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

Cotunneling Transport and Quantum Phase Transitions in Coupled Josephson-Junction Chains with Charge Frustration

We investigate the quantum phase transitions in two capacitively coupled chains of ultra-small Josephson-junctions, with emphasis on the external charge effects. The particle-hole symmetry of the system is broken by the gate voltage applied to each superconducting island, and the resulting induced charge introduces frustration to the system. Near the maximal-frustration line, where the system is transformed into a spin-1/2 Heisenberg antiferromagnetic chain, cotunneling of the particles along the two chains is shown to play a major role in the transport and to drive a quantum phase transition out of the charge-density wave insulator, as the Josephson-coupling energy is increased. We also argue briefly that slightly off the symmetry line, the universality class of the transition remains the same as that right on the line, still being driven by the particle-hole pairs.Comment: Final version accepted to Phys. Rev. Lett. (Longer version is available from http://ctp.snu.ac.kr/~choims/

Processing of carbon-fiber-reinforced Zr41.2Ti13.8Cu12.5Ni10.0Be22.5 bulk metallic glass composites

Carbon-fiber-reinforced bulk metallic glass composites are produced by infiltrating liquid Zr41.2Ti13.8Cu12.5Ni10.0Be22.5 into carbon fiber bundles with diameter of the individual fiber of 5 mum. Reactive wetting occurs by the formation of a ZrC layer around the fibers. This results in a composite with a homogeneous fiber distribution. The volume fraction of the fibers is about 50% and the density of the composite amounts to 4.0 g/cm(^3)

Anomalous Transmission Phase of a Kondo-Correlated Quantum Dot

We study phase evolution of transmission through a quantum dot with Kondo correlations. By considering a model that includes nonresonant transmission as well as the Anderson impurity, we explain unusually large phase evolution of about $\pi$ in the Kondo valley observed in recent experiments. We argue that this anomalous phase evolution is a universal property that can be found in the high-temperature Kondo phase in the presence of the time-reversal symmetry.Comment: 5 pages, 3 figure

Self-tuned quantum dot gain in photonic crystal lasers

We demonstrate that very few (1 to 3) quantum dots as a gain medium are sufficient to realize a photonic crystal laser based on a high-quality nanocavity. Photon correlation measurements show a transition from a thermal to a coherent light state proving that lasing action occurs at ultra-low thresholds. Observation of lasing is unexpected since the cavity mode is in general not resonant with the discrete quantum dot states and emission at those frequencies is suppressed. In this situation, the quasi-continuous quantum dot states become crucial since they provide an energy-transfer channel into the lasing mode, effectively leading to a self-tuned resonance for the gain medium.Comment: 4 pages, 4 figures, submitted to Phys. Re

Vibrations of amorphous, nanometric structures: When does continuum theory apply?

Structures involving solid particles of nanometric dimensions play an increasingly important role in material sciences. These structures are often characterized through the vibrational properties of their constituent particles, which can be probed by spectroscopic methods. Interpretation of such experimental data requires an extension of continuum elasticity theory down to increasingly small scales. Using numerical simulation and exact diagonalization for simple models, we show that continuum elasticity, applied to disordered system, actually breaks down below a length scale of typically 30 to 50 molecular sizes. This length scale is likely related to the one which is generally invoked to explain the peculiar vibrational properties of glassy systems.Comment: 4 pages, 5 figures, LATEX, Europhysics Letters accepte

The Effect of Providing Peer Information on Retirement Savings Decisions

We conducted a field experiment in a 401(k) plan to measure the effect of disseminating information about peer behavior on savings. Low-saving employees received simplified plan enrollment or contribution increase forms. A randomized subset of forms stated the fraction of age-matched coworkers participating in the plan or age-matched participants contributing at least 6% of pay to the plan. We document an oppositional reaction: the presence of peer information decreased the savings of non-participants who were ineligible for 401(k) automatic enrollment, and higher observed peer savings rates also decreased savings. Discouragement from upward social comparisons seems to drive this reaction.

77^{77}Se and 63^{63}Cu NMR studies of the electronic correlations in Cux_xTiSe2_2 (x=0.05,0.07x=0.05, 0.07)

We report $^{77}$Se and $^{63}$Cu nuclear magnetic resonance (NMR) investigation on the charge-density-wave (CDW) superconductor Cu$_x$TiSe$_2$ ($x=0.05$ and 0.07). At high magnetic fields where superconductivity is suppressed, the temperature dependence of $^{77}$Se and $^{63}$Cu spin-lattice relaxation rates 1/T_{1}$follow a linear relation. The slope of$^{77}1/T_{1}$ vs \emph{T} increases with the Cu doping. This can be described by a modified Korringa relation which suggests the significance of electronic correlations and the Se 4\emph{p}- and Ti 3\emph{d}-band contribution to the density of states at the Fermi level in the studied compounds.Comment: Revised manuscript. Submitted to Journal of Physics: Condensed Matte