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This chapter describes our changing views on psychopathology and our attempts to model it. In particular, it argues how, for a significant step forward in mental health research, we should acknowledge the complex nature of mental illness. We introduce an exciting new paradigm in the field of psychopathology: the network paradigm. We discuss the basics of network theory, its application to psychopathology and some future directions of where this avenue may take us.
Co-ingestion of almonds with carbohydrate prevents excessive increase in plasma glucose level (PGL), but information about the functional fraction is limited. Identifying the functional fraction is necessary to use almonds more efficiently in terms of controlling postprandial glycaemia after a high-carbohydrate meal. In the present study, we evaluated the effects of almond skin, oil, water-soluble fraction and water-insoluble fraction on both postprandial glycaemia and insulinaemia. The effect of almond skin was tested by comparing the effect of whole almonds with the effect of skinless almonds. Male ICR mice were administered dextrin and 4 g/kg body weight test samples. After the administration, 2-h postprandial changes in glycaemia and insulinaemia were measured. Oil was the only fraction being able to blunt postprandial glycaemia. Interestingly, when co-ingesting with dextrin, almond oil did not change the insulin level compared with the control but whole almonds or skinless almonds triggered a 4-fold increase in insulin level. The co-ingestion of whole almonds or skinless almonds similarly suppressed the PGL at 15 and 30 min (P < 0·05), which means almond skin has no effect on postprandial glycaemia. Neither soluble nor insoluble fractions lead to any significant changes in postprandial glycaemia and insulinaemia. In conclusion, oil is the main functional component accounting for the glycaemia-lowering effect without altering insulin level.
The abnormalities of the puerperium can be arbitrarily divided into two broad categories. Those which arise following a difficult calving or retained placenta are referred to as “common”, while abnormalities such as sub- and anoestrus, irregular cycles, cystic follicles, absence of ovarian activity, repeat breeding and increased number of inseminations per pregnancy are described as “special”. Since the “common” abnormalities are well understood, this paper deals in greater detail with the “special” abnormalities of the puerperium. Based on the axiom that many facets of the “special” abnormalities can be caused by dysfunction of the liver (as in the case of fatty liver), information is presented based on experiments conducted with the over-conditioned dairy cow model (AM) which suffers from both a severe negative energy balance (NEB) and fatty liver syndrome during early lactation. This cow model guarantees a severe NEB, with body weight loss and clear changes in the body condition score (BCS), lower milk production, a higher milk fat concentration, temporary decline in blood insulin and glucose concentrations, elevated blood concentrations of non esterified fatty acids (NEFAs) and beta-hydroxybutyrate (BHB) as well as elevated liver concentrations of tri-acyl-glycerol (TAG) during the first weeks post partum. Additionally, this model leads to a higher incidence of metabolic and infectious diseases. Particular attention was paid to LH pulse frequency and to its value in predicting the occurrence of first post partum ovulation would occur, to oestrous behaviour and to oocytes quality. Cows with fatty liver (> 50 mg TAG/g liver tissue) had longer intervals between parturition and 1st ovulation and showed fewer standing heats within the first 100 days post partum, but the proportion of detected heats, compared to endocrinological “heats” was higher in confirmed AM-cows. Moreover, when AM cows come in heat, their heats lasted longer and had a higher pregnancy rate following AI. However, the developmental capacity of oocytes in AM cows, and in particular oocytes that were destined to ovulate between 80 and 120 days pp, was adversely affected. We conclude that the fatty liver condition is a trigger for many problems, including metabolic and infectious diseases, and also of reduced fertility. Prevention of over fatness at calving (BCS>3.5) is the best guarantee for a normal puerperium.
Despite significant research examining mental health in conflict-affected populations we do not yet have a comprehensive epidemiological model of how mental disorders are distributed, or which factors influence the epidemiology in these populations. We aim to derive prevalence estimates specific for region, age and sex of major depression, and PTSD in the general populations of areas exposed to conflict, whilst controlling for an extensive range of covariates.
A systematic review was conducted to identify epidemiological estimates of depression and PTSD in conflict-affected populations and potential predictors. We analyse data using Bayesian meta-regression techniques.
We identified 83 studies and a list of 34 potential predictors. The age-standardised pooled prevalence of PTSD was 12.9% (95% UI 6.9–22.9), and major depression 7.6% (95% UI 5.1–10.9) – markedly lower than estimated in previous research but over two-times higher than the mean prevalence estimated by the Global Burden of Disease Study [3.7% (95% UI 3.0–4.5) and 3.5% (95% UI 2.9–4.2) for anxiety disorders and MDD, respectively]. The age-patterns reveal sharp prevalence inclines in the childhood years. A number of ecological variables demonstrated associations with prevalence of both disorders. Symptom scales were shown to significantly overestimate prevalence of both disorders. Finding suggests higher prevalence of both disorders in females.
This study provides, for the first time, age-specific estimates of PTSD and depression prevalence adjusted for an extensive range of covariates and is a significant advancement on our current understanding of the epidemiology in conflict-affected populations.
Mental and substance use disorders are common and often persistent, with many emerging in early life. Compared to adult mental and substance use disorders, the global burden attributable to these disorders in children and youth has received relatively little attention.
Data from the Global Burden of Disease Study 2010 was used to investigate the burden of mental and substance disorders in children and youth aged 0–24 years. Burden was estimated in terms of disability-adjusted life years (DALYs), derived from the sum of years lived with disability (YLDs) and years of life lost (YLLs).
Globally, mental and substance use disorders are the leading cause of disability in children and youth, accounting for a quarter of all YLDs (54.2 million). In terms of DALYs, they ranked 6th with 55.5 million DALYs (5.7%) and rose to 5th when mortality burden of suicide was reattributed. While mental and substance use disorders were the leading cause of DALYs in high-income countries (HICs), they ranked 7th in low- and middle-income countries (LMICs) due to mortality attributable to infectious diseases.
Mental and substance use disorders are significant contributors to disease burden in children and youth across the globe. As reproductive health and the management of infectious diseases improves in LMICs, the proportion of disease burden in children and youth attributable to mental and substance use disorders will increase, necessitating a realignment of health services in these countries.
Mortality-associated burden of disease estimates from the Global Burden of Disease 2010 (GBD 2010) may erroneously lead to the interpretation that premature death in people with mental, neurological and substance use disorders (MNSDs) is inconsequential when evidence shows that people with MNSDs experience a significant reduction in life expectancy. We explore differences between cause-specific and excess mortality of MNSDs estimated by GBD 2010.
GBD 2010 cause-specific death estimates were produced using the International Classification of Diseases death-coding system. Excess mortality (all-cause) was estimated using natural history models. Additional mortality attributed to MNSDs as underlying causes but not captured through GBD 2010 methodology is quantified in the comparative risk assessments.
In GBD 2010, MNSDs were estimated to be directly responsible for 840 000 deaths compared with more than 13 million excess deaths using natural history models.
Numbers of excess deaths and attributable deaths clearly demonstrate the high degree of mortality associated with these disorders. There is substantial evidence pointing to potential causal pathways for this premature mortality with evidence-based interventions available to address this mortality. The life expectancy gap between persons with MNSDs and the general population is high and should be a focus for health systems reform.
Autism spectrum disorders (ASDs) are persistent disabling neurodevelopmental disorders clinically evident from early childhood. For the first time, the burden of ASDs has been estimated for the Global Burden of Disease Study 2010 (GBD 2010). The aims of this study were to develop global and regional prevalence models and estimate the global burden of disease of ASDs.
A systematic review was conducted for epidemiological data (prevalence, incidence, remission and mortality risk) of autistic disorder and other ASDs. Data were pooled using a Bayesian meta-regression approach while adjusting for between-study variance to derive prevalence models. Burden was calculated in terms of years lived with disability (YLDs) and disability-adjusted life-years (DALYs), which are reported here by world region for 1990 and 2010.
In 2010 there were an estimated 52 million cases of ASDs, equating to a prevalence of 7.6 per 1000 or one in 132 persons. After accounting for methodological variations, there was no clear evidence of a change in prevalence for autistic disorder or other ASDs between 1990 and 2010. Worldwide, there was little regional variation in the prevalence of ASDs. Globally, autistic disorders accounted for more than 58 DALYs per 100 000 population and other ASDs accounted for 53 DALYs per 100 000.
ASDs account for substantial health loss across the lifespan. Understanding the burden of ASDs is essential for effective policy making. An accurate epidemiological description of ASDs is needed to inform public health policy and to plan for education, housing and financial support services.
Despite their high prevalence, the global burden of anxiety disorders has never been calculated comprehensively. The new Global Burden of Disease (GBD) study has estimated burden due to morbidity and mortality caused by any anxiety disorder.
Prevalence was estimated using Bayesian meta-regression informed by data identified in a systematic review. Years of life lived with disability (YLDs) were calculated by multiplying prevalent cases by an average disability weight based on severity proportions (mild, moderate and severe). Disability-adjusted life years (DALYs) were then calculated and age standardized using global standard population figures. Estimates were also made for additional suicide mortality attributable to anxiety disorders. Findings are presented for YLDs, DALYs and attributable burden due to suicide for 21 world regions in 1990 and 2010.
Anxiety disorders were the sixth leading cause of disability, in terms of YLDs, in both high-income (HI) and low- and middle-income (LMI) countries. Globally, anxiety disorders accounted for 390 DALYs per 100 000 persons [95% uncertainty interval (UI) 191–371 DALYs per 100 000] in 2010, with no discernible change observed over time. Females accounted for about 65% of the DALYs caused by anxiety disorders, with the highest burden in both males and females experienced by those aged between 15 and 34 years. Although there was regional variation in prevalence, the overlap between uncertainty estimates means that substantive differences in burden between populations could not be identified.
Anxiety disorders are chronic, disabling conditions that are distributed across the globe. Future estimates of burden could be further improved by obtaining more representative data on severity state proportions.
The incidence of rabies in livestock is an important factor for estimating the economic impact of the disease, but obtaining reliable data is hindered by inadequate surveillance. In order to understand the contribution of livestock rabies to the overall burden of disease, the rabies incidence in cattle was investigated in detail for Turkey between 2008 and 2011. Data were compiled on cattle numbers, samples submitted for rabies diagnosis, vaccinated animals and positive rabies cases in animals for seven regions in Turkey. Rabies incidence in cattle fluctuated annually and differed between regions from 0·10 to 3·87 cases/100 000 animals. The positive influence of compensation schemes was observed. Livestock losses were conservatively estimated at around $250 000 international dollars per annum, although in areas where compensation schemes are not operating this could be an underestimate of the economic burden. Vaccination of cattle remains an option for disease prevention, although oral rabies vaccination through aerially distributed baits should be implemented to prevent the further spread of fox-mediated rabies, which could result in much greater economic costs.
We reviewed photographic images of fishes from depths of 381–2282 m in Marguerite Bay and 405–2007 m in the Amundsen Sea. Marguerite Bay fishes were 33% notothenioids and 67% non-notothenioids. Channichthyids (47%) and nototheniids (44%) were the most abundant notothenioids. The deep-living channichthyid Chionobathyscus dewitti (74%) and the nototheniid genus Trematomus (66%) were the most abundant taxa within these two families. The most abundant non-notothenioids were the macrourid Macrourus whitsoni (72%) and zoarcids (18%). Amundsen Sea fishes were 87% notothenioids and 13% non-notothenioids, the latter exclusively Macrourus whitsoni. Bathydraconids (38%) and artedidraconids (30%) were the most abundant notothenioids. We observed that Macrourus whitsoni was benthopelagic and benthic and infested by large ectoparasitic copepods. Juvenile (42 cm) Dissostichus mawsoni was not neutrally buoyant and resided on the substrate at 1277 m. Lepidonotothen squamifrons was seen near and on nests of eggs in early December. A Pogonophryne sp. from 2127 m was not a member of the deep-living unspotted P. albipinna group. Chionobathyscus dewitti inhabited the water column as well as the substrate. The pelagic zoarcid Melanostigma gelatinosum was documented in the water column a few metres above the substrate. The zoogeographic character of the Marguerite Bay fauna was West Antarctic or low-Antarctic and the Amundsen Sea was East Antarctic or high-Antarctic.
Summarizing the epidemiology of major depressive disorder (MDD) at a global level is complicated by significant heterogeneity in the data. The aim of this study is to present a global summary of the prevalence and incidence of MDD, accounting for sources of bias, and dealing with heterogeneity. Findings are informing MDD burden quantification in the Global Burden of Disease (GBD) 2010 Study.
A systematic review of prevalence and incidence of MDD was undertaken. Electronic databases Medline, PsycINFO and EMBASE were searched. Community-representative studies adhering to suitable diagnostic nomenclature were included. A meta-regression was conducted to explore sources of heterogeneity in prevalence and guide the stratification of data in a meta-analysis.
The literature search identified 116 prevalence and four incidence studies. Prevalence period, sex, year of study, depression subtype, survey instrument, age and region were significant determinants of prevalence, explaining 57.7% of the variability between studies. The global point prevalence of MDD, adjusting for methodological differences, was 4.7% (4.4–5.0%). The pooled annual incidence was 3.0% (2.4–3.8%), clearly at odds with the pooled prevalence estimates and the previously reported average duration of 30 weeks for an episode of MDD.
Our findings provide a comprehensive and up-to-date profile of the prevalence of MDD globally. Region and study methodology influenced the prevalence of MDD. This needs to be considered in the GBD 2010 study and in investigations into the ecological determinants of MDD. Good-quality estimates from low-/middle-income countries were sparse. More accurate data on incidence are also required.
The literature describing the global prevalence of anxiety disorders is highly variable. A systematic review and meta-regression were undertaken to estimate the prevalence of anxiety disorders and to identify factors that may influence these estimates. The findings will inform the new Global Burden of Disease study.
A systematic review identified prevalence studies of anxiety disorders published between 1980 and 2009. Electronic databases, reference lists, review articles and monographs were searched and experts then contacted to identify missing studies. Substantive and methodological factors associated with inter-study variability were identified through meta-regression analyses and the global prevalence of anxiety disorders was calculated adjusting for study methodology.
The prevalence of anxiety disorders was obtained from 87 studies across 44 countries. Estimates of current prevalence ranged between 0.9% and 28.3% and past-year prevalence between 2.4% and 29.8%. Substantive factors including gender, age, culture, conflict and economic status, and urbanicity accounted for the greatest proportion of variability. Methodological factors in the final multivariate model (prevalence period, number of disorders and diagnostic instrument) explained an additional 13% of variance between studies. The global current prevalence of anxiety disorders adjusted for methodological differences was 7.3% (4.8–10.9%) and ranged from 5.3% (3.5–8.1%) in African cultures to 10.4% (7.0–15.5%) in Euro/Anglo cultures.
Anxiety disorders are common and the substantive and methodological factors identified here explain much of the variability in prevalence estimates. Specific attention should be paid to cultural differences in responses to survey instruments for anxiety disorders.
Health claims for probiotics are evaluated by the Panel on Dietetic Products, Nutrition and Allergies of the European Food Safety Authority. Despite a substantial amount of basic and clinical research on the beneficial effects of probiotics, all of the evaluated claim applications thus far have received a negative opinion. With the restrictions on the use of clinical endpoints, validated biomarkers for gut health and immune health in relation to reduction in disease risk are needed. Clear-cut criteria for design as well as evaluation of future studies are needed. An open dialogue between basic and clinical scientists, regulatory authorities, food and nutrition industry, and consumers could bridge the gap between science and marketing of probiotics.
Rabies is considered one of the oldest infectious diseases known to humans. However, the first written reports on rabies cases in the Americas did not appear until the first decade of the 18th century from Mexico. In an attempt to clarify if the disease was already present in pre-Columbian times, we searched for evidence in the Maya and Aztec cultures. Other sources of information were early manuscripts written by the conquistadors and early explorers. We did not identify any unequivocal direct evidence that the disease rabies was known in pre-Columbian Central America but sufficient circumstantial evidence is available suggesting that (bat) rabies was already present in these early times.
To achieve 65 nm technology node requirements, CMP processes must provide improved control of selectivity, topography, wire cross section, and process robustness. Slurries and processes must also be compatible with fragile low k materials by providing low erosion and shear forces. We present data on a unique step 1 bulk Cu removal slurry with high selectivity, removal rates over 8000 Å/min, and extremely low liner removal/erosion in high (90%) density structures. This is achieved through a combination of surface modified abrasives and alternative inhibitors which provide superior performance and reduced electrochemical activity compared to benzotriazole, a commonly used inhibitor. The step 1 slurry was used with a step 2 liner removal slurry that can be chemically tuned to adjust relative selectivities of Cu:Ta:oxide from the nominal ratio of 1:0.9:1.6, allowing its use with a variety of integration schemes. Results of CMP planarization experiments on 200 mm blanket and patterned single damascene test wafers are described, including electrical data which demonstrates low overpolish sensitivity.
Due to the ever-increasing popularity of STI in microelectronic device fabrication, designer slurries must be tailored to meet increasingly stringent planarity requirements. Although dielectric polishing is primarily mechanical in nature, the chemical and surface chemical effects can be tailored to enhance selectivity and planarity. Examples of chemical and surface chemical effects in dielectric CMP include; control of slurry pH, use of reactive particles such as cerium dioxide, and addition of surfactants to modulate the particle-substrate interactions. Cerium dioxide particles are utilized due to an increase in substrate dissolution through particle-substrate bonding, which accelerates the material removal of the dielectric surface. The increased efficiency of reactive particles is largely dependent on the area of contact between particle and substrate during polishing. The chemical nature of the interaction between the particles and silica substrates has been investigated using polishing experiments, AFM, and an in-situ friction force apparatus. Both the pH and cerium dioxide particles have been found to significantly affect the near surface region of the oxide film.
The synthesis of multipodes based on substituted ferrocene groups and the results of the investigations of the liquid-crystalline phase properties of these materials, determined by optical polarising microscopy DSC and X-ray diffraction studies as central cores is reported.
Ion implantation followed by thermal annealing in a reducing atmosphere has been used to create a high density of oriented Si and Ge nanocrystals in (0001) AI2O3. Both types of nanocrystals are three-dimensionally aligned with respect to the AI2O3 matrix, but the orientational relationships are different, and the two types of nanocrystals have different shapes in AI2O3. Implantation of Si and Ge in fused silica also produces nanocrystals, but in this case, the nanocrystals are randomly oriented relative to each other.