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Late-life depression (LLD) is associated with poor social functioning. However, previous research uses bias-prone self-report scales to measure social functioning and a more objective measure is lacking. We tested a novel wearable device to measure speech that participants encounter as an indicator of social interaction.
Twenty nine participants with LLD and 29 age-matched controls wore a wrist-worn device continuously for seven days, which recorded their acoustic environment. Acoustic data were automatically analysed using deep learning models that had been developed and validated on an independent speech dataset. Total speech activity and the proportion of speech produced by the device wearer were both detected whilst maintaining participants' privacy. Participants underwent a neuropsychological test battery and clinical and self-report scales to measure severity of depression, general and social functioning.
Compared to controls, participants with LLD showed poorer self-reported social and general functioning. Total speech activity was much lower for participants with LLD than controls, with no overlap between groups. The proportion of speech produced by the participants was smaller for LLD than controls. In LLD, both speech measures correlated with attention and psychomotor speed performance but not with depression severity or self-reported social functioning.
Using this device, LLD was associated with lower levels of speech than controls and speech activity was related to psychomotor retardation. We have demonstrated that speech activity measured by wearable technology differentiated LLD from controls with high precision and, in this study, provided an objective measure of an aspect of real-world social functioning in LLD.
Twins Research Australia (TRA) is a community of twins and researchers working on health research to benefit everyone, including twins. TRA leads multidisciplinary research through the application of twin and family study designs, with the aim of sustaining long-term twin research that, both now and in the future, gives back to the community. This article summarizes TRA’s recent achievements and future directions, including new methodologies addressing causation, linkage to health, economic and educational administrative datasets and to geospatial data to provide insight into health and disease. We also explain how TRA’s knowledge translation and exchange activities are key to communicating the impact of twin studies to twins and the wider community. Building researcher capability, providing registry resources and partnering with all key stakeholders, particularly the participants, are important for how TRA is advancing twin research to improve health outcomes for society. TRA provides researchers with open access to its vibrant volunteer membership of twins, higher order multiples (multiples) and families who are willing to consider participation in research. Established four decades ago, this resource facilitates and supports research across multiple stages and a breadth of health domains.
Disaster Medicine (DM) education for Emergency Medicine (EM) residents is highly variable due to time constraints, competing priorities, and program expertise. The investigators’ aim was to define and prioritize DM core competencies for EM residency programs through consensus opinion of experts and EM professional organization representatives.
Investigators utilized a modified Delphi methodology to generate a recommended, prioritized core curriculum of 40 DM educational topics for EM residencies.
The DM topics recommended and outlined for inclusion in EM residency training included: patient triage in disasters, surge capacity, introduction to disaster nomenclature, blast injuries, hospital disaster mitigation, preparedness, planning and response, hospital response to chemical mass-casualty incident (MCI), decontamination indications and issues, trauma MCI, disaster exercises and training, biological agents, personal protective equipment, and hospital response to radiation MCI.
This expert-consensus-driven, prioritized ranking of DM topics may serve as the core curriculum for US EM residency programs.
The authors present clinical experience with 28 cases of ruptured anterior cerebral artery (ACA) aneurysms managed personally during a 36 month period, and 10 unruptured ACA aneurysms. The cases included five giant aneurysms and four distal ACA aneurysms. Management strategy was uniform and included early operative intervention (except in the setting of deteriorating neurologic deficit, not attributable to hydrocephalus or hematoma), and vasospasm prophylaxis including calcium channel blockers and hypervolemic hemodilution and arterial hypertension. Modern diagnostic adjuncts including transcranial doppler were used as they became available. Good outcome (outcome grade 1 or 2) was observed at 6 months in 71% (20/28) of ruptured cases and in 90% (9/10) of unruptured cases; fair outcome (outcome grade 3) was observed in 14% (4/28) of ruptured cases and in 10% of unruptured cases; bad outcome (outcome grade 4 or 5) was observed in 14% (4/28) of ruptured cases. There were no instances of rebleeding after admission to the hospital. There was a single mortality in a patient moribund on admission. Delayed ischemic deterioration (DID) was documented in 46% (13 of 28) of the ruptured cases, and was a major source of morbidity in 7 of the 9 instances of fair or poor outcome in the series. Management outcome, including the occurrence of subtle neuropsychological difficulties commonly described in cases with ACA aneurysms, is discussed with relation to the incidence of DID, the clinical course of DID, and the possible impact of various therapeutic strategies.
Stocker cattle ownership is compared to contract grazing using stochastic simulation. Returns are evaluated for both cattle owners and caretakers in contract grazing agreements. For caretakers, contract grazing is significantly less risky than cattle ownership. Slightly to moderately risk-averse caretakers could be expected to prefer some type of contract grazing to direct ownership of cattle. For cattle owners, contracting reduces risk only slightly while significantly reducing expected returns.
By upbringing, family connections, and education, Felix Mendelssohn was ideally positioned to contribute to the historical legacies of the German people, who in the aftermath of the Napoleonic Wars discovered that they were a nation with a distinct culture. The number of cultural icons of German nationalism that Mendelssohn "discovered," promoted, or was asked to promote (by way of commissions) in his compositions is striking: Gutenberg and the invention of the printing press, Dürer and Nuremberg, Luther and the Augsburg Confession as the manifesto of Protestantism, Bach and the St. Matthew Passion, Beethoven and his claims to universal brotherhood. The essays in this volume investigate Mendelssohn's relationship to the music of the past from a variety of perspectives, including the pervasive presence of Bach's music within the larger Mendelssohn family, the influence of Beethoven in the Reformation Symphony, and Mendelssohn's compositions for organ and his relationship to English organs in particular. Together, they shed light on the construction of legacies that, in some cases, served to assert German cultural supremacy only two decades after the composer's death. Contributors: Celia Applegate, John Michael Cooper, Hans Davidsson, Wm. A. Little, Peter Mercer-Taylor, Siegwart Reichwald, Glenn Stanley, Russell Stinson, Benedict Taylor, Nicholas Thistlewaite, Jürgen Thym, R. Larry Todd, Christoph Wolff. Jürgen Thym is Professor Emeritus of Musicology at the Eastman School of Music and editor of Of Poetry and Song: Approaches to the Nineteenth-Century Lied (University of Rochester Press, 2010).
This chapter illustrates the complexity of personality by the exploration of its neurobiology, including neurochemistry, and neuroanatomy via the temperament and character dimensional model and its relationship to psychiatric and neurological disorders. Thomas and Chess conceptualized temperament as the stylistic component of behavior, as differentiated from the motivation and content of behavior. Character is influenced by socio-cultural learning and matures in progressive steps throughout life. Character can be measured in three dimensions: self-directedness, cooperativeness, and self-transcendence. Personality dimensions involve complex adaptive systems of multiple genetic and environmental variables. Both gene-gene and gene-environment interactions are expected for understanding quantitative developmental phenomena and these have been abundantly confirmed for personality. Gene-environment interaction has also been demonstrated for novelty seeking and for harm avoidance in prospective population-based studies. Twin studies show that human personality traits are roughly equally influenced by genetic and by environmental influences.