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Depression is a common and significant health problem. Hearing loss is the third most common chronic physical condition in the USA and might be a factor in depression. To determine whether hearing loss is associated with depressive symptoms in US adults ages 20–69 years.
National Health and Nutrition Examination Survey (NHANES) data (2011–2012) were used to assess the potential relationship between hearing loss and depression, in adults (20–69 years) who answered the Patient Health Questionnaire (PHQ-9) depression screening module, with pure tone audiometry measurements, and complete information on the co-variates data (n = 3316). The degree of speech-frequency hearing loss (SFHL) and high-frequency hearing loss (HFHL) were defined as slight/mild hearing loss ⩾26–40 dB; moderate/worse hearing loss ⩾41 dB by pure tone audiometry examination.
Moderate/worse HFHL was statistically significantly associated with depressive symptoms (OR 1.54, 95% CL 1.04–2.27) when the analyses were conducted among all participants. Further stratification by gender and age groups found that moderate/worse HFHL (OR 3.85, 95% CL 1.39–10.65) and moderate/worse SFHL (OR 5.75, 95% CL 1.46–22.71) were associated with depressive symptoms in women ages 52–69 years.
Moderate/worse speech frequency and HFHL are associated with depression in women ages 52–69 years, independent of other risk factors. Hearing screenings are likely to reduce delays in diagnosis and provide early opportunities for noise prevention counseling and access to hearing aids. Health professionals should be aware of depressive signs and symptoms in patients with hearing loss.
One of Philip Rieff's favourite paintings was Poussin's The Adoration of the Golden Calf, in the National Gallery in London. It shows an angry Moses thundering down the mountain about to dash the stone tablets of the law to pieces in outrage at his fickle people dancing around and worshipping a huge statue of a golden calf. Rieff strongly identified with this Moses, the bearer of the law – the Thou Shalt Nots – sent from God. In Poussin's scene, the people renounce the authority of the Old Testament divinity and turn to the leisurely fun of dancing and feasting, worshipping a pagan pleasure god. Poussin had provided an uncanny parable for Rieff's own working life.
To my mind, the most striking thing about Rieff's work, when one stands back to take stock, is the deadly seriousness with which it takes culture, and the role of the cultural elites, or the clerisy – its custodians. Culture is the housing structure for God, and his later sublimations – a structure without which he could not exist. Rieff stands diametrically opposite to the mainstream of the times, which set about deconstructing culture, turning it from the central bearer of the truths that matter to a mask for power, exploitation and disadvantage. The task of culture for Rieff is to enchant and repress; the task for most of his academic contemporaries was to disenchant and liberate.
Rieff's work is also compelling because of its intellectual virtuosity, its originality, its blend of analytical insight and grander theme, and for the farrago of brilliant aphorisms peppered through it. There are types of intelligence and lucidity that have their own charisma.
There was a teaching virtuosity too. His students – of which I was never one – report the painstaking care with which he would proceed through his chosen texts. In 1980 he delivered a two- hour lecture as the finale to a Sociology of Culture Conference at my university in Melbourne. The title would have surprised no one familiar with his later work: ‘Authority and Culture’. In a darkened room, speaking without notes, he held the audience spellbound, mesmerized by an entirely new experience, even though 90 per cent of the 200 present would have found the content an appalling anathema – if they had understood it – proclaimed in raw- edged violation of almost everything intellectual they held dear.
Objectives: Dysbiosis of the gut microbiome is implicated in numerous human health conditions. Animal studies have linked microbiome disruption to changes in cognitive functioning, although no study has examined this possibility in neurologically healthy older adults. Methods: Participants were 43 community-dwelling older adults (50–85 years) that completed a brief cognitive test battery and provided stool samples for gut microbiome sequencing. Participants performing≥1 SD below normative performance on two or more tests were compared to persons with one or fewer impaired scores. Results: Mann Whitney U tests revealed different distributions of Bacteroidetes (p=.01), Firmicutes (p=.02), Proteobacteria (p=.04), and Verrucomicrobia (p=.003) between Intact and Impaired groups. These phyla were significantly correlated with cognitive test performances, particularly Verrucomicrobia and attention/executive function measures. Conclusions: The current findings suggest that composition of the gut microbiome is associated with cognitive test performance in neurologically healthy older adults. Future studies are needed to confirm these findings and explore possible mechanisms. (JINS, 2017, 23, 700–705)
The collective response of electrons in an ultrathin foil target irradiated by an ultraintense (
) laser pulse is investigated experimentally and via 3D particle-in-cell simulations. It is shown that if the target is sufficiently thin that the laser induces significant radiation pressure, but not thin enough to become relativistically transparent to the laser light, the resulting relativistic electron beam is elliptical, with the major axis of the ellipse directed along the laser polarization axis. When the target thickness is decreased such that it becomes relativistically transparent early in the interaction with the laser pulse, diffraction of the transmitted laser light occurs through a so called ‘relativistic plasma aperture’, inducing structure in the spatial-intensity profile of the beam of energetic electrons. It is shown that the electron beam profile can be modified by variation of the target thickness and degree of ellipticity in the laser polarization.
The president calls attention to the large and increasing membership of Commission 12 and the policy of concentrating in it all matters relating to the sun. The result makes it comparable in breadth of field and in membership to the former Union for Co-operation in Solar Research. The main point in favour of this policy is the increased interest in the meetings of the Commission and the larger number of individuals reached compared with the meetings of small committees. One recalls the general sessions of the Solar Union in which each one present felt himself a part of the Union and in real touch with the work of different sections and after the discussions went away with fuller knowledge of what it was all about. This was a valuable result not attained to the same degree from the general sessions of the present Union, but in a measure it does follow from the meetings of the Solar Physics Committee. On the other hand the question may be raised whether or not the merging of independent commissions into subdivisions of a large commission lessens their interest to an extent not balanced by the advantages. If the present policy holds, it seems to the president that a re-organisation of Commission 12 is advisable by which more responsibility is laid upon the directors of centres. The basis of membership in the Commission may well be considered and recommendations formulated for transmission to the Executive Committee.
In the 1928 report of this Commission, reference was made to differences in the specifications for the production of the red cadmium line adopted by the International Conference of Weights and Measures in 1927 and by the International Astronomical Union in 1925. The difference appears to have arisen mainly from the inadvertent adherence of the International Conference to the text of the provisional recommendation of the Commission on Wave-lengths (Tr. I.A.U. 2, 47) instead of to that finally adopted (p. 232).
Community-based conservation efforts are designed to foster local stewardship of important ecological resources. However, inequitable distribution of costs and benefits in communities surrounding protected areas can negatively impact livelihoods, increase wealth disparities and create conflict. To examine the potential for conflict between host communities involved in a community-based conservation program and neighbouring (non-host) communities, we explored local residents’ attitudes towards conservation at Tiwai Island Wildlife Sanctuary (TIWS) in Sierra Leone. Intercept surveys (n = 368) were conducted in 18 villages (eight host, ten non-host) within 8 km of TIWS during 2010. Results revealed significant differences between residents of the host and non-host villages with respect to attitudes towards resource use and overall support for site protection. The most substantial discrepancies centred on perceived benefits associated with TIWS, and these drastically different perspectives generated a high potential for conflict. To minimize conflict and foster broader community support for conservation, managers must carefully consider how benefits associated with protected areas are communicated and distributed across protected area-proximate landscapes.
Is it possible for Suzy to travel back in time and kill her infant self? Vihvelin (1996) and Vranas (2009) hold that autoinfanticide is logically/metaphysically possible but physically impossible. Horacek (2005) believes that autoinfanticide has a nonzero chance of occurring and so is physically possible, but believes that autoinfanticide is metaphysically impossible. To sort out these issues, I describe six ways to commit autoinfanticide; for all six, there is a case to be made for their physical and metaphysical possibility.
This study examined associations between loneliness, a construct associated with serious adverse mental health outcomes, and positive mental wellbeing. Validated measures of loneliness (represented by friendship-related loneliness, isolation, positive attitude to solitude, and negative attitude to solitude) and positive mental wellbeing were administered to 1,143 adolescents from urban and rural schools. Confirmatory factor analyses revealed satisfactory model fit for both measures. A structural equation model confirmed significant positive associations between positive mental wellbeing and friendship-related loneliness and positive attitude to solitude; a significant negative association was found for isolation. Regression analyses provided support for significant differences in these associations according to gender, age, and geographical location (although only marginally). The implications of these findings during adolescence are reviewed.
Clostridium difficile infection (CDI) in hospitalized patients is generally attributed to the current stay, but recent studies reveal high C. difficile colonization rates on admission.
To determine the rate of colonization with toxigenic C. difficile among intensive care unit patients upon admission as well as acquired during hospitalization, and the risk of subsequent CDI.
Prospective cohort study from April 15 through July 8, 2013. Adults admitted to an intensive care unit within 48 hours of admission to the Johns Hopkins Hospital, Baltimore, Maryland, were screened for colonization with toxigenic C. difficile. The primary outcome was risk of developing CDI.
Among 542 patients, 17 (3.1%) were colonized with toxigenic C. difficile on admission and an additional 3 patients were found to be colonized during hospitalization. Both colonization with toxigenic C. difficile on admission and colonization during hospitalization were associated with an increased risk for development of CDI (relative risk, 10.29 [95% CI, 2.24–47.40], P=.003; and 15.66 [4.01–61.08], P<.001, respectively). Using multivariable analysis, colonization on admission and colonization during hospitalization were independent predictors of CDI (relative risk, 8.62 [95% CI, 1.48–50.25], P=.017; and 10.93 [1.49–80.20], P=.019, respectively), while adjusting for potential confounders.
In intensive care unit patients, colonization with toxigenic C. difficile is an independent risk factor for development of subsequent CDI. Further studies are needed to identify populations with higher toxigenic C. difficile colonization rates possibly benefiting from screening or avoidance of agents known to promote CDI.
Infect. Control Hosp. Epidemiol. 2015;36(11):1324–1329
The pygmy hippopotamus Choeropsis liberiensis is an Endangered species found only in the Upper Guinea rainforests of West Africa. Using a two-phase approach, with initial semi-structured interviews followed by more extensive questionnaires, we examined local residents' awareness of and attitudes towards the pygmy hippopotamus along the Moa River near Tiwai Island Wildlife Sanctuary in Sierra Leone. The interviews and questionnaires addressed human–hippopotamus interactions, local knowledge and awareness of pygmy hippopotamus ecology and behaviour, and public attitudes towards hippopotamus conservation. Overall, 22% of questionnaire respondents acknowledged benefits related to hippopotamus conservation; factors affecting the perception of benefits included age, livestock ownership, distance from Tiwai Island and exposure to conservation programmes. The results of this study could be used to inform the conservation of the pygmy hippopotamus and highlight the critical role of local support in the management of threatened species in biodiversity hotspots.
Interactions of institutions in the financial industry
There are many unique financial institutions in the USA, with each fulfilling a specific role in financial transactions. Information providers, financial intermediaries, buy-side and sell-side firms, commercial banks, Government Sponsored Entities (GSEs), and regulators, all interact with one another to form the complex web that is the financial industry today (see Figure 15.1). Broker-dealers, Investment Banks, Commercial Banks and Asset Managers transact their own and their clients' business in the financial services markets. Custodians, Agents, Exchanges and Depositories perform diverse functions throughout the financial industry.
Maintaining a fluid transactional system requires institutions to communicate with one another using the same or similar data types. Both investors and regulators need to understand the data provided to them in transactions. The best way to accomplish this is through the use of industry-wide standards for data capture and reporting. Unfortunately, this does not exist in most cases; data collection methods are diverse, and processing the sheer amount of data available is difficult – if not impossible – for most individual investors. For example, classes of derivatives are often mislabeled as other instrument types. This throws off the data stream, and makes for bad data collection.
Depression is expensive to treat, but providing ineffective treatment is more expensive. Such is the case for many patients who do not respond to antidepressant medication.
To assess the cost-effectiveness of cognitive–behavioural therapy (CBT) plus usual care for primary care patients with treatment-resistant depression compared with usual care alone.
Economic evaluation at 12 months alongside a randomised controlled trial. Cost-effectiveness assessed using a cost-consequences framework comparing cost to the health and social care provider, patients and society, with a range of outcomes. Cost-utility analysis comparing health and social care costs with quality-adjusted life-years (QALYs).
The mean cost of CBT per participant was £910. The difference in QALY gain between the groups was 0.057, equivalent to 21 days a year of good health. The incremental cost-effectiveness ratio was £14 911 (representing a 74% probability of the intervention being cost-effective at the National Institute of Health and Care Excellence threshold of £20 000 per QALY). Loss of earnings and productivity costs were substantial but there was no evidence of a difference between intervention and control groups.
The addition of CBT to usual care is cost-effective in patients who have not responded to antidepressants. Primary care physicians should therefore be encouraged to refer such individuals for CBT.