Caregiver burden as a predictor of depression among family and friends who provide care for persons with bipolar disorder

OBJECTIVES: Over one-third of caregivers of people with bipolar disorder report clinically significant levels of depressive symptoms. This study examined the causal relationship between depression and caregiver burden in a large sample of caregivers of adult patients with bipolar disorder. METHODS: Participants were 500 primary caregivers of persons with bipolar disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).This study evaluates the strength and direction of the associations between caregiver burden and depressive symptoms at baseline and at six- and 12-month follow-up using cross-lagged panel analyses, controlling for the clinical status of patients and sociodemographic variables. RESULTS: Higher levels of overall caregiver burden at baseline were associated with increased levels of depressive symptoms among caregivers at follow-up (F = 8.70, df = 1,290, p < 0.001), after controlling for baseline caregiver depression, gender, race, age, social support, and patients' clinical status. By contrast, caregiver depression at baseline was not significantly associated with caregiver burden at follow-up (F = 1.65, p = 0.20). CONCLUSIONS: Caregiver burden is a stronger predictor of caregiver depressive symptoms over time than the reverse. Interventions that help alleviate caregiver burden may decrease depressive symptoms.

A Bayesian approach to study the risk variables for tuberculosis occurrence in domestic and wild ungulates in South Central Spain

BACKGROUND Bovine tuberculosis (bTB) is a chronic infectious disease mainly caused by Mycobacterium bovis. Although eradication is a priority for the European authorities, bTB remains active or even increasing in many countries, causing significant economic losses. The integral consideration of epidemiological factors is crucial to more cost-effectively allocate control measures. The aim of this study was to identify the nature and extent of the association between TB distribution and a list of potential risk factors regarding cattle, wild ungulates and environmental aspects in Ciudad Real, a Spanish province with one of the highest TB herd prevalences. RESULTS We used a Bayesian mixed effects multivariable logistic regression model to predict TB occurrence in either domestic or wild mammals per municipality in 2007 by using information from the previous year. The municipal TB distribution and endemicity was clustered in the western part of the region and clearly overlapped with the explanatory variables identified in the final model: (1) incident cattle farms, (2) number of years of veterinary inspection of big game hunting events, (3) prevalence in wild boar, (4) number of sampled cattle, (5) persistent bTB-infected cattle farms, (6) prevalence in red deer, (7) proportion of beef farms, and (8) farms devoted to bullfighting cattle. CONCLUSIONS The combination of these eight variables in the final model highlights the importance of the persistence of the infection in the hosts, surveillance efforts and some cattle management choices in the circulation of M. bovis in the region. The spatial distribution of these variables, together with particular Mediterranean features that favour the wildlife-livestock interface may explain the M. bovis persistence in this region. Sanitary authorities should allocate efforts towards specific areas and epidemiological situations where the wildlife-livestock interface seems to critically hamper the definitive bTB eradication success.

Young people's well-being and the economic crisis: How does parental unemployment and family wealth affect the downturn experience?

Background: Portugal is among the European countriesmost severely hit by the economic recession and the fifth with the highest unemployment rate. Given that adolescents' development is highly influenced by their living contexts, monitoring the repercussions of the economic recession is essential for the evaluation and improvement of their current and future public health. Objective: To investigate youth perceived repercussions of the economic recession, its association with life satisfaction, as well as to assess differences across parental employment status and family perceived wealth. Methods: Data were drawn from the Portuguese 2014 Health Behaviour in School-aged children survey, aWHO collaborative cross-national study, with a nationally representative sample of 2748 students (Mage = 14.7 years ± 1.2; 48% boys). Descriptive statistics and linear regression models were performed. Results: Levels of life satisfaction are lower when young people perceive that the economic recession generated negative lifestyle changes. Having unemployed parents was found to be significantly associated with perceiving such repercussions and family wealth to decrease the perception of repercussions of the recession. Conclusions: Findings enhance our understanding of how Portuguese youth are being affected by the socioeconomic conditions surrounding them. Such information contributes to improve future research and also allow some considerations about the policies aimed at protecting young people'swellbeing during a period of high unemployment and socioeconomic downturn.

Adolescent’s subjective perceptions of chronic disease and related psychosocial factors: Highlights from an outpatient context study

Background: Adolescents with chronic disease (CD) can be more vulnerable to adverse psychosocial outcomes. This study aims: 1) to identify differences in psychosocial variables (health-related quality of life, psychosomatic complaints, resilience, self-regulation and social support) among adolescents who feel that CD affects or does not affect school/peers connectedness (measured by self-reported participation in school and social activities); and 2) to assess the extent to which psychosocial variables are associated with connectedness in school and peer domains. Methods: A cross-sectional study was conducted in 135 adolescents with CD (51.9% boys), average age of 14 ± 1. 5 years old (SD = 1.5). Socio-demographic, clinical, and psychosocial variables were assessed, using a self-reported questionnaire, which included the Chronic Conditions Short Questionnaire, KIDSCREEN-10 Index, Symptoms Check-List, Healthy Kids Resilience Assessment Module Scale, Adolescent Self-Regulatory Inventory, and Satisfaction with Social Support Scale. Descriptive statistics, GLM-Univariate ANCOVA and Logistic Regression were performed using the IBM Statistical Package for Social Sciences (SPSS), version 22.0. The significance level was set at p < 0.05. Results: Thirteen to eighteen percent of the adolescents felt that CD affected participation at school (PSCH) and participation in leisure time with friends (PLTF). These adolescents presented lower results for all psychosocial study variables, when compared with adolescents who did not feel affected in both areas of participation. From the studied psychosocial variables, the most important ones associated with PSCH (after controlling for age, gender, diagnosis, and education level of father/mother) were self-regulation and psychosomatic health. Concerning the PLTF, social support was the sole variable explaining such association. Conclusions: The present study pointed out the association between psychosocial variables; and living with a CD and school/peers connectedness. The need to focus on the assessment of the effects of a CD on adolescents’ lives and contexts is suggested, as well as on the identification of vulnerable adolescents. Such identification could help to facilitate the maximization of social participation of adolescents with CD, and to plan interventions centered on providing support and opportunities for a healthy youth development. For that purpose, a complex and multifactorial approach that includes clinicians, schools, family, and peers may be proposed.

Clinical skills and communication in nursing students

Abstract Background: Communication is a basic tool in nursing, a crucial element of care. The quality of the interactions that take place between the nurse and the user/family influence their satisfaction and security felt with the care received. Objectives: To identify the communication skills and interpersonal relationship of nursing students in health care; identify the sociodemographic and academic variables influencing communication skills and interpersonal relationship of nursing students in health care. Methodology: Quantitative study, cross-sectional, descriptive and correlational. The data collection instrument was a questionnaire with questions concerning the socio-demographic and academic characterization; basic skills of interview and clinical communication in health care; learning of clinical communication skills and range of communication skills and interpersonal relationship. The sample consisted of 374 nursing students from two Portuguese schools. Results: The majority were female (80.5%), in the age group of 18-21 years. The students recognize the importance of clinical communication skills and interpersonal relations in nursing practice (82.4%); agreed on the teaching methods of communicational skills (54.3%). Evaluated their training in the area as good (71.7%). Age, semester and school influenced communication skills and interpersonal relationship of students (p <0.5) Conclusion: The results obtained allow us to state that the education / training of nursing student in the relational context is of fundamental importance in building capacity for competent professional practice.

Health profile of centenarians in Portugal: a census-based approach

Background: The number of centenarians is rapidly increasing in Europe. In Portugal, it has almost tripled over the last 10 years and constitutes one of the fastest-growing segments of the population. This paper aims to describe the health and sociodemographic characteristics of Portuguese centenarians as given in the 2011 census and to identify sex differences. Methods: All persons living in Portugal mainland and Madeira and Azores islands aged 100 years old at the time of the 2011 census (N = 1,526) were considered. Measures include sociodemographic characteristics and perceived difficulties in six functional domains of basic actions (seeing, hearing, walking, cognition, self-care, and communication) as assessed by the Portuguese census official questionnaires. Results: Most centenarians are women (82.1 %), widowed (82 %), never attended school (51 %), and live in private households (71 %). The majority show major constraints in seeing (67.4 %), hearing (72.3 %), and particularly in their mobility (83.7 % cannot/have great difficulties in walking/climbing stairs and 80.7 % in bathing/dressing). In general, a better outcome was found for reported memory/concentration and understanding, with 39.1 % and 42.5 % presenting no or mild difficulty, respectively. Top-level functioning (no/mild difficulties in all dimensions concurrently) was observed in a minority of cases (5.96 %). Women outnumber men by a ratio of 4.6, and statistically significant differences were found between men and women for all health-related variables, with women presenting a higher percentage of difficulties. Conclusion: Portuguese centenarians experience great difficulties in sensory domains and basic daily living activities, and to a lesser extent in cognition and communication. The obtained profile, though self-reported, is important in considering the potential of social and family participation of this population regardless of their functional and sensory limitations. Based on the observed differences between men and women, gender-specific and gender-sensitive interventions are recommended in order to acknowledge women’s worse overall condition.

Les facteurs affectant les taux de réussite des cours d’anglais et de sciences humaines des étudiants dans les programmes de formation technique

A large percentage of Vanier College's technology students do not attain their College degrees within the scheduled three years of their program. A closer investigation of the problem revealed that in many of these cases these students had completed all of their program professional courses but they had not completed all of the required English and/or Humanities courses. Fortunately, most of these students do extend their stay at the college for the one or more semesters required for graduation, although some choose to go on into the workforce without returning to complete the missing English and/or Humanities and without their College Degrees. The purpose of this research was to discover if there was any significant measure of association between a student's family linguistic background, family cultural background, high school average, and/or College English Placement Test results and his or her likelihood of succeeding in his or her English and/or Humanities courses within the scheduled three years of the program. Because of both demographic differences between 'hard' and 'soft' technologies, including student population, more specifically gender ratios and student average ages in specific programs; and program differences, including program writing requirements and types of practical skill activities required; in order to have a more uniform sample, the research was limited to the hard technologies where students work hands-on with hardware and/or computers and tend to have overall low research and writing requirements. Based on a review of current literature and observations made in one of the hard technology programs at Vanier College, eight research questions were developed. These questions were designed to examine different aspects of success in the English and Humanities courses such as failure and completion rates and the number of courses remaining after the end of the fifth semester and as well examine how the students assessed their ability to communicate in English. The eight research questions were broken down into a total of 54 hypotheses. The high number of hypotheses was required to address a total of seven independent variables: primary home language, high school language of instruction, student's place of birth (Canada, Not-Canada), student's parents' place of birth (Both-born-in-Canada, Not-both-born-in-Canada), high school averages and English placement level (as a result of the College English Entry Test); and eleven dependent variables: number of English completed, number of English failed, whether all English were completed by the end of the 5th semester (yes, no), number of Humanities courses completed, number of Humanities courses failed, whether all the Humanities courses were completed by the end of the 5th semester (yes, no), the total number of English and Humanities courses left, and the students' assessments of their ability to speak, read and write in English. The data required to address the hypotheses were collected from two sources, from the students themselves and from the College. Fifth and sixth semester students from Building Engineering Systems, Computer and Digital Systems, Computer Science and Industrial Electronics Technology Programs were surveyed to collect personal information including family cultural and linguistic history and current language usages, high school language of instruction, perceived fluency in speaking, reading and writing in English and perceived difficulty in completing English and Humanities courses. The College was able to provide current academic information on each of the students, including copies of college program planners and transcripts, and high school transcripts for students who attended a high school in Quebec. Quantitative analyses were done on the data using the SPSS statistical analysis program. Of the fifty-four hypotheses analysed, in fourteen cases the results supported the research hypotheses, in the forty other cases the null hypotheses had to be accepted. One of the findings was that there was a strong significant association between a student's primary home language and place of birth and his or her perception of his or her ability to communicate in English (speak, read, and write) signifying that both students whose primary home language was not English and students who were not born in Canada, considered themselves, on average, to be weaker in these skills than did students whose primary home language was English. Although this finding was noteworthy, the two most significant findings were the association found between a student's English entry placement level and the number of English courses failed and the association between the parents' place of birth and the student's likelihood of succeeding in both his or her English and Humanities courses. According to the research results, the mean number of English courses failed, on average, by students placed in the lowest entry level of College English was significantly different from the number of English courses failed by students placed in any of the other entry level English courses. In this sample students who were placed in the lowest entry level of College English failed, on average, at least three times as many English courses as those placed in any of the other English entry level courses. These results are significant enough that they will be brought to the attention of the appropriate College administration. The results of this research also appeared to indicate that the most significant determining factor in a student's likelihood of completing his or her English and Humanities courses is his or her parents' place of birth (both-born-in-Canada or not-both-born-in-Canada). Students who had at least one parent who was not born in Canada, would, on average, fail a significantly higher number of English courses, be significantly more likely to still have at least one English course left to complete by the end of the 5th semester, fail a significantly higher number of Humanities courses, be significantly more likely to still have at least one Humanities course to complete by the end of the 5th semester and have significantly more combined English and Humanities courses to complete at the end of their 5th semester than students with both parents born in Canada. This strong association between students' parents' place of birth and their likelihood of succeeding in their English and Humanities courses within the three years of their program appears to indicate that acculturation may be a more significant factor than either language or high school averages, for which no significant association was found for any of the English and Humanities related dependent variables. Although the sample size for this research was only 60 students and more research needs to be conducted in this area, to see if these results are supported with other groups within the College, these results are still significant. If the College can identify, at admission, the students who will be more likely to have difficulty in completing their English and Humanities courses, the College will now have the opportunity to intercede during or before the first semester, and offer these students the support they require in order to increase their chances of success in their education, whether it be classes or courses designed to meet their specific needs, special mentoring, tutoring or other forms of support. With the necessary support, the identified students will have a greater opportunity of successfully completing their programs within the scheduled three years, while at the same time the College will have improved its capacity to meeting the needs of its students.

No evidence for association of ataxia-telangiectasia mutated gene T2119C and C3161G amino acid substitution variants with risk of breast cancer

Background There is evidence that certain mutations in the double-strand break repair pathway ataxia-telangiectasia mutated gene act in a dominant-negative manner to increase the risk of breast cancer. There are also some reports to suggest that the amino acid substitution variants T2119C Ser707Pro and C3161G Pro1054Arg may be associated with breast cancer risk. We investigate the breast cancer risk associated with these two nonconservative amino acid substitution variants using a large Australian population-based case–control study. Methods The polymorphisms were genotyped in more than 1300 cases and 600 controls using 5' exonuclease assays. Case–control analyses and genotype distributions were compared by logistic regression. Results The 2119C variant was rare, occurring at frequencies of 1.4 and 1.3% in cases and controls, respectively (P = 0.8). There was no difference in genotype distribution between cases and controls (P = 0.8), and the TC genotype was not associated with increased risk of breast cancer (adjusted odds ratio = 1.08, 95% confidence interval = 0.59–1.97, P = 0.8). Similarly, the 3161G variant was no more common in cases than in controls (2.9% versus 2.2%, P = 0.2), there was no difference in genotype distribution between cases and controls (P = 0.1), and the CG genotype was not associated with an increased risk of breast cancer (adjusted odds ratio = 1.30, 95% confidence interval = 0.85–1.98, P = 0.2). This lack of evidence for an association persisted within groups defined by the family history of breast cancer or by age. Conclusion The 2119C and 3161G amino acid substitution variants are not associated with moderate or high risks of breast cancer in Australian women.

Cross-correlations between weather variables in Australia

The information on climate variations is essential for the research of many subjects, such as the performance of buildings and agricultural production. However, recorded meteorological data are often incomplete. There may be a limited number of locations recorded, while the number of recorded climatic variables and the time intervals can also be inadequate. Therefore, the hourly data of key weather parameters as required by many building simulation programmes are typically not readily available. To overcome this gap in measured information, several empirical methods and weather data generators have been developed. They generally employ statistical analysis techniques to model the variations of individual climatic variables, while the possible interactions between different weather parameters are largely ignored. Based on a statistical analysis of 10 years historical hourly climatic data over all capital cities in Australia, this paper reports on the finding of strong correlations between several specific weather variables. It is found that there are strong linear correlations between the hourly variations of global solar irradiation (GSI) and dry bulb temperature (DBT), and between the hourly variations of DBT and relative humidity (RH). With an increase in GSI, DBT would generally increase, while the RH tends to decrease. However, no such a clear correlation can be found between the DBT and atmospheric pressure (P), and between the DBT and wind speed. These findings will be useful for the research and practice in building performance simulation.

The Expanded Human Kallikrein (KLK) gene family : genomic organisation, tissue specific expression and potential functions

The tissue kallikreins are serine proteases encoded by highly conserved multigene families. The rodent kallikrein (KLK) families are particularly large, consisting of 13 26 genes clustered in one chromosomal locus. It has been recently recognised that the human KLK gene family is of a similar size (15 genes) with the identification of another 12 related genes (KLK4-KLK15) within and adjacent to the original human KLK locus (KLK1-3) on chromosome 19q13.4. The structural organisation and size of these new genes is similar to that of other KLK genes except for additional exons encoding 5 or 3 untranslated regions. Moreover, many of these genes have multiple mRNA transcripts, a trait not observed with rodent genes. Unlike all other kallikreins, the KLK4-KLK15 encoded proteases are less related (25–44%) and do not contain a conventional kallikrein loop. Clusters of genes exhibit high prostatic (KLK2-4, KLK15) or pancreatic (KLK6-13) expression, suggesting evolutionary conservation of elements conferring tissue specificity. These genes are also expressed, to varying degrees, in a wider range of tissues suggesting a functional involvement of these newer human kallikrein proteases in a diverse range of physiological processes.