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To examine the cross-sectional and longitudinal (2-year follow-up) associations between dietary diversity (DD) and depressive symptoms.
Design:
An energy-adjusted dietary diversity score (DDS) was assessed using a validated FFQ and was categorised into quartiles (Q). The variety in each food group was classified into four categories of diversity (C). Depressive symptoms were assessed with Beck Depression Inventory-II (Beck II) questionnaire and depression cases defined as physician-diagnosed or Beck II >= 18. Linear and logistic regression models were used.
Setting:
Spanish older adults with metabolic syndrome (MetS).
Participants:
A total of 6625 adults aged 55–75 years from the PREDIMED-Plus study with overweight or obesity and MetS.
Results:
Total DDS was inversely and statistically significantly associated with depression in the cross-sectional analysis conducted; OR Q4 v. Q1 = 0·76 (95 % CI (0·64, 0·90)). This was driven by high diversity compared to low diversity (C3 v. C1) of vegetables (OR = 0·75, 95 % CI (0·57, 0·93)), cereals (OR = 0·72 (95 % CI (0·56, 0·94)) and proteins (OR = 0·27, 95 % CI (0·11, 0·62)). In the longitudinal analysis, there was no significant association between the baseline DDS and changes in depressive symptoms after 2 years of follow-up, except for DD in vegetables C4 v. C1 = (β = 0·70, 95 % CI (0·05, 1·35)).
Conclusions:
According to our results, DD is inversely associated with depressive symptoms, but eating more diverse does not seem to reduce the risk of future depression. Additional longitudinal studies (with longer follow-up) are needed to confirm these findings.
Paramos are high-elevation tropical Andean ecosystems above the tree line that display variable temperature and frequent freezing spells. Because a significant anuran community lives in this environment, physiological protection against freezing must characterise individuals in this community. Antifreeze protection has been studied in amphibians from other communities, and it is likely that Paramo anurans rely on the same underlying molecules that convey such protection to Nearctic species. However, given the pervasive presence of freezing spells in the Paramos year-round, the processes of activating protection mechanisms may differ from that of seasonal counterparts. Accordingly, this study investigated cryoprotection strategies in high-elevation tropical frogs, using as a model the terrestrial and nocturnal genus Pristimantis, specifically P. bogotensis, P. elegans and P. nervicus from Paramos, and the warm ecosystem counterparts P. insignitus, P. megalops and P. sanctaemartae. We focused on freeze tolerance and its relationship with glucose accumulation and ice formation. Under field conditions, the highest elevation P. nervicus exhibited higher glucose concentration at dawn compared to noon (1.7 ± 0.6 mmol/L versus 3.5 ± 1.32 mmol/L). Under experimental thermal freeze exposure for 2 hours between −2 and −4 ºC, the glucose concentration of the three Paramo species increased but physiological diversity was evident (P. nervicus 126%; P. bogotensis 100%; and P. elegans 55%). During this test, body ice formation was assessed calorimetrically. The species with the highest body ice formation was P. bogotensis (17% ± 5.37; maximum value: 63%; n = 8), followed by P. nervicus (5% ± 3.27; maximum value: 11%; n = 5) and P. elegans (0.34% ± 0.09; maximum value: 1%; n = 4). The study shows physiological diversity both within a genus and across the amphibian community around the freezing contour. Overall, Paramo species differ in freezing physiology from their low-elevation counterparts. Thus, climate shifts increasing freezing spells may affect the structure of communities in this zone.
Human resource (HR) flexibility emerges as the most critical source of flexibility for professional services firms (PSFs), given that the success of these companies depends on the knowledge, expertise and behaviors of their employees. Nonetheless, few empirical studies have analyzed the extent to which the characteristics of the workforce explain the results of this type of firm. This study attempts to advance in this line of research by analyzing the influence of HR resource flexibility dimensions (skill flexibility – SF and behavior flexibility – BF) on PSF performance. It also examines whether HR coordination flexibility (CF) strengthens the effect of SF and BF on performance. Matched data from 97 general managers and 291 professionals in a sample of Spanish PSFs is used to test the hypotheses through structural equation modeling methodology. The study demonstrates that employee BF has a significant effect on the development of new services in PSFs. The moderation model shows that HR CF increases the influence of BF on the development of new services. Contrary to what was expected, no significant relationship between SF and PSF performance was found.
Pulses such as peas, beans or lentils are one of the most complete foods at the nutritional level; however, they are one of the most often neglected foods in the diets of university students. Entrance to university translates into a major lifestyle change for many young people, and the habits acquired or cemented at this time will remain into adulthood. The objective of this study is to analyse the association between personal/sociodemographic factors, dietary intake of other food groups and the consumption of pulses in first-year university students. This cross-sectional study is part of the UniHcos project, a multicentre study of multipurpose prospective cohorts in eleven Spanish universities. Data from 9862 university students were collected through an online self-questionnaire completed by all students who met the selection criteria and agreed to participate in the project during the 2011–2018 academic years. Of students, 75·8 % presented an inadequate (≤2 times/week) consumption of pulses. Living outside the family home in either a student residence (OR 0·76; 95 % CI 0·69, 0·84) or rental (OR 0·81; 95 % CI 0·70, 0·95) decreased the compliance with recommendations on the consumption of pulses. Low consumption of pulses is seemingly not restricted to a specific profile or dietary pattern among university students, and no specific focus group for intervention can be identified. Policies promoting the consumption of pulses among the university population as a whole are necessary to increase compliance rates with the dietary recommendations.
To evaluate the safety and tolerability of olanzapine in the treatment of elderly patients with schizophrenia.
Methods
A total of 135 outpatients with schizophrenia ≥60 years of age were treated with olanzapine (n = 105) or another antipsychotic (n = 30) and followed up for 6 months. Safety measures included the recording of spontaneous adverse events and extrapyramidal symptoms (EPS). Clinical status and effectiveness of the medications were measured using the Clinical Global Impressions-Severity of Illness and the Global Assessment of Function (GAF) scales. Quality of life was assessed by means of the Spanish version of the EuroQol. The Awad scale was applied to evaluate patients’ subjective attitude towards medication.
Results
The incidence of overall adverse events and EPS was non-significantly lower in patients treated with olanzapine than in patients treated with other antipsychotics. The use of anticholinergic drugs was significantly lower (P = 0.04) in patients treated with olanzapine. Both groups of patients experienced similar improvements in Clinical Global Impressions-Severity and GAF scores. Non-significantly greater improvement in the acceptance of medication occurred at endpoint in olanzapine-treated patients than in control patients as measured by the Awad scale. The improvement in the EuroQol quality of life scale achieved at the end of study did not differ between both treatment groups.
Conclusions
Results from this naturalistic study showed that olanzapine was as safe and effective as other antipsychotic drugs in the treatment of elderly patients with schizophrenia.
Este libro reúne un número significativo de artículos suponen una aportación ciertamente notable a la bibliografía disponible hasta la fecha. Juan de Mena: de letrado a poeta recoge dieciséis trabajos en los que se estudia su figura y su obra desde perspectivas distintas pero complementarias que abren nuevas líneas de investigación o bien enriquecen otras ya existentes. El libro está estructurado en tres grandes bloques temáticos: El primero de ellos se dedica al contexto histórico de Juan de Mena. El segundo bloque gira en torno a la configuración del poeta, atendiendo a la conciencia autorial de Mena y a los recursos literarios que emplea. El tercer y último bloque está dedicado a la transformación del 'famosíssimo poeta Juan de Mena' en un clásico. Cristina Moya García es profesora en la Universidad de Córdoba. This book contains several studies reviewing the two facets of Juan de Mena's life as lawyer and poet. These contributions open up new lines of research on this important early-fifteenth-century Castilian writer and enrich some existing ones, studying Juan de Mena from different perspectives. The book is structured into three thematic blocks: The first is devoted to the historical context of Juan de Mena. The second section focuses on the configuration of the poet. The third and final part is dedicated to the transformation of "famosíssimo poeta Juan de Mena" into a classic author. Cristina Moya García is a profesor at the Universidad de Córdoba.Contributors: Federica Accorsi, Carlos Alvar, Linde M. Brocato, Daniel Capra, Juan Luis Carriazo Rubio, Antonio Cortijo, Sila Gómez Álvarez, Ángel Gómez Moreno, Daniel Hartnett, Julián Jiménez Heffernan, Maxim Kerkhof, Françoise Maurizi, Cristina Moya García, Francisco de Paula Cañas Gálvez, Pedro Ruiz Pérez.
Atypical antipsychotics are widely used in bipolar mania. However, the
efficacy of atypical antipsychotics in bipolar depression has not been
comprehensively explored.
Aims
To evaluate olanzapine monotherapy in patients with bipolar
depression.
Method
Patients with bipolar depression received olanzapine (5–20mg/day,
n = 343) or placebo (n = l71) for 6
weeks. The primary outcome was change from baseline to end-point in
Montgomery-Åsberg Depression Rating Scale (MADRS) total score. Secondary
outcomes included: Clinical Global impression - Bipolar Version (CGI-BP)
scale, 17-item Hamilton Rating Scale for Depression (HRSD-17) and Young
Mania Rating Scale (YMRS) scores, and the rate of response (≥50%
reduction in MADRS at end-point), recovery (MADRS ≤12 for ≥4 weeks plus
treatment completion) and remission (MADRS ≤8). The trial was registered
with ClinicalTrials.gov (NCT00510146).
Results
Olanzapine demonstrated: significantly greater
(P<0.04) improvements on MADRS (least-squares mean
change -13.82 v. -11.67), HRSD-17 and YMRS total scores
and all CGI-BP subscale scores v. placebo; significantly
(P≤0.05) more response and remission, but not
recovery; significantly (P<0.01) greater mean
increases in weight, fasting cholesterol and triglycerides; and
significantly more (P<0.001) patients gained ≥7% body
weight.
Conclusions
Olanzapine monotherapy appears to be efficacious in bipolar depression.
Additional long-term studies are warranted to confirm these results.
Safety findings were consistent with the known safety profile of
olanzapine.
To evaluate the effectiveness of a multimodal intervention in primary care health professionals for improved compliance with hand hygiene practice, based on the World Health Organization's 5 Moments for Health Hygiene.
Design.
Cluster randomized trial, parallel 2-group study (intervention and control).
Setting.
Primary healthcare centers in Madrid, Spain.
Participants.
Eleven healthcare centers with 198 healthcare workers (general practitioners, nurses, pediatricians, auxiliary nurses, midwives, odontostomatologists, and dental hygienists).
Methods.
The multimodal hand hygiene improvement strategy consisted of training of healthcare workers by teaching sessions, implementation of hydroalcoholic solutions, and installation of reminder posters. The hand hygiene compliance level was evaluated by observation during regular care activities in the office visit setting, at the baseline moment, and 6 months after the intervention, all by a single external observer.
Results.
The overall baseline compliance level was 8.1% (95% confidence interval [CI], 6.2-10.1), and the healthcare workers of the intervention group increased their hand hygiene compliance level by 21.6% (95% CI, 13.83-28.48) compared with the control group.
Conclusions.
This study has demonstrated that hand hygiene compliance in primary healthcare workers can be improved with a multimodal hand hygiene improvement strategy.
New biomedical technologies enable the diagnosis of brain tumours by using non-invasive methods. HealthAgents is a European Union-funded research project that aims to build an agent-based distributed decision support system (dDSS) for the diagnosis of brain tumours. This is achieved using the latest biomedical knowledge, information and communication technologies and pattern recognition (PR) techniques. As part of the PR development of HealthAgents, an independent and automatic classification framework (CF) has been developed. This framework has been integrated with the HealthAgents dDSS using the HealthAgents agent platform. The system offers (1) the functionality to search for distributed classifiers to solve specific questions; (2) automatic classification of new cases; (3) instant deployment of new validated classifiers; and (4) the ability to rank a set of classifiers according to their performance and suitability for the case in hand. The CF enables both the deployment of new classifiers using the provided Extensible Markup Language1 classifier specification, and the inclusion of new PR techniques that make the system extensible. These features may enable the rapid integration of PR laboratory results into industrial or research applications, such as the HealthAgents dDSS. Two classification nodes have been deployed and they currently offer classification services by means of dedicated servers connected to the HealthAgents agent platform: one node being located at the Katholieke Universiteit Leuven, Belgium and the other at the Universidad Politécnica de Valencia, Spain. These classification nodes share the current set of brain tumour classifiers that have been trained from in vivo magnetic resonance spectroscopy data. The combination of the CF with a distributed agent system constitutes the basis of the brain tumour dDSS developed in HealthAgents.