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To estimate the risks of depressive symptoms for developing frailty, accounting for baseline robust or pre-frailty status.
An incident cohort study design.
Community dwellers aged 55 years and above from urban and rural areas in seven regions in Taiwan.
A total of 2,717 participants from the Healthy Aging Longitudinal Study in Taiwan (HALST) were included. Subjects with frailty at baseline were excluded. The average follow-up period was 5.9 years.
Depressive symptoms were measured by the 20-item Center for Epidemiological Studies Depression (CES-D) Scale. Frailty was assessed using the Fried frailty measurement. Participants were stratified by baseline robust or pre-frailty status to reduce the confounding effects of the shared criteria between depressive symptoms and frailty. Overall and stratified survival analyses were conducted to assess risks of developing frailty as a result of baseline depressive symptoms.
One hundred individuals (3.7%) had depressive symptoms at baseline. Twenty-seven individuals (27.0%) with depressive symptoms developed frailty, whereas only 305 out of the 2,617 participants (11.7%) without depressive symptoms developed frailty during the follow-up period. After adjusting for covariates, depressive symptoms were associated with a 2.6-fold (95% CI 1.6, 4.2) increased hazard of incident frailty. The patterns of increased hazard were also observed when further stratified by baseline robust or pre-frailty status.
Depressive symptoms increased the risk of developing frailty among the older Asian population. The impact of late-life depressive symptoms on physical health was notable. These findings also replicated results from Western populations. Future policies on geriatric public health need to focus more on treatment and intervention against geriatric depressive symptoms to prevent incident frailty among older population.
Exposure to adverse childhood experiences (ACEs) is not only associated with one's adverse health outcomes in adulthood but also increases the risk of child developmental problems in offspring. However, the mechanisms involved in the transmission of the effects of maternal ACEs to the offspring largely remain unexplored. This study sought to identify possible psychosocial pathways of intergenerational effects of maternal ACEs on child development at 6 months. Data from a longitudinal study on maternal childhood adversity and maternal psychosocial risk during pregnancy as well as maternal mental health problems and child development at 6 months postnatal were used. Structural equation modeling with bootstrapping was used to estimate the indirect effects of maternal ACEs on child development at 6 months. The model showed that maternal ACEs indirectly influenced offspring's development via maternal stressful events during pregnancy and pre- and postnatal mental health problems. This finding highlights the possible interventions at the prenatal and postnatal periods. Early identification of women who have ACEs or who are at psychosocial risk during pre- and postnatal periods is critical to provide interventions to buffer those negative effects on offspring's development. Future studies are needed to longitudinally assess the effects of maternal ACEs on child development over time.
Population-based colorectal cancer (CRC) screening programs that use a fecal immunochemical test (FIT) are often faced with a noncompliance issue and its subsequent waiting time (WT) for those FIT positives complying with confirmatory diagnosis. We aimed to identify factors associated with both of the correlated problems in the same model.
A total of 294,469 subjects, either with positive FIT test results or having a family history, collected from 2004 to 2013 were enrolled for analysis. We applied a hurdle Poisson regression model to accommodate the hurdle of compliance and also its related WT for undergoing colonoscopy while assessing factors responsible for the mixture of the two outcomes.
The effect on compliance and WT varied with contextual factors, such as geographic areas, type of screening units, and level of urbanization. The hurdle score, representing the risk score in association with noncompliance, and the WT score, reflecting the rate of taking colonoscopy, were used to classify subjects into each of three groups representing the degree of compliance and the level of health awareness.
Our model was not only successfully applied to evaluating factors associated with the compliance and the WT distribution, but also developed into a useful assessment model for stratifying the risk and predicting whether and when screenees comply with the procedure of receiving confirmatory diagnosis given contextual factors and individual characteristics.
Although some studies show that women are more likely to oppose free trade than men, others demonstrate that economic globalization empowers women. Given this paradox, we examine whether gender shapes individual preferences with respect to foreign direct investment (FDI) in developing countries. We hypothesize that women do not disfavor FDI more than men because multinational corporations (MNCs) bring more jobs for women, provide better working conditions and higher wages than domestic firms, and spread norms and values that favor gender equality. Moreover, this gender gap will be wider in more globalized countries because women can observe such benefits of MNCs. To test our arguments, we used survey data from the 2007 Pew Global Attitudes Project. Overall, women view FDI more positively than men, and this effect is stronger in economically more globalized countries and countries that are less dependent on agriculture. Women have a different view on FDI than that on trade.
To investigate the reciprocal relationship between unhealthy eating behaviours and depressive symptoms from childhood to adolescence.
Unhealthy eating behaviours were measured by the frequencies of eating foods with excess salt, sugar or fat in the past week. Depressive symptoms in the past two weeks were measured using a seven-item scale. Hierarchical linear growth models were used to analyse longitudinal associations between unhealthy eating behaviours and depressive symptoms. Time-fixed variables (sex, parents’ education level and household monthly income) and time-varying variables (parents’ marital status, family activities, body weight, vegetable or fruit consumption, exercising and smoking) were controlled for.
The Child and Adolescent Behaviors in Long-Term Evolution study, which commenced in 2001 and has annual follow-up.
Students (n 2630) followed from 2nd grade (8 years old in 2002) to 11th grade.
The frequency of unhealthy eating behaviours in the previous year and the difference between the frequency in the previous and successive year were positively associated with the initiation and growth rate of depressive symptoms. Depressive symptoms in the previous year and the difference in depressive symptoms between the previous and successive year were positively associated with the initial state and growth rate of unhealthy eating behaviours.
Our results suggest a reciprocal relationship between depressive symptoms and unhealthy eating behaviours. This relationship should be considered when developing programmes targeting depressive symptoms and unhealthy diet in children and adolescents.
Previous studies have identified numerous factors that affect incident-reporting behavior. However, few studies have applied an individual psychology perspective to identify and examine the factors affecting the intention of nursing staff to report incidents. We integrate the theory of planned behavior, organizational behavior, psychological behavior, and social exchange theory to identify which factors affect the intentions of nursing staff to report incidents. Samples were collected from nursing staff at 40 regional or larger hospitals for model verification. The results of this study show that psychological safety, attitude toward reporting incidents, subjective norms, and perceived behavioral control correlate positively with the intention to report incidents. The perceived cost and perceived benefit of incident reporting directly affects the attitude toward incident-reporting behavior, and self-efficacy influences perceived behavioral control. Furthermore, subjective norms and the perceived benefits of incident reporting mediate the effect of psychological safety on attitude toward incident-reporting behavior.
Unawareness of deficits is common and is associated with poor outcomes in Alzheimer's disease (AD); however, little is known about correlated neurobiochemical changes.
Proton magnetic resonance spectroscopy was used to examine neurobiochemical correlates of unawareness of deficits as assessed by the Dementia Deficit Scale in 36 patients with AD. Magnetic resonance spectroscopy spectra were acquired from the anterior cingulate area and right orbitofrontal area. Concentrations of N-acetyl-aspartate (NAA), total creatine, and other neurometabolites were calculated.
Nineteen (52.8%) participants had relative unawareness of deficits. This condition was negatively correlated with NAA/creatine in the anterior cingulate area (β = −0.36, p = 0.025) and positively correlated with NAA/creatine in the right orbitofrontal area (β = 0.41, p = 0.009) after controlling for dementia severity.
These findings suggest unawareness of deficits in AD was associated with the altered neurochemical metabolites in the anterior cingulate area and right orbitofrontal area. However, the two areas might have opposite neuronal functions in unawareness of deficits.
Isothermal crystallization kinetics of gamma-irradiated syndiotactic polystyrene (sPS) has been investigated by differential scanning calorimetry. Amorphous sPS samples were irradiated in air with gamma ray at various doses from 0 to 800 kGy, at a rate of 30 kGy/h, and melt-crystallized at different temperatures and times. Kinetics parameters were determined using Avrami's model with Gaussian functions and a modified Arrhenius equation. Isothermally crystallized sPS irradiated in air with gamma ray exhibited multiple endothermic melting peaks corresponding to various crystalline forms, and the radiation dose had a strong effect on their melting enthalpies, crystallinities, and crystallization kinetic parameters. The amount of the α-crystalline form increased with increasing crystallization time and those of the β- and β′ forms had an opposite trend. Both crystallization half time and crystallization activation energy of the α form in gamma-irradiated sPS increased with increasing radiation dose.
Queues operated by a processor-sharing mode have important applications in many modern systems. However, because of the simultaneous sharing of service capacity by all customers, the distribution function and moments of the sojourn time are difficult to derive, even with a given initial condition. In addition, when a limit on the number of customers in the system is enforced to ensure the quality of service, the sojourn time becomes more complicated. In recent literature, the distribution function is obtained via the Laplace–Stieltjes transform. In this paper, we take a pure algebraic approach to derive the moments of the sojourn time. We obtain an iterative formula and use it to investigate properties of the conditional sojourn time. The approach is simple and intuitive, and applies to queues with multiple class customers as well.
We investigated a cluster of postoperative febrile episodes and episodes of Acinetobacter baumannii bacteremia in obstetrics and gynecology wards after an electrical blackout and loss of the water supply. The use of patient-controlled analgesia was the only independent risk factor associated with postoperative fever, and A. baumannii isolates recovered from the blood of patients who had received patient-controlled analgesia were genetically related to an isolate recovered from the diluted morphine solution used for this procedure. After inappropriate preparation of the morphine solution was identified and stopped, the outbreak ended.
A 200°C fluxless process is developed to produce In-Cu joints. The fluxless feature is achieved by the prevention of indium oxidation during the solder fabrication and the bonding process. Indium and copper are deposited on an object in high vacuum to inhibit indium oxidation. Copper interacts with indium to form CuIn compound that further protects the inner indium from oxidation. For a specific design, the resulting joints consist of mainly CuIn intermetallic grains surrounded by a small amount of pure indium as revealed by SEM with EDX. Scanning acoustic microscope examination indicates that the joints are nearly void-free. This technology enables versatile control of the alloy composition, thus leading to several remelting temperatures and various physical properties.
A joining technique for electronic devices has been developed. This technique uses a leadindium- gold multilayer composite solder deposited directly on GaAs wafers in high vacuum to prevent indium oxidation. The gold layer on the composite further protects the indium layer from oxidation in atmosphere. The GaAs dies are bonded to a gold-coated alumina substrate at a process temperature of 250°C. Nearly perfect joints are achieved as verified by a scanning acoustic microscope (SAM). SEM and EDX results indicate that the alloy joint consists of AuIn2 grains embedded in an In-Pb solid solution phase, as predicted from the Au- In-Pb phase diagram. Compared to lead-tin solder, indium-lead solder has been shown by others to exhibit much better fatigue resistance and have much less of a scavenging effect. Thermal shock as well as shear tests confirm that a good die attach is obtained with the leadindium- gold composite.
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