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Although many mental health care systems provide care interventions that are not related to direct health care, little is known about the interfaces between the latter and core health care. ‘Core health care’ refers to services whose explicit aim is direct clinical treatment which is usually provided by health professionals, i.e., physicians, nurses, psychologists. ‘Other care’ is typically provided by other staff and includes accommodation, training, promotion of independence, employment support and social skills. In such a definition, ‘other care’ does not necessarily mean being funded or governed differently. The aims of the study were: (1) using a standard classification system (Description and Evaluation of Services and Directories in Europe for Long Term Care, DESDE-LTC) to identify ‘core health’ and ‘other care’ services provided to adults with mental health problems; and (2) to investigate the balance of care by analysing the types and characteristics of core health and other care services.
The study was conducted in eight selected local areas in eight European countries with different mental health systems. All publicly funded mental health services, regardless of the funding agency, for people over 18 years old were identified and coded. The availability, capacity and the workforce of the local mental health services were described using their functional main activity or ‘Main Types of Care’ (MTC) as the standard for international comparison, following the DESDE-LTC system.
In these European study areas, 822 MTCs were identified as providing core health care and 448 provided other types of care. Even though one-third of mental health services in the selected study areas provided interventions that were coded as ‘other care’, significant variation was found in the typology and characteristics of these services across the eight study areas.
The functional distinction between core health and other care overcomes the traditional division between ‘health’ and ‘social’ sectors based on governance and funding. The overall balance between core health and other care services varied significantly across the European sites. Mental health systems cannot be understood or planned without taking into account the availability and capacity of all services specifically available for this target population, including those outside the health sector.
The clinical and pathologic characterisation of two fatal cases of tick-borne rickettsiosis in rural (El Valle) and urban (City of Panama) Panama are described. Clinical and autopsy findings were non-specific, but the molecular analysis was used to identify Rickettsia rickettsii in both cases. No ticks were collected in El Valle, while in the urban case, R. rickettsii was detected in Rhipicephalus sanguineus s.l., representing the first molecular finding in this tick in Panama and Central America.
One of the main objectives in conservation programmes is to maintain the highest levels of genetic variability, for the population to be able to face future environmental changes and to assure long-term response to selection, either natural or artificial (Oldenbroek, 1999, Barker, 2001). The classical measure of genetic diversity is the expected heterozygosity, or gene diversity (GD), but allelic diversity (AD), or the number of different alleles per locus, also has evolutionary importance. Most optimal strategies for conservation have aimed to maximise GD (e.g. Caballero and Toro 2000), but AD has received much less attention. The objective of the present study is to test the efficiency of the maintenance of allelic diversity of strategies based either on the allelic diversity itself or on the expected heterozygosity in a small population, using information from molecular markers.
There is a need of more quantitative standardised data to compare local Mental Health Systems (MHSs) across international jurisdictions. Problems related to terminological variability and commensurability in the evaluation of services hamper like-with-like comparisons and hinder the development of work in this area. This study was aimed to provide standard assessment and comparison of MHS in selected local areas in Europe, contributing to a better understanding of MHS and related allocation of resources at local level and to lessen the scarcity in standard service comparison in Europe. This study is part of the Seventh Framework programme REFINEMENT (Research on Financing Systems’ Effect on the Quality of Mental Health Care in Europe) project.
A total of eight study areas from European countries with different systems of care (Austria, England, Finland, France, Italy, Norway, Romania, Spain) were analysed using a standard open-access classification system (Description and Evaluation of Services for Long Term Care in Europe, DESDE-LTC). All publicly funded services universally accessible to adults (≥18 years) with a psychiatric disorder were coded. Care availability, diversity and capacity were compared across these eight local MHS.
The comparison of MHS revealed more community-oriented delivery systems in the areas of England (Hampshire) and Southern European countries (Verona – Italy and Girona – Spain). Community-oriented systems with a higher proportion of hospital care were identified in Austria (Industrieviertel) and Scandinavian countries (Sør-Trøndelag in Norway and Helsinki-Uusimaa in Finland), while Loiret (France) was considered as a predominantly hospital-based system. The MHS in Suceava (Romania) was still in transition to community care.
There is a significant variation in care availability and capacity across MHS of local areas in Europe. This information is relevant for understanding the process of implementation of community-oriented mental health care in local areas. Standard comparison of care provision in local areas is important for context analysis and policy planning.
Precision agriculture (PA) requires reasonably homogeneous areas for site-specific management. This work explores the applicability of digital terrain classes obtained from a digital elevation model derived from UAV-acquired images, to define management units in in a relative flat area of about 6 ha. Elevation, together with other terrain variables such as: slope degree, profile curvature, plan curvature, topographic wetness index, sediment transport index, were clustered using the Fuzzy Kohonen Clustering Network (FKCN). Four terrain classes were obtained. The result was compared with a map produced by a classification of soil properties previously interpolated by ordinary kriging. The results suggest that areas for site-specific management can be defined from terrain classes based on environmental covariates, saving time and cost in comparison with interpolation of soil variables.
Cosmopolitan pests such as Brevicoryne brassicae, Lipaphis pseudobrassicae, and Myzus persicae (Aphididae) cause significant damage to Brassicaceae crops. Assessment of the important biotic and abiotic factors that regulate these pests is an essential step in the development of effective Integrated Pest Management programs for these aphids. This study evaluated the influence of leaf position, precipitation, temperature, and parasitism on populations of L. pseudobrassicae, M. persicae, and B. brassicae in collard greens fields in the Triângulo Mineiro region (Minas Gerais state), Brazil. Similar numbers of B. brassicae were found on all parts of the collard green plants, whereas M. persicae and L. pseudobrassicae were found in greatest numbers on the middle and lower parts of the plant. While temperature and precipitation were positively related to aphid population size, their effects were not accumulative, as indicated by a negative interaction term. Although Diaeretiella rapae was the main parasitoid of these aphids, hyperparasitism was dominant; the main hyperparasitoid species recovered from plant samples was Alloxysta fuscicornis. Parasitoids seem to have similar distributions on plants as their hosts. These results may help predict aphid outbreaks and gives clues for specific intra-plant locations when searching for and monitoring aphid populations.
Clinical manifestations of acute bronchiolitis (AB) vary from minimal disease to severe respiratory failure. The response to respiratory viral infections is possibly influenced by genetic polymorphisms linked to the regulation of the inflammatory response. In the present study, we investigated whether interleukin-8 (IL-8) and interleukin-17 (IL-17) genetic variants are associated with the severity of AB. A group of Brazilian infants hospitalized with AB and a control group (infants with no or mild AB, without hospitalization) were genotyped for four IL-8/IL-17 variations. For replication, we studied an Argentinean population sample of infants with mild and severe AB. IL-8 polymorphism (rs 2227543) and IL-17 (rs2275913) variants showed significant associations with the severity of AB. The effect of the IL-8 variation could be replicated in the Argentinean sample. This finding suggests that IL-8 variations may influence the severity of AB in young infants. Further genetic association studies in low- or middle-income populations are necessary with the aim of expanding knowledge in this area.
We present VLT/MUSE observations of NGC 2070, the dominant ionizing nebula of 30 Doradus in the LMC, plus HST/STIS spectroscopy of its central star cluster R136. Integral Field Spectroscopy (MUSE) and pseudo IFS (STIS) together provides a complete census of all massive stars within the central 30×30 parsec2 of the Tarantula. We discuss the integrated far-UV spectrum of R136, of particular interest for UV studies of young extragalactic star clusters. Strong He iiλ1640 emission at very early ages (1–2 Myr) from very massive stars cannot be reproduced by current population synthesis models, even those incorporating binary evolution and very massive stars. A nebular analysis of the integrated MUSE dataset implies an age of ~4.5 Myr for NGC 2070. Wolf-Rayet features provide alternative age diagnostics, with the primary contribution to the integrated Wolf-Rayet bumps arising from R140 rather than the more numerous H-rich WN stars in R136. Caution should be used when interpreting spatially extended observations of extragalactic star-forming regions.
We have obtained series of images in the near infrared J and Ks bands for seven L-type dwarfs with a duration of 3 to 6 hours. We present results on: 1) the amplitude of variability associated with atmospheric changes over time scales from minutes to several hours; 2) the search for cool companions in wide orbits; 3) the search for transits of brown dwarfs and planetary companions in very close orbits.
The σ Orionis cluster (~3 Myr, 350 pc) is an ideal site to investigate the early evolution of substellar (brown dwarf and planetary mass) objects. To date, the cluster photometric and spectroscopic sequence of free-floaters is known for a wide mass range from 1 M⊙ down to roughly 3 MJup. The substellar domain covers spectral types that go from mid-M classes to the recently defined “methane” T-types, i.e., surface temperatures between ~3000K and 800 K. We derive a rising initial substellar mass function in the mass interval of 150–5 MJup (dN/dM ~ M-α, with α = 0.9 ± 0.4). We also find evidence for a extension of this mass function toward lower masses down to 2–3 MJup. This indicates that the population of isolated planetary mass objects with masses below the deuterium burning threshold is rather abundant in the cluster.
We present a detailed study of the kinematics of M dwarfs in the CARMENES (Calar Alto high-Resolution search for M dwarfs with Exoearths with Near-infrared and optical Échelle Spectrographs) input catalog. We have selected all M dwarfs with known parallactic distance or a good photometric distance estimation, precise proper motion in the literature or as determined by us, and radial velocity measurements. Using these parameters, we computed the M dwarfs galactic space motions (U, V, W). For the stars with U and V velocity components inside or near the boundaries that determine the young disk population, we have analyzed the possible membership in the classical moving groups and nearby loose associations with ages between 10 and 600 Myr. For the candidate members, we have compiled information available in the literature in order to constrain their membership by applying other age-dating methods.
The mid-Holocene eruption of Aniakchak volcano (Aniakchak II) in southwest Alaska was among the largest eruptions globally in the last 10,000 years (VEI-6). Despite evidence for possible impacts on global climate, the precise age of the eruption is not well-constrained and little is known about regional environmental impacts. A closely spaced sequence of radiocarbon dates at a peatland site over 1000 km from the volcano show that peat accumulation was greatly reduced with a hiatus of approximately 90–120 yr following tephra deposition. During this inferred hiatus no paleoenvironmental data are available but once vegetation returned the flora changed from a Cyperaceae-dominated assemblage to a Poaceae-dominated vegetation cover, suggesting a drier and/or more nutrient-rich ecosystem. Oribatid mites are extremely abundant in the peat at the depth of the ash, and show a longer-term, increasingly wet peat surface across the tephra layer. The radiocarbon sample immediately below the tephra gave a date of 1636–1446 cal yr BC suggesting that the eruption might be younger than previously thought. Our findings suggest that the eruption may have led to a widespread reduction in peatland carbon sequestration and that the impacts on ecosystem functioning were profound and long-lasting.
This study describes the incidence rate of reported lymphogranuloma venereum (LGV) in men who have sex with men (MSM) in Barcelona from 2007 to 2012. Epidemiological, clinical and sexual behaviour characteristics of LGV cases are described. Seroadaptive behaviours as a transmission risk factor were assessed by a telephone questionnaire during 2012. Data were handled on a strictly confidential basis. LGV annual rate ratios in MSM were compared with cases from 2007. Differences were statistically analysed with a Poisson test. The incidence rate of LGV in MSM aged 15–69 years ranged from 32·1/105 MSM per year in 2007 to 182·7/105 MSM per year in 2012. In 2012, 31/51 LGV cases (61%) answered the telephone questionnaire, of which 84% (26/31) were HIV positive, 39% (12/31) reported having sex according to their partners’ serostatus and 7% (2/31) used strategic positioning. The incidence of LGV has increased since 2007 and mainly affects HIV-positive MSM. It is probable that seroadaptation has facilitated LGV transmission.
We present the results of an all sky survey for binary systems among the massive stars that we made with the HST Fine Guidance Sensors. The sample of 225 stars is comprised mainly of Galactic O- and B-type stars and Luminous Blue Variables, plus a few luminous stars in the LMC. The FGS TRANS mode observations are sensitive to detection of companions with an angular separation of 0.01–1 arcsec and brighter than △m = 5 mag. The FGS observations resolved 52 binary and 6 triple star systems and detected partially resolved binaries in 7 additional targets, yielding a companion detection frequency of 29%. We also gathered literature results on the numbers of close spectroscopic binaries and wider astrometric binaries among the sample. These results confirm the high multiplicity fraction. The period distribution is essentially flat in increments of log P, although there remains an observational gap in detections for periods of years and decades.
We evaluated the effect of feeding dietary tannins from Lysiloma latisiliquum fresh forage on the saliva tannin-binding capacity of hair sheep lambs without previous exposure to tannin-rich (TR) fodder. Twenty-four hair sheep lambs (13.6±3.04 kg LW) were fed a tannin-free diet at the beginning of the experimental period (from day 10 to 13). On day 14, lambs were distributed into three groups (n=8): control group (CG), fed with the tannin-free diet (from D10 to D112); tannin short-term group (TST), fed the basal diet and 650 g of L. latisiliquum forage (from D14 to D55); tannin long-term group (TLT), fed the basal diet and 650 g of L. latisiliquum forage (from D14 to D112). Saliva samples were collected from the mouth of each lamb in the morning before feeding time on D10 and D14 (baseline period), on D49 and D56 (period 1) and on D97 and D112 (period 2). The tannin binding response of salivary protein (∆% turbidity) was determined with the haze development test (HDT) using either tannic acid or L. latisiliquum forage acetone extract. A turbidity protein index (TPI) was calculated as (∆% turbidity/[salivary protein (mg)]). Differences in HDT and TPI in the different groups were compared by repeated measures ANOVA using Proc Mixed. All groups had similar ∆% turbidity throughout the experiment (P>0.05). At baseline and period 1, the TPI of the different groups was similar (P>0.05). On period 2 the TLT group showed higher TPI compared with CG (P<0.05). Meanwhile, CG and TST showed similar salivary TPI. The saliva of hair sheep lambs consuming TR L. latisiliquum fresh fodder (TLT group) increased their TPI compared with control lambs not exposed to tannins.
CARMENES (Calar Alto high-Resolution search for M dwarfs with Exo-earths with Near-infrared and optical Echelle Spectrographs) will conduct a radial-velocity survey of ~ 300 M dwarfs with the 3.5m telescope at the Calar Alto Observatory. The CARMENES instrument is currently under construction; it consists of two independent échelle spectrographs, which together cover the wavelength range 0.55 – 1.7μm at a spectral resolution of R = 82,000. The spectrographs and the fiber input are designed with a goal of 1m/s radial velocity precision using simultaneous calibration with emission-line lamps.
The management of patients with Fontan physiology who undergo scoliosis surgery is difficult. The purpose of this article was to describe our experience in the management of patients with Fontan circulation undergoing spinal surgery for correction of scoliosis.
Materials and methods
This was a retrospective study including patients with Fontan physiology who underwent spinal orthopaedic surgery. Anaesthetic management, post-operative complications, paediatric intensive care unit and total hospital stay, and the need for blood transfusions were analysed.
We identified eight children with Fontan physiology who had undergone spinal surgery from 2000 to 2010. All patients were receiving cardiac medications at the time of spinal surgery. The mean age at surgery was 14.8 years (range 12–21). In all, three patients needed inotropic support with dopamine (3, 5, and 8 μg/kg/min), which was started during surgery. During the immediate post-operative period, one patient died because of hypovolaemic shock caused by massive bleeding and dysrythmia. Mean blood loss during the post-operative period was 22.2 cc/kg (7.8–44.6). Surgical drainages were maintained for a mean time of 3 days (range 1–7). The mean hospital stay was 9.2 days (range 6–19). Pleural effusions developed in two patients. On follow-up, one patient presented with thoracic pseudarthrosis and another with a serohaematoma of the surgical wound.
Spinal surgery in patients with Fontan circulation is a high-risk operation. These patients must be managed by a specialised team.
DHA deficiency has been related to skeletal malformations in fish, but high DHA levels have produced controversial results that could relate to the oxidative status of fish tissues in the different reports. In the present study, gilthead seabream (Sparus aurata) larvae were fed deficient, adequate or high DHA levels, or high DHA levels supplemented with the antioxidant α-tocopherol. Larvae fed deficient DHA levels tended to be smaller, and showed the highest incidence of urinary bladder calculi, lordosis and kyphosis and the lowest number of mineralised vertebrae for any given size class. Elevation of dietary DHA increased larval growth and significantly enhanced the expression of the insulin-like growth factor 1 (IGF-1) gene. However, a DHA level increase up to 5 % raised the degree of lipid oxidation in larval tissues and deformities in cranial endochondral bones and in axial skeletal haemal and neural arches. The increase in dietary α-tocopherol supplementation in high-DHA feeds reduced again the occurrence of skeletal deformities. Moreover, the expression of genes coding for specific antioxidants such as catalase, superoxide dismutase or glutathione peroxidase, which neutralised reactive oxygen substances formed by increased dietary DHA, was significantly decreased in larvae fed high α-tocopherol levels. These results denoted the importance of DHA for early bone formation and mineralisation. Low dietary DHA levels delay early mineralisation and increase the risk of cranial and axial skeletal deformities. Excessive DHA levels, without an adequate balance of antioxidant nutrients, increase the production of free radicals damaging cartilaginous structures before bone formation.
The objective of the present work was to study the differences in the fatty acid (FA) composition of raw sheep milk fat under commercial milk production conditions throughout lactation, in two consecutive years. Particular attention was placed on the C18:2cis-9,trans-11 isomer, C18:1trans-11 acid, and unsaturated FA as the feeding regimen of 10 commercial flocks of latxa dairy sheep changed from indoor feeding to part-time grazing conditions (from early spring) as traditionally practiced in the Basque Country (Northern Spain). Farms located at an altitude of between 600 and 700 m, in two different geographical areas with different rainfall were selected. Milk samples were collected monthly from late January (indoor feeding) until mid-, or end of, June (outdoor feeding), during two consecutive years. In spite of some interannual variability (most likely due to large differences in rainfall), the evolution of individual FA throughout lactation was comparable between years, indicating that it was reproducible under commercial milk production conditions. The average concentrations of C18:2cis-9,trans-11 isomer and C18:1trans-11 acid in milk from the commercial flocks increased about 200% during the transition period (end of March or early April until May), from indoor feeding (late January or early February until the end of March) to the outdoor period (early May to mid-June), remaining constant during the outdoor period (27·53 ± 9·32 μmol/g fat and 71·58 ± 20·53 μmol/g fat, respectively). Non-atherogenic FA comprised approximately 50% of all saturated FA at any time during lactation, whereas the milk atherogenicity index decreased significantly during the outdoor period. The Trolox-equivalent antioxidant capacity of the water-soluble milk fraction did not appear to be influenced by feeding management. The FA composition of cheeses made during the second year with milk from the indoor or outdoor periods reflected those of the corresponding milks. A principal components analysis clearly showed that differences in the milk FA composition were primarily due to outdoor grazing, with very little contribution from the geographical zone or the year.
CARMENES (Calar Alto high-Resolution search for M dwarfs with Exo-earths with Near-infrared and optical Echelle Spectrographs) is a next-generation instrument under construction for the 3.5 m telescope at the Calar Alto Observatory by a consortium of eleven Spanish and German institutions. The scientific goal of the project is a five-year exoplanet survey targeting 300 M stars with the completed instrument. The CARMENES hardware consists of two separate échelle spectrographs covering the wavelength range from 0.55 to 1.7 μm at a spectral resolution of R = 82,000, fed by fibers from the Cassegrain focus of the telescope. Both spectrographs are housed in a temperature-stabilized environment in vacuum tanks, to enable a long-term radial velocity precision of 1 m s−1 employing a simultaneous calibration with Th-Ne and U-Ne emission line lamps.