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Doing there is no consensus for a multidimensional definition of Quality of Life (QoL) in dementia, and that informant- and self-perceptions of QoL differed substantially, lately it has been proposed to analyze Overall QoL using a simple item. Our objective was to investigate Overall QoL and how this perception among people with Cognitive Impairment and Dementia is associated with other variables. Thus, obtained predictor variables of QoL will act as confirmatory indexes to corroborate the self-reported QoL in clinical setting.
Methods
We conducted a cross-sectional survey where 106 participants with Cognitive Impairment (CI) and Dementia completed a face to face interview including diagnosis of dementia (DSM-III-R / DSM-IV), sociodemographic information, health perception and a list of chronic medical conditions, depressive symptoms (GDS-15) and functional ability (Barthel Index). Quality of life was measured with the self-assessment of overall QoL item from WHOQOL-BREF.
Results
Mean age was 78.7 y.o. (SD: 7.1, range 55-91); 64.8% were female and 50% had primary school or more. Ordinal Logistic Regression analysis showed four factors correlated with a better QoL: (1) patients rating their health as good or more than good, (2) patients considering themselves healthy, (3) patients reporting not having depression, and (4) patients having less depressive symptoms (lower GDS scores).
Conclusions
A single-item global rating of patient QoL could prove useful in assessing QoL of most mild-to-moderate-stage CI and dementia patients. Affective states should be considered when assessing QoL in patients with CI and dementia; consistently, negative mood have a detrimental impact on QoL.
The frost susceptibility of Australian commercial cereal crops, in particular wheat and barley, has become an economically devastating issue for growers. The relative risk to frost damage of the currently available varieties is obtained through testing varieties in a series of field experiments at locations susceptible to frost events (FEs). The experimental design, measurement protocols and resultant data from these frost expression experiments (FEEs) are complex due to the unpredictability of the timing and severity of FEs, and the maturity of the plants at the time of the events. Design and protocol complexities include the use of multiple sowing dates and the recording of plant maturity. Data difficulties include a high degree of unbalance, and in the instance of multiple frosts in a FEE, there is a longitudinal aspect. A linear mixed model analysis was adopted to accommodate these characteristics of individual FEEs and the multi-environment trial analysis of 17 FEEs. Finally, an approach is demonstrated for dissemination of results that are of use to both growers and breeders.
Olfactory disorders increase with age and often affect elderly people who have pre-dementia or dementia. Despite the frequent occurrence of olfactory changes at the early stages of neurodegenerative disorders such as Alzheimer's disease, olfactory disorders are rarely assessed in daily clinical practice, mainly due to a lack of standardised assessment tools. The aims of this review were to (1) summarise the existing literature on olfactory disorders in ageing populations and patients with neurodegenerative disorders; (2) present the strengths and weaknesses of current olfactory disorder assessment tools; and (3) discuss the benefits of developing specific olfactory tests for neurodegenerative diseases.
Methods:
A systematic review was performed of literature published between 2000 and 2015 addressing olfactory disorders in elderly people with or without Alzheimer's disease or other related disorders to identify the main tools currently used for olfactory disorder assessment.
Results:
Olfactory disorder assessment is a promising method for improving both the early and differential diagnosis of Alzheimer's disease. However, the current lack of consensus on which tests should be used does not permit the consistent integration of olfactory disorder assessment into clinical settings.
Conclusion:
Otolaryngologists are encouraged to use olfactory tests in older adults to help predict the development of neurodegenerative diseases. Olfactory tests should be specifically adapted to assess olfactory disorders in Alzheimer's disease patients.
The Dark Energy Survey is undertaking an observational programme imaging 1/4 of the southern hemisphere sky with unprecedented photometric accuracy. In the process of observing millions of faint stars and galaxies to constrain the parameters of the dark energy equation of state, the Dark Energy Survey will obtain pre-discovery images of the regions surrounding an estimated 100 gamma-ray bursts over 5 yr. Once gamma-ray bursts are detected by, e.g., the Swift satellite, the DES data will be extremely useful for follow-up observations by the transient astronomy community. We describe a recently-commissioned suite of software that listens continuously for automated notices of gamma-ray burst activity, collates information from archival DES data, and disseminates relevant data products back to the community in near-real-time. Of particular importance are the opportunities that non-public DES data provide for relative photometry of the optical counterparts of gamma-ray bursts, as well as for identifying key characteristics (e.g., photometric redshifts) of potential gamma-ray burst host galaxies. We provide the functional details of the DESAlert software, and its data products, and we show sample results from the application of DESAlert to numerous previously detected gamma-ray bursts, including the possible identification of several heretofore unknown gamma-ray burst hosts.
A correct interpretation of ligament ontogeny and structure is essential for establishing phylogenetic relationships among higher taxa in the bivalve superorder Pteriomorphia. Recent research on pteriomorphian ligaments has focused on understanding ligament morphospace (Thomas et al., 2000; Ubukata, 2003) and evolutionary pathways. In this regard, studies of the transition from larval to post-larval and adult ligaments (Malchus, 2004) have been especially fruitful.
During the early afternoon of June 29, 2012, a line of destructive thunderstorms producing straight line winds known as a derecho developed near Chicago (Illinois, USA). The storm moved southeast with wind speeds recorded from 100 to 160 kilometers per hour (kph, 60 to 100 miles per hour [mph]). The storm swept across much of West Virginia (USA) later that evening. Power outage was substantial as an estimated 1,300,000 West Virginians (more than half) were without power in the aftermath of the storm and approximately 600,000 citizens were still without power a week later. This was one of the worst storms to strike this area and occurred as residents were enduring a prolonged heat wave. The wind damage left much of the community without electricity and the crippling effect compromised or destroyed critical infrastructure including communications, air conditioning, refrigeration, and water and sewer pumps. This report describes utilization of Emergency Medical Services (EMS) and hospital resources in West Virginia in response to the storm. Also reported is a review of the weather phenomena and the findings and discussion of the disaster and implications.
KearnsRD, WigalMS, FernandezA, TuckerMAJr, ZuidgeestGR, MillsMR, CairnsBA, CairnsCB. The 2012 Derecho: Emergency Medical Services and Hospital Response. Prehosp Disaster Med. 2014;29(5):1-4.
Conventional and reference-surface mass-balance data from Gulkana and Wolverine Glaciers, Alaska, USA, are used to address the questions of how rapidly these glaciers are adjusting (or ‘responding’) to climate, whether their responses are stable, and whether the glaciers are likely to survive in today’s climate. Instability means that a glacier will eventually vanish, or at least become greatly reduced in volume, if the climate stabilizes at its present state. A simple non-linear theory of response is presented for the analysis. The response of Gulkana Glacier is characterized by a timescale of several decades, but its stability and therefore its survival in today’s climate are uncertain. Wolverine seems to be responding to climate more slowly, on the timescale of one to several centuries. Its stability is also uncertain, but a slower response time would make it more susceptible to climate changes.
BMI is commonly used as a sole indicator for the assessment of nutritional status. While it is a good predictor of morbidity and mortality among young and middle-aged adults, its predictive ability among the oldest old remains unclear. The objective of the present study was to investigate the relationship between BMI and risk of falls, fractures and all-cause mortality among older Australians in residential aged care facilities. One thousand eight hundred and forty-six residents of fifty-two nursing homes and thirty hostels in northern Sydney, Australia, participated in the present study. Baseline weight and height were measured and BMI (kg/m2) calculated. For 2 years following the baseline measurements, incidence and date of all falls and fractures were recorded by research nurses who visited the facilities regularly and date of death was documented based on the participants' records at each facility. Cox proportional hazards regression models were calculated to determine the relationship between baseline BMI and time to fall, fracture or death, within 2 years following the baseline measures taken to be the censoring date. After adjustments were made for age, sex and level of care, low BMI ( < 22 kg/m2) increased the risk of fracture by 38 % (hazard ratio = 1·38, 95 % CI 1·11, 1·73) and all-cause mortality by 52 % (hazard ratio = 1·52, 95 % CI 1·30, 1·79). The magnitude of this effect was only slightly reduced when adjustments were further made to incorporate cognition, number of medications, falls and fracture in the subsequent 2-year period. In conclusion, BMI has predictive ability in the area of fracture and all-cause mortality for residents of aged care facilities. It is a simple and rapid indicator of nutritional status rendering it a useful nutrition screen and goal for nutrition intervention.
The more than 40 year record of net and seasonal mass-balance records from measurements made by the United States Geological Survey on South Cascade Glacier, Washington, and Wolverine and Gulkana Glaciers, Alaska, shows annual and interannual fluctuations that reflect changes in the controlling climatic conditions at regional and global scales. As the mass-balance record grows in length, it is revealing significant changes in previously described glacier mass-balance behavior, and both inter-glacier and glacier–climate relationships. South Cascade and Wolverine Glaciers are strongly affected by the warm and wet maritime climate of the northeast Pacific Ocean. Their net balances have generally been controlled by winter accumulation, with fluctuations that are strongly related to the Pacific Decadal Oscillation (PDO). Recently, warm dry summers have begun to dominate the net balance of the two maritime glaciers, with a weakening of the correlation between the winter balance fluctuations and the PDO. Non-synchronous periods of positive and negative net balance for each glacier prior to 1989 were followed by a 1989–2004 period of synchronous and almost exclusively negative net balances that averaged –0.8m for the three glaciers.
Phytate (inositol hexaphosphate; InsP6) was determined in rat tissues fed on diets with different phytate contents, using a GC–mass detection methodology that permitted the evaluation of the total amount of this substance present in such tissues. The highest InsP6 concentrations were found in brain (5·89×10-2 (SE 5·7×10-3) MG/G DM), WHEREAS THE CONCENTRATIONS DETECTED IN KIDNEYS, LIVER AND BONE WERE SIMILAR TO EACH OTHER (1·96×10-3 (se 0·20×10-3), 3·11×10-3 (se 0·24×10-3), 1·77×10-3 (se 0·17×10-3) mg/g DM respectively) and 10-fold less than those detected in brain. When rats were fed on a purified diet in which InsP6 was undetectable, the InsP6 levels of the organs mentioned earlier decreased dramatically (9·0×10-4, 3·8×10-5, 1·4×10-5 mg/g DM in brain, kidneys and liver respectively) and in some cases became undetectable (bone). The addition of InsP6 to this purified diet led to the increase of InsP6 levels in these tissues. This clearly demonstrated that the majority of the InsP6 found in organs and tissues has a dietary origin and is not a consequence of endogenous synthesis. Consequently, considering that InsP6 could be involved in some important biological roles, the value of any diet on supplying this substance is noteworthy.
Progress in the neurobiology of childhood anxiety has recently focused on the effects of rearing and environment in the progression of anxiety states. Convergence of evidence from both child studies of stress and trauma (Pfefferbaum, 1997; Pynoos, Steinberg & Wrath, 1995) as well as primate rearing and deprivation studies (Coplan et al., 1996; Higley, Suomi & Linnoila, 1992) illustrate that the effects of stress in the genesis of anxiety disorder can be profound. Anxiety disorders are now viewed from a developmental perspective (Ollendick, 1998; Rosenberg & Keshavan, 1998) in which an individual's history of exposure to threat and that threat's developmental and cognitive context are interwoven with internal factors (e.g. genetic and neurophysiological) as keys to the individual's ‘stress-response system’. Later in this chapter, neuroanatomical and information processing models of panic and childhood obsessive–compulsive disorders (OCD) are discussed in their developmental context in order to shed light on both the development of anxiety disorder and its frequent association with comorbid conditions, such as attention-deficit hyper-activity disorder (ADHD), in child psychiatry. The implication is clear: anxiety disorders, now viewed across the life span (Ballenger, 1997; Lydiard & Brawman-Mintzer, 1997), require treatments that reflect both the developmental stage and context of anxiety disorder genesis and maintenance.
Our understanding of the neurobiology of anxiety has been propelled by new pharmacological therapeutic tools specific in their impact on certain central nervous system (CNS) receptors within the ‘stress-response system’.
Several studies have indicated that additional genes in the major histocompatibility complex
(MHC) region, other than the class II genes HLA-DQB1 and -DRB1 (the IDDM1 locus), may
contribute to susceptibility and resistance to type 1 diabetes. The relative magnitude of these non-
DR/DQ effects is uncertain and their map location is unknown owing to the extraordinary linkage
disequilibrium that extends over the 3.5 Mb of the MHC. The homozygous parent test has been
proposed as a method for detection of additional risk factors conditional on HLA-DQB1 and -DRB1.
However, this method is inefficient since it uses only parents homozygous for the primary disease
locus, the DQB1-DRB1 haplotype. To overcome this limitation, Conditional ETDT was used in the
present report to test for association conditional on the DQB1-DRB1 haplotype, thereby allowing all
parents to be included in the analysis. First, we confirm in UK and Sardinian type 1 diabetic families
that allelic variation at HLA-DRB1 has a very significant effect on the association of DQB1 and vice
versa. The Conditional ETDT was then applied to the HLA TNF (tumour necrosis factor) region and
microsatellite marker D6S273 region, both of which have been reported to contribute to IDDM1
independent of the HLA-DQB1-DRB1 genes. We found no evidence for a major role for either of these
two regions in IDDM1.
We consider a geometric motion associated with the minimization of a curvature dependent
functional, which is related to the Willmore functional. Such a functional arises in connection
with the image segmentation problem in computer vision theory. We show by using formal
asymptotics that the geometric motion can be approximated by the evolution of the zero
level set of the solution of a nonlinear fourth-order equation related to the Cahn–Hilliard
and Allen–Cahn equations.
The risk of Borrelia burgdorferi infection and the value
of antibiotic prophylaxis after tick bite
are controversial. In this study, performed in two areas of southwestern
Germany, ticks were
collected from 730 patients and examined by the polymerase chain reaction
(PCR) for
B. burgdorferi. To assess whether transmission of B.
burgdorferi occurred, the patients were
clinically and serologically examined after tick removal and during follow-up
examinations.
Data from all tick bites gave a total transmission rate of 2·6%
(19 patients). Eighty-four ticks
(11·3%) were PCR positive. Transmission occurred to 16
(26·7%) of 60 patients who were
initially seronegative and could be followed up after the bite of
an infected tick. These results
indicate that the transmission rate from infected ticks in Europe is higher
than previously
assumed. Examination of ticks and antibiotic prophylaxis in the case of
positivity appears to
be indicated.