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Major depression and sleep disturbances are closely related and often occur concomitantly. Many of the observed changes of sleep characteristics in depression are also present in healthy aging, which led to the premise that sleep in depression resembles premature aging.
Here, we aimed at quantifying the homeostatic and circadian sleep-wake regulatory components in young women suffering from major depression disorder and healthy young and older control women during 40 hours of sustained wakefulness.
After an 8-h baseline night 9 depressed women, 8 healthy young and 8 healthy older women underwent a 40-hour sustained wakefulness protocol followed by a recovery night under constant routine conditions. Polysomnographic recordings were carried out continuously. Sleep parameters as well as the time course of EEG slow-wave activity (SWA) (EEG spectra range: 0.75-4.5 Hz), as a marker of homeostatic sleep pressure, was analyzed during the recovery night.
Young depressed women exhibited higher absolute mean SWA levels and a stronger response to sleep deprivation compared to healthy young and healthy older women, particularly in frontal brain regions. In contrast, healthy older women exhibited attenuated SWA values compared to the other two groups and an absence of the frontal predominance of mean SWA during the recovery night.
Our data clearly show that homeostatic sleep regulation as well as sleep architecture in young depressed women is not equal to premature aging. Moreover, our findings demonstrate that young depressed women live on an elevated level of homeostatic sleep pressure.
Introduction: Patient-reported outcome measures (PROM) are questionnaires that can be used to elicit care outcome information from patients. We sought to develop and validate the first PROM for adult patients without a primary mental health or addictions presentation receiving emergency department (ED) care and who were not hospitalized. Methods: PROM development used a multi-phase process based on national and international guidance (FDA, NQF, ISPOR). Phase 1: ED outcome conceptual framework qualitative interviews with ED patients post-discharge informed four core domains (previously published). Phase 2: Item generation scoping review of the literature and existing instruments identified candidate questions relevant for each domain for inclusion in tool. Phase 3: Cognitive debriefing existing and newly written questions were tested with ED patients post-discharge for comprehension and wording preference. Phase 4: Field and validity testing revised tool pilot tested on a national online survey panel and then again at 2 weeks (test-retest). Phase 5: Final item reduction using a Delphi process involving ED clinicians, researchers, patients and system administrators. Phase 6: Validation - psychometric testing of PROM-ED 1.0. Results: Four core outcome domains were defined in Phase 1: (1) understanding; (2) symptom relief; (3) reassurance and (4) having a plan. The domains informed a review of existing relevant questionnaires and instruments and the writing of additional questions creating an initial long-form questionnaire. Eight patients participated in cognitive debriefing of the long-form questionnaire. Expert clinicians, researchers and patient partners provided input on item refinement and reduction. Four hundred forty-four patients completed a second version of the long-form questionnaire (add in retest numbers) which informed the final item reduction process by a modified Delphi method involving 21 diverse contributors. The questionnaire was validated and underwent final revisions to create the 21 questions that constitute PROM-ED 1.0. Conclusion: Using accepted PROM instrument development methodology, we developed the first outcome questionnaire for use with adult ED patients who are not hospitalized. This questionnaire can be used to systematically gather patient-reported outcome information that could support and inform improvement work in ED care.
The current situation of volatile milk prices and rising costs of, e.g. grain and labour, suggests that it is worth studying productivity and efficiency in dairy farming. The objective of the current whole-system study, carried out in lowland Central Switzerland from 2007 to 2010, was to compare the performance, efficiency, land productivity and profitability of indoor-feeding (IF) dairy production with that of pasture-based feeding (PF) dairy production. An IF herd consisting of 11 Holstein–Friesian (HF) and 13 Brown Swiss (BS) cows was kept in a free-stall barn and fed a part-mixed ration (PMR) of maize silage, grass silage and protein concentrate. The cows were allocated 15·8 ha of agricultural land (AL). In the PMR, an average per lactation of 443 kg protein concentrate and 651 kg compound feed was fed by a concentrate dispenser according to the requirements of each cow. The PF herd comprised 14 Swiss Fleckvieh (SF) and 14 BS cows, which were kept in a free-stall barn throughout the winter; barn-ventilated hay was offered ad libitum during the lactation period. This herd was allocated 15·7 ha of AL. After calving in spring, the PF cows grazed on semi-continuous pastures; they consumed an average of 285 kg of concentrate per lactation. The IF cows of the BS breed produced significantly more energy-corrected milk (ECM) per standard lactation compared with PF cows (8750 v. 5610 kg), more milk fat (350 v. 213 kg) and more milk protein (306 v. 203 kg). However, the milk of PF cows had higher levels of conjugated linoleic acid (CLA) (1·9 v. 0·6 g/100 g fat) and ω−3 fatty acids (1·7 v. 0·9 g/100 g fat) than the milk of the IF cows. The calving interval (378 v. 405 days) and the empty time (87 v. 118 days) of the BS breed were significantly shorter in the PF in comparison with that of the IF production system. The IF herd yielded significantly higher ECM/ha AL and year (12 716 v. 10 307 kg), and showed a higher feed efficiency (1·3 v. 1·1 kg ECM/kg of total dry matter intake (DMI)). The productivity per hour was roughly similar in the two systems (IF: 76 v. PF: 73 kg milk/h). The PF system resulted in higher labour income compared with the IF system (20·7 v. 13·4 €/h), but the difference was not significant. In conclusion, land productivity and efficiency were higher with the IF herd than the PF herd due to the higher energy intake per kg feed. However, within the given conditions, the more interesting case, economically, might be the reduced costs and improved milk quality of the PF system rather than the increased milk yield of the IF cows.
This study evaluates the extent to which the 2004 well publicized Catholic Bishops' warnings and the Church Doctrinal Note mandating that parishioners oppose candidates who supported policies contrary to Church doctrine influenced Catholic support for presidential candidate John Kerry. Data were drawn from a 2004 national survey of 493 Catholic adults using random digit dial procedures and commissioned by Time magazine. Multivariate analyses indicate that the influence of the Bishops' warnings and the Doctrinal Note diverged by respondents' religious belief. Liberal Catholics exposed to these messages were more likely to support Kerry while conservative Catholics exposed to these messages were more likely to support Bush. The net effect of leaders' messages appeared to have helped rather than hurt Kerry. Our findings point to a multiplicity of effects for religious leaders' messages and should provide a note of caution for religious leaders who take pronounced stances on political affairs.
Using a nationwide survey of American Muslims conducted in 2004, we evaluate models of political participation, specifically the influence of religious characteristics, political resources, social structures, and political awareness on Muslims' reported political participation. American Muslims reported extremely high rates of political participation in comparison to the general public and in this regard are model citizens. Using path analysis, our findings concluded that religious beliefs were negatively associated with political participation, while measures of religious resources were positively related to participation. Social structures had mixed influence in most cases statistically indistinguishable from zero. Political resources and measures of political awareness, specifically feelings of anxiety following 9/11, were positively associated with participation.
Jeremy Zilber and David Niven bolster a brief but cogent argument with evidence that news coverage of Congress has been “racialized” to the detriment of African-American congressmen and congresswomen, that African-American members of Congress are less favorably portrayed, less likely to be associated with a diverse agenda, and portrayed as more marginal than Caucasian members, factors other than race being equal (p. 90). By implication, the argument extends to all minority political activists and public officials. It also implies that constituencies represented by African-American politicians are greatly disadvantaged in the political process.
The relative insensitivity of traditional IQ tests to
mild cognitive deficits has led investigators to develop
a version of the widely used Wechsler intelligence scales
that allows quantitative analysis of underlying qualitative
responses. This instrument, the Wechsler Adult Intelligence
Scale–Revised as a Neuropsychological Instrument
(WAIS–R NI) was administered to 16 Parkinson's
disease (PD) patients and 30 normal controls (NC). The
2 groups did not differ significantly in mean age or education,
or on their mean Mattis Dementia Rating Scale score. Relative
to NC participants, PD patients showed decreased visual
attention span, longer response latencies, slower visuomotor
processing, and more stimulus-bound errors. Many of the
WAIS–R NI measures were able to detect cognitive
impairment in a greater percentage of patients than the
traditional WAIS–R measures, making it easier to
identify deficits that could affect quality of life early
in the course of the disease. (JINS, 2001, 7,
We report on the OMVPE growth and characterization of AlGalnN and its heterostructures, including measurements of electrical properties (Hall), optical properties (photo- and cathodo- luminescence), structural characteristics (x-ray diffraction and TEM); and also the emission of InGaN/AlGaN heterostructures subject to optical and electrical pumping.