The psychometric properties of ADCS - activities of daily living inventory and comparison of different ADL scores

Several multi-item activities of daily living (ADL) scales have been developed for assessment of functional status of patients with Alzheimer’s Disease (AD) in the last few decades. A disadvantage of the large number of scales is that scores of different ADL scales cannot be compared directly with each other. ADL scales which are used by McNamee’s (Townsend's disability scale) and Hill’s (Medicare Beneficiary definitions and Katz index of ADL) provide suitable tools for modelling the cost-effectiveness of different treatments in patients with Alzheimer’s disease, since they report empirical results about the relationship between the degree of functional impairment (healthcare costs) and the prevalence of institutionalisation. The IDEAL trial examines the efficacy of Exelon Patch with the ADCS - Activities of Daily Living Inventory (ADCS-ADL). This ADL instrument is not directly comparable to the ADL scales used by McNamee and Hill. However, the use of the ADL scale from the IDEAL study to predict the prevalence of institutionalisation with scales by Hill and McNamee would be desirable. Because of the generic nature of the ADL construct, and considering the fact that these well validated ADL instruments identify the main physical impairments and functional disabilities in Alzheimer's disease, we should expect high overlap in item content between different ADL instruments. The high overlap in item content between instruments, and the similar wording and scoring criteria, makes it possible to pair each impairment with another. The intention of this study was to establish the link between these ADL scales in order to provide appropriate conditions for further economic analyses on the dataset provided by the IDEAL study

A koherencia mint a lelki és testi egészség alapvető meghatározója a mai magyar társadalomban = Sense of coherence as an important determinant of mental and physical health

Az ún. salutogenezis modell olyan keretet kínál, amelyben a koherencia élmény bevezetésével lehetőség nyílik az „egész”-ség dinamikus értelmezésére. Vizsgálatunkban a Richard Rahe-féle, az „élet értelme” koherencia kérdőív összefüggéseit vizsgáltuk az egészségi állapottal. A Hungarostudy 2002 felmérés a 18 évesnél idősebb magyar népességet életkor, nem és terület szerint képviseli. 12 640 személlyel vettünk fel otthoni interjút. Az így vizsgált koherencia mutatót az egészségi állapot igen fontos előrejelzőjének találtuk. Ha az adatokat életkor, nem és iskolázottság szerint korrigáltuk, az egészségi állapot önbecslése mintegy 10-szer, a munkaképesség 8-szor jobb, a depresszió valószínűsége 7-szer alacsonyabb volt. Az „élet értelme” mutató igen szoros kapcsolatban áll az önhatékonysággal, a problémaorientált megbirkózással, a társas támogatással, ezzel szemben kevésbé függ az iskolázottságtól, az életkortól és a nemtől

How to Decrease Suicide Rates in Both Genders? An Effectiveness Study of a Community-Based Intervention (EAAD)

BACKGROUND: The suicide rate in Hungary is high in international comparison. The two-year community-based four-level intervention programme of the European Alliance Against Depression (EAAD) is designed to improve the care of depression and to prevent suicidal behaviour. Our aim was to evaluate the effectiveness of a regional community-based four-level suicide prevention programme on suicide rates. METHOD: The EAAD programme was implemented in Szolnok (population 76,311), a town in a region of Hungary with an exceptionally high suicide rate. Effectiveness was assessed by comparing changes in suicide rates in the intervention region after the intervention started with changes in national suicide rates and those in a control region (Szeged) in the corresponding period. RESULTS: For the duration of the programme and the follow-up year, suicide rates in Szolnok were significantly lower than the average of the previous three years (p = .0076). The suicide rate thus went down from 30.1 per 100,000 in 2004 to 13.2 in 2005 (-56.1 %), 14.6 in 2006 (-51.4 %) and 12.0 in 2007 (-60.1 %). This decrease of annual suicide rates in Szolnok after the onset of the intervention was significantly stronger than that observed in the whole country (p = .017) and in the control region (p = .0015). Men had the same decrease in suicide rates as women. As secondary outcome, an increase of emergency calls to the hotline service (200%) and outpatient visits at the local psychiatry clinic (76%) was found. CONCLUSIONS: These results seem to provide further support for the effectiveness of the EAAD concept. Whilst the majority of suicide prevention programs mainly affect female suicidal behaviour, this programme seems to be beneficial for both sexes. The sustainability and the role of the mediating factors (social service and health care utilization, community attitudes about suicide) should be key points in future research

The use of GNSS zenith total delays in operational AROME/Hungary 3D-Var over a central European domain

The delay of satellite signals broadcasted by Global Navigation Satellite System (GNSS) provides unique atmospheric observations which endorse numerical weather prediction from global to limited-area models. Due to the possibility of its frequent and near-real-time estimation, the zenith total delays (ZTDs) are valuable information for any state-of-the-art data assimilation system. This article introduces the data assimilation of ZTDs in a Hungarian numerical weather prediction system, which was carried out by taking into account observations from central European GNSS analysis and processing centres. The importance of ZTD observations is described and shown by a diagnostic tool in the 3-hourly updated 3D-Var assimilation scheme. Furthermore, observing system experiments are done to evaluate the impact of GNSS ZTDs on mesoscale limited-area forecasts. The results of the use of GNSS ZTDs showed a clear added value to improve screen-level temperature and humidity forecasts when the bias is accurately estimated and corrected in the data assimilation scheme. The importance of variational, i.e. adaptive bias correction, is highlighted by verification scores compared to static bias correction. Moreover, this paper reviews the quality control of GNSS ground-based stations inside the central European domain, the calculation of optimal thinning distance and the preparation of the two above-mentioned bias correction methods. Finally, conclusions are drawn on different settings of the forecast and analysis experiments with a brief future outlook.</p

Breaking through the Mermin-Wagner limit in 2D van der Waals magnets

The Mermin-Wagner theorem states that long-range magnetic order does not exist in one- (1D) or two-dimensional (2D) isotropic magnets with short-ranged interactions. Here we show that in finite-size 2D van der Waals magnets typically found in lab setups (within millimetres), short-range interactions can be large enough to allow the stabilisation of magnetic order at finite temperatures without any magnetic anisotropy. We demonstrate that magnetic ordering can be created in 2D flakes independent of the lattice symmetry due to the intrinsic nature of the spin exchange interactions and finite-size effects. Surprisingly we find that the crossover temperature, where the intrinsic magnetisation changes from superparamagnetic to a completely disordered paramagnetic regime, is weakly dependent on the system length, requiring giant sizes (e.g., of the order of the observable universe ~ 1026 m) to observe the vanishing of the magnetic order as expected from the Mermin-Wagner theorem. Our findings indicate exchange interactions as the main ingredient for 2D magnetism