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Autism and epilepsy often occur together. Epilepsy and other associated conditions have a substantial impact on the well-being of autistic people and their families, reduce quality of life, and increase premature mortality. Despite this, there is a lack of studies investigating the care pathway of autistic children with co-occurring epilepsy in Europe.
Methods
We analyzed the care pathway for autistic children with associated epilepsy in Italy, Spain, and the United Kingdom from the perspective of caregivers (using a survey aimed at caregivers of autistic children 0–18 years old), the autistic community, and professionals, in order to identify major barriers preventing caregivers and autistic children from receiving timely screening and treatment of possible co-occurring epilepsy.
Results
Across all three countries, an analysis of the current care pathway showed a lack of systematic screening of epilepsy in all autistic children, lack of treatment of co-occurring epilepsy, and inappropriate use of antiepileptic drugs. A major challenge is the lack of evidence-based harmonized guidelines for autism with co-occurring epilepsy in these countries.
Conclusions
Our findings show both heterogeneity and major gaps in the care pathway for autism with associated epilepsy and the great efforts that caregivers must make for timely screening, diagnosis, and adequate management of epilepsy in autistic children. We call for policy harmonization in Europe in order to improve the experiences and quality of life of autistic people and their families.
The combination of advances in knowledge, technology, changes in consumer preference and low cost of manufacturing is accelerating the next technology revolution in crop, livestock and fish production systems. This will have major implications for how, where and by whom food will be produced in the future. This next technology revolution could benefit the producer through substantial improvements in resource use and profitability, but also the environment through reduced externalities. The consumer will ultimately benefit through more nutritious, safe and affordable food diversity, which in turn will also contribute to the acceleration of the next technology. It will create new opportunities in achieving progress towards many of the Sustainable Development Goals, but it will require early recognition of trends and impact, public research and policy guidance to avoid negative trade-offs. Unfortunately, the quantitative predictability of future impacts will remain low and uncertain, while new chocks with unexpected consequences will continue to interrupt current and future outcomes. However, there is a continuing need for improving the predictability of shocks to future food systems especially for ex-ante assessment for policy and planning.
To estimate the prevalence of unmet needs for assistance among middle-aged and older adults with subjective cognitive decline (SCD) in the US and to evaluate whether unmet needs were associated with health-related quality of life (HRQOL).
Design:
Cross-sectional
Setting:
US – 50 states, District of Columbia, and Puerto Rico
Participants:
Community-dwelling adults aged 45 years and older who completed the Cognitive Decline module on the 2015-–2018 Behavioral Risk Factor Surveillance System reported experiencing SCD and always, usually, or sometimes needed assistance with day-to-day activities because of SCD (n = 6,568).
Measurements:
We defined SCD as confusion or memory loss that was happening more often or getting worse over the past 12 months. Respondents with SCD were considered to have an unmet need for assistance if they sometimes, rarely, or never got the help they needed with day-to-day activities. We measured three domains of HRQOL: (1) mental (frequent mental distress, ≥14 days of poor mental health in the past 30 days), (2) physical (frequent physical distress, ≥14 days of poor physical health in the past 30 days), and (3) social (SCD always, usually, or sometimes interfered with the ability to work, volunteer, or engage in social activities outside the home). We used log-binomial regression models to estimate prevalence ratios (PRs). All estimates were weighted.
Results:
In total, 40.2% of people who needed SCD-related assistance reported an unmet need. Among respondents without depression, an unmet need was associated with a higher prevalence of frequent mental distress (PR = 1.55, 95% CI: 1.12–2.13, p = 0.007). Frequent physical distress and social limitations did not differ between people with met and unmet needs.
Conclusions:
Middle-aged and older adults with SCD-related needs for assistance frequently did not have those needs met, which could negatively impact their mental health. Interventions to identify and meet the unmet needs among people with SCD may improve HRQOL.
In a modified case–control association study we tested the assumption that two polymorphisms (A118G in exon 1 and IVS2+31 in intron 2) of the human μ-opioid receptor gene (OPRM1) confer susceptibility to opioid dependence.
Methods. –
In contrast to classical case–control studies both groups, opioid dependent cases and non-opioid dependent controls were recruited from individuals who have had access to drugs including opioids and who had been sentenced for violation of the “Dangerous Drugs Act” in Germany.
Results. –
For the two allelic variants of OPRM1 under study we did not find evidence for association with opioid dependence.
Conclusions. –
Despite absence of association we think that this recruitment approach introduced here, is useful since it putatively offers a more adequate matching for case–control association studies of opioid dependent individuals.
Stigma and social exclusion related to mental health are of substantial public health importance for Europe. As part of ROAMER (ROAdmap for MEntal health Research in Europe), we used systematic mapping techniques to describe the current state of research on stigma and social exclusion across Europe. Findings demonstrate growing interest in this field between 2007 and 2012. Most studies were descriptive (60%), focused on adults of working age (60%) and were performed in Northwest Europe—primarily in the UK (32%), Finland (8%), Sweden (8%) and Germany (7%). In terms of mental health characteristics, the largest proportion of studies investigated general mental health (20%), common mental disorders (16%), schizophrenia (16%) or depression (14%). There is a paucity of research looking at mechanisms to reduce stigma and promote social inclusion, or at factors that might promote resilience or protect against stigma/social exclusion across the life course. Evidence is also limited in relation to evaluations of interventions. Increasing incentives for cross-country research collaborations, especially with new EU Member States and collaboration across European professional organizations and disciplines, could improve understanding of the range of underpinning social and cultural factors which promote inclusion or contribute toward lower levels of stigma, especially during times of hardship.
The nucleation and growth of silica nanoparticles in supersaturated geothermal waters was simulated using a flow-through geothermal simulator system. The effect of silica concentration ([SiO2]), ionic strength (IS), temperature (T) and organic additives on the size and polydispersity of the forming silica nanoparticles was quantified. A decrease in temperature (58 to 33°C) and the addition of glucose restricted particle growth to sizes <20 nm, while varying [SiO2] or ISdid not affect the size (30—35 nm) and polydispersity (±9 nm) observed at 58°C. Conversely, the addition of xanthan gum induced the development of thin films that enhanced silica aggregation.
In this study, we report the characterization of a 304L stainless steel cylindrical projectile produced by additive manufacturing. The projectile was compressively deformed using a Taylor Anvil Gas Gun, leading to a huge strain gradient along the axis of the deformed cylinder. Spatially resolved neutron diffraction measurements on the HIgh Pressure Preferred Orientation time-of-flight diffractometer (HIPPO) and Spectrometer for Materials Research at Temperature and Stress diffractometer (SMARTS) beamlines at the Los Alamos Neutron Science CEnter (LANSCE) with Rietveld and single-peak analysis were used to quantitatively evaluate the volume fractions of the α, γ, and ε phases as well as residual strain and texture. The texture of the γ phase is consistent with uniaxial compression, while the α texture can be explained by the Kurdjumov–Sachs relationship from the γ texture after deformation. This indicates that the material first deformed in the γ phase and subsequently transformed at larger strains. The ε phase was only found in volumes close to the undeformed material with a texture connected to the γ texture by the Shoji–Nishiyama orientation relationship. This allows us to conclude that the ε phase occurs as an intermediate phase at lower strain, and is superseded by the α phase when strain increases further. We found a proportionality between the root-mean-squared microstrain of the γ phase, dominated by the dislocation density, with the α volume fraction, consistent with strain-induced martensite α formation. Knowledge of the sample volume with the ε phase from the neutron diffraction analysis allowed us to identify the ε phase by electron back scatter diffraction analysis, complementing the neutron diffraction analysis with characterization on the grain level.
Common waterhemp, giant foxtail, and velvetleaf seed germination in response to temperature was studied with a two-way thermogradient plate. Seeds were maintained under dark and wet conditions at 4 C for 12 wk, and velvetleaf seeds were scarified before the experiments were conducted. The seeds were germinated at 25 different temperature treatments. Minimum and optimum temperatures for velvetleaf germination were approximately 8 and 24 C, respectively. Temperature alternation did not affect the germination of this species. The minimum germination temperature was 10 C for common waterhemp and 14 C for giant foxtail. The optimum germination of giant foxtail occurred at approximately 24 C, but common waterhemp optimum germination was variable depending on temperature alternation. Increased amplitude of the diurnal temperature alternation increased percent germination of these two species, and this was more evident at lower temperatures. In the case of common waterhemp, the temperature required to reach specific germination percentages was reduced by increasing the amplitude of the temperature alternation.
Echinococcus multilocularis is a cestode that causes human alveolar echinococcosis, a lethal zoonosis of public health concern in central Asia and western China. In the present study, one of 42 Eastern mole voles (Ellobius tancrei) caught in Sary Mogol (Alay valley, southern Kyrgyzstan) presented liver lesions with E. multilocularis from which the EmsB target was amplified. The Asian profile obtained was almost identical to one amplified from domestic dog faeces collected in a nearby village. This observation adds additional information to the potential role of E. tancrei in the transmission of E. multilocularis, and to the known distribution range of E. multilocularis (Asian strain) in central Asia.
Introduction: Major depressive disorder (MDD) is thought to negatively impact cognitive function; however, the relationship has not been well explored.
Objective: This study examined the association between depression severity and global cognitive function and memory in subjects with severe, treatment-resistant MDD.
Methods: We enrolled 66 subjects with Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosed unipolar MDD in a multicenter trial to assess the efficacy and neurocognitive effects of electroconvulsive therapy (ECT). We measured depression severity with the 24 item Hamilton Rating Scale for Depression (HRSD24). Neuropsychologic measures included the Mini Mental State Examination (MMSE), Rey Auditory Verbal Learning Test (RAVLT), and the Complex Figure Test (CFT). Correlational and regression analyses were conducted to explore associations between depression severity and cognitive function.
Results: The mean age of the subjects was 53.6 years (SD=15.8), 65% were female, and mean HRSD24 was 33.9 (SD=6.7). Mean demographic-corrected T-scores for each neurocognitive measure were in the average to borderline range, and HRSD24 values were unrelated to performance on the MMSE, RAVLT immediate and delayed recall, and CFT immediate and delayed recall.
Conclusion: In this sample of severely depressed subjects referred for ECT, depression severity was unrelated to global cognitive function or memory. Future research should examine the interactions between other depressive characteristics and neurocognitive function.
John Gower's great poem, the Confessio Amantis, was the first work of English literature translated into any European language. Occasioned by the existence in Spain of fifteenth-century Portuguese and Spanish manuscripts ofthe Confessio, the nineteen essays brought together here represent new and original approaches to Gower's role in Anglo-Iberian literary relations. They include major studies of the palaeography of the Iberian manuscripts; of the ownership history of the Portuguese Confessio manuscript; of the glosses of Gowerian manuscripts; and of the manuscript of the Yale Confessio Amantis. Other essays situate the translations amidst Anglo-Spanish relations generally in the fourteenth and fifteenth centuries; examine possible Spanish influences on Gower's writing; and speculate on possible providers of the Confessio to Philippa, daughter of John of Gaunt and queenof Portugal. Further chapters broaden the scope of the volume. Amongst other topics, they look at Gower's use of Virgilian/Dantean models; classical gestures in the Castilian translation; Gower's conscious contrasting of epic ideals and courtly romance; nuances of material goods and the idea of "the good" in the Confessio; Marxian aesthetics, Balzac, and Gowerian narrative in late medieval trading culture between England and Iberia; reading the Confessio through the lens of gift exchange; literary form in Gower's later Latin poems; Gower and Alain Chartier as international initiators of a new "public poetry"; and the modern sales history of manuscript and early printed copies of the Confessio, and what ir reveals about literary trends. Ana Sáez Hidalgo is Associate Professor at the University of Valladolid, Spain; R.F. Yeager is Professor of English and World Languages and chair of the department at the University of West Florida. Contributors: María Bullón-Fernández, David R. Carlson, Siân Echard, A.S.G. Edwards, Robert R. Edwards, Tiago Viúla de Faria, Andrew Galloway, Fernando Galván, Marta María Gutiérrez Rodríguez, Mauricio Herrero Jiménez, Ethan Knapp, Roger A. Ladd, Alberto Lázaro, María Luisa López-Vidriero Abelló, Matthew McCabe, Alastair J. Minnis, Clara Pascual-Argente, Tamara Pérez-Fernández, Barbara A. Shailor, Winthrop Wetherbee.
Edited by
Ana Sáez-Hidalgo, Associate Professor at the University of Valladolid, Spain,R. F. Yeager, Professor of English and World Languages and chair of the department at the University of West Florida
Scholarship in Anglo-Iberian relations developed during the second half of the twentieth and first decade of the twenty-first century to such an extent that few readers would subscribe today to the often quoted statement made in 1906 by the eminent hispanophile James Fitzmaurice-Kelly about the “almost complete insulation of each country with regard to one another” in the Middle Ages, or his other affirmation that “the first step to sustained intellectual commerce” started at the end of the fifteenth century, in allusion to the thirteen Fables of Alfonce (by the Aragonese Jewish convert, Pedro Alfonso, or Petrus Alphonsus) which were included in the 1483 edition of Caxton's Aesop. María Bullón-Fernández, among others, has also drawn our attention to this fact. Two historians in the 1950s had indeed opened the ground for new views in relation to the fourteenth century: the Spanish medievalist Luis Suárez Fernández and the Oxford scholar Peter E. Russell, although in more recent years the current interest in Al-Andalus as a decisive factor in the conformation of Europe and European culture has yielded books such as those by Jeffrey Jerome Cohen, Simon R. Doubleday and David Coleman, Sharon Kinoshita, Lisa Lampert-Weissig, or, some decades earlier, one by Alice E. Lasater.
My purpose in this chapter is not to focus on this latter sort of exploration, but rather to look back again on the particular historical, political, and dynastic conditions that linked England to Iberia during the fourteenth century, a period when writers such as John Gower, Geoffrey Chaucer, and Canciller Pero López de Ayala lived and composed their best known works.
Edited by
Ana Sáez-Hidalgo, Associate Professor at the University of Valladolid, Spain,R. F. Yeager, Professor of English and World Languages and chair of the department at the University of West Florida
Edited by
Ana Sáez-Hidalgo, Associate Professor at the University of Valladolid, Spain,R. F. Yeager, Professor of English and World Languages and chair of the department at the University of West Florida
Edited by
Ana Sáez-Hidalgo, Associate Professor at the University of Valladolid, Spain,R. F. Yeager, Professor of English and World Languages and chair of the department at the University of West Florida
Venus's dismissal of John Gower at the end of the Confessio Amantis ostensibly represents the end of his dual career as a lover and an author. Freed from his “trance” (CA VIII.2813) and shocked into recognition by the mirror rendering an accurate “liknesse of miselve” (CA VIII.2437), the poet receives a rosary of black beads with the gold inscription “Por reposer” (CA VIII.2907) and a new commission, to seek and pray for peace. This scene is echoed in the Confessio's explicit, literally the final words, in which the poet's book is sent to find lasting repose under the earl of Derby: sub eo requiesce futurus. Other elements of the poem, however, belie this sense of closure. Venus directs Gower not just to erotic and poetic retirement but to his own works: “But go ther vertu moral duelleth, | where ben thi bokes, as men telleth, | Which of long time thou has write” (CA VIII.2925–27). His literary destination is the Mirour de l'Omme and the Vox Clamantis, works that treat ethics, have found an audience influential enough to be proverbial (“as men telleth”), and were written “of long time” – both in the authoritative past and through a long process of composition and conceptual development.