http://www.hindawi.comThe latest articles from Hindawi Publishing Corporation© 2012, Hindawi Publishing Corporation. All rights reserved.http://www.hindawi.com/journals/eri/2012/357348/Background. The aim of this study was to determine the prevalence of psychiatric morbidity in selected semiurban primary care centers in Lagos Island, Nigeria using the screening tool GHQ-12 and the ICD 10 mental disorders checklist (primary care) (ICD 10 PC). Methods. In this multistage cross-sectional study, 400 participants were recruited by using proportional sampling of 17,787 attendees. Results. Of all respondents, 45.8% scored positive on GHQ-12. The most prevalent “any ICD 10 disorder” was unexplained somatic disorder (57.5%), while 2.0 to 7.8% of the respondents reported varying levels of disablement. Younger age (P<0.001) and being widowed (P=0.03) were significantly associated with high GHQ scores while younger age (P<0.001) and male gender (P=0.04) were significantly associated with “any ICD 10 disorder”. Conclusion. These findings are a useful guide to the probable prevalence of psychiatric morbidity in primary care in Nigeria and in the design of appropriate interventions.V. O. Lasebikan, A. Ejidokun, and O. A. CokerCopyright © 2012 V. O. Lasebikan et al. All rights reserved.http://www.hindawi.com/journals/eri/2011/698705/During a 2003-2004 PCR-based surveillance study conducted in 6 Puerto Rico Medical Center hospitals, 27/92 multi-beta-lactam-resistant Klebsiella pneumoniae strains were identified as carbapenemase (KPC) positive in 4 hospitals. The objectives of this study were to identify the KPC variants, their genetic relatedness, and any other beta-lactamases present. Susceptibility testing, pulsed field gel electrophoresis (PFGE), isoelectric focusing, PCR, and DNA sequencing were performed. KPC variants -2, -3, -4, and -6 were identified. Additional beta-lactamases detected were TEM, DHA, OXA-9 and -30. Antimicrobial susceptibility to carbapenems varied depending on the KPC variant. Five PFGE genetically related groups were identified in 15 isolates and 12 unrelated types. PFGE profiles suggested that both clonal and horizontal transfer are contributing to the dissemination of these isolates among the various hospitals. Comparison of the 2003 and a 2009 surveillance studies showed a significant increase in the KPC-positive K. pneumoniae isolates in the latter.Iraida E. Robledo, Guillermo J. Vázquez, Ellen S. Moland, Edna E. Aquino, Richard V. Goering, Kenneth S. Thomson, María I. Santé, and Nancy D. HansonCopyright © 2011 Iraida E. Robledo et al. All rights reserved.http://www.hindawi.com/journals/eri/2011/608719/The standard estimate of prevalence is the proportion of positive results obtained from the application of a diagnostic test to a random sample of individuals drawn from the population of interest. When the diagnostic test is imperfect, this estimate is biased. We give simple formulae, previously described by Greenland (1996) for correcting the bias and for calculating confidence intervals for the prevalence when the sensitivity and specificity of the test are known. We suggest a Bayesian method for constructing credible intervals for the prevalence when sensitivity and specificity are unknown. We provide R code to implement the method.Peter J. DiggleCopyright © 2011 Peter J. Diggle. All rights reserved.http://www.hindawi.com/journals/eri/2011/381597/Background. Initially the course of the 2009 swine flu pandemic was uncertain and impossible to predict with any confidence. An effective prospective data resource exists in the United Kingdom (UK) that could have been utilized to describe the scope and extent of the swine flu outbreak as it unfolded. We describe the 2009 swine flu outbreak in the UK as recorded daily by general practitioners and the potential use of this database for real-time tracking of flu outbreaks. Methods. Using the General Practice Research Database, a real-time general practice, electronic database, we estimated influenza incidence from July 1998 to September 2009 according to age, region, and calendar time. Results. From 1998 to2008, influenza outbreaks regularly occurred yearly from October to March, but did not typically occur from April to September until the swine flu outbreak began in April 2009. The weekly incidence rose gradually, peaking at the end of July, and the outbreak had largely dissipated by early September. Conclusions. The UK swine flu outbreak, recorded in real time by a large group of general practitioners, was mild and limited in time. Simultaneous online access seemed feasible and could have provided additional clinical-based evidence at an early planning stage of the outbreak.Hershel Jick, Dean S. MacLaughlin, Pascal Egger, and Peter WigginsCopyright © 2011 Hershel Jick et al. All rights reserved.http://www.hindawi.com/journals/eri/2011/412150/This study evaluated the effectiveness of a short scale in screening for autism spectrum disorders (ASDs) and documented the prevalence of ASD in twins born in 1988–2000 as registered in the Danish Psychiatric Central Research Registry (DPCRR). Five child behaviour checklist (CBCL) items were used in a first-phase screening of all twins born 1988–2000, recruited from the Danish Twin Registry. In Denmark, nearly all psychiatric diagnoses are reported to DPCRR, and the two registers were linked for validation purposes. Parents of >16,000 twins responded (68.4%); among the twins, 108 were registered with ASD. The optimal cut-off score of two out of ten yielded a sensitivity of 79.6% and a specificity of 81.4%. The registry linkage identified 176 twins with ASD (point prevalence = 0.72%). This study demonstrates that it is feasible to screen large populations for ASD with a 5-item questionnaire. The prevalence of registered ASD in twins corresponds to recent population-based studies in singletons.Claudia Nordenbæk, Kirsten Ohm Kyvik, Axel Skytthe, and Niels BilenbergCopyright © 2011 Claudia Nordenbæk et al. All rights reserved.http://www.hindawi.com/journals/eri/2011/832945/Background. Depressive disorders are associated with substantial risk of premature mortality. A number of factors may contribute to reported risk estimates, making it difficult to determine actual risk of excess mortality in community cases of depression. The aim of this study is to conduct a systematic review and meta-analysis of excess mortality in population-based studies of clinically defined depression. Methods. Population-based studies reporting all-cause mortality associated with a clinically defined depressive disorder were included in the systematic review. Estimates of relative risk for excess mortality in population-representative cases of clinical depressive disorders were extracted. A meta-analysis was conducted using Stata to pool estimates of excess mortality and identify sources of heterogeneity within the data. Results. Twenty-one studies reporting risk of excess mortality in clinical depression were identified. A significantly higher risk of mortality was found for major depression (RR 1.92 95% CI 1.65–2.23), but no significant difference was found for dysthymia (RR 1.37 95% CI 0.93–2.00). Relative risk of excess mortality was not significantly different following the adjustment of reported risk estimates. Conclusion. A mortality gradient was identified with increasing severity of clinical depression. Recognition of depressive symptoms in general practice and appropriate referral for evidence-based treatment may help improve outcomes, particularly in patients with comorbid physical disorders.Amanda J. Baxter, Andrew Page, and Harvey A. WhitefordCopyright © 2011 Amanda J. Baxter et al. All rights reserved.http://www.hindawi.com/journals/eri/2011/404538/General psychiatric assessment instruments do not cover DSM-IV dissociative disorders. Many large-scale epidemiological studies led to biased results due to this deficit in their methodology. Nevertheless, screening studies using diagnostic tools designed to assess dissociative disorders yielded lifetime prevalence rates around 10% in clinical populations and in the community. Special populations such as psychiatric emergency ward applicants, drug addicts, and women in prostitution demonstrated the highest rates. Data derived from epidemiological studies also support clinical findings about the relationship between childhood adverse experiences and dissociative disorders. Thus, dissociative disorders constitute a hidden and neglected public health problem. Better and early recognition of dissociative disorders would increase awareness about childhood traumata in the community and support prevention of them alongside their clinical consequences.Vedat SarCopyright © 2011 Vedat Sar. All rights reserved.http://www.hindawi.com/journals/eri/2011/467265/Background. This study examines whether the relationship between maternal stress or abuse situations and infant birth weight differs between homeless and non-homeless women. Methods. Analyses are based on data from the Pregnancy Risk Assessment Monitoring System (PRAMS), 2002–2007. Results. Homeless women were significantly more likely to experience stressful life events, abusive situations, and poor maternal health than non-homeless women during pregnancy. Birth weight among infants of homeless women was, on average, 17.4 grams lighter than for infants of non-homeless women, after adjusting for maternal age, race, ethnicity, region, education, and marital status. The impact of maternal health, stress, and abuse variables on pregnancy and infant birth weight significantly interacted with homeless status. For example, vaginal bleeding, nausea, kidney/bladder infection, and failure to receive early prenatal care had significantly larger negative impacts on birth weight among homeless women than non-homeless women. Infant birth weight was consistently lower among homeless women, more so when maternal stress and abuse were involved, across all classifications of their prepregnancy weight. Conclusion. Stress and abusive situations among pregnant women have a negative influence on pregnancy-related conditions and infant birth weight. However, this negative influence is even more pronounced among homeless women.Ray M. Merrill, Rickelle Richards, and Arielle SloanCopyright © 2011 Ray M. Merrill et al. All rights reserved.http://www.hindawi.com/journals/eri/2011/136946/The aim of this study is to describe a Q fever outbreak that affected the staff of a machine-tool factory in the Basque Country between 2009/12/20 and 2010/02/23. Study subjects were interviewed using a Q fever specific questionnaire and tested for Q fever serology (immunofluorescence assay with phase II antigen) and detecting Coxiella burnetii DNA using real-time PCR. We interviewed and tested 40 employees (90% of the staff). 33 employees, all of them men, had positive serology (attack rate 82.5%, 95% CI: 70.2–94.8). Mean age was 43.7 years (95% CI: 38.7–48.7) in positive men, 33.7 years (95% CI: −16.6–83.9) in negative men, and 36.25 (95% CI: 27.5–45.0) in women (all negatives). 15 cases (45.5%) were asymptomatic, 9 (27.3%) had flu-like symptoms, and the other 9 (27.3%) had developed radiologically confirmed pneumonia. We obtained 28 blood samples, 22 faeces samples, 11 milk samples, and one vaginal swab from 28 goats resting in a stable near the factory. Serology was positive in 18 goats (64.3%). All environmental samples were negative.Jesús Delgado Naranjo, Eva Alonso Fustel, Inmaculada Aspiritxaga Gamarra, Guillermo Ezpeleta Lobato, and Nerea Muniozguren AgirreCopyright © 2011 Jesús Delgado Naranjo et al. All rights reserved.http://www.hindawi.com/journals/eri/2011/583682/This study investigated the association of ADH1B (rs1229984) and ALDH2 (rs671) polymorphisms with glucose tolerance status, as determined by a 75-g oral glucose tolerance test, and effect modification of these polymorphisms on the association between alcohol consumption and glucose intolerance in male officials of the Self-Defense Forces. The study subjects included 1520 men with normal glucose tolerance, 553 with prediabetic condition (impaired fasting glucose and impaired glucose tolerance), and 235 men with type 2 diabetes. There was an evident interaction between alcohol consumption and ADH1B polymorphism in relation to type 2 diabetes (interaction P=.03). The ALDH24∗87Lys allele was associated with a decreased prevalence odds of type 2 diabetes regardless of alcohol consumption. In conclusion, the ADH1B polymorphism modified the association between alcohol consumption and type 2 diabetes. A positive association between alcohol consumption and type 2 diabetes was confounded by ALDH2 polymorphism.Guang Yin, Keizo Ohnaka, Makiko Morita, Shinji Tabata, Osamu Tajima, and Suminori KonoCopyright © 2011 Guang Yin et al. All rights reserved.