bluuebunny/crossref_metadata_2025 huggingface dataset:
Information Sharing in Interdisciplinary Team Meetings: An Evaluation of Hospice Goals
Authors: Wittenberg-Lyles Elaine M.
Published: November 2005

The author observed interdisciplinary team (IDT) meetings of “Town Hospice” to examine how the company goal of providing for the “psychosocial needs of the patient and their loved ones” is addressed. More specifically, she used an ethnographic approach to explore how case managers negotiate the addition of psychosocial information about patients during IDT meetings. She found that psychosocial information on patients was primarily limited to three types of information sharing: (a) information related to care goals, (b) family issues related to bereavement and caretaking, and (c) the request of additional help from team members. Furthermore, she understood that the addition of psychosocial information creates a dialectical tension for the team.
Publish or Perish
Authors: De Rond Mark , Miller Alan N.
Published: November 2005

There are few more familiar aphorisms in the academic community than “publish or perish.” Venerated by many and dreaded by more, this phenomenon is the subject of the authors’ essay. Here they consider the publish or perish principle that has come to characterize life at many business schools. They explain when and why it began and suggest reasons for its persistence. This exercise elicits questions that appear as relatively neglected but are integral to our profession, namely, the effect of publish or perish on the creativity, intellectual lives, morale, and psychological and emotional states of faculty.
A Theory of the Firm Only a Microeconomist Could Love?
Authors: Lange Thomas
Published: November 2005

Despite recent criticism of agency theory to inform corporate governance research, the author of this article remains wholly unconvinced and argues that the theory has much to offer to help scholars understand organizational complexities. In response to Michael Lubatkin’s critique of agency theory, he highlights shared interests between the scholarship of organizational behaviorists and microeconomists and contends that both discipline areas can do more than merely coexist.
The Revenge of Gratuitousness on Utilitarianism
Authors: Gagliardi Pasquale
Published: November 2005

This essay seeks to demonstrate that the spread of utilitarian rationalism within developed Western societies has had two crucial consequences: (a) gratuitousness and expressiveness, as irrepressible human needs, have been crushed “at the door” of utilitarian organizations but then have surreptitiously re-entered through the window, camouflaging themselves in forms that render them difficult to recognize and enable them to evade the mechanisms of social censorship that protect the image of organizations as the uncontested domain of instrumental rationality, and (b) the expert knowledge produced about organizations since the beginning of the last century has for almost 80 years ignored the expressive dimension of organizational life. From this point of view, the scientific community of organizational scholars has displayed an astonishing sort of collective repression. The forms taken by this repression and the expedients used to reduce the cognitive dissonance inevitably provoked by evidence of what has been repressed are examined.
Robert Morris and a Lost 18th-Century Vegetarian Book
Authors: Adams Carol J.
Published: November 2005

In 1746, Robert Morris, an 18th-century architectural innovator, authored A Reasonable Plea for the Animal Creation. It never entered the vegetarian canon, nor is it listed among his other published works. The bulk of the book is devoted to reprinting nine letters Morris had sent to a friend defending his abstinence from eating meat. He also responds to published arguments that the book of Genesis prohibits eating of blood but permits the eating of animals. I provide an introduction to the book and excerpts from the letters. Morris’s arguments include that in an interconnected world, flesh eating exhibits rank Pride and Haughtiness of Soul, that the Golden Rule guides humans not to prey on animals, that animal confinement causes illness and infections, and that we have no right of property from nature. Morris’s work is a valuable addition to vegetarian history, to discussions of veganism, and to factory farming and animal confinement debates.
Long-Term Follow-up of Patients with Spinal Cord Injury
Authors: Yilmaz Figen , Sahin Fusun , Aktug Semra , Kuran Banu , Yilmaz Adem
Published: November 2005

Objective. The aim of this study was to evaluate the motor, sensory, and functional recovery in patients with spinal cord injury (SCI). Methods. Forty-one patients with SCI participated in this study. Twenty patients were evaluated after discharge. Each patient was evaluated by the American Spinal Injury Association (ASIA) impairment scale and the Functional Independence Measure (FIM) at admission, before discharge, and at least at 6 months after discharge. Friedman, Dunn, and Mann-Whitney U tests were used for statistical analysis. Results. There were 17 male and 3 female patients. Seven patients had complete SCI, and 13 patients had incomplete SCI. The evaluation of motor, sensory, and FIM scores at admission showed significant improvement in all of the patients during the follow-up period (P < 0.0001). Five incompletely injured cases improved with regard to ASIA staging. Motor and FIM scores significantly increased at follow-up for converted and unconverted patients. All parameters increased at follow-up in patients who were complete and incomplete. Motor scores significantly increased at discharge and at follow-up. FIM scores also increased significantly at follow-up in incomplete patients. Conclusion. Motor, sensory, and FIM scores increased in patients with SCI after a follow-up period of 18 months. Improvement to a higher ASIA stage could be accomplished by 25% of the patients. Although both complete and incomplete patients recovered significantly at the follow-up period, only incompletely injured cases could convert to a higher ASIA stage.
Development of a Schedule of Current Physiotherapy Treatment Used to Improve Movement Control and Functional Use of the Lower Limb after Stroke: A Precursor to a Clinical Trial
Authors: Pomeroy V. M. , Cooke E. , Hamilton S. , Whittet A. , Tallis R. C.
Published: November 2005

Objective. To develop a treatment schedule of physical therapy techniques used to improve movement control and functional use of the paretic lower limb after stroke in U.K. clinical centers to be involved in a subsequent clinical trial of experimental interventions given in addition to routine clinical practice. Methods. Ten physiotherapists experienced in stroke rehabilitation who worked in or near the clinical centers to be involved in a subsequent clinical trial completed an individual semi-structured interview. The verbatim transcripts were condensed independently by 2 researchers into a draft list of interventions. The researchers then resolved disagreement through discussion and produced a preliminary list of interventions. At a focus group meeting, the participating physiotherapists discussed the preliminary list, refined it to produce a final list, and then transformed it into a draft treatment schedule. The draft treatment schedule was piloted in clinical practice. Refinements were made, and the final treatment schedule was produced. Results. The treatment schedule consists of an A4 recording form with instructions and glossary of terms printed on the back. Each treatment record provides information including duration of treatment, treatment aims, and the 45 specific physical therapy interventions provided in the 11 sections (e.g., “splinting techniques” and “function - in sitting towards standing”). Conclusion. A treatment schedule was produced, which can now be used in a subsequent phase II evaluative trial.
Combined Effects of Neurotrophin Secreting Transplants, Exercise, and Serotonergic Drug Challenge Improve Function in Spinal Rats
Authors: Nothias J- M , Mitsui T. , Shumsky J. S. , Fischer I. , Antonacci M. D. , Murray M.
Published: November 2005

Objectives. To determine the effects of neurotrophin-secreting transplants combined with exercise and serotonergic drug challenges on recovery of hindlimb function in rats with midthoracic spinal cord transection injuries. Methods. Spinalized animals received transplants of fibroblasts genetically modified to express brain-derived neurotrophic factor and neurotrophin-3 and daily cycling exercise. Hindlimb movement in an open-field test (BBB) was scored weekly. Serotonin agonists were used monthly to further stimulate motor function. Axonal growth was quantified in the transplant and at L5 using immunocytochemical markers. Weights of hindlimb muscles were used to assess muscle atrophy. Results. Neurotrophin-secreting transplants stimulated axonal growth, and cycling prevented muscle atrophy, but individual treatments did not improve motor scores. Combined treatments resulted in improvements in motor function. Serotonergic agonists further improved function in all groups, and transplant groups with exercise achieved weight-supporting levels following drug treatment. Conclusion. Combined treatments, but not individual treatments, improved hindlimb function.
Rehabilitation and Functional Neuroimaging Dose-Response Trajectories for Clinical Trials
Authors: Dobkin Bruce H.
Published: November 2005

Background. In clinical trials, behavioral outcomes and physiological measures of activity-dependent plasticity that evolve with task-oriented therapies may fail to reach statistical significance. When significant, clinical effectiveness may not be robust enough to alter professional practices. Objective. Provide the conceptual basis for a research design to optimize the effect of an experimental treatment. Methods. Literature review. Results. Research designs usually do not take into consideration the dynamic state of each subject’s potential responsiveness to an intervention. Providing a rational, rather than convenient, intensity and duration of therapy may remedy this potential confounder for clinical trials. To determine whether a most effective dose of a therapy exists, investigators could assess subjects before the intervention, administer interim measures at planned intervals, and continue the intervention until the primary behavioral outcomes or functional imaging parameters or both reach a plateau for at least 15 h of additional treatment. Conclusion. Promising interventions ought to be continued in phase II/III trials until subjects reach an asymptote in the primary outcome for behavioral gains. For neuroimaging studies that aim to correlate brain-behavior measures during rehabilitation, the specific intervention should also continue until behavioral gains and cerebral adaptations have attained a persistent plateau. Future trials can investigate whether functional neuroimaging performed in parallel with repeated behavioral assessments can better inform researchers about the optimal duration of an experimental therapy and a subject’s maximal capacity for intervention-induced cerebral reorganization.
Perceptions of asthma among physicians: an exploratory study with the ISAAC video
Authors: Van Sickle D.
Published: November 2005

The current study examined the perception and interpretation of asthma symptoms among practitioners using standardised audiovisual presentations of asthma.

Two groups of practitioners (n = 70) in Chennai, India, were shown the International Study of Asthma and Allergies in Childhood (ISAAC) video questionnaire and asked to describe the symptoms and signs they observed and to identify possible diagnoses for each presentation.

The number of practitioners who correctly described the principal symptom(s) of asthma depicted in the five video sequences ranged from 26.1% for scene 5 (wheezing and dyspnoea), to 94.2% for scene 4 (nocturnal cough). The number who identified asthma as a possible cause of the presentations ranged from 17.4% for scene 4, to 67.1% for scene 2 (wheeze after exercise). Practitioners with postgraduate medical education were significantly more likely to identify asthma as a possible cause of the presentations, as were practitioners with postgraduate training in respiratory diseases.

In conclusion, the perceptions of asthma and asthma symptoms among many physicians in Chennai, India, do not match the presentations of asthma depicted in the International Study of Asthma and Allergies in Childhood (ISAAC) video. These differences may be limiting the diagnosis and apparent prevalence of asthma, and suggest the need for additional attention to asthma in the education and training of practitioners in India.
Driving simulator and neuropsychological testing in OSAS before and under CPAP therapy
Authors: Orth M. , Duchna H-W. , Leidag M. , Widdig W. , Rasche K. , Bauer T. T. , Walther J. W. , de Zeeuw J. , Malin J-P. , Schultze-Werninghaus G. , Kotterba S.
Published: November 2005

Patients with obstructive sleep apnoea syndrome (OSAS) have an increased car accident rate. Investigations on accident frequency are based on case history, insurance reports and driving simulator studies. The present study combines neuropsychological testing of different attention aspects engaged in driving a car and driving simulation to evaluate a suitable instrument for assessing therapeutic effects of continuous positive airway pressure (CPAP).

Driving simulator investigation and neuropsychological testing of alertness, vigilance and divided attention were performed in 31 patients with polysomnographically confirmed OSAS (apnoea–hypopnoea index 24.8±21.5·h−1) before, and 2 and 42 days after initiation of CPAP.

Divided attention and alertness improved significantly during CPAP, whereas vigilance remained unchanged. However, accident frequency (OSAS before therapy: 2.7±2.0; 2 days after CPAP: 1.5±1.4; 42 days after CPAP: 0.9±1.3) and frequency of concentration faults (OSAS before therapy: 12.4±5.1; 2 days after CPAP: 6.5±3.9; 42 days after CPAP: 4.9±3.3) decreased in the simulated driving situation after 2 and 42 days of therapy. There was no relation between accident frequency, concentration faults and daytime sleepiness, as measured by the Epworth Sleepiness Scale, and polysomnographic or neuropsychological findings, respectively.

In conclusion, the present results suggest that driving simulation is a possible benchmark parameter of driving performance in obstructive sleep apnoea syndrome patients.
The effects ofAspergillus fumigatuschallenge on exhaled and nasal NO levels
Authors: Stark H. J. , Randell J. T. , Hirvonen M-R. , Purokivi M. K. , Roponen M. H. , Tukiainen H. O.
Published: November 2005

Several studies have previously shown that exposure to indoor air microbes from moisture-damaged buildings can cause adverse health effects.Aspergillus fumigatusis one of the best-documented moulds causing health problems to those exposed.

In this study, inhalation of a commercialA. fumigatussolution was assessed, to establish if it would have effects on fractional exhaled (FeNO) and nasal (FnNO) nitric oxide levels and on lung function. The results were compared with placebo challenge.

A total of 28 subjects were divided into three study groups: group 1 had been exposed to occupational mould; group 2 consisted of atopic subjects; and group 3 was a control group. Some 3 h afterA. fumigatuschallenge, there was a considerable increase in FeNO, and a significant difference was observed between theA. fumigatusand placebo inhalations. The difference was seen in all study groups. No such differences were found in the levels of FnNOor nitrite in nasal lavage fluid. Subjects reported significantly more frequent respiratory tract symptoms after theA. fumigatusinhalation compared with placebo challenge.

In conclusion, it was shown here that inhalation challenge ofAspergillus fumigatuselevated fractional exhaled nitric oxide levels. An increase in fractional exhaled nitric oxide may serve as an indicator of respiratory inflammation of acute mould exposure.
Self-management reduces both short- and long-term hospitalisation in COPD
Authors: Gadoury M-A. , Schwartzman K. , Rouleau M. , Maltais F. , Julien M. , Beaupré A. , Renzi P. , Bégin R. , Nault D. , Bourbeau J.
Published: November 2005

The aim of the present study was to assess the long-term impact on hospitalisation of a self-management programme for chronic obstructive pulmonary disease (COPD) patients.

A multicentre, randomised clinical trial was carried out involving 191 COPD patients from seven hospitals. Patients who had one or more hospitalisations in the year preceding study enrolment were assigned to a self-management programme “Living Well with COPDTM” or to standard care. Hospitalisations from all causes were the primary outcome and were documented from the provincial hospitalisation database; emergency visits were recorded from the provincial health insurance database.

Most patients were elderly, not highly educated, had advanced COPD (reflected by a mean forced expiratory volume in one second of 1 L), and almost half reported a dyspnoea score of 5/5 (modified Medical Research Council). At 2 years, there was a statistically significant and clinically relevant reduction in all-cause hospitalisations of 26.9% and in all-cause emergency visits of 21.1% in the intervention group as compared to the standard-care group. After adjustment for the self-management intervention effect, the predictive factors for reduced hospitalisations included younger age, sex (female), higher education, increased health status and exercise capacity.

In conclusion, in this study, patients with chronic obstructive pulmonary disease who received educational intervention with supervision and support based on disease-specific self-management maintained a significant reduction in hospitalisations after a 2-year period.
Granulocytosis and increased adhesion molecules after resistive loading of the diaphragm
Authors: Wang X. , Jiang T-X. , Road J. D. , Redenbach D. M. , Reid W. D.
Published: November 2005

Upregulation of endothelial cell adhesion molecules, followed by an influx of granulocytes and macrophages, can contribute to exertion-induced skeletal muscle injury. The purpose of this study was to quantify circulating leukocyte subsets, diaphragm injury and infiltrating leukocyte subsets, and surface expression of vascular cell adhesion molecule (VCAM)-1 and intracellular adhesion molecule (ICAM)-1 in the diaphragm after inspiratory resistive loading (IRL).

Eight New Zealand white rabbits underwent 1.5 h of IRL and seven control rabbits underwent a sham procedure. Blood samples, taken at baseline and 2, 6, 12, 24, 48 and 72 h after the onset of IRL or sham, showed that band cell counts had increased at 6 h post-IRL. Point counting of haematoxylin and eosin-stained cross-sections, sampled at 72 h post-IRL, showed greater injury in diaphragms from IRL rabbits compared with controls. Immunohistochemical processing showed increased expression of ICAM-1 and VCAM-1, and higher granulocyte and macrophage counts in IRL diaphragms than control diaphragms. Macrophages were the predominant inflammatory cells.

Increased intracellular adhesion molecule-1 and vascular cell adhesion molecule-1 expression, and infiltration of granulocytes and macrophages may contribute to inspiratory resistive loading-induced diaphragm injury.
Effect of 1-year smoking cessation on airway inflammation in COPD and asymptomatic smokers
Authors: Willemse B. W. M. , ten Hacken N. H. T. , Rutgers B. , Lesman-Leegte I. G. A. T. , Postma D. S. , Timens W.
Published: November 2005

Smoking cessation is the only treatment in patients with chronic obstructive pulmonary disease (COPD) effective in slowing down disease progression. Its effect on airway inflammation in COPD is unknown, although cross-sectional studies suggest ongoing inflammation in ex-smokers.

In order to elucidate the effect of smoking cessation on airway inflammation, 28 smokers with COPD (mean age: 55 yrs; forced expiratory volume in one second: 71% predicted) and 25 asymptomatic smokers with normal lung function (aged 50 yrs) were included in a 1-yr smoking cessation programme. Effects of smoking cessation on airway inflammation were investigated in bronchial biopsies (baseline, 12 months) and sputum samples (baseline, 2, 6 and 12 months).

In the 12 candidates with COPD who successfully ceased smoking, airway inflammation persisted in bronchial biopsies, while the number of sputum neutrophils, lymphocytes, interleukin (IL)-8 and eosinophilic-cationic-protein levels significantly increased at 12 months. In the 16 asymptomatic smokers who successfully quitted, inflammation significantly reduced (i.e.number of sputum macrophages, percentage of eosinophils and IL-8 levels) or did not change.

The current authors suggest that the observed persistent airway inflammation in patients with chronic obstructive pulmonary disease is related to repair of tissue damage in the airways. It remains to be elucidated whether this reflects a beneficial or detrimental effect.
Reversibility of pulmonary arterial hypertension in HIV/HHV8-associated Castleman's disease
Authors: Montani D. , Achouh L. , Marcelin A. G. , Viard J-P. , Hermine O. , Canioni D. , Sitbon O. , Simonneau G. , Humbert M.
Published: November 2005

The present study describes a case of pulmonary arterial hypertension (PAH) associated with multicentric Castleman's disease in a patient infected with HIV type 1 and human herpes virus 8.

Therapy included highly active antiretroviral therapy, warfarin, diuretics, continuousi.v.epoprostenol and 12-monthly pulses of cyclophosphamide.

The patient's condition improved dramatically with complete reversibility of PAH, allowing weaning of continuousi.v.epoprostenol therapy. After 5 yrs, both Castleman's disease and PAH have not relapsed. This supports the hypothesis that control of inflammation and retroviral replication may be of interest in the context of PAH, complicating the course of an inflammatory condition associated with viral infection.

In conclusion, further studies should help in characterising the best candidates for anti-inflammatory treatment in the setting of pulmonary arterial hypertension.
Nonmalignant pleural lesions due to environmental exposure to asbestos: a field-based, cross-sectional study
Authors: Metintas M. , Metintas S. , Hillerdal G. , Ucgun I. , Erginel S. , Alatas F. , Yildirim H.
Published: November 2005

The aim of the present study was to investigate the frequencies of asbestos-related benign pleural diseases in villagers environmentally exposed to asbestos and the factors affecting these frequencies.

A field-based, cross-sectional study was designed. In total, 991 villagers from 10 villages, randomly chosen from 67 villages with known use of asbestos-containing white soil in central Anatolia (Turkey), were investigated. The type of asbestos in the white soil was determined for each village, as well as air-borne fibre concentrations. The villagers were investigated with small-size chest roentgenograms and epidemiological features were recorded.

The air-borne fibre levels were generally low. Despite this, pleural plaques were found in 14.4% of the villagers, 10.4% had diffuse pleural fibrosis and 0.4% asbestosis. The significant variables for plaques were age, sex, type of asbestos fibre,e.g.actinolite and tremolite, and exposure duration, while there was a negative relationship with cumulative exposure. The variables affecting diffuse pleural fibrosis were age, exposure duration and cumulative exposure.

In conclusion, villagers exposed to environmental asbestos have high frequencies of pleural plaques and diffuse pleural fibrosis, similar to occupationally exposed asbestos cohorts. Different types of asbestos appear to result in different frequencies of pleural lesions.
Autistic-spectrum disorders: lessons from neuroimaging
Authors: Toal Fiona , Murphy Declan G. M. , Murphy Kieran C.
Published: November 2005

Autistic-spectrum disorder is approximately half as common as schizophrenia but its cause remains unknown. Recent studies have begun to clarify the underlying neuroanatomical abnormalities and brain-behaviour relationships in autism. In the past decade, great advances have been made in our understanding of the neurobiological basis of autism.
IQ and mental disorder in young men
Authors: Mortensen Erik Lykke , Sørensen Holger Jelling , Jensen Hans Henrik , Reinisch June Machover , Mednick Sarnoff A.
Published: November 2005

Background

Most research investigating the relationship between IQ and risk of mental disorder has focused on schizophrenia.

Aims

To illuminate the relationship between IQ test scores in early adulthood and various mental disorders.

Method

For 3289 men from the Copenhagen Perinatal Cohort, military IQ test scores and information on psychiatric hospitalisation were available. We identified 350 men in the Danish Psychiatric Central Register, and compared the mean IQ test scores of nine diagnostic categories with the mean scores of 2939 unregistered cohort controls.

Results

Schizophrenia and related disorders, other psychotic disorders, adjustment, personality, alcohol and substance-use-related disorders were significantly associated with low IQ scores, but this association remained significant for the four non-psychotic disorders only when adjusting for comorbid diagnoses. For most diagnostic categories, test scores were positively associated with the length of the interval between testing and first admission. ICD mood disorders as well as neuroses and related disorders were not significantly associated with low IQ scores.

Conclusions

Low IQ may be a consequence of mental disease or a causal factor in psychotic and non-psychotic disorders.
Cognitive style in bipolar disorder
Authors: Jones Lisa , Scott Jan , Haque Sayeed , Gordon-Smith Katherine , Heron Jessica , Caesar Sian , Cooper Caroline , Forty Liz , Hyde Sally , Lyon Louisa , Greening Jayne , Sham Pak , Farmer Anne , McGuffin Peter , Jones Ian , Craddock Nick
Published: November 2005

Background

Abnormalities of cognitive style in bipolar disorder are of both clinical and theoretical importance.

Aims

To compare cognitive style in people with affective disorders and in healthy controls.

Method

Self-rated questionnaires were administered to 118 individuals with bipolar I disorder, 265 with unipolar major recurrent depression and 268 healthy controls. Those with affective disorder were also interviewed using the Schedules for Clinical Assessment in Neuropsychiatry and case notes were reviewed.

Results

Those with bipolar disorder and those with unipolar depression demonstrated different patterns of cognitive style from controls; negative self-esteem best discriminated between those with affective disorders and controls; measures of cognitive style were substantially affected by current levels of depressive symptomatology; patterns of cognitive style were similar in bipolar and unipolar disorder when current mental state was taken into account.

Conclusions

Those with affective disorder significantly differed from controls on measures of cognitive style but there were no differences between unipolar and bipolar disorders when current mental state was taken into account.
Reality orientation therapy combined with cholinesterase inhibitors in Alzheimer's disease: randomised controlled trial
Authors: Onder Graziano , Zanetti Orazio , Giacobini Ezio , Frisoni Giovanni B. , Bartorelli Luisa , Carbone Gabriele , Lambertucci Paola , Silveri Maria Caterina , Bernabei Roberto
Published: November 2005

Background

Reality orientation therapy combined with cholinesterase inhibitors has not been evaluated in patients with Alzheimer's disease.

Aims

To perform such an evaluation.

Method

We randomly assigned 79 of 156 patients treated with donepezil to receive a reality orientation programme. Caregivers of the treatment group were trained to offer the programme at home 3 days a week, 30 min/day for 25 consecutive weeks, and were invited to stimulate and involve patients in reality-based communication.

Results

The treatment group showed a slight improvement in Mini-Mental State Examination (MMSE) scores (mean change + 0.2, s.e. = 0.4) compared with a decline in the control group (mean change −1.1, s.e. =0.4; P=0.02). Similarly for the Alzheimer's Disease Assessment Scale – Cognition (treatment group mean change +0.4, s.e.=0.8; control group –2.5, s.e.=0.8; P = 0.01). The intervention had an equal effect on cognition in those with mild (MMSE score ⩾20) and moderate (score < 20) dementia. No significant effect was observed for behavioural and functional outcomes.

Conclusions

Reality orientation enhances the effects of donepezil on cognition in Alzheimer's disease.
Internet-based self-help for depression: randomised controlled trial
Authors: Andersson Gerhard , Bergström Jan , Holländare Fredrik , Carlbring Per , Kaldo Viktor , Ekselius Lisa
Published: November 2005

Background

Major depression can be treated by means of cognitive–behavioural therapy but as skilled therapists are in short supply there is a need for self-help approaches. Many individuals with depression use the internet for discussion of symptoms and to share their experience.

Aims

To investigate the effects of an internet-administered self-help programme including participation in a monitored, web-based discussion group, compared with participation in web-based discussion group only.

Method

A randomised controlled trial was conducted to compare the effects of internet-based cognitive–behavioural therapy with minimal therapist contact (plus participation in a discussion group) with the effects of participation in a discussion group only.

Results

Internet-based therapy with minimal therapist contact, combined with activity in a discussion group, resulted in greater reductions of depressive symptoms compared with activity in a discussion group only (waiting-list control group). At 6 months' follow-up, improvement was maintained to a large extent.

Conclusions

Internet-delivered cognitive–behavioural therapy should be pursued further as a complement or treatment alternative for mild-to-moderate depression.
Clustering of suicides among people with mental illness
Authors: McKenzie Nigel , Landau Sabine , Kapur Navneet , Meehan Janet , Robinson Jo , Bickley Harriet , Parsons Rebecca , Appleby Louis
Published: November 2005

Background

Most previous investigations of imitative suicide have reported suicide clustering in the general population, either temporal clustering following media reporting of suicide or case studies of geographically localised clusters.

Aims

To determine whether space–time and space–time–method clustering occur in a national case register of those who had recent contact with mental health services and had died by suicide and to estimate the suicide imitation rate in this population.

Method

Knox tests were used for space–time and space–time–method clustering. Model simulations were used to estimate effect size.

Results

Highly significant space–time and space–time–method clustering was found in a sample of 2741 people who died by suicide over 4 years who had had recent contact with one of 105 mental health trusts. Model simulations with an imitation rate of 10.1% (CI 4-17) reproduced the observed space–time–method clustering.

Conclusions

This study provides indirect evidence that imitative suicide occurs among people with mental illnesses and may account for about 10% of suicides by current and recent patients.
Potential effects of retraction of the high-security hospitals
Authors: Abbott Pat , Davenport Sarah , Davies Steffan , Nimmagadda S. Rao , O'Halloran Aideen , Tattan Theresa
Published: November 2005

The high-security hospitals are undergoing a retraction process. In conjunction with this, regional services are being developed for those patients who require longer-term treatment at medium-security units.
Survey of specialised UK traumatic stress services
Authors: Gavrilovic Jelena Jankovic , D'Ardenne Patricia , Bogic Maria , Capuzzo Nicoletta , Priebe Stefan
Published: November 2005

Aims and Method

The aim of the survey was to establish the organisational structure and practice of specialised services for post-traumatic stress in the UK. Questionnaires were collected from 17 specialised trauma services across the UK.

Results

Specialised trauma services use similar therapeutic programmes, but differ with respect to the characteristics of the treated clientele and organisational features. Although almost all services routinely measure outcome, some of the instruments used vary. There is no clear association between staff resources and number of patients treated.

Clinical Implications

Specialised traumatic stress services in the UK employ evidence-based treatment methods. A uniform protocol to measure outcome may help to establish a common UK-wide database on outcome of specialised treatment, and facilitate a reliable comparison between different service organisations and programmes. Organisational features should be considered to increase the efficiency of services.
Review of the Mental Capacity Act 2005
Authors: Jones Rowena
Published: November 2005

An incapacity to make decisions can crucially affect quality of life. Those who lack capacity are vulnerable to abuse from others, ranging from overpaternalism to exploitation, neglect and violence. Historically, those lacking capacity have not been served well by statutory services, with institutionalisation being commonplace. Community care has had its successes and failures; although care provided is often well intentioned and of good quality, abuses of power and trust continue to occur.
Disease-Free Survival Versus Overall Survival As a Primary End Point for Adjuvant Colon Cancer Studies: Individual Patient Data From 20,898 Patients on 18 Randomized Trials
Authors: Sargent Daniel J. , Wieand Harry S. , Haller Daniel G. , Gray Richard , Benedetti Jacqueline K. , Buyse Marc , Labianca Roberto , Seitz Jean Francois , O'Callaghan Christopher J. , Francini Guido , Grothey Axel , O'Connell Michael , Catalano Paul J. , Blanke Charles D. , Kerr David , Green Erin , Wolmark Norman , Andre Thierry , Goldberg Richard M. , De Gramont Aimery
Published: November 2005

Purpose

A traditional end point for colon adjuvant clinical trials is overall survival (OS), with 5 years demonstrating adequate follow-up. A shorter-term end point providing convincing evidence to allow treatment comparisons could significantly speed the translation of advances into practice.

Methods

Individual patient data were pooled from 18 randomized phase III colon cancer adjuvant clinical trials. Trials included 43 arms, with a pooled sample size of 20,898 patients. The primary hypothesis was that disease-free survival (DFS), with 3 years of follow-up, is an appropriate primary end point to replace OS with 5 years of follow-up.

Results

The recurrence rates for years 1 through 5 were 12%, 14%, 8%, 5%, and 3%, respectively. Median time from recurrence to death was 12 months. Eighty percent of recurrences were in the first 3 years; 91% of patients with recurrence by 3 years died before 5 years. Correlation between 3-year DFS and 5-year OS was 0.89. Comparing control versus experimental arms within each trial, the correlation between hazard ratios for DFS and OS was 0.92. Within-trial log-rank testing using both DFS and OS provided the same conclusion in 23 (92%) of 25 cases. Formal measures of surrogacy were satisfied.

Conclusion

In patients treated on phase III adjuvant colon clinical trials, DFS and OS are highly correlated, both within patients and across trials. These results suggest that DFS after 3 years of median follow-up is an appropriate end point for adjuvant colon cancer clinical trials of fluorouracil-based regimens, although marginally significant DFS improvements may not translate into significant OS benefits.
Immunogenicity, Including Vitiligo, and Feasibility of Vaccination With AutologousGM-CSF–Transduced Tumor Cells in Metastatic Melanoma Patients
Authors: Luiten Rosalie M. , Kueter Esther W.M. , Mooi Wolter , Gallee Maarten P.W. , Rankin Elaine M. , Gerritsen Winald R. , Clift Shirley M. , Nooijen Willem J. , Weder Pauline , van de Kasteele Willeke F. , Sein Johan , van den Berk Paul C.M. , Nieweg Omgo E. , Berns Anton M. , Spits Hergen , de Gast Gijsbert C.
Published: November 2005

Purpose

To determine the feasibility, toxicity, and immunologic effects of vaccination with autologous tumor cells retrovirally transduced with the GM-CSF gene, we performed a phase I/II vaccination study in stage IV metastatic melanoma patients.

Patients and Methods

Sixty-four patients were randomly assigned to receive three vaccinations of high-dose or low-dose tumor cells at 3-week intervals. Tumor cell vaccine preparation succeeded for 56 patients (88%), but because of progressive disease, the well-tolerated vaccination was completed in only 28 patients. We analyzed the priming of T cells against melanoma antigens, MART-1, tyrosinase, gp100, MAGE-A1, and MAGE-A3 using human leukocyte antigen/peptide tetramers and functional assays.

Results

The high-dose vaccination induced the infiltration of T cells into the tumor tissue. Three of 14 patients receiving the high-dose vaccine showed an increase in MART-1– or gp100-specific T cells in the peripheral blood during vaccination. Six patients experienced disease-free survival for more than 5 years, and two of these patients developed vitiligo at multiple sites after vaccination. MART-1– and gp100-specific T cells were found infiltrating in vitiligo skin. Upon vaccination, the T cells acquired an effector phenotype and produced interferon-γ on specific antigenic stimulation.

Conclusion

We conclude that vaccination with GM-CSF–transduced autologous tumor cells has limited toxicity and can enhance T-cell activation against melanocyte differentiation antigens, which can lead to vitiligo. Whether the induction of autoimmune vitiligo may prolong disease-free survival of metastatic melanoma patients who are surgically rendered as having no evidence of disease before vaccination is worthy of further investigation.
Use of Statins and Breast Cancer: A Meta-Analysis of Seven Randomized Clinical Trials and Nine Observational Studies
Authors: Bonovas Stefanos , Filioussi Kalitsa , Tsavaris Nikolaos , Sitaras Nikolaos M.
Published: November 2005

Purpose

A growing body of evidence suggests that statins may have chemopreventive potential against breast cancer. Laboratory studies demonstrate that statins induce apoptosis and reduce cell invasiveness in various cell lines, including breast carcinoma cells. However, the clinical relevance of these data remains unclear. The nonconclusive nature of the epidemiologic data prompted us to conduct a detailed meta-analysis of the studies published on the subject in peer-reviewed literature.

Patients and Methods

A comprehensive search for articles published up until 2005 was performed; reviews of each study were conducted; and data were abstracted. Before meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% CIs were calculated using the random and the fixed-effects models. Subgroup and sensitivity analyses were also performed.

Results

Seven large randomized trials and nine observational studies (five case-control and four cohort studies) contributed to the analysis. We found no evidence of publication bias or heterogeneity among the studies. Statin use did not significantly affect breast cancer risk (fixed effects model: RR = 1.03; 95% CI, 0.93 to 1.14; random effects model: RR = 1.02; 95% CI, 0.89 to 1.18). When the analyses were stratified into subgroups, there was no evidence that study design substantially influenced the estimate of effects. Furthermore, the sensitivity analysis confirmed the stability of our results.

Conclusion

Our meta-analysis findings do not support a protective effect of statins against breast cancer. However, this conclusion is limited by the relatively short follow-up times of the studies analyzed. Further studies are required to investigate the potential decrease in breast cancer risk among long-term statin users.
Spectrochemical Analysis with the Rotating Electrode
Authors: Pagliassoti J. P.
Published: November 2005

Spectrochemical analysis of solutions has conventionally required drying or ashing the sample to convert it to a solid form. New procedures that continuously feed fresh solution directly into the excitation zone are free of many variables associated with the analysis of dried salts and ashes. Solid materials can usually be put into solution and analyzed with comparative ease. The often-difficult problem of preparing and verifying standards is particularly simplified. Most convenient of these procedures is the use of the rotating electrode.

Sensitivity and precision with the rotating electrode are usually excellent. In oil solution, 2 ppm of phosphorus, 0.2 ppm of vanadium, and 0.05 ppm of silver can be detected. In routine analysis of additives in lubricating oils, precision is 2 to 3% of the amount present of each element being determined. Comparable precision applies to the analysis of catalysts, steels, and other solids in solution.
Quantitative Determination of Metals in Polyvinyl Chloride
Authors: Rouir E. V. , Merkeman M. J.
Published: November 2005

The quantitative determination of metals in organic substances is performed usually by ashing the material, followed by the spectrographic analysis of the ash. Because of the long duration of the chemical process employed for preparing samples, we have endeavored to find an easier method for the direct analysis of plastic materials.

The procedure consists in dissolving the solid matter in an appropriate solvent in the presence of a reference element. The spectrum of the mixture is then directly recorded by the method of the rotating graphite disk.

In this study, we have compiled the results obtained with a Geon compound.
The Respectra: A New Calculating Board for Quantitative Emission Spectrography
Authors: Anderson James W.
Published: November 2005

The Respectra* is a calculating board for preparing photographic emulsion calibrations and for performing the mathematical steps involved in both simple and complex spectrographic determinations.

This paper describes the transformation of emulsion calibrations into straight lines through the use of Kaiser's modification of the Seidel function.
Investigations concerning Light Sources for Spectrum Analysis IX. Electronically Controlled High Voltage D.C. Spark Source with Wide Frequency Range
Authors: Bardocz A.
Published: November 2005

An electronically controlled d.c. high voltage spectrographic spark source, operating in a frequency range between 10 and 1100 cycles per second, is described. The spark discharges are controlled by a thyratron tube connected in parallel to the analytical spark gap. In the range of higher sparking frequencies, an air jet is applied to the controlling spark gap. The condenser supplying the exciting energy is fed from a high capacity condenser. The high capacity condenser is charged by a high voltage transformer through a rectifying element. The thyratron tube controlling the spark discharges is operated by a pulse generator, which sends various igniting signals to its grid. The pulse generator consists of a free running multivibrator and the pulse former Spark sources with conventional air-interrupter type controlling spark gaps are compared to the one described.
A Versatile Electrode Holder for Use with the Hilger Steeloscope
Authors: Landis F. P. , Pelrine J. R.
Published: November 2005

An electrode holder for use with the Hilger Steeloscope is described. The holder may be set up with the Steeloscope as a portable unit for the spectroscopic examination of bulk metal stock of any size or shape. Unique design features are the rotatable mount for the jaw assembly and the hinged counter-electrode jaws.
Shutter and Motor Drive for a Littrow-Echelle Spectrograph
Authors: Owen Louis E.
Published: November 2005

An internally mounted shutter and a motor drive attachment for the plate-racking mechanism of a Littrow-Echelle Spectrograph are described. An associated electrical circuit provides automatic exposure control and predetermined automatic racking. Ease and exactness of operation are the primary benefits obtained.
Time-Resolved Spectroscopy in Spectrochemical Analysis
Authors: Bardocz A.
Published: November 2005

Light radiated from transient spark discharges varies with time as the conditions vary in the source Observation of the variation with time of the radiation emitted gives useful information concerning excitation levels, intensity variation, intensity ratios, pressure broadening, wavelength shift, Stark broadening, and self absorption of spectrum lines. This information can be obtained from time-resolved spark spectra taken with an electronically controlled high precision spark source, combined with a rotating mirror optical system From time-resolved spark spectra, spectrum lines suitable for spectrochemical analysis can be selected on a theoretical basis In time-resolved spectra the continuous background originating at the beginning of the discharge is separated from the rest of the spectrum. The background-free spectrum, in addition to facilitating the construction of straight working curves without background correction, is suitable for estimation of minor constituents in metals and alloys The background separated from the rest of the spectrum can be used as an internal standard in spectrochemical analysis As an example, working curves are given for the estimation of impurities in aluminum
Spectrochemical Analysis by the Evaporation Method
Authors: Mandelstam S.
Published: November 2005

The experience of the author and others with the evaporation method is described. The technique consists of evaporating trace amounts of impurities from the molten sample in an electrically heated crucible and condensing them on a water-cooled electrode, which is then arced or sparked. Temperatures used range from 1500 to 2000°C and element sensitivities from 20 to 0 02 ppm
Mass Spectrometry in Chemical Research and Production
Authors: McLafferty Fred W.
Published: November 2005

The mass spectrometer is uniquely applicable to the solution of a wide range of problems in chemical research and production Plant stream analyzers now available enhance its advantages for rapid accurate quantittive analyses of mixtures of a large number of components Unique information concerning identity or molecular structure is obtainable from a mass spectrum, complementing well present instrumental methods such as infrared spectrophotometry Illustrations are given to show the broad potentialities of the technique. A method of classification and mechanisms of formation are discussed for the anomalous molecular rearrangements found in many spectra.
Infrared Spectra of Organo-Phosphorus Compounds: New Correlations
Authors: Nyquist R. A.
Published: November 2005

This infrared investigation of organo-phosphorus compounds correlates certain group frequencies Table I contains the groups investigated and the resulting data
An Infrared Study of the Reaction of Barbiturates with p-Nitrobenzyl Chloride
Authors: Chatten Leslie G. , Levi Leo
Published: November 2005

In alkaline media barbiturates of the general formula HNCONHCOCR'R“CO react with p-nitrobenzyl chloride to sive derivatives of the composition NCONCOCH2 C6HNO2CR'R”COCH2-C4HNO2. It is postulated that the process of complex formation proceeds via the interaction of a negatively charged enolized barbituric acid ion with a positively charged p-nitrobenzyl ion. The infrared absorption spectra of the derivatives are in accord with this mechanism and suggest that in the complex the barbiturate is bonded to the p-nitrobenzyl moiety through the carbonyl oxygens in the 4 and 6 positions The compounds show unique features throughout the region studied, 4000–650 cm−1, and hence the method affords a high degree of specificity for detecting and characterizing these sedative drugs