Prevention of major depression in complex medically ill patients: preliminary results from a randomized, controlled trial

Background: Depression is highly prevalent in patients with physical illness and is associated with a diminished quality of life and poorer medical outcomes. Objective: The authors evaluated whether a multifaceted intervention conducted by a psychiatric consultation-liaison nurse could reduce the incidence of major depression in rheumatology inpatients and diabetes outpatients with a high level of case complexity. Method: Of 247 randomized patients, the authors identified 100 patients with a high level of case complexity at baseline and without major depression (65 rheumatology and 35 diabetes patients). Patients were randomized to usual care (N = 53) or to a nurse-led intervention (N = 47). Main outcomes were the incidence of major depression and severity of depressive symptoms during a 1-year follow-up, based on quarterly assessments with standardized psychiatric interviews. Results: The incidence of major depression was 63% in usual-care patients and 36% in the intervention group. Effects of intervention on depressive symptoms were observed in outpatients with diabetes but not in rheumatology inpatients. Conclusion: These preliminary results based on subgroup analysis suggest that a multifaceted nurse-led intervention may prevent the occurrence of major depression in complex medically ill patients and reduce depressive symptoms in diabetes outpatients. (Psychosomatics 2009; 50: 227-233)

Project Selection Directed By Intellectual Capital Scorecards

Management of intellectual capital is an important issue in knowledgeintensive organizations. Part of this is the composition of theoptimal project portfolio the organization will carry out in thefuture. Standard methods that guide this process mostly focus onproject selection on the basis of expected returns. However, in manycases other strategic factors should be considered in theirinterdependence such as customer satisfaction, reputation, anddevelopment of core competences.In this paper we present a tool for the selection of a projectportfolio, explicitly taking into account the balancing of thesestrategic factors. The point of departure is the intellectual capitalscorecard in which the indicators are periodically measured against atarget; the scores constitute the input of a programming model. Fromthe optimal portfolio computed, objectives for management can bederived. The method is illustrated in the case of R&D departments.knowledge management;intellectual assets;knowledge capitalization;optimal portfolio

Crystallographic and magnetic structure of RbCoCl3 · 2 D2O

The crystallographic and magnetic structure of RbCoCl3 · 2 D2O were determined mainly by means of neutron diffraction measurements. Below TN = 2.79 K the magnetic moments are ordered in a canted antiferromagnetic pattern. A meta-magnetic phase transition is observed at unusually small field values (H = 18 Oe at T = 2 K)

Searching the critical soil organic carbon threshold for satisfactory tilth conditions – test of the Dexter clay:carbon hypothesis

The concern for deteriorating soil structure at low soil organic matter (SOM) contents calls for better knowledge of SOM interaction with soil minerals as well as guidelines for soil conservation. We measured clay dispersibility in a field with a textural gradient. Our results support the concept of differentiating soil content of clay in a complexed and non-complexed part although our data did not point out an exact clay/OC ratio threshold. Our results also indicated that labile fractions of SOM may play an important role in soil physical behavior. We revisited literature data and found evidence that soil content of fines (<2 or <20 μm) is a major determinant of soil specific surface area (SA). We noted that soil SA coverage with SOM changed dramatically at a specific ratio of either clay (<2 μm) or clay+silt (<20 μm) with soil OC. This is an indirect support of the recently suggested quantification of the soil mineral ‘saturation’ hypothesis. More studies are needed on the causal relationships. We conclude that clay/OC~10 or (clay+silt20μm)/OC~20 are corresponding indices reflecting shift in soil physical behavior

How to Eat a Cake Without Having It: An Evaluation of the IFIP Working Group 8.1 Report on Information Systems Methodologies

This paper reviews some aspects of Olle et al. [1988]. After an analysis of the terms "method" and "methodology", it is concluded that the book is an exercise in information system (IS) development methodology. We then argue that the aim of the book, the provision of a framework which should help in understanding existing IS development methods, is only partly reached, and that much work towards this goal is still to be done. Finally, we indicate some of the improvements which can be made to the text with respect to the presentation of the material as well as to the attainment of the goal

Complementation of mutant phenotypes and genotypes of cultured mammalian cells

This dissertation describes experiments aimed at the complementation of a genetic mutation in cultured mammalian cells in order to investigate several aspects of the structure and functioning of the human genome. Complementation is indicated by the correction of a biochemical function in which the mutant eel ls are deficient. Where appropriate in this text, a synonymous use of the terms 1 complementation 1 and 1correction 1 is made. Complementation at the level of the cellular phenotype was studied as well as complementation at the level of the cellular genotype. The phenotype of a cultured mammal ian cell can be changed by the introduction of protein molecules which are not normally produced by that cell or messenger RNA molecules which direct the intracellular synthesis of such molecules. Since both protein and RNA molecules are not self perpetuating, a transient change in cell phenotype is usually observed. We have used phenotypic correction to investigate proteins for their ability to correct the deficiency in DNA repair displayed by human excision deficient xeroderma pigmentosum (XP) cells. For this purpose we developed an assay procedure in which prokaryotic DNA repair enzymes of known specificity were introduced into 1 iving XP cells by microinjection (Ml) via glass microneedles and the complementation to a repair proficient phenotype was investigated (Appendix paper 1). In addition, extracts of repair proficient human cells were assayed for activities that are able to complement the deficiency in XP cells. Appendix paper II describes the identification of a protein factor which specifically corrects the deficiency in one class of XP cells but not in others. These papers demonstrate the use of the living cell as part of a microinjection assay system to investigate the biological activity of proteins. The genotype of a cultured mammalian cell can be supplemented by the introduction of genetic material (gene transfer). For DNA-mediated gene transfer (DMGT) using genomic DNA and chromosome-mediated gene transfer (CMGT) using metaphase chromosomes isolated from eukaryotic cells, the genetic material is usually administered as a co-precipitate with calcium phosphate. For DMGT via viral or plasmid DNA molecules, Ml has also been found useful. Gene transfer can be detected as a transient or a more or less permanent change in cell phenotype if the genetic material is expressed correctly. The transfer and continued expression of genes generally occurs at such a low frequency that it is necessary to use marker genes which confer viability on complemented cells in selective culture conditions. Although transient genotypic complementation has been studied occasionally, the more permanent mode of correction has been investigated extensively and used in a number of eel genetic studies. We have used the genotypic complementation of cultured mammalian cells to compare the DMGT and CMGT processes. In addition, two aspects of the structure and expression of the human genome were investigated. Firstly, a contribution was made to the mapping of genes to human chromosomes by the regional localization of the human gene for acid alpha glucosidase (a lysosomal enzyme) on human chromosome 17, as deduced from the pattern of co-transfer with syntenic genes (Appendix paper I I I). Secondly, the nature of X-chromosome inactivation was investigated in OMGT experiments. It is demonstrated in Appendix paper IV that DNA isolated from inactive human X-chromosomes can be expressed efficiently after gene transfer. Various aspects and appiications of Ml, OMGT and CMGT, including the experimental work, wi 11 be discussed in chapters I I and I l I of this dissertation. For such a discussion, a distinction can conveniently be made between the donor cell providing the material transferred, the recipient cell which receives the donor material and -in the case of gene transferthe resulting transformant cell containing the recipient cell genome plus a variable amount of donor genetic material (usually referred to as the transgenome). Part of this text has appeared in a review of chromosome and DNA-mediated gene transfer (de Jonge and Bootsma, 1984)