after remission of depressive episodes reflect a pre-existing vulnerability, while the scar hypothesis proposes that depression leaves residual impairments that confer risk of subsequent episodes. We prospectively examined vulnerability and scar effects in mental and physical functioning in a representative Dutch population sample.
Three waves were used from the Netherlands Mental Health Survey and Incidence Study-2, a population-based study with a 6-years follow-up. Mental and physical functioning were assessed with the Medical Outcomes Study Short Form (SF-36). Major depressive disorder (MDD) was assessed with the Composite International Diagnostic Interview 3.0. Vulnerability effects were examined by comparing healthy controls (n = 2826) with individuals who developed a first-onset depressive episode during first follow-up but did not have a lifetime diagnosis of MDD at baseline (n = 181). Scarring effects were examined by comparing pre- and post-morbid functioning in individuals who developed a depressive episode after baseline that was remitted at the third wave (n = 108).
Both mental (B = −5.4, s.e. = 0.9, p < 0.001) and physical functioning (B = −8.2, s.e. = 1.1, p < 0.001) at baseline were lower in individuals who developed a first depressive episode after baseline compared with healthy controls. This effect was most pronounced in people who developed a severe episode. No firm evidence of scarring in mental or physical functioning was found. In unadjusted analyses, physical functioning was still lowered post-morbidly (B = −5.1, s.e. = 2.1, p = 0.014), but this effect disappeared in adjusted analyses.
Functional impairments after remission of depression seem to reflect a pre-existing vulnerability rather than a scar.
Telomere attrition might be one of the mechanisms through which psychosocial stress leads to somatic disease. To date it is unknown if exposure to adverse life events in adulthood is associated with telomere shortening prospectively. In the current study we investigated whether life events are associated with shortening of telomere length (TL).
Participants were 1094 adults (mean age 53.1, range 33–79 years) from the PREVEND cohort. Data were collected at baseline (T1) and at two follow-up visits after 4 years (T2) and 6 years (T3). Life events were assessed with an adjusted version of the List of Threatening Events (LTE). TL was measured by monochrome multiplex quantitative PCR at T1, T2, and T3. A linear mixed model was used to assess the effect of recent life events on TL prospectively. Multivariable regression analyses were performed to assess whether the lifetime life events score or the score of life events experienced before the age of 12 predicted TL cross-sectionally. All final models were adjusted for age, sex, body mass index, presence of chronic diseases, frequency of sports, smoking status, and level of education.
Recent life events significantly predicted telomere attrition prospectively (B = −0.031, p = 0.007). We were not able to demonstrate a significant cross-sectional relationship between the lifetime LTE score and TL. Nor did we find exposure to adverse life events before the age of 12 to be associated with TL in adulthood.
Exposure to recent adverse life events in adulthood is associated with telomere attrition prospectively.
The association between depression after myocardial infarction and increased risk of mortality and cardiac morbidity may be due to cardiac disease severity.
To combine original data from studies on the association between post-infarction depression and prognosis into one database, and to investigate to what extent such depression predicts prognosis independently of disease severity.
An individual patient data meta-analysis of studies was conducted using multilevel, multivariable Cox regression analyses.
Sixteen studies participated, creating a database of 10 175 post-infarction cases. Hazard ratios for post-infarction depression were 1.32 (95% CI 1.26–1.38, P<0.001) for all-cause mortality and 1.19 (95% CI 1.14–1.24, P<0.001) for cardiovascular events. Hazard ratios adjusted for disease severity were attenuated by 28% and 25% respectively.
The association between depression following myocardial infarction and prognosis is attenuated after adjustment for cardiac disease severity. Still, depression remains independently associated with prognosis, with a 22% increased risk of all-cause mortality and a 13% increased risk of cardiovascular events per standard deviation in depression z-score.
Paliperidone palmitate long‐acting injection (PP‐LAI) has recently been approved for treatment of chronic schizophrenia. Its cost‐effectiveness has not been established. The objective was to compare direct costs and outcomes between PP‐LAI and olanzapine pamoate (OLZ‐LAI) in treating chronic schizophrenia in Norway from the perspective of the government payer.
We used a decision analytic model over a 1‐year time horizon. Clinical inputs were derived from the literature and an expert panel; costs were taken from standard lists, adjusted to 2010 Norwegian kroner (NOK). Discounting was not done. Main outcomes included average cost per patient treated, hospitalisations, emergency room (ER) visits and quality‐adjusted life years (QALYs). The pharmacoeconomic outcome was the incremental cost per QALY. Robustness was examined using one‐way sensitivity analyses on critical variables and a 5000‐iteration probabilistic Monte Carlo sensitivity analysis with all variables included.
PP‐LAI generated 0.845 QALY at a cost of 151 336 NOK of which 23% was due to drugs; 25% of patients were hospitalised and another 12% required ER visits. OLZ‐LAI cost 174 351 NOK (21% due to drugs); patient outcomes included 0.844 QALY, 27% hospitalisations and 14% ER visits. PP‐LAI dominated OLZ‐LAI in the base case. The analysis was reasonably robust against variations in drug cost but sensitive to small changes in adherence and hospitalisation rates. Overall, PP‐LAI was dominant over OLZ‐LAI in 54.5% of simulations. Replacing OLZ‐LAI with PP‐LAI would be cost saving for the Norwegian healthcare system.
PP‐LAI was cost‐effective compared with OLZ‐LAI in treating patients with chronic schizophrenia in Norway but sensitive to changes in adherence and hospitalisation rates.
Stress questionnaires are included in many epidemiological cohort studies but the psychometric characteristics of these questionnaires are largely unknown. The aim of this study was to describe these characteristics for two short questionnaires measuring the lifetime and past year occurrence of stress: the List of Threatening Events (LTE) as a measure of acute stress and the Long-term Difficulties Inventory (LDI) as a measure of chronic stress.
This study was performed in a general population cohort consisting of 588 females (53.7%) and 506 males (46.3%), with a mean age of 53.5 years (s.d.=11.3 years). Respondents completed the LTE and the LDI for the past year, and for the age categories of 0–12, 13–18, 19–39, 40–60, and >60 years. They also completed questionnaires on perceived stress, psychological distress (the General Health Questionnaire, GHQ-12), anxiety and depression (the Symptom Checklist, SCL-8) and neuroticism (the Eysenck Personality Questionnaire – Revised Short Scale, EPQ-RSS-N). Approximately 2 years later, 976 respondents (89%) completed these questionnaires for a second time.
The stability of the retrospective reporting of long-term difficulties and life events was satisfactory: 0.7 for the lifetime LDI and 0.6 for the lifetime LTE scores. The construct validity of these lists is indicated by their positive associations with psychological distress, mental health problems and neuroticism.
This study in a large population-based sample shows that the LDI and LTE have sufficient validity and stability to include them in major epidemiological cohort studies.
In recent years the control of low pathogenicity avian influenza (LPAI) viruses of the H5 and H7 subtypes has increasingly become a concern. We evaluated the measures (stamping out, controlled marketing, emergency and preventive vaccination, farm density reduction and restocking in homogenous areas) implemented to control the LPAI epidemics that occurred in Italy between 2000 and 2005, using a combination of spatial and space–time analyses and estimates of the basic reproduction ratio (R0). Clustering of infected farms decreased over the years, indicating the effectiveness of the control strategies implemented. Controlled marketing [relative risk (RR) 0·46, 95% confidence interval (CI) 0·27–0·80], emergency (RR 0·47, 95% CI 0·39–0·57) and preventive vaccination (RR 0·19, 95% CI 0·09–0·41) were the most effective measures, yet R0<1 was only for preventive vaccination. Our results are useful for identifying the most effective measures for reducing the risk of the spread of LPAI and optimizing the allocation of resources.
Techniques have been developed to produce microbial phytase for addition to diets for simple-stomached animals, with the aim to improve phosphorus availability from phytate-P in plant sources. The activityof the crude microbial phytase showed pH optima at pH 5-5 and 2·5. The enzyme was able to degradephytate in vitro in soya-bean meal, maize and a liquid compound feed for pigs. When microbial phytasewas added to low-P diets for broilers the availability of P increased to over 60 % and the amount of Pin the droppings decreased by 50%. The growth rate and feed conversion ratio on the low-P dietscontaining microbial phytase were comparable to or even better than those obtained on control diets.Addition of microbial phytase to diets for growing pigs increased the apparent absorbability of P by24%. The amount of P in the faeces was 35% lower.
An updated compilation of published and new data of major-ion (Ca, Cl, K, Mg, Na, NO3, SO4) and methylsulfonate (MS) concentrations in snow from 520 Antarctic sites is provided by the national ITASE (International Trans-Antarctic Scientific Expedition) programmes of Australia, Brazil, China, Germany, Italy, Japan, Korea, New Zealand, Norway, the United Kingdom, the United States and the national Antarctic programme of Finland. The comparison shows that snow chemistry concentrations vary by up to four orders of magnitude across Antarctica and exhibit distinct geographical patterns. The Antarctic-wide comparison of glaciochemical records provides a unique opportunity to improve our understanding of the fundamental factors that ultimately control the chemistry of snow or ice samples. This paper aims to initiate data compilation and administration in order to provide a framework for facilitation of Antarctic-wide snow chemistry discussions across all ITASE nations and other contributing groups. The data are made available through the ITASE web page (http://www2.umaine.edu/itase/content/syngroups/snowchem.html) and will be updated with new data as they are provided. In addition, recommendations for future research efforts are summarized.
A computer-controlled xyz dispensing system called the Biological Architecture Tool (BAT) has been extensively tested in the creation of multilayered and three-dimensional biological objects: tissue scaffolds and plain and patterned cellular-array slides. The BAT dispensing system has proven its versatility and reliability in tissue engineering and biological experiments. The potential employments of modified versions of the xyz dispensers for in vivo minimally invasive surgery and other in vitro aspects of biological and medical research are discussed.
Bismuth was implanted at room temperature in (100)-Si wafers with controlled energy and doses to result in a plateau-like implantation profile. The van der Pauw Si : Bi samples were characterized by the Hall effect and resistivity measurements from room temperature down to 13 K. The electron concentration of the prepared samples at 290 K varied from 3.0 × 1017 to 1.4 × 1020 cm−3. The resistivity of the Si : Bi samples presents a larger enhancement, compared to other dopants, when decreasing the Bi concentration. The metal-nonmetal transition was determined to be around 2 × 1019 cm−3. The calculated values obtained from the Generalized Drude Approach and an equation derived from Kubo formalism agree very well with the experimental data. The results confirm also the behavior ρc (Bi) < ρc(As) < ρc(P) < ρc(Sb) at 290 K.
The new method of preparation of La1−xSrxMnO3 catalysts supported on ceramic foam materials was developed. The synthesized supported perovskite catalysts were examined by X-ray diffraction analysis and BET methods. It was shown that in coated samples there is a pure perovskite phase on the support surface up to temperatures of 1000°C.
Unsupported La1−xSrxMnO3 catalysts were synthesized applying co-precipitation technique using La, Sr and Mn acetylacetonates and were studied by X-ray diffraction analysis. Temperature programmed reduction method revealed that catalysts contain 2 types of active centers: low temperature (α) and high temperature (β), the quantity of these centers and correlation between them depend on the value of x. It was shown that supported perovskite catalysts, similarly to the massive ones, maintain two types of active centers (α and β).
The activity of La1−xSrxMnO3 on mullite foam was characterized in the methane oxidation reaction.
Techniques have been developed to produce microbial phytase for addition to diets for simple-stomached animals, with the aim to improve phosphorus availability from phytate-P in plant sources. The activity of the crude microbial phytase showed pH optima at pH 5.5 and 2.5. The enzyme was able to degrade phytate in vitro in soya-bean meal, maize and a liquid compound feed for pigs. When microbial phytase was added to low-P diets for broilers the availability of P increased to over 60% and the amount of P in the droppings decreased by 50%. The growth rate and feed conversion ratio on the low-P diets containing microbial phytase were comparable to or even better than those obtained on control diets. Addition of microbial phytase to diets for growing pigs increased the apparent absorbability of P by 24%. The amount of P in the faeces was 35% lower.
A slow, continuous infusion of 1000 μg TRH (thyrotropin releasing hormone) over a period of 4 h had a very faint and diffuse short-lasting beneficial effect on a group of 10 depressive patients. This was assessed in a double blind cross-over trial with placebo. The effect was of no therapeutic value. No difference was found between the depressive patients and a control group of normal subjects in TSH response, T3 resin uptake, T4 or free thyroxine index values as a consequence of the TRH infusion.
In a double reversal design the potency of thyrotropin releasing hormone (TRH) (500 μg intravenously) as a quick-acting antidepressive agent was evaluated. A first injection did seem to give rise to a very slight short-lasting effect, though this could not be ascertained clearly. There were no visible effects after a second injection. The thyroid stimulating hormone (TSH) response curve after TRH administration in the depressive patients group was blunted in comparison with that in a matched control group of normals.