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The aim of the current study was to examine the heterogeneity of functional outcomes in first episode psychosis (FEP) patients and related clinical, neurocognitive and sociodemographic factors using a cluster analytic approach.
A large sample of FEP patients (N = 209) was functionally reassessed 10 years after the first contact with an early intervention service. Multiple baseline, 3-year and 10-year follow-up variables were explored.
The cluster analysis emphasized the existence of six independent clusters of functioning: one cluster was normal overall (42.16%), two clusters showed moderate interpersonal (9.63%) or instrumental (12.65%) deficits, two clusters showed more severe interpersonal (12.05%) or interpersonal and instrumental (13.85%) deficits and there was a significantly overall impaired cluster (9.63%). Cluster comparisons showed that several baseline and follow-up factors were differentially involved in functional outcomes.
The current study demonstrated that distinct clusters of functioning in FEP patients can be identified. The fact that a variety of profiles was observed contributes to a better understanding of the nature of the heterogeneity characterizing FEP patients and has clinical implications for developing individualized treatment plans.
Food environments may be contributing to the rapid increase in obesity occurring in most Latin American (LA) countries. The present study reviews literature from LA that (i) describes the food environment and policies targeting the food environment (FEP); and (ii) analytic studies that investigate associations between the FEP and dietary behaviours, overweight/obesity and obesity related chronic diseases. We focus on six dimensions of the FEP: food retail, provision, labelling, marketing, price and composition.
Systematic literature review. Three databases (Web of Science, SciELO, LILACS) were searched, from 1 January 1999 up to July 2017. Two authors independently selected the studies. A narrative synthesis was used to summarize, integrate and interpret findings.
Studies conducted in LA countries.
The search yielded 2695 articles of which eighty-four met inclusion criteria.
Most studies were descriptive and came from Brazil (61 %), followed by Mexico (18 %) and Guatemala (6 %). Studies were focused primarily on retail/provision (n 27), marketing (n 16) and labelling (n 15). Consistent associations between availability of fruit and vegetable markets and higher consumption of fruits and vegetables were found in cross-sectional studies. Health claims in food packaging were prevalent and mostly misleading. There was widespread use of marketing strategies for unhealthy foods aimed at children. Food prices were lower for processed relative to fresh foods. Some studies documented high sodium in industrially processed foods.
Gaps in knowledge remain regarding policy evaluations, longitudinal food retail studies, impacts of food price on diet and effects of digital marketing on diet/health.
Neighbourhood greenness or vegetative presence has been associated with indicators of health and well-being, but its relationship to depression in older adults has been less studied. Understanding the role of environmental factors in depression may inform and complement traditional depression interventions, including both prevention and treatment.
This study examines the relationship between neighbourhood greenness and depression diagnoses among older adults in Miami-Dade County, Florida, USA.
Analyses examined 249 405 beneficiaries enrolled in Medicare, a USA federal health insurance programme for older adults. Participants were 65 years and older, living in the same Miami location across 2 years (2010–2011). Multilevel analyses assessed the relationship between neighbourhood greenness, assessed by average block-level normalised difference vegetative index via satellite imagery, and depression diagnosis using USA Medicare claims data. Covariates were individual age, gender, race/ethnicity, number of comorbid health conditions and neighbourhood median household income.
Over 9% of beneficiaries had a depression diagnosis. Higher levels of greenness were associated with lower odds of depression, even after adjusting for demographics and health comorbidities. When compared with individuals residing in the lowest tertile of greenness, individuals from the middle tertile (medium greenness) had 8% lower odds of depression (odds ratio 0.92; 95% CI 0.88, 0.96; P = 0.0004) and those from the high tertile (high greenness) had 16% lower odds of depression (odds ratio 0.84; 95% CI 0.79, 0.88; P < 0.0001).
Higher levels of greenness may reduce depression odds among older adults. Increasing greenery – even to moderate levels – may enhance individual-level approaches to promoting wellness.
The keystone role of Antarctic krill, Euphausia superba Dana, in Southern Ocean ecosystems, means it is essential to understand the factors controlling their abundance and secondary production. One such factor that remains poorly known is the role of parasites. A recent study of krill diet using DNA analysis of gut contents provided a snapshot of the parasites present within 170 E. superba guts in a small area along the West Antarctic Peninsula. These parasites included Metschnikowia spp. fungi, Haptoglossa sp. peronosporomycetes, Lankesteria and Paralecudina spp. apicomplexa, Stegophorus sp. nematodes, and Pseudocollinia spp. ciliates. Of these parasites, Metschnikowia spp. fungi and Pseudocollinia spp. ciliates had previously been observed in E. superba, as had other genera of apicomplexans, though not Lankesteria and Paralecudina. In contrast, nematodes had previously only been observed in eggs of E. superba, and there are no literature reports of peronosporomycetes in euphausiids. Pseudocollinia spp., parasitoids which obligately kill their host, were the most frequently observed infection, with a prevalence of 12%. The wide range of observed parasites and the relatively high frequency of infections suggest parasites may play a more important role than previously acknowledged in E. superba ecology and population dynamics.
Health technology has no or low added value when it is harmful and/or is deemed to deliver limited health gain relative to its cost, representing inefficient health resource allocation. A joint effort by the Health Technology Assessment International (HTAi) interest group (IG) on disinvestment and early awareness, the IG on ethics, the EuroScan network and the International Network of Agencies for Health Technology Assessment (INAHTA) is aiming to design a toolkit that could aid organizations and individuals considering disinvestment activities. We synthesized state of the art methods for identifying candidate technologies for disinvestment, and propose a framework for executing this task.
We searched systematic reviews on disinvestment and compared the methods used for identifying potential candidates. A descriptive analysis was performed including sources of evidence used and methods for selection / filtration.
Ten systematic reviews were retrieved, and the methods of 29 disinvestment initiatives were compared. A new framework for identifying potential candidates was proposed which comprises seven basic approaches based on the wide definition of evidence provided by Lomas et al.; 11 triggers for disinvestment were adapted from Elshaug's proposal, and 13 methods for applying these triggers that were grouped in embedded and ad-hoc methods.
Identification methods have been described in the literature, and have been tested in different contexts. Context is crucial in determining the ‘not to do’ practices as they are described in different sources.
Composites from carbon nanotubes and polymers have been synthesized and studied. The composites were obtained joining carbon nanotubes with polymethyl methacrylate, nylon-6 and polystyrene. The materials were observed through scanning electron microscopy to evaluate the carbon nanotubes dispersion in the polymeric matrices. FTIR and Raman spectroscopies were used to analyze the interactions among functionalized and non-functionalized multiwalled carbon nanotubes and polymers, demonstrating affinity and peculiar spectra behaviors for each composite with different carbon nanotubes loads.
PA6 and PMMA polymers with different MWCNTs addition (5, 7 and 9 wt %) were synthetized through casting solution, resulting in improvement properties in contrast to pristine polymers. SEM images showed the MWCNTs embedded into polymeric matrices. D, G and G´ bands of MWCNTs were confirmed by Raman spectroscopy and functional groups observed in both nanocomposites by FTIR demonstrated a strong interaction. A significant increasing in electrical conductivity and microhardness was observed in all the nanocomposites. Major microhardness values were obtained in MWCNTs/PA6 (50 HV) however the MWCNTs/PMMA nanocomposites showed the highest electrical conductivity value (6.4×10-4 S/cm).
For more than 60 years, Colombia experienced an armed conflict involving government forces, guerrillas, and other illegal armed groups. Violence, including torture and massacres, has caused displacement of entire rural communities to urban areas. Lack of information on the problems displaced communities face and on their perceptions on potential solutions to these problems may prevent programs from delivering appropriate services to these communities. This study explores the problems of Afro-Colombian survivors from two major cities in Colombia; the activities they do to take care of themselves, their families, and their community; and possible solutions to these problems.
This was a qualitative, interview-based study conducted in Quibdó and Buenaventura (Colombia). Free-list interviews and focus groups explored the problems of survivors and the activities they do to take care of themselves, their families, and their community. Key-informant interviews explored details of the identified mental health problems and possible solutions.
In Buenaventura, 24 free-list interviews, one focus group, and 17 key-informant interviews were completed. In Quibdó, 29 free-list interviews, one focus group, and 15 key-informant interviews were completed. Mental health problems identified included: (1) problems related to exposure to torture/violent events; (2) problems with adaptation to the new social context; and (3) problems related to current poverty, lack of employment, and ongoing violence. These problems were similar to trauma symptoms and features of depression and anxiety, as described in other populations. Solutions included psychological help, talking to friends/family, relying on God’s help, and getting trained in different task or jobs.
Afro-Colombian survivors of torture and violence described mental health problems similar to those of other trauma-affected populations. These results suggest that existing interventions that address trauma-related symptoms and current ongoing stressors may be appropriate for improving the mental health of survivors in this population.
Santaella-TenorioJ, Bonilla-EscobarFJ, Nieto-GilL, Fandiño-LosadaA, Gutiérrez-MartínezMI, BassJ, BoltonP. Mental Health and Psychosocial Problems and Needs of Violence Survivors in the Colombian Pacific Coast: A Qualitative Study in Buenaventura and Quibdó. Prehosp Disaster Med. 2018;33(6):567–574.
In this survey we give very simple proofs of Kepler's Laws and other facts about central force fields using only Newton's second law, Newton's law of universal gravitation, basic notions of vector calculus, and an elementary double integral.
Hopefully, this article will help undergraduate students of mathematics and engineering who wish to understand these fundamental scientific discoveries.
In many textbooks (see, for instance, [1, 2, 3, 4, 5]), Kepler's Laws are obtained using conservation of energy and angular momentum, differential equations, mobile reference systems, or notions not so well-defined such as differentials or ‘infinitesimal elements’. Some of the arguments appear to be rather involved if one is not accustomed to them, whereas the proof of Kepler's Laws may actually be obtained from quite simple facts.
To compare the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP) and to examine the differences in clinical characteristics and outcome between BSIs caused by isolates with CTX-M versus other ESBL genotypes
As part of the INCREMENT project, 33 tertiary hospitals in 12 countries retrospectively collected data on adult patients diagnosed with ESBL-EC BSI or ESBL-KP BSI between 2004 and 2013. Risk factors for ESBL-EC versus ESBL-KP BSI and for 30-day mortality were examined by bivariate analysis followed by multivariable logistic regression.
The study included 909 patients: 687 with ESBL-EC BSI and 222 with ESBL-KP BSI. ESBL genotype by polymerase chain reaction amplification of 286 isolates was available. ESBL-KP BSI was associated with intensive care unit admission, cardiovascular and neurological comorbidities, length of stay to bacteremia >14 days from admission, and a nonurinary source. Overall, 30-day mortality was significantly higher in patients with ESBL-KP BSI than ESBL-EC BSI (33.7% vs 17.4%; odds ratio, 1.64; P=.016). CTX-M was the most prevalent ESBL subtype identified (218 of 286 polymerase chain reaction-tested isolates, 76%). No differences in clinical characteristics or in mortality between CTX-M and non–CTX-M ESBLs were detected.
Clinical characteristics and risk of mortality differ significantly between ESBL-EC and ESBL-KP BSI. Therefore, all ESBL-producing Enterobacteriaceae should not be considered a homogeneous group. No differences in outcomes between genotypes were detected.
Con el primer número del volumen 29 de Latin American Antiquity (LAQ) estamos muy contentos de poder anunciar buenas noticias para nuestros lectores y colaboradores. A partir de la edición de marzo 2018, el recuento anual de páginas de LAQ se incrementará a 880, al igual que American Antiquity (AAQ). Hace solo dos años se le asignaron a LAQ 576 páginas, por lo que esto significa un aumento del 53%, el mayor en la historia de la revista.
The Spanish National Network (REDETS) is a group of eight agencies, units and services, depending on National and Regional Governments that coordinate their work within a common methodological framework, guided by the principles of mutual recognition and cooperation. The necessity of considering a Quality Management System has been detected and, consequently, a common tool for all the members needs to be developed. We describe in this study the process to achieve that goal.
Based on both a review of previous literature and the proposal for a self-evaluating tool, a group of experts from each agency through consensus have developed a tool for self-evaluation in Health Technology Assessment (HTA) agencies. Through the structure described in the handbook of the Andalusian Agency for Healthcare Quality (ACSA), each standard should have a statement or proposal that needs to also include evidence or good practices, and the corresponding evaluation questions. In separate workgroups, the definition of these proposals, evidence and evaluation questions were developed. One face-to-face meeting and two meetings via teleconference were necessary to achieve a final document with all the quality standards.
From a proposed structure of sixty-six standards, the titles, definitions, statements and evidence as well as good practices and evaluation questions were established in workgroups with consensus among all of the members (1 - 3). The final version of the self-assessment tool was composed of sixty-eight standards, grouped in twelve quality criteria structured in four dimensions: I Responsibility, II Clients and Stakeholders, III Production Process, and IV Resources.
Quality management requires an evaluation tool and this version, based on a systematic review and consensus, is a useful and practical instrument for developing a handbook by each member of REDETS. An online version of the tool is in process of development.
Burkart et al. consider that the relationship between general intelligence and socio-cognitive abilities is poorly understood in animals and humans. We examine this conclusion in the perspective of an already substantial evidence base on the relationship among general intelligence, theory of mind, and emotional intelligence. We propose a link between general intelligence and socio-cognitive abilities within humans.
The synthesis and antiprotozoal activity of some simple dialkyl pyrazole-3,5-dicarboxylates (compounds 2–6) and their sodium salts (pyrazolates) (compounds 7–9) against Trypanosoma cruzi, Leishmania infantum and Leishmania braziliensis are reported. In most cases the studied compounds showed, especially against the clinically significant amastigote forms, in vitro activities higher than those of the reference drugs (benznidazole for T. cruzi and glucantime for Leishmania spp.); furthermore, the low non-specific cytotoxicities against Vero cells and macrophages shown by these compounds led to good selectivity indexes, which are 8–72 times higher for T. cruzi amastigotes and 15–113 times higher for Leishmania spp. amastigotes than those of the respective reference drugs. The high efficiency of diethyl ester 3 and its sodium salt 8 against the mentioned protozoa was confirmed by further in vitro assays on infection rates and by an additional in vivo study in a murine model of acute and chronic Chagas disease. The inhibitory capacity of compounds 3 and 8 on the essential iron superoxide dismutase of the aforementioned parasites may be related to the observed anti-trypanosomatid activity. The low acute toxicity of compounds 3 and 8 in mice is also reported in this article.
The March 2017 issue of Latin American Antiquity brings with it momentous changes. It also marks the conclusion of our first term as coeditors. We think it important to let you know how LAQ has grown this decade and especially over the past three years, and to inform you of significant changes that commence with this issue.
Childhood overweight and obesity are worldwide public health problems and risk factors for chronic diseases. The presence of SNP in several genes has been associated with the presence of obesity. A total of 580 children (8–13 years old) from Queretaro, Mexico, participated in this cross-sectional study, which evaluated the associations of rs9939609 (fat mass obesity-associated (FTO)), rs17782313 (melanocortin 4 receptor (MC4R)) and rs6548238 (transmembrane protein 18 (TMEM18)) SNP with obesity and metabolic risk factors. Overweight and obesity prevalence was 19·8 and 19·1 %, respectively. FTO, MC4R and TMEM18 risk allele frequency was 17, 9·8 and 89·5 %, respectively. A significant association between FTO homozygous and MC4R heterozygous risk alleles and obesity was found (OR 3·9; 95 % CI 1·46, 10·22, and OR 2·1; 95 % CI 1·22, 3·71; respectively). The FTO heterozygous subjects showed higher systolic and diastolic blood pressures, compared with the homozygous for the ancestral allele subjects. These results remain significant after considering adiposity as a covariate. The FTO and MC4R genotypes were not significantly associated with total cholesterol, HDL-cholesterol and insulin concentration. No association was found between TMEM18 risk allele and obesity and/or metabolic alterations. Our results show that, in addition to a higher BMI, there is also an association of the risk genotype with blood pressure in the presence of the FTO risk genotype. The possible presence of a risk genotype in obese children must be considered to offer a more comprehensive therapeutic approach in order to delay and/or prevent the development of chronic diseases.
Chitosan is biocompatible polymer has a great commercial interest because it can be processed in a sort of devices varying in shape and size, such as membranes, gels and nanoparticles. Mostly, the cell’s attachment and proliferation are very positive on nanostructurated materials with a three-dimensional formation. An irreversible network can be produced by covalently binding the polymer to the cross-linker molecules. Chitosan nanoparticles were prepared using glutaraldehyde as cross-linker. This crosss-liker mostly reacts with chitosan amino groups. In order to control and understand the physical characteristics of chitosan nanoparticle, in this work is showed the molecular behavior of chitosan/glutaraldehyde from the viewpoint of molecular interactions base in a series of molecular dynamics (MD) computer simulation. The results indicated the conformations of both molecules, which had a significant influence on the molecular association. The chitosan chains were uniformly distributed presenting a high flexibility and preference for the relaxed two-fold helix. This was due to the various associations such as intramolecular chitosan interactions –O-H···O-C-. While the chitosan-glutaraldehyde associations were due to the positive net charge density of hydrogens in the chitosan plus - H2N···C=O associations. In solid state chitosan nano and microparticles were analyzed by scanning electron microscopy (SEM). According to the micrographs results, the nanoparticles presented a monomorphism with piles of particles arranged in linear order which was consistent with the conformations determined by simulation.
This paper presents and discusses several methods for predicting the low-frequency (LF) noise at the output of a mm-wave detector. These methods are based on the extraction of LF noise source parameters from the single diode under a specific set of bias conditions and the transfer or conversion of these noise sources, under different operating conditions including cyclostationary regime, to the quasi-dc output of a mm-wave detector constructed with the same model of diode. The noise analysis is based on a conversion-matrix type formulation, which relates the carrier noisy sidebands of the input signal with the detector output spectrum through a pair of transfer functions obtained in commercial software. Measurements of detectors in individual and differential setups will be presented and compared with predictions.
The effects of thermal treatments on the thermoluminescent (TL) signal of NaCl (ACS reagent) induced by gamma radiation were investigated. Samples of NaCl were thermally treated at 500, 800 and 1000 °C and characterized by X-Ray diffraction and scanning electron microscopy. After their exposure 0.1 to 150 Gy of gamma radiation from a gamma-ray source of 60Co, a TL curve for each temperature of treatment was obtained. We observed a different TL behavior on the irradiated samples as a function of the temperature applied during the thermal treatments. For the sample treated at 500 °C, three peaks centered at 102, 133 and 228 °C were observed. Samples treated at 800 and 1000 °C showed two main peaks at 128 and 220 °C and 136 and 219 °C, respectively; however, the highest TL intensity signal was observed for the sample at 800 °C. All samples showed a linear dependency of the integrated TL intensity from the signal emitted as function of the irradiation time. This is an important advantage because NaCl could be applied as a very low cost thermoluminescent dosimetric material. A comparison between the TL signal induced by gamma radiation in pure and Eu doped NaCl is also reported.