Good morning!? I am so happy today? to be playing it smart with Delia from Delia Creates and her series:Delia is one of my most-admired bloggers.? She?s the real deal, total package.? She?s sweet and genuine, insanely talented, and always coming up with amazing things to do for yourself and with your children.? One of the first posts I ever remember seeing of hers was a little outdoor table and chair set made of ice she made for her boys to have a winter picnic.? I knew then I wanted to follow her blog to be inspired to do more things like that with my own children.? She?s amazing.??
So let?s play it smart!
I like my kids.? They?re pretty much some of the best people I know.? I share a lot of the things I sew for my kids, but I?m really excited today to get to share some of the fun things I do with my kids.? When Delia invited me to participate in this series, I immediately knew what I wanted to share with you all.? My boys and I had just finished working on some fun creative writing, and we had such a great time doing it. I think it?s the perfect way to work a little learning into your child?s playtime, and record some of what comes out of their amazing imaginations.
First off, I have to give credit to my kids? Nana, Linda, who inspired this recent creative writing spree.? She is an amazing doll artist.? I wish I had pictures of some of her other creations.? They?re mind-blowing.? We recently visited her and my dad for a week.? Shortly after our return home, the boys received a package from Nana in the mail.? Inside were three friends she?d created and a note explaining who they were, with a little back story on each and a request for the boys to write more of the dolls? stories and send them back to Nana.
Seriously, what a great idea!? And how incredibly easy would this be to do with any of your kids? favorite toys?!? Just write up a brief paragraph, or list of characteristics on the toy, and encourage your child to add to it.? You could designate a specific notebook for the stories, like Nana Linda has her Book of Dolls, and have your child record all sorts of adventures and details of their most-loved playthings.?
My boys wanted to dive into their stories of Mr. Meeps, Captain Bomback and Voodoo Daddy as soon as I?d finished reading the note to them.? Using the note as a jumping off point, all three boys spent an afternoon coming up with stories to accompany the stuffed friends.? My four year old dictated his to me, but my ten- and seven year olds were able to work independently on theirs.?
Later that night, we had a really awesome family night where the boys shared their stories with all of us, and then called Nana Linda to read them to her over the phone. Another afternoon, they illustrated their stories.
I need to scan their stories and illustrations for us to have copies , and then send them off to Nana Linda for her Book of Dolls.
All three boys have been playing with the stuffed toys, and acting out the stories they wrote.? Toys inspiring story telling inspiring more play.? So fun!?
My oldest decided he wanted to add to the characters, and has started a sewing project to make a pet armadillo, Arrmy.? We haven?t had a chance to finish it up yet, but hopefully we can get to it once school is out next week.
?via my instagram @sewastraightline
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We haven?t done it for these stories, but another idea would be to have your kids write and perform a short skit based on the stories they come up with. When I was a little girl, I had a friend who was always organizing us to put on plays she?d written for her family. I?m hoping to have my boys do something like that this summer. I doubt they?ll need much prompting, they love to put on ?Silly Shows? frequently for each other, and love it even more when my husband and I record them so they can watch them later. Performing skits, especially ones they?ve written, is a great way to teach communication and public speaking, memorization, organization and follow-through, and working with others. And they?re fun.
If your child, or you, are having a hard time organizing thoughts and details to write the stories, you can make a simple spider diagram.? Below is one I made for my oldest son to use on another creative writing assignment.? I?m currently homeschooling him, and I had given him the assignment to come up with a superhero and then write about the character he came up with.????
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?Over the course of a week, we worked on this particular project.? The first day, I had him fill in the bubbles on the diagram.? Then over the next few days, he?d take a couple of bubbles and write a paragraph for each using what he?d written in them the first day.? By the end of the week, all he had to do was come up with an opening paragraph and conclusion, and he had a two-page story.? He?s my kid who is very easily overwhelmed, and has a hard time because he only sees the big picture.? Telling him to write a five-paragraph assignment is enough to send him into full on panic.? But by breaking things down, he wrote the whole thing without a fuss.? It was so fun when he was done, and I was able to point out he?d written as much as he had.? He told me that day maybe he?d like to be a writer when he grows up, he had so much fun doing it and the process was so much easier than he?d been expecting.?
Kids have great imaginations. Mine are always coming up with imaginary friends and alter egos, and silly stories to go along with them. I mentioned last week my oldest son?s long-time alter ego, Jellyfishman.? We?ve had Crap, Loco, Door Nog, Mummy Guy and more over the years between the three boys.?? If your child has an alter ego or imaginary friend, encourage them to sit down and record the details that are floating around in their heads.? Illustrate the story, make a small toy or a molded-clay action figure for them to play out their writing.? Maybe even help them put together a costume they can wear to more fully act out their story through a fun little skit or just impromptu play.? Having something tangible they can hold and read and share with others reinforces your child?s ideas, and validates their creativity.? Plus, it?s just fun to see what they come up with!
Creative writing and story-telling, smart play for kids of all ages!?
Be sure to check out the rest of Delia?s Play it Smart series, including Christie?s awesome science experiment
Cloud encoding vendor Encoding.com launched Vid.ly a couple of years ago to provide video creators with a way to publish a single universal video URL and then have that content accessible on any device. Now it's providing a way to monetize those videos, thanks to an integration with ad delivery platorm FreeWheel.
iPhone and iPad accessory maker Otterbox has announced that they're buying iPhone and iPad accessory maker LifeProof. "OtterProof" -- as I'm sure someone will be calling them since "LifeBox" is probably taken? -- CEO Brian Thomas had this to say:
The joining of OtterBox and LifeProof is a way to combine two great brands and provide customers with even more great products, services and choices for smartphone accessories. Both companies are successful because we foster an environment where everyone takes pride in being part of a culture that knows how to identify opportunities and grow them quickly. Our goal in this acquisition is to create more value for our customers than we ever could have generated while operating individually.
I love both companies' products, and we our accessory division sells both companies' products in the iMore store so here's hoping they become greater than the sum of their parts and put out even more spectacular products post-merger.
Anyone else looking forward to a sleeker, slimmer, even more rugged OtterProof Defender? Or are you already lamenting the deal?
Question by harlowtoo: Crockpot Cocktail Weiners Recipe? Does anyone know a good recipe for cocktail weiners (not little smokies) made in a crockpot? Do NOT want the ones using jelly of any kind, or bottled barbeque sauce. I used to have a good recipe for this, but cannot locate it now.
Best answer:
Answer by MAX G you are the gourmet Russ.
Give your answer to this question below!
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Most people think of Skype as a secure means of communication, with messages kindly delivered using end-to-end encryption. But a new report by Ars Technica suggests that's far from the case?and Microsoft is often dipping into your communications.
Having teamed up with security researcher Ashkan Soltani, Ars sent fresh web links across Skype, and found that half of them were accessed by a machine with an IP address belonging to Microsoft as they traversed the internet. That means that Skype messages are sent across the web in such a way that allows Microsoft to study plaintext within them, and clearly its a technique it uses regularly. Matt Green, a professor specializing in encryption at Johns Hopkins University, told Ars:
"The problem right now is that there's a mismatch between the privacy people expect and what Microsoft is actually delivering. Even if Microsoft is only scanning links for 'good' purposes, say detecting malicious URLs, this indicates that they can intercept some of your text messages. And that means they could potentially intercept a lot more of them."
It's not clear how the text is scrutinized by Microsoft: whole messages could be being scanned on Microsoft servers, end-user Skype installs could send snippets to be checked, or something else entirely could be happening. What is clear, though, is that the ability to extract content is very, very real.
Perhaps it shouldn't come as a massive surprise that Microsoft wants to keep tabs on what's being sent using its Skype service?it has a duty to make sure its services aren't being abused, after all. But it's important for end users to be aware that their communications aren't as private as they perhaps thought. Now you do. [Ars Technica]
Image by RoccoAlpha under Creative Commons license
JAKARTA (Reuters) - Freeport McMoRan Copper and Gold Inc said it will not restart production at the world's second-largest copper mine in Indonesia after a tunnel collapse that killed 28 workers until it is convinced of the mine's safety.
Arizona-based Freeport suspended operations at the remote Papua mine on Wednesday last week, at a cost estimated at about $15 million a day in lost production, a day after a training tunnel away from its main operations fell in on 38 workers.
Ten workers were saved, but rescuers on Wednesday gave up hope of finding more survivors and the search for seven workers still listed as missing has turned into an attempt the retrieve their bodies.
"We're not going to let people go back until we're comfortable they're safe and that will be done in cooperation with the union and the rest of the workers," Freeport CEO Richard Adkerson told a news conference at Indonesia's mining ministry in Jakarta.
Freeport said it was too early to say when production would resume.
"We have not decided on when we will start the operation again because we are still focusing on how to solve the problem," Rozik Soetjipto, president director of Freeport Indonesia, said, referring to the cause of the tunnel collapse.
Investors are concerned the accident, one of the country's worst mining disasters, could further strain relations between Freeport and trade unions after a three-month strike in late 2011 and smaller disputes since.
The Grasberg mine, which also holds the world's largest gold reserves, normally produces around 220,000 tons of concentrated ore a day. Around 140,000 tons comes from open pit mining and 80,000 tons from underground operations, the firm said.
Indonesia has ordered an independent investigation into the accident and will also check all other underground mining facilities in the country, said Jero Wacik, Indonesia's energy and mineral resources minister, without elaborating. He did not say when the government may decide on whether to reopen the mine.
Indonesia's mining sector has a poor safety record after a series of previous accidents including an explosion at a coal mine in Sumatra that killed at least 28 people in 2009 and a landslide in 2006 that killed eight.
LIMITED IMPACT
The suspension of operations at Grasberg follows Rio Tinto's decision to suspend work at its Bingham Canyon copper and gold mine near Salt Lake City, Utah, in early April after a land slide.
The impact of the Grasberg closure on global copper supply has so far been limited as the mine complex keeps stockpiles in reserve in case of disruptions, although that would change if the closure drags on.
Benchmark three-month copper on the London Metal Exchange traded at $7,391.50 a ton on Wednesday, down slightly from where it was trading before the mine closure.
The impact on Freeport's stock has also been limited. Freeport shares closed at $31.98 on Tuesday, having held to a fairly tight range in recent days.
Still, analysts are concerned that the mine could face a prolonged closure. Freeport has said it would only reopen with government permission.
Mining industry sources say the tunnel collapse has also raised fears that a planned underground expansion by Freeport may prove more complex than first thought, putting at risk its aggressive production targets over the next few years.
"The tunnel was deep underground. The ore body is deeper still. The collapse suggests actually getting in there could be problematic and that Freeport will have to curtail its production estimates," said a mining industry source in Singapore.
Freeport Indonesia has forecast sales of 1.1 billion pounds of copper and 1.2 million ounces of gold in 2013, up 54 percent and 31 percent over 2012, respectively.
At current prices, the forecast production equates to an expected output of about $10 million of copper and $4.7 million of gold of day, according to Reuters calculations.
The expected rise in sales is due to higher ore grades and a ramp up in production from underground operations.
(Additional reporting by Randy Fabi in Jakarta and Melanie Burton in Singapore; Writing by Randy Fabi; Editing by Richard Pullin)
The one word you think of when you see those three letters. CAT. As in Caterpillar. As in construction equipment.
Rugged.
And that's translated nicely to the Cat 15 ruggedized Android smartphone. Available now for $349 after its unveiling a couple months ago at Mobile World Congress, it's billed as a durable smartphone for the active set, whether that's on the side of the mountain or atop a rather impressive piece of construction equipment.
In fact, we watched this sucker hit the floor hard in Las Vegas. Hard. As in up all night gambling and you can't take it anymore hard. We've got hands-on video and more after the break.
FILE - In this Aug. 2, 2012 file photo, U.S. gymnast Gabrielle Douglas displays her gold medal during the artistic gymnastics women's individual all-around competition at the 2012 Summer Olympics in London. Douglas is back in the gym.The Olympic all-around champion was to practice Monday afternoon, May 20, 2013 after meeting with coach Liang Chow to discuss her comeback plan. The workout is in her old gym in West Des Moines, Iowa. (AP Photo/Julie Jacobson, File)
FILE - In this Aug. 2, 2012 file photo, U.S. gymnast Gabrielle Douglas displays her gold medal during the artistic gymnastics women's individual all-around competition at the 2012 Summer Olympics in London. Douglas is back in the gym.The Olympic all-around champion was to practice Monday afternoon, May 20, 2013 after meeting with coach Liang Chow to discuss her comeback plan. The workout is in her old gym in West Des Moines, Iowa. (AP Photo/Julie Jacobson, File)
Gabby Douglas had been looking forward to this appearance for a long time.
The Olympic all-around champion returned to the gym Monday, going through her first practice since the London Games after meeting with coach Liang Chow to discuss her comeback plan.
"She is very excited to be coming back," Chow told The Associated Press. "She can't wait any longer."
Douglas has always said she wanted to continue competing through the Rio Olympics in 2016. She is only 17, and Chow said in London that she hadn't come close to reaching her potential. (The Olympics were only the fifth international event for Douglas.)
But her life has been a whirlwind since London, where she also helped the U.S. win only its second team title. Her Olympic success, dazzling smile and captivating personality turned her into a worldwide celebrity, and she's been going nonstop since the games ended.
She was the AP's female athlete of the year and one of Barbara Walters' "10 Most Fascinating People" in 2012. She was the only female on Forbes' recent list of 10 most influential athletes in the U.S. She had a guest spot on "The Vampire Diaries," one of her favorite shows, and she performed at the Video Music Awards after walking the red carpet with the rest of the Fierce Five.
Douglas and fellow Fierce Five members Aly Raisman, Jordyn Wieber and McKayla Maroney did a 40-city gymnastics tour last fall, and she's made dozens of other celebrity appearances. She signed deals with Nike, Kellogg Co. and AT&T, among others, and recently published her second book.
Gymnastics was never far from her mind, though, and Chow got the sense from the text messages Douglas would send him that she'd eventually be back in the gym in West Des Moines, Iowa.
"She's the kind of person who wants to be achieving," he said. "She wants to feel good about her improvement and her goal setting. That's the attitude Gabby is about and now she can set out a goal and achieve it, through the sport."
Chow wouldn't put a timetable on Douglas' return, saying she has to get back in gymnastics shape before they can put a "realistic" training plan together.
"I think 2014 is an excellent possibility for competition," he said.
But this won't be an easy process, Chow said. Gymnastics is a sport that requires hundreds of hours of repetition to perfect skills, and Douglas has been out of action for nine months.
"I did warn her, 'If you think preparing for London was hard, preparing for Rio will be harder.' There's many challenges ahead of us," Chow said. "Also, 'You're going to have to have a lot more patience with yourself. Nine months off, you have to get yourself in very good physical condition first before we even talk about the training plan for the next steps."
But Douglas is undeterred.
"She understood," Chow said, "and she is super excited."
On Tuesday I was at Portcullis House as the Labour party outlined its new vision for post-2015 development. The event was titled ?Tackling inequality and promoting sustainable development?. These were indeed the main overriding themes, but this is not the place to examine Labour?s actual vision.
But of particular interest to me were the references to the sustainable intensification of agriculture, which appeared throughout. This is a term which descends directly from our Reaping the Benefitsreport, and also a subject of our successful and lively Policy Lab meeting last week.
Mary Creagh MP was on the post-2015 ?panel? representing the shadow view of Defra?s development policies. Martin Nesbit represented Defra at our PolicyLab event, and reassuringly, the themes were similar. Mary encouraged a stark look at our own food supply chains with reference to the horsemeat scandal. ?We are a bit blas? about food in the developed world, we trust, almost without question, that we have food systems to deliver us the nutrition that we want and need, exactly when we want and need it, but this is not failsafe?
When we look at the broader picture of food supply in a global development context (a theme which was addressed in our People and the Planet report), we have an emerging food conundrum related to the emerging middle classes. As countries increase in wealth, their residents will want a nutrient high, meat rich diet (which as UK citizens we all have the opportunity to enjoy). Why shouldn?t others have this too?!
The problem is that meat production is wasteful and bad for the planet (huge generalisation). This is well known among policymakers, scientists and vegetarians. I had a very interesting discussion on this and laboratory produced meat with Dr Matt Reed, the Chair of our PolicyLab event, last Thursday. Can synthetic biology provide the answers through laboratory created meat? Surely this is the ultimate example of sustainable intensification ? how science and technology can combine to feed the world?
Regardless of your opinion on synthetic biology, feeding grain which could be fed to humans, to animals, is indeed energetically wasteful, and this leads me onto Mary Creagh?s comment from yesterday?s event. She likened using crops for bio-fuel to feeding grain to cows. ?Use waste products for bio-fuel and feed grass to cows instead! It is more sustainable and economically cheaper.?
If we assume that lab meat is not going to happen (or more crucially, be accepted for the mainstream market) anytime soon, and that the growing middle classes will still want a nutritious diet containing meat; inevitably the consumer demand for meat as a valued resource will increase above supply, and even with my amateur knowledge of economics, I?m guessing the price goes up? ?Will this lead to food rationing to ensure fairness? Woe betides the politician who has to inform the British public that they may only be able to eat meat three days a week. ?I imagine most people in the UK would not look upon this suggestion favourably!
With regards to sustainable intensification, Mary had another interesting point, which is strongly linked to the post-2015 development agenda (and justifies a strong, cross-cutting, and joined up approach to the new goals). She suggests that the real key is in supporting subsistence farming in developing countries, and crucially, the role of women. Road networks are also vital. By allowing isolated farmers access to new technologies and education, sustainable intensification can be achieved in all corners of the earth. And not only that. If women are able to grow excess crops to sell, they are therefore able to save for the future, they can educate their children, and thus improve the lives of future generations.
There you go. Emancipation of women ? sustainable intensification ? education- economic growth, sustainable development, all in one.
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The post-2015 development goals have many cross-cutting themes, which will incorporate a large number of Royal Society interests. But what role can science play in informing this policy? Our next PolicyLab event on 6 June will aim to address this.
Our People and the Planet report published in April 2012 covers the issues of population and consumption in detail; And our Reaping the Benefits report, published in October 2009, explores the sustainable intensification of global agriculture. Synthetic biology is one of our ongoing research themes.
New study identifies risk factors for depression among COPD patientsPublic release date: 20-May-2013 [ | E-mail | Share ]
Contact: Nathaniel Dunford ndunford@thoracic.org American Thoracic Society
ATS 2013, PHILADELPHIA ? Patients suffering from chronic obstructive pulmonary disease (COPD) typically suffer from depression more frequently than those without COPD, resulting in higher levels of disability and illness and increasing the overall healthcare burden for the COPD population. Now, a study from researchers in Argentina indicates female COPD patients and patients who experience significant shortness of breath may have the greatest risk for developing depression.
The results of the study will be presented at the ATS 2013 International Conference.
"About 10 percent of the general population suffers from depression, and studies have shown that rate to be significantly higher in patients with COPD," said study lead author Orlando Lopez Jove, MD, chief of the pulmonary laboratory at the Hospital Cetrangolo in Buenos Aires. "Not every COPD patient will suffer from depression, and being able to identify which patients are most at risk could be a valuable tool in ensuring those patients receive counseling and other treatment that could help improve their quality of life.
"In this study, we wanted to learn if factors including gender, lifestyle habits, COPD severity, shortness of breath and overall quality of life were related to the frequency of depression in COPD patients, and if they were related, to try to determine the extent of that relationship," he said.
For their study, the researchers evaluated 113 COPD patients who were treated at the Hospital Cetrangolo in Buenos Aires from January 2009 to March 2011 and who had not had exacerbations of their disease within the previous 30-day period. Patients were evaluated for pulmonary function and for the degree of shortness of breath they experienced, as well as other physical characteristics including weight and body mass index (BMI). The researchers used previous diagnoses of depression and the Beck Depression Inventory (BDI) to determine the presence and level of depression and the Saint George's Respiratory Questionnaire (SGRQ) to evaluate quality of life measures for each patient, and they also looked at specific lifestyle factors and habits like smoking and evaluated family history of depression. Patients were considered to be physically active if they engaged in physical activity for at least 150 minutes each week, the amount recommended by the American Heart Association to maintain good health.
At the end of the study, the researchers discovered that while the severity of COPD and smoking had no bearing on whether or not a patient had depression or their level of depression, patients who were female and those experiencing significant shortness of breath were at a significantly greater risk for the condition. They also found that the presence of depression and its intensity had a direct bearing on a patient's quality of life, affecting both the total quality-of-life score and the score for individual factors measured by the SGRQ.
The researchers also identified physical activity as a protective factor against depression, meaning patients who had higher levels of physical activity were less prone to developing depression.
"Depression is a disorder which remains easily undiagnosed due to underpresentation and because the symptoms are not very specific," said Dr. Lopez Jove, who is also vice-director of the pathophysiology department at the Latin American Thoracic Association (ALAT). "Therefore, it is important to consider this disorder in patients with COPD, especially in female patients and patients who experience significant shortness of breath.
A future planned study will help evaluate how treatment of depression affects these patients and their quality of life, he said.
"COPD patients have to deal not only with the physical consequences of the disease, but they also must deal with the psychological consequences of COPD," Dr. Lopez Jove noted. "Patients with depression often suffer from low self-confidence or self-efficacy, and early diagnosis and treatment of depression is very important for improving a patient's quality of life, maximizing healthcare utilization and improving treatment outcomes."
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* Please note that numbers in this release may differ slightly from those in the abstract. Many of these investigations are ongoing; the release represents the most up-to-date data available at press time.
Abstract 39776
Depression In Patients With Chronic Obstructive Pulmonary Disease (COPD): Relationship To Dyspnea Degrees And Impact On Quality Of Life (Qol)
Type: Scientific Abstract
Category: 09.03 - COPD: Comorbidities (CP)
Authors: O.R. Lopez Jove1, A. Galdames2, V. Barrionuevo2, E. Giugno3, S. Rey2, Y.F. Wu4, G. Tabaj2, E. Lopez Gonzalez5; 1Hopital Cetrangolo - Buenos Aires/AR, 2Hospital "Dr. Antonio A.Cetrngolo" - Vicente Lopez - Buenos Aires/AR, 3Hospital "Dr. Antonio A.Cetrngolo" - 1147912090/AR, 4Hopital Cetrangolo - Vicente Lopez- Buenos Aires/AR, 5Argentine Diabetes Society - Caba/AR
Abstract Body
Background: The prevalence of depression in the general population is around 10%, being higher in patients with COPD. The presence of this comorbidity increases morbidity, disability, and health care burden.
Aims: To evaluate the frequency of depression in COPD patients and its relationship with gender, habits, COPD severity, degree of dyspnea and QoL.
Material and methods: we performed an observational, prospective study at Hospital "Dr. Cetrngolo", Argentina, in patients with COPD according to GOLD criteria (stages I to IV) without exacerbations in the last month. Evaluation included the following issues: anthropometric measures, pulmonary function tests, the Beck Depression Inventory (BDI), the Saint George's Respiratory Questionnaire (SGRQ) and the modified Medical Research Council dyspnea scale (mMRC) from 0 to 4. The SGRQ measures QoL dimensions: symptoms, activity, and impact. It has total and individual scores. Depression was considered in patients who had former diagnosis or with a BDI score >9 points. Physical activity was considered if was performed for more than 150 minutes (=3 times)/week. Statistical
Analysis: Chi2 test, Student's t test, Pearson correlation, and Kruskal-Wallis test. Software: Intercooled STATA.
Results: We evaluated 113 patients, mean age 63.1 8.3 years. 33 females (28.9%). Current smokers: 18.6%. Smoking intensity: 56.129.2 packs/year. Family history of depression: 13(11.2%). GOLD stage: Stage I: 2.6%, Stage II: 47.8%, Stage III: 37.2%, Stage IV: 12.4%. BMI: mean 26.94.7 kg/m2. The mean scores in each dimension of SGRQ were: total 46.2 18.7, symptoms 50.1 20.5, activity 61.1 22.4 and impact 35.4 19.2.
Depression n=51 (45.3%): patients who had previous diagnosis 7 (13.7%); diagnosed by BDI 44 (86.3%), BDI mean 11.48.4 points.
Depression was associated with: female gender (rough OR: 4.14, p Risk factors for depression (logistic regression) were: female gender (OR=5.37; IC 1.76-16.37; pDepression impacts on Quality of Life measured by SGRQ in total and in each dimension.
Conclusions: We found depression as a common finding in this sample of COPD individuals. Female gender, and higher degree of dyspnea were predictors. Physical activity was a protective factor. Depression was associated with greater impairment in QoL. Screening for depression may be necessary in COPD patients.
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New study identifies risk factors for depression among COPD patientsPublic release date: 20-May-2013 [ | E-mail | Share ]
Contact: Nathaniel Dunford ndunford@thoracic.org American Thoracic Society
ATS 2013, PHILADELPHIA ? Patients suffering from chronic obstructive pulmonary disease (COPD) typically suffer from depression more frequently than those without COPD, resulting in higher levels of disability and illness and increasing the overall healthcare burden for the COPD population. Now, a study from researchers in Argentina indicates female COPD patients and patients who experience significant shortness of breath may have the greatest risk for developing depression.
The results of the study will be presented at the ATS 2013 International Conference.
"About 10 percent of the general population suffers from depression, and studies have shown that rate to be significantly higher in patients with COPD," said study lead author Orlando Lopez Jove, MD, chief of the pulmonary laboratory at the Hospital Cetrangolo in Buenos Aires. "Not every COPD patient will suffer from depression, and being able to identify which patients are most at risk could be a valuable tool in ensuring those patients receive counseling and other treatment that could help improve their quality of life.
"In this study, we wanted to learn if factors including gender, lifestyle habits, COPD severity, shortness of breath and overall quality of life were related to the frequency of depression in COPD patients, and if they were related, to try to determine the extent of that relationship," he said.
For their study, the researchers evaluated 113 COPD patients who were treated at the Hospital Cetrangolo in Buenos Aires from January 2009 to March 2011 and who had not had exacerbations of their disease within the previous 30-day period. Patients were evaluated for pulmonary function and for the degree of shortness of breath they experienced, as well as other physical characteristics including weight and body mass index (BMI). The researchers used previous diagnoses of depression and the Beck Depression Inventory (BDI) to determine the presence and level of depression and the Saint George's Respiratory Questionnaire (SGRQ) to evaluate quality of life measures for each patient, and they also looked at specific lifestyle factors and habits like smoking and evaluated family history of depression. Patients were considered to be physically active if they engaged in physical activity for at least 150 minutes each week, the amount recommended by the American Heart Association to maintain good health.
At the end of the study, the researchers discovered that while the severity of COPD and smoking had no bearing on whether or not a patient had depression or their level of depression, patients who were female and those experiencing significant shortness of breath were at a significantly greater risk for the condition. They also found that the presence of depression and its intensity had a direct bearing on a patient's quality of life, affecting both the total quality-of-life score and the score for individual factors measured by the SGRQ.
The researchers also identified physical activity as a protective factor against depression, meaning patients who had higher levels of physical activity were less prone to developing depression.
"Depression is a disorder which remains easily undiagnosed due to underpresentation and because the symptoms are not very specific," said Dr. Lopez Jove, who is also vice-director of the pathophysiology department at the Latin American Thoracic Association (ALAT). "Therefore, it is important to consider this disorder in patients with COPD, especially in female patients and patients who experience significant shortness of breath.
A future planned study will help evaluate how treatment of depression affects these patients and their quality of life, he said.
"COPD patients have to deal not only with the physical consequences of the disease, but they also must deal with the psychological consequences of COPD," Dr. Lopez Jove noted. "Patients with depression often suffer from low self-confidence or self-efficacy, and early diagnosis and treatment of depression is very important for improving a patient's quality of life, maximizing healthcare utilization and improving treatment outcomes."
###
* Please note that numbers in this release may differ slightly from those in the abstract. Many of these investigations are ongoing; the release represents the most up-to-date data available at press time.
Abstract 39776
Depression In Patients With Chronic Obstructive Pulmonary Disease (COPD): Relationship To Dyspnea Degrees And Impact On Quality Of Life (Qol)
Type: Scientific Abstract
Category: 09.03 - COPD: Comorbidities (CP)
Authors: O.R. Lopez Jove1, A. Galdames2, V. Barrionuevo2, E. Giugno3, S. Rey2, Y.F. Wu4, G. Tabaj2, E. Lopez Gonzalez5; 1Hopital Cetrangolo - Buenos Aires/AR, 2Hospital "Dr. Antonio A.Cetrngolo" - Vicente Lopez - Buenos Aires/AR, 3Hospital "Dr. Antonio A.Cetrngolo" - 1147912090/AR, 4Hopital Cetrangolo - Vicente Lopez- Buenos Aires/AR, 5Argentine Diabetes Society - Caba/AR
Abstract Body
Background: The prevalence of depression in the general population is around 10%, being higher in patients with COPD. The presence of this comorbidity increases morbidity, disability, and health care burden.
Aims: To evaluate the frequency of depression in COPD patients and its relationship with gender, habits, COPD severity, degree of dyspnea and QoL.
Material and methods: we performed an observational, prospective study at Hospital "Dr. Cetrngolo", Argentina, in patients with COPD according to GOLD criteria (stages I to IV) without exacerbations in the last month. Evaluation included the following issues: anthropometric measures, pulmonary function tests, the Beck Depression Inventory (BDI), the Saint George's Respiratory Questionnaire (SGRQ) and the modified Medical Research Council dyspnea scale (mMRC) from 0 to 4. The SGRQ measures QoL dimensions: symptoms, activity, and impact. It has total and individual scores. Depression was considered in patients who had former diagnosis or with a BDI score >9 points. Physical activity was considered if was performed for more than 150 minutes (=3 times)/week. Statistical
Analysis: Chi2 test, Student's t test, Pearson correlation, and Kruskal-Wallis test. Software: Intercooled STATA.
Results: We evaluated 113 patients, mean age 63.1 8.3 years. 33 females (28.9%). Current smokers: 18.6%. Smoking intensity: 56.129.2 packs/year. Family history of depression: 13(11.2%). GOLD stage: Stage I: 2.6%, Stage II: 47.8%, Stage III: 37.2%, Stage IV: 12.4%. BMI: mean 26.94.7 kg/m2. The mean scores in each dimension of SGRQ were: total 46.2 18.7, symptoms 50.1 20.5, activity 61.1 22.4 and impact 35.4 19.2.
Depression n=51 (45.3%): patients who had previous diagnosis 7 (13.7%); diagnosed by BDI 44 (86.3%), BDI mean 11.48.4 points.
Depression was associated with: female gender (rough OR: 4.14, p Risk factors for depression (logistic regression) were: female gender (OR=5.37; IC 1.76-16.37; pDepression impacts on Quality of Life measured by SGRQ in total and in each dimension.
Conclusions: We found depression as a common finding in this sample of COPD individuals. Female gender, and higher degree of dyspnea were predictors. Physical activity was a protective factor. Depression was associated with greater impairment in QoL. Screening for depression may be necessary in COPD patients.
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Public release date: 20-May-2013
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