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The medical burden in mood disorders is high; various factors are thought to drive this pattern. Little research has examined the role of childhood maltreatment and its effects on medical morbidity in adulthood among people with unipolar depression and bipolar disorder.
This is the first study to explore the association between childhood maltreatment and medical morbidity in bipolar disorder and in unipolar depression, and examine whether the impact of abuse and neglect are distinct or combined.
The participants consisted of 354 psychiatrically healthy controls, 248 participants with recurrent unipolar depression and 72 with bipolar disorder. Participants completed the Childhood Trauma Questionnaire and received a validated medical history interview.
Any type of childhood maltreatment, child abuse and child neglect were significantly associated with the medical burden in bipolar disorder, but not unipolar depression or for controls. These associations worked in a dose–response fashion where participants with bipolar disorder with a history of two or more types of childhood maltreatment had the highest odds of having a medical illness relative to those without such history or those who reported one form. No such significant dose–response patterns were detected for participants with unipolar depression or controls.
These findings suggest that childhood maltreatment may play a stronger role in the development of medical illnesses in individuals with bipolar disorder relative to those with unipolar depression. Individuals who had been maltreated with a mood disorder, especially bipolar disorder may benefit most from prevention and intervention efforts surrounding physical health.
The role of vegetable and fruit intake in reducing falls risk in elderly populations is uncertain. This study examined the associations of vegetable and fruit intake with falls-related hospitalisations in a prospective cohort study of elderly women (n 1429, ≥70 years), including effects on muscular function, which represented a potential causal pathway. Muscular function, measured using grip strength and timed-up-and-go (TUG), and vegetable and fruit intake, quantified using a validated FFQ, were assessed at baseline (1998). Incident falls-related hospitalisation over 14·5-year follow-up was captured by the Hospital Morbidity Data Collection, linked via the Western Australian Data Linkage System. Falls-related hospitalisation occurred in 568 (39·7 %) of women. In multivariable-adjusted models, falls-related hospitalisations were lower in participants consuming more vegetables (hazard ratio (HR) per 75 g serve: 0·90 (95 % CI 0·82, 0·99)), but not fruit intake (per 150 g serve: 1·03 (95 % CI 0·93, 1·14)). Only total cruciferous vegetable intake was inversely associated with falls-related hospitalisation (HR: per 20 g serve: 0·90 (95 % CI 0·83, 0·97)). Higher total vegetable intake was associated with lower odds for poor grip strength (OR: 0·87 (95 % CI 0·77, 0·97)) and slow TUG (OR: 0·88 (95 % CI 0·78, 0·99)). Including grip strength and TUG in the multivariable-adjusted model attenuated the association between total vegetable intake and falls-related hospitalisations. In conclusion, elderly women with higher total and cruciferous vegetable intake had lower injurious falls risk, which may be explained in a large part by better physical function. Falls reduction may be considered an additional benefit of higher vegetable intake in older women.
The newborn lamb lacks circulating antibodies and relies on an early and adequate intake of colostrum for passive protection against disease and for energy (Black, Francis and Nicholls, 1985; Mellor, 1990). However, lambs may receive less colostrum than they require because of sibling competition, maternal undernutrition or udder disease. Colostrum insufficiency accounts for about 25% of perinatal lamb deaths world wide (Khalaf, Doxey and Baxter, 1979).
Powdered colostrum substitutes may be used to supplement ‘at risk’ lambs but, because the products are manufactured outside the United Kingdom (UK), mainly from bovine sources, their relevance to UK sheep enterprises is uncertain. Further, their available energy content is low because the main constituent, protein, is not catabolized by newborn lambs (Mellor and Cockburn, 1986). The present work measured the ability of one substitute derived from bovine whey (based on ProLAM, Fisons Animal Health Ltd), with or without supplementary glucose; to prevent disease and promote growth to 3 months in lambs reared in typical UK farm conditions.
Rumen protected fats are often included in dairy cow rations in order to increase the energy density of the ration without compromising rumen function. Various studies have examined the effects of protected fats, with some studies reporting an improvement in various fertility parameters (McNamara et al., 2003). This study examined the effect of feeding protected fat (Megalac™) on production parameters, and on the reproductive performance of high-yielding Holstein-Friesian dairy cattle.
High flavonoid consumption can improve vascular health. Exploring flavonoid–metabolome relationships in population-based settings is challenging, as: (i) there are numerous confounders of the flavonoid–metabolome relationship; and (ii) the set of dependent metabolite variables are inter-related, highly variable and multidimensional. The Metabolite Fingerprint Score has been developed as a means of approaching such data. This study aims to compare its performance with that of more traditional methods, in identifying the metabolomic fingerprint of high and low flavonoid consumers. This study did not aim to identify biomarkers of intake, but rather to explore how systemic metabolism differs in high and low flavonoid consumers. Using liquid chromatography–tandem MS, 174 circulating plasma metabolites were profiled in 584 men and women who had complete flavonoid intake assessment. Participants were randomised to one of two datasets: (a) training dataset, to determine the models for the discrimination variables (n 399); and (b) validation dataset, to test the capacity of the variables to differentiate higher from lower total flavonoid consumers (n 185). The stepwise and full canonical variables did not discriminate in the validation dataset. The Metabolite Fingerprint Score successfully identified a unique pattern of metabolites that discriminated high from low flavonoid consumers in the validation dataset in a multivariate-adjusted setting, and provides insight into the relationship of flavonoids with systemic lipid metabolism. Given increasing use of metabolomics data in dietary association studies, and the difficulty in validating findings using untargeted metabolomics, this paper is of timely importance to the field of nutrition. However, further validation studies are required.
Arterial wall thickening, stimulated by low-grade systemic inflammation, underlies many cardiovascular events. As diet is a significant moderator of systemic inflammation, the dietary inflammatory index (DIITM) has recently been devised to assess the overall inflammatory potential of an individual’s diet. The primary objective of this study was to assess the association of the DII with common carotid artery–intima-media thickness (CCA–IMT) and carotid plaques. To substantiate the clinical importance of these findings we assessed the relationship of DII score with atherosclerotic vascular disease (ASVD)-related mortality, ischaemic cerebrovascular disease (CVA)-related mortality and ischaemic heart disease (IHD)-related mortality more. The study was conducted in Western Australian women aged over 70 years (n 1304). Dietary data derived from a validated FFQ (completed at baseline) were used to calculate a DII score for each individual. In multivariable-adjusted models, DII scores were associated with sub-clinical atherosclerosis: a 1 sd (2·13 units) higher DII score was associated with a 0·013-mm higher mean CCA–IMT (P=0·016) and a 0·016-mm higher maximum CCA–IMT (P=0·008), measured at 36 months. No relationship was seen between DII score and carotid plaque severity. There were 269 deaths during follow-up. High DII scores were positively associated with ASVD-related death (per sd, hazard ratio (HR): 1·36; 95 % CI 1·15, 1·60), CVA-related death (per sd, HR: 1·30; 95 % CI 1·00, 1·69) and IHD-related death (per sd, HR: 1·40; 95 % CI 1·13, 1·75). These results support the hypothesis that a pro-inflammatory diet increases systemic inflammation leading to development and progression of atherosclerosis and eventual ASVD-related death.
Flavonoids are bioactive compounds found in foods such as tea, red wine, fruits and vegetables. Higher intakes of specific flavonoids, and flavonoid-rich foods, have been linked to reduced mortality from specific vascular diseases and cancers. However, the importance of flavonoid-rich foods, and flavonoids, in preventing all-cause mortality remains uncertain. As such, we examined the association of intake of flavonoid-rich foods and flavonoids with subsequent mortality among 93 145 young and middle-aged women in the Nurses’ Health Study II. During 1 838 946 person-years of follow-up, 1808 participants died. When compared with non-consumers, frequent consumers of red wine, tea, peppers, blueberries and strawberries were at reduced risk of all-cause mortality (P<0·05), with the strongest associations observed for red wine and tea; multivariable-adjusted hazard ratios 0·60 (95 % CI 0·49, 0·74) and 0·73 (95 % CI 0·65, 0·83), respectively. Conversely, frequent grapefruit consumers were at increased risk of all-cause mortality, compared with their non-grapefruit consuming counterparts (P<0·05). When compared with those in the lowest consumption quintile, participants in the highest quintile of total-flavonoid intake were at reduced risk of all-cause mortality in the age-adjusted model; 0·81 (95 % CI 0·71, 0·93). However, this association was attenuated following multivariable adjustment; 0·92 (95 % CI 0·80, 1·06). Similar results were observed for consumption of flavan-3-ols, proanthocyanidins and anthocyanins. Flavonols, flavanones and flavones were not associated with all-cause mortality in any model. Despite null associations at the compound level and select foods, higher consumption of red wine, tea, peppers, blueberries and strawberries, was associated with reduced risk of total and cause-specific mortality. These findings support the rationale for making food-based dietary recommendations.
This article argues for the continued merits of research with rural, long-marginalized peoples, including those whose fervent invocations of ethnic difference—such as Maasai—make many scholars and politicians nervous. Their perspectives “from the margins” offer key theoretical and political insights into this complicated place we call “Africa” by challenging grand narratives of modernization, “Africa rising,” and supposedly “universal” ideas of progress and justice. They also defy enduring stereotypes about the passivity and ignorance of rural peoples. I argue, in other words, for the value of both seeing and theorizing Africa from the margins.
The active management of the experience of living with dementia appears to improve quality of life despite the lack of disease modification. However, research to date has been largely of modest scale and explanatory factors for improvements have been under-conceptualised. Thus, although promulgated through national strategies, the evidence base is relatively weak. This paper reports on a nation-wide study of the influence of the National Dementia Strategy for England in relation to Dementia Adviser and Peer Support Network services in 40 demonstration sites. The research aimed to identify ways in which the services contribute to the wellbeing and resilience of people with dementia and care partners. A mixed-methods research design collected data through: activity and outcome monitoring; organisational surveys; in-depth case studies, including qualitative interviews with people with dementia (N = 47) and care partners (N = 54), wellbeing and quality of life measures, and interviews with staff and other stakeholders (N = 82). Three themes are explored: addressing individual and community needs; promoting independence, control and choice; and getting a life back. Services promoted independence, control and choice, and consequently enabled people to re-narrate their lives as purposeful within their communities. Ways in which these are achieved resemble the public health model of lay health advisor and this research adds to the imperative to approach dementia as a key public health concern.
Higher fruit intake is associated with lower risk of all-cause and disease-specific mortality. However, data on individual fruits are limited, and the generalisability of these findings to the elderly remains uncertain. The objective of this study was to examine the association of apple intake with all-cause and disease-specific mortality over 15 years in a cohort of women aged over 70 years. Secondary analyses explored relationships of other fruits with mortality outcomes. Usual fruit intake was assessed in 1456 women using a FFQ. Incidence of all-cause and disease-specific mortality over 15 years was determined through the Western Australian Hospital Morbidity Data system. Cox regression was used to determine the hazard ratios (HR) for mortality. During 15 years of follow-up, 607 (41·7 %) women died from any cause. In the multivariable-adjusted analysis, the HR for all-cause mortality was 0·89 (95 % CI 0·81, 0·97) per sd (53 g/d) increase in apple intake, HR 0·80 (95 % CI 0·65, 0·98) for consumption of 5–100 g/d and HR 0·65 (95 % CI 0·48, 0·89) for consumption of >100 g/d (an apple a day), compared with apple intake of <5 g/d (Pfor trend=0·03). Our analysis also found that higher apple intake was associated with lower risk for cancer mortality, and that higher total fruit and banana intakes were associated lower risk of CVD mortality (P<0·05). Our results support the view that regular apple consumption may contribute to lower risk of mortality.
Purpose: Hemangiopericytoma and Meningioma appear similar on routine diagnostic imaging. Diffusion weighted images (DWI) has been used to characterize different types of tumors. The purpose of this study was to assess whether DWI can be used to differentiate hemangiopericytoma from meningioma on diagnostic imaging. Materials and Methods: In a retrospective study, our tumor database was analyzed for diagnosis of hemangiopericytoma with DWI available at the time of diagnostic imaging. These patients were then matched based on location and size of the tumor in a ratio of 1 hemangiopericytoma vs. 2 matched meningioma. The minimum and mean Apparent Diffusion Coefficient (ADC) was measured in the tumor and the contralateral Normal Appearing White Matter (NAWM) to calculate a normalized ADC (nADC) as the ratio of the two. The two tumors were also subjectively assessed for their heterogeneity. Results: Seven patients with histopathological diagnosis of hemangiopericytoma were matched based on size and location with 14 patients of meningioma. Primary meningioma were significantly homogeneous (p<0.001) in appearance compared to hemangiopericytomas. Hemangiopericytomas had a higher mean ADC compared to that of meningioma (p<0.001). Conclusion: Hemangiopericytoma showed heterogeneity on DWI and significantly higher ADC compared to that of meningiomas in our small study. This needs to be confirmed in a study with a larger sample size.
Purpose: CTA is becoming the frontline modality to reveal aneurysms in patients with SAH. However, in about 20% of SAH patients no aneurysm is found. In these cases, intra-arterial DSA is still performed. Our aim was to evaluate whether negative findings on CTA can reliably exclude aneurysms in patients with acute SAH. Materials and Method: We conducted a retrospective analysis of all DSA performed from August 2010 to July 2014 in patients with various indications. We selected patient who presented with SAH and had a negative CTA. Findings of the CTA were compared with DSA. Results: 857 DSA were performed during the study period. 51(5.95%) patients with SAH and negative findings on CTA who underwent subsequent DSA were identified. Of these, only 3(5.9%) of patients had positive findings on the DSA. One patient had a posterior inferior cerebellar artery aneurysm on the DSA, not seen on CTA due to the incomplete coverage of the head. Second patient’ CTA did not show any evidence of aneurysm. DSA showed suspicious dissection of the right vertebral artery, potentially iatrogenic. The third patient’s DSA showed suspicious tiny protuberance from left ICA, possibly infundibulum. Conclusion: In patients with SAH, negative CTA findings are reliable in ruling out aneurysms in any pattern of SAH on CT.
In a constant effort to capture effectively more of the spectral range from the sun, multi-junction cells are being investigated. In this context, the marriage of thin film and dye-sensitized solar cells (DSC) PV technologies may be able to offer greater efficiency whilst maintaining the benefits of each individual technology. DSC devices offer advantages in the nature of both the metal oxide photo-electrode and dye absorption bands, which can be tuned to vary the optical performance of this part of a tandem device, while CdTe cells absorb the majority of light above their band-gap in only a few microns of thickness. The key challenge is to assess the optical losses with the goal of reaching a net gain in photocurrent and consequently increased conversion efficiency. This study reports on the influence of optical losses from various parts of the stacked tandem structure using UV-VIS spectrometry and EQE measurements. A net gain in photocurrent was achieved from a model developed for the DSC/CdTe mechanically stacked tandem structure.
Epidemiological studies have indicated that dietary flavonoids generally, and flavonols specifically, may contribute to cardiovascular health. Tea consumption, which is often the main dietary source of flavonoids and flavonols, is associated with a reduced risk of cardiovascular outcomes. The primary objective of the present study was to explore the association of the habitual intake of flavonols from tea and non-tea sources with the risk of atherosclerotic vascular disease mortality in a population of elderly women. A total of 1063 women, aged over 75 years, were randomly selected from ambulant Caucasian women living in Perth, Western Australia. Flavonoid consumption was assessed using the US Department of Agriculture Flavonoid, Flavone and Proanthocyanidin databases. Atherosclerotic vascular disease mortality was assessed over 5 years of follow-up through the Western Australian Data Linkage System. During the follow-up, sixty-four women died from atherosclerotic vascular disease. Women in the highest compared with the lowest tertile of flavonol intake had a lower risk of atherosclerotic vascular disease death (OR 0·27, 95 % CI 0·13, 0·59; P≤ 0·01 for trend in multivariate-adjusted models). Similar relationships were observed for flavonol intake derived from both tea (OR 0·38, 95 % CI 0·18, 0·79; P< 0·01) and non-tea (OR 0·41, 95 % CI 0·20, 0·85; P= 0·05) sources. Tea was the main contributor to flavonol intake (65 %), and the intakes of flavonols from tea and non-tea sources were not significantly correlated. In conclusion, increased consumption of flavonols was independently associated with a lower risk of atherosclerotic vascular disease mortality. Both tea and non-tea sources of flavonols were independently associated with this benefit.
The main objectives of our study were to explore reasons for seasonal influenza vaccine acceptance and declination in employees of a large integrated healthcare system and to identify underlying constructs that influence acceptance versus declination. Secondary objectives were to determine whether vaccine acceptance varied by hospital location and to identify facility-level measures that explained variability.
A national health promotion survey of employees was conducted that included items on vaccination in the 2009-2010 influenza season. The survey was administered with two other institutional surveys in a stratified fashion: approximately 40% of participating employees were randomly assigned to complete the health promotion survey.
National single-payer healthcare system with 152 hospitals.
Employees of the healthcare system in 2010 who responded to the survey.
Factor analysis was used to identify underlying constructs that influenced vaccine acceptance versus declination. Mean factor scores were examined in relation to demographic characteristics and occupation. Multilevel logistic regression models were used to determine whether vaccine acceptance varied by location and to identify facility-level measures that explained variability.
Four factors were identified related to vaccine declination and were labeled as (1) “don't care,” (2) “don't want,” (3) “don't believe,” and (4) “don't know.” Significant differences in mean factor scores existed by demographic characteristics and occupation. Vaccine acceptance varied by location, and vaccination rates in the previous year were an important facility-level predictor.
Results should guide interventions that tailor messages on the basis of particular reasons for declination. Occupation-specific and culturally appropriate messaging should be considered. Continued efforts will be taken to better understand how workplace context influences vaccine acceptance.