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The rate of antidepressant use in the United Kingdom has outpaced diagnostic increases in the prevalence of depression. Research has suggested that personal and socioeconomic risk factors may be contributing to antidepressant use. To date, few studies have addressed these possible contributions. Thus, this study aimed to assess the relative strength of personal, socioeconomic and trauma-related risk factors in predicting antidepressant use.
Data were derived from the Adult Psychiatric Morbidity Survey (n=7403), a nationally representative household sample of adults residing in England in 2007. A multivariate binary logistic regression model was developed to assess the associations between personal, socioeconomic and trauma-related risk factors and current antidepressant use.
The strongest predictor of current antidepressant use was meeting the criteria for an ICD-10 depressive episode [odds ratio (OR)=9.04]. Other significant predictors of antidepressant use in this analysis included English as first language (OR=3.45), female gender (OR=1.98), unemployment (OR=1.82) and childhood sexual abuse (OR=1.53).
Several personal, socioeconomic and trauma-related factors significantly contributed to antidepressant use in the multivariate model specified. These findings aid our understanding of the broader context of antidepressant use in the United Kingdom.
Introduction: Most ambulance communication officers receive minimal education on agonal breathing, often leading to unrecognized out-of-hospital cardiac arrest (OHCA). We sought to evaluate the impact of an educational program on cardiac arrest recognition, and on bystander CPR and survival rates. Methods: Ambulance communication officers in Ottawa, Canada received additional training on agonal breathing, while the control site (Windsor, Canada) did not. Sites were compared to their pre-study performance (before-after design), and to each other (concurrent control). Trained investigators used a piloted-standardized data collection tool when reviewing the recordings for all potential OHCA cases submitted. OHCA was confirmed using our local OHCA registry, and we requested 9-1-1 recordings for OHCA cases not initially suspected. Two independent investigators reviewed medical records for non-OHCA cases receiving telephone-assisted CPR in Ottawa. We present descriptive and chi-square statistics. Results: There were 988 confirmed and suspected OHCA in the “before” (540 Ottawa; 448 Windsor), and 1,076 in the “after” group (689 Ottawa; 387 Windsor). Characteristics of “after” group OHCA patients were: mean age (68.1 Ottawa, 68.2 Windsor); Male (68.5% Ottawa, 64.8% Windsor); witnessed (45.0% Ottawa, 41.9% Windsor); and initial rhythm VF/VT (Ottawa 28.9, Windsor 22.5%). Before-after comparisons were: for cardiac arrest recognition (from 65.4% to 71.9% in Ottawa p=0.03; from 70.9% to 74.1% in Windsor p=0.37); for bystander CPR rates (from 23.0% to 35.9% in Ottawa p=0.0001; from 28.2% to 39.4% in Windsor p=0.001); and for survival to hospital discharge (from 4.1% to 12.5% in Ottawa p=0.001; from 3.9% to 6.9% in Windsor p=0.03). “After” group comparisons between Ottawa and Windsor (control) were not statistically different, except survival (p=0.02). Agonal breathing was common (25.6% Ottawa, 22.4% Windsor) and present in 18.5% of missed cases (15.8% Ottawa, 22.2% Windsor p=0.27). In Ottawa, 31 patients not in OHCA received chest compressions resulting from telephone-assisted CPR instructions. None suffered injury or adverse effects. Conclusion: While all OHCA outcomes improved over time, the educational intervention significantly improved OHCA recognition in Ottawa, and appeared to mitigate the impact of agonal breathing.
In general population samples, better childhood cognitive functioning is associated with decreased risk of depression in adulthood. However, this link has not been examined in extremely low birth weight survivors (ELBW, <1000 g), a group known to have poorer cognition and greater depression risk. This study assessed associations between cognition at age 8 and lifetime risk of major depressive disorder in 84 ELBW survivors and 90 normal birth weight (NBW, ⩾2500 g) individuals up to 29–36 years of age. The Wechsler Intelligence Scale for Children, Revised (WISC-R), Raven’s Coloured Progressive Matrices and the Token Test assessed general, fluid, and verbal intelligence, respectively, at 8 years of age. Lifetime major depressive disorder was assessed using the Mini International Neuropsychiatric Interview at age 29–36 years. Associations were examined using logistic regression adjusted for childhood socioeconomic status, educational attainment, age, sex, and marital status. Neither overall intelligence quotient (IQ) [WISC-R Full-Scale IQ, odds ratios (OR)=0.87, 95% confidence interval (CI)=0.43–1.77], fluid intelligence (WISC-R Performance IQ, OR=0.98, 95% CI=0.48–2.00), nor verbal intelligence (WISC-R Verbal IQ, OR=0.81, 95% CI=0.40–1.63) predicted lifetime major depression in ELBW survivors. However, every standard deviation increase in WISC-R Full-Scale IQ (OR=0.43, 95% CI=0.20–0.92) and Performance IQ (OR=0.46, 95% CI=0.21–0.97), and each one point increase on the Token Test (OR=0.80, 95% CI=0.67–0.94) at age 8 was associated with a reduced risk of lifetime depression in NBW participants. Higher childhood IQ, better fluid intelligence, and greater verbal comprehension in childhood predicted reduced depression risk in NBW adults. Our findings suggest that ELBW survivors may be less protected by superior cognition than NBW individuals.
A search for Type Ia supernovae at cosmological distances is being undertaken in an attempt to exploit their standard candle property to constrain the mass density of the universe. We describe the rationale for such a program, the observational approach and strategy taken, and the progress made to date. The science that is being generated by the project in additional to supernova detection is also discussed briefly.
Immunoglobulin A (IgA) is a predominant immunoglobulin present in human breast milk and is known to play an important role in infant gut immunity maturation. Breast milk composition varies between populations, but the environmental and maternal factors responsible for these variations are still unclear. We examined the relationship between different exposures and levels of IgA in colostrum. The objective of this study was to examine whether exposures analysed influence levels of IgA in colostrum. The present study used 294 colostrum samples from the MecMilk International cohort, collected from women residing in London, Moscow and Verona. Samples were analysed in automated Abbott Architect Analyser. We found an inverse correlation between time postpartum and colostrum total IgA level (r=−0.49, P<0.001). Adjusting for maternal parity, smoking, fresh fruit and fish consumption and allergen sensitization, multiple regression model showed that IgA levels were influenced by colostrum collection time (P<0.0001) and country of collection (P<0.01). Mode of delivery influence did not appear to be significant in univariate comparisons, once adjusted for the above maternal characteristics it showed a significant influence on total IgA (P=0.01). We conclude that the concentration of IgA in colostrum drops rapidly after birth and future studies should always consider this factor in analysis. IgA concentration varied significantly between countries, with the highest level detected in Moscow and lowest in Verona. Mode of delivery effect should be confirmed on larger cohorts. Further work is needed to determine ways to correct for IgA decline over time in colostrum, and to find the cause of variations in IgA levels between the countries.
To assess an intervention to limit community-associated methicillin-resistant Staphylococcus aureus (MRSA) dissemination.
Randomized, controlled trial.
County Jail, Dallas, Texas.
A total of 4,196 detainees in 68 detention tanks.
Tanks were randomly assigned to 1 of 3 groups: in group 1, detainees received cloths that contained chlorhexidine gluconate (CHG) to clean their entire skin surface 3 times per week for 6 months; group 2 received identical cloths containing only water; and group 3 received no skin treatment. During the study, all newly arrived detainees were invited to enroll. Nares and hand cultures were obtained at baseline and from all current enrollees at 2 and 6 months.
At baseline, S. aureus was isolated from 41.2% and MRSA from 8.0% (nares and/or hand) of 947 enrollees. The average participation rate was 47%. At 6 months, MRSA carriage was 10.0% in group 3 and 8.7% in group 1 tanks (estimated absolute risk reduction [95% confidence interval (CI)], 1.4% [−4.8% to 7.1%]; P = .655). At 6 months, carriage of any S. aureus was 51.1% in group 3, 40.7% in group 1 (absolute risk reduction [95% CI], 10.4% [0.01%–20.1%]; P = .047), and 42.8% (absolute risk reduction [95% CI], 8.3% [−1.4% to 18.0%]; P = .099) in group 2.
Skin cleaning with CHG for 6 months in detainees, compared with no intervention, significantly decreased carriage of S. aureus, and use of water cloths produced a nonsignificant but similar decrease. A nonsignificant decrease in MRSA carriage was found with CHG cloth use.
This paper describes the system architecture of a newly constructed radio telescope – the Boolardy engineering test array, which is a prototype of the Australian square kilometre array pathfinder telescope. Phased array feed technology is used to form multiple simultaneous beams per antenna, providing astronomers with unprecedented survey speed. The test array described here is a six-antenna interferometer, fitted with prototype signal processing hardware capable of forming at least nine dual-polarisation beams simultaneously, allowing several square degrees to be imaged in a single pointed observation. The main purpose of the test array is to develop beamforming and wide-field calibration methods for use with the full telescope, but it will also be capable of limited early science demonstrations.
To understand the genotypic spectrum of environmental contamination of Staphylococcus aureus in households and its persistence
Prospective longitudinal cohort investigation.
Index participants identified at 2 academic medical centers.
Adults and children with S. aureus skin infections and their household contacts in Los Angeles and Chicago.
Household fomites were surveyed for contamination at baseline and 3 months. All isolates underwent genetic typing.
We enrolled 346 households, 88% of which completed the 3-month follow-up visit. S. aureus environmental contamination was 49% at baseline and 51% at 3 months. Among households with a USA300 methicillin-resistant S. aureus (MRSA) body infection isolate, environmental contamination with an indistinguishable MRSA strain was 58% at baseline and 63% at 3 months. Baseline factors associated with environmental contamination by the index subject’s infection isolate were body colonization by any household member with the index subject’s infection isolate at baseline (odds ratio [OR], 10.93 [95% confidence interval (CI), 5.75–20.79]), higher housing density (OR, 1.47 [95% CI, 1.10–1.96]), and more frequent household fomite cleaning (OR, 1.62 [95% CI, 1.16–2.27]). Household environmental contamination with the index subject’s infection strain at 3 months was associated with USA300 MRSA and a synergistic interaction between baseline environmental contamination and body colonization by any household member with the index subject’s infection strain.
We found that infecting S. aureus isolates frequently persisted environmentally in households 3 months after skin infection. Presence of pathogenic S. aureus strain type in the environment in a household may represent a persistent reservoir that places household members at risk of future infection.
Infect Control Hosp Epidemiol 2014;35(11):1373–1382
A simple hydrothermal route to the eulytite phase of bismuth germanium oxide (E-BGO: Bi4(GeO4)3) that required no post-processing has been developed. The E-BGO material was isolated from a mixture of bismuth nitrate pentahydrate and a slight excess of germanium oxide in water under hydrothermal conditions (185 °C for 24 h). The resultant materials were characterized by powder x-ray diffraction, scanning electron microscopy, transmission electron microscopy, and luminescence measurements to verify the particle's phase (eulytite), morphology, size, and response to a variety of excitation energy sources, respectively. Photoluminescence spectroscopic response from E-BGO pellets indicated that the samples exhibited a strong emission peak consistent with an x-ray induced luminescence of a E-BGO single crystal (500 nm excited at 285 nm). Cathodoluminescent properties of the E-BGO displayed a broadband spectrum with a maximum at 487 nm. The growth process was consistent with a standard Oswald ripening and LaMer growth processes.
MoO3 films with a high work function (5.5 eV), high transparency, and a wide bandgap (3.0 - 3.4 eV) are a potential candidate for the primary back contact of Cu(InGa)Se2 thin film solar cells. This may be advantageous to form ohmic contact in superstrate devices where the back contact will be deposited after the Cu(InGa)Se2 layer and MoSe2 layer doesn’t form during Cu(InGa)Se2 deposition. In addition, the MoO3 may be incorporated in a transparent back contact in tandem or bifacial cells. In this study, MoO3 films for use as a back contact for Cu(In,Ga)Se2 thin film solar cells were prepared by reactive rf sputtering with O2/(O2+Ar) = 35%. The effect of post processing on the structural properties of the deposited films were investigated using x-ray diffraction and scanning electron microscopy. Annealing resulted in crystallization of the films to the α-MoO3 phases at 400°C. Increasing the oxygen partial pressure had no significant effect on optical transmittance of the films, and bandgaps in the range of 2.6-2.9 eV and 3.1-3.4 eV were obtained for the as deposited and annealed films, respectively. Cu(In,Ga)Se2 thin film solar cells prepared using an as-deposited Mo-MoO3 back contact yielded an efficiency of >14% with VOC = 647 (mV), JSC = 28.4 (mA), and FF. = 78.1%. Cells with ITO-MoO3 back contact showed an efficiency of ∼12% with VOC = 642 (mV), JSC = 26.8 (mA), and FF. = 69.2%. The efficiency of cells with an annealed MoO3 back contact was limited to 4%, showing a blocking diode behavior in the forward bias J-V curve. This may be caused by the presence of a barrier between the valence bands of the Cu(In,Ga)Se2 and MoO3, due to the higher bandgap of the annealed MoO3 films. SEM cross section studies showed uniform coverage of the as-deposited MoO3 layer and formation of voids for the annealed MoO3 film. Structural orientation of the Cu(In,Ga)Se2 absorber layer was also altered by the MoO3 film and less-oriented films were observed for either cases.
Growing pigs can display undesirable behaviours, reflecting or causing poor welfare. Addition of magnesium (Mg) to the diet could reduce these, as Mg supplementation has been associated with improved coping ability in response to stress. This study examined the effect of supplementation with a Mg-rich marine extract-based product (Supplement) on the behaviour, skin and tail lesion scores and salivary cortisol concentrations of growing pigs. At weaning (28 days), 448 piglets were assigned to either Control or Supplement (0.05%) diets in single-sex groups of 14. Four weeks later (c. 17 kg), pigs were blocked according to weight and back test scores. Seven piglets from each pen were mixed with seven from another pen of the same sex and dietary treatment to yield the following groups: control male, Supplement male, control female and Supplement female (n = 4 of each). This marked the start of the 9-week experimental period. Instances of the following behaviours were recorded in each pen for 8 × 2 min periods 1 day/week: aggression (fight, head-knock and bite); harmful (tail-in-mouth, ear-chewing and belly-nosing); and sexual/mounting behaviour. Four focal pigs were selected from each pen, and their behaviour was continuously recorded for 2 × 5 min periods on the same day. Saliva was collected once per week at 1000 h by allowing pigs to chew on a cotton bud for c. 1 min. Salivary cortisol was analysed in duplicate by an enzyme immunoassay. Skin and tail lesions were scored according to severity 1 day/week. There were fewer aggressive incidents in Supplement pens (P < 0.01), and mounting behaviour (performed only by males) was almost three times lower in Supplement than in control pens (P < 0.01). However, there was no effect of Supplement on the incidence of each of the harmful behaviours. Behaviour of the focal pigs showed no treatment effect on the duration or incidence of aggressive behaviour. However, Supplement pigs spent less time performing harmful behaviours compared with control pigs (P < 0.001). Supplement had no effect on the occurrence or severity of tail-biting outbreaks or on tail lesion scores. However, Supplement females had lower skin lesion scores, in particular in the ears and shoulders (P < 0.01). Finally, Supplement pigs had lower salivary cortisol concentrations (P < 0.01). Mounting is a major welfare concern in uncastrated pigs, and therefore this represents an important welfare benefit of Supplement. Reduced salivary cortisol, in conjunction with reduced skin lesion scores in supplemented females, suggests that addition of a Mg-rich marine extract improved pig welfare in this system.
Literature on food environments has expanded rapidly, yet most research focuses on stores and community characteristics without integrating customer-level data. The present study combines customer shopping behaviour with store food inventory data.
Face-to-face interviews were conducted with customers shopping in corner stores to measure food shopping behaviour, household food security and demographics. Store inventories were conducted to measure availability of healthy food in corner stores. Multilevel logistic regression models estimated the probability of customers purchasing a food item given the availability of that item in the store.
Nineteen corner stores in Hartford, CT, USA, average size 669 ft2 (62·15 m2).
Sample of 372 customers.
The majority of customers were Black or Hispanic (54 % and 40 %, respectively) and 61 % experienced food insecurity. For each additional type of fruits or vegetables available in the store, the estimated odds of a customer purchasing fruits increased by 12 % (P = 0·03) and the odds for purchasing vegetables increased by 15 % (P = 0·01). Customers receiving the Supplemental Nutrition Assistance Program (SNAP) were 1·7 times as likely to purchase fruit as those not receiving SNAP (P = 0·04). Greater availability of reduced-fat milk was not associated with increased likelihood of customers purchasing reduced-fat milk.
There is a positive association between fruit and vegetable variety and the probability that a customer purchases fruits and vegetables. Increasing the selection of produce in corner stores may increase their consumption by food-insecure and low-income residents at risk for health disparities. These findings have implications for future store interventions and food policies.
Background: Behavioral and psychological symptoms of dementia (BPSD) are common and are core symptoms of the condition. They cause considerable distress to the person with dementia and their carers and predict early institutionalization and death. Historically, these symptoms have been managed with anxiolytic and antipsychotic medication. Although potentially effective, such medication has been used too widely and is associated with serious adverse side-effects and increased mortality. Consequently, there is a need to evaluate non-pharmacological therapies for behavioral and psychological symptoms in this population. One such therapy is physical activity, which has widespread health benefits. The aim of this review is to summarize the current findings of the efficacy of physical activity on BPSD.
Method: Published articles were identified using electronic and manual searches. Rather than systematically aggregating data, this review adopted a rapid critical interpretive approach to synthesize the literature.
Results: Exercise appears to be beneficial in reducing some BPSD, especially depressed mood, agitation, and wandering, and may also improve night-time sleep. Evidence of the efficacy of exercise on improving other symptoms such as anxiety, apathy, and repetitive behaviors is currently weak or lacking.
Conclusion: The beneficial effect of exercise type, its duration, and frequency is unclear although some studies suggest that walking for at least 30 minutes, several times a week, may enhance outcome. The methodological shortcomings of current work in this area are substantial. The research and clinical implications of current findings are discussed.
The formal commissioning of the IRWG occurred at the 1991 Buenos Aires General Assembly, following a Joint Commission meeting at the IAU GA in Baltimore in 1988 that identified the problems with ground-based infrared photometry. The meeting justification, papers, and conclusions, can be found in Milone (1989). In summary, the challenges involved how to explain the failure to achieve the milli-magnitude precision expected of infrared photometry and an apparent 3% limit on system transformability. The proposed solution was to redefine the broadband Johnson system, the passbands of which had proven so unsatisfactory that over time effectively different systems proliferated, although bearing the same “JHKLMNQ” designations; the new system needed to be better positioned and centered in the spectral windows of the Earth's atmosphere, and the variable water vapour content of the atmosphere needed to be measured in real time to better correct for atmospheric extinction.
To evaluate the first phase of a specialist weight management programme provided entirely within the UK National Health Service.
Prospective cohort study using multiple logistic regression analysis to report odds of ≥5 kg weight loss in all referrals and completers, and odds of completion, with 95 % confidence intervals. Anxiety and depression ‘caseness’ were measured by the Hospital Anxiety and Depression Scale.
Glasgow and Clyde Weight Management Service (GCWMS) is a specialist multidisciplinary service, with clinical psychology support, for patients with BMI ≥35 kg/m2 or BMI ≥30 kg/m2 with co-morbidities.
All patients referred to GCWMS between 2004 and 2006.
Of 2976 patients referred to GCWMS, 2156 (72·4 %) opted into the service and 809 completed phase 1. Among 809 completers, 35·5 % (n 287) lost ≥5 kg. Age ≥40 years, male sex (OR = 1·39, 95 % CI 1·05, 1·82), BMI ≥ 50 kg/m2 (OR = 1·70, 95 % CI 1·14, 2·54) and depression (OR = 1·81, 95 % CI 1·35, 2·44) increased the likelihood of losing ≥5 kg. Diabetes mellitus (OR = 0·55, 95 % CI 0·38, 0·81) and socio-economic deprivation were associated with poorer outcomes. Success in patients aged ≥40 years and with BMI ≥50 kg/m2 was associated with higher completion rates of the programme. Patients from the most deprived areas were less likely to lose ≥5 kg because of non-completion of the programme.
Further improvements in overall effectiveness might be achieved through targeting improvements in appropriateness of referrals, retention and effective interventions at specific populations of patients.
In response to epidemic methicillin-resistant Staphylococcus aureus (MRSA) in the community, the Illinois General Assembly mandated that all patients admitted to intensive care units statewide be screened for MRSA. Screening was instituted at our neonatal intensive care unit (NICU) in September 2007 by a polymerase chain reaction (PCR)-based strategy. The law created an opportunity to determine the rate of MRSA colonization among neonates, to gather information about subsequent MRSA infections, and to evaluate risk factors for MRSA colonization on admission to the NICU.