Perceived risk of death in older primary care patients

There is a large gap between life expectancy and healthy life years at age 65. To reduce this gap, it is necessary that people with medical concerns perceived at higher risk of adverse outcomes are readily identified and treated. The same goes for the need to implement prevention plans. The main objectives of this study are to, in a first step, (a) estimate the percentage of medical concerns, (b) identify factors associated with this concern; in a second step, (c) estimate the perceived risk of death, and (d) evaluate the ability of medical concerns to predict this risk. Results show that the existence and severity of medical concerns are crucial in the prediction of perceived risk of death. Early identification of severity of medical concerns and the availability and adequacy of informal caregiving should allow healthcare professionals to promptly initiate an appropriate assessment and treatment of older patients.

Syndemic Health Disparities and Resilience Processes Related to HIV Transmission Risk among African American/Black Men in South Florida

Rates of HIV infection continue to climb among minority populations and men who have sex with men (MSM), with African American/Black MSM being especially impacted. Numerous studies have found HIV transmission risk to be associated with many health and social disparities resulting from larger environmental and structural forces. Using anthropological and social environment-based theories of resilience that focus on individual agency and larger social and environmental structures, this dissertation employed a mixed methods design to investigate resilience processes among African American/Black MSM. Quantitative analyses compared African American/Black (N=108) and Caucasian/White (N=250) MSM who participated in a previously conducted randomized controlled trial (RCT) of sexual and substance use risk reduction interventions. At RCT study entry, using past 90 day recall periods, there were no differences in unprotected sex frequency, however African American/Black MSM reported higher frequencies of days high (P Qualitative data collected among a sub-sample of African American/Black MSM from the RCT (N=21) described the men’s experiences of living with multiple health and social disparities and the importance of RCT study assessments in facilitating reductions in risk behaviors. A cross-case analysis showed different resilience processes undertaken by men who experienced low socioeconomic status, little family support, and homophobia (N=16) compared to those who did not (N=5). The dissertation concludes that resilience processes to HIV transmission risk and related health and social disparities among African American/Black MSM varies and are dependent on specific social environmental factors, including social relationships, structural homophobia, and access to social, economic, and cultural capital. Men define for themselves what it means to be resilient within their social environment. These conclusions suggest that both individual and structural-level resilience-based HIV prevention interventions are needed.

Annotated record of the detailed examination of Mn deposits from the SS Tschernomoretz expedition in the Black Sea in 1890-1891

Professor N. Andrussow, of Juriew (Dorpat) sent to the author a series of the deposit-samples collected in the Black Sea during the Russian explorations in 1890 and 1891 in the steamships Tschernomoretz, Zaporojetz, and Donetz. These deposits were submitted to careful microscopical examination and chemical analysis.

(Table 1) Main parameters of consumption of inorganic nitrogen compounds by microplankton in the western Black Sea in April 1993

Parameters of provision of the phytoplankton community with inorganic nitrogen compounds in the western Black Sea in April 1993 are analyzed (specifically, dependence of rates of uptake of nitrates and ammonium by microplankton on substrate concentration, diurnal dynamics of assimilation of mineral nitrogen, values of f-ratios, and proportions of carbon and nitrogen fluxes). In most cases all the parameters of degree of phytoplankton provision with mineral nitrogen are shown to vary unidirectionally, both at the surface and in the photosynthesis zone. Individual areas of a relatively small region studied differed markedly in their level of provision of algae with inorganic nitrogen compounds - from complete saturation to high degree of limitation of phytoplankton development due to nitrogen deficiency in the environment. Obtained results allow to estimate provision of Black Sea phytoplankton with nitrogen in terms of limitation of rates of uptake of its inorganic compounds.

On gathering in Art therapy: a way to understand and build the discipline with the other

In the present article I try to share some reflections on a case study of an attachment disorder child I worked with for two years through art therapy in a day hospital. Those reflections let me go deeply in some specific elements concerning the discipline which let us delimit its theoretical and methodological possible scope. In this way, from the specific of the case study on propose to reflect on those elements that conform a methodology related to the art therapist way of doing, in order to concrete and evaluate other possible interventions to develop in similar cases and contexts.

The puppet as a tool for working in Art Therapy

This article aims to investigate the possibilities of building puppets in art therapy workshop, for this it realizes a tour of the primitive use of the puppet as a magical twin and potential towards the study of authors who have used the puppets as a therapeutic tool from the first half of the twentieth century. It’s raised an own theoretical organization, which includes the consideration of the significance of the body in the construction and management of the puppet and the puppet transitional perspective, halfway of external reality and psychic reality as an object that makes fantasy and reality arises built.

Main causes of death in Dande, Angola: results from verbal autopsies of deaths occurring during 2009–2012

bACKGROUND - The Dande Health and Demographic Surveillance System (HDSS) located in Bengo province, Angola, covers nearly 65,500 residents living in approximately 19,800 households. This study aims to describe the main causes of deaths (CoD) occurred within the HDSS, from 2009 to 2012, and to explore associations between demographic or socioeconomic factors and broad mortality groups (Group I-Communicable diseases, maternal, perinatal and nutritional conditions; Group II-Non-communicable diseases; Group III-Injuries; IND-Indeterminate). Methods - Verbal Autopsies (VA) were performed after death identification during routine HDSS visits. Associations between broad groups of CoD and sex, age, education, socioeconomic position, place of residence and place of death, were explored using chi-square tests and fitting logistic regression models. Results - From a total of 1488 deaths registered, 1009 verbal autopsies were performed and 798 of these were assigned a CoD based on the 10th revision of the International Classification of Diseases (ICD-10). Mortality was led by CD (61.0%), followed by IND (18.3%), NCD (11.6%) and INJ (9.1%). Intestinal infectious diseases, malnutrition and acute respiratory infections were the main contributors to under-five mortality (44.2%). Malaria was the most common CoD among children under 15 years old (38.6%). Tuberculosis, traffic accidents and malaria led the CoD among adults aged 15–49 (13.5%, 10.5 % and 8.0% respectively). Among adults aged 50 or more, diseases of the circulatory system (23.2%) were the major CoD, followed by tuberculosis (8.2%) and malaria (7.7%). CD were more frequent CoD among less educated people (adjusted odds ratio, 95% confidence interval for none vs. 5 or more years of school: 1.68, 1.04–2.72). Conclusion - Infectious diseases were the leading CoD in this region. Verbal autopsies proved useful to identify the main CoD, being an important tool in settings where vital statistics are scarce and death registration systems have limitations.

The importance of novelty: Male–female interactions among blue-black grassquits in captivity

Mate choice is a primary mechanism driving the evolution of sexually selected traits such as elabo-rate displays and ornaments. In a majority of taxa studied to date, females are seen to actively sampleand evaluate multiple males, presumably to optimize mating opportunities. During this process femalesmay encounter males both familiar and novel, a distinction that might influence how mate choice pro-ceeds. Using a socially monogamous passerine, the blue-black grassquit (Volatinia jacarina), we studiedhow females respond to novel versus familiar (“paired”) males, and how encounters with novel malesinfluence subsequent interactions with their paired males. Additionally, we measured the hormonalresponse of males after visualizing their paired females interacting with novel males. We found thatfemales were attentive to novel males irrespective of these males’ phenotypic attributes, suggesting thatin these interactions novelty is highly relevant. After exposure to novel males, females tended to respondaggressively towards their paired males; by contrast, the behaviour of males towards their paired femalesdid not change. Moreover, we did not detect any hormonal responses of males to viewing their pairedfemales interacting with novel males. Together these results suggest that the distinction between famil-iarity and novelty may hold special relevance for females in mate choice, a finding that bears upon ourunderstanding of the evolution of extra-pair paternity and reproductive behaviour.

A cross sectional study of leptospirosis and fetal death in Yucatan, Mexico

Introduction: Leptospirosis is a zoonotic disease affecting mainly to low income human population. Acute leptospiral infection during pregnancy has been associated with spontaneous abortion and fetal death during the first trimester and the abortion may occur as consequence of systemic failure. Objective: To estimate the frequency of Leptospira interrogans infection in women with spontaneous abortion in the state of Yucatan, Mexico. Methods: A cross sectional study on women with spontaneous abortion was conducted. Serum samples were tested for Leptospirosis by the microaglutination test, to estimate the frequency of the infecting serovar. The indirect ELISA IgM was used to detect recent infection by L. interrogans. DNA was extracted from paraffin-embedded tissue of placenta for PCR detection of L. interrogans. Results: Overall frequency of infection with L. interrogans in the 81 women with abortion was 13.6%. Five of the 12 serovars evaluated were found and included. Two of the 11 women with abortion and positive to microaglutination test were also positive to the ELISA IgM test. None samples were positive for PCR Leptospira diagnosis. Conclusion: two women could be associated with spontaneous abortion due to leptospirosis, because they showed antibodies against L. interrogans in the microaglutination test and ELISA IgM assays. Differences between regions were found with respect to the prevalences of lesptospirosis.

Environmental Dynamics of Dissolved Black Carbon in Aquatic Ecosystems

Black carbon (BC), the incomplete combustion product from biomass and fossil fuel burning, is ubiquitously found in soils, sediments, ice, water and atmosphere. Because of its polyaromatic molecular characteristic, BC is believed to contribute significantly to the global carbon budget as a slow-cycling, refractory carbon pool. However, the mass balance between global BC generation and accumulation does not match, suggesting a removal mechanism of BC to the active carbon pool, most probable in a dissolved form. The presence of BC in waters as part of the dissolved organic matter (DOM) pool was recently confirmed via ultrahigh resolution mass spectrometry, and dissolved black carbon (DBC), a degradation product of charcoal, was found in marine and coastal environments. However, information on the loadings of DBC in freshwater environments and its global riverine flux from terrestrial systems to the oceans remained unclear. The main objectives of this study were to quantify DBC in diverse aquatic ecosystems and to determine its environmental dynamics. Surface water samples were collected from aquatic environments with a spatially significant global distribution, and DBC concentrations were determined by a chemical oxidation method coupled with HPLC detection. While it was clear that biomass burning was the main sources of BC, the translocation mechanism of BC to the dissolved phase was not well understood. Data from the regional studies and the developed global model revealed a strong positive correlation between DBC and dissolved organic carbon (DOC) dynamics, indicating a co-generation and co-translocation between soil OC and BC. In addition, a DOC-assistant DBC translocation mechanism was identified. Taking advantage of the DOC-DBC correlation model, a global riverine DBC flux to oceans on the order of 26.5 Mt C yr-1 (1 Mt = 1012 g) was determined, accounting for 10.6% of the global DOC flux. The results not only indicated that DOC was an important environmental intermediate for BC transfer and storage, but also provided an estimate of a major missing link in the global BC budget. The ever increasing DBC export caused by global warming will change the marine DOM quality and may have important consequences for carbon cycling in marine ecosystem.

Urinary osteopontin predicts incident chronic kidney disease, while plasma osteopontin predicts cardiovascular death in elderly men

Background and objectives The matricellular protein osteopontin is involved in the pathogenesis of both kidney and cardiovascular disease. However, whether circulating and urinary osteopontin levels are associated with the risk of these diseases is less studied. Design, setting, participants and measurements A community-based cohort of elderly (Uppsala Longitudinal Study of Adult Men [ULSAM; n=741; mean age: 77 years]) was used to study the associations between plasma and urinary osteopontin, incident chronic kidney disease, and the risk of cardiovascular death during a median of 8 years of follow-up. Results There was no significant cross-sectional correlation between plasma and urinary osteopontin (Spearman rho=0.07, p=0.13). Higher urinary, but not plasma osteopontin, was associated with incident chronic kidney disease in multivariable models adjusted for age, cardiovascular risk factors, baseline glomerular filtration rate (GFR), urinary albumin/creatinine ratio, and inflammatory markers interleukin 6 and high sensitivity C-reactive protein (Odds ratio for 1-standard deviation (SD) of urinary osteopontin, 1.42, 95% CI (1.00-2.02), p=0.048). Conversely, plasma osteopontin, but not urinary osteopontin, was independently associated with cardiovascular death (multivariable hazard ratio per SD increase, 1.35, 95% CI (1.14-1.58), p<0.001, and 1.00, 95% CI (0.79-1.26), p=0.99, respectively). The addition of plasma osteopontin to a model with established cardiovascular risk factors significantly increased the C-statistics for the prediction of cardiovascular death (p<0.002). Conclusions Higher urinary osteopontin specifically predicts incident chronic kidney disease while plasma osteopontin specifically predicts cardiovascular death. Our data put forward osteopontin as an important factor in the detrimental interplay between the kidney and the cardiovascular system. The clinical implications, and why plasma and urinary osteopontin mirror different pathologies, remains to be established.

Risk analysis of climate change on black sigatoka in banana in Brazil.

2008

Digital 3D reconstruction as a research environment in art and architecture history: uncertainty classification and visualisation

The dissertation addresses the still not solved challenges concerned with the source-based digital 3D reconstruction, visualisation and documentation in the domain of archaeology, art and architecture history. The emerging BIM methodology and the exchange data format IFC are changing the way of collaboration, visualisation and documentation in the planning, construction and facility management process. The introduction and development of the Semantic Web (Web 3.0), spreading the idea of structured, formalised and linked data, offers semantically enriched human- and machine-readable data. In contrast to civil engineering and cultural heritage, academic object-oriented disciplines, like archaeology, art and architecture history, are acting as outside spectators. Since the 1990s, it has been argued that a 3D model is not likely to be considered a scientific reconstruction unless it is grounded on accurate documentation and visualisation. However, these standards are still missing and the validation of the outcomes is not fulfilled. Meanwhile, the digital research data remain ephemeral and continue to fill the growing digital cemeteries. This study focuses, therefore, on the evaluation of the source-based digital 3D reconstructions and, especially, on uncertainty assessment in the case of hypothetical reconstructions of destroyed or never built artefacts according to scientific principles, making the models shareable and reusable by a potentially wide audience. The work initially focuses on terminology and on the definition of a workflow especially related to the classification and visualisation of uncertainty. The workflow is then applied to specific cases of 3D models uploaded to the DFG repository of the AI Mainz. In this way, the available methods of documenting, visualising and communicating uncertainty are analysed. In the end, this process will lead to a validation or a correction of the workflow and the initial assumptions, but also (dealing with different hypotheses) to a better definition of the levels of uncertainty.