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 email@example.com
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.
To know prevalence of depression in Spanish nursing home(NH) by analysing the clinical profile of residents from RESYDEM study (Identification of patients with cognitive deterioration and dementia in NH).
A multicentral, transversal, observational study was carried out in April 2005. 71 geriatrician from 54 NH representing the Spanish state participated. Depression was analysed in patient´s history and determined by NPI of Cummings, NH version.
1037 residents were randomized, 1020 were used by clinical data analysis. 941 were used to determine depression prevalence. Median age 83,4yo, 66.6% were women, 70.9% with basic educational level, 57.4% widows, 25.7% single, 41.5% had some degree of functional deterioration, 22.1% had delirium. In 26.4% were documented Stroke(17,9% TIA). 61.7% had dementia.
Depression appears in 31.4% of elderly institutionalized with the only diagnosis of depression or independent of others. There were no significant differences in age groups. However, was most frequent in women. 95.7% of patients with diagnosis of dementia had at least one drug for depression. Most used anti-depressants were trazadone (23%), citalopram (20.9%), sertraline (15.8%), fluoxetine (10.1%). No tricyclical anti-depressant reached 1% of consumption.
Depression affects practically one in three institutionalized elderly in Spain
Institutionalized elderly with depression are largely treated with ISRS. It is believed that the use of trazadone is linked with the effects on sleep and anxiety.
The high prevalence of depression, its overlapping with other processes and the comorbility of residents requires a careful search and approach in NH which implies a challenge for professionals in order to treat it.
Determine the presence of neuropsychiatric symptoms (NPS), using the NPI-NH(Neuropsychiatric Inventory Nursing Home(NH) Version),in order to provide a multidimensional profile in behavioural symptoms in residents and to calculate its prevalence in Spanish NH.
From randomized population of RESYDEM study (Identification of patients with cognitive deterioration and dementia in NH) a multi-central, cross-sectional and observational study was carried out. 71 geriatrician from 54 NH representative the Spanish state participated.NPS was determinated by NPI Cummings NH version. This version includes upsets in sleep and feeding patterns.
992 residents were examined (Median age 83.4yo, 66.6% women, 91.8% received at least one type of treatment, 61.7% with dementia). 523 (52.7%) presented at least one type of NPS. In order of greatest frequency, the following were noted: alterations in sleep patterns (41.7%), depression/disphoria (31.4%), anxiety (31.2%), agitation/aggressiveness (29.6%), apathy/indifference (25.8%), delirious ideas (23.7%), irritability (22.4%), feeding/appetite upsets (18.5%), anomalous motor behaviour (15.3%), hallucinations (13.8%), desinhibition (11.1%), euphoria (4.4%).
35.9% of residents received benzodiapines, 26.7% antidepressants. Atypical neuroleptics were used in 15.8%, in contrast with 7.4% of the use of classic ones.
NPS ´s reached a high prevalence in NH and it is usual that more than one co-exists in the patients.
Alterations in sleep patterns, depression, anxiety, agitation/aggressiveness affect approximately one in three residents.
It is useful and recommendable to evaluate the 12 behavioural areas from the NH version of the NPI scale. This instrument was chosen as a sifting measure to establish neuropyschiatric symptomology in residences.
The Square Kilometre Array (SKA) is a planned large radio interferometer designed to operate over a wide range of frequencies, and with an order of magnitude greater sensitivity and survey speed than any current radio telescope. The SKA will address many important topics in astronomy, ranging from planet formation to distant galaxies. However, in this work, we consider the perspective of the SKA as a facility for studying physics. We review four areas in which the SKA is expected to make major contributions to our understanding of fundamental physics: cosmic dawn and reionisation; gravity and gravitational radiation; cosmology and dark energy; and dark matter and astroparticle physics. These discussions demonstrate that the SKA will be a spectacular physics machine, which will provide many new breakthroughs and novel insights on matter, energy, and spacetime.
We aimed to investigate the heterogeneity of seasonal suicide patterns among multiple geographically, demographically and socioeconomically diverse populations.
Weekly time-series data of suicide counts for 354 communities in 12 countries during 1986–2016 were analysed. Two-stage analysis was performed. In the first stage, a generalised linear model, including cyclic splines, was used to estimate seasonal patterns of suicide for each community. In the second stage, the community-specific seasonal patterns were combined for each country using meta-regression. In addition, the community-specific seasonal patterns were regressed onto community-level socioeconomic, demographic and environmental indicators using meta-regression.
We observed seasonal patterns in suicide, with the counts peaking in spring and declining to a trough in winter in most of the countries. However, the shape of seasonal patterns varied among countries from bimodal to unimodal seasonality. The amplitude of seasonal patterns (i.e. the peak/trough relative risk) also varied from 1.47 (95% confidence interval [CI]: 1.33–1.62) to 1.05 (95% CI: 1.01–1.1) among 12 countries. The subgroup difference in the seasonal pattern also varied over countries. In some countries, larger amplitude was shown for females and for the elderly population (≥65 years of age) than for males and for younger people, respectively. The subperiod difference also varied; some countries showed increasing seasonality while others showed a decrease or little change. Finally, the amplitude was larger for communities with colder climates, higher proportions of elderly people and lower unemployment rates (p-values < 0.05).
Despite the common features of a spring peak and a winter trough, seasonal suicide patterns were largely heterogeneous in shape, amplitude, subgroup differences and temporal changes among different populations, as influenced by climate, demographic and socioeconomic conditions. Our findings may help elucidate the underlying mechanisms of seasonal suicide patterns and aid in improving the design of population-specific suicide prevention programmes based on these patterns.
To examine a library-based approach to addressing food insecurity through a child and adult summer meal programme. The study examines: (i) risk of household food insecurity among participants; (ii) perspectives on the library meal programme; and (iii) barriers to utilizing other community food resources.
Quantitative surveys with adult participants and qualitative semi-structured interviews with a sub-sample of adult participants.
Ten libraries using public and private funding to serve meals to children and adults for six to eight weeks in low-income Silicon Valley communities (California, USA) during summer 2015.
Adult survey participants (≥18 years) were recruited to obtain maximum capture, while a sub-sample of interview participants was recruited through maximum variation purposeful sampling.
Survey participants (n 161) were largely Latino (71 %) and Asian (23 %). Forty-one per cent of participants screened positive for risk of food insecurity in the past 12 months. A sub-sample of programme participants engaged in qualitative interviews (n 67). Interviewees reported appreciating the library’s child enrichment programmes, resources, and open and welcoming atmosphere. Provision of adult meals was described as building community among library patrons, neighbours and staff. Participants emphasized lack of awareness, misinformation about programmes, structural barriers (i.e. transportation), immigration fears and stigma as barriers to utilizing community food resources.
Food insecurity remains high in our study population. Public libraries are ideal locations for community-based meal programmes due to their welcoming and stigma-free environment. Libraries are well positioned to link individuals to other social services given their reputation as trusted community organizations.
The highlight of this work is the synthesis of copper sulfide nanocrystals by a simple one-pot colloidal process, and the study of its electrochemical, electrical and morphological properties. Nanocrystals of Cu1.8S of about 15-30 nm were obtained at a temperature of 240°C under an argon atmosphere. The colloidal solution of the nanocrystals was analyzed by cyclic voltammetry. Agreeing to the values of EOx and ERedvs. SCE, and the average of three samples the HOMO and LUMO levels are 6.16 and 4.27 eV, respectively, the calculated HOMO – LUMO (Eg) is 1.89 eV. The Eg value, differs of that value obtained from Kubelka-Munk equation (1.7 eV). The photocurrent vs. time results showed that the Cu1.8S/Cu junction is photosensitive and could be used as absorbing material. The morphology and the topography of the film were analyzed by SEM and AFM techniques. Irregular agglomeration of nanocrystals was observed and a roughness of about 194 nm.
We utilize the concept of sparsity or compressibility to develop an new generation of inversion codes for the Stokes parameters. The inversion code uses numerical optimization techniques based on the idea of proximal algorithms to impose sparsity. In so doing, we allow to exploit the presence of spatial correlation on the maps of physical parameters. Sparsity also regularizes the solution by reducing the number of unknowns. The solution has an increased robustness.
Neurological soft signs (NSS) have been inconsistently reported in obsessive-compulsive disorder (OCD) but may make an impact on treatment response.
The current study examined the presence of NSS in two independent European samples of OCD patients (combined 85 patients and 88 matched healthy controls) using a standardized instrument and conducted a meta-analysis of all published studies identified in the literature with the aim to provide a more definitive answer to the question of whether OCD patients are characterized by increased NSS.
Both empirical studies found elevated NSS scores in patients compared with matched controls. The results of the meta-analysis, which included 15 studies (combined 498 patients and 520 controls) showed large effect sizes (Hedges' g=1.27, 95% confidence interval 0.80–1.75), indicating that OCD patients have significantly higher rates of NSS than matched controls on both sides of the body and in multiple domains (motor coordination, sensory integration and primitive reflexes). The results were robust and remained largely unchanged in our reliability analyses, which controlled for possible outliers. Meta-regression was employed to examine the role of potential variables of interest including sociodemographic variables, symptom severity, medication effects and the use of different instruments, but none of these variables was clearly associated with NSS.
As a group, OCD patients are characterized by increased rates of NSS, compared with healthy controls. However, their origins and potential clinical importance remain to be clarified. Future directions for research are discussed.
Since the introduction of percutaneous closure in the United States, rates of secundum atrial septal defect and patent foramen ovale closures have increased substantially. Whether or not closure rates are uniform or vary due to differences in regional practice patterns is unknown. We sought to investigate this by comparing regional rates of closure across Florida.
We identified all atrial septal defect closures from 2001 to 2006 in the Florida State Inpatient Database. Using small area analysis, zip codes were assigned to Hospital Referral Regions based on where patients were most likely to go for closure. We obtained population-normalised rates of overall, percutaneous, and surgical closure.
Of 1830 atrial septal defect and patent foramen ovale closures from 2001 to 2006, 751 were surgical and 1004 were percutaneous. The statewide closure rate was 1.91 per 100,000 people per year; regional rates varied 3.8-fold from 0.78 to 2.94 per 100,000 people per year. Percutaneous rates varied sevenfold from 0.25 to 1.75 per 100,000 people per year, while surgical rates varied 2.71-fold from 0.53 to 1.44 per 100,000 people per year.
Despite a consistent prevalence of atrial septal defects, and patent foramens ovale, rates of repair vary across regions, suggesting that closure is driven by provider practice patterns rather than patient pathology. Efforts should be directed towards increasing consensus regarding the appropriate, evidence-based indications for closure so as to avoid the costs and potential negative sequelae of over- or undertreatment.
A programme of work, commissioned within the BIOPROTA collaborative forum, has recently been undertaken to assess the quantitative and qualitative elements of uncertainty associated with non-human biota (NHB) dose assessment in relation to the potential long-term release of radionuclides from a geological disposal facility (GDF). This was achieved through combining quantitative sensitivity and qualitative knowledge quality analyses based on the EC ERICA assessment approach and default assessment parameters. The results of the project demonstrate that this combination of approaches may be used to identify important parameters that could be significant in assessments of the impacts of any radionuclide release from a GDF on NHB, and for which there is low confidence. The output is intended to provide information on those parameters that may need to be considered in more detail for site-specific assessments. Such information should help users to enhance the quality of their assessments and build greater confidence in the results.
To estimate the duration of Cryptosporidium-specific antibody,
a Western blot assay measured
antibody in paired sera from 124 residents of Jackson County, Oregon
collected 0·5 and 2·5
years after the end of an outbreak in Talent, Jackson County. The outcome
measure was the
intensity of antibody responses, (which may approximate to a titre),
to 27-kDa and 15/17-kDa
antigens. Intensity of response to the 27-kDa antigen(s) declined to 54%
of the 1992 value
while responses to a 15/17-kDa antigen(s) remained close to the
initial values. Increasing age
of the donor predicted higher intensity of antibody to the 15/17-kDa
antigen(s) in both the
initial (P=0·004) and follow-up (P=0·038)
surveys. No relationship was observed between
age and antibody intensity for the 27-kDa antigen(s) during either survey
(P>0·10). Both the
initial and follow-up surveys showed significant elevations in antibody
intensity for Talent
residents, possibly indicating a high endemic rate of
infection/re-infection or high levels of chronic infection.
El Berrocal is an abandoned uranium mine in a mineralised quartz vein hosted by a Hercynian granite in central Spain. This mine is the focus of an international project to characterise and model natural elemental migration in a fractured-rock environment as an aid to understanding and predicting processes that may occur in a geological repository for radioactive wastes.
Uranium in the mineralised quartz vein has been shown to have originated from the orthomagmatic uraninite in the granite with the elemental removal and migration occurring predominately by hydrothermal fluids. Mobilisation of uranium from the mineralised quartz vein and from granite adjacent to hydraulically-active fractures away from the vein occurred over the geologically-recent past and in the present-day. The most recent mobilisation is evidenced by dissolution features seen in SEM photomicrographs; mineral growth and sorption signatures identified by enhanced uranium concentrations on the surfaces of preexisting minerals; and measured disequilibrium in the uranium series for whole rock close to fracture walls.
Present-day groundwaters in the studied area are young meteoric waters. They are generally calcium-sulphate enriched, oxidising and mildly acidic near the surface, becoming more bicarbonate-rich with near neutral pH in the deeper zones, except around the mineralised vein where the waters are acid (pH around 3) due to oxidisation of the sulphide minerals. No deep, chemically-reducing groundwaters have yet been identified in the El Berrocal boreholes.
Email your librarian or administrator to recommend adding this to your organisation's collection.