Assessing positive mental health in people with chronic physical health problems: correlations with socio-demographic variables and physical health status

Background: A holistic perspective on health implies giving careful consideration to the relationship between physical and mental health. In this regard the present study sought to determine the level of Positive Mental Health (PMH) among people with chronic physical health problems, and to examine the relationship between the observed levels of PMH and both physical health status and socio-demographic variables. Methods: The study was based on the Multifactor Model of Positive Mental Health (Lluch, 1999), which comprises six factors: Personal Satisfaction (F1), Prosocial Attitude (F2), Self-control (F3), Autonomy (F4), Problem-solving and Self-actualization (F5), and Interpersonal Relationship Skills (F6). The sample comprised 259 adults with chronic physical health problems who were recruited through a primary care center in the province of Barcelona (Spain). Positive mental health was assessed by means of the Positive Mental Health Questionnaire (Lluch, 1999). Results: Levels of PMH differed, either on the global scale or on specific factors, in relation to the following variables: age: global PMH scores decreased with age (r=-0.129; p=0.038); b) gender: men scored higher on F1 (t=2.203; p=0.028) and F4 (t=3.182; p=0.002), while women scored higher on F2 (t -3.086; p=0.002) and F6 (t=-2.744; p=0.007); c) number of health conditions: the fewer the number of health problems the higher the PMH score on F5 (r=-0.146; p=0.019); d) daily medication: polymedication patients had lower PMH scores, both globally and on various factors; e) use of analgesics: occasional use of painkillers was associated with higher PMH scores on F1 (t=-2.811; p=0.006). There were no significant differences in global PMH scores according to the type of chronic health condition. The only significant difference in the analysis by factors was that patients with hypertension obtained lower PMH scores on the factor Autonomy (t=2.165; p=0.032). Conclusions: Most people with chronic physical health problems have medium or high levels of PMH. The variables that adversely affect PMH are old age, polypharmacy and frequent consumption of analgesics. The type of health problem does not influence the levels of PMH. Much more extensive studies with samples without chronic pathology are now required in order to be able to draw more robust conclusions.

Systems Medicine and Integrated Care to Combat Chronic Noncommunicable Diseases.

We propose an innovative, integrated, cost-effective health system to combat major non-communicable diseases (NCDs), including cardiovascular, chronic respiratory, metabolic, rheumatologic and neurologic disorders and cancers, which together are the predominant health problem of the 21st century. This proposed holistic strategy involves comprehensive patient-centered integrated care and multi-scale, multi-modal and multi-level systems approaches to tackle NCDs as a common group of diseases. Rather than studying each disease individually, it will take into account their intertwined gene-environment, socio-economic interactions and co-morbidities that lead to individual-specific complex phenotypes. It will implement a road map for predictive, preventive, personalized and participatory (P4) medicine based on a robust and extensive knowledge management infrastructure that contains individual patient information. It will be supported by strategic partnerships involving all stakeholders, including general practitioners associated with patient-centered care. This systems medicine strategy, which will take a holistic approach to disease, is designed to allow the results to be used globally, taking into account the needs and specificities of local economies and health systems.

Investigating ferromagnetism and charge order in Bi1-xSrxMnO3(x<0.3)ceramic oxides.

The possible coexistence of ferromagnetism and charge/orbital order in Bi3/4Sr1/4MnO3 has been investigated. The manganite Bi0.75Sr0.25MnO3, with commensurate charge balance, undergoes an electronic transition at TCO~600 K that produces a longrange modulation with double periodicity along a and c axis, and unusual anisotropic evolution of the lattice parameters. The previously proposed ferromagnetic properties of this new ordered phase were studied by magnetometry and diffraction techniques. In zero field the magnetic structure is globally antiferromagnetic, ruling out the apparition of spontaneous ferromagnetism. However, the application of magnetic fields produces a continuous progressive canting of the moments, inducing a ferromagnetic phase even for relatively small fields (H<<1 T). Application of pulsed high fields produces a remarkable and reversible spin polarization (under 30 T, the ferromagnetic moment is ~3 ¿B/Mn, without any sign of charge order melting). The coexistence of ferromagnetism and charge order at low and very-high fields is a remarkable property of this system.

Beurling-Landau densities of weighted Fekete sets and correlation kernel estimates

Let $Q$ be a suitable real function on $C$. An $n$-Fekete set corresponding to $Q$ is a subset ${Z_{n1}},\dotsb, Z_{nn}}$ of $C$ which maximizes the expression $\Pi^n_i_{globally, and we conjecture that such global results are true for a wide range of potentials.

Impact of geographical and cultural factors on clinical trials in acute mania: lessons from a ziprasidone and haloperidol placebo-controlled study

Clinical trials today are conducted in multiple countries to enhance patient recruitment and improve efficiency of trials. However, the demographic and cultural diversity may contribute to variations in study outcomes. Here we conducted post-hoc analyses for a placebo-controlled study with ziprasidone and haloperidol for the treatment of acute mania to address the demographic, dosing, and outcome disparities in India, Russia and the USA. We compared the baseline characteristics, outcomes and discontinuations in patients and explored the relationship between the outcome measures across these countries. We found substantial differences in baseline characteristics of subjects, administered dosage and disease severity in India compared to the USA and Russia. Conversely, US subjects had a higher placebo response compared to subjects in Russia and India. These results are probably due to demographic differences in patient populations and psychiatric clinical practice across countries. While we offer initial ideas to address the disparities identified in this analysis, it is clear that further research to improve our understanding of geographical differences is essential to ensure globally applicable results for clinical trials in psychiatry.

Coneixements, actituds i percepció versus la infecció per Virus del Papil·loma Humà en els professionals d'infermeria : tendències en salut pública

Actualment, s’evidencia una dificultat en el seguiment estricte de les infeccions de transmissió sexual (ITS). A nivell mundial, aquestes causen un problema de Salut Pública (SP) en termes de morbiditat i mortalitat per complicacions i seqüeles que es poden originar si no es diagnostiquen i no es tracten adequadament. Entre les ITS més comunes trobem la provocada pel Virus del Papil·loma Humà (VPH), la principal causant del càncer de cèrvix, entre altres complicacions La família de VPH compta amb més de 150 tipus virals. El coneixement de la situació epidemiològica de la infecció per VPH es veu dificultada per varis aspectes: el caràcter asimptomàtic; l’estigma social; les dificultats diagnòstiques; la falta de homogeneïtat dels sistemes de vigilància amb la infradeclaració de casos. Ens trobem en una inversemblança constant. Les intervencions des de SP, ja sigui a nivell nacional com regional, sónpròpiament enfocades a la prevenció de la malaltia. Paral·lelament, la incidència de les ITS continua amb una tendència ascendent, cosa que provoca una inquietant preocupació. Partint de la problemàtica exposada, el present estudi pretén identificar elsconeixements que tenen els professionals d’infermeria de l’atenció primària en relació a la infecció de transmissió sexual pel virus del papil·loma humà i quina és la seva percepció i actitud sobre l’atenció a l’usuari. Es tractarà d’un estudi multicèntric amb disseny descriptiu transversal. La instrumentació es farà mitjançant una enquesta totalment anònima sobre una mostra aproximada de 115 professionals d’infermeria que durant l’any 2013 que treballen a les àrees bàsiques de salut (ABS) de l’Institut Català de la Salut (ICS) del Gironès. Aquest estudi vol fer visible la necessitat d’incrementar la formació dels professionals d’infermeria en relació a la infecció VPH i el requeriment d’un consell addicional que promogui la salut encaminat a empoderar a la comunitat mitjançant educació per a la salut

Geographic patterns of genetic variation in a broadly distributed marine vertebrate: new insights into loggerhead turtle stock structure from expanded mitochondrial DNA sequences

Previous genetic studies have demonstrated that natal homing shapes the stock structure of marine turtle nesting populations. However, widespread sharing of common haplotypes based on short segments of the mitochondrial control region often limits resolution of the demographic connectivity of populations. Recent studies employing longer control region sequences to resolve haplotype sharing have focused on regional assessments of genetic structure and phylogeography. Here we synthesize available control region sequences for loggerhead turtles from the Mediterranean Sea, Atlantic, and western Indian Ocean basins. These data represent six of the nine globally significant regional management units (RMUs) for the species and include novel sequence data from Brazil, Cape Verde, South Africa and Oman. Genetic tests of differentiation among 42 rookeries represented by short sequences (380 bp haplotypes from 3,486 samples) and 40 rookeries represented by long sequences (~800 bp haplotypes from 3,434 samples) supported the distinction of the six RMUs analyzed as well as recognition of at least 18 demographically independent management units (MUs) with respect to female natal homing. A total of 59 haplotypes were resolved. These haplotypes belonged to two highly divergent global lineages, with haplogroup I represented primarily by CC-A1, CC-A4, and CC-A11 variants and haplogroup II represented by CC-A2 and derived variants. Geographic distribution patterns of haplogroup II haplotypes and the nested position of CC-A11.6 from Oman among the Atlantic haplotypes invoke recent colonization of the Indian Ocean from the Atlantic for both global lineages. The haplotypes we confirmed for western Indian Ocean RMUs allow reinterpretation of previous mixed stock analysis and further suggest that contemporary migratory connectivity between the Indian and Atlantic Oceans occurs on a broader scale than previously hypothesized. This study represents a valuable model for conducting comprehensive international cooperative data management and research in marine ecology.

On the Connectivity of the Julia sets of meromorphic functions

We prove that every transcendental meromorphic map $f$ with disconnected Julia set has a weakly repelling fixed point. This implies that the Julia set of Newton's method for finding zeroes of an entire map is connected. Moreover, extending a result of Cowen for holomorphic self-maps of the disc, we show the existence of absorbing domains for holomorphic self-maps of hyperbolic regions, whose iterates tend to a boundary point. In particular, the results imply that periodic Baker domains of Newton's method for entire maps are simply connected, which solves a well-known open question.

Erratum: Global pressures, specific responses: effects of nutrient enrichment in streams from different biomes

We assessed the effects of nutrient enrichment on three stream ecosystems running through distinct biomes (Mediterranean, Pampean and Andean). We increased the concentrations of N and P in the stream water 1.6–4-fold following a before–after control–impact paired series (BACIPS) design in each stream, and evaluated changes in the biomass of bacteria, primary producers, invertebrates and fish in the enriched (E) versus control (C) reaches after nutrient addition through a predictive-BACIPS approach. The treatment produced variable biomass responses (2–77% of explained variance) among biological communities and streams. The greatest biomass response was observed for algae in the Andean stream (77% of the variance), although fish also showed important biomass responses (about 9–48%). The strongest biomass response to enrichment (77% in all biological compartments) was found in the Andean stream. The magnitude and seasonality of biomass responses to enrichment were highly site specific, often depending on the basal nutrient concentration and on windows of ecological opportunity (periods when environmental constraints other than nutrients do not limit biomass growth). The Pampean stream, with high basal nutrient concentrations, showed a weak response to enrichment (except for invertebrates), whereas the greater responses of Andean stream communities were presumably favored by wider windows of ecological opportunity in comparison to those from the Mediterranean stream. Despite variation among sites, enrichment globally stimulated the algal-based food webs (algae and invertebrate grazers) but not the detritus-based food webs (bacteria and invertebrate shredders). This study shows that nutrient enrichment tends to globally enhance the biomass of stream biological assemblages, but that its magnitude and extent within the food web are complex and are strongly determined by environmental factors and ecosystem structure

Global pressures, specific responses: effects of nutrient enrichment in streams from different biomes

We assessed the effects of nutrient enrichment on three stream ecosystems running through distinct biomes (Mediterranean, Pampean and Andean). We increased the concentrations of N and P in the stream water 1.6–4-fold following a before–after control–impact paired series (BACIPS) design in each stream, and evaluated changes in the biomass of bacteria, primary producers, invertebrates and fish in the enriched (E) versus control (C) reaches after nutrient addition through a predictive-BACIPS approach. The treatment produced variable biomass responses (2–77% of explained variance) among biological communities and streams. The greatest biomass response was observed for algae in the Andean stream (77% of the variance), although fish also showed important biomass responses (about 9–48%). The strongest biomass response to enrichment (77% in all biological compartments) was found in the Andean stream. The magnitude and seasonality of biomass responses to enrichment were highly site specific, often depending on the basal nutrient concentration and on windows of ecological opportunity (periods when environmental constraints other than nutrients do not limit biomass growth). The Pampean stream, with high basal nutrient concentrations, showed a weak response to enrichment (except for invertebrates), whereas the greater responses of Andean stream communities were presumably favored by wider windows of ecological opportunity in comparison to those from the Mediterranean stream. Despite variation among sites, enrichment globally stimulated the algal-based food webs (algae and invertebrate grazers) but not the detritus-based food webs (bacteria and invertebrate shredders). This study shows that nutrient enrichment tends to globally enhance the biomass of stream biological assemblages, but that its magnitude and extent within the food web are complex and are strongly determined by environmental factors and ecosystem structure

Temperature-Specific Competition between Invasive Mosquitofish and an Endangered Cyprinodontid Fish

Condition-specific competition is widespread in nature. Species inhabiting heterogeneous environments tend to differ in competitive abilities depending on environmental stressors. Interactions between these factors can allow coexistence of competing species, which may be particularly important between invasive and native species. Here, we examine the effects of temperature on competitiveinteractions between invasive mosquitofish, Gambusia holbrooki, and an endemic Iberian toothcarp, Aphanius iberus. We compare the tendency to approach heterospecifics and food capture rates between these two species, and examine differences between sexes and species in aggressive interactions, at three different temperatures (19, 24 and 29uC) in three laboratory experiments. Mosquitofish exhibit much more aggression than toothcarp. We show that mosquitofish have the capacity to competitively displace toothcarp through interference competition and this outcome is more likely at higher temperatures. We also show a reversal in the competitive hierarchy through reduced food capture rate by mosquitofish at lower temperatures and suggest that these two types of competition may act synergistically to deprive toothcarp of food at higher temperatures. Males of both species carry out more overtly aggressive acts than females, which is probably related to the marked sexual dimorphism and associated mating systems of these two species. Mosquitofish may thus impact heavily on toothcarp, and competition from mosquitofish, especially in warmer summer months, may lead to changes in abundance of the native species and displacement to non-preferred habitats. Globally increasing temperatures mean that highly invasive, warm-water mosquitofish may be able to colonize environments from which they are currently excluded through reduced physiological tolerance to low temperatures. Research into the effects of temperature on interactions between native and invasive species is thus of fundamental importance