The Birmingham relationship continuity measure:the development and evaluation of a measure of the perceived continuity of spousal relationships in dementia

Background: Qualitative research has suggested that spousal carers of someone with dementia differ in terms of whether they perceive their relationship with that person as continuous with the premorbid relationship or as radically different, and that a perception of continuity may be associated with more person-centered care and the experience of fewer of the negative emotions associated with caring. The aim of the study was to develop and evaluate a quantitative measure of the extent to which spousal carers perceive the relationship to be continuous. Methods: An initial pool of 42 questionnaire items was generated on the basis of the qualitative research about relationship continuity. These were completed by 51 spousal carers and item analysis was used to reduce the pool to 23 items. The retained items, comprising five subscales, were then administered to a second sample of 84 spousal carers, and the questionnaire's reliability, discriminative power, and validity were evaluated. Results: The questionnaire showed good reliability: Cronbach's α for the full scale was 0.947, and test-retest reliability was 0.932. Ferguson's δ was 0.987, indicating good discriminative power. Evidence of construct validity was provided by predicted patterns of subscale correlations with the Closeness and Conflict Scale and the Marwit-Meuser Caregiver Grief Inventory. Conclusion: Initial psychometric evaluation of the measure was encouraging. The measure provides a quantitative means of investigating ideas from qualitative research about the role of relationship continuity in influencing how spousal carers provide care and how they react emotionally to their caring role. © 2012 International Psychogeriatric Association.

Bernice E. Cullinan with a group of children reading around a table

Inscription: Verso: Bernice E. Cullinan, president, International Reading Association, surrounded by children reading magazines, New York.

Suicide and deliberate self harm in older Irish adults

Background: Hospital-treated deliberate self harm and suicide among older adults have rarely been examined at a national level. Methods: The Irish Central Statistics Office provided suicide and undetermined death data for 1980-2006. The National Registry of Deliberate Self Harm collected data relating to deliberate self harm presentations made in 2006-2008 to all 40 Irish hospital emergency departments. Results: Rates of female suicide among older adults (over 55 years) were relatively stable in Ireland during 1980-2006 whereas male rates increased in the 1980s and decreased in more recent decades. Respectively, the annual male and female suicide and undetermined death rate was 22.1 and 7.6 per 100,000 in 1997-2006. Male and female deliberate self harm was 3.0 and 11.0 times higher at 67.4 and 83.4 per 100,000, respectively. Deliberate self harm and suicide decreased in incidence with increasing age. Deliberate self harm generally involved drug overdose (male: 72%; female 85%) or self-cutting (male: 15%; female 9%). The most common methods of suicide were hanging (41%) and drowning (29%) for men and drowning (39%) and drug overdose (24%) for women. City and urban district populations had the highest rates of hospital-treated self harm. The highest suicide rates were in urban districts. Conclusions: Older Irish adults have high rates of hospital-treated deliberate self harm but below average rates of suicide. Drowning was relatively common as a method of suicide. Restricting availability of specific medications may reduce both forms of suicidal behavior.

Peroxisome Proliferator-Activated Receptor-γ Coactivator 1-α (PPARGC1A) Genetic Associations with Type 2 Diabetes in Three Ethnicities

Genetic heterogeneity, lifestyle factors, gene-gene or gene-environment interactions are the determinants of T2D which puts Hispanics and populations with African ancestry at higher risk of developing T2D. In this dissertation, the genetic associations of PPARGC1A polymorphisms with T2D and its related phenotypes (metabolic markers) in Haitian Americans (cases=110, controls=116), African Americans (cases=120, controls=124) and Cuban Americans (cases=160, controls=181) of South Florida were explored. Five single nucleotide polymorphisms of gene PPARGC1A were evaluated in each ethnicity for their disease association. In Haitian Americans, rs7656250 (OR= 0.22, pp=0.03) had significant protective association with T2D but had risk association in African Americans for rs7656250 (OR=1.02, p=0.96) and rs4235308 (OR=2.53, p=0.03). We found that in Haitian American females, both rs7656250 (OR=0.23, pp=0.03) had protective association with T2D. In African American females, rs7656250 (OR=1.14, p=0.78) had risk association whereas in males, it had significant protective effect (OR=0.37, p=0.04). However, the risk association exhibited by rs4235308 was stronger in African American females (OR=2.69, p=0.03) than males (OR=1.16, p=0.72). In Cuban Americans, only rs7656250 showed significant risk association with T2D (OR=6.87, p=0.02) which was stronger in females alone (OR=7.67, p=0.01). We also observed significant differences among correlations of PPARGC1A SNPs and T2D phenotypes. Positive correlation was observed for log Hs-CRP with rs3774907 (pp=0.03) in Cuban Americans respectively. Correlation of log A1C with rs7656250 (p=0.02) was positive in Cuban Americans while it was negative for rs3774907 in Haitian Americans (ppPPARGC1A correlations with T2D and its phenotypes among the three ethnicities studied (ii) the associations of PPARGC1A SNPs showed significant effect modification by sex. The findings suggest that variations in effects of PPARGC1A gene polymorphisms among three ethnicities and between sexes may have biomedical implications for the development of T2D as well as the phenotypes related to T2D.

(Table 1) Mean annual ground temperatures and description of permafrost boreholes in Russia

The results of the International Permafrost Association's International Polar Year Thermal State of Permafrost (TSP) project are presented based on field measurements from Russia during the IPY years (2007-09) and collected historical data. Most ground temperatures measured in existing and new boreholes show a substantial warming during the last 20 to 30 years. The magnitude of the warming varied with location, but was typically from 0.5°C to 2°C at the depth of zero annual amplitude. Thawing of Little Ice Age permafrost is ongoing at many locations. There are some indications that the late Holocene permafrost has begun to thaw at some undisturbed locations in northeastern Europe and northwest Siberia. Thawing of permafrost is most noticeable within the discontinuous permafrost domain. However, permafrost in Russia is also starting to thaw at some limited locations in the continuous permafrost zone. As a result, a northward displacement of the boundary between continuous and discontinuous permafrost zones was observed. This data set will serve as a baseline against which to measure changes of near-surface permafrost temperatures and permafrost boundaries, to validate climate model scenarios, and for temperature reanalysis.

Análisis de la información y documentación científica española sobre el fenómeno de las smart cities, el hábitat de los nativos digitales

Estudiosos de todo el mundo se están centrando en el estudio del fenómeno de las ciudades inteligentes. La producción bibliográfica española sobre este tema ha crecido exponencialmente en los últimos años. Las nuevas ciudades inteligentes se fundamentan en nuevas visiones de desarrollo urbano que integran múltiples soluciones tecnológicas ligadas al mundo de la información y de la comunicación, todas ellas actuales y al servicio de las necesidades de la ciudad. La literatura en español sobre este tema proviene de campos tan diferentes como la Arquitectura, la Ingeniería, las Ciencias Políticas y el Derecho o las Ciencias Empresariales. La finalidad de las ciudades inteligentes es la mejora de la vida de sus ciudadanos a través de la implementación de tecnologías de la información y de la comunicación que resuelvan las necesidades de sus habitantes, por lo que los investigadores del campo de las Ciencias de la Comunicación y de la Información tienen mucho que decir. Este trabajo analiza un total de 120 textos y concluye que el fenómeno de las ciudades inteligentes será uno de los ejes centrales de la investigación multidisciplinar en los próximos años en nuestro país.

Economic crisis and national health system

The text analyzes the impact of the economic crisis in some critical aspects of the National Health System: outcomes, health expenditure, remuneration policy and privatization through Private Public Partnership models. Some health outcomes related to social inequalities are worrying. Reducing public health spending has increased the fragility of the health system, reduced wage income of workers in the sector and increased heterogeneity between regions. Finally, the evidence indicates that privatization does not mean more efficiency and better governance. Deep reforms are needed to strengthen the National Health System.

El impacto de la presencia online en las cuentas de Twitter de las universidades vascas y navarras

Las Universidades han tenido que adaptarse a los nuevos modelos de comunicación surgidos en la época de Internet. Dentro de estos nuevos paradigmas las redes sociales han irrumpido y Twitter se ha establecido como una de las más importantes. El objetivo de esta investigación es demostrar que existe una relación entre la presencia online de una Universidad, definida por la cantidad de información disponible en Internet, y su cuenta en Twitter. Para ello se analizó la relación entre la presencia online y los perfiles oficiales de las cinco universidades del País Vasco y Navarra. Los resultados demostraron la existencia de una correlación significativa entre la presencia online de las instituciones y el número de seguidores de sus respectivas cuentas. En segundo lugar, esta investigación se planteó si Twitter puede servir para potenciar la presencia online de una Universidad. Es por eso que se formuló una segunda hipótesis que buscaba analizar si tener varias cuentas en Twitter aumentaría la presencia online de las Universidades. Los hallazgos para esta segunda hipótesis demostraron una correlación muy significativa entre tener varios perfiles en Twitter y la presencia online de las Universidades. Así queda demostrada la importancia de la presencia online para las cuentas de Twitter y la relevancia de Twitter a la hora de potenciar la presencia online de los centros.

Statin use and breast cancer survival: a nationwide cohort study in Scotland

Background: Preclinical evidence suggests that statins could delay cancer progression. Previous epidemiological findings have been inconsistent and some have been limited by small sample sizes, as well as certain time-related biases. This study aimed to investigate whether breast cancer patients who were exposed to statins had reduced breast cancer-specific mortality. Methods: We conducted a retrospective cohort study of 15,140 newly diagnosed invasive breast cancer patients diagnosed from 2009 to 2012 within the Scottish Cancer Registry. Dispensed medication usage was obtained from linkages to the Scottish Prescribing Information System and breast cancer-specific deaths were identified from National Records of Scotland Death Records. Using time-dependent Cox regression models, hazard ratios (HR) and 95 % confidence intervals (CI) were calculated for the association between post-diagnostic exposure to statins (including simvastatin) and breast cancer-specific mortality. Adjustments were made for a range of potential confounders including age at diagnosis, year of diagnosis, cancer stage, grade, cancer treatments received, comorbidities, socioeconomic status and use of aspirin. Results: A total of 1,190 breast cancer-specific deaths occurred up to January 2015. Overall, after adjustment for potential confounders, there was no evidence of an association between statin use and breast cancer-specific death (adjusted HR 0.93, 95 % CI 0.77, 1.12). No significant associations were observed in dose–response analyses or in analysis of all-cause mortality. For simvastatin use specifically, a weak non-significant reduction in breast cancer-specific mortality was observed compared to non-users (adjusted HR 0.89, 95 % CI 0.73, 1.08). Statin use before diagnosis was weakly associated with a reduction in breast cancer-specific mortality (adjusted HR 0.85, 95 % CI 0.74, 0.98). Conclusion: Overall, we found little evidence of a protective association between post-diagnostic statin use and cancer-specific mortality in a large nation-wide cohort of breast cancer patients. These findings will help inform the decision whether to conduct randomised controlled trials of statins as an adjuvant treatment in breast cancer.