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Many women experience both vasomotor menopausal symptoms (VMS) and depressed mood at midlife, but little is known regarding the prospective bi-directional relationships between VMS and depressed mood and the role of sleep difficulties in both directions.
A pooled analysis was conducted using data from 21 312 women (median: 50 years, interquartile range 49−51) in eight studies from the InterLACE consortium. The degree of VMS, sleep difficulties, and depressed mood was self-reported and categorised as never, rarely, sometimes, and often (if reporting frequency) or never, mild, moderate, and severe (if reporting severity). Multivariable logistic regression models were used to examine the bi-directional associations adjusted for within-study correlation.
At baseline, the prevalence of VMS (40%, range 13–62%) and depressed mood (26%, 8–41%) varied substantially across studies, and a strong dose-dependent association between VMS and likelihood of depressed mood was found. Over 3 years of follow-up, women with often/severe VMS at baseline were more likely to have subsequent depressed mood compared with those without VMS (odds ratios (OR) 1.56, 1.27–1.92). Women with often/severe depressed mood at baseline were also more likely to have subsequent VMS than those without depressed mood (OR 1.89, 1.47–2.44). With further adjustment for the degree of sleep difficulties at baseline, the OR of having a subsequent depressed mood associated with often/severe VMS was attenuated and no longer significant (OR 1.13, 0.90–1.40). Conversely, often/severe depressed mood remained significantly associated with subsequent VMS (OR 1.80, 1.38–2.34).
Difficulty in sleeping largely explained the relationship between VMS and subsequent depressed mood, but it had little impact on the relationship between depressed mood and subsequent VMS.
The authors would like to apologise for a typographical error in the abstract of the above mentioned article.
In the results section of the abstract on the first page of the article, the first odds ratio that refers to ‘aged care facilities’ should be (OR 5.44; 95% CI 4.43–6.67) and the second odds ratio that refers to health service facilities should be (OR 4.56; 95%CI 4.06–5.13).
Medicinal substances have been identified as common agents of both unintentional and intentional poisoning among older people, including those with dementia. This study aims to compare the characteristics of poisoning resulting in hospitalization in older people with and without dementia and their clinical outcomes.
A retrospective cohort study involving an examination of poisoning by intent involving individuals aged 50+ years with and without dementia using linked hospitalization and mortality records during 2003–2012. Individuals who had dementia were identified from hospital diagnoses and unintentional and intentional poisoning was identified using external cause classifications. The epidemiological profile (i.e. individual and incident characteristics) of poisoning by intent and dementia status was compared, along with clinical outcomes of hospital length of stay (LOS), 28-day readmission and 30-day mortality.
The hospitalization rate for unintentional and intentional poisoning for individuals with dementia was double and 1.5 times higher than the rates for individuals without dementia (69.5 and 31.6 per 100,000) and (56.4 and 32.5 per 1,00,000). The home was the most common location of poisoning. Unintentional poisoning was more likely to involve individuals residing in aged care facilities (OR 2.12; 95%CI 1.70–2.63) or health service facilities (OR 3.91; 95%CI 3.45–4.42). There were higher mortality rates and longer LOS for unintentional poisoning for individuals with dementia.
Clinicians need to be aware of the risks of poisoning for individuals with dementia and care is required in appropriate prescription, safe administration, and potential for self-harm with commonly used medications, such as anticholinesterase medications, antihypertensive drugs, and laxatives.
Considerable research attention has been devoted to understanding the importance of knowledge creation in organisations over the last decade. Research suggests that leadership plays an important role in knowledge-creation processes. Nonetheless, there is an important omission in knowledge creation research; namely, what are the underlying processes that underpin the implications of leadership for knowledge creation? This article aims to develop a theoretical model of leadership and knowledge creation by drawing on two contrasting leadership perspectives; that is transformational leadership and leader–member exchange (LMX), and the research on open-mindedness norms. Specifically, we argue why transformational leadership is related to knowledge creation, and also theorise how open-mindedness norms and LMX quality serve as underlying mechanisms to underpin the effect of transformational leadership on knowledge creation. We conclude with a discussion of implications of the model for theory and practice, and also suggest potential avenues for future research.
In two investigations (N = 62 and 59), three- and four-year-old children sometimes disbelieved what they were told about the unexpected contents of a deceptive box, even when they had seen the adult speaker look inside the box before s/he told them what s/he saw, and despite being able to recall the utterance: utterances were treated as unreliable sources of knowledge compared with seeing directly. Those who did believe the utterance were no better at recalling their prior belief about the box's contents (now treated as false), than those who saw inside the box. However using a narrative procedure, we replicated Zaitchik's (1991) result that children are more likely to acknowledge another's belief when they are told about reality, than when they see reality for themselves. We argue that these children were acknowledging alternative rather than false belief.
To determine the prevalence and risk factors for bloodborne exposure and infection in correctional healthcare workers (CHCWs).
Cross-sectional risk assessment study with a confidential questionnaire and serological testing performed during 1999-2000.
Correctional systems in 3 states.
Among 310 participating CHCWs, the rate of percutaneous injury (PI) was 32 Pis per 100 person-years overall and 42 Pis per 100 person-years for CHCWs with clinical job duties. Underreporting was common, with only 25 (49%) of 51 Pis formally reported to the administration. Independent risk factors for experiencing PI included being age 45 or older (adjusted odds ratio [aOR], 2.41 (95% confidence interval (CI), 1.31-4.46]) and having job duties that involved needle contact (aOR, 3.70 [95% CI, 1.28-10.63]) or blood contact (aOR, 5.05 [95% CI, 1.45-17.54]). Overall, 222 CHCWs (72%) reported having received a primary hepatitis В vaccination series; of these, 150 (68%) tested positive for anti-hepatitis B surface antigen, with negative results significantly associated with receipt of last dose more than 5 years previously. Serologic markers of hepatitis В virus infection were identified in 31 individuals (10%), and the prevalence of hepatitis B virus infection was 2% (n = 7). The high hepatitis B vaccination rate limited the ability to identify risk factors for infection, but hepatitis C virus infection correlated with community risk factors only.
Although the wide coverage with hepatitis B vaccination and the decreasing rate of hepatitis C virus infection in the general population are encouraging, the high rate of exposure in CHCWs and the lack of exposure documentation are concerns. Continued efforts to develop interventions to reduce exposures and encourage reporting should be implemented and evaluated in correctional healthcare settings. These interventions should address infection control barriers unique to the correctional setting.