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Despite the high prevalence of domestic violence and abuse (DVA) among patients with psychiatric conditions, detection rates are low. Limited knowledge and skills on DVA in mental healthcare (MHC) professionals might contribute to poor identification.
To assess the level of, and factors associated with, DVA knowledge and skills among MHC professionals.
A total of 278 professionals in Dutch MHC institutions completed a survey assessing factual knowledge, perceived knowledge, perceived skills and attitudes about DVA.
On average, low scores were reported for perceived skills and knowledge. MHC professionals in primary care scored higher than those working with individuals with severe mental illness (P<0.005). Levels of factual knowledge were higher; levels of attitudes moderate. Previous training was positively associated with skills (odds ratios (OR) = 3.0) and attitudes (OR = 2.7). Years of work was negatively associated with factual knowledge (OR = 0.97). Larger case-loads predicted higher scores on skills (OR = 2.1).
Training is needed, particularly for clinicians working with patients with severe mental illness.
An efficient and robust method to measure vitamin D (25-hydroxy vitamin D3 (25(OH)D3) and 25-hydroxy vitamin D2 in dried blood spots (DBS) has been developed and applied in the pan-European multi-centre, internet-based, personalised nutrition intervention study Food4Me. The method includes calibration with blood containing endogenous 25(OH)D3, spotted as DBS and corrected for haematocrit content. The methodology was validated following international standards. The performance characteristics did not reach those of the current gold standard liquid chromatography-MS/MS in plasma for all parameters, but were found to be very suitable for status-level determination under field conditions. DBS sample quality was very high, and 3778 measurements of 25(OH)D3 were obtained from 1465 participants. The study centre and the season within the study centre were very good predictors of 25(OH)D3 levels (P<0·001 for each case). Seasonal effects were modelled by fitting a sine function with a minimum 25(OH)D3 level on 20 January and a maximum on 21 July. The seasonal amplitude varied from centre to centre. The largest difference between winter and summer levels was found in Germany and the smallest in Poland. The model was cross-validated to determine the consistency of the predictions and the performance of the DBS method. The Pearson’s correlation between the measured values and the predicted values was r 0·65, and the sd of their differences was 21·2 nmol/l. This includes the analytical variation and the biological variation within subjects. Overall, DBS obtained by unsupervised sampling of the participants at home was a viable methodology for obtaining vitamin D status information in a large nutritional study.
Neuroimaging studies have indicated that prenatal alcohol exposure is associated with alterations in the structure of specific brain regions in children. However, the temporal and regional specificity of such changes and their behavioural consequences are less known. Here we explore the integrity of regional white matter microstructure in infants with in utero exposure to alcohol, shortly after birth.
Twenty-eight alcohol-exposed and 28 healthy unexposed infants were imaged using diffusion tensor imaging sequences to evaluate white matter integrity using validated tract-based spatial statistics analysis methods. Second, diffusion values were extracted for group comparisons by regions of interest. Differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity were compared between groups and associations with measures from the Dubowitz neonatal neurobehavioural assessment were examined.
Lower AD values (p<0.05) were observed in alcohol-exposed infants in the right superior longitudinal fasciculus compared with non-exposed infants. Altered FA and MD values in alcohol-exposed neonates in the right inferior cerebellar were associated with abnormal neonatal neurobehaviour.
These exploratory data suggest that prenatal alcohol exposure is associated with reduced white matter microstructural integrity even early in the neonatal period. The association with clinical measures reinforces the likely clinical significance of this finding. The location of the findings is remarkably consistent with previously reported studies of white matter structural deficits in older children with a diagnosis of foetal alcohol spectrum disorders.
If a photovoltaic (PV) technology is assessed today in a technical framework, then efficiency is the most commonly addressed parameter, followed by service lifetime. Cost, as the third parameter of the "magic triangle", is even less often reported. However, if a new technology is prepared to enter a market, other important parameters have to be considered, especially if non-standard PV applications are targeted.
Organic photovoltaic (OPV) is a well known but young PV technology of the so called third generation, which offers unique advantages for integrated products such as building integrated photovoltaics (BIPV). In this contribution we would like to highlight some of the advantages and challenges which are specific to the application of OPV in the field of building integration. Architectural design features of OPV include the ability to adapt semi-transparency, color and shape of the module. Moreover, glass-laminated OPV modules are deemed suitable for BIPV because of their ease of integration, good fire resistance, high energy harvest per nominal watt-peak and long lifetimes.
European computerised decision support systems are currently targeted for large accidental atmospheric contaminant releases from nuclear installations. To make these systems applicable also for malicious dispersion events, such as ‘dirty bomb’ blasts, a series of modifications and extensions are necessary. Also European decision support handbooks need supplementary sections to cover the features of these types of scenarios. An overview is given of the requirements.
Diet plausibly has a role in the aetiology of endometriosis through effects on steroid hormone levels; however, few published studies have examined the diet and endometriosis risk. We evaluated dietary risk factors for endometriosis in a population-based case–control study. Cases were 284 Group Health (GH) enrollees aged 18–49 years with newly diagnosed, surgically confirmed endometriosis between 1996 and 2001. Controls were 660 randomly selected age-matched female GH enrollees without a history of endometriosis. Nutrients and selected food groups were assessed using the Women's Health Initiative FFQ. OR of endometriosis risk associated with dietary exposures were estimated using unconditional logistic regression and adjusted for identified covariates. Increased total fat consumption was associated with decreased endometriosis risk (fourth quartile v. lowest: OR 0·5, 95 % CI 0·2, 1·0, P-trend = 0·12). Increased β-carotene consumption and servings/d of fruit were associated with increased risk (β-carotene third quartile v. lowest: OR 1·7, 95 % CI 1·1, 2·6; fourth quartile v. lowest: OR 1·6, 95 % CI 1·0, 2·5, P-trend 0·16; fruit >2 servings/d v. < 1: OR 1·5, 95 % CI 1·0, 2·3, P-trend = 0·04). We also found a suggestion of decreased endometriosis risk associated with the consumption of dairy products (2 servings/d v. ≤ 1: OR 0·6, >2 servings/d v. ≤ 1: OR 0·7), but this association was not statistically significant for the highest tertile. The present study suggests that specific dietary components may be associated with endometriosis risk.
To compare the type of pathogens isolated from patients with early-onset intensive care unit (ICU)-acquired pneumonia with those isolated from patients with late-onset ICU-acquired pneumonia and to study risk factors for the isolation of pathogens that are potentially resistant to multiple drugs.
Prospective cohort study.
Patients admitted to the ICU of a 677-bed, university-affiliated teaching hospital in Belgium during 1997-2002.
ICU-acquired pneumonia was defined as a case of pneumonia that occurred 2 days or more after admission to the ICU in combination with a positive results of radiologic analysis, clinical signs and symptoms, and a positive culture result. All cases of pneumonia were categorized as either early onset (within 7 days after admission) and late onset (7 days or more after admission), with or without previous antibiotic treatment, and the corresponding pathogens were analyzed. Risk factors for the isolation of pathogens potentially resistant to multiple drugs (ie, Pseudomonas aeruginosa, Serratia marcescens, Enterobacter species, Morganella morganii, methicillin-resistant Stapylococcus aureus, Citrobacter species, Acinetobacter species, Burkholderia species, extended-spectrum β-lactamase–producing pathogens, and Stenotrophomonas maltophilia) were analyzed using logistic regression analysis.
A total of 4,200 patients stayed at the ICU for 2 or more days, 298 of whom developed ICU-acquired pneumonia, for an overall incidence of 13 cases (95% confidence interval [CI], 11-14 cases) per 1,000 ICU-days. Pathogens potentially resistant to multiple drugs were isolated from 52% of patients with early-onset pneumonia. Risk factors for the isolation of these pathogens were greater age and previous receipt of antibiotic prophylaxis (adjusted odds ratio [aOR], 4.6 [95% CI, 1.6-13.0]) or antibiotic therapy (aOR, 8.2 [95% CI, 2.8-23.8]). The length of ICU admission and hospital stay were weaker risk factors for the isolation of these pathogens.
Pathogens potentially resistant to multiple drugs were isolated in 52% of cases of early-onset ICU-acquired pneumonia. Previous antibiotic use (both prophylactic and therapeutic) is the main risk factor for the isolation of these pathogens.
Despite its negative consequences, little is known about the natural
history of depression in the oldest old.
To study the incidence, course and predictors of depression in the
general population of the oldest old.
The Leiden 85-plus Study is a prospective population-based study of 500
people from their 85th to their 89th birthdays. Depressive symptoms were
annually assessed with the 15-item Geriatric Depression Scale, using a
cut-off of 4 points.
During a mean follow-up of 3.9 years, the annual risk for the emergence
of depression was 6.8%. Poor daily functioning and institutionalisation
predicted depression. Among the 77 participants with depression at
baseline (prevalence 15%) the annual remission rate was ony 14%. In more
than half of the participants with a remission of depression, we observed
a relapse of depression during follow-up. No predictors of remission
could be identified.
Among the oldest old, depression is frequent and highly persistent. More
active case-finding and treatment would be potentially rewarding.
This report is a brief summary of some of the major achievements in studies of planets and satellites that have been accomplished during the years 2003–2005. Unlike previous years, we do not attempt to provide a detailed overview of the field but rather choose to highlight aspects which are of particular novelty.
This review evaluates the quality of available administrative data in the Canadian provinces, emphasizing the information needed to create integrated systems. We explicitly compare approaches to quality measurement, indicating where record linkage can and cannot substitute for more expensive record re-abstraction. Forty-nine original studies evaluating Canadian administrative data (registries, hospital abstracts, physician claims, and prescription drugs) are summarized in a structured manner. Registries, hospital abstracts, and physician files appear to be generally of satisfactory quality, though much work remains to be done. Data quality did not vary systematically among provinces. Primary data collection to check place of residence and longitudinal follow-up in provincial registries is needed. Promising initial checks of pharmaceutical data should be expanded. Because record linkage studies were “conservative” in reporting reliability, the reduction of time-consuming record re-abstraction appears feasible in many cases. Finally, expanding the scope of administrative data to study health, as well as health care, seems possible for some chronic conditions. The research potential of the information-rich environments being created highlights the importance of data quality.
Our objective was to maximize Canada thistle control and plant community diversity in a waterfowl production area administered by the U.S. Fish and Wildlife Service. We tested three rates (1.5, 3.0, and 4.5 ai/ha) of glyphosate applied during spring, summer, or fall using two application methods. The lowest rate of glyphosate decreased the Canada thistle density by about 30% relative to the control. Glyphosate applied in the fall decreased Canada thistle density below that of the control more consistently than when applied in spring or summer. Wick application generally resulted in less Canada thistle biomass than did broadcast application. Species richness was generally higher when glyphosate was wick applied, and all rates of this application method increased species richness when compared with the control. We recommend fall wick application of glyphosate at 1.5 kg ai/ha to control Canada thistle near the riparian areas. This application provided optimum Canada thistle control, while maintaining species richness important for waterfowl.
Many countries are currently studying the possibility of mass vaccination against varicella. The objective of this study was to provide a comprehensive picture of the pre-vaccine epidemiology of the varicella zoster virus (VZV) to aid in the design of immunization programs and to adequately measure the impact of vaccination. Population-based data including physician visit claims, sentinel surveillance and hospitalization data from Canada and the United Kingdom were analysed. The key epidemiological characteristics of varicella and zoster (age specific consultation rates, seasonality, force of infection, hospitalization rates and inpatient days) were compared. Results show that the overall epidemiology of varicella and zoster is remarkably similar between the two countries. The major difference being that, contrary to Canada, the epidemiology of varicella seems to be changing in the United Kingdom with an important decrease in the average age at infection that coincides with a significant increase in children attending preschool. Furthermore, differences exist in the seasonality between the United Kingdom and Canada, which seem to be primarily due to the school calendar. These results illustrate that school and preschool contact patterns play an important role in the dynamics of varicella. Finally, our results provide baseline estimates of varicella and zoster incidence and morbidity for VZV vaccine effectiveness and cost-effectiveness studies.
The island of Santa Catarina lies in the Atlantic Forest Domain of southern Brazil, one of the most threatened ecosys
tems on the planet. It holds a wide variety of habitats, ranging from sand dune ‘restingas’ to mature rain forest. We
report, for the first time, a survey of the bird species and their conservation status for the different habitats present on
the island. We recorded 269 bird species of 54 families (25 species were seabirds). More than 50% (140) of the total
number of species were residents or probable residents, 20% (58) were visitors and a relatively high number of species
(61, 23%) had indeterminate residential status. Nearly 15% (35 species) of the 244 landbird species observed were
endemic to the Atlantic Forest. Habitat specificity was recorded for 40% (97 species). We recorded one Endangered
(Solitary Tinamou Tinamus solitarius), one Vulnerable (White-necked Hawk Leucopternis lacernulata), and three
Near-threatened species (Azure Jay Cyanocorax caeruleus, Azure-shouldered Tanager Thraupis cyanoptera, Black-backed
Tanager Tangara peruviana). We also recorded six locally threatened species that we predict will become extinct in
the near future. The future for the birds of the island is uncertain, especially for habitat specialists, due to habitat loss
for resort developments, and a lack of concern by the government and local people.
Lactacystin, a specific inhibitor of proteasomes in eukaryotic cells, did not block parasite entry or the establishment of the
parasitophorous vacuole, but did inhibit parasite growth and daughter cell budding, as well as DNA synthesis. Two other
proteasome inhibitors, MG-132 and proteasome inhibitor 1, also blocked parasite growth and intracellular development.
Adding lactacystin to established, dividing parasites, rapidly blocked parasite growth and daughter cell budding at all
stages in the process. Pre-treating host cells with lactacystin did not block parasite entry or development. Moreover, under
the conditions used, the host cells appeared not to be adversely affected indicating that host cell proteasome activity was
not essential for parasite entry or development. Concomitant with these effects on parasite growth and division were
morphological changes in the parasite including the appearance of whorls of ER-derived membranes presumably related
to the failure to breakdown misfolded proteins. These changes were specific to lactacystin and were not seen in parasites
treated with other protease inhibitors. Although the ER-derived structures resembled autophagic bodies, similar structures
could not be induced by serum starvation nor did the membranous whorls acidify or undergo morphological changes
consistent with autophagosomal maturation. These results highlight the possible role of proteasome activity in Toxoplasma
in intracellular development and the regulation of parasite replication. However, how the dividing parasite recycles its
organelles and the functional relationship between any lysosomal–autophagic pathway and proteasomes in the parasite
Cafestol and kahweol, coffee lipids present in unfiltered coffee brews, potently increase LDL-cholesterol concentration in human subjects. We searched for an animal species in which cafestol similarly increases LDL-cholesterol. Such an animal model could be used subsequently as a model to study the mechanism of action of cafestol and kahweol. Cafestol and kahweol increased serum lipids in African green monkeys (Cercopithecus aethiops), cebus (Cebus apella) and rhesus (Macaca mulatta) monkeys, hamsters, rats and gerbils differently from the increase in human subjects. In African green monkeys, the rise in total cholesterol was less pronounced than that in human subjects. In addition, the increase in total cholesterol was predominantly due to a rise in HDL-cholesterol rather than LDL-cholesterol. Thus, the rise in plasma lipids might illustrate the mechanism in these monkeys rather than the mechanism in human subjects. In other animal species, cafestol and kahweol did not raise cholesterol consistently. The variability in effects on serum lipids could not be explained by the mode of administration or dose of diterpenes, nor by the amount of cholesterol in the diet. In conclusion, we did not find an animal model in which cafestol and kahweol elevate plasma lipoproteins to the same extent as in human subjects. For the time being, therefore, studies on the mechanism of action should be done preferably in human subjects.
We have characterized particulates from a 1993 11.1 Detroit Diesel Series 60 engine with electronic unit injectors operated using fuels with and without methylcyclopentadienyl manganese tricarbonyl (MMT) and overbased calcium sulfonate added. x-ray photoabsorption (XAS) spectroscopy was used to characterize the diesel particulates. Results reveal a mixture of primarily Mn-phosphate with some Mn-oxide, and Ca-sulfate on the surface of the filtered particulates from the diesel engine.
The Hyrkkölä U-Cu mineralization located in south-western Finland is reassessed with reference to the corrosion mechanisms affecting the stability of native copper and the time-scales of corrosion processes. The mineral assemblage native copper – copper sulfide occurs in open fractures at several depth intervals within granite pegmatites (GP). The surfaces of these open fractures have accumulations of uranophane crystals and other unidentified uranyl compounds. The secondary uranium minerals are mainly distributed around copper sulfide grains. Microscopic intergrowths of copper sulfides and uranyl compounds also have been observed. Groundwater samples were collected from the vicinity of the Cu samples. The hydrogeochemical features of these samples indicate that the present conditions are oxidising. The minimum age of U(VI) transport and deposition is about 200 000 years. This age is indicated by 234U/238U and 230Th/234U activity ratios of uranophane. The age of the hexavalent uranium precipitation may be somewhat later than the last influxes and/or demobilisation of sulfur.
The mineral assemblage native copper – copper oxide (cuprite) occurs only at one depth interval within altered granite pegmatite. The fracture surface was coated by smectite. The content of uranium in smectite was 69–75 ppm U. The 234U/238U and 230Th/234U activity ratios of smectite showed that it has been exposed to recent groundwaters (e.g., during the last million years). The pH of the groundwater at this interval was near neutral (6.9). The copper grains present at this fracture surface were as large as 1 mm in diameter and had rims of cuprite of 0.01 to 0.1 mm thick. The smallest grains were totally oxidised.
which differentially accumulates in acidic compartments, was used to identify
such compartments in Toxoplasma gondii tachyzoites at the electron
microscope level. In both
free tachyzoites and dividing intracellular parasites the only sites of
DAMP accumulation were mature and forming
rhoptries. No labelling of other secretory organelles (micronemes and dense
granules), the ER, Golgi or any other
membrane-bounded organelles or anything resembling a lysosomal system was
observed. Labelling of the forming
rhoptries was higher and more homogenous than in mature rhoptries in which
labelling was confined to the expanded ends
of each organelle. The acid pH-dependent accumulation of DAMP in the forming
and mature rhoptries was blocked by
ammonium chloride and monensin, reagents known to abolish intracellular
pH gradients. Estimates of rhoptry pH, based
on the level of DAMP accumulation, show that the intralumenal pH of forming
rhoptries is more acidic (pH 5·5–3·5) than
the mature rhoptries (pH 7·0–5·0).