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HCWs not fulfilling COVID-19 case definition underwent SARS-CoV-2 screening. Risk of exposure, PPE adherence and symptoms were assessed. Two thousand HCWs were screened: 5.5% were PCR+. There were no differences in PPE use between PCR+ and PCR- HCWs (adherence >90%). Nursing and kitchen staff were independently associated with PCR+.
In his Bellum Ciuile, Caesar reports the events of 1 January 49 with these words (1.3.1):
misso ad uesperum senatu omnes qui sunt eius ordinis a Pompeio euocantur. laudat <promptos> Pompeius atque in posterum confirmat, segniores castigat atque incitat.
When the Senate had been dismissed towards dusk, all who belonged to that order were summoned by Pompeius. He praised the determined and encouraged them for the future while criticizing and stirring up those who were less eager to act.
This meeting has not attracted much scholarly attention and admittedly for a good reason: other circumstances of the outbreak of the Civil War are, perhaps, more significant for understanding the events as well as the intentions and decisions of the political actors. The importance of this gathering lies, however, not so much in what its role might have been in the developments of the year 49 but rather in the context of the phenomenon of the promagistrates’ interference in the domestic politics of Late Republican Rome.
The recently-advancing Taku Glacier is excavating subglacial sediments at high rates over multi-decadal timescales. However, sediment redistribution over shorter timescales remains unquantified. We use a variety of methods to study subglacial and proglacial sediment redistribution on decadal, seasonal, and daily timescales to gain insight into sub- and proglacial landscape formation. Both excavation and deposition were observed from 2003 to 2015 (2.8 ± 0.9 m a−1 to +2.9 ± 0.9 m a−1). The observed patterns imply that a subglacial conduit has occupied the same site over the past decade. Outwash fans on the subaerial end moraine experience fluvial sediment reworking almost year-round, with net sediment gain in winter and net sediment loss in summer, and an overall mass gain between 2005 and 2015. We estimate that tens of meters of sediment still underlie the glacier terminus, sediments which can be remobilized during future activity. However, imminent retreat from the proglacial moraine will limit its sediment supply, leaving the moraine vulnerable to erosion by bordering rivers. Retreat into an over-deepened basin will leave the glacier vulnerable to increased frontal ablation and accelerating retreat.
The coronavirus disease (COVID-19) has seen a violent and fast spread worldwide. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a predominantly respiratory transmission through droplets and aerosol with serious implications for dental settings. This article is based on recent research, guidelines issued by relevant authorities, as well as on the authors’ experience acquired through their involvement in setting up an emergency dental care hub in Cluj-Napoca, Romania during the COVID-19 lockdown. The present article aims to provide a brief description of COVID-19 implications in dental office and to recommend preventive protocols for dental practitioners to ensure a safe and healthful workplace. The recommendations for infection control presented in this article address the specific risks of exposure to SARS-CoV-2. The article provides a special customized guideline covering patient triage and entrance into the dental practice, personnel protection, dental treatment and after-treatment management. The implementation of strict preventive measures has been found to be efficient in the prevention of SARS-CoV-2 contamination since no infections have been reported among our staff or patients. COVID-19 is a major emergency worldwide marked by a rapid evolution, and warranting a need for further assessment of the implications of COVID-19 outbreak in dental practice.
Life events (LEs) are a risk factor for first onset and relapse of psychotic disorders. However, the impact of LEs on specific symptoms – namely reality distortion, disorganization, negative symptoms, depression, and mania – remains unclear. Moreover, the differential effects of negative v. positive LEs are poorly understood.
Methods
The present study utilizes an epidemiologic cohort of patients (N = 428) ascertained at first-admission for psychosis and followed for a decade thereafter. Symptoms were assessed at 6-, 24-, 48-, and 120-month follow-ups.
Results
We examined symptom change within-person and found that negative events in the previous 6 months predicted an increase in reality distortion (β = 0.07), disorganized (β = 0.07), manic (β = 0.08), and depressive symptoms (β = 0.06), and a decrease in negative symptoms (β = −0.08). Conversely, positive LEs predicted fewer reality distortion (β = −0.04), disorganized (β = −0.04), and negative (β = −0.13) symptoms, and were unrelated to mood symptoms. A between-person approach to the same hypotheses confirmed that negative LEs predicted change in all symptoms, while positive LEs predicted change only in negative symptoms. In contrast, symptoms rarely predicted future LEs.
Conclusions
These findings confirm that LEs have an effect on symptoms, and thus contribute to the burden of psychotic disorders. That LEs increase positive symptoms and decrease negative symptoms suggest at least two different mechanisms underlying the relationship between LEs and symptoms. Our findings underscore the need for increased symptom monitoring following negative LEs, as symptoms may worsen during that time.
Embolic ischemic strokes cause significant mortality and morbidity worldwide. It has been proposed that some of these strokes are due to unstable carotid plaques with intraplaque hemorrhage (IPH) but a low overall degree of stenosis. Our aim was to test a fat-saturated T1-weighted (T1WI) black-blood sequence on MRI for the detection of IPH in symptomatic individuals and to quantify the relation between IPH, severity of stenoses, and ischemic brain lesions.
Materials and Methods:
Sixty-two patients were examined by 3T MRI. Sequences included brain diffusion-weighted imaging (DWI) as well as 3D turbo spin echo (TSE) fat-saturated black-blood T1 of the carotid bifurcations, to detect IPH as a focal intraplaque hyperintensity. Both carotid arteries were analyzed in each patient. The North American Symptomatic Carotid Endarterectomy Trial scale was used for quantification of stenosis degree.
Results:
Thirty-six out of 62 patients (mean age, 74) showed brain ischemia on DWI. Fifteen of these 36 patients (42%) had associated ipsilateral IPH at the carotid bifurcation or the proximal internal carotid artery. Mean degree of stenosis in this group was 50%. In 21 patients with ischemia without IPH, the mean degree of stenosis was 44%.
Conclusions:
MRI with 3D TSE fat-saturated black-blood T1 technique is a safe, reliable, and noninvasive tool for the detection of IPH. A high percentage (42%) of ischemic events in patients with low- to moderate-degree stenosis were associated with IPH, an easily detectable imaging biomarker of plaque vulnerability. The ability to confirm IPH by MRI may help stratify patients into different risk and treatment groups in the future.
Saxicolous, lecideoid lichenized fungi have a cosmopolitan distribution but, being mostly cold adapted, are especially abundant in polar and high-mountain regions. To date, little is known of their origin or the extent of their trans-equatorial dispersal. Several mycobiont genera and species are thought to be restricted to either the Northern or the Southern Hemisphere, whereas others are thought to be widely distributed and occur in both hemispheres. However, these assumptions often rely on morphological analyses and lack supporting molecular genetic data. Also unknown is the extent of regional differentiation in the southern polar regions. An extensive set of lecideoid lichens (185 samples) was collected along a latitudinal gradient at the southern end of South America. Subantarctic climate conditions were maintained by increasing the elevation of the collecting sites with decreasing latitude. The investigated specimens were placed in a global context by including Antarctic and cosmopolitan sequences from other studies. For each symbiont three markers were used to identify intraspecific variation (mycobiont: ITS, mtSSU, RPB1; photobiont: ITS, psbJ-L, COX2). For the mycobiont, the saxicolous genera Lecidea, Porpidia, Poeltidea and Lecidella were phylogenetically re-evaluated, along with their photobionts Asterochloris and Trebouxia. For several globally distributed species groups, the results show geographically highly differentiated subclades, classified as operational taxonomical units (OTUs), which were assigned to the different regions of southern South America (sSA). Furthermore, several small endemic and well-supported clades apparently restricted to sSA were detected at the species level for both symbionts.
Ice mélange has been postulated to impact glacier and fjord dynamics through a variety of mechanical and thermodynamic couplings. However, observations of these interactions are very limited. Here, we report on glaciological and oceanographic data that were collected from 2016 to 2017 at LeConte Glacier and Bay, Alaska, and serendipitously captured the formation, flow and break-up of ephemeral ice mélange. Sea ice formed overnight in mid-February. Over the subsequent week, the sea ice and icebergs were compacted by the advancing glacier terminus, after which the ice mélange flowed quasi-statically. The presence of ice mélange coincided with the lowest glacier velocities and frontal ablation rates in our record. In early April, increasing glacier runoff and the formation of a sub-ice-mélange plume began to melt and pull apart the ice mélange. The plume, outgoing tides and large calving events contributed to its break-up, which took place over a week and occurred in pulses. Unlike observations from elsewhere, the loss of ice mélange integrity did not coincide with the onset of seasonal glacier retreat. Our observations provide a challenge to ice mélange models aimed at quantifying the mechanical and thermodynamic couplings between ice mélange, glaciers and fjords.
Lithium has been used in the treatment of pregnant women with bipolar disorder for many decades but information on the effects of its exposure on perinatal variables is scarce.
Objectives:
To determine the effects of in-utero exposure to lithium on neonatal outcomes among infants born to women with treatment with lithium during pregnancy.
Methods:
Prospective and observational study including all consecutive cases of pregnant women with bipolar disorder type I or II (N = 22) and maintenance treatment with lithium monotherapy (n=13) or polytherapy (n=9), attended at the PERINATAL PSYCHIATRY PROGRAM CLÍNIC-BARCELONA between 2005 and 2012. We evaluated sociodemographic data, lithium plasma concentrations in maternal blood and umbilical cord, obstetric and neonatal variables.
Results:
No statistically significant differences were found regarding sociodemographic data between both groups. Rates for umbilical cord:maternal plasma lithium levels were higher in women treated with polytherapy than in women who received lithium alone (1.08 vs. 1.05). Neonates exposed to polytherapy had a higher weight percentile at birth (p70 vs p50) and greater gestational age (39.72 vs. 38.28 weeks), than those exposed to lithium alone. Acute neonatal complications were more frequently observed in infants that were exposed to lithium monotherapy (33.3% vs. 38.50), being all complications transitory and not severe.
Conclusions:
The infants exposed to lithium polytherapy presented a higher weight at birth compared to those who received lithium monotherapy. However, no statistically significant differences were found between treatment groups. Further research is needed to better clarify safety of lithium and its effect on neonatal outcomes.
The implantation of a pacemaker or an implantable cardioverter-defibrillator during childhood may reduce quality of life and lead to mental health problems. This study aimed to evaluate potential mental health problems (i.e., depressive and anxiety symptoms) and quality of life in children with cardiac active devices in comparison to healthy peers.
Methods:
We analysed data of children with pacemakers or implantable cardioverter-defibrillators aged 6–18 years. Quality of life, depressive and anxiety symptoms were assessed by standardised questionnaires. The results were compared to age-matched reference groups.
Results:
Children with implantable cardioverter-defibrillator showed significant lower quality of life in comparison to reference group (p = 0.03), but there was no difference in quality of life between children with pacemaker and reference group. There was no significant difference in depressive symptoms between children with a cardiac rhythm device compared to reference group (self-report: p = 0.67; proxy report: p = 0.49). There was no significant difference in anxiety (p = 0.53) and depressive symptoms (p = 0.86) between children with pacemaker and children with implantable cardioverter-defibrillator.
Conclusions:
Living with an implantable cardioverter-defibrillator in childhood seems to decrease the patients’ quality of life. Although children with pacemaker and implantable cardioverter-defibrillator don’t seem to show more depressive and anxiety symptoms in comparison to their healthy peers, there still can be an increased risk for those children to develop mental health problems. Therefore, treating physicians should be aware of potential mental health problems and provide the patients and their families with appropriate therapeutic offers.
Hikikomori, a form of severe social isolation, once characterized as a Japanese cultural-bond behavior with social and economic consequences, it is now being described in other countries. Its presentation mimics some clinical features of various classified mental diseases, such as prodromal phase of schizophrenia, personality disorders, Internet dependence, social phobia or depression, without fulfilling their defining criteria.
Objectives/method
This work aimed to do a brief review of this subject, describing one case that is probably the first ever reported in Portugal, comparing it with similar cases around the world.
Results
The patient was a 22-year-old male, taken to psychiatry evaluation after 4 years of social withdrawal, avoiding or blocking any contact even with family members, which resulted in work and school impairment. He spent most of his days locked at his room, investing his time in particular interests and Internet use, only leaving to eat or do his basic hygiene. At that time, he presented no affective or psychotic symptoms and perceived his behavior as egosintonic. After six appointments with psychotherapeutic approach, he was able to get a job and improved his communication with the others, especially with family.
Discussion/conclusion
This case fits most of the reports found on literature, in its presentation and clinical management. Hikikomori is not considered yet a disorder and further documentation of these cases is still needed to define its place in psychiatric nosology.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Although psychoactive substance use disorders (PSUD) belong to the domain of mental health, their management varies greatly among European countries. Furthermore, both the role of psychiatrists and trainees in the treatment of PSUD is not the same for each European country.
Aims
Among the context of the European Federation of Psychiatric Trainees (EFPT), the PSUD Working Group has developed a survey that has been spread out between the 15th of august 2015 and 15th of October 2016, at the aim of gathering information about the training in PSUD in Europe, both from Child and Adolescent, and General Adult Psychiatric (CAP and GAP) trainees.
Objectives
The survey investigated, at European level, the organisation of the PSUD training, trainees satisfaction, attitudes towards people who use psychoactive substances, management of pharmacologic and involvement in common clinical situations.
Methods
A 70-items questionnaire regarding the aforementioned objectives was developed, and shared trough an online data-collecting system among European CAP and GAP trainees, with 40 trainees per country filling the survey in at least 25 countries. One national coordinator per country facilitated the delivering of the survey.
Results
A total of 1250 surveys were filled from more than 25 European countries.
Conclusions
Data from the survey will be promptly analysed.
The survey will be the first to explore European psychiatric trainees attitudes and practices about PSUD. Findings from this independent survey may serve in understanding the needs of trainees in the field of substance misuse psychiatry.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The term contrail is a contraction of condensation and trail, as chemtrail is of chemical and trail. The first one is used to name trails left in the sky by aircrafts under certain atmospheric conditions. Some people argue that when contrails do not dissipate quickly is because contain substances added and sprayed for sinister purposes undisclosed to the population (weather modification and biological and/or chemical war are the most common).
Objective
Exist various versions of the chemtrail theory, most of them propagated via the internet in discussions forums or websites, and to a lesser degree by the mass media such as TV and radio programs. The outspread popularity and diffusion of the theory has already become a reality. Scientific community has repeatedly rejected that chemtrails exist, insisting that are just contrails. We analyze this phenomenon.
Methods
We made a exhaustive literature review in Journals of Meteorology and Aviation, about the formation of condensation trails, in Social Pychology Journals about the genesis and dissemination of the chemtrails theory. Finally, we will make a brief presentation of documentation built around the theory of chemtrails in the province of Zamora (Spain), where is one of the most active spots in southern Europe.
Conclusions
official statements on the non-existence of chemtrails have not discouraged the proponents of the theory of chemtrails.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The European Federation of Psychiatric Trainees (EFPT) is an independent Federation of Psychiatric Trainees and represents the consensus of psychiatric trainee's organizations across European countries and advocates for what training should look like, regardless of the country. Spain was one of the last countries to be part of the Association. Finally, and after months of hard work and networking, on September 2015 the Spanish Society of Psychiatry Trainees(SERP), was founded and Spain became a observer member of the EFPT.
Objectives
One of the main goals of the SERP, is creating a program of clerkships, in both directions, from other trainees to come to Spain, and for Spanish Trainees to go abroad.
Methods
Our idea in this poster is to explain a first look of which Hospitals/Units would be appropriate to make a rotation, and to explain the first steps in order to create a database with information about the nightshifts, possible accommodation and other aspects related to the organization. We want to use this poster to present to Europe our new Association.
Results
On September 25 at the National Congress of Psychiatry in Santiago de Compostela, a Group of Spanish trainees founded the SERP, organized the first Board and signed the Founding Amendments.
Conclusions
After two previous failed attempts, finally on 25th September 201; the Spanish Society of Psychiatry Residents (SERP) was founded, an important part of the activity of this company is promoting exchanges between residents of member countries in Spain.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Suicide is the second most frequent cause of death among the youth and its rates among adolescents have recently risen. Up to 30% of adolescents who attempt suicide will try it again within a year. Our objective is to analyze how previous attempts and diagnosed psychiatric disorder behave as markers of risk of reattempts and their statistical interaction. We include every underage patient treated by an emergency room psychiatrist after a suicide attempt in a General Hospital between years 2010 and 2015. Patients free of relapse after 1000 days are censored. We obtain Kaplan–Meier estimates for the risk of a new attempt as a time-dependant variable, dividing them by the presence of previous suicide attempts, diagnosed psychiatric disorder or both at a time, checking the differences by using log-rank tests. Then, we perform Cox proportional risk models including both variables and a factor of their interaction and adjust them by sex and age in a non-automatically driven multivariate analysis, thus obtaining HR estimates. We present 150 cases (118 female; mean[SD] age in years: 15.8 [1.6]). Overall, 22.6% of them relapse during follow-up time. Multivariate models show interaction of previous attempts and diagnosed psychiatric disorder is associated with relapse with an HR of 1.27 × 108 (95% CI: 5.51 × 107 – 2.9 × 108). Interaction of both factors is an outstanding risk marker of relapse after an attempted suicide and should thus be given clinical importance in tertiary prevention.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The Composite Index of Anthropometric Failure (CIAF) can only be applied to children under 5 years of age and does not contemplate obesity. The aim of this study was to propose an Extended CIAF (ECIAF) that combines the characterization of malnutrition due to undernutrition and excess weight, and apply it in six Argentine provinces.
Design:
ECIAF excludes children not in anthropometric failure (group A) and was calculated from a percentage of children included in malnutrition categories B: wasting only; C: wasting and underweight; D: wasting, stunting and underweight; E: stunting and underweight; F: stunting only; Y: underweight only; G: only weight excess; and H: stunting and weight excess.
Setting:
Cross-sectional study conducted in Buenos Aires, Catamarca, Chubut, Jujuy, Mendoza and Misiones (Argentina).
Participants:
10 879 children of both sexes aged between 3 and 13·99.
Results:
ECIAF in preschool children (3 to 4·99 years) was 15·1 %. The highest prevalence was registered in Mendoza (16·7 %) and the lowest in Misiones (12·0 %). In school children (5 to 13·99 years) ECIAF was 28·6 %. Mendoza also recorded the highest rate (30·7 %), while Catamarca and Chubut had the lowest values (27·0 %). In the whole sample, about 25 % of the malnutrition was caused by undernutrition and 75 % by excess weight.
Conclusions:
The ECIAF summarizes anthropometric failure by both deficiency and excess weight and it highlights that a quarter of the malnutrition in the Argentine population was caused by undernutrition, although there are differences between Provinces (P < 0·05). ECIAF estimates are higher than those of CIAF or under-nutrition.
Lentic freshwater habitats are important centres of biodiversity within the infrequent ice-free oases across Antarctica. Given imminent climate changes, it is crucial to catalogue these habitats in order to provide baseline data for future monitoring and biological surveys. The lacustrine systems of Clearwater Mesa, a previously unexplored part of James Ross Island, north-eastern Antarctic Peninsula, are described here. We conducted basic geomorphological and limnological surveys over three Antarctic summers (2009–16) to characterize landscape evolution, infer the origin of lake basins and assess the variability in their water chemistry. Stable shallow lakes, formed in depressions between lava tumuli following the last deglaciation, were found to dominate the volcanic mesa, although several peripheral lakes in ice-proximal settings appear to have formed recently as a result of post-Neoglacial ice recession. We found large heterogeneity in conductivity (~10–7000 μS cm−1), despite the lithologically uniform substrate. This variability was shown to be related to lake type, basin type (open vs closed), meltwater source and proximity to the coast. Inter-annual differences were attributed to changes in sea spray influx and snow accumulation driven by variable weather conditions. Overall, the ion composition of lakes suggested that sea spray was the dominant source of ions, followed by the weathering of bedrock.
We present a workflow to track icebergs in proglacial fjords using oblique time-lapse photos and the Lucas-Kanade optical flow algorithm. We employ the workflow at LeConte Bay, Alaska, where we ran five time-lapse cameras between April 2016 and September 2017, capturing more than 400 000 photos at frame rates of 0.5–4.0 min−1. Hourly to daily average velocity fields in map coordinates illustrate dynamic currents in the bay, with dominant downfjord velocities (exceeding 0.5 m s−1 intermittently) and several eddies. Comparisons with simultaneous Acoustic Doppler Current Profiler (ADCP) measurements yield best agreement for the uppermost ADCP levels (~ 12 m and above), in line with prevalent small icebergs that trace near-surface currents. Tracking results from multiple cameras compare favorably, although cameras with lower frame rates (0.5 min−1) tend to underestimate high flow speeds. Tests to determine requisite temporal and spatial image resolution confirm the importance of high image frame rates, while spatial resolution is of secondary importance. Application of our procedure to other fjords will be successful if iceberg concentrations are high enough and if the camera frame rates are sufficiently rapid (at least 1 min−1 for conditions similar to LeConte Bay).