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Historically and across societies people with disabilities have been stigmatized and excluded from social opportunities on a variety of culturally specific grounds. In this collection, the authors explore the impact that the philosophical framing of disability can have on public policy questions, in the clinic, in the courtroom, and elsewhere. They examine the implications of this understanding for legal and policy approaches to disability, strategies for allocating and accessing health care, the implementation of the Americans with Disabilities Act, health care rights, and other legal tools designed to address discrimination. This volume should be read by anyone seeking a balanced view of disability and an understanding of the connection between the framing of disability and policies that have a real-world impact on individuals.
This is a copy of the slides presented at the meeting but not formally written up for the volume.
Superparamagnetic iron oxide (SPIO) nanoparticles are prevalent as nanoprobes for molecular magnetic resonance imaging (MRI), providing positive or negative contrast by locally affecting the relaxation of water protons. Fe3O4 nanoparticles are commonly used as a negative MRI contrast agent, implementing various surface functionalization techniques to provide molecular targeting to biological macromolecules. The authors recently demonstrated targeting of cancer antigen 125 (CA125) with differentiable MRI contrast in human ovarian cancer cell lines using monoclonal antibodies covalently conjugated to phospholipid micelle encapsulated 10 nm single crystalline SPIO nanoparticles, demonstrating molecular targeting capabilities via surface functionalization . While molecular targeting of SPIO nanoparticles has been thoroughly demonstrated, the effects of surface modifications have not been studied in regard to proton relaxation. The authors will present spin-lattice (T1) and spin-spin (T2) proton relaxometry of SPIO nanoparticles with varying surface chemistries. The effects of surface modification on T1 and T2 relaxation have not been thoroughly investigated, and results recently reported by the authors indicate a correlation of spin-spin relaxation with SPIO nanoparticle hydrodynamic radius . T1 and T2 relaxometry (Varian 300 MHz NMR) of polyethylene glycol modified (PEGylated) phospholipid micelle encapsulated SPIO nanoparticles and covalently PEGylated SPIO nanoparticles for varying hydrodynamic radii will be presented. These results are of particular interest to molecular imaging applications due to the common practice of SPIO nanoparticle PEGylation to improve biocompatibility. The authors will also present results of magnetic anisotropy studies with respect to proton relaxation by SPIO nanoparticles. Recent work by Roch et al emphasizes the role of magnetic anisotropy in the proton relaxation mechanism of SPIO nanoparticles . The authors have synthesized monodisperse Fe3-xCoxO4 nanoparticles with similar properties to SPIO. Cobalt substitution in SPIO nanoparticles increases the magnetic anisotropy of the SPIO nanoparticles, thus affecting the proton relaxation. The authors will present T1 and T2 relaxometry (Varian 300 MHz NMR) of Fe3-xCoxO4 nanoparticles and corresponding SQUID (superconducting quantum interference device) magnetic anisotropy measurements (Quantum Design, MPMS-7). The results of this study elucidate the role of magnetic anisotropy in the proton relaxation mechanism and demonstrates the feasibility of Fe3-xCoxO4 nanoparticles as a T2 contrast agent.1. Larsen BA et al, Proceedings of the 5th Annual Meeting of Molecular Imaging, 20062. Barker AJ, Larsen BA et al, Proceedings of the ASME SBC, 20063. Roch et al, Journal of Mag Res Imaging 14, pp 94-96, 2001.
Bipolar disorder (BD) and obsessive compulsive disorder (OCD) are prevalent, comorbid, and disabling conditions, often characterized by early onset and chronic course. When comorbid, OCD and BD can determine a more pernicious course of illness, posing therapeutic challenges for clinicians. Available reports on prevalence and clinical characteristics of comorbidity between BD and OCD showed mixed results, likely depending on the primary diagnosis of analyzed samples.
We assessed prevalence and clinical characteristics of BD comorbidity in a large international sample of patients with primary OCD (n = 401), through the International College of Obsessive–Compulsive Spectrum Disorders (ICOCS) snapshot database, by comparing OCD subjects with vs without BD comorbidity.
Among primary OCD patients, 6.2% showed comorbidity with BD. OCD patients with vs without BD comorbidity more frequently had a previous hospitalization (p < 0.001) and current augmentation therapies (p < 0.001). They also showed greater severity of OCD (p < 0.001), as measured by the Yale–Brown Obsessive Compulsive Scale (Y-BOCS).
These findings from a large international sample indicate that approximately 1 out of 16 patients with primary OCD may additionally have BD comorbidity along with other specific clinical characteristics, including more frequent previous hospitalizations, more complex therapeutic regimens, and a greater severity of OCD. Prospective international studies are needed to confirm our findings.
The phenomenon of buying-shopping disorder (BSD) was described over 100 years ago. Definitions of BSD refer to extreme preoccupation with shopping and buying, to impulses to purchase that are experienced as irresistible, and to recurrent maladaptive buying excesses that lead to distress and impairments. Efforts to stop BSD episodes are unsuccessful, despite the awareness of repeated break-downs in self-regulation, experiences of post-purchase guilt and regret, comorbid psychiatric disorders, reduced quality of life, familial discord, work impairment, financial problems, and other negative consequences. A recent meta-analysis indicated an estimated point prevalence of BSD of 5%. In this narrative review, the authors offer a perspective to consider BSD as a mental health condition and to classify this disorder as a behavioral addiction, based on both research data and on long-standing clinical experience.
Good education requires student experiences that deliver lessons about practice as well as theory and that encourage students to work for the public good—especially in the operation of democratic institutions (Dewey 1923; Dewy 1938). We report on an evaluation of the pedagogical value of a research project involving 23 colleges and universities across the country. Faculty trained and supervised students who observed polling places in the 2016 General Election. Our findings indicate that this was a valuable learning experience in both the short and long terms. Students found their experiences to be valuable and reported learning generally and specifically related to course material. Postelection, they also felt more knowledgeable about election science topics, voting behavior, and research methods. Students reported interest in participating in similar research in the future, would recommend other students to do so, and expressed interest in more learning and research about the topics central to their experience. Our results suggest that participants appreciated the importance of elections and their study. Collectively, the participating students are engaged and efficacious—essential qualities of citizens in a democracy.
Evidence suggests that skin picking disorder (SPD) could be a prevalent condition associated with comorbidity and psychosocial dysfunction. However, just a few studies have assessed the prevalence and correlates of SPD in samples from low- and middle-income countries. In addition, the impact of SPD on quality of life (QoL) dimension after multivariable adjustment to potential confounders remains unclear.
Data were obtained from a Brazilian anonymous Web-based research platform. Participants provided sociodemographic data and completed the modified Skin Picking–Stanford questionnaire, the Hypomania Checklist (HCL-32), the Patient Health Questionnaire-9 (PHQ-9), the Fagerström Test for Nicotine Dependence, Alcohol Use Disorder Identification Test (AUDIT), Symptom Checklist-90-Revised inventory (SCL-90R), early trauma inventory self report–short form, and the World Health Organization quality of life abbreviated scale (WHOQOL-Bref). Associations were adjusted to potential confounders through multivariable models.
For our survey, 7639 participants took part (71.3% females; age: 27.2±7.9 years). The prevalence of SPD was 3.4% (95% CI: 3.0–3.8%), with a female preponderance (P<0.001). In addition, SPD was associated with a positive screen for a major depressive episode, nicotine dependence, and alcohol dependence, as well as suicidal ideation. Physical and psychological QoL was significantly more impaired in participants with SPD compared to those without SPD, even after adjustment for comorbidity.
In this large sample, SPD was a prevalent condition associated with co-occurring depression, nicotine, and alcohol dependence. In addition, SPD was independently associated with impaired physical and psychological QoL. Public health efforts toward the early recognition and treatment of SPD are warranted.
Obsessive-compulsive disorder (OCD) is associated with variable risk of suicide and prevalence of suicide attempt (SA). The present study aimed to assess the prevalence of SA and associated sociodemographic and clinical features in a large international sample of OCD patients.
A total of 425 OCD outpatients, recruited through the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) network, were assessed and categorized in groups with or without a history of SA, and their sociodemographic and clinical features compared through Pearson’s chi-squared and t tests. Logistic regression was performed to assess the impact of the collected data on the SA variable.
14.6% of our sample reported at least one SA during their lifetime. Patients with an SA had significantly higher rates of comorbid psychiatric disorders (60 vs. 17%, p<0.001; particularly tic disorder), medical disorders (51 vs. 15%, p<0.001), and previous hospitalizations (62 vs. 11%, p<0.001) than patients with no history of SA. With respect to geographical differences, European and South African patients showed significantly higher rates of SA history (40 and 39%, respectively) compared to North American and Middle-Eastern individuals (13 and 8%, respectively) (χ2=11.4, p<0.001). The logistic regression did not show any statistically significant predictor of SA among selected independent variables.
Our international study found a history of SA prevalence of ~15% in OCD patients, with higher rates of psychiatric and medical comorbidities and previous hospitalizations in patients with a previous SA. Along with potential geographical influences, the presence of the abovementioned features should recommend additional caution in the assessment of suicide risk in OCD patients.
Most of the previous studies attempted to disentangle the relationship between disability and depressive symptoms were limited to observation periods of only few years. Moreover, evidence is missing regarding the complex co-occurrence of disability and depressive symptoms in old age in Germany. In order to close the research gap, we aimed at disentangling the complex co-occurrence of disability and depressive symptoms in old age in Germany over a longer time frame.
Based on data from a representative survey of the German general population aged 75 years and older, the course of disability as well as depressive symptoms was observed every 1.5 years over six waves. While disability was quantified by the Lawton and Brody Instrumental Activities of Daily Living scale, the Geriatric Depression Scale was used to measure depressive symptoms. Taking into account the complex co-occurrence of depressive symptoms and disability, a panel vector autoregressive model was used. By taking the first differences, unobserved heterogeneity was taken into account.
In the total sample and in both sexes, we revealed a robust positive association between an initial change in depressive symptoms and subsequent changes in disability. No robust association between an initial change in disability and a subsequent change in depressive symptoms was detected.
Our findings highlight the importance of changes in depressive symptoms for future changes in disability in old age.
The Two Micron All-Sky Survey was conceived over a decade ago for the express purpose of mapping the Milky Way and the Universe nearby. 2MASS is now complete and the final data products, including the extended source catalog (XSC), have been released. The XSC contains nearly a million galaxies to the stated completeness goal of K=13.5. While the catalog becomes incomplete at the faintest magnitudes and lowest galactic latitudes due to confusion, at the bright end the catalog is essentially complete down to very low latitudes (b less than 5 degrees), which makes it an excellent survey for the distribution of matter in the nearby Universe. Redshift information is now nearly complete for the 24,000 galaxies brighter than K=11.25 and above |b|=5°. We now have an amazing census of galaxy (baryonic mass) concentrations over the whole sky and inside z=0.04. Several new structures are elucidated and the characteristics of the structures are described. We also examine the match between the predicted gravitational velocity vector of the Local Group and the motions determined by other experiments including the CMB dipole.
Obsessive compulsive disorder (OCD) showed a lower prevalence of cigarette smoking compared to other psychiatric disorders in previous and recent reports. We assessed the prevalence and clinical correlates of the phenomenon in an international sample of 504 OCD patients recruited through the International College of Obsessive Compulsive Spectrum Disorders (ICOCS) network.
Cigarette smoking showed a cross-sectional prevalence of 24.4% in the sample, with significant differences across countries. Females were more represented among smoking patients (16% vs 7%; p<.001). Patients with comorbid Tourette’s syndrome (p<.05) and tic disorder (p<.05) were also more represented among smoking subjects. Former smokers reported a higher number of suicide attempts (p<.05).
We found a lower cross-sectional prevalence of smoking among OCD patients compared to findings from previous studies in patients with other psychiatric disorders but higher compared to previous and more recent OCD studies. Geographic differences were found and smoking was more common in females and comorbid Tourette’s syndrome/tic disorder.
Inappropriate distribution of casualties in mass-casualty incidents (MCIs) may overwhelm hospitals. This study aimed to review the consequences of evacuating casualties from a bus accident to a single peripheral hospital and lessons learned regarding policy of casualty evacuation.
Medical records of all casualties relating to evacuation times, injury severity, diagnoses, treatments, resources utilized and outcomes were independently reviewed by two senior trauma surgeons. In addition, four senior trauma surgeons reviewed impact of treatment provided on patient outcomes. They reviewed the times for the primary and secondary evacuation, injury severity, diagnoses, surgical treatments, resources utilized, and the final outcomes of the patients at the point of discharge from the tertiary care hospital.
Thirty-one survivors were transferred to the closest local hospital; four died en route to hospital or within 30 minutes of arrival. Twenty-seven casualties were evacuated by air from the local hospital within 2.5 to 6.15 hours to Level I and II hospitals. Undertriage of 15% and overtriage of seven percent were noted. Four casualties did not receive treatment that might have improved their condition at the local hospital.
In MCIs occurring in remote areas, policy makers should consider revising the current evacuation plan so that only immediate unstable casualties should be transferred to the closest primary hospital. On site Advanced Life Support (ALS) should be administered to non-severe casualties until they can be evacuated directly to tertiary care hospitals. First responders must be trained to provide ALS to non-severe casualties until evacuation resources are available.
AdiniB, CohenR, GlassbergE, AzariaB, SimonD, SteinM, KleinY, PelegK. Reconsidering Policy of Casualty Evacuation in a Remote Mass-Casualty Incident. Prehosp Disaster Med. 2013;28(6):1-5.
Remoras (echeneid fish) reversibly attach and detach to marine hosts, almost instantaneously, to “hitchhike” and feed. The adhesion mechanisms that they use are remarkably insensitive to substrate topology and quite different from the latching and suction cup-based systems associated with other species at similar length scales. Remora adhesion is also anisotropic; drag forces induced by the swimming host increase adhesive strength, while rapid detachment occurs when the remora reverses this shear load. In this work, an investigation of the adhesive system’s functional morphology and tissue properties was carried out initially through dissection and x-ray microtomographic analyses. Resulting finite element models of these components have provided new insights into the adaptive, hierarchical nature of the mechanisms and a path toward a wide range of engineering applications.
Many advances in nanomaterials synthesis have been recorded during the last 30 years. Bacterial cellulose (BC) produced by bacteria belonging to the genera Acetobacter, Rhizobium, Agrobacterium, and Sarcina is acquiring major importance as one of many eco-friendly materials with great potential in the biomedical field. The shape of BC bulk is sensitive to the container shape and incubation conditions such as agitation, carbon source, rate of oxygenation, electromagnetic radiation, temperature, and pH. The challenge is to control the dimension and the final shape of biosynthesized cellulose, by the optimization of culture conditions. The production of 3D structures based on BC is important for many industrial and biomedical applications such as paper and textile industries, biological implants, burn dressing material, and scaffolds for tissue regeneration. In our work, wild strains of Acetobacter spp. were isolated from homemade vinegar then purified and used for cellulose production. Four media of different initial viscosity were used. Cultures were performed under static conditions at 29°C, in darkness. The dimensions and texture of obtained bacterial cellulose nanofibers were studied using scanning electron microscopy (SEM). X-ray diffraction (XRD) showed that the biosynthesized material has a cellulose I crystalline phase characterized by three crystal planes. fourrier transform infrared spectroscopy (FTIR) data confirmed the chemical nature of the fibers. Thermo-gravimetric analysis (TGA) showed that BC preserves a relatively superior non-degradable fraction compared to microcrystalline cellulose.