Relationship between depressive symptom severity and emergency department use among low-income, depressed homebound older adults aged 50 years and older

Namkee G. Choi, and C. Nathan Marti are with The University of Texas at Austin, Austin, TX, USA. -- Martha L. Bruce is with the Weill Cornell Medical College, White Plains, NY, USA. -- Mark E. Kunik is with the VA HSRD Houston Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA, and Baylor College of Medicine, Houston, TX, USA, and VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA.Background: Previous research found a high prevalence of depression, along with chronic illnesses and disabilities, among older ED patients. This study examined the relationship between depressive symptom severity and the number of ED visits among low-income homebound older adults who participated in a randomized controlled trial of telehealth problem-solving therapy (PST). Methods: The number of and reasons for ED visits were collected from the study participants (n=121 at baseline) at all assessment points—baseline and 12- and 24-week follow-ups. Depressive symptoms were measured with the 24-item Hamilton Rating Scale for Depression (HAMD). All multivariable analyses examining the relationships between ED visits and depressive symptoms were conducted using zero-inflated Poisson regression models. Results: Of the participants, 67.7% used the ED at least once and 61% of the visitors made at least one return visit during the approximately 12-month period. Body pain (not from fall injury and not including chest pain) was the most common reason. The ED visit frequency at baseline and at follow-up was significantly positively associated with the HAMD scores at the assessment points. The ED visit frequency at follow-up, controlling for the ED visits at baseline, was also significantly associated with the HAMD score change since baseline. Conclusions: The ED visit rate was much higher than those reported in other studies. Better education on self-management of chronic conditions, depression screening by primary care physicians and ED, and depression treatment that includes symptom management and problem-solving skills may be important to reduce ED visits among medically ill, low-income homebound adults. Trial registration ClinicalTrials.gov Identifier: NCT00903019Psycholog

Medical ultrasonic tomographic system

An electro-mechanical scanning assembly was designed and fabricated for the purpose of generating an ultrasound tomogram. A low cost modality was demonstrated in which analog instrumentation methods formed a tomogram on photographic film. Successful tomogram reconstructions were obtained on in vitro test objects by using the attenuation of the fist path ultrasound signal as it passed through the test object. The nearly half century tomographic methods of X-ray analysis were verified as being useful for ultrasound imaging

The radial evolution of solar wind speeds

The WSA-ENLIL model predicts significant evolution of the solar wind speed. Along a flux tube the solar wind speed at 1.0 AU and beyond is found to be significantly altered from the solar wind speed in the outer corona at 0.1 AU, with most of the change occurring within a few tenths of an AU from the Sun. The evolution of the solar wind speed is most pronounced during solar minimum for solar wind with observed speeds at 1.0 AU between 400 and 500 km/s, while the fastest and slowest solar wind experiences little acceleration or deceleration. Solar wind ionic charge state observations made near 1.0 AU during solar minimum are found to be consistent with a large fraction of the intermediate-speed solar wind having been accelerated or decelerated from slower or faster speeds. This paper sets the groundwork for understanding the evolution of wind speed with distance, which is critical for interpreting the solar wind composition observations near Earth and throughout the inner heliosphere. We show from composition observations that the intermediate-speed solar wind (400-500 km/s) represents a mix of what was originally fast and slow solar wind, which implies a more bimodal solar wind in the corona than observed at 1.0 AU

Dynamics of confined water reconstructed from inelastic x-ray scattering measurements of bulk response functions

Nanoconfined water and surface-structured water impacts a broad range of fields. For water confined between hydrophilic surfaces, measurements and simulations have shown conflicting results ranging from “liquidlike” to “solidlike” behavior, from bulklike water viscosity to viscosity orders of magnitude higher. Here, we investigate how a homogeneous fluid behaves under nanoconfinement using its bulk response function: The Green's function of water extracted from a library of S(q,ω) inelastic x-ray scattering data is used to make femtosecond movies of nanoconfined water. Between two confining surfaces, the structure undergoes drastic changes as a function of surface separation. For surface separations of ≈9 Å, although the surface-associated hydration layers are highly deformed, they are separated by a layer of bulklike water. For separations of ≈6 Å, the two surface-associated hydration layers are forced to reconstruct into a single layer that modulates between localized “frozen’ and delocalized “melted” structures due to interference of density fields. These results potentially reconcile recent conflicting experiments. Importantly, we find a different delocalized wetting regime for nanoconfined water between surfaces with high spatial frequency charge densities, where water is organized into delocalized hydration layers instead of localized hydration shells, and are strongly resistant to `freezing' down to molecular distances (<6 Å)

Invasive Wild pigs as primary nest predators for Wild turkeys

Depredation of wild turkey (Meleagris gallopavo) nests is a leading cause of reduced recruitment for the recovering and iconic game species. invasive wild pigs (Sus scrofa) are known to depredate nests, and have been expanding throughout the distributed range of wild turkeys in north America. We sought to gain better insight on the magnitude of wild pigs depredating wild turkey nests. We constructed simulated wild turkey nests throughout the home ranges of 20 GPS-collared wild pigs to evaluate nest depredation relative to three periods within the nesting season (i.e., early, peak, and late) and two nest densities (moderate = 12.5-25 nests/km2, high = 25-50 nests/km2) in south-central Texas, USA during March–June 2016. Overall, the estimated probability of nest depredation by wild pigs was 0.3, equivalent to native species of nest predators in the study area (e.g., gray fox [Urocyon cinereoargenteus], raccoon [Procyon lotor], and coyote [Canis latrans]). female wild pigs exhibited a constant rate of depredation regardless of nesting period or density of nests. However, male wild pigs increased their rate of depredation in areas with higher nest densities. Management efforts should remove wild pigs to reduce nest failure in wild turkey populations especially where recruitment is low

Outstanding Educational Performance Awards: Highlighting High Achieving Arkansas Schools, 2010

So, in this Arkansas Education Report (AER) we aim to highlight excellent performance and give our congratulations. To that end, we are happy to highlight many high performing schools around the state in our now-annual AER entitled the Outstanding Educational Performance Awards

Constraints on the Intergalactic Transport of Cosmic Rays

Motivated by recent experimental proposals to search for extragalactic cosmic rays (including anti-matter from distant galaxies), we study particle propagation through the intergalactic medium (IGM). We first use estimates of the magnetic field strength between galaxies to constrain the mean free path for diffusion of particles through the IGM. We then develop a simple analytic model to describe the diffusion of cosmic rays. Given the current age of galaxies, our results indicate that, in reasonable models, a completely negligible number of particles can enter our Galaxy from distances greater than $\sim 100$ Mpc for relatively low energies ($E$ $< 10^6$ GeV/n). We also find that particle destruction in galaxies along the diffusion path produces an exponential suppression of the possible flux of extragalactic cosmic rays. Finally, we use gamma ray constraints to argue that the distance to any hypothetical domains of anti-matter must be roughly comparable to the horizon scale.Comment: 24 pages, AAS LaTex, 1 figure, accepted to Ap