15 results
Incidence and risk factors for catheter-associated urinary tract infection in 623 intensive care units throughout 37 Asian, African, Eastern European, Latin American, and Middle Eastern nations: A multinational prospective research of INICC
- Victor Daniel Rosenthal, Ruijie Yin, Eric Christopher Brown, Brandon Hochahn Lee, Camilla Rodrigues, Sheila Nainan Myatra, Mohit Kharbanda, Prasad Rajhans, Yatin Mehta, Subhash Kumar Todi, Sushmita Basu, Suneeta Sahu, Shakti Bedanta Mishra, Rajesh Chawla, Pravin K. Nair, Rajalakshmi Arjun, Deepak Singla, Kavita Sandhu, Vijayanand Palaniswamy, Arpita Bhakta, Mohd-Basri Mat Nor, Tai Chian-Wern, Ider Bat-Erdene, Subhash P. Acharya, Aamer Ikram, Nellie Tumu, Lili Tao, Gustavo Andres Alvarez, Sandra Liliana Valderrama-Beltran, Luisa Fernanda Jiménez-Alvarez, Claudia Milena Henao-Rodas, Katherine Gomez, Lina Alejandra Aguilar-Moreno, Yuliana Andrea Cano-Medina, Maria Adelia Zuniga-Chavarria, Guadalupe Aguirre-Avalos, Alejandro Sassoe-Gonzalez, Mary Cruz Aleman-Bocanegra, Blanca Estela Hernandez-Chena, Maria Isabel Villegas-Mota, Daisy Aguilar-de-Moros, Alex Castañeda-Sabogal, Eduardo Alexandrino Medeiros, Lourdes Dueñas, Nilton Yhuri Carreazo, Estuardo Salgado, Safaa Abdulaziz-Alkhawaja, Hala Mounir Agha, Amani Ali El-Kholy, Mohammad Abdellatif Daboor, Ertugrul Guclu, Oguz Dursun, Iftihar Koksal, Merve Havan, Suna Secil Ozturk-Deniz, Dincer Yildizdas, Emel Okulu, Abeer Aly Omar, Ziad A. Memish, Jarosław Janc, Sona Hlinkova, Wieslawa Duszynska, George Horhat-Florin, Lul Raka, Michael M. Petrov, Zhilin Jin
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 45 / Issue 5 / May 2024
- Published online by Cambridge University Press:
- 04 January 2024, pp. 567-575
- Print publication:
- May 2024
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Objective:
To identify urinary catheter (UC)–associated urinary tract infection (CAUTI) incidence and risk factors.
Design:A prospective cohort study.
Setting:The study was conducted across 623 ICUs of 224 hospitals in 114 cities in 37 African, Asian, Eastern European, Latin American, and Middle Eastern countries.
Participants:The study included 169,036 patients, hospitalized for 1,166,593 patient days.
Methods:Data collection took place from January 1, 2014, to February 12, 2022. We identified CAUTI rates per 1,000 UC days and UC device utilization (DU) ratios stratified by country, by ICU type, by facility ownership type, by World Bank country classification by income level, and by UC type. To estimate CAUTI risk factors, we analyzed 11 variables using multiple logistic regression.
Results:Participant patients acquired 2,010 CAUTIs. The pooled CAUTI rate was 2.83 per 1,000 UC days. The highest CAUTI rate was associated with the use of suprapubic catheters (3.93 CAUTIs per 1,000 UC days); with patients hospitalized in Eastern Europe (14.03) and in Asia (6.28); with patients hospitalized in trauma (7.97), neurologic (6.28), and neurosurgical ICUs (4.95); with patients hospitalized in lower–middle-income countries (3.05); and with patients in public hospitals (5.89).
The following variables were independently associated with CAUTI: Age (adjusted odds ratio [aOR], 1.01; P < .0001), female sex (aOR, 1.39; P < .0001), length of stay (LOS) before CAUTI-acquisition (aOR, 1.05; P < .0001), UC DU ratio (aOR, 1.09; P < .0001), public facilities (aOR, 2.24; P < .0001), and neurologic ICUs (aOR, 11.49; P < .0001).
Conclusions:CAUTI rates are higher in patients with suprapubic catheters, in middle-income countries, in public hospitals, in trauma and neurologic ICUs, and in Eastern European and Asian facilities.
Based on findings regarding risk factors for CAUTI, focus on reducing LOS and UC utilization is warranted, as well as implementing evidence-based CAUTI-prevention recommendations.
Ten new insights in climate science 2023
- Mercedes Bustamante, Joyashree Roy, Daniel Ospina, Ploy Achakulwisut, Anubha Aggarwal, Ana Bastos, Wendy Broadgate, Josep G. Canadell, Edward R. Carr, Deliang Chen, Helen A. Cleugh, Kristie L. Ebi, Clea Edwards, Carol Farbotko, Marcos Fernández-Martínez, Thomas L. Frölicher, Sabine Fuss, Oliver Geden, Nicolas Gruber, Luke J. Harrington, Judith Hauck, Zeke Hausfather, Sophie Hebden, Aniek Hebinck, Saleemul Huq, Matthias Huss, M. Laurice P. Jamero, Sirkku Juhola, Nilushi Kumarasinghe, Shuaib Lwasa, Bishawjit Mallick, Maria Martin, Steven McGreevy, Paula Mirazo, Aditi Mukherji, Greg Muttitt, Gregory F. Nemet, David Obura, Chukwumerije Okereke, Tom Oliver, Ben Orlove, Nadia S. Ouedraogo, Prabir K. Patra, Mark Pelling, Laura M. Pereira, Åsa Persson, Julia Pongratz, Anjal Prakash, Anja Rammig, Colin Raymond, Aaron Redman, Cristobal Reveco, Johan Rockström, Regina Rodrigues, David R. Rounce, E. Lisa F. Schipper, Peter Schlosser, Odirilwe Selomane, Gregor Semieniuk, Yunne-Jai Shin, Tasneem A. Siddiqui, Vartika Singh, Giles B. Sioen, Youba Sokona, Detlef Stammer, Norman J. Steinert, Sunhee Suk, Rowan Sutton, Lisa Thalheimer, Vikki Thompson, Gregory Trencher, Kees van der Geest, Saskia E. Werners, Thea Wübbelmann, Nico Wunderling, Jiabo Yin, Kirsten Zickfeld, Jakob Zscheischler
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- Journal:
- Global Sustainability / Volume 7 / 2024
- Published online by Cambridge University Press:
- 01 December 2023, e19
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Non-technical summary
We identify a set of essential recent advances in climate change research with high policy relevance, across natural and social sciences: (1) looming inevitability and implications of overshooting the 1.5°C warming limit, (2) urgent need for a rapid and managed fossil fuel phase-out, (3) challenges for scaling carbon dioxide removal, (4) uncertainties regarding the future contribution of natural carbon sinks, (5) intertwinedness of the crises of biodiversity loss and climate change, (6) compound events, (7) mountain glacier loss, (8) human immobility in the face of climate risks, (9) adaptation justice, and (10) just transitions in food systems.
Technical summaryThe Intergovernmental Panel on Climate Change Assessment Reports provides the scientific foundation for international climate negotiations and constitutes an unmatched resource for researchers. However, the assessment cycles take multiple years. As a contribution to cross- and interdisciplinary understanding of climate change across diverse research communities, we have streamlined an annual process to identify and synthesize significant research advances. We collected input from experts on various fields using an online questionnaire and prioritized a set of 10 key research insights with high policy relevance. This year, we focus on: (1) the looming overshoot of the 1.5°C warming limit, (2) the urgency of fossil fuel phase-out, (3) challenges to scale-up carbon dioxide removal, (4) uncertainties regarding future natural carbon sinks, (5) the need for joint governance of biodiversity loss and climate change, (6) advances in understanding compound events, (7) accelerated mountain glacier loss, (8) human immobility amidst climate risks, (9) adaptation justice, and (10) just transitions in food systems. We present a succinct account of these insights, reflect on their policy implications, and offer an integrated set of policy-relevant messages. This science synthesis and science communication effort is also the basis for a policy report contributing to elevate climate science every year in time for the United Nations Climate Change Conference.
Social media summaryWe highlight recent and policy-relevant advances in climate change research – with input from more than 200 experts.
Multinational prospective study of incidence and risk factors for central-line–associated bloodstream infections in 728 intensive care units of 41 Asian, African, Eastern European, Latin American, and Middle Eastern countries over 24 years
- Victor Daniel Rosenthal, Ruijie Yin, Sheila Nainan Myatra, Ziad A. Memish, Camilla Rodrigues, Mohit Kharbanda, Sandra Liliana Valderrama-Beltran, Yatin Mehta, Majeda Afeef Al-Ruzzieh, Guadalupe Aguirre-Avalos, Ertugrul Guclu, Chin Seng Gan, Luisa Fernanda Jiménez Alvarez, Rajesh Chawla, Sona Hlinkova, Rajalakshmi Arjun, Hala Mounir Agha, Maria Adelia Zuniga Chavarria, Narangarav Davaadagva, Yin Hoong Lai, Katherine Gomez, Daisy Aguilar-de-Moros, Chian-Wern Tai, Alejandro Sassoe Gonzalez, Lina Alejandra Aguilar Moreno, Kavita Sandhu, Jarosław Janc, Mary Cruz Aleman Bocanegra, Dincer Yildizdas, Yuliana Andrea Cano Medina, Maria Isabel Villegas Mota, Abeer Aly Omar, Wieslawa Duszynska, Amani Ali El-Kholy, Safaa Abdulaziz Alkhawaja, George Horhat Florin, Eduardo Alexandrino Medeiros, Lili Tao, Nellie Tumu, May Gamar Elanbya, Reshma Dongol, Vesna Mioljević, Lul Raka, Lourdes Dueñas, Nilton Yhuri Carreazo, Tarek Dendane, Aamer Ikram, Tala Kardas, Michael M. Petrov, Asma Bouziri, Nguyen Viet-Hung, Vladislav Belskiy, Naheed Elahi, Estuardo Salgado, Zhilin Jin
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 44 / Issue 11 / November 2023
- Published online by Cambridge University Press:
- 28 April 2023, pp. 1737-1747
- Print publication:
- November 2023
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Objective:
To identify central-line (CL)–associated bloodstream infection (CLABSI) incidence and risk factors in low- and middle-income countries (LMICs).
Design:From July 1, 1998, to February 12, 2022, we conducted a multinational multicenter prospective cohort study using online standardized surveillance system and unified forms.
Setting:The study included 728 ICUs of 286 hospitals in 147 cities in 41 African, Asian, Eastern European, Latin American, and Middle Eastern countries.
Patients:In total, 278,241 patients followed during 1,815,043 patient days acquired 3,537 CLABSIs.
Methods:For the CLABSI rate, we used CL days as the denominator and the number of CLABSIs as the numerator. Using multiple logistic regression, outcomes are shown as adjusted odds ratios (aORs).
Results:The pooled CLABSI rate was 4.82 CLABSIs per 1,000 CL days, which is significantly higher than that reported by the Centers for Disease Control and Prevention National Healthcare Safety Network (CDC NHSN). We analyzed 11 variables, and the following variables were independently and significantly associated with CLABSI: length of stay (LOS), risk increasing 3% daily (aOR, 1.03; 95% CI, 1.03–1.04; P < .0001), number of CL days, risk increasing 4% per CL day (aOR, 1.04; 95% CI, 1.03–1.04; P < .0001), surgical hospitalization (aOR, 1.12; 95% CI, 1.03–1.21; P < .0001), tracheostomy use (aOR, 1.52; 95% CI, 1.23–1.88; P < .0001), hospitalization at a publicly owned facility (aOR, 3.04; 95% CI, 2.31–4.01; P <.0001) or at a teaching hospital (aOR, 2.91; 95% CI, 2.22–3.83; P < .0001), hospitalization in a middle-income country (aOR, 2.41; 95% CI, 2.09–2.77; P < .0001). The ICU type with highest risk was adult oncology (aOR, 4.35; 95% CI, 3.11–6.09; P < .0001), followed by pediatric oncology (aOR, 2.51;95% CI, 1.57–3.99; P < .0001), and pediatric (aOR, 2.34; 95% CI, 1.81–3.01; P < .0001). The CL type with the highest risk was internal-jugular (aOR, 3.01; 95% CI, 2.71–3.33; P < .0001), followed by femoral (aOR, 2.29; 95% CI, 1.96–2.68; P < .0001). Peripherally inserted central catheter (PICC) was the CL with the lowest CLABSI risk (aOR, 1.48; 95% CI, 1.02–2.18; P = .04).
Conclusions:The following CLABSI risk factors are unlikely to change: country income level, facility ownership, hospitalization type, and ICU type. These findings suggest a focus on reducing LOS, CL days, and tracheostomy; using PICC instead of internal-jugular or femoral CL; and implementing evidence-based CLABSI prevention recommendations.
Multinational prospective cohort study of rates and risk factors for ventilator-associated pneumonia over 24 years in 42 countries of Asia, Africa, Eastern Europe, Latin America, and the Middle East: Findings of the International Nosocomial Infection Control Consortium (INICC)
- Victor Daniel Rosenthal, Zhilin Jin, Ziad A. Memish, Camilla Rodrigues, Sheila Nainan Myatra, Mohit Kharbanda, Sandra Liliana Valderrama-Beltran, Yatin Mehta, Mohammad Abdellatif Daboor, Subhash Kumar Todi, Guadalupe Aguirre-Avalos, Ertugrul Guclu, Chin Seng Gan, Luisa Fernanda Jiménez Alvarez, Rajesh Chawla, Sona Hlinkova, Rajalakshmi Arjun, Hala Mounir Agha, Maria Adelia Zuniga Chavarria, Narangarav Davaadagva, Mat Nor Mohd Basri, Katherine Gomez, Daisy Aguilar De Moros, Chian-Wern Tai, Alejandro Sassoe Gonzalez, Lina Alejandra Aguilar Moreno, Kavita Sandhu, Jarosław Janc, Mary Cruz Aleman Bocanegra, Dincer Yildizdas, Yuliana Andrea Cano Medina, Maria Isabel Villegas Mota, Abeer Aly Omar, Wieslawa Duszynska, Souad BelKebir, Amani Ali El-Kholy, Safaa Abdulaziz Alkhawaja, George Horhat Florin, Eduardo Alexandrino Medeiros, Lili Tao, Nellie Tumu, May Gamar Elanbya, Reshma Dongol, Vesna Mioljević, Lul Raka, Lourdes Dueñas, Nilton Yhuri Carreazo, Tarek Dendane, Aamer Ikram, Souha S. Kanj, Michael M. Petrov, Asma Bouziri, Nguyen Viet Hung, Vladislav Belskiy, Naheed Elahi, María Marcela Bovera, Ruijie Yin
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- Journal:
- Antimicrobial Stewardship & Healthcare Epidemiology / Volume 3 / Issue 1 / 2023
- Published online by Cambridge University Press:
- 09 January 2023, e6
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Objective:
Rates of ventilator-associated pneumonia (VAP) in low- and middle-income countries (LMIC) are several times above those of high-income countries. The objective of this study was to identify risk factors (RFs) for VAP cases in ICUs of LMICs.
Design:Prospective cohort study.
Setting:This study was conducted across 743 ICUs of 282 hospitals in 144 cities in 42 Asian, African, European, Latin American, and Middle Eastern countries.
Participants:The study included patients admitted to ICUs across 24 years.
Results:In total, 289,643 patients were followed during 1,951,405 patient days and acquired 8,236 VAPs. We analyzed 10 independent variables. Multiple logistic regression identified the following independent VAP RFs: male sex (adjusted odds ratio [aOR], 1.22; 95% confidence interval [CI], 1.16–1.28; P < .0001); longer length of stay (LOS), which increased the risk 7% per day (aOR, 1.07; 95% CI, 1.07–1.08; P < .0001); mechanical ventilation (MV) utilization ratio (aOR, 1.27; 95% CI, 1.23–1.31; P < .0001); continuous positive airway pressure (CPAP), which was associated with the highest risk (aOR, 13.38; 95% CI, 11.57–15.48; P < .0001); tracheostomy connected to a MV, which was associated with the next-highest risk (aOR, 8.31; 95% CI, 7.21–9.58; P < .0001); endotracheal tube connected to a MV (aOR, 6.76; 95% CI, 6.34–7.21; P < .0001); surgical hospitalization (aOR, 1.23; 95% CI, 1.17–1.29; P < .0001); admission to a public hospital (aOR, 1.59; 95% CI, 1.35-1.86; P < .0001); middle-income country (aOR, 1.22; 95% CI, 15–1.29; P < .0001); admission to an adult-oncology ICU, which was associated with the highest risk (aOR, 4.05; 95% CI, 3.22–5.09; P < .0001), admission to a neurologic ICU, which was associated with the next-highest risk (aOR, 2.48; 95% CI, 1.78–3.45; P < .0001); and admission to a respiratory ICU (aOR, 2.35; 95% CI, 1.79–3.07; P < .0001). Admission to a coronary ICU showed the lowest risk (aOR, 0.63; 95% CI, 0.51–0.77; P < .0001).
Conclusions:Some identified VAP RFs are unlikely to change: sex, hospitalization type, ICU type, facility ownership, and country income level. Based on our results, we recommend focusing on strategies to reduce LOS, to reduce the MV utilization ratio, to limit CPAP use and implementing a set of evidence-based VAP prevention recommendations.
Genetic influences on externalizing psychopathology overlap with cognitive functioning and show developmental variation
- Part of
- Josephine Mollon, Emma E. M. Knowles, Samuel R. Mathias, Amanda Rodrigue, Tyler M. Moore, Monica E. Calkins, Ruben C. Gur, Juan Manuel Peralta, Daniel J. Weiner, Elise B. Robinson, Raquel E. Gur, John Blangero, Laura Almasy, David C. Glahn
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- Journal:
- European Psychiatry / Volume 64 / Issue 1 / 2021
- Published online by Cambridge University Press:
- 31 March 2021, e29
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Background
Questions remain regarding whether genetic influences on early life psychopathology overlap with cognition and show developmental variation.
MethodsUsing data from 9,421 individuals aged 8–21 from the Philadelphia Neurodevelopmental Cohort, factors of psychopathology were generated using a bifactor model of item-level data from a psychiatric interview. Five orthogonal factors were generated: anxious-misery (mood and anxiety), externalizing (attention deficit hyperactivity and conduct disorder), fear (phobias), psychosis-spectrum, and a general factor. Genetic analyses were conducted on a subsample of 4,662 individuals of European American ancestry. A genetic relatedness matrix was used to estimate heritability of these factors, and genetic correlations with executive function, episodic memory, complex reasoning, social cognition, motor speed, and general cognitive ability. Gene × Age analyses determined whether genetic influences on these factors show developmental variation.
ResultsExternalizing was heritable (h2 = 0.46, p = 1 × 10−6), but not anxious-misery (h2 = 0.09, p = 0.183), fear (h2 = 0.04, p = 0.337), psychosis-spectrum (h2 = 0.00, p = 0.494), or general psychopathology (h2 = 0.21, p = 0.040). Externalizing showed genetic overlap with face memory (ρg = −0.412, p = 0.004), verbal reasoning (ρg = −0.485, p = 0.001), spatial reasoning (ρg = −0.426, p = 0.010), motor speed (ρg = 0.659, p = 1x10−4), verbal knowledge (ρg = −0.314, p = 0.002), and general cognitive ability (g)(ρg = −0.394, p = 0.002). Gene × Age analyses revealed decreasing genetic variance (γg = −0.146, p = 0.004) and increasing environmental variance (γe = 0.059, p = 0.009) on externalizing.
ConclusionsCognitive impairment may be a useful endophenotype of externalizing psychopathology and, therefore, help elucidate its pathophysiological underpinnings. Decreasing genetic variance suggests that gene discovery efforts may be more fruitful in children than adolescents or young adults.
1554 – Verbal Fluencies Associated Factors In Elderly
- L. Caldas, H. Espirito-Santo, J. Matreno, M. Marques, I.T. Pena, M.D. Costa, A. Costa, D. Simões, A. Conde, A.R. Correia, R. Almeida, S. Moitinho, F. Rodrigues, S.C. Simões, L. Lemos, F. Daniel
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- Journal:
- European Psychiatry / Volume 28 / Issue S1 / 2013
- Published online by Cambridge University Press:
- 15 April 2020, 28-E851
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Verbal fluency (VF) involves complex processes and has been a good marker of cognitive decline. However, the literature is inconsistent concerning to witch factors are associated with VF.
Our aims are to analyze the relationship between both phonemic verbal fluency (PVF) and semantic verbal fluency (SVF) and sociodemographic and psychopathological variables, and explore which emerge as significant predictors.
A subsample of 429 of healthy institutionalized elderly from the Aging Trajectories at Coimbra Council Project were surveyed (60 to 100 years; mean age = 80.38 ± 7.24), the majority was women (76.9%), without a partner (82.2%), without education or with less than four years of education (85.7%), manual occupation (90.1%), and attending day care centers. We evaluated VF phonetically (letters P, M, R) and semantically (animals and food), anxiety symptoms through the Geriatric Anxiety Inventory (GAI), depressive symptoms through Geriatric Depression Scale (GDS), and feelings of loneliness through Loneliness Scale (UCLA).
PVF was significantly related with education, occupation, GAI, and GDS. SVF was significantly associated with age, education, occupation, and GDS. Furthermore, SVF scores were worse in elderly men and in those living in night care center, and PVF scores were lower in those with high levels of anxiety symptomatology. In logistic regression analysis none of the variables accounted for the variance in PVF. The only predictor of SVF was sex. In conclusion, this study allowed us to elucidate the only key factor underlying verbal fluency. Being a man may affect SVF performance in institutionalized elderly.
Therapy Adherence Predictors in Type 2 Diabetes Mellitus
- I. Massano-Cardoso, A. Galhardo, F. Daniel, M. Cunha, V. Rodrigues, M. Carvalheiro
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- European Psychiatry / Volume 30 / Issue S1 / March 2015
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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Introduction
The changing epidemiological profile of population in recent decades is related to the socio-economic conditions of contemporaneity. Diabetes mellitus (DM) is positioned in the chronic non-communicable diseases spectrum as one of the most prevalent being responsible for high rates of morbidity and mortality. Therapeutic adhere is of crucial importance because there are high risks associated with non-adherence and it impacts on quality of life.
ObjectivesIdentifying therapeutic adherence predictors in type 2 diabetes (DM2).
Methods188 patients attending diabetology consultations at the Department of Endocrinology, Diabetes and Metabolism, at Centro Hospitalar e Universitário de Coimbra and at Associação Protetora dos Diabéticos de Portugal participated in the study. Participants completed the following set of self-report instruments: Beck Depression Inventory (BDI), the Diabetes Health Profile (DHP), the Rosenberg Self-Esteem (RSE), and the social relations dimension of the World Health Organization Quality of Life (WHOQOL). Therapeutic adherence was established base on HbA1C clinical criteria.
ResultsMultiple regression analyses revealed that the full model was statistically significant [c 2 (4, n = 188) = 20.79, p >0.001] explaining between 20% and 29.6% of total variance and 76.3% of the cases were correctly classified. The four variables significantly contributed to the model, especially the BDI and the RSE, registering an odds ratio of 1.104 and 1.203, respectively.
ConclusionsIn DM2 predictors of non-adherence were depression and diabetes patient health profile while self-esteem and quality of life in social relations, emerged as predictors of adherence.
EPA-1653 – Risk and Protective Factors of Depression in Institutionalized Elderly
- H. Espirito-Santo, F. Vicente, D. Cardoso, G.F. Silva, L. Ventura, M. Costa, S. Martins, I. Torres-Pena, C.S. Neves, F. Rodrigues, V. Vigário, A.L. Pinto, S. Moitinho, C. Morgado, S. Guadalupe, H. Vicente, L. Lemos, F. Daniel
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- Journal:
- European Psychiatry / Volume 29 / Issue S1 / 2014
- Published online by Cambridge University Press:
- 15 April 2020, p. 1
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Introduction/objectives
Depression is very common among institutionalized elders. Because of the increased risk of cognitive impairment/dementia, and mortality we want to describe the evolution of depression and analyze predictive factors.
MethodsIn the Aging Trajectories Study (Instituto Superior Miguel Torga - Coimbra), we followed up a sample of 83 nondemented persons (M ± SD baseline age = 79.51 ± 6.58; men: 17; women: 66). In a 2-year prospective cohort analysis (2010-2011, and 2013), we assessed depression using the Geriatric Depressive Scale/GDS as screening tool and the Mini International Neuropsychiatric Interview to diagnose depression. We also used the UCLA Loneliness Scale, the Geriatric Anxiety Inventory/GAI, the Positive and Negative Affect Scale/PANAS. Sociodemographics, and health were control variables. We performed a multinomial logistic regression to identify predicitive factors.
ResultsFifty participants had depression at baseline, nine developed, 49 maintained, nine remitted, and 16 maintained without depression.
Having depression was associated with worse scores in UCLA, GAI, and PANAS. Not having depression was correlated with higher positive affect.
Baseline higher GAI and UCLA, and lower positive affect and satisfaction predicted recurrent depression.
Improvement in GDS, GAI, and positive affect predicted depression remission.
ConclusionResults show that depression is a concern issue for professionals working with institutionalized elderly. Anxiety, loneliness, low positive affect and satisfaction constitute a risk factor for maintaing depression in institutionalized elderly and low anxiety and depressive symptoms are a protective factors for depression. These results could be used in depression prevention programs.
1553 – Affectivity And Cognitive Functioning In Institutionalized Elderly
- H. Espirito-Santo, A.R. Correia, M. Marques, I.T. Pena, L. Caldas, F. Rodrigues, L. Ferreira, M.D. Costa, S. Moitinho, R. Almeida, A. Costa, D. Simões, A. Conde, S. Guadalupe, F. Daniel, L. Lemos
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- Journal:
- European Psychiatry / Volume 28 / Issue S1 / 2013
- Published online by Cambridge University Press:
- 15 April 2020, 28-E850
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Affectivity is related to cognitive impairment, but it is not known whether positive affect and negative affect increase/decrease the risk of cognitive impairment. In this study, we sought to examine the prevalence of cognitive impairment, and the potential role of positive and negative affectivity on cognitive functioning in institutionalized portuguese elderly, controlling the potential role of demographic and emotional factors.
A cross sectional investigation has been conducted with a portuguese institutionalized sample at Coimbra’s Council. We inquired 412 healthy elderly with a mean age of 80.38 years (SD = 7.24) using the Positive and Negative Affect Schedule (PANAS), the Mini-Mental State Examination (MMSE), the Geriatric Depression Scale (GDS) and the Geriatric Anxiety Inventory (GAI). Demographic (76.9% women, 14.3% > 4 years of education, 99.1% manual occupation, 82.2% without partner) and other self-reported related factors were taken into consideration (GDS mean 14.30 ± 6.31; GAI mean = 12.49 ± 5.93).
The prevalence of cognitive impairment was 66.6% (youngest-old: 1.4%; young-old: 24.7%, old-old: 36.5%, oldest-old: 3.9%). We found that only the positive affect was significantly related with the MMSE (r = 0.22). Multiple logistic regression analysis showed that positive affect predicted impairment in cognitive performance (OR = 0.96, CI 95% = 0.93-0.98; p < 0.001). These relationships were significant even after controlling for depression and anxiety status, age, education, and occupation.
These findings suggest that positive affect is a variable to attend to when evaluating cognitive functioning in institutionalized elderly.
1230 – Selective Attention And Cognitive Decline In Institutionalized Elderly
- R. Almeida, M. Marques, H. Espírito Santo, S. Moitinho, V. Vigário, I. Pena, J. Matreno, F. Rodrigues, E. Antunes, D. Simões, A. Costa, A.R. Correia, A.S. Pimentel, V. Alves, T. Nascimento, M. Costa, M. Tomaz, L. Caldas, L. Ferreira, S. Simões, S. Guadalupe, L. Lemos, F. Daniel
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- European Psychiatry / Volume 28 / Issue S1 / 2013
- Published online by Cambridge University Press:
- 15 April 2020, 28-E596
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Introduction
When cognitive decline (CD) is present, attention is one of the impaired mental functions. CD is also associated with anxious/depressive symptoms and with some demographic variables, particularly, age.
ObjectivesInvestigate the associations between selective attention (Stroop Test: Stroop_Word, Stroop_Color, Difference between Stroop_Word and Stroop_Color, Stroop Ratio_Word, Stroop Ratio_Color and Difference between Stroop Ratio_Word and Stroop Ratio_ Color) and CD (Montreal Cognitive Assessment/MoCA) in institutionalized elders; explore the predictive value of Stroop variables for CD, controlling anxious/depressive symptoms and sociodemographic variables.
Methods140 institutionalized elders (mean age, M = 78.4, SD = 7.48, range = 60-97) voluntarily answered to sociodemographic questions, the MoCA, the Geriatric Anxiety Inventory/GAI, the Geriatric Depression Scale/GDS and Stroop test.
Results73 elders (52, 1%) had CD. Dichotomized MoCA was associated with Stroop_Word, Stroop_Color, Stroop Ratio_Word, Stroop Ratio_Color, GDS and the sociodemographic variable schooling × profession. Age and education were not tested, since MoCA was stratified according to those variables. GDS, Stroop Ratio_Word and Stroop Ratio_Color showed to predict CD.
ConclusionsThere was an association between Stroop_Word, Stroop_Color, Stroop Ratio_Word and Stroop Ratio_Color and CD, confirming that selective attention is smaller when the elderly reveal CD. GDS and CD were, also, associated. However, there was no association between MoCA dichotomized and differences between the correct answers (Stroop_Word and Stroop_Color) and Ratios (Stroop Ratio_Word and Stroop Ratio_Color). Selective attention and depressive symptoms predicted CD. It would be important to intervene through cognitive rehabilitation with the elders to improve their attention.
The Avifauna of the Rio Branco, an Amazonian evolutionary and ecological hotspot in peril
- LUCIANO N. NAKA, THIAGO ORSI LARANJEIRAS, GISIANE RODRIGUES LIMA, ALICE C. PLASKIEVICZ, DANIELE MARIZ, BRUNA M. DA COSTA, H. SUZANY G. DE MENEZES, MARCELA DE F. TORRES, MARIO COHN-HAFT
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- Journal:
- Bird Conservation International / Volume 30 / Issue 1 / March 2020
- Published online by Cambridge University Press:
- 24 June 2019, pp. 21-39
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The Rio Branco is a river with unique biogeographic and ecological features, threatened by the Brazilian Government’s plan to build a major hydroelectric dam and associated hydroway along its course. The river crosses one of Amazonia’s largest rainfall gradients and a major geomorphological boundary along a savanna/forest ecotone, marked by the Bem Querer rapids. Above the rapids, the upper Rio Branco runs through the Boa Vista sedimentary formation and crosses the crystalline rocks of the Guiana Shield, and its margins are flanked by gallery forests. Downriver, it runs through a low-lying sedimentary basin, with Amazonian floodplain forests along its margins. Here, we present the results of ∼ 15 years of ornithological research on the Branco and its major tributaries, providing baseline data and evaluating potential threats to the riverine avifauna. Our surveys included opportunistic observations and standardized surveys along the entire length of the river in 16 systematically distributed localities. We catalogued 439 bird species, 87% of which are documented by physical evidence (specimens, recordings, photographs). Forty-six percent are restricted to single habitats, suggesting a high degree of habitat specialisation. A third of the species are widely distributed along the river, whereas 45% are restricted to either the upper or the lower Rio Branco, including 40 and 30 Indicator Species, respectively. Twenty-five species are threatened at global or national levels, including two ‘Critically Endangered’, nine ‘Vulnerable’, and 14 ‘Near Threatened’. We present a list of 50 bird species that are candidates for monitoring studies. Threats to the avifauna from dam construction include permanent flooding above the dam, eliminating gallery forests, river islands, and sandy beaches, and the disruption of the flood pulse along the river, affecting river island and floodplain forest specialists, many of which are globally threatened with extinction. If built, the Bem Querer dam will wipe out the ecotone region and affect dramatically the river’s avifauna.
Understanding the role of the family physician in early psychosis intervention
- Kelly K. Anderson, Suzanne Archie, Richard G. Booth, Chiachen Cheng, Daniel Lizotte, Arlene G. MacDougall, Ross M. G. Norman, Bridget L. Ryan, Amanda L. Terry, Rebecca Rodrigues,
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- Journal:
- BJPsych Open / Volume 4 / Issue 6 / November 2018
- Published online by Cambridge University Press:
- 30 October 2018, pp. 447-453
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Background
The family physician is key to facilitating access to psychiatric treatment for young people with first-episode psychosis, and this involvement can reduce aversive events in pathways to care. Those who seek help from primary care tend to have longer intervals to psychiatric care, and some people receive ongoing psychiatric treatment from the family physician.
AimsOur objective is to understand the role of the family physician in help-seeking, recognition and ongoing management of first-episode psychosis.
MethodWe will use a mixed-methods approach, incorporating health administrative data, electronic medical records (EMRs) and qualitative methodologies to study the role of the family physician at three points on the pathway to care. First, help-seeking: we will use health administrative data to examine access to a family physician and patterns of primary care use preceding the first diagnosis of psychosis; second, recognition: we will identify first-onset cases of psychosis in health administrative data, and look back at linked EMRs from primary care to define a risk profile for undetected cases; and third, management: we will examine service provision to identified patients through EMR data, including patterns of contacts, prescriptions and referrals to specialised care. We will then conduct qualitative interviews and focus groups with key stakeholders to better understand the trends observed in the quantitative data.
DiscussionThese findings will provide an in-depth description of first-episode psychosis in primary care, informing strategies to build linkages between family physicians and psychiatric services to improve transitions of care during the crucial early stages of psychosis.
Declaration of interestNone.
Comparison of cognitive functions among frail and prefrail older adults: a clinical perspective
- Bárbara Bispo da Silva Alves, Elizabete de Oliveira Barbosa, Daniel de Moraes Pimentel, Lara S. F. Carneiro, Ana Carolina M. A. Rodrigues, Andréa Camaz Deslandes, Mariana Rocha Alves, Vinícius Dias Rodrigues, Ester Liberato Pereira, Alfredo Maurício Batista de Paula, Camila Castelo Branco Pupe, Renato Sobral Monteiro-Junior
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- Journal:
- International Psychogeriatrics / Volume 31 / Issue 2 / February 2019
- Published online by Cambridge University Press:
- 29 June 2018, pp. 297-301
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Objective:
To compare cognitive function among frail and prefrail older adults.
Design:Cross-sectional clinical study.
Participants:Fifty-one non-institutionalized older individuals participated in this study.
Measurements:Cognitive functions were evaluated through Mini-Mental State Examination (Global Cognition), Digit Span Forward (short-term memory), Digit Span Backward (working memory), Verbal Fluency Test (semantic memory/executive function). Data were compared using parametric and non-parametric bivariate tests. Binary logistic regression was used to test a frailty prediction model. Statistical significance was defined as p ≤ 0.01 to compare groups. In the regression model, the p value was set to be ≤0.05.
Results:Statistically significant differences were observed in global cognition, and short-term memory between frail and prefrail individuals (p ≤ 0.01). Global cognition explained 14–19% of frailty's model.
Conclusion:According to our findings, the evaluation of cognitive functions among older persons with frailty and prefrailty provides important complementary information to better manage frailty and its progression.
Dietary availability in elderly Portuguese households
- Débora M Santos, Sara SP Rodrigues, Bruno MPM Oliveira, Maria Daniel V de Almeida
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- Journal:
- Public Health Nutrition / Volume 18 / Issue 3 / February 2015
- Published online by Cambridge University Press:
- 24 April 2014, pp. 392-402
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Objective
To identify dietary availability and its time trends in elderly Portuguese households.
DesignA set of four cross-sectional studies based on the Household Budget Surveys was used. The dietary data were described using the daily per capita availability of food and beverages, energy and selected nutrients (macronutrients, different lipid fractions and simple sugars). Differences between elderly household types and time trends were studied.
SettingPortuguese Household Budget Survey data from 1989/1990, 1994/1995, 2000/2001 and 2005/2006.
SubjectsHouseholds with members aged ≥65 years were selected and categorized as solitary elderly female, solitary elderly male or couple (composed of one elderly female and one elderly male).
ResultsWhile cereals, fats/oils, potatoes and sugar/sugar products decreased, an increase occurred in milk/milk products, fruits, bottled water, fruit/vegetable juices and soft drinks (P<0·05). The highest values for foods and beverages were mostly found in couples, while the lowest ones were from solitary males. Exceptions were observed for cereals, eggs, milk/milk products, vegetables, fruits and non-alcoholic beverages, higher in solitary females; and for sugar/sugar products and alcoholic beverages, higher in solitary males. Over time, total energy and carbohydrates decreased while proteins and saturated fatty acids increased (P<0·001). Lipids increased in solitary males and couples (P<0·05). Simple sugars increased in solitary males but decreased in solitary females and couples (P<0·05).
ConclusionsThe increases in fruits and vegetables in solitary females accord with a healthier food pattern, but overall imbalances in the macronutrient profile for all elderly households may imply a decreasing diet quality.
Impacts of varying habitat quality on the physiological stress of spotted salamanders (Ambystoma maculatum)
- Rebecca Newcomb Homan, Jonathan V. Regosin, Daniel M. Rodrigues, J. Michael Reed, Bryan S. Windmiller, L. Michael Romero
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- Journal:
- Animal Conservation forum / Volume 6 / Issue 1 / February 2003
- Published online by Cambridge University Press:
- 06 February 2003, pp. 11-18
- Print publication:
- February 2003
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We sampled blood from free-living spotted salamanders (Ambystoma maculatum) to test whether differences in the concentrations of a stress hormone (corticosterone) were associated with different qualities of breeding and migration habitat. Spotted salamanders are forest specialists that migrate to vernal pools to breed, and upland habitat degradation may have sub-lethal effects on animals that lead to population declines. An individual's level of physiological stress may function as a biomonitor for sub-lethal effects, and thus as a biomonitor for ecosystem quality. We compared unstressed (baseline) and stress-induced corticosterone concentrations in spotted salamanders: (1) at sites that differed in amount of forest loss; (2) during breeding migration across forest habitat versus pavement; (3) in microhabitats that varied in soil drainage and canopy cover. Removal of large amounts of terrestrial habitat surrounding a breeding pond was correlated with lower baseline (in males) and stress-induced corticosterone concentrations, which may indicate healthy individuals with a reduced ability to respond to additional stress or individuals experiencing chronic stress. Male salamanders migrating across pavement had elevated baseline corticosterone concentrations compared to animals migrating through a forest, consistent with an acute stress response. However, concentrations of corticosterone did not differ between individuals in microhabitats with canopy cover and well-drained soil versus those in microhabitats with no canopy cover and/or swampy soil. This endocrinological technique may be one useful measure of a population's health, helping to identify populations where further ecological study is recommended to evaluate conservation concerns.