Aspirin for the older person: report of a meeting at the Royal Society of Medicine, London, 3rd November 2011

On November 23rd 2011, the Aspirin Foundation held a meeting at the Royal Society of Medicine in London to review current thinking on the potential role of aspirin in preventing cardiovascular disease and reducing the risk of cancer in older people. The meeting was supported by Bayer Pharma AG and Novacyl

Exact diagonalization of the S=1/2 Heisenberg antiferromagnet on finite bcc lattices to estimate properties on the infinite lattice

Here we generate finite bipartite body-centred cubic lattices up to 32 vertices. We have studied the spin one half Heisenberg antiferromagnet by diagonalizing its Hamiltonian on each of the finite lattices and hence computing its ground state properties. By extrapolation of these data we obtain estimates of the T = 0 properties on the infinite bcc lattice. Our estimate of the T = 0 energy agrees to five parts in ten thousand with third order spin wave and series expansion method estimates, while our estimate of the staggered magnetization agrees with the spin wave estimate to within a quarter of one percent.Comment: 16 pages, LaTeX, 1 ps figure, to appear in J.Phys.

Spin-1/2 J1-J2 model on the body-centered cubic lattice

Using exact diagonalization (ED) and linear spin wave theory (LSWT) we study the influence of frustration and quantum fluctuations on the magnetic ordering in the ground state of the spin-1/2 J1-J2 Heisenberg antiferromagnet (J1-J2 model) on the body-centered cubic (bcc) lattice. Contrary to the J1-J2 model on the square lattice, we find for the bcc lattice that frustration and quantum fluctuations do not lead to a quantum disordered phase for strong frustration. The results of both approaches (ED, LSWT) suggest a first order transition at J2/J1 $\approx$ 0.7 from the two-sublattice Neel phase at low J2 to a collinear phase at large J2.Comment: 6.1 pages 7 figure

A study of the diagnostic accuracy of the PHQ-9 in primary care elderly

<p>Abstract</p> <p>Background</p> <p>The diagnostic accuracy of the Patient Health Questionnaire-9 (PHQ-9) for assessment of depression in elderly persons in primary care settings in the United States has not been previously addressed. Thus, the purpose of this study was to evaluate the test performance of the PHQ-9 for detecting major and minor depression in elderly patients in primary care.</p> <p>Methods</p> <p>A prospective study of diagnostic accuracy was conducted in two primary care, university-based clinics in the Pacific Northwest of the United States. Seventy-one patients aged 65 years or older participated; all completed the PHQ-9 and the 15-item Geriatric Depression Scale (GDS) and underwent the Structured Clinical Interview for Depression (SCID). Sensitivity, specificity, area under the receiver operating characteristic (ROC) curve, and likelihood ratios (LRs) were calculated for the PHQ-9, the PHQ-2, and the 15-item GDS for major depression alone and the combination of major plus minor depression.</p> <p>Results</p> <p>Two thirds of participants were female, with a mean age of 78 and two chronic health conditions. Twelve percent met SCID criteria for major depression and 13% minor depression. The PHQ-9 had an area under the curve (AUC) of 0.87 (95% confidence interval [CI], 0.74-1.00) for major depression, while the PHQ-2 and the 15-item GDS each had an AUC of 0.81 (95% CI for PHQ-2, 0.64-0.98, and for 15-item GDS, 0.70-0.91; <it>P </it>= 0.551). For major and minor depression combined, the AUC for the PHQ-9 was 0.85 (95% CI, 0.73-0.96), for the PHQ-2, 0.80 (95% CI, 0.68-0.93), and for the 15-item GDS, 0.71 (95% CI, 0.55-0.87; <it>P </it>= 0.187).</p> <p>Conclusions</p> <p>Based on AUC values, the PHQ-9 performs comparably to the PHQ-2 and the 15-item GDS in identifying depression among primary care elderly.</p

Multiple barriers against successful care provision for depressed patients in general internal medicine in a Japanese rural hospital: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>A general internist has an important role in primary care, especially for the elderly in rural areas of Japan. Although effective intervention models for depressed patients in general practice and primary care settings have been developed in the US and UK medical systems, there is little information regarding even the recognition rate and prescription rate of psychotropic medication by general internists in Japan. The present study surveyed these data cross-sectionally in a general internal medicine outpatient clinic of a Japanese rural hospital.</p> <p>Methods</p> <p>Patients were consecutively recruited and evaluated for major depressive disorder or any mood disorder using the Patient Health Questionnaire (PHQ). Physicians who were blinded to the results of the PHQ were asked to diagnose whether the patients had any mental disorders, and if so, whether they had mood disorders or not. Data regarding prescription of psychotropic medicines were collected from medical records.</p> <p>Results</p> <p>Among 312 patients, 27 (8.7%) and 52 (16.7%) were identified with major depressive disorder and any mood disorder using the PHQ, respectively. Among those with major depressive disorder, 21 (77.8%) were recognized by physicians as having a mental disorder, but only three (11.1%) were diagnosed as having a mood disorder.</p> <p>Only two patients with major depressive disorder (7.4%) had been prescribed antidepressants. Even among those (n = 15) whom physicians diagnosed with a mood disorder irrespective of the PHQ results, only four (26.7%) were prescribed an antidepressant.</p> <p>Conclusions</p> <p>Despite a high prevalence of depression, physicians did not often recognize depression in patients. In addition, most patients who were diagnosed by physicians as having a mood disorder were not prescribed antidepressants. Multiple barriers to providing appropriate care for depressed patients exist, such as recognizing depression, prescribing appropriate medications, and appropriately referring patients to mental health specialists.</p

Bright green light treatment of depression for older adults [ISRCTN69400161]

BACKGROUND: Bright white light has been successfully used for the treatment of depression. There is interest in identifying which spectral colors of light are the most efficient in the treatment of depression. It is theorized that green light could decrease the intensity duration of exposure needed. Late Wake Treatment (LWT), sleep deprivation for the last half of one night, is associated with rapid mood improvement which has been sustained by light treatment. Because spectral responsiveness may differ by age, we examined whether green light would provide efficient antidepressant treatment in an elder age group. METHODS: We contrasted one hour of bright green light (1,200 Lux) and one hour of dim red light placebo (<10 Lux) in a randomized treatment trial with depressed elders. Participants were observed in their homes with mood scales, wrist actigraphy and light monitoring. On the day prior to beginning treatment, the participants self-administered LWT. RESULTS: The protocol was completed by 33 subjects who were 59 to 80 years old. Mood improved on average 23% for all subjects, but there were no significant statistical differences between treatment and placebo groups. There were negligible adverse reactions to the bright green light, which was well tolerated. CONCLUSION: Bright green light was not shown to have an antidepressant effect in the age group of this study, but a larger trial with brighter green light might be of value

Structure and lithium transport pathways in Li₂FeSiO₄ cathodes for lithium batteries

The importance of exploring new low-cost and safe cathodes for large-scale lithium batteries has led to increasing interest in Li(2)FeSiO(4). The structure of Li(2)FeSiO(4) undergoes significant change on cycling, from the as-prepared γ(s) form to an inverse β(II) polymorph; therefore it is important to establish the structure of the cycled material. In γ(s) half the LiO(4), FeO(4), and SiO(4) tetrahedra point in opposite directions in an ordered manner and exhibit extensive edge sharing. Transformation to the inverse β(II) polymorph on cycling involves inversion of half the SiO(4), FeO(4), and LiO(4) tetrahedra, such that they all now point in the same direction, eliminating edge sharing between cation sites and flattening the oxygen layers. As a result of the structural changes, Li(+) transport paths and corresponding Li-Li separations in the cycled structure are quite different from the as-prepared material, as revealed here by computer modeling, and involve distinct zigzag paths between both Li sites and through intervening unoccupied octahedral sites that share faces with the LiO(4) tetrahedra