Age related differences in mental health scale scores and depression diagnosis: Adult responses to the CIDI-SF and MHI-5.

Inconsistencies surrounding the prevalence levels of depression in later life suggest that the measurement of depression in older people may be problematic. The current study aimed to map responses to a depressive symptom scale, the Mental Health Index-5 (MHI-5) which is part of the Short form 36 (SF-36, Ware et al., 1993) against the diagnostic screening items of the Composite International Diagnostic Instrument-Short Form (CIDI-SF, Kessler et al., 1998) to examine disagreement rates across age groups. The study examined data from a national random sample of 10,641 participants living in Ireland, 58.8% were female and 19% were over 65 (SLÁN, 2007). CIDI-SF depression screening endorsement was lower in older groups, whereas mean MHI-5 depressive symptoms showed less change across age groups. Results showed that the odds of MHI-5 endorsers aged 18–44 endorsing CIDI-SF screening questions were 5 times and 4.5 times (dysphoria and anhedonia, respectively) greater than the odds of people aged 75 or more endorsing these items. Findings suggest that although the risk of depressive disorder may decrease with age, complex diagnostic screening questions may exaggerate lower rates of depression among older people.

Factors influencing acquisition of Burkholderia cepacia complex organisms in patients with cystic fibrosis

Burkholderia cepacia complex organisms are important transmissible pathogens found in cystic fibrosis (CF) patients. In recent years, the rates of cross-infection of epidemic strains have declined due to effective infection control efforts. However, cases of sporadic B. cepacia complex infection continue to occur in some centers. The acquisition pathways and clinical outcomes of sporadic B. cepacia complex infection are unclear. We sought to determine the patient clinical characteristics, outcomes, incidence, and genotypic relatedness for all cases of B. cepacia complex infection at two CF centers. We also sought to study the external conditions that influence the acquisition of infection. From 2001 to 2011, 67 individual organisms were cultured from the respiratory samples of 64 patients. Sixty-five percent of the patients were adults, in whom chronic infections were more common (68%) (P = 0.006). The incidence of B. cepacia complex infection increased by a mean of 12% (95% confidence interval [CI], 3 to 23%) per year. The rates of transplantation and death were similar in the incident cases who developed chronic infection compared to those in patients with chronic Pseudomonas aeruginosa infection. Multilocus sequence typing revealed 50 individual strains from 65 isolates. Overall, 85% of the patients were infected with unique strains, suggesting sporadic acquisition of infection. The yearly incidence of nonepidemic B. cepacia complex infection was positively correlated with the amount of rainfall in the two sites examined: subtropical Brisbane (r = 0.65, P = 0.031) and tropical Townsville (r = 0.82, P = 0.002). This study demonstrates that despite strict cohort segregation, new cases of unrelated B. cepacia complex infection continue to occur. These data also support an environmental origin of infection and suggest that climate conditions may be associated with the acquisition of B. cepacia complex infections.

Effect of a Web-Based Behavior Change Program on Weight Loss and Cardiovascular Risk Factors in Overweight and Obese Adults at High Risk of Developing Cardiovascular Disease:Randomized Controlled Trial

BACKGROUND: Web-based programs are a potential medium for supporting weight loss because of their accessibility and wide reach. Research is warranted to determine the shorter- and longer-term effects of these programs in relation to weight loss and other health outcomes.

OBJECTIVE: The aim was to evaluate the effects of a Web-based component of a weight loss service (Imperative Health) in an overweight/obese population at risk of cardiovascular disease (CVD) using a randomized controlled design and a true control group.

METHODS: A total of 65 overweight/obese adults at high risk of CVD were randomly allocated to 1 of 2 groups. Group 1 (n=32) was provided with the Web-based program, which supported positive dietary and physical activity changes and assisted in managing weight. Group 2 continued with their usual self-care (n=33). Assessments were conducted face-to-face. The primary outcome was between-group change in weight at 3 months. Secondary outcomes included between-group change in anthropometric measurements, blood pressure, lipid measurements, physical activity, and energy intake at 3, 6, and 12 months. Interviews were conducted to explore participants' views of the Web-based program.

RESULTS: Retention rates for the intervention and control groups at 3 months were 78% (25/32) vs 97% (32/33), at 6 months were 66% (21/32) vs 94% (31/33), and at 12 months were 53% (17/32) vs 88% (29/33). Intention-to-treat analysis, using baseline observation carried forward imputation method, revealed that the intervention group lost more weight relative to the control group at 3 months (mean -3.41, 95% CI -4.70 to -2.13 kg vs mean -0.52, 95% CI -1.55 to 0.52 kg, P<.001), at 6 months (mean -3.47, 95% CI -4.95 to -1.98 kg vs mean -0.81, 95% CI -2.23 to 0.61 kg, P=.02), but not at 12 months (mean -2.38, 95% CI -3.48 to -0.97 kg vs mean -1.80, 95% CI -3.15 to -0.44 kg, P=.77). More intervention group participants lost ≥5% of their baseline body weight at 3 months (34%, 11/32 vs 3%, 1/33, P<.001) and 6 months (41%, 13/32 vs 18%, 6/33, P=.047), but not at 12 months (22%, 7/32 vs 21%, 7/33, P=.95) versus control group. The intervention group showed improvements in total cholesterol, triglycerides, and adopted more positive dietary and physical activity behaviors for up to 3 months verus control; however, these improvements were not sustained.

CONCLUSIONS: Although the intervention group had high attrition levels, this study provides evidence that this Web-based program can be used to initiate clinically relevant weight loss and lower CVD risk up to 3-6 months based on the proportion of intervention group participants losing ≥5% of their body weight versus control group. It also highlights a need for augmenting Web-based programs with further interventions, such as in-person support to enhance engagement and maintain these changes.

Official histories of parliament and the nature of the union of 1707:a forgotten episode in Anglo-Scottish academic relations

The Scottish Committee on the History of Parliament was established in 1936 as an offshoot of Col. Josiah Wedgwood's scheme for a collaborative ‘history of parliament’ researched and written on biographical lines. Circumstances, however, determined that the Scottish history would take a separate path. When Wedgwood's scheme was revived in 1951 an unsuccessful attempt was made to reintegrate the two projects. Discussions between the respective managing committees were conflicted and often bad-tempered, focussing on different interpretations of the nature of the united parliament created in 1707. The Scottish committee insisted that it was a new constitutional entity, while the English saw it as a continuation of the Westminster parliament with Scottish MPs added. This story of mutual incomprehension illustrates the profound differences between Scottish and English academics in the writing of parliamentary history, and also reveals a hitherto unobserved element in the development among leading Scottish jurists of a strain of ‘legal nationalism’ based on their interpretation of the constitutional significance of the Union.

Rotary moulding of ceramic hollow wares

A novel processing method for the fast and economic production of hollow ceramic components has been developed by combining in situ coagulation moulding with a modified version of the technique of rotary moulding[Binner, J. G. P., Al-Dawery, I. A., Tari, G. and Yan, Y., Rotary casting technique. UK Patent application No. 0506349.0, March 2005], the latter being adapted from the polymer industry. The process was found to require a high solids content suspension, hence development work was performed in this direction though in the end a new, commercial suspension was utilised. Of the three forming routes of gel casting, direct coagulation casting and in situ coagulation moulding, the latter was found to be the most promising for the new process of rotary moulding of ceramics. Due to the low value of clay-based ceramics, a new low cost coagulant was identified and the effect of lactone concentration and temperature on setting time determined. Following substantial optimisation work, it was found that a two-speed approach to multi-axial rotation was the most successful; medium sized cream jugs could be produced in just 7 min. With respect to mould materials, the porous resin normally used for pressure casting of sanitary ware was found to be the best option, though since this is quite expensive conventional plaster-of-paris moulds were found to be a suitable material to enable companies, particularly SMEs, to become familiar with the technology whilst avoiding high costs for trials. The processed articles could be successfully fired and glazed using gas-fired kilns with no sign of any black cores. Major advantages of the process include the ability to precisely calculate the amount of ceramic slip required, eliminating either slip wastage or the need to pour used slip back into the virgin material as currently happens with slip casting. In addition, since the precursor suspension has a very high solids content, the time and energy required to dry the green product and associated moulds has been considerably reduced. © 2008 Elsevier Ltd. All rights reserved.