To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Recent models of psychopathology suggest the presence of a general factor capturing the shared variance among all symptoms along with specific psychopathology factors (e.g., internalizing and externalizing). However, few studies have examined predictors that may serve as transdiagnostic risk factors for general psychopathology from early development. In the current study we examine, for the first time, whether observed and parent-reported infant temperament dimensions prospectively predict general psychopathology as well as specific psychopathology dimensions (e.g., internalizing and externalizing) across childhood. In a longitudinal cohort (N = 291), temperament dimensions were assessed at 4 months of age. Psychopathology symptoms were assessed at 7, 9, and 12 years of age. A bifactor model was used to estimate general, internalizing, and externalizing psychopathology factors. Across behavioral observations and parent-reports, higher motor activity in infancy significantly predicted greater general psychopathology in mid to late childhood. Moreover, low positive affect was predictive of the internalizing-specific factor. Other temperament dimensions were not related with any of the psychopathology factors after accounting for the general psychopathology factor. The results of this study suggest that infant motor activity may act as an early indicator of transdiagnostic risk. Our findings inform the etiology of general psychopathology and have implications for the early identification for children at risk for psychopathology.
Early adversity has been shown to sensitize individuals to the effects of later stress and enhance risk of psychopathology. Using a longitudinal randomized trial of foster care as an alternative to institutional care, we extend the stress sensitization hypothesis to examine whether early institutional rearing sensitizes individuals to stressful events in adolescence engendering chronic low-grade inflammation. At baseline, institutionalized children in Romania (ages 6–31 months) were randomly assigned to foster care or to remain in usual care within institutions. A group of never-institutionalized children was recruited as an in-country comparison sample. At ages 12 and 16, participants reported stressful events. At age 16, Interleukin-6 (IL-6) and C-reactive protein (CRP) were derived from blood spots. Among children assigned to care as usual, more stressful events at age 12, but not age 16, were associated with higher IL-6. In the same group, stressful events at age 16 were associated with higher CRP, though these effects attenuated after adjusting for covariates. These associations were not observed in the foster care or never-institutionalized groups. The findings suggest that heightened inflammation following stress exposure is one pathway through which early neglect could compromise physical health. In contrast, early family care might buffer against these risks.
Depression occurs in ~50% of Parkinson’s disease (PD) patients, increases in severity and duration as the disease progresses, and is associated with increased morbidity. Improvement of depression in PD patients is correlated with reduced physical disability and improved quality of life. We are assessing use of pimavanserin (PIM) for treatment of depression in adults with PD.
A Phase-2, 8-week, open-label, single-arm study is being conducted to evaluate the safety and efficacy of PIM as an adjunct to SSRI/SNRI or as monotherapy in adults with both PD and symptoms of depression (baseline Hamilton Depression Scale [17-items] total score [HAMD-17] ≥15). The primary endpoint of the study is change from Baseline to Week 8 in the HAMD-17. Secondary measures included the Clinical Global Impression (CGI) scales (improvement and severity) and Scales of Outcomes in PD-Sleep (SCOPA).
Interim results based on the first 34 of 40 planned patients have been evaluated: 55.9% of patients were male, and average age was 68.1 years, with 19 patients on adjunctive therapy and 15 on monotherapy. At baseline, patients had a mean (SE) HAMD-17 of 19.8(0.6). Change from Baseline to Week 8 (least squares mean [LSM] [SE]) in the HAMD-17 was –10.7(1.0) (95% CI; –12.7,–8.7; P<0.001), with significant improvement seen as early as Week 2 (–8.4[1.0]; 95% CI; –10.5,–6.4; P<0.001). Significant improvement was seen for both adjunctive treatment and monotherapy: 45.2% of patients responded to treatment (≥50% improvement on the HAMD-17) at Week 8, and 35.5% reached remission (HAMD-17 ≤7). On the Clinical Global Impressions–Improvement scale, 54.8% were much/very much improved at Week 8. Significant improvement was seen in change from Baseline to Week 8 SCOPA–Global Sleep Quality, –Nighttime Sleep, and –Daytime Sleepiness: –1.0(0.4) (95% CI; –1.7,–0.3; P=0.010), –2.1(0.7) (95% CI; –3.6,–0.6; P=0.008), –2.1(0.4) (95% CI; –3.0,–1.2; P<0.001) respectively. Twenty-one of the 34 enrolled patients have completed the study to date, and another 7 are still continuing. Thirteen patients reported adverse events, the most common being falls, UTI, diarrhea, and nausea.
These interim data suggest that PIM as adjunctive treatment or monotherapy is associated with early improvement of depressive symptoms in patients with PD and is well tolerated. This is consistent with recently reported data of PIM in major depressive disorder. Final data will be shared at the time of this presentation. However, additional placebo-controlled data will be needed to determine fully the efficacy of PIM in patients with comorbid PD and depression.
Hurricane Harvey left a path of destruction in its wake, resulting in over 100 deaths and damaging critical infrastructure. During a disaster, public health surveillance is necessary to track emerging illnesses and injuries, identify at-risk populations, and assess the effectiveness of response efforts. The Centers for Disease Control and Prevention (CDC) and American Red Cross collaborate on shelter surveillance to monitor the health of the sheltered population and help guide response efforts.
We analyzed data collected from 24 Red Cross shelters between August 25, 2017, and September 14, 2017. We described the aggregate morbidity data collected during Harvey compared with previous hurricanes (Gustav, Ike, and Sandy).
Over one-third (38%) of reasons for visit were for health care maintenance; 33% for acute illnesses, which includes respiratory conditions, gastrointestinal symptoms, and pain; 19% for exacerbation of chronic disease; 7% for mental health; and 4% for injury. The Red Cross treated 41% of clients within the shelters; however, reporting of disposition was often missed. These results are comparable to previous hurricanes.
The capacity of Red Cross shelter staff to address the acute health needs of shelter residents is a critical resource for local public health agencies overwhelmed by the disaster. However, there remains room for improvement because reporting remained inconsistent.
Patients with Parkinson’s disease psychosis (PDP) are often treated with an atypical antipsychotic, especially quetiapine or clozapine, but side effects, lack of sufficient efficacy, or both may motivate a switch to pimavanserin, the first medication approved for management of PDP. How best to implement a switch to pimavanserin has not been clear, as there are no controlled trials or case series in the literature to provide guidance. An abrupt switch may interrupt partially effective treatment or potentially trigger rebound effects from antipsychotic withdrawal, whereas cross-taper involves potential drug interactions. A panel of experts drew from published data, their experience treating PDP, lessons from switching antipsychotic drugs in other populations, and the pharmacology of the relevant drugs, to establish consensus recommendations. The panel concluded that patients with PDP can be safely and effectively switched from atypical antipsychotics used off label in PDP to the recently approved pimavanserin by considering each agent’s pharmacokinetics and pharmacodynamics, receptor interactions, and the clinical reason for switching (efficacy or adverse events). Final recommendations are that such a switch should aim to maintain adequate 5-HT2A antagonism during the switch, thus providing a stable transition so that efficacy is maintained. Specifically, the consensus recommendation is to add pimavanserin at the full recommended daily dose (34 mg) for 2–6 weeks in most patients before beginning to taper and discontinue quetiapine or clozapine over several days to weeks. Further details are provided for this recommendation, as well as for special clinical circumstances where switching may need to proceed more rapidly.
Between AD 100 and 800, the Moche culture emerged on the north coast of Peru. Diverse debates surround the nature of Moche territorial and political centralization, sociopolitical identities, and the internal social diversity of Moche society. Here we address some of these issues in a biodistance study based on phenotypic variation of inherited dental traits within and between 36 individuals in the royal tombs of Sipán (Lambayeque valley), Úcupe (Zaña valley), and Dos Cabezas (Jequetepeque valley). Metric and nonmetric dental trait data were analyzed using hierarchical cluster and R-matrix analyses. The results independently indicate that the highest-level Sipán and Dos Cabezas lords likely represented different endogamous kin groups, while limited gene flow occurred between groups of Moche lower nobility between the Lambayeque and Jequetepeque regions. Although biology and material cultural link the Lord of Úcupe to Dos Cabezas, many objects in his tomb demonstrate his participation the world of the Sipán elites. These Moche lords were, on some levels, bioculturally interconnected. Nonetheless, the data broadly lend support to a “many Moches” model of sociopolitical structure, further casting doubt on earlier one-dimensional visions of a centralized hegemonic Moche polity.
Los festines fueron una práctica común y recurrente en los Andes Centrales durante la época prehispánica. Sin embargo, no existe un consenso sobre los criterios utilizados en la caracterización arqueológica de estos eventos. En este artículo revaluamos las evidencias del Repositorio de Ofrendas 1 de Sipán, un sitio Mochica (siglos tres y cuatro dC) ubicado en el valle de Lambayeque, a través del empleo de una variable cuantitativa llamada “peso de carne disponible”. Asociado a la tumba del Señor de Sipán, este depósito contiene centenas de ofrendas de prestigio, pero también miles de restos de fauna. El análisis de estos últimos proporciona nuevas perspectivas sobre la comida funeraria dada en homenaje a este alto dignatario después de su entierro. El uso de la variable mencionada permite evaluar la magnitud de esta comida y muestra la importancia de definir criterios metodológicos fiables para seguir investigando los festines, eventos que constituyen una de las bases de las relaciones sociales y políticas de las sociedades prehispánicas.
By using strontium isotopic ratios of dental enamel from molars, we were able to reconstruct the migration context for three individuals of a Columbian mammoth population (Mammuthus columbi) around Laguna de las Cruces, San Luis Potosí, central México. A three-step leaching procedure was applied to eliminate secondary Sr contributions in the molar enamel. One of the studied individuals showed 87Sr/86Sr ratios similar to those obtained from soils and plants from Laguna de las Cruces and was identified as local, whereas the other two mammoths had different molar 87Sr/86Sr values, indicative of migration and mobility contexts.
Understanding how linguistic cues map to the environment is crucial for early language comprehension and may provide a way for bootstrapping and learning words. Research has suggested that learning how plural syntax maps to the perceptual environment may show a trajectory in which children first learn surrounding cues (verbs, modifiers) before a full mastery of the noun morpheme alone. The Spanish plural system of simple codas, dominated by one allomorph -s, and with redundant agreement markers, may facilitate early understanding of how plural linguistic cues map to novel referents. Two-year-old Mexican children correctly identified multiple novel object referents when multiple verbal cues in a phrase indicated plurality as well as in instances when the noun morphology in novel nouns was the only indicator of plurality. These results demonstrate Spanish-speaking children's ability to use plural noun inflectional morphology to infer novel word referents which may have implications for their word learning.
Background: To estimate the 12-month incidence, prevalence, and persistence of mental disorders among recently admitted assisted living (AL) residents and to describe the recognition and treatment of these disorders.
Methods: Two hundred recently admitted AL residents in 21 randomly selected AL facilities in Maryland received comprehensive physician-based cognitive and neuropsychiatric evaluations at baseline and 12 months later. An expert consensus panel adjudicated psychiatric diagnoses (using DSM-IV-TR criteria) and completeness of workup and treatment. Incidence, prevalence, and persistence were derived from the panel's assessment. Family and direct care staff recognition of mental disorders was also assessed.
Results: At baseline, three-quarters suffered from a cognitive disorder (56% dementia, 19% Cognitive Disorders Not Otherwise Specified) and 15% from an active non-cognitive mental disorder. Twelve-month incidence rates for dementia and non-cognitive psychiatric disorders were 17% and 3% respectively, and persistence rates were 89% and 41% respectively. Staff recognition rates for persistent dementias increased over the 12-month period but 25% of cases were still unrecognized at 12 months. Treatment was complete at 12 months for 71% of persistent dementia cases and 43% of persistent non-cognitive psychiatric disorder cases.
Conclusions: Individuals recently admitted to AL are at high risk for having or developing mental disorders and a high proportion of cases, both persistent and incident, go unrecognized or untreated. Routine dementia and psychiatric screening and reassessment should be considered a standard care practice. Further study is needed to determine the longitudinal impact of psychiatric care on resident outcomes and use of facility resources.
Values for δ13C and δ18O obtained from molar samples from three individuals pertaining to Glyptotherium sp. from Cedral (San Luis Potosí, México) are provided and are utilized to infer general aspects of glyptodont diet and habitat. On average this animal showed a C3/C4 mixed diet, with a high consumption of C4 plants. Comparisons of the δ13CVPDB and δ18OVPDB values for glyptodonts with horses, mastodons, mammoths and tapirs from the same locality show that glyptodonts from Cedral lived in an open habitat.
One of the greatest factors that significantly affect the quality of astronomical images is the atmospheric turbulence causing what we call “seeing”. We present results of the reduction and photometry of astronomical images obtained at the Sasahuine mountain astronomical site (4511 m.a.s.l.), located in the Southern Peruvian Andes, in the department of Moquegua, near the town of Cambrune. These data show preliminary seeing measurements for this site. The present work is part of a bigger investigation program called JANAX which seeks to evaluate potential astronomical observation sites in Peruvian territory through a series of observation missions. The program's aim is to gather data to validate the site for the future construction of a National Astronomical Observatory. The observations were made using an SBIG ST-7MX CCD camera and a BVR standard filter set, attached to a MEADE LX200 356mm telescope.
We report an advanced presentation of osteomyelitis of the temporal bone secondary to malignant otitis externa.
We present a case report and a review of the world literature concerning osteomyelitis of the temporal bone secondary to malignant otitis externa.
A 60-year-old diabetic man developed osteomyelitis of the temporal bone and a temporoparietal abscess as advanced complications of malignant otitis externa. He was successfully treated in our institution using a post aural incision after draining the abscess and excising the fistula, a modified radical mastoidectomy with canal wall down procedure with sequesterectomy and debridement of surrounding area done.
The terms ‘osteomyelitis of the temporal bone’, ‘skull base osteomyelitis’ and ‘malignant otitis externa’ have not been clearly defined, and have in the past often been used interchangeably in the literature. Osteomyelitis of the temporal bone can occur secondary to malignant otitis externa, acute otitis media, chronic suppurative otitis media or trauma. Here, we present the management of an advanced case of osteomyelitis of the temporal bone.
Volunteer potato is a major weed pest of sweet corn in regions where winter soil temperatures fail to kill tubers left in the ground after harvest. Studies were conducted in 2004 to 2005 to determine the effect of combining atrazine with mesotrione applied POST on volunteer potato control and new tuber production in sweet corn. Mesotrione at 0.035, 0.07, and 0.1 kg/ha and atrazine at 0.3, 0.6, and 1.1 kg/ha were applied alone and in all possible combinations when volunteer potato ranged from 5 to 12 cm tall. Mesotrione applied alone at all rates, atrazine at 1.1 kg/ha, or mesotrione plus atrazine combinations reduced the number of new tubers produced to ≤ 1.1 per plant compared with 11 tubers per plant in nontreated checks. Potatoes treated with atrazine alone at 0.3 or 0.6 kg/ha produced 3.3 or 1.9 tubers per plant, respectively, which could lead to volunteer potato problems in the succeeding crop. Sweet corn yield was not affected by herbicide treatment in 2004 but was reduced in 2005 when atrazine was used alone at 0.3 or 0.6 kg/ha because of poor control of volunteer potato. Additional studies were conducted from 2004 to 2006 to determine volunteer potato control in sweet corn in reduced and conventional tillage and treated with fluroxypyr, mesotrione, or no herbicide. Volunteer potato control was improved and the number and weight of tubers was reduced 79 and 91%, respectively, in conventionally tilled plots treated with fluroxypyr compared with reduced-tillage plots. Control of volunteer potato with mesotrione was greater than 98% and reduced tuber number and weight greater than or equal to all other treatments regardless of tillage level.