Shared geriatric mental health care in a rural community

Introduction: A pilot project in shared mental health care was initiated to explore opportunities to increase the capacity of the rural primary care system as a resource for older people with mental health needs. This was done within a framework for the delivery of best practices in geriatric mental health outreach. Methods: Shared-care strategies combining education and clinical consultation between mentor psychiatrists and family physicians were implemented and then evaluated after one year to identify key factors in the success of approaches to shared mental health care for older people in a rural setting. Results: Results provided new insights into shared care between primary care and specialty geriatric mental health services, rural geriatric mental health service delivery, developmental phases in service learning approaches, and building knowledge networks to promote continuing best practices. Conclusion: The results from the project's process evaluation have been integrated into the development of a permanent shared geriatric mental health care service for the rural setting. Preparation for an outcome evaluation that will focus on the impact on patient care has also been initiated

Transcriptomic Characterization of the Human Habenula Highlights Drug Metabolism and the Neuroimmune System

Due to size and accessibility, most information about the habenula is derived from rodent studies. To better understand the molecular signature of the habenula we characterized the genes that have high expression in the habenula. We compared anatomical expression profiles of three normal adult human brains and four fetal brains. We used gene set enrichment analyses to determine if genes annotated to specific molecular functions, cellular components, and biological processes are enriched in the habenula. We also tested gene sets related to depression and addiction to determine if they uniquely involve the habenula. As expected, we observed high habenular expression of GPR151, nicotinic cholinergic receptors, and cilia-associated genes (medial division). Genes identified in genetic studies of smoking and associated with nicotine response were enriched in the habenula. Genes associated with major depressive disorder did not have enriched expression in the habenula but genes negatively correlated with hedonic well-being were, providing a link to anhedonia. We observed enrichment of genes associated with diseases that are comorbid with addictions (hematopoiesis, thrombosis, liver cirrhosis, pneumonia, and pulmonary fibrosis) and depression (rheumatoid arthritis, multiple sclerosis, and kidney disease). These inflammatory diseases mark a neuroimmune signature that is supported by genes associated with mast cells, acute inflammatory response, and leukocyte migration. We also found enrichment of cytochrome p450 genes suggesting the habenula is uniquely sensitive to endogenous and xenobiotic compounds. Our results suggest the habenula receives negative reward signals from immune and drug processing molecules. This is consistent with the habenular role in the “anti-reward” system and suggests it may be a key bridge between autoimmune disorders, drug use, and psychiatric diseases

Leishmaniose en Equateur : 5. Leishmaniose et anthropisation sur la façade pacifique

On a étudié l'impact de l'anthropisation du milieu forestier sur l'incidence de la leishmaniose, due à #Leishmania panamensis, dans trois stations côtières de l'Equateur, Corriente Grande, en forêt primaire, Paraiso Escondido et La Tablada, en forêt secondarisée; on a considéré aussi la situation des maisons isolées en milieu déforesté dans les deux dernières stations. En parallèle, on a étudié la densité des espèces de phlébotomes anthropophiles, particulièrement #Lutzomyia trapidoi, dans le milieu domestique et les caféières adjacentes, ainsi qu'en sous-bois. L'incidence de la leishmaniose était quasiment nulle en forêt primaire, alors qu'elle oscillait entre 106 et 147 °/oo en forêt plus ou moins dégradée. A Corriente Grande, aucun #Lu. trapidoi$n'était récolté dans les maisons; en sous-bois ses récoltes atteignaient 8$ représentait plus de 83 % des captures en sous-bois et dans les caféières (41 Homme/heure), ainsi que dans les maisons (10,6 H/h). A La Tablada, en milieu domestique, #Lu. gomezi était l'espèce dominante : 2,8 H/h contre 1 H/h #Lu. trapidoi, dans les caféières et en sous-bois #Lu. trapidoi était l'espèce dominante, 21 H/h et 14 H/h. En forêt primaire très humide, la transmission peut être très faible. En milieu secondarisé, les caféières proches des habitations procurent un excellent biotope aux populations de #Lu. trapidoi; le cycle de #L. panamensis s'est adapté à cette situation écologique en se rapprochant des maisons, les réservoirs circulant dans les caféières. En milieu déforesté, on ne constate plus de nuisances de phlébotomes et plus de transmission de leishmaniose. (Résumé d'auteur

Coulomb drag between two spin incoherent Luttinger liquids

In a one dimensional electron gas at low enough density, the magnetic (spin) exchange energy $J$ between neighboring electrons is exponentially suppressed relative to the characteristic charge energy, the Fermi energy $E_F$. At non-zero temperature $T$, the energy hierarchy $J \ll T \ll E_F$ can be reached, and we refer to this as the spin incoherent Lutinger liquid state. We discuss the Coulomb drag between two parallel quantum wires in the spin incoherent regime, as well as the crossover to this state from the low temperature regime by using a model of a fluctuating Wigner solid. As the temperature increases from zero to above $J$ for a fixed electron density, the $2k_F$ oscillations in the density-density correlations are lost. As a result, the temperature dependence of the Coulomb drag is dramatically altered and non-monotonic dependence may result. Drag between wires of equal and unequal density are discussed, as well as the effects of weak disorder in the wires. We speculate that weak disorder may play an important role in extracting information about quantum wires in real drag experiments.Comment: 19 pages, 10 figure