Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

2016 Alzheimer's disease facts and figures

This report provides information to increase understanding of the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality rates, health expenditures and costs of care, and effect on caregivers and society in general. It also explores the roles and unique challenges of long‐distance caregivers, as well as interventions that target those challenges. An estimated 5.2 million Americans have AD. Approximately 200,000 people younger than 65 years with AD comprise the younger onset AD population; 5 million comprise the older onset AD population. Throughout the coming decades, the baby boom generation is projected to add about 10 million to the total number of people in the United States with AD. Today, someone in America develops AD every 68 seconds. By 2050, one new case of AD is expected to develop every 33 seconds, or nearly a million new cases per year, and the total estimated prevalence is expected to be 13.8 million. AD is the sixth leading cause of death in the United States and the fifth leading cause of death in Americans age 65 years or older. Between 2000 and 2010, the proportion of deaths resulting from heart disease, stroke, and prostate cancer decreased 16%, 23%, and 8%, respectively, whereas the proportion resulting from AD increased 68%. The number of deaths from AD as determined by official death certificates (83,494 in 2010) likely underrepresents the number of AD‐related deaths in the United States. A projected 450,000 older Americans with AD will die in 2013, and a large proportion will die as a result of complications of AD. In 2012, more than 15 million family members and other unpaid caregivers provided an estimated 17.5 billion hours of care to people with AD and other dementias, a contribution valued at more than $216 billion. Medicare payments for services to beneficiaries age 65 years and older with AD and other dementias are three times as great as payments for beneficiaries without these conditions, and Medicaid payments are 19 times as great. Total payments in 2013 for health care, long‐term care, and hospice services for people age 65 years and older with dementia are expected to be $203 billion (not including the contributions of unpaid caregivers). An estimated 2.3 million caregivers of people with AD and other dementias live at least 1 hour away from the care recipient. These “long‐distance caregivers” face unique challenges, including difficulty in assessing the care recipient's true health condition and needs, high rates of family disagreement regarding caregiving decisions, and high out‐of‐pocket expenses for costs related to caregiving. Out‐of‐pocket costs for long‐distance caregivers are almost twice as high as for local caregivers.

2013 Alzheimer's disease facts and figures

This study suggests that there are sex differences in vocational attitude maturity. In the four-school stratified sample of eleventh grade boys and girls studied, the girls scored significantly higher than the boys in vocational attitude. No sex differences in overall level of self-esteem, as measured by the Tennessee Self-Concept Scale, were found. For both sexes a significant relationship between the over all level of self-esteem and vocational attitude maturity was indicated, with the relationship being higher for males than for females. The self-concept variables of self-satisfaction, family, and moral-ethical self were found to contribute to the vocational attitude maturity of males. For females, the self-concept variables of identity and moral-ethical self contributed to their vocational attitude maturity.

Sex Differences in

This review provides the reader with the up-to-date evidence-based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculo-skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise.

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Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases

Objective: To develop a brief alcohol and other drug (AOD) screening test for adolescents. Methods: A 9-item test was constructed by combining and modifying items from several AOD assessments, and administered concurrently with the Personal Involvement With Chemicals Scale (PICS), the criterion standard. Setting: A hospital-based adolescent clinic. Subjects: Fourteen- to 18-year-old patients consecutively arriving for routine medical care who were known to have used AOD. Measures: Internal consistency of the 9 items was calculated using the Cronbach α. The relationship between the brief screen and PICS raw score was determined by stepwise linear regression analysis. The PICS T score has been shown to correctly classify substance abuse treatment need as no treatment (T<35), brief office intervention (T = 35-40), outpatient or short-term treatment (T =41-54), and inpatient or long-term treatment (T≥55). Sensitivity and specificity rates for predicting a PICS T score of 55 or higher were calculated from 2 × 2 tables. Results: Ninety-nine adolescents were tested (70.7% female, 36.4% black, 32.3% white, 19.2% Hispanic, mean age, 16.3 years). The 9 items had good internal consistency (Cronbach α =.79). Stepwise linear regression analysis identified 6 items whose total combined score was highly correlated with PICS (Pearson r=0.84, P<.01). This model correctly classified 86% of subjects according to the PICS criteria. Two or more yes answers had a sensitivity of 92.3% and specificity of 82.1% for intensive AOD treatment need. The 6 items were arranged into a mnemonic (CRAFFT). Conclusions: Further research must confirm the test's psychometric properties in a general clinic population. However, CRAFFT seems promising as a brief AOD screening test.

https://jamanetwork.com/journals/jamapediatrics/articlepdf/347094/poa8345.pdf

A new brief screen for adolescent substance abuse.

The Hamilton Anxiety Rating Scale, a widely used clinical interview assessment tool, lacks instructions for administration and clear anchor points for the assignment of severity ratings. We developed a Structured Interview Guide for the Hamilton Anxiety Scale (SIGH-A) and report on a study comparing this version to the traditional form of this scale. Experienced interviewers from three Anxiety Disorders research sites conducted videotaped interviews using both traditional and structured instruments in 89 participants. A subset of the tapes was co-rated by all raters. Participants completed self-report symptom questionnaires. We observed high inter-rater and test-retest reliability using both formats. The structured format produced similar but consistently higher (+ 4.2) scores. Correlation with a self-report measure of overall anxiety was also high and virtually identical for the two versions. We conclude that in settings where extensive training is not practical, the structured scale is an acceptable alternative to the traditional Hamilton Anxiety instrument.

Reliability and validity of a structured interview guide for the Hamilton Anxiety Rating Scale (SIGH‐A)

Reliability and validity of the Panic Disorder Severity Scale: replication and extension

This project was funded by a grant from the National Center for Responsible Gaming (NCRG), Kansas City, Missouri. The National Center for Responsible Gaming is the first national organization devoted exclusively to funding independent research on problem gambling and underage gambling. The NCRG funds basic and applied research projects selected through a rigorous peer review process. The authors accept full responsibility for the content and conclusions of this report.

/pdf/titulo-estimating-the-prevalence-of-disordered-gambling-1cgve04krg.pdf

Título: Estimating the Prevalence of Disordered Gambling Behavior in the United States and Canada: A Meta-analysis

Background Mild cognitive impairment (MCI) has been defined in several ways. Objective To determine the 1-year outcomes of MCI by different definitions at the population level. Design Inception cohort with 1-year follow-up. Participants were classified as having MCI using the following definitions operationalized for this study: amnestic MCI by Mayo criteria, expanded MCI by International Working Group criteria, Clinical Dementia Rating (CDR) = 0.5, and a purely cognitive classification into amnestic and nonamnestic MCI. Setting General community. Participants Stratified random population-based sample of 1982 individuals 65 years and older. Main Outcome Measures For each MCI definition, there were 3 possible outcomes: worsening (progression to dementia [CDR ≥ 1] or severe cognitive impairment), improvement (reversion to CDR = 0 or normal cognition), and stability (unchanged CDR or cognitive status). Results Regardless of MCI definition, over 1 year, a small proportion of participants progressed to CDR > 1 (range, 0%-3%) or severe cognitive impairment (0%-20%) at rates higher than their cognitively normal peers. Somewhat larger proportions of participants improved or reverted to normal (6%-53%). Most participants remained stable (29%-92%). Where definitions focused on memory impairment and on multiple cognitive domains, higher proportions progressed and lower proportions reverted on the CDR. Conclusions As ascertained by several operational definitions, MCI is a heterogeneous entity at the population level but progresses to dementia at rates higher than in normal elderly individuals. Proportions of participants progressing to dementia are lower and proportions reverting to normal are higher than in clinical populations. Memory impairments and impairments in multiple domains lead to greater progression and lesser improvement. Research criteria may benefit from validation at the community level before incorporation into clinical practice.

https://jamanetwork.com/journals/jamaneurology/articlepdf/503368/noc05082_761_767.pdf

Joni Vander Bilt

Papers

A new brief screen for adolescent substance abuse.

Reliability and validity of a structured interview guide for the Hamilton Anxiety Rating Scale (SIGH‐A)

Reliability and validity of the Panic Disorder Severity Scale: replication and extension

Título: Estimating the Prevalence of Disordered Gambling Behavior in the United States and Canada: A Meta-analysis

Outcomes of Mild Cognitive Impairment by Definition: A Population Study