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This study aimed to identify the roles of community pharmacists (CPs) during the coronavirus disease 2019 (COVID-19) pandemic, the differences in their role performance compared with their perceived importance, and limiting factors.
A cross-sectional online survey of CPs was conducted. The CPs self-measured the importance and performance of each role during the pandemic using a five-point Likert scale. A paired t-test was used to compare each role’s importance and performance scores. A logistic regression analysis of the roles with low performance scores, despite their level of importance, was conducted to determine the factors affecting performance. The limiting factors were also surveyed.
The 436 responses to the questionnaire were analyzed. The performance scores were significantly lower than the perceived importance scores for 15 of the 17 roles. The source and update frequency of COVID-19 information and participation in outreach pharmaceutical services were associated with low performance scores. Insufficient economic compensation, the lack of communication channels, and legal limitations were the limiting factors in performing the CPs’ roles.
The participation in outreach pharmaceutical services, economic compensation, and communication channel should be improved to motivate the CPs in performing their roles.
What determines public support for trade liberalization? Scholars of international political economy have generally focused on the effects of openness on employment via individuals’ skill level, sector, or occupation. Recent developments in trade economics suggest that the characteristics of individual citizens’ employing firms may also shape their attitudes on trade policy. In this paper, using under-explored survey data combining trade opinion with measures of employer productivity (from the 2008 Japanese General Social Survey), we present evidence that employees of more productive, more globalized firms are much more supportive of trade openness than employees of less productive, domestically oriented firms, even when accounting for skill level and sectoral and occupational characteristics. Moreover, we find evidence that the effects of these characteristics described in the literature are conditioned by globalized firm employment. Last, we find that the effect of globalized firm employment is conditioned by employees’ relative position within their firms. Those who are more likely to benefit directly from firm success—such as permanent employees and managers—hold the most pro-trade preferences. These findings suggest that economic interests affect individual policy preferences in more nuanced ways than previously recognized.
A large literature has established that the International Monetary Fund (IMF) is heavily politicized. We argue that this politicization has important consequences for international reserve accumulation and financial crises. The IMF generates moral hazard asymmetrically, reducing the expected costs of risky lending and policies for states that are politically influential vis-à-vis the institution. Using a panel data set covering 1980 to 2010, we show that proxies for political influence over the IMF are associated with outcomes indicative of moral hazard: lower international reserves and more frequent financial crises. We support our causal claims by applying the synthetic control method to Taiwan, which was expelled from the IMF in 1980. Consistent with our predictions, Taiwan's expulsion led to a sharp increase in precautionary international reserves and exceptionally conservative financial policies.
Personality may predispose family caregivers to experience caregiving differently in similar situations and influence the outcomes of caregiving. A limited body of research has examined the role of some personality traits for health-related quality of life (HRQoL) among family caregivers of persons with dementia (PWD) in relation to burden and depression.
Data from a large clinic-based national study in South Korea, the Caregivers of Alzheimer's Disease Research (CARE), were analyzed (N = 476). Path analysis was performed to explore the association between family caregivers’ personality traits and HRQoL. With depression and burden as mediating factors, direct and indirect associations between five personality traits and HRQoL of family caregivers were examined.
Results demonstrated the mediating role of caregiver burden and depression in linking two personality traits (neuroticism and extraversion) and HRQoL. Neuroticism and extraversion directly and indirectly influenced the mental HRQoL of caregivers. Neuroticism and extraversion only indirectly influenced their physical HRQoL. Neuroticism increased the caregiver's depression, whereas extraversion decreased it. Neuroticism only was mediated by burden to influence depression and mental and physical HRQoL.
Personality traits can influence caregiving outcomes and be viewed as an individual resource of the caregiver. A family caregiver's personality characteristics need to be assessed for tailoring support programs to get the optimal benefits from caregiver interventions.
During the past decade, carbapenemase-producing Enterobacteriaceae (CPE) has emerged and spread across the world.1 The major carbapenemase enzymes currently being reported are KPC, NDM-1, VIM, IMP, and OXA.2 Because carbapenemase can be effectively transmitted via mobile genetic elements, and current therapeutic options for CPE infections are extremely limited, CPE may be one of the most serious contemporary threats to public health. However, very little is known about the characteristics of CPE carriage during hospitalization. The aims of this study were to investigate the clearance rate of CPE carriage and determine the number of consecutive negative cultures required to confirm CPE clearance. We also examined CPE transmission among hospitalized patients.
Infect. Control Hosp. Epidemiol. 2015;36(11):1361–1362
Decreased hemoglobin levels increase the risk of developing dementia among the elderly. However, the underlying mechanisms that link decreased hemoglobin levels to incident dementia still remain unclear, possibly due to the fact that few studies have reported on the relationship between low hemoglobin levels and neuroimaging markers. We, therefore, investigated the relationships between decreased hemoglobin levels, cerebral small-vessel disease (CSVD), and cortical atrophy in cognitively healthy women and men.
Cognitively normal women (n = 1,022) and men (n = 1,018) who underwent medical check-ups and magnetic resonance imaging (MRI) were enrolled at a health promotion center. We measured hemoglobin levels, white matter hyperintensities (WMH) scales, lacunes, and microbleeds. Cortical thickness was automatically measured using surface based methods. Multivariate regression analyses were performed after controlling for possible confounders.
Decreased hemoglobin levels were not associated with the presence of WMH, lacunes, or microbleeds in women and men. Among women, decreased hemoglobin levels were associated with decreased cortical thickness in the frontal (Estimates, 95% confidence interval, −0.007, (−0.013, −0.001)), temporal (−0.010, (−0.018, −0.002)), parietal (−0.009, (−0.015, −0.003)), and occipital regions (−0.011, (−0.019, −0.003)). Among men, however, no associations were observed between hemoglobin levels and cortical thickness.
Our findings suggested that decreased hemoglobin levels affected cortical atrophy, but not increased CSVD, among women, although the association is modest. Given the paucity of modifiable risk factors for age-related cognitive decline, our results have important public health implications.
We report on the formation of highly flexible and transparent TiO2/Ag/ITO multilayer films deposited on polyethylene terephthalate substrates. The optical and electrical properties of the multilayer films were investigated as a function of oxide thickness. The transmission window gradually shifted toward lower energies with increasing oxide thickness. The TiO2 (40 nm)/Ag (18 nm)/ITO (40 nm) films gave the transmittance of 93.1% at 560 nm. The relationship between transmittance and oxide thickness was simulated using the scattering matrix method to understand high transmittance. As the oxide thickness increased from 20 to 50 nm, the carrier concentration gradually decreased from 1.08 × 1022 to 6.66 × 1021 cm−3, while the sheet resistance varied from 5.8 to 6.1 Ω/sq. Haacke's figure of merit reached a maximum at 40 nm and then decreased with increasing oxide thickness. The change in resistance for the 60 nm-thick ITO single film rapidly increased with increasing bending cycles, while that of the TiO2/Ag/ITO (40 nm/18 nm/40 nm) film remained virtually unchanged during the bending test.
There is increasing evidence of a relationship between underweight or obesity and dementia risk. Several studies have investigated the relationship between body weight and brain atrophy, a pathological change preceding dementia, but their results are inconsistent. Therefore, we aimed to evaluate the relationship between body mass index (BMI) and cortical atrophy among cognitively normal participants.
We recruited cognitively normal participants (n = 1,111) who underwent medical checkups and detailed neurologic screening, including magnetic resonance imaging (MRI) in the health screening visits between September 2008 and December 2011. The main outcome was cortical thickness measured using MRI. The number of subjects with five BMI groups in men/women was 9/9, 148/258, 185/128, 149/111, and 64/50 in underweight, normal, overweight, mild obesity, and moderate to severe obesity, respectively. Linear and non-linear relationships between BMI and cortical thickness were examined using multiple linear regression analysis and generalized additive models after adjustment for potential confounders.
Among men, underweight participants showed significant cortical thinning in the frontal and temporal regions compared to normal weight participants, while overweight and mildly obese participants had greater cortical thicknesses in the frontal region and the frontal, temporal, and occipital regions, respectively. However, cortical thickness in each brain region was not significantly different in normal weight and moderate to severe obesity groups. Among women, the association between BMI and cortical thickness was not statistically significant.
Our findings suggested that underweight might be an important risk factor for pathological changes in the brain, while overweight or mild obesity may be inversely associated with cortical atrophy in cognitively normal elderly males.
Epidemiological studies have reported that higher education (HE) is associated with a reduced risk of incident Alzheimer's disease (AD). However, after the clinical onset of AD, patients with HE levels show more rapid cognitive decline than patients with lower education (LE) levels. Although education level and cognition have been linked, there have been few longitudinal studies investigating the relationship between education level and cortical decline in patients with AD. The aim of this study was to compare the topography of cortical atrophy longitudinally between AD patients with HE (HE-AD) and AD patients with LE (LE-AD).
We prospectively recruited 36 patients with early-stage AD and 14 normal controls. The patients were classified into two groups according to educational level, 23 HE-AD (>9 years) and 13 LE-AD (≤9 years).
As AD progressed over the 5-year longitudinal follow-ups, the HE-AD showed a significant group-by-time interaction in the right dorsolateral frontal and precuneus, and the left parahippocampal regions compared to the LE-AD.
Our study reveals that the preliminary longitudinal effect of HE accelerates cortical atrophy in AD patients over time, which underlines the importance of education level for predicting prognosis.
Background: Highly educated participants with normal cognition show lower incidence of Alzheimer's disease (AD) than poorly educated participants, whereas longitudinal studies involving AD have reported that higher education is associated with more rapid cognitive decline. We aimed to evaluate whether highly educated amnestic mild cognitive impairment (aMCI) participants show more rapid cognitive decline than those with lower levels of education.
Methods: A total of 249 aMCI patients enrolled from 31 memory clinics using the standard assessment and diagnostic processes were followed with neuropsychological evaluation (duration 17.2 ± 8.8 months). According to baseline performances on memory tests, participants were divided into early-stage aMCI (−1.5 to −1.0 standard deviation (SD)) and late-stage aMCI (below −1.5 SD) groups. Risk of AD conversion and changes in neuropsychological performances according to the level of education were evaluated.
Results: Sixty-two patients converted to AD over a mean follow-up of 1.43 years. The risk of AD conversion was higher in late-stage aMCI than early-stage aMCI. Cox proportional hazard models showed that aMCI participants, and late-stage aMCI participants in particular, with higher levels of education had a higher risk of AD conversion than those with lower levels of education. Late-stage aMCI participants with higher education showed faster cognitive decline in language, memory, and Clinical Dementia Rating Sum of Boxes (CDR-SOB) scores. On the contrary, early-stage aMCI participants with higher education showed slower cognitive decline in MMSE and CDR-SOB scores.
Conclusions: Our findings suggest that the protective effects of education against cognitive decline remain in early-stage aMCI and disappear in late-stage aMCI.
The present study examines whether illusory movement (IM) of a
horizontal line, induced by a moving background (MB), influences
line-bisection performance in normal subjects. The first experiment
attempted to identify the speeds of MB that induce IM. We found that when
speed is increased from 1.53° to 13.3°/sec, IM increases, but
that with further speed increases, IM decreases. Leftward MB induces
rightward IM, and vice versa. In the second experiment, we had subjects
bisect lines at MB speeds that had been shown to induce IM in the first
experiment. We found that leftward MB induced a rightward bias, and vice
versa. We also found that there was a relationship between the magnitude
of IM and the degree of bias. In the third experiment, by making the
target line larger than the MB, we made the conditions where IM was
presumably absent. Unlike the results of bisection performed with IM,
subjects showed a bias in the direction of the MB. Overall, these
experiments demonstrated that the perception of motion induces subjects to
attend in the direction of movement. (JINS, 2005, 11,
We used an electronic speckle pattern interferometer (ESPI) for nondestructive measurement in-situ displacement fields in microsystems. A four-step phase-shift technique and magnifier with long working distance were adopted to increase displacement resolution to ∼10−2 μm and spatial resolution to ∼2 μm. A thermal vacuum chamber was designed to induce thermal treatments, including annealing. From the identification of the residual-stress-free state, we quantitatively modeled thermal strains/stress fields, relaxation stresses during annealing, and residual stress fields. Thermoelasticity theory was applied to model the relationship between the relaxation stresses and the displacements measured by ESPI during the evolution of the residual-stress-free state. We assessed the surface residual stress fields of indented bulk Cu; a Fe-Ni lead frame of 100 μm width; and 0.5 μm Au film. In the indented Cu, the normal and shear residual stresses around the indented point range from –1.7 GPa to 700 MPa and –800 MPa to 600 MPa, respectively, and the residual stress in the bending area of the Fe-Ni lead frame was estimated at 148 MPa and verified using beam-bending theory. In the Au film, tensile residual stresses are uniformly distributed from 500 MPa to 800 MPa as verified by X-ray diffraction.
Based on the identification of the residual stress-free state using electronic speckle pattern interferometry (ESPI), we modeled the relaxed stress in annealing, the thermal strain/stress and the residual stress field in case of both single and film/substrate systems by using the thermo-elastic theory and the relationship between relaxed stresses and displacements. Thus we mapped the surface residual stress fields on the indented bulk Cu and the 0.5μm Au film by ESPI. In indented Cu, the normal and shear residual stress are distributed over -800 MPa to 700 MPa and -600 MPa to 600 MPa respectively around the indented point and in deposited Au film on Si wafer, the tensile residual stress is uniformly distributed on the Au film from 500 MPa to 800 MPa. Also we measured the residual stress by the x-ray diffractometer (XRD) for the verification of above residual stress results by ESPI.
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