Chiral symmetry is consistently implemented in the two-nucleon problem at low-energy through the general e ective chiral lagrangian. The potential is obtained up to a certain order in chiral perturbation theory both in momentum and coordinate space. Results of a t to scattering phase shifts and bound state data are presented, where satisfactory agreement is found for laboratory energies up to about 100 MeV.

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OBJECTIVE -To examine the separate and combined effects of depression and diabetes on the incidence of adverse health outcomes among older Mexican Americans. RESULTS -The interaction of diabetes and depression was found to be synergistic, predicting greater mortality, greater incidence of both macro-and microvascular complications, and greater incidence of disability in activities of daily living, even when controlling for sociodemographic characteristics such as sex, age, education, acculturation, and marital status. Importantly, this interaction was found to predict not only greater incidence but also earlier incidence of adverse events in older adults. RESEARCH DESIGN AND METHODSCONCLUSIONS -Whether a marker for underlying disease severity, an indicator of diminished self-care motivation, or the result of physiologic changes, the interaction of depression and diabetes has a synergistic effect on the health of older Mexican Americans, increasing the risk for poor outcomes. This is of particular clinical importance because although depression is often underrecognized in older adults, effective treatment is available and can result in improved medical outcomes.

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