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Increased fruit and vegetable (FV) intake is associated with reduced blood pressure. However, it is not clear whether the effect of FV on blood pressure depends on the type of FV consumed. Furthermore, there is limited research regarding the comparative effect of juices or whole FV on blood pressure. Baseline data from a prospective cohort study examined the cross-sectional association between total FV intake, but also specific types of FV and blood pressure in France and Northern Ireland. A total of 10660 men aged 50–59 years were recruited from 1991 to 1994. Blood pressure was measured in a clinic setting, and dietary intake was assessed by food-frequency questionnaire (FFQ). After adjusting for potential confounders, both systolic (SBP) and diastolic blood pressure (DBP) were significantly inversely associated with total fruit, vegetable and fruit juice intake however when results were examined according to the sub-type of fruit or vegetable (citrus fruit, other fruit, fruit juices, cooked vegetables and raw vegetables), only the other fruit and raw vegetable categories were consistently associated with reduced SBP and DBP. In relation to the risk of hypertension based on systolic blood pressure >140 mmHg, the odds ratio for total fruit, vegetable and fruit juice intake (per fourth) was 0.95 (95 % CI 0.91, 1.00), with the same estimates being 0.98 (CI % 0.94, 1.02) for citrus fruit intake (per fourth), 1.02 (CI % 0.98, 1.06) for fruit juice intake (per fourth), 0.93 (CI % 0.89, 0.98) for other fruit intake (per fourth), 1.05 (CI % 0.99, 1.10) for cooked vegetable intake (per fourth) and 0.86 (CI % 0.80, 0.91) for raw vegetable intake (per fourth). Similar results were obtained for DBP. In conclusion, a high overall intake of fruit, vegetables and fruit juice was inversely associated with SBP and DBP and risk of hypertension, but that this association differs by FV sub-type, suggesting that the strength of the association between these FV sub-types and blood pressure might be related to the type consumed, or to processing or cooking-related factors.
Bipolar Affective Disorder is one of the ten most disabling diseases.UK Guidelines recommend that specialist opinion is saught for difficult to treat patients and our aim was to characterize the Bipolar Patients referred to a Specialist Tertiary Centre.
A consecutive sample of thirty patients referred, who met ICD 10 criteria for Bipolar Disorder, were studied. Information was collected from the patient files. Recorded variables included socio-demographic, clinical and treatment characteristics.
20% were male, 80% female. The mean age was 46.2 years old (SD 13.5).The modal age of first episode of mental illness was 18.5 years. High rates of unemployment (76.7%) and family history of mental illness (93.3%) were found. 30% were Bipolar I, 63.3% Bipolar II, and 6.7% Bipolar III. 56.7% met criteria for Rapid Cycling. 83.3% had anxiety features, 73.3% a risk of self- harm and 53.3% psychotic symptoms. Low rates of substance misuse were found.73,3% had a concurrent medical illness. The mean number of psychotrophic medications was 3.23(SD 1.54) and ECT was tried in 23.3% of the patients.
This sample had higher rate of rapid cycling than found in routine bipolar populations. The majority of patients were at a high risk of self-harm, showed features of anxiety, had a positive family history and concurrent medical illnesses which worsened their prognosis and turned them into a “very difficult to treat” group. The characteristics of the sample satisfy the referral policy of the Centre and the current and draft UK Guidelines.
Previous research demonstrates various associations between depression, cardiovascular disease (CVD) incidence and mortality. Differences between studies may occur as a result of different methodologies.
This work investigated the impact of using two different methods to measure depression and two different methods of analysis to establish relationships.
The work investigated the association between depression, CVD incidence (CVDI) and mortality from coronary heart disease (MCHD), smoking related conditions (MSRC), and all causes (MALL), in a major population study using depression measured from a validated scale and a depression measure derived by factor analysis, and analyses based on continuous data and grouped data.
Data from the PRIME Study (N=9,798 men) on depression and ten year CVD incidence and mortality were analysed using Cox proportional hazards models.
Using continuous data, no relationships with CVDI were found, but both measures of depression resulted in the emergence of positive associations between depression and mortality (MCHD, MSRC, MALL). Using grouped data, no associations with CVDI or MCVD were found, and associations between the measure derived from factor analysis and MSRC and MALL were also lost. Positive associations were only found between depression measured using validated items, MSRC and MALL.
These data demonstrate a possible association between depression and mortality but detecting this association is dependent on the methodology used. Different findings based on methodology present clear problems for the determination of relationships. The differences here suggest the preferential use of validated scales and suggest against over-reduction via factor analysis and grouping.
Space Infrared Telescope for Cosmology and Astrophysics (SPICA), the cryogenic infrared space telescope recently pre-selected for a ‘Phase A’ concept study as one of the three remaining candidates for European Space Agency (ESA's) fifth medium class (M5) mission, is foreseen to include a far-infrared polarimetric imager [SPICA-POL, now called B-fields with BOlometers and Polarizers (B-BOP)], which would offer a unique opportunity to resolve major issues in our understanding of the nearby, cold magnetised Universe. This paper presents an overview of the main science drivers for B-BOP, including high dynamic range polarimetric imaging of the cold interstellar medium (ISM) in both our Milky Way and nearby galaxies. Thanks to a cooled telescope, B-BOP will deliver wide-field 100–350
m images of linearly polarised dust emission in Stokes Q and U with a resolution, signal-to-noise ratio, and both intensity and spatial dynamic ranges comparable to those achieved by Herschel images of the cold ISM in total intensity (Stokes I). The B-BOP 200
m images will also have a factor
30 higher resolution than Planck polarisation data. This will make B-BOP a unique tool for characterising the statistical properties of the magnetised ISM and probing the role of magnetic fields in the formation and evolution of the interstellar web of dusty molecular filaments giving birth to most stars in our Galaxy. B-BOP will also be a powerful instrument for studying the magnetism of nearby galaxies and testing Galactic dynamo models, constraining the physics of dust grain alignment, informing the problem of the interaction of cosmic rays with molecular clouds, tracing magnetic fields in the inner layers of protoplanetary disks, and monitoring accretion bursts in embedded protostars.
Childhood maltreatment is one of the strongest predictors of adulthood depression and alterations to circulating levels of inflammatory markers is one putative mechanism mediating risk or resilience.
To determine the effects of childhood maltreatment on circulating levels of 41 inflammatory markers in healthy individuals and those with a major depressive disorder (MDD) diagnosis.
We investigated the association of childhood maltreatment with levels of 41 inflammatory markers in two groups, 164 patients with MDD and 301 controls, using multiplex electrochemiluminescence methods applied to blood serum.
Childhood maltreatment was not associated with altered inflammatory markers in either group after multiple testing correction. Body mass index (BMI) exerted strong effects on interleukin-6 and C-reactive protein levels in those with MDD.
Childhood maltreatment did not exert effects on inflammatory marker levels in either the participants with MDD or the control group in our study. Our results instead highlight the more pertinent influence of BMI.
Declaration of interest
D.A.C. and H.W. work for Eli Lilly Inc. R.N. has received speaker fees from Sunovion, Jansen and Lundbeck. G.B. has received consultancy fees and funding from Eli Lilly. R.H.M.-W. has received consultancy fees or has a financial relationship with AstraZeneca, Bristol-Myers Squibb, Cyberonics, Eli Lilly, Ferrer, Janssen-Cilag, Lundbeck, MyTomorrows, Otsuka, Pfizer, Pulse, Roche, Servier, SPIMACO and Sunovian. I.M.A. has received consultancy fees or has a financial relationship with Alkermes, Lundbeck, Lundbeck/Otsuka, and Servier. S.W. has sat on an advisory board for Sunovion, Allergan and has received speaker fees from Astra Zeneca. A.H.Y. has received honoraria for speaking from Astra Zeneca, Lundbeck, Eli Lilly, Sunovion; honoraria for consulting from Allergan, Livanova and Lundbeck, Sunovion, Janssen; and research grant support from Janssen. A.J.C. has received honoraria for speaking from Astra Zeneca, honoraria for consulting with Allergan, Livanova and Lundbeck and research grant support from Lundbeck.
Late-life depression (LLD) is associated with a decline in physical activity. Typically this is assessed by self-report questionnaires and, more recently, with actigraphy. We sought to explore the utility of a bespoke activity monitor to characterize activity profiles in LLD more precisely.
The activity monitor was worn for 7 days by 29 adults with LLD and 30 healthy controls. Subjects underwent neuropsychological assessment and quality of life (QoL) (36-item Short-Form Health Survey) and activities of daily living (ADL) scales (Instrumental Activities of Daily Living Scale) were administered.
Physical activity was significantly reduced in LLD compared with controls (t = 3.63, p < 0.001), primarily in the morning. LLD subjects showed slower fine motor movements (t = 3.49, p < 0.001). In LLD patients, activity reductions were related to reduced ADL (r = 0.61, p < 0.001), lower QoL (r = 0.65, p < 0.001), associative learning (r = 0.40, p = 0.036), and higher Montgomery–Åsberg Depression Rating Scale score (r = −0.37, p < 0.05).
Patients with LLD had a significant reduction in general physical activity compared with healthy controls. Assessment of specific activity parameters further revealed the correlates of impairments associated with LLD. Our study suggests that novel wearable technology has the potential to provide an objective way of monitoring real-world function.
Hippocampal volume reductions in major depression have been frequently reported. However, evidence for functional abnormalities in the same region in depression has been less clear. We investigated hippocampal function in depression using functional magnetic resonance imaging (fMRI) and neuropsychological tasks tapping spatial memory function, with complementing measures of hippocampal volume and resting blood flow to aid interpretation.
A total of 20 patients with major depressive disorder (MDD) and a matched group of 20 healthy individuals participated. Participants underwent multimodal magnetic resonance imaging (MRI): fMRI during a spatial memory task, and structural MRI and resting blood flow measurements of the hippocampal region using arterial spin labelling. An offline battery of neuropsychological tests, including several measures of spatial memory, was also completed.
The fMRI analysis showed significant group differences in bilateral anterior regions of the hippocampus. While control participants showed task-dependent differences in blood oxygen level-dependent (BOLD) signal, depressed patients did not. No group differences were detected with regard to hippocampal volume or resting blood flow. Patients showed reduced performance in several offline neuropsychological measures. All group differences were independent of differences in hippocampal volume and hippocampal blood flow.
Functional abnormalities of the hippocampus can be observed in patients with MDD even when the volume and resting perfusion in the same region appear normal. This suggests that changes in hippocampal function can be observed independently of structural abnormalities of the hippocampus in depression.
Previous studies of facial emotion processing in bipolar disorder (BD) have reported conflicting findings. In independently conducted studies, we investigate facial emotion labeling in euthymic and depressed BD patients using tasks with static and dynamically morphed images of different emotions displayed at different intensities. Study 1 included 38 euthymic BD patients and 28 controls. Participants completed two tasks: labeling of static images of basic facial emotions (anger, disgust, fear, happy, sad) shown at different expression intensities; the Eyes Test (Baron-Cohen, Wheelwright, Hill, Raste, & Plumb, 2001), which involves recognition of complex emotions using only the eye region of the face. Study 2 included 53 depressed BD patients and 47 controls. Participants completed two tasks: labeling of “dynamic” facial expressions of the same five basic emotions; the Emotional Hexagon test (Young, Perret, Calder, Sprengelmeyer, & Ekman, 2002). There were no significant group differences on any measures of emotion perception/labeling, compared to controls. A significant group by intensity interaction was observed in both emotion labeling tasks (euthymia and depression), although this effect did not survive the addition of measures of executive function/psychomotor speed as covariates. Only 2.6–15.8% of euthymic patients and 7.8–13.7% of depressed patients scored below the 10th percentile of the controls for total emotion recognition accuracy. There was no evidence of specific deficits in facial emotion labeling in euthymic or depressed BD patients. Methodological variations—including mood state, sample size, and the cognitive demands of the tasks—may contribute significantly to the variability in findings between studies. (JINS, 2015, 21, 709–721)
Attentional impairment is a core cognitive feature of major depressive disorder (MDD) and bipolar disorder (BD). However, little is known of the characteristics of response time (RT) distributions from attentional tasks. This is crucial to furthering our understanding of the profile and extent of cognitive intra-individual variability (IIV) in mood disorders.
A computerized sustained attention task was administered to 138 healthy controls and 158 patients with a mood disorder: 86 euthymic BD, 33 depressed BD and 39 medication-free MDD patients. Measures of IIV, including individual standard deviation (iSD) and coefficient of variation (CoV), were derived for each participant. Ex-Gaussian (and Vincentile) analyses were used to characterize the RT distributions into three components: mu and sigma (mean and standard deviation of the Gaussian portion of the distribution) and tau (the ‘slow tail’ of the distribution).
Compared with healthy controls, iSD was increased significantly in all patient samples. Due to minimal changes in average RT, CoV was only increased significantly in BD depressed patients. Ex-Gaussian modelling indicated a significant increase in tau in euthymic BD [Cohen's d = 0.39, 95% confidence interval (CI) 0.09–0.69, p = 0.011], and both sigma (d = 0.57, 95% CI 0.07–1.05, p = 0.025) and tau (d = 1.14, 95% CI 0.60–1.64, p < 0.0001) in depressed BD. The mu parameter did not differ from controls.
Increased cognitive variability may be a core feature of mood disorders. This is the first demonstration of differences in attentional RT distribution parameters between MDD and BD, and BD depression and euthymia. These data highlight the utility of applying measures of IIV to characterize neurocognitive variability and the great potential for future application.
Fresh water is vital for the function of all terrestrial ecosystems – the flora and the fauna that make up those ecosystems, and, of course, for humans. Humanity relies on water not just for drinking, but also for food production, dealing with waste, providing energy and transport, to name but a few. To meet its needs humanity harnesses water through dams, irrigation networks, and pumps and pipes that supply drinking water and remove wastes. It is estimated that humanity consumes 1000–1700 m3 of the globe's surface and groundwater resources per year; that is between 22% and 150% of the annual global supply of fresh water (Hoekstra & Wiedmann 2014). This proportion is likely to increase as the global human population increases in the next 30 years and the demands for water in developing countries catches up with that of developed countries. According to the Intergovernmental Panel on Climate Change, changes in climate will amplify existing stress on water availability and will exacerbate different forms of water pollution, with impacts on ecosystems, human health, and water system reliability in large parts of the world (Stocker et al. 2013).
For a number of years, academics have tried to understand the linkages between the water system and human needs and the impacts that anthropogenic activities have on the water system itself. In the early days, the scientific approach sat within individual domains (e.g. hydrology for the water cycle (Thompson 1999); ecology for ecological impacts of water pollution (Abel 1996)). Given the complexity of the interactions and the centrality of humans in the water environment, more recently interdisciplinary approaches have come to the fore (e.g. Ferrier & Jenkins 2010; Renaud & Kuenzer 2014). The latest of such approaches is what we define in this book as ecosystem services-based approaches. These encompass a range of ways of understanding, assessing, and managing ecosystems at which core is the notion of ecosystem services, understood as the benefits that humans obtain from ecosystems.
This comprehensive volume describes how ecosystem services-based approaches can assist in addressing major global and regional water challenges, such as climate change, biodiversity loss, and water security in the developing world, by integrating scientific knowledge from different disciplines, such as hydrological modelling, environmental economics, psychology and international law. Empirical assessments at the national, catchment and regional levels are used to critically appraise this systemic approach, and the merits and potential limitations are presented. The practicalities of this approach with regard to water resources management, nature conservation, and sustainable business practices are discussed, and the role of society in underpinning the concept of ecosystem services is explored. Presenting new insights and perspectives on how to shape future strategies, this contributory volume is a valuable reference for researchers, academics, students and policy makers, in environmental studies, hydrology, water resource management, ecology, environmental law, policy and economics, and conservation biology.
Understanding water ecosystem services requires both an elucidation of the interrelationships between hydrology, landscapes and ecology, and a contextualization of how water influences human livelihoods and wellbeing and how ecosystems themselves are affected by human activities. Ecosystem services-based approaches, as defined in this book, aim to understand these complex relationships to support more efficient and sustainable decision-making. Society needs to recognize the requirement to balance and manage the benefits derived from water resources, rather than simply managing the resource itself (United Nations Environmental Programme 2009). These benefits come from the realization of a whole range of provisioning, regulating, and cultural services provided by ecosystems. This way of interpreting water systems and water resources represents a change from traditional sectoral control policies and approaches to delivering an integrated view of natural resource management.
In this book the editors and authors took up the challenge, ten years after the publication of the Millennium Ecosystem Assessment (2005), of reflecting on what has been achieved, what lessons have been learnt, and how to improve the application of ecosystem services-based approaches for managing water ecosystems in the future. By proposing a structured definition of ecosystem services-based approaches (in Martin-Ortega et al.) and exploring the forefront of their application at the conceptual level and through a series of national and regional case studies from across the world, the authors have completed a comprehensive vision of the current knowledge and challenges of applying ecosystem services-based approaches to address water challenges.
In this concluding chapter we reflect upon the key messages that have emerged from the discussions contained in this book and on the way forward. We organize this discussion around the four parts in which the book is structured.
20.1 HOW CAN ECOSYSTEM SERVICESBASED APPROACHES HELP ADDRESS MAJOR GLOBAL CHALLENGES?
Capon et al., Febria et al., and Salman and Martinez explore how ecosystem services-based approaches have been, and can be, applied to address three of the critical global challenges that humanity currently face, namely climate change, biodiversity loss, and meeting the growing population's food and energy demands (notably in the developing world).