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Despite the high prevalence of psychiatric disorders among children and adolescents, services are often accessed too late or not at all. Inpatient-equivalent treatment can be a good option here, as it can counteract structural barriers by enabling treatment from home. Although national and international studies highlight the benefits, this form of treatment is offered by only a few psychiatric facilities.
Objectives
The aim is to provide a decision-making aid for the introduction of outreach treatments with regard to cost-effectiveness. Based on this, the question will be answered whether telemedicine can be an option for the distribution of rare (human) resources.
Methods
1) Based on a systematic review, the best available evidence will serve for deriving hypotheses and providing assumptions for the decision-making model. 2) Decision analytic modeling will be used to determine the cost-effectiveness of inpatient-equivalent treatment compared to conservative inpatient treatment. 3) An additional systematic review will provide information on the use of telemedicine in inpatient equivalent treatment.
Results
The following questions need to be discussed: 1)Is there an indication for all psychiatric diseases and age groups? 2) Are there ethical considerations that need to be taken into account, especially in the use of telemedicine? What incentives need to be set for psychiatrists to opt for inpatient-equivalent treatment?
Conclusions
The results of the study may help to raise awareness of inpatient equivalent treatment among decision-makers. Furthermore, fears could be reduced, since admission to a psychiatric facility can mean a stigmatizing intervention in the lives of young patients.
Algae like diatoms are widely studied as a means to remediate anthropogenically contaminated sites. In the present study, CL (cathodoluminescence) and EDX (energy-dispersive X-ray) spectroscopy in an SEM (scanning electron microscope) were optimized for the detection of Eu(III) sorbed on diatom biosilica. The required stability of biosilica under a focused electron beam was extensively investigated. Using experimentally determined data of thermal properties, the temperature increase within biosilica exposed to an electron beam was simulated by finite element calculations based on results from Monte Carlo simulations of electron scattering. Complementary thermogravimetric studies substantiated a chemical stability of biosilica in a wide temperature range, confirming its suitability for long-lasting SEM investigations. In subsequent EDX measurements, characteristic Eu lines were detected. Eu was found to preferentially accumulate and aggregate on silica fragments. CL spectra were obtained for the Eu(III) reference material, EuCl3. For Eu-loaded biosilica, even parts without detectable Eu signal in the EDX spectra show significant Eu(III) signals in the CL spectra. This highlights the sensitivity of CL in studying f-element sorption. CL data showed that Eu(III) was distributed on the entire surface. In conclusion, this work demonstrates the merit of CL and EDX methods for sorption studies on biogenic materials.
The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services.
Objectives
This material specifically aims to inform clinical practices in countries where clinics and operating theatres are reopening for elective work. It endeavours to present a current European view in relation to common procedures, many of which fall under the aegis of aerosol generating procedures.
Conclusion
As evidence continues to build, some of the recommended practices will undoubtedly evolve, but it is hoped that the updated position statement will offer clinicians precepts on safe clinical practice.
Social implications and long-term consequences of mental disorders regarding sick days at work, unemployment rates and early retirement are substantial. There is no clear understanding
1) whether and which social psychiatric strategies of vocational rehabilitation and
2) whether and how atypical antipsychotics are successful in supporting vocational rehabilitation in schizophrenia.
Objectives
Primary objective was to demonstrate the enhanced ability of schizophrenic patients to be successfully in employment after attending specific “job-consulting” programs. Secondary objective was to demonstrate positive effects of ziprasidone and risperidone on work-related functions.
Aims
Aim of the study was to enlighten the complex relationship between working performance of schizophrenic patients, their social psychiatric and medical treatment, and their cognitive capabilities in a first step.
Methods
The study was conducted in inpatients, day-clinic- or outpatients diagnosed with schizophrenia, paranoid type (ICD 10: F20.0). All patients received regular pharmacological treatment and intense cognitive training, additionally one group completed specific “job-consulting” programs. ANT, CPT, WCST, PANSS and WBN were performed after 3, 6, 12 and 24 months.
Results
At present eighteen schizophrenic patients (6 female and 12 male, mean age: 33.6 years) have been included in the study. Analyzing the data after 3 months the results are:
1) specific “job-consulting” programs increase the probability of employment
2) both, ziprasidone and risperidone, exert positive and comparable effects in work-related functions,
3) the better the cognitive capability the better the vocational outcome.
Conclusions
Specific “job-consulting” programs constitute a clinically relevant therapeutic option in vocational rehabilitation of schizophrenic patients.
We introduce the Galaxy IFU Spectroscopy Tool (GIST), a convenient, all-in-one and multi-purpose tool for the analysis and visualisation of already reduced (integral-field) spectroscopic data. In particular, the pipeline performs all steps from read-in and preparation of data to its scientific analysis and visualisation in publication-quality plots. The code measures stellar kinematics and non-parametric star formation histories using the pPXF routine (Cappellari & Emsellem 2004; Cappellari 2017), performs an emission-line analysis with the GandALF procedure (Sarzi et al. 2006; Falcón-Barroso et al. 2006), and determines absorption line-strength indices and their corresponding single stellar population equivalent population properties (Kuntschner et al.2006; Martín-Navarro et al. 2018). The dedicated visualisation routine Mapviewer facilitates the access of all data products in a sophisticated graphical user interface with fully interactive plots.
The outermost “crust” and an underlying, compositionally distinct, and denser layer, the “mantle,” constitute the silicate portion of a terrestrial planet. The “lithosphere” is the planet’s high-strength outer shell. The crust records the history of shallow magmatism, which along with temporal changes in lithospheric thickness, provides information on a planet’s thermal evolution. We focus on the basic structure and mechanics of Mercury’s crust and lithosphere as determined primarily from gravity and topography data acquired by the MESSENGER mission. We first describe these datasets: how they were acquired, how the data are represented on a sphere, and the limitations of the data imparted by MESSENGER’s highly eccentric orbit. We review different crustal thickness models obtained by parsing the observed gravity signal into contributions from topography, relief on the crust–mantle boundary, and density anomalies that drive viscous flow in the mantle. Estimates of lithospheric thickness from gravity–topography analyses are at odds with predictions from thermal models, thus challenging our understanding of Mercury’s geodynamics. We show that, like those of the Moon, Mercury's ellipsoidal shape and geoid are far from hydrostatic equilibrium, possibly the result of Mercury's peculiar surface temperature distribution and associated buoyancy anomalies and thermoelastic stresses in the interior.
Dispersions of Laponite clay in various electrolyte solutions have been studied. In the total absence of electrolyte the synthetic clay forms a sol at 2% concentration. All cations cause gelling and flocculation.
It has been found that for any given clay concentration the yield value of the dispersions at equivalent flocculation level is the same for all electrolyte solutions, making it possible to study all types of dispersions at a standard level of flocculation.
At standard level of flocculation, the yield values have been found to follow exponential relationships with clay concentration with a break in the curves occurring at about 1·6% clay concentration. It is postulated that the break in the yield value curve occurs when enough clay is present to form a card-house structure. The plastic viscosities show a linear relationship with concentration and indicate high effective dispersed volume fractions at low clay concentrations.
When comparing the flocculating effects of different cations at fixed clay concentration, an empirical relationship has been found between cation concentration giving standard flocculation level, cation valency and radius.
The effects of simultaneous additions of electrolyte and peptiser to dispersions of the synthetic hectorite-like clay, Laponite, have been studied. It has been unexpectedly discovered that whereas many cations cause gelling and flocculation of the dispersions as expected by colloid chemical theory, some cations actually stabilize the sols obtained with peptiser. A relationship has been found between the effectiveness of the cations in increasing sol stability and their size and charge.
The effects of time, temperature and peptiser concentration have also been examined, and explanations are offered for the phenomena observed.
Pollen and macrofossils are an integral part of palaeoenvironmental reconstruction. Here we discuss palaeobotanical evidence for vegetation and climate changes since the origins of modern biomes in southern Africa during the Miocene, and through the Pleistocene and Holocene. Examples of palaeobotanical records are provided from different biomes in different climate zones across southern Africa. These examples show that different biomes responded in different ways to climate changes throughout the Neogene and Quaternary, and that these environmental changes are also recorded in different ways though pollen, charcoal and macrofossils. In the latter part of the record, biome composition also reflects the impact of human activity.
Persistent katabatic winds form widely distributed localized areas of near-zero net surface accumulation on the East Antarctic ice sheet (EAIS) plateau. These areas have been called 'glaze' surfaces due to their polished appearance. They are typically 2-200 km2 in area and are found on leeward slopes of ice-sheet undulations and megadunes. Adjacent, leeward high-accumulation regions (isolated dunes) are generally smaller and do not compensate for the local low in surface mass balance (SMB). We use a combination of satellite remote sensing and field-gathered datasets to map the extent of wind glaze in the EAIS above 1500 m elevation. Mapping criteria are derived from distinctive surface and subsurface characteristics of glaze areas resulting from many years of intense annual temperature cycling without significant burial. Our results show that 11.2 ± 1.7%, or 950 ± 143 × 103km2, of the EAIS above 1500 m is wind glaze. Studies of SMB interpolate values across glaze regions, leading to overestimates of net mass input. Using our derived wind-glaze extent, we estimate this excess in three recent models of Antarctic SMB at 46-82 Gt. The lowest-input model appears to best match the mean in regions of extensive wind glaze.
To examine the effects of animal-source foods on toddler growth.
Design
A 5-month comparison feeding intervention study with one of three millet-based porridges randomized to eighteen feeding stations serving 303 children aged 11–40 months. Feeding stations served plain millet porridge (Plain group), porridge with milk (Milk group) or porridge with beef (Meat group). Anthropometry, morbidity and food intake were measured at baseline and regular intervals. Longitudinal mixed models were used to analyse growth.
Setting
Embu, Kenya.
Subjects
Two hundred and seventy-four children were included in final analyses.
Results
Linear growth was significantly greater for the Milk group than the Meat group (P = 0·0025). Slope of growth of mid-arm muscle area of the Plain group was significantly greater than in the Meat group (P = 0·0046), while the Milk group's mid-upper arm circumference growth rate was significantly greater than the Meat group's (P = 0·0418). The Milk and Plain groups’ measures did not differ.
Conclusions
Milk and meat porridges did not have a significantly greater effect on growth than plain porridge in this undernourished population. Linear growth was influenced by more than energy intakes, as the Plain group's total body weight-adjusted energy intakes were significantly greater than the Meat group's, although linear growth did not differ. Energy intakes may be more important for growth in arm muscle. The diverse age distribution in the study makes interpretation difficult. A longer study period, larger sample size and more focused age group would improve clarity of the results.
To determine whether drinking water contaminated with antimicrobial-resistant E. coli is associated with the carriage of resistant E. coli, selected households sending water samples to Ontario and Alberta laboratories in 2005–2006 were asked to participate in a cross-sectional study. Household members aged ⩾12 years were asked to complete a questionnaire and to submit a rectal swab. In 878 individuals, 41% carried a resistant strain of E. coli and 28% carried a multidrug-resistant strain. The risk of carriage of resistant E. coli was 1·26 times higher for users of water contaminated with resistant E. coli. Other risk factors included international travel [prevalence ratio (PR) 1·33], having a child in nappies (PR 1·33), being male (PR 1·33), and frequent handling of raw red meats (PR 1·10). Protecting private water sources (e.g. by improving systems to test and treat them) may help slow the emergence of antimicrobial resistance in E. coli.
New excavations in ravines at Ounjougou in Mali have brought to light a lithic and ceramic assemblage that dates from before 9400 cal BC. The authors show that this first use of pottery coincides with a warm wet period in the Sahara. As in East Asia, where very early ceramics are also known, the pottery and small bifacial arrowheads were the components of a new subsistence strategy exploiting an ecology associated with abundant wild grasses. In Africa, however, the seeds were probably boiled (then as now) rather than made into bread.
There is controversy extending beyond that of whether family planning or population control measures should be promoted among various populations. Even when the decision has been made to provide family planning advice, information and service, debate often arises as to the best method of administering a family planning programme—whether to integrate it with maternal and child health (MCH) services, offer it post-partum, or provide it independently of all other health activities.
The Danfa Comprehensive Rural Health and Family Planning Project, Ghana, is investigating the general problem of health service delivery, including family planning, and is doing so with a firm commitment to efficient management, staff training and supervisory maintenance. An established research design and ongoing evaluation efforts, including cost and functional analyses, are an integral part of the project. While it is believed that the integrated MCH/Family Planning approach will yield optimal results in family planning acceptance (as well as reduction in morbidity and mortality), other alternatives of health care and family planning service delivery are being evaluated.