Socioeconomic status and anxiety as predictors of antidepressant treatment response and suicidal ideation in older adults.

BACKGROUND: Separate reports from the maintenance treatment for late-life depression (MTLD) trials have shown that low socioeconomic status (SES) and anxiety symptoms at the time of treatment initiation predict lower levels of response to antidepressant treatment and higher levels of suicidal ideation in older adults. AIM: To determine whether SES and anxiety independently contribute to worse treatment outcomes, as indicated by persistence of depressive symptoms during treatment and the persistence of suicidal ideation. Consistent with prior evidence that sociodemographic factors and clinical history are both prognostic of depression treatment efficacy, we hypothesized that SES and pre-existing anxiety symptoms will both predict lower levels of response to treatment and higher levels of suicidal ideation. METHOD: Secondary analyses of data from the MTLD trials. RESULTS: Regression analyses which controlled for comorbid anxiety indicated that residents of middle- and high-income census tracts were more likely to respond to treatment (HR, 1.63; 95%CI, 1.08-2.46) and less likely to report suicidal ideation during treatment (OR, 0.51; 95%CI, 0.28-0.90) than residents of low income census tracts. The same regression models indicated that pre-existing anxiety symptoms were independently related to lower treatment response (HR, 0.73; 95%CI, 0.60-0.89) and higher risk of suicidal ideation (OR, 1.45; 95%CI, 0.98-2.14). CONCLUSION: These findings demonstrate the importance of treating anxiety symptoms during the course of treatment for late-life depression and, at the same time, addressing barriers to treatment response related to low SES

Association of the World War II Finnish Evacuation of Children With Psychiatric Hospitalization in the Next Generation

Importance Although there is evidence that adverse childhood experiences are associated with worse mental health in adulthood, scarce evidence is available regarding an emerging concern that the next generation might also be affected. Objective To compare the risk of psychiatric hospitalization in cousins whose parents were vs were not exposed to the Finnish evacuation policy that involved a mean 2-year stay with a Swedish foster family. Design, Setting, and Participants This multigenerational, population-based cohort study of Finnish individuals and their siblings born between January 1, 1933, and December 31, 1944, analyzed the association of evacuee status as a child during World War II in the first generation with the risk of psychiatric hospitalization among offspring in the second generation. Evacuee status during World War II was determined using the Finnish National Archive’s registry of participants in the Finnish evacuation. Data on evacuee status were linked to the psychiatric diagnoses in the Finnish Hospital Discharge Register from January 1, 1971, through December 31, 2012, for offspring (n = 93 391) born between January 1, 1950, and December 31, 2010. Sex-specific Cox proportional hazards regression models were used to estimate hazard ratios for risk of psychiatric hospitalization during the follow-up period. Because offspring of evacuees and their nonevacuated siblings are cousins, the Cox proportional hazards regression models included fixed effects to adjust for confounding factors in families. Data analysis was performed from June 15, 2016, to August 26, 2017. Exposures Parental participation in the evacuation during World War II (coded 1 for parents who were evacuated and placed in foster care and 0 for those not evacuated). Main Outcomes and Measures Offspring’s initial admission to the hospital for a psychiatric disorder, obtained from the Finnish Hospital Discharge Register from January 1, 1971, through December 31, 2012. Results Of the 93 391 study persons, 45 955 (49.2%) were women and 47 436 (50.8) were men; mean (SD) age in 2012 among survivors was 45.4 (6.58) years. Female offspring of mothers evacuated to Sweden during childhood had an elevated risk of psychiatric hospitalization (hazard ratio for any type of psychiatric disorder: 2.04 [95% CI, 1.04-4.01]; hazard ratio for mood disorder: 4.68 [95% CI, 1.92-11.42]). There was no excess risk of being hospitalized for a psychiatric disorder among women whose fathers were exposed to the Finnish evacuation policy during World War II or among men whose mothers or fathers were exposed. Conclusions and Relevance In a prior follow-up study of the Finnish evacuees, girls evacuated to Swedish foster families during World War II were more likely to be hospitalized for a psychiatric disorder—in particular, a mood disorder—in adulthood than their nonevacuated sisters. The present study found that the offspring of these individuals were also at risk for mental health problems that required hospitalization and suggests that early-life adversities, including war-related exposures, may be associated with mental health disorders that persist across generations.Peer reviewe

Erich Auerbach, Mimesis; la realidad en la literatura. Trad. de I. Villanueva y E. Ímaz. Fondo de Cultura Económica, México, 1950. 532 págs.

Se reseñó el libro: Mimesis; la realidad en la literatura. Trad. de I. Villanueva y E. Ímaz

Pedro Salinas, Jorge Manrique o tradición y originalidad, Editorial Sudamericana, Buenos Aires, 1947, 233 págs.

Se reseñó el libro: Jorge Manrique o tradición y originalida

Las referencias clásicas de "Doña Perfecta". Tema y estructura de la novela

En este número no se incluyeron resúmenes ni palabras clave

Long term mental health outcomes of Finnish children evacuated to Swedish families during the second world war and their non-evacuated siblings: cohort study

Objectives To compare the risks of admission to hospital for any type of psychiatric disorder and for four specific psychiatric disorders among adults who as children were evacuated to Swedish foster families during the second world war and their non-evacuated siblings, and to evaluate whether these risks differ between the sexes. Design Cohort study. Setting National child evacuation scheme in Finland during the second world war. Participants Children born in Finland between 1933 and 1944 who were later included in a 10% sample of the 1950 Finnish census ascertained in 1997 (n=45 463; women: n=22 021; men: n=23 442). Evacuees in the sample were identified from war time government records. Main outcome measure Adults admitted to hospital for psychiatric disorders recorded between 1971 and 2011 in the Finnish hospital discharge register. Methods We used Cox proportional hazards models to estimate the association between evacuation to temporary foster care in Sweden during the second world war and admission to hospital for a psychiatric disorder between ages 38 and 78 years. Fixed effects methods were employed to control for all unobserved social and genetic characteristics shared among siblings. Results Among men and women combined, the risk of admission to hospital for a psychiatric disorder did not differ between Finnish adults evacuated to Swedish foster families and their non-evacuated siblings (hazard ratio 0.89, 95% confidence interval 0.64 to 1.26). Evidence suggested a lower risk of admission for any mental disorder (0.67, 0.44 to 1.03) among evacuated men, whereas for women there was no association between evacuation and the overall risk of admission for a psychiatric disorder (1.21, 0.80 to 1.83). When admissions for individual psychiatric disorders were analyzed, evacuated girls were significantly more likely than their non-evacuated sisters to be admitted to hospital for a mood disorder as an adult (2.19, 1.10 to 4.33). Conclusions The Finnish evacuation policy was not associated with an increased overall risk of admission to hospital for a psychiatric disorder in adulthood among former evacuees. In fact, evacuation was associated with a marginally reduced risk of admission for any psychiatric disorder among men. Among women who had been evacuated, however, the risk of being admitted to hospital for a mood disorder was increased.Peer reviewe

Magnetorheological fluid dynamics for high speed energy absorbers

Fluids with a controllable yield stress allow rapid variations in viscous force in response to an externally applied field. These fluids are used in adaptive energy dissipating devices, which have a controllable force response, reducing shock and vibration loads on occupants and structures. This thesis investigates the physics of these fluids at high speeds and shear rates, through particle modeling and fluid dynamics. The focus is on the experimentally observed reduction in controllable force at high speeds seen in magnetorheological (MR) fluid, a suspension of magnetizable particles that develop a yield stress when a magnetic field is applied. After ruling out particle dynamic effects, this dissertation takes the first rigorous look at the fluid dynamics of a controllable yield stress fluid entering an active region. A simplified model of the flow is developed and, using computational fluid dynamics to inform a control volume analysis, we show that the reduction in high speed controllable force is caused by fluid dynamics. The control volume analysis provides a rigorous criteria for the onset of high speed force effects, based purely on nondimensional fluid quantities. Fits for pressure loss in the simplified flow are constructed, allowing yield force prediction in arbitrary flow mode geometries. The fits are experimentally validated by accurately predicting yield force in all of the known high speed devices. These results should enable the design of a next generation of high performance adaptive energy absorbers

1864-10-24 Stephen Gilman requests to transfer his wounded son Walter from Portsmouth Grove, Lovell General Hospital

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