bluuebunny/crossref_metadata_2025 huggingface dataset:
Older adults and withdrawal from benzodiazepine hypnotics in general practice: effects on cognitive function, sleep, mood and quality of life
Authors: CURRAN H. V. , COLLINS R. , FLETCHER S. , KEE S. C. Y. , WOODS B. , ILIFFE S.
Published: October 2003

Background. Older adults are the main recipients of repeat prescriptions for benzodiazepine (BZD) hypnotics. BZDs can impair cognitive function and may not aid sleep when taken continuously for years. This study therefore aimed to determine if withdrawing from BZDs leads to changes in patients' cognitive function, quality of life, mood and sleep.

Method. One hundred and ninety-two long-term users of BZD hypnotics, aged [ges ]65 years, were identified in 25 general practices. One hundred and four who wished to withdraw were randomly allocated to one of two groups under double-blind, placebo controlled conditions: group A's BZD dose was tapered from week 1 of the trial; group B were given their usual dose for 12 weeks and then it was tapered. An additional group (C) of 35 patients who did not wish to withdraw from BZDs participated as ‘continuers’. All patients were assessed at 0, 12 and 24 weeks and 50% were re-assessed at 52 weeks.

Results. Sixty per cent of patients had taken BZDs continuously for >10 years; 27% for >20 years. Of all patients beginning the trial, 80% had successfully withdrawn 6 months later. There was little difference between groups A and B, but these groups differed from continuers (C) in that the performance of the withdrawers on several cognitive/psychomotor tasks showed relative improvements at 24 or 52 weeks. Withdrawers and continuers did not differ in sleep or BZD withdrawal symptoms.

Conclusions. These results have clear implications for clinical practice. Withdrawal from BZDs produces some subtle cognitive advantages for older people, yet little in the way of withdrawal symptoms or emergent sleep difficulties. These findings also suggest that, taken long-term, BZDs do not aid sleep.
Family study of the aggregation of eating disorders and mood disorders
Authors: MANGWETH B. , HUDSON J. I. , POPE H. G. , HAUSMANN A. , De COL C. , LAIRD N. M. , BEIBL W. , TSUANG M. T.
Published: October 2003

Background. Family studies have suggested that eating disorders and mood disorders may coaggregate in families. To study further this question, data from a family interview study of probands with and without major depressive disorder was examined.

Method. A bivariate proband predictive logistic regression model was applied to data from a family interview study, conducted in Innsbruck, Austria, of probands with (N=64) and without (N=58) major depressive disorder, together with 330 of their first-degree relatives.

Results. The estimated odds ratio (OR) for the familial aggregation of eating disorders (anorexia nervosa, bulimia nervosa and binge-eating disorder) was 7·0 (95% CI 1·4, 28; P=0·006); the OR for the familial aggregation of mood disorders (major depression and bipolar disorder) was 2·2 (0·92, 5·4; P=0·076); and for the familial coaggregation of eating disorders with mood disorders the OR was 2·2 (1·1, 4·6; P=0·035).

Conclusions. The familial coaggregation of eating disorders with mood disorders was significant and of the same magnitude as the aggregation of mood disorders alone – suggesting that eating disorders and mood disorders have common familial causal factors.
Life events, difficulties and dilemmas in the onset of chronic fatigue syndrome: a case–control study
Authors: HATCHER SIMON , HOUSE ALLAN
Published: October 2003

Background. The role of stress in the onset of chronic fatigue syndrome is unclear. Our objectives in this study were first, to determine the relation between the onset of chronic fatigue syndrome and stressful life events and difficulties. Secondly, we examined the role of a particular type of problem, dilemmas, in the onset of chronic fatigue syndrome.

Method. We used a case–control design with 64 consecutive referrals from an Infectious Diseases/Liaison Psychiatry Fatigue clinic and 64 age- and sex-matched controls from a general practice population control group in Leeds. We had two main outcome measures; the odds ratios of the risk of developing chronic fatigue syndrome after experiencing a severe life event, severe difficulties or both in the year and 3 months preceding onset; and the proportion of subjects in each group who experienced a dilemma prior to onset.

Results. Patients with chronic fatigue syndrome were more likely to experience severe events and difficulties in the 3 months (OR=9, 95% CI 3·2 to 25·1) and year (OR=4·3, 95% CI 1·8 to 10·2) prior to onset of their illness than population controls. In the 3 months prior to onset 19 of the 64 patients (30%) experienced a dilemma compared to none of the controls.

Conclusions. Chronic fatigue syndrome is associated with stressful events and difficulties prior to onset. Those events and difficulties characterized as being dilemmas seem to be particularly important.
Life events, social support and depression in childbirth: perspectives from a rural community in the developing world
Authors: RAHMAN A. , IQBAL Z. , HARRINGTON R.
Published: October 2003

Background. High rates of depression associated with childbirth have been reported in many parts of the developing world. However, the prevalence and associations of antenatal and post-natal depression in the rural population remain unknown. Disability associated with depression and its impact on infant health and development could have important public health implications for many developing countries where large proportions of the population are rural.

Method. All women living in southern Kahuta, Pakistan, in their third trimester of pregnancy were interviewed at 6 weeks before delivery (N=632) and again at 10–12 weeks after delivery (N=541), using WHO Schedule for Clinical Assessment in Neuropsychiatry (SCAN), Personal Information Questionnaire (PIQ) and Brief Disability Questionnaire (BDQ).

Results. The point prevalence of ICD-10 depressive disorder was 25% in the antenatal period and 28% in the post-natal period. Depressed mothers were significantly more disabled, had more threatening life events, and poorer social and family support than non-depressed mothers. Vulnerable mothers were more likely to be depressed during pregnancy, rather than have an onset in the post-natal period.

Conclusion. Over one-quarter of mothers in a rural sub-district of Pakistan suffer from depression shortly before and after childbirth. Rapidly changing traditional family structures and practices may be increasing the risk of depression in many women. Recognizing and treating depression should be initiated during the antenatal, rather than post-natal period.
Personality and the experience of environmental adversity
Authors: KENDLER K. S. , GARDNER C. O. , PRESCOTT C. A.
Published: October 2003

Background. While psychiatric epidemiology often focuses on the causal relationship between environmental adversity and the individual (e.g. environment to person), individuals probably make important contributions to the quality of their environments (person to environment).

Method. In a population based sample of >7000 male and female adult twins, we examined the relationship between the personality trait of neuroticism (N) and the occurrence of stressful life events (SLEs) and the quality of interpersonal relationships (IPR). We compared the magnitude of the prediction of twin 1's self-reported SLEs and IPR from: (i) twin 1's self-reported N; (ii) twin 2's report of twin 1's N; and (iii) twin 2's report of twin 2's N in monozygotic pairs.

Results. In our entire sample, self-report N significantly predicted the occurrence of most SLEs and all dimensions of IPR. Using the co-twin's report of N produced associations that were of the same magnitude for SLEs and modestly weaker for IPR. In monozygotic pairs, the level of N in one twin predicted SLEs and IPR in the co-twin at levels similar to those found for the co-twin's report of N. Repeating these analyses with a prospective subsample produced similar results.

Conclusion. An individual's personality in adulthood plays a significant role in influencing exposure to some forms of environmental adversity and this association is not the result of reporting bias. Furthermore, this relationship is largely mediated by a common set of familial factors that predispose both to a ‘difficult’ temperament and to environmental adversity. Developmental models of psychiatric illness should adopt an interactionist view of individuals and their environment (person and environment).
How often do patients with psychosis fail to adhere to treatment programmes? A systematic review
Authors: NOSÉ M. , BARBUI C. , TANSELLA M.
Published: October 2003

Background. Studies that assess the rates of psychotic patients who fail to adhere to treatment programmes have generated heterogeneous results, with estimates ranging from 24 to 90%. This paper presents findings from a systematic review on adherence to treatment by patients with psychosis. Its purpose is to provide an overall estimate of treatment non-adherence in community psychiatric services, and to analyse and study patient characteristics explaining the between-study heterogeneity in rates of non-adherence.

Method. A systematic review of published studies that report rates of non-adherence with medication and scheduled appointments by psychotic patients in community settings has been undertaken.

Results. A total of 103 studies were included in this systematic review. Eighty-six of these studies were suitable for data re-analysis. The overall weighted mean rate of non-adherence, calculated in a sample of 23796 patients, was 25·78%. A linear regression analysis of non-adherence rates on background characteristics showed that sample size was negatively associated with non-adherence rates, while first-contact cases and low-adherence cases, in comparison with ongoing cases, were associated with higher non-adherence rates. Factors associated with poor compliance included: lack of insight; positive symptoms; younger age; male gender; history of substance abuse; unemployment; and low social functioning.

Conclusions. Approximately one in four patients with psychosis fails to adhere with treatment programmes. Preventive evidence-based clinical interventions should be routinely implemented in community settings to reduce patient non-adherence.
Humiliation, loss and other types of life events and difficulties: a comparison of depressed subjects, healthy controls and their siblings
Authors: FARMER ANNE E. , McGUFFIN PETER
Published: October 2003

Background. It has been proposed that adverse life events involving loss or humiliation are particularly potent in provoking depressive episodes. We have also previously suggested that experiencing high rates of non-severe events may play a role in the development of resilience to the impact of severe threatening events when these occur.

Method. The Life Events and Difficulties Schedule (LEDS) (Brown & Harris, 1978) was used to record the life events experienced by 108 depressed probands and their nearest aged siblings as well as 105 healthy control subjects and their nearest aged siblings. All subjects were interviewed using the Schedule for the Clinical Assessment of Neuropsychiatry (SCAN) (Wing et al. 1990).

Results. Depressed probands were significantly more likely to have experienced a severe threatening event, loss event, or a humiliation event compared to the other subjects. These events also made up a greater proportion of the total number of events, in the depressed probands. Humiliation events were more frequent in depressed men than depressed women. There were no differences between the four groups for experiencing a non-severe event, although depressed probands also experienced more difficulties than the other three groups. Fifty-six healthy subjects who had not become depressed despite having experienced at least one severe and threatening event, had significantly more non-severe events, than the 116 subjects who were depressed at the time of interview.

Conclusions. The findings support the hypothesis that loss and humiliation events are particularly depressogenic. Experiencing a high rate of non-severe events may be associated with resilience to becoming depressed in the face of a threatening event.
Life events and early onset depression: cause or consequence?
Authors: PATTON G. C. , COFFEY C. , POSTERINO M. , CARLIN J. B. , BOWES G.
Published: October 2003

Background. Adverse life events prior to episodes of depression are assumed to play a causal role. Earlier studies have, however, not adequately controlled for the potential confounding effects of previous depression.

Method. A two-phase study was nested within a six-wave population based cohort study of 1947 adolescents. Interviews at two assessment phases with the CIS-R and CIDI were used to generate ICD-10 diagnoses of depressive disorder. Life events with longer-term contextual threat were reported for the 6 months before first diagnosis and categorized on the basis of participant appraisal as negative and neutral/positive in effects. Previous depressive and anxiety symptoms were measured 6 months earlier.

Results. Pre-existing depressive and anxiety symptoms predicted later events, increasing three-fold the risks for both neutral/positive and negative events in females and increased seven-fold the risk of negative events in males. Life events in turn predicted the onset of depressive disorder independently of previous symptoms. Single negative events held an over five-fold elevated risk and multiple events an almost eight-fold higher risk. Personal threat and loss were associated with disorder in females but not males.

Conclusions. The findings are consistent with a causal role for life events in early episodes of depression. The association also reflects a reciprocal relationship in which earlier symptoms predict later events, perhaps as a result of an individual's attempts to change unfavourable social circumstances.
Life events: effects and genesis
Authors: PAYKEL EUGENE
Published: October 2003

It is more than 40 years since a burst of studies in the late 1960s started what has become a substantial corpus of work, establishing the role of life events in psychiatric disorders (Brown & Birley, 1968; Paykel et al. 1969). Findings depended on advances in methodology. First, came development of a life events questionnaire and a scaling of their stress magnitude (Holmes & Rahe, 1967); then, replacement by more reliable and valid interview methods and better ways of distinguishing major and minor events (Brown & Harris, 1978; Paykel, 1996).
Adult Javanese migrants to Indonesian Papua at high risk of severe disease caused by malaria
Authors: BAIRD J. K. , BASRI H. , WEINA P. , MAGUIRE J. D. , BARCUS M. J. , PICAREMA H. , ELYAZAR I. R. F. , AYOMI E. , SEKARTUTI
Published: October 2003

Migrants from Java arrive in hyperendemic Papua, Indonesia lacking exposure to endemic malaria. We evaluated records of evacuation to hospital with a diagnosis of severe malaria from a transmigration village in northeastern Papua. During the first 30 months, 198 residents with severe disease were evacuated (7·5 evacuations/100 person-years). During this period the risk of evacuation for adults (>15 years of age) was 2·8. (95% CI=2·1–3·8; P<0·0001) relative to children, despite apparently equal exposure to risk of infection. Relative risk (RR) for adults was greatest during the first 6 months (RR>16; 95% CI[ges ]2·0–129; P=0·0009), and diminished during the second 6 months (RR=9·4; 95% CI=2·7–32·8; P<0·0001) and the third 6 months (RR=3·7; 95% CI=1·7–7·9; P=0·0004). During the next two 6-month intervals, the RR for adults was 1·6 and 1·5 (95% CI range 0·8–2·6; P<0·18). Adults lacking chronic exposure were far more likely to progress to severe disease compared to children during initial exposure, but not after chronic exposure to infection.
Real-time application of automated ribotyping and DNA macrorestriction analysis in the setting of a listeriosis outbreak
Authors: INGLIS T. J. J. , CLAIR A. , SAMPSON J. , O'REILLY L. , VANDENBERG S. , LEIGHTON K. , WATSON A.
Published: October 2003

A cluster of three cases of listeriosis cases occurred against a background of endemic listeriosis in Western Australia. Human and environmental isolates of Listeria monocytogenes obtained during the outbreak investigation were rapidly subtyped by automated ribotyping using an EcoRI protocol and a RiboPrinter®. DNA macrorestriction analysis by pulsed-field gel electrophoresis (PFGE) was used to confirm the relatedness of isolates. Serogroup 1/2 predominated among the food samples and the four clinical isolates from the outbreak cluster were also of this serogroup. All isolates from chicken material were serogroup 1/2 and indistinguishable by ribotype pattern. PFGE subdivided strains of this ribotype into four subtypes. The preliminary analysis had an immediate impact on hypothesis generation, environmental health investigations, environmental specimen collection and initial control measures. Sufficient typing data to guide environmental health and disease control initiatives was generated in less than one week by combining automated ribotyping with PCR-based detection of L. monocytogenes in suspect foodstuffs and an L. monocytogenes DNA probe. There were no further cases of bacteriologically confirmed listeriosis in Western Australia for six months after completion of the investigation.
Seroepidemiology of hepatitis B virus in Addis Ababa, Ethiopia: transmission patterns and vaccine control
Authors: ABEBE A. , NOKES D. J. , DEJENE A. , ENQUSELASSIE F. , MESSELE T. , CUTTS F. T.
Published: October 2003

A community-based seroepidemiological survey of Addis Ababa, Ethiopia was conducted in 1994 to inform on the transmission dynamics and control of hepatitis B virus (HBV) infection. Venous blood from 4736 individuals under 50 years of age from 1262 households, selected using stratified cluster-sampling, was screened for HBV markers using commercial ELISAs. HBsAg prevalence was 7% (95% CI 6–8), higher in males (9%; 7–10) than females (5%; 4–6). HBeAg prevalence in HBsAg positives was 23% (18–29), and less than 1% of women of childbearing age were HBeAg positive. Overall HBV seroprevalence (any marker), rose steadily with age to over 70% in 40–49 year olds, indicating significant childhood and adult transmission. Estimated instantaneous incidence was 3–4/100 susceptibles/year, higher in males than females in 0–4 year olds, and peaking in early childhood and young adults. The age at which 50% had evidence of infection was around 20 years, and the herd immunity threshold is approximated at 63–77%. Addis Ababa is of intermediate-high HBV endemicity, with negligible perinatal transmission. Our main findings are the identification of a significant difference between males and females in the age-acquisition of HBV infection, and marked differences between age groups in HBV incidence rates. These results should target future research studies of underlying risk factors. Furthermore, we generate a crude estimate of the level of coverage of HBV vaccine that would be required to eliminate the virus from the study population.
An outbreak of hepatitis A associated with consumption of raw blueberries
Authors: CALDER L. , SIMMONS G. , THORNLEY C. , TAYLOR P. , PRITCHARD K. , GREENING G. , BISHOP J.
Published: October 2003

This report describes the epidemiology, investigation and control of a hepatitis A (HAV) outbreak in New Zealand. Descriptive and analytical epidemiology, virology, product traceback and an orchard investigation were carried out. A case–control study revealed that 56% of 39 cases had consumed raw blueberries, compared with 14% of 71 controls (odds ratio 7·6; 95% confidence intervals 2·6–22·4). Traceback of product through retailers and wholesalers implicated a single commercial orchard. Hepatitis A virus was detected by reverse transcriptase polymerase chain reaction in faecal specimens from cases as well as a blueberry product from the orchard. Presence of hepatitis A virus was confirmed by DNA hybridization and sequencing of PCR products. Sanitary audit of the orchard revealed multiple opportunities for contamination of blueberries by pickers. This outbreak highlights the need for food safety programmes in the berry fruit industry.
Children at risk of giardiasis in Auckland: a case–control analysis
Authors: HOQUE M. E. , HOPE V. T. , SCRAGG R. , KJELLSTRÖM T.
Published: October 2003

The incidence rate of giardiasis in New Zealand is one of the highest among developed countries, peaking in the 1–4 year age group. A case–control study was undertaken to identify risk factors for giardiasis among Auckland children under 5 years of age. The exposure history of 69 cases and 98 controls were analysed. Ninety-five per cent cases and 86% controls used water from the Auckland Metropolitan mains (AMM) supply for domestic purpose, 44 cases and 42 controls swam and 59 cases and 54 controls wore nappies. Children wearing nappies were at significantly increased risk of the disease (OR=3·0, 95% CI=1·01–8·9), as were those from households which had more than one child wearing a nappy (6·5, 1·8–23·4). The Auckland metropolitan mains water supply was associated with a reduced risk compared to other drinking water sources. Significantly increased risks were also associated with drinking water consumed away from home (4·7, 2·2–10·1), swimming at least once a week (2·4, 1·1–5·3) and travelling domestically (2·5, 1·03–6·0). The study identified vulnerable groups and modifiable risk factors for diarrhoeal diseases, particularly Giardia infection. Nappy wearing was an independent risk factor for infection. Further study is advocated to ensure better protection of public health, especially for children.
A Norwalk-like virus waterborne community outbreak in a Swedish village during peak holiday season
Authors: CARRIQUE-MAS J. , ANDERSSON Y. , PETERSÉN B. , HEDLUND K.-O. , SJÖGREN N. , GIESECKE J.
Published: October 2003

An outbreak of gastroenteritis due to Norwalk-like virus (NLV) affecting approximately 500 people occurred in a Swedish ski resort during February–March 2002. Epidemiological investigations were performed on cohorts of schoolchildren, permanent residents and skiers visiting the area. Attack rates were respectively 39·7, 29·9 and 38·5%. Drinking un-boiled water originating from one of the three communal water systems was a significant risk factor for all groups. For schoolchildren, the risk of illness increased with increasing amount of water consumed. Nine of 12 stool samples of patients analysed tested positive for NLV. The water tested negative for indicator bacteria and results of NLV tests were inconclusive. In the absence of microbiological findings, the environmental authorities were reluctant to act based on the epidemiological analysis alone, and intervention was delayed until mid-April, following the discovery of a crack in a sewage pipe 10 m from the well.
Repeat capture–recapture studies as part of the evaluation of the surveillance of Legionnaires' disease in France
Authors: NARDONE A. , DECLUDT B. , JARRAUD S. , ETIENNE J. , HUBERT B. , INFUSO A. , GALLAY A. , DESENCLOS J.-C.
Published: October 2003

We evaluated improvements made to the mandatory notification surveillance system for Legionnaires' disease in France by estimating its sensitivity in 1995 and 1998 using a repeat capture–recapture method. A case of Legionnaires' disease was defined as a person treated for pneumonia in whom legionella had been detected. Patient details were collected from (1) mandatory notifications; (2) the National Reference Centre for Legionella; (3) a postal survey of all hospital laboratories. The three sources were cross-matched and 715 individual cases were identified. A log-linear model, which included an interaction term between mandatory notifications and both the National Reference Centre and Laboratory sources, provided an estimated total of 1124 cases (95% CI 973–1275) in 1998, a twofold increase compared with 1995. The sensitivity of the surveillance system improved from 10% in 1995 to 33% (95% CI 29–38%) in 1998. Capture-recapture methods are important tools in the evaluation of surveillance systems.
Molecular and antigenic characterization of rabies viruses from Iran identifies variants with distinct epidemiological origins
Authors: NADIN-DAVIS S. A. , SIMANI S. , ARMSTRONG J. , FAYAZ A. , WANDELER A. I.
Published: October 2003

A molecular epidemiological study of 48 recent rabies isolates recovered from cases reported throughout Iran identified three distinct viral variants, the evolutionary origins of which were identified by phylogenetic comparison with rabies viruses originating from Europe and Asia. Members of group 1 (15 isolates) were recovered from the northern half of the country only, while those of group 2 (31 isolates) were widely dispersed; both groups clustered within the widely disseminated cosmopolitan lineage. The two isolates of group 3 were detected in the northeastern tip of the country only and belonged to the Arctic strain. Rapid variant discrimination tools, employing restriction fragment length polymorphisms applied to amplified fragments of the viral genome, were devised whilst antigenic characterization of representative viruses identified a small panel of monoclonal antibodies that were also discriminatory. The future application of such methods should provide valuable epidemiological information on rabies incidence in Iran.
Antibodies against mumps in The Netherlands as assessed by indirect ELISA and virus neutralization assay
Authors: VAN DEN HOF S. , BEAUMONT M. T. A. , BERBERS G. A. M. , de MELKER H. E.
Published: October 2003

To obtain insight into mumps immunity 9 years after introduction of vaccination in The Netherlands, antibodies were measured in a national sample (n=8298) and in clustered religious groups with low vaccine acceptance (n=254). All sera were tested by indirect ELISA, and agreement with neutralization assay was assessed in a subsample (n=623). Overall seroprevalence in the adult age groups in the national sample was 96·2% (95% confidence interval 95·4–97·0%). Seroprevalence was somewhat lower in the vaccinated age groups, but still sufficient to maintain herd immunity. After the first dose of vaccine, an increase up to age three years to 93·2% (89·8–96·6%) and a subsequent decline in prevalence to 88·9% (81·7–96·0%) at age 7 years was seen. Seroprevalence in those eligible for two vaccinations was 94·4% (91·3–97·4%). In the religious groups, seroprevalence was generally lower in the age group 1–4 years (30% (18–95%)) than in the national sample, but similar in the older age groups. Seroprevalence as estimated by neutralization assay was only slightly lower for all age groups [ges ]1 year. Therefore, the indirect ELISA is a reliable method for measuring mumps virus-specific antibodies in population-based studies. However, to allow for inter-laboratory comparison, international unitage should be developed.
Peak occurrences of ciguatera fish poisoning precede cholera outbreaks in Hong Kong
Authors: KWAN L. C. , CHEUNG D. K. F. , KAM K. M.
Published: October 2003

Occurrences of ciguatera fish poisoning (CFP) and Vibrio cholerae infected patients in Hong Kong were reviewed for the 13-year period 1989–2001. Peak activity of CFP preceded peak activity of cholera in nine of the years except in 4 years (1990, 1991, 1992, 1996) where it was observed that the total number of cholera cases were all less than or equal to five per year (P<0·05). Average time interval was 2·4 months between peaks of CFP and Vibrio cholerae outbreaks. Findings suggested that the factors that affect cholera and ciguatera occurrences may not be operating in some years but when they are operating, they will affect both cholera and CFP. CFP peaks have consistently occurred before Vibrio cholerae peaks in our locality so much so that the occurrence of the latter can now be almost accurately predicted since 1998. CFP peaks served as an early warning for public measures to be in place before occurrence of cholera outbreaks.
A school outbreak of Norwalk-like virus: evidence for airborne transmission
Authors: MARKS P. J. , VIPOND I. B. , REGAN F. M. , WEDGWOOD K. , FEY R. E. , CAUL E. O.
Published: October 2003

An outbreak of gastroenteritis affected a school attended by children aged 4–11 years. Epidemiological features suggested this was due to Norwalk-like virus (NLV) and this was confirmed by polymerase chain reaction (PCR). Nucleotide sequence analysis of the PCR amplicons revealed identical strains in all five positive stool samples. Pupils were significantly more likely to become ill following an episode of vomiting within their classroom (adjusted odds ratio 4·1, 95% CI 1·8–9·3). The times from exposure to illness were consistent with direct infection from aerosolized viral particles where exposure to vomiting was high.

Cleaning with quaternary ammonium preparations made no impact on the course of the outbreak. However, the outbreak stopped after the school closed for 4 days and was cleaned using chlorine-based agents. This study confirms the importance of vomiting in the transmission of NLV and provides evidence that direct infection with aerosolized viral particles occurs.
A special risk group for hepatitis E infection: Turkish agricultural workers who use untreated waste water for irrigation
Authors: CEYLAN A. , ERTEM M. , ILCIN E. , OZEKINCI T.
Published: October 2003

Untreated waste water usage in agriculture is an important health-threatening issue which could affect both workers' and the public's health. In this study we researched hepatitis E infection in 46 of 57 farmers who used untreated waste water in agriculture. We compared them with 45 persons of the same socio-economic status and age. Anti-HEV seropositivity was 34·8% in the workers and 4·4% in the control group. We suggest that this type of irrigation is an important potential risk for hepatitis E infection.
Serological survey of anti-group A rotavirus IgM in UK adults
Authors: COX M. J. , MEDLEY G. F.
Published: October 2003

Rotaviral associated disease of infants in the UK is seasonal and infection in adults not uncommon but the relationship between these has been little explored. Adult sera collected monthly for one year from routine hospital samples were screened for the presence of anti-group A rotavirus immunoglobulin M class antibodies as a marker of recent infection. Anti-rotavirus IgM was seen in all age groups throughout the year with little obvious seasonal variation in the distribution of antibody levels. IgM concentrations and the proportion seropositive above a threshold both increased with age with high concentrations consistently observed in the elderly. Results suggest either high infection rates of rotavirus in adults, irrespective of seasonal disease incidence in infants, IgM persistence or IgM cross-reactivity. These results support recent evidence of differences between infant and adult rotavirus epidemiology and highlight the need for more extensive surveys to investigate age and time related infection and transmission of rotavirus.
Factors associated with the serological prevalence of Salmonella enterica in Greek finishing swineherds
Authors: LEONTIDES L. S. , GRAFANAKIS E. , GENIGEORGIS C.
Published: October 2003

Blood samples were taken from 50 finishing pigs at 90–105 kg in each of 59 randomly selected farrow-to-finish herds. The sera were tested for antibodies to Salmonella enterica by the Danish mix-ELISA. Samples with an optical density of >10% were considered to be positive. Associations between the odds of seropositivity of pigs and possible risk factors were evaluated in multivariable logistic regression models. The results of the analysis indicated that pigs fed non-pelleted dry or wet ration had 11 (P=0·0004) or 9 (P=0·02) times, respectively, lower odds of seropositivity than those fed pelleted ration. The risk of seropositivity was 4 (P=0·0006) times higher in pigs fed a combination of chlortetracycline, procaine penicillin and sulphamethazine during fattening than in those fed an approved growth promotor or a probiotic.
Sero-epidemiology of mumps in western Europe
Authors: NARDONE A. , PEBODY R. G. , VAN DEN HOF S. , LEVY-BRUHL D. , PLESNER A. M. , ROTA M. C. , TISCHER A. , ANDREWS N. , BERBERS G. , CROVARI P. , EDMUNDS W. J. , GABUTTI G. , SALIOU P. , MILLER E.
Published: October 2003

Six countries (Denmark, England and Wales, France, Germany, Italy and the Netherlands) conducted large serological surveys for mumps, in the mid-1990s, as part of the European Sero-Epidemiology Network (ESEN). The assay results were standardized and related to the schedules and coverage of the immunization programmes and the reported incidence of mumps. Low incidence of disease and few susceptibles amongst adolescents and young adults was observed in countries with high mumps vaccine coverage (e.g. the Netherlands). High disease incidence and large proportions of mumps virus antibody negative samples in adolescent and young adult age groups was noted in countries with poor vaccine coverage (e.g. Italy). The build-up of susceptibles in older children and adolescents in England and Wales, France, the former West Germany and Italy indicate the possibility of further mumps outbreaks in secondary school environments. To control mumps in western Europe, current MMR immunization programmes will need to be strengthened in a number of countries. Sero-surveillance of mumps is an important component of disease control and its usefulness will be enhanced by the development of an international mumps standard.
Genotyping of Cryptosporidium spp. isolated from human stool samples in Switzerland
Authors: FRETZ R. , SVOBODA P. , RYAN U. M. , THOMPSON R. C. A. , TANNER M. , BAUMGARTNER A.
Published: October 2003

In a study to estimate the frequency of Cryptosporidium infections in Switzerland, stool samples from patients found to be positive for Cryptosporidium spp. by modified Ziehl–Neelson staining and fluorescence microscopy were used for genotyping experiments. With 9 of 12 samples, DNA extraction and subsequent genotyping was successful. All Cryptosporidium-isolates belonged to the bovine genotype. In one stool sample, two strains of Cryptosporidium were demonstrated, suggesting a mixed infection. In comparison with reference strains from calves, one of the isolates showed a full sequence identity and the other a similarity of 97·5%. The fact that only bovine genotypes were detected suggests, that cryptosporidiosis must primarily be considered as a zoonotic disease in Switzerland. This is in contrast to other countries, where the human genotype of C. parvum was shown to dominate the epidemiological situation. The results of our study are supported by the previous finding, that two of the analysed strains originated from patients who used to consume raw milk or raw cream, a known risk factor for cryptosporidiosis.
Bacterial infection in exacerbated COPD with changes in sputum characteristics
Authors: MONSÓ E. , GARCIA-AYMERICH J. , SOLER N. , FARRERO E. , FELEZ M. A. , ANTÓ J. M. , TORRES A. ,   for the EFRAM Investigators
Published: October 2003

We examined the risk factors for bacterial exacerbation, defined as the presence of pathogenic bacteria in sputum, in 90 chronic obstructive pulmonary disease (COPD) patients with an exacerbation and changes in sputum characteristics. Smoking, alcohol, lung function, body mass index, medical visits and treatments were the independent variables assessed using multivariable logistic regression modelling (OR, 95% CI). A bacterial exacerbation was diagnosed in 39 (43·3%) of 90 patients. Bacterial exacerbations were more prevalent among current smokers (OR 3·77, 95% CI 1·17–12·12), in patients with poor compliance with inhalation therapy (OR 3·25, 95% CI 1·18–8·93) and with severe lung function impairment (FEV1 OR 0·96, 95% CI 0·93-1·00). Prior use of antibiotics was a risk factor for Pseudomonas aeruginosa infection (OR 6·06, 95% CI 1·29–28·44) and influenza vaccination appeared to have a protective effect against this infection (OR 0·15, 95% CI 0·03–0·67). We conclude that severe impairment of lung function, smoking and poor compliance with therapy are risk factors for bacterial infection in COPD, and P. aeruginosa should be suspected in patients who have been treated with antibiotics and in those not vaccinated against influenza.
Estimating the sensitivity and specificity of matching name-based with non-name-based case registries
Authors: ETKIND P. , TANG Y. , WHELAN M. , RATELLE S. , MURPHY J. , SHARNPRAPAI S. , DEMARIA A.
Published: October 2003

Because non-name-based case registries have recently been used for reporting human immunodeficiency virus infection, this study attempted to define the sensitivity, specificity and accuracy of case registry matches using non-name-based registries. The AIDS, sexually transmitted disease (STD), and tuberculosis (TB) case registries were matched using all available information to establish the standard. The registries were then matched again using five increasingly less specific criteria to compare sensitivity, specificity and accuracy. The registries were then also transformed into non-name-based codes as if they were the HIV registry and matched again. With name-based registries, sensitivities increased as the matching criteria became less exacting, while the accuracy declined slightly. Specificities remained close to 100% due to the relatively small number of matched cases. Results from matches of non-name-based registry matches were similar to those of the name-based registry matches. Non-name reporting can be used for data matching with acceptable accuracy.
The Persians in the Roman Near East (602–630 AD)
Authors: Foss Clive
Published: October 2003

When the decisive battle of the Yarmuk in 636 AD gave the Muslim Arabs control of Syria, they gained a land that had been Roman for 700 years. Yet in the memory of most of its inhabitants, their recent subjection to the Sassanian Persians would have been fresh and even dominant. The forces of Chosroes II, which had controlled Syria for a generation, had only been withdrawn in 630. Anyone who had reached adulthood by the time the Arabs arrived had already experienced the Persian occupation; many were born or raised during it. This period of Persian rule, which lasted twenty years or more in Syria, Mesopotamia and Armenia, fifteen in Palestine and ten in Egypt, may have played a major role in accustoming the locals to non-Roman rule, or may have had violently disruptive effects that facilitated the subsequent Arab conquest. So far, the period has been poorly known and never studied as a whole, allowing many theories to be projected upon it. For the most part, historians and especially archaeologists have assigned to the Persians a highly negative and destructive role.
Update on Luri: How many languages?
Authors: Anonby Erik John
Published: October 2003

Luri is an Indo-Iranian language cluster with over four million speakers. The Luri ethnic area is found in southwestern Iran and southeastern Iraq, although smaller numbers of speakers have emigrated to elsewhere in Asia and a number of cities in the West.
“The Islamization of Yoga in the Amrtakunda Translations”
Authors: Ernst Carl W.
Published: October 2003

From the beginning of Orientalist studies of the Muslim world, it was axiomatic to define certain religious phenomena in terms of their origins. Because of the tendency to view all Eastern doctrines as essentially alike, Orientalist scholars of the Romantic period invariably defined Sufism as a mysticism that was Indian in origin; from the first appearance of the term in European languages, “Sufism” was characterised as essentially Looking back at this early scholarship today, it is surprising that this unanimous belief in the Indian origin of Sufism was almost entirely unconnected to any historical evidence. From the days of Sir William Jones and Sir John Malcolm to relatively recent times, this opinion has had a remarkable longevity, despite the ludicrous appearance of some of these claims today. As an example one may consider the outrageous claim of Max Horten, in a 1928 study that sought to explain Sufism as a pure expression of Vedanta: “No doubt can any longer remain that the teaching of Hallaj (d. 922) and his circle Another pertinent example is found in an observation of William James in his 1902 Gifford Lectures, published as The Varieties of Religious Experience:

In the Mohammedan world the Sufi sect and various dervish bodies are the possessors of the mystical tradition. The Sufis have existed in Persia from the earliest times, and as their pantheism is so at variance with the hot and rigid monotheism of the Arab mind, it has been suggested that Sufism must have

James's remark illustrates, innocently enough, how widely this opinion was shared at the time by the academic world in Europe and America. It is easier to see from the perspective of the later twentieth century that this opinion was conditioned by nineteenth-century racial attitudes as well as assumptions about the unchanging nature of religions.
Prosodic cues to semantic structure in native and nonnative listening
Authors: AKKER EVELIEN , CUTLER ANNE
Published: October 2003

Listeners efficiently exploit sentence prosody to direct attention to words bearing sentence accent. This effect has been explained as a search for focus, furthering rapid apprehension of semantic structure. A first experiment supported this explanation: English listeners detected phoneme targets in sentences more rapidly when the target-bearing words were in accented position or in focussed position, but the two effects interacted, consistent with the claim that the effects serve a common cause. In a second experiment a similar asymmetry was observed with Dutch listeners and Dutch sentences. In a third and a fourth experiment, proficient Dutch users of English heard English sentences; here, however, the two effects did not interact. The results suggest that less efficient mapping of prosody to semantics may be one way in which nonnative listening fails to equal native listening.
Competing activation in bilingual language processing: Within- and between-language competition
Authors: MARIAN VIORICA , SPIVEY MICHAEL
Published: October 2003

Two eye-tracking experiments examined spoken language processing in Russian-English bilinguals. The proportion of looks to objects whose names were phonologically similar to the name of a target object in either the same language (within-language competition), the other language (between-language competition), or both languages at the same time (simultaneous competition) was compared to the proportion of looks in a control condition in which no objects overlapped phonologically with the target. Results support previous findings of parallel activation of lexical items within and between languages, but suggest that the magnitude of the between-language competition effect may vary across first and second languages and may be mediated by a number of factors such as stimuli, language background, and language mode.
Testing Hulk & Müller (2000) on crosslinguistic influence: Root Infinitives in a bilingual German/English child
Authors: UNSWORTH SHARON
Published: October 2003

This paper considers whether the findings on the referential properties of Root Infinitives in monolingual children (Wijnen, 1997; Hoekstra and Hyams, 1998) are replicated in a bilingual situation. Testing a proposal put forward by Hulk and Müller (2000), the present study investigates whether and how crosslinguistic influence manifests itself, using original longitudinal data from a bilingual German/English child. The bilingual results are found to be broadly consistent with the monolingual data: there is no indication of either quantitative or qualitative crosslinguistic influence. Consequently, it is argued that these data show that Hulk and Müller's proposal needs refining. Suggestions are made as to how this could be achieved.
Effects of wind‐forcing on the dynamic spectrum in wave development: A statistical approach using a parametric model
Authors: Hokimoto T. , Kimura N. , Amagai K. , Iwamori T. , Huzii M.
Published: October 2003

Previously, studies on the dynamic structure of the spectrum in the wave development process have considered only the physical mechanism of the transmission of energy from wind to wave or have considered purely mathematical methodologies. Few studies have examined the statistical mechanism of the dynamic relationship between sea surface movement, wind motion, and the time‐varying spectrum of the sea surface movement. In the present paper, we investigate the statistical structure of the sea surface movement and the wind motion in developing wind waves and propose a spectral model to estimate the time‐varying spectral density function. The validity of the proposed model is demonstrated through numerical experiments to evaluate the forecasting accuracy. The proposed model is used to examine the degree of the influence by wind motion, which affects the spectral density function. In the present study, we analyzed the time series record in the wave development process measured in Uchiura (Funka) Bay, Hokkaido, Japan. The basic results are summarized as follows: (1) the nonstationary statistical structure presented herein yields one of the effective classes by which to explain the dynamic mechanism between the time‐varying spectral density function of sea surface movement and wind motion, and (2) in our numerical experiments the spectral model allowed effective forecasting, especially in the case of high wind speed.
Sensitivity of biogenic carbon export to ocean climate in the Labrador Sea, a deep‐water formation region
Authors: Tian Ru Cheng , Vézina Alain F. , Deibel Don , Rivkin Richard B.
Published: October 2003

We used a physical‐biogeochemical model to examine the sensitivity of biogenic carbon export to ocean climate in the Labrador Sea, a subpolar, deep‐water formation region. Documented changes in winter mixed layer depth between the late 1960s and the mid‐1990s were used to construct scenarios of weak, moderate, and strong winter convection that drive the biogeochemical model. The model simulations suggest that the total biogenic carbon export (particle sinking flux + DOC export) is higher under strong winter convection (e.g., during the early 1990s) than under weak winter convection (e.g., during the late 1960s), by ∼70% across the 200‐m isobath and nearly double at 500 m and 1000 m depth. These large variations in total biogenic carbon export are essentially due to the response of DOC export to ocean climate conditions. Sensitivity analyses indicate that the variations in DOC export from the euphotic zone are due to the impact of the convection regime on the development of the microbial food web and on the bacterial consumption of DOC in surface waters. Although DOC downward fluxes within the mesopelagic zone (below ∼500 m) are largely controlled by physical processes, the effect of convection on microbial dynamics can potentially amplify the year‐to‐year variations in the transport of DOC to the deep ocean due to convection.