Effectiveness of a brief lifestyle intervention targeting mental health staff: analysis of physical fitness and activity in the Keeping Our Staff in Mind study.

BackgroundPeople with mental illness die on average 15 years less than the general population, primarily to cardiometabolic disease. Lifestyle interventions are effective in reducing cardiometabolic risk but are not routinely provided to mental health consumers. Lifestyle interventions targeting mental health staff may be beneficial in changing culture surrounding physical health and subsequently improving consumer outcomes. This study examines exercise and fitness outcomes of a targeted lifestyle intervention directed at Australian mental health staff.MethodsA pragmatic single-arm intervention study was conducted within an Australian public mental health service. Mental health staff were provided a five-session individualised lifestyle intervention (incorporating exercise and nutritional counselling) over 5 weeks. Two waves of the programme were delivered between 2015 and 2016. This paper examines the exercise and fitness outcomes of the second wave of the study. Participants were assessed at baseline and at a 16-week follow-up. The primary exercise outcome was a measurement of cardiorespiratory fitness. Secondary outcomes included self-reported physical activity and a measurement of handgrip strength.ResultsA total of 106 staff participated in this component of the study. Cardiorespiratory fitness increased significantly from baseline to follow-up (pConclusionLifestyle interventions incorporating exercise counselling may improve the physical health of mental health staff. Such strategies may be effective in improving culture surrounding physical health and/or increasing the effectiveness of lifestyle interventions targeting mental health consumers

Short- and intermediate-term survival after extracorporeal membrane oxygenation in children with cardiac disease

ObjectivesIn children with cardiac disease, common indications for extracorporeal membrane oxygenation (ECMO) include refractory cardiopulmonary resuscitation (E-CPR), failure to separate from cardiopulmonary bypass (OR-ECMO), and low cardiac output syndrome (LCOS-ECMO). Despite established acceptance, ECMO outcomes are suboptimal with a survival between 38% and 55%. We evaluated factors associated with significantly increased survival in cardiac patients requiring ECMO.MethodsWe conducted a retrospective investigation of consecutive patients undergoing ECMO between 2006 and 2010. Demographic, pre-ECMO, ECMO, and post-ECMO parameters were analyzed. Neurologic outcomes were assessed with the pediatric overall performance category scale at the latest follow-up.ResultsThere were 3524 admissions, 95 (3%) of which necessitated ECMO; 40 (42%) E-CPR, 31 (33%) OR-ECMO, and 24 (25%) LCOS-ECMO. The overall hospital survival was 73%. The within-groups hospital survival was 75% in E-CPR, 77% OR-ECMO and 62% LCOS-ECMO. In the multivariable logistic regression analysis, chromosomal anomalies (odds ratio [OR], 8; 95% confidence interval [CI], 2-35), single ventricle (OR ,6; 95% CI, 3-33), multiple ECMO runs (OR, 15; 95% CI, 4-42), higher 24-hour ECMO flows (OR, 8; 95% CI, 4-22), decreased lung compliance (OR, 5; 95% CI, 2-16), and need for plasma exchange (OR, 5; 95% CI, 3-18) were all significant factors associated with mortality. From the univariate analysis, a common parameter associated with mortality within all groups was intracranial hemorrhage. At 1.9 years (0.9, 2.9) of follow-up, 66% were still alive, and 89% of survivors had normal function or only mild neurodevelopmental disability.ConclusionsECMO was successfully used in children with cardiac disease with 73% and 66% short- and intermediate-term survival, respectively. The majority of the survivors had normal function or only a minimal neurodevelopmental deficit

Th Ages for Metal-Poor Stars

With a sample of 22 metal-poor stars, we demonstrate that the heavy element abundance pattern (Z > 55) is the same as the r-process contributions to the solar nebula. This bolsters the results of previous studies that there is a universal r-process production pattern. We use the abundance of thorium in five metal-poor stars, along with an estimate of the initial Th abundance based on the abundances of stable r-process elements, to measure their ages. We have four field red giants with errors of 4.2 Gyr in their ages and one M92 giant with an error of 5.6 Gyr, based on considering the sources of observational error only. We obtain an average age of 11.4 Gyr, which depends critically on the assumption of an initial production ratio of Th/Eu of 0.496. If the Universe is 15 Gyr old, then the initial Th/Eu value should be 0.590, in agreement with some theoretical models of the r-process.Comment: 26 pages, to be published in Ap

Origin and function of short-latency inputs to the neural substrates underlying the acoustic startle reflex

The acoustic startle reflex (ASR) is a survival mechanism of alarm, which rapidly alerts the organism to a sudden loud auditory stimulus. In rats, the primary ASR circuit encompasses three serially connected structures: cochlear root neurons (CRNs), neurons in the caudal pontine reticular nucleus (PnC), and motoneurons in the medulla and spinal cord. It is well-established that both CRNs and PnC neurons receive short-latency auditory inputs to mediate the ASR. Here, we investigated the anatomical origin and functional role of these inputs using a multidisciplinary approach that combines morphological, electrophysiological and behavioral techniques. Anterograde tracer injections into the cochlea suggest that CRNs somata and dendrites receive inputs depending, respectively, on their basal or apical cochlear origin. Confocal colocalization experiments demonstrated that these cochlear inputs are immunopositive for the vesicular glutamate transporter 1 (VGLUT1). Using extracellular recordings in vivofollowed by subsequent tracer injections, we investigated the response of PnC neurons after contra-, ipsi-, and bilateral acoustic stimulation and identified the source of their auditory afferents. Our results showed that the binaural firing rate of PnC neurons was higher than the monaural, exhibiting higher spike discharges with contralateral than ipsilateral acoustic stimulations. Our histological analysis confirmed the CRNs as the principal source of short-latency acoustic inputs, and indicated that other areas of the cochlear nucleus complex are not likely to innervate PnC. Behaviorally, we observed a strong reduction of ASR amplitude in monaural earplugged rats that corresponds with the binaural summation process shown in our electrophysiological findings. Our study contributes to understand better the role of neuronal mechanisms in auditory alerting behaviors and provides strong evidence that the CRNs-PnC pathway mediates fast neurotransmission and binaural summation of the ASR. © 2014 Gómez-Nieto, Horta-Júnior, Castellano, Millian-Morell, Rubio and López

Overall evaluation of Skylab imagery for mapping of Latin America

The author has identified the following significant results. Skylab imagery is both desired and needed by the Latin American catographic agencies. The imagery is cost beneficial for the production of new mapping and maintenance of existing maps at national topographic series scales. If this information was available on a near time routine coverage basis, it would provide an excellent additional data base to the Latin American cartographic community, specifically Argentina, Bolivia, Chile, Colombia, Dominican Republic, Guatemala, Paraguay, and Venezuela

A Novel Restorative Pulmonary Valve Conduit : early Outcomes of Two Clinical Trials

Objectives: We report the first use of a biorestorative valved conduit (Xeltis pulmonary valve-XPV) in children. Based on early follow-up data the valve design was modified; we report on the comparative performance of the two designs at 12 months post-implantation. Methods: Twelve children (six male) median age 5 (2 to 12) years and weight 17 (10 to 43) kg, had implantation of the first XPV valve design (XPV-1, group 1; 16 mm (n = 5), and 18mm (n = 7). All had had previous surgery. Based on XPV performance at 12 months, the leaflet design was modified and an additional six children (five male) with complex malformations, median age 5 (3 to 9) years, and weight 21 (14 to 29) kg underwent implantation of the new XPV (XPV-2, group 2; 18 mm in all). For both subgroups, the 12 month clinical and echocardiographic outcomes were compared. Results: All patients in both groups have completed 12 months of follow-up. All are in NYHA functional class I. Seventeen of the 18 conduits have shown no evidence of progressive stenosis, dilation or aneurysm formation. Residual gradients of >40 mm Hg were observed in three patients in group 1 due to kinking of the conduit (n = 1), and peripheral stenosis of the branch pulmonary arteries (n = 2). In group 2, one patient developed rapidly progressive stenosis of the proximal conduit anastomosis, requiring conduit replacement. Five patients in group 1 developed severe pulmonary valve regurgitation (PI) due to prolapse of valve leaflet. In contrast, only one patient in group 2 developed more than mild PI at 12 months, which was not related to leaflet prolapse. Conclusions: The XPV, a biorestorative valved conduit, demonstrated promising early clinical outcomes in humans with 17 of 18 patients being free of reintervention at 1 year. Early onset PI seen in the XPV-1 version seems to have been corrected in the XPV-2, which has led to the approval of an FDA clinical trial

The Age of the Galactic Disk

I review different methods devised to derive the age of the Galactic Disk, namely the Radio-active Decay (RD), the Cool White Dwarf Luminosity Function (CWDLF), old opne clusters (OOC) and the Color Magnitude Diagram (CMD) of the stars in the solar vicinity. I argue that the disk is likely to be 8-10 Gyr old. Since the bulk of globulars has an age around 13 Gyr, the possibility emerges that the Galaxy experienced a minimum of Star Formation at the end of the halo/bulge formation. This minimum might reflect the time at which the Galaxy started to acquire material to form the disk inside-out.Comment: 10 pages, 4 figure, invited review, in "The chemical evolution of the Milky Way : Stars vs Clusters, Vulcano (Italy), 20-24 September 199

The r-Process Enriched Low Metallicity Giant HD 115444

New high resolution, very high signal-to-noise spectra of ultra-metal-poor (UMP) giant stars HD 115444 and HD 122563 have been gathered with the High-Resolution Echelle Spectrometer of the McDonald Observatory 2.7m Telescope. With these spectra, line identification and model atmosphere analyses have been conducted, emphasizing the neutron-capture elements. Twenty elements with Z > 30 have been identified in the spectrum of HD 115444. This star is known to have overabundances of the neutron-capture elements, but it has lacked a detailed analysis necessary to compare with nucleosynthesis predictions. The new study features a line-by-line differential abundance comparison of HD 115444 with the bright, well-studied halo giant HD 122563. For HD 115444, the overall metallicity is [Fe/H]~ -3.0. The abundances of the light and iron-peak elements generally show the same pattern as other UMP stars (e.g. overdeficiencies of manganese and chromium, overabundances of cobalt), but the differential analysis indicates several nucleosynthesis signatures that are unique to each star.Comment: To Appear in the Astrophysical Journa

Keck/HIRES Spectroscopy of Four Candidate Solar Twins

We use high S/N, high-resolution Keck/HIRES spectroscopy of 4 solar twin candidates (HIP 71813, 76114, 77718, 78399) from our Hipparcos-based CaII H & K survey to carry out parameter and abundance analyses of these objects. Our spectroscopic Teff estimates are some 100 K hotter than the photometric scale of the recent Geneva-Copenhagen survey; several lines of evidence suggest the photometric temperatures are too cool at solar $T_{\rm eff}$. At the same time, our abundances for the 3 solar twin candidates included in the Geneva-Copenhagen survey are in outstanding agreement with the photometric metallicities; there is no sign of the anomalously low photometric metallicities derived for some late-G UMa group and Hyades dwarfs. A first radial velocity determination is made for HIP 78399, and UVW kinematics derived for all stars. HIP 71813 appears to be a kinematic member of the Wolf 630 moving group (a structure apparently reidentified in a recent analysis of late-type Hipparcos stars), but its metallicity is 0.1 dex higher than the most recent estimate of this group's metallicity. While certainly ``solar-type'' stars, HIP 76114 and 77718 are a few percent less massive, significantly older, and metal-poor compared to the Sun; they are neither good solar twin candidates nor solar analogs providing a look at the Sun at some other point in its evolution. HIP 71813 appears to be an excellent solar analog of age 8 Gyr. Our results for HIP 78399 suggest the promise of this star as a solar twin may be equivalent to the ``closest ever solar twin'' HR 6060; follow up study of this star is encouraged.Comment: Accepted for publication in The Astronomical Journal (November 2005 volume

La evaluación del abuso sexual en personas con discapacidad intelectual: proceso de construcción y validación de un instrumento de autoinforme

People with functional diversity have certain limitations in the functioning of their daily life, which makes them dependent on their primary caregivers, leaving their bodies exposed to them. In addition, they have fewer resources to detect and defend themselves against abuse. These factors, among others, make them a group vulnerable to sexual abuse. But in the detection of potential victims, we find limitations in comprehension and literacy, which makes questioning the reliability of the information obtained. The objective of this study is the development of a reliable and valid instrument adapted to the characteristics of people with functional diversity and allows the detection of cases of sexual abuse. In order to do so, the construction-validation process of the scale has been carried out in two phases, generating, in each of them, different versions that have been applied to two groups of participants. It details the analysis that the group of experts has made from the two pilot applications and the consequent modifications derived from these analyzes. In the first phase the version applies to 20 participants and in the second to 150. The final version has a reliability of .91. The study has shown the complexity of developing an instrument for assessing sexual abuse for people with intellectual disabilities because of the limitations of understanding inherent in the collective, stressing the importance of having the contributions of professionals who work daily with them.Las personas con diversidad funcional presentan ciertas limitaciones en el funcionamiento desu día a día, lo que les convierten en dependientes de sus cuidadores principales, quedando su cuerpo expuesto a ellos. Además, presentan menos recursos para detectar y defenderse ante situaciones de abuso. Estos factores, entre otros, hacen que se conviertan en un colectivo vulnerable al abuso sexual. Pero en la detección de las víctimas potenciales, nos encontramos con limitaciones en comprensión y lectoescritura, lo que hace cuestionar la fiabilidad de la información obtenida. El objetivo de este estudio, es la elaboración de un instrumento fiable y válido que se adapte a las características de las personas con diversidad funcional, y posibilite la detección de casos de abuso sexual. Para ello, el proceso de construcción-validación de la escala se ha realizado en dos fases generándose, en cada una de ellas, diferentes versiones que se han aplicado a dos grupos de participantes.Se detalla el análisis que el grupo de expertos ha realizado a partir de las dos aplicacionespiloto y las consecuentes modificaciones derivadas de dichos análisis. En la primera fase la versión se aplica a 20 participantes y en la segunda a 150. La versión final cuenta con una fiabilidad de .91.El estudio ha mostrado la complejidad que supone elaborar un instrumento de evaluación del abuso sexual para personas con discapacidad intelectual por las limitaciones de comprensión inherentes al colectivo, remarcando la importancia de contar con las aportaciones de profesionales que trabajan diariamente con ellos