bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnosis and Management of Primary Aldosteronism
Authors: Wheeler Malcolm H. , Harris Dean A.
Published: January 2004

Identifying primary aldosteronism within the hypertensive population is an important clinical challenge, as most patients with a unilateral source of excess aldosterone secretion are amenable to surgical cure. At least 20% of patients with primary aldosteronism have normal serum potassium levels. Therefore, screening tests should not be based on recognition of hypokalemia alone. Rather, the diagnosis should depend on identifying renin suppression and measuring the ratio of plasma aldosterone concentration to plasma renin activity. The diagnosis may be confirmed by performing an aldosterone suppression test after oral salt loading. Once primary aldosteronism has been established, it is necessary to exclude glucocorticoid‐remediable aldosteronism and then proceed to localization studies. Detecting a unilateral source of aldosterone, usually due to an adenoma (Conn syndrome), is achieved by postural hormonal testing and confirmed by selective venous sampling (SVS) with measurement of aldosterone concentrations (expressed as the aldosterone/cortisol ratio) in each adrenal vein. SVS is enjoying a revival in many institutions as it is more sensitive and specific than either cross‐sectional imaging or scintigraphy and has the potential to influence significantly both the diagnosis and clinical decision‐making. Patients with unilateral disease are ideally treated by laparoscopic adrenalectomy. Patients in whom localization is not achieved usually have bilateral adrenal hyperplasia and are treated medically.
Temperature-dependent fractionation of stable oxygen isotopes in otoliths of juvenile cod (Gadus morhua L.)
Authors: Høie Hans , Otterlei Erling , Folkvord Arild
Published: January 2004

Analysis of stable oxygen isotopes in otoliths is a promising technique for estimating the ambient temperature experienced by fish, but consistent equations relating temperature and fractionation of stable oxygen isotopes in otoliths among different fish species are lacking. Juvenile cod were reared at constant temperatures from 6 to 20°C and the sagittal otoliths were analysed for oxygen isotope values. We determined that temperature-dependent fractionation of oxygen isotopes in the otoliths was close to that reported for inorganic aragonite at low temperatures, but there were deviations from oxygen isotope fractionation equations for otoliths of other species. The linear relationship between oxygen isotope value in the cod otoliths and temperature was determined to be: 1000 Ln α = 16.75(103 TK−1) − 27.09. Temperature estimates with 1°C precision at the 95% probability level require a sample size of ≥5 otoliths. Only an insignificant amount of the variance in the data was due to variance between left and right otolith, and due to repeated measurements of otolith subsamples. This study confirms that stable isotope values of cod otoliths can give precise and accurate estimates of the ambient temperature experienced by fish.
Prion protein is a component of the multimolecular signaling complex involved in T cell activation
Authors: Mattei Vincenzo , Garofalo Tina , Misasi Roberta , Circella Annapia , Manganelli Valeria , Lucania Giuseppe , Pavan Antonio , Sorice Maurizio
Published: January 2004

In this study we analyzed the interaction of prion protein PrPC with components of glycosphingolipid‐enriched microdomains in lymphoblastoid T cells. PrPC was distributed in small clusters on the plasma membrane, as revealed by immunoelectron microscopy. PrPC is present in microdomains, since it coimmunoprecipitates with GM3 and the raft marker GM1. A strict association between PrPC and Fyn was revealed by scanning confocal microscopy and coimmunoprecipitation experiments. The phosphorylation protein ZAP‐70 was immunoprecipitated by anti‐PrP after T cell activation. These results demonstrate that PrPC interacts with ZAP‐70, suggesting that PrPC is a component of the multimolecular signaling complex within microdomains involved in T cell activation.
Transient expression analysis of the mouse ornithine decarboxylase antizyme haploid‐specific promoter using in vivo electroporation
Authors: Ike Akiko , Ohta Hiroshi , Onishi Masayoshi , Iguchi Naoko , Nishimune Yoshitake , Nozaki Masami
Published: January 2004

The testicular isoform of the ornithine decarboxylase antizyme (OAZt) gene is expressed exclusively in the haploid spermatids of mice. The 357‐bp region, which includes a TATA‐less promoter and an untranslated region, is sufficient for OAZt gene expression in the spermatids of transgenic mice. In this study, in vivo transient transfection to living mouse testes was used to define the transcriptional regulatory elements of the OAZt gene promoter. We found that the 10‐bp element that contains an initiator (Inr) plays a central role as the core promoter, in combination with a downstream element, while two cyclic adenosine monophosphate‐responsive element (CRE)‐like sites in the upstream region also contribute to promoter activity. The electrophoretic mobility shift assay showed binding of the testis‐specific factors to these elements. Our results show that the in vivo DNA transfer technique enables detailed analysis of haploid germ cell‐specific gene regulation in mice.
Analysis of effects in wheat of high temperature on grain filling attributes estimated from mathematical models of grain filling
Authors: ZAHEDI M. , JENNER C. F.
Published: January 2004

Compared with growth at 20/15°C (day/night), exposure of wheat (Triticum aestivum L.) plants to moderately high temperature (30/25°C) significantly decreased grain weight through shortening the duration of grain filling, combined with small (or no) positive increases in the rate of grain filling. Several mathematical models of grain filling were assessed for their suitability as means of analysing these effects of temperature. The ordinary logistic model was found to be the most appropriate model and was used for the analysis of grain filling responses in four cultivars differing in their responses. Genotypic variation in response to temperature was observed for both rate and duration of grain filling, but the variation for the duration of grain filling among cultivars was small at the higher temperature. Significant correlation was found between single grain weight with the rate, but not with the duration, of grain filling at high temperature, which indicated an important role for synthetic processes involved in grain filling in the temperature sensitivity of wheat cultivars. As they are independent traits, both rate and duration are required selection criteria for the improvement of heat tolerance. Responses of one attribute estimated from the logistic model, the inflection point of the course of grain filling, may give insight into a temperature response that is distinguishable from that associated with the duration of grain filling. The inflection point appears to be worth including as a criterion in selecting for high temperature tolerance in wheat.
Phenological responses of wheat and barley to water and temperature: improving simulation models
Authors: McMASTER G. S. , WILHELM W. W.
Published: January 2004

Understanding and predicting small-grain cereal development is becoming increasingly important in enhancing management practices. Recent efforts to improve phenology submodels in crop simulations have focused on incorporating developmental responses to water stress and interpreting and understanding thermal time. The objectives of the present study were to evaluate data from three experiments to (a) determine the qualitative and quantitative response of wheat (Triticum aestivum L.) and barley (Hordeum vulgare L.) to water stress and (b) ascertain where in space to measure temperature, to provide information required to improve phenological submodels. The first experiment tested the phenological responses of 12 winter wheat cultivars to water stress for two seasons at two sites. The second experiment tested the timing of water stress on spring barley phenological responses for 2 years. In a third experiment, soil near the shoot apex of field-grown spring wheat was heated to 3°C above ambient soil temperature for three planting dates in each of 2 years, to test whether it is better to use soil or air temperature in calculating thermal time. The general response of wheat and barley to water stress was to reach growth stages earlier (i.e. to hasten development). The most significant response was for the grain filling period. Water stress had little effect on jointing and flag leaf complete/booting growth stages. Thermal time to jointing was highly variable across locations. However, thermal time to subsequent growth stages was very consistent both within and across locations. The winter wheat cultivars tested followed this general response across site-years, but inconsistencies were found, suggesting a complicated genotype by environment (G×E) interaction that makes improving phenology submodels for all cultivars difficult. The G×E interaction was most prominent for anthesis (A) and maturity (M) growth stages. Results of heating the soil at the shoot apex depth were completely unexpected: heating the soil did not speed spring wheat phenological development. These results, and others cited, suggest caution in allocating effort and resources to measuring or estimating soil temperature rather than relying on readily available air temperature as a means of universally improving phenology submodels. These results help quantify the response of wheat to water stress and thermal time for improving crop simulation models and management.
Quantitative developmental response to the length of exposure to long photoperiod in wheat and barley
Authors: MIRALLES D. J. , SLAFER G. A. , RICHARDS R. A. , RAWSON H. M.
Published: January 2004

The present study was designed to analyse the effect of the length of exposure to a long photoperiod imposed c. 3 weeks after sowing in spring wheat (cv. UQ189) and barley (cv. Arapiles) to (i) establish whether the response to the number of cycles of exposure is quantitative or qualitative, (ii) determine the existence of a commitment to particular stages well before the stage has been observable, and (iii) study the interrelationships between the effects on final leaf number and phyllochron when the stimulus is provided several days after seedling emergence. Both wheat and barley seemed to respond quantitatively to the number of long-day cycles they were exposed to. However, wheat showed a requirement of approximately 4 long-day cycles to be able to produce a significant response in time to heading. The barley cultivar used in the study was responsive to the minimum length of exposure. The response to extended photoperiod cycles during the stem elongation phase was due to the ‘memory’ photoperiod effects being related, in the case of wheat, to the fact that the pre-terminal spikelet appearance phase saturated its photoperiod response well before that stage was reached. Therefore, the commitment to the terminal spikelet appearance in wheat may be reached well before this stage could be recognized.

As the response in duration to heading exceeded that of the final leaf number, and the stem elongation phase responded to memory effects of photoperiod, the phyllochron of both cereals was responsive to the treatments accelerating the average phyllochron when exposed to longer periods of long days. The response in average phyllochron was due to a switch from bi-linear to linear models of leaf number v. time when the conditions were increasingly inductive, with the phyllochron of the initial (6–8) leaves being similar for all treatments (within each species), and from then on increased.
Comparison of central and northern European winter rye cultivars grown at high latitudes
Authors: HAKALA K. , PAHKALA K.
Published: January 2004

Finnish rye (Secale cereale L.) cultivars are extremely tolerant of freezing and are fairly resistant to low-temperature fungal infection. Finnish cultivars usually have long straw, are lodging-sensitive, low yielding and have low Hagberg falling number. Many central European rye cultivars have been bred to overcome these problems, but are less winter hardy and have lower yield stability under northern conditions. In the present study, the development and growth of Finnish and foreign rye cultivars were compared in the field and also under simulated average autumn hardening conditions in a growth chamber. Leaf elongation, but not tillering, of both Finnish and foreign rye cultivars ceased during the simulated hardening period in the growth chamber. At the end of the hardening period, both Finnish and foreign cultivars had reached equal dry weights and soluble sugar contents of crowns and leaves. It was concluded that in a typical Finnish autumn, the foreign and domestic cultivars responded similarly when development and hardening were monitored. Thus, the risks related to overwintering are likely to be emphasized under adverse conditions either in the autumn or in the spring. In the field, a German hybrid cultivar performed better than a Finnish population cultivar under favourable growing conditions, but when stresses such as drought occurred, it lost its superiority. When low seeding rates were used, the Finnish cultivar compensated through tillering more efficiently than the German one for the reduced number of main shoots. However, the yield potential of the German cultivar was, in general, higher irrespective of seeding rate. This was due to a higher photosynthesis rate, larger harvest index and grain size.
A comparison of root and stem lodging risks among winter wheat cultivars
Authors: BERRY P. M. , SPINK J. H. , GAY A. P. , CRAIGON J.
Published: January 2004

Plant characters that determine stem and root lodging were measured on 15 winter wheat cultivars at three UK sites between 2000 and 2002. A model of lodging was used to estimate stem failure wind speeds (resistance to stem lodging) and anchorage failure wind speeds (resistance to root lodging). The degree and type of natural lodging was also recorded in the plots and this correlated well with the stem and anchorage failure wind speeds. Only a weak correlation (R2=0·33) was observed between the stem and anchorage failure wind speeds for the 15 cultivars. This can be explained by the absence of genetic correlation between the plant characters that determine the stem and anchorage strength. There was a significant interaction between type of lodging (stem or root) and cultivar for failure wind speed (P<0·001). This showed that the difference between the resistances for root and stem lodging was not the same for all cultivars. Separate classifications for the stem and root lodging resistance of cultivars are developed that would allow the most appropriate crop management to reduce the risk of both types of lodging. Significant differences were found between cultivars for all lodging-related plant characters (P<0·05). These resulted in the cultivar range of the anchorage failure moment to be 110% of the overall mean. Stem failure moment, shoot and plant base bending moments had ranges of 37–49% of their overall means. Breeders should select for wide, deep root plates and wide stems with a high stem wall failure yield stress for the greatest improvement in lodging resistance.
Wheat productivity and N use-efficiency as influenced by inclusion of cowpea as a grain legume in a rice–wheat system
Authors: YADAV R. L. , SINGH V. K. , DWIVEDI B. S. , SHUKLA A. K.
Published: January 2004

In high productivity zones of the Indo–Gangetic Plain Region (IGPR) of India, the rice–wheat cropping system (RWCS) is exhibiting a decline in factor productivity, low N use-efficiency and deterioration in soil health. Inclusion of legumes in RWCS is advocated as one of the promising agro-techniques to sustain productivity. A field experiment was conducted during 1996/97 and 1997/98 on sandy loam (Typic Ustrochrept) soil of Modipuram, India (29°4′N, 77°46′E, 237 m above sea level) to explore the possibilities of inclusion of cowpea as a break crop in RWCS. The effect of rice or cowpea was measured on the yield, fertilizer N requirement and N use-efficiency in wheat, and also on the soil organic carbon and available N content. The yields of wheat following cowpea were significantly (P<0·05) greater by 19–20%, compared with those following rice. In a cowpea–wheat rotation economic optimum dose of fertilizer N for wheat was smaller than that in a rice–wheat rotation due to increased N availability, better growing environment and greater N use-efficiency (measured as agronomic efficiency, apparent recovery and partial factor productivity) in the former case. On termination of the experiment, soil organic carbon and available N content increased over initial content with increasing rates of fertilizer N under both rotations, but the magnitude of increase was greater in treatments where cowpea preceded wheat.
The long-term persistence of seeds of oilseed rape (Brassica napus) in arable fields
Authors: LUTMAN P. J. W. , FREEMAN S. E. , PEKRUN C.
Published: January 2004

The present paper reports on three sets of experiments exploring the persistence of seeds of oilseed rape (Brassica napus). The first, where known numbers of seeds were buried in September 1991 in two field experiments, demonstrated substantial initial losses of seeds, such that only 0·2 and 3·8% of seeds were still present after 4 months. In these experiments, which were not disturbed by mechanical cultivation, there was little evidence of further decline over the following 13 months. In the second of the two experiments, seeds were then left undisturbed for a further 136 months. A mean of 1·8% of seeds were still present after this period, providing further confirmation of the lack of decline in seed numbers in these undisturbed conditions. In the second pair of experiments, known numbers of seeds of three rape cultivars were broadcast onto plots and then either ploughed into the soil immediately after the start of the experiments, or were exposed to weekly shallow tine cultivation followed by ploughing after 4 weeks. The former created a larger seedbank than the latter. The experiments were then ploughed, annually (Expt 1) or at less frequent intervals (Expt 2); appreciable numbers of seeds survived for 65 months in both. Calculations based on exponential decline curves indicated that 95% seed loss would take 15–39 months, depending on the site, cultivar and initial post-harvest stubble treatment. The third part of the paper is based on more detailed studies of persistence of seeds of six cultivars in Petri dishes and buried in 25 cm pots. This work confirmed that cultivars differed in their persistence, as Apex was confirmed as highly persistent, whereas Rebel was short-lived. There were inconsistencies in the response of cultivar Synergy between the Petri-dish and pot experiment, which need further study. This experiment also reinforced the conclusion of the initial field experiments that little seed loss occurs in the absence of cultivations. Appreciable numbers of rape seeds will persist up to 4 years, in normal cropping conditions and in the absence of cultivation one experiment has confirmed persistence for over 11 years.
Depressive disorder as a long-term antecedent risk factor for incident back pain: a 13-year follow-up study from the Baltimore Epidemiological Catchment Area Sample
Authors: LARSON S. L. , CLARK M. R. , EATON W. W.
Published: January 2004

Background. The co-occurrence of affective distress and back pain is well documented but the relationship between them is less certain. This study examines the relationship between lifetime occurrence of depressive disorder and incident back pain reported over a 13-year period.

Method. The Baltimore Epidemiologic Catchment Area Study is a prospective study of a household-residing cohort, selected probabilistically from East Baltimore in 1981. Between 1982–3 (wave 2) and again between 1993–6 (wave 3), a follow-up study of the original cohort was conducted. Questions on depressive disorder and back pain were drawn from the Diagnostic Interview Schedule. Logistic regression analyses were used to evaluate whether depressive disorder acts as a risk factor for incident back pain.

Results. In cross-sectional analyses, lifetime occurrence of depressive disorder was a significant correlate of lifetime prevalence of back pain at wave 1 (OR=1·6, P=0·01). During the 13-year follow-up, across three data collection points, there was an increase in the risk for incident back pain when depressive disorder was present at baseline (OR=1·9, 95% CI 1·03, 3·4). However, during the short-term follow-up period of 1 year, between baseline and wave 2, depressive disorder at baseline was unrelated to first-ever reports of back pain. Lifetime depressive disorder in both waves 1 (baseline) and 2 (1 year later) was associated with a more than three times greater risk for a first-ever report of back pain during the 12 to 13 year follow-up period, in comparison to those who did not have depressive disorder at waves 1 or 2 (OR=3·4, 95% CI 1·4, 7·8). Back pain at wave 1 was not significantly associated with an increased risk for depression in the longitudinal analysis (OR=0·8, 95% CI 0·5, 1·4).

Conclusions. Depressive disorder appears to be a risk factor for incident back pain independent of other characteristics often associated with back pain. Back pain is not a short-term consequence of depressive disorder but emerges over periods longer than 1 year. Moreover, in this study the alternative pathway of back pain as a risk factor for depressive disorder could not be supported.
Life dissatisfaction and subsequent work disability in an 11-year follow-up
Authors: KOIVUMAA-HONKANEN H. , KOSKENVUO M. , HONKANEN R. J. , VIINAMÄKI H. , HEIKKILÄ K. , KAPRIO J.
Published: January 2004

Background. Mental disorders are associated with disability, but the long-term effects of low subjective well-being on work ability in general population are not known. In this study we investigated whether self-reported life dissatisfaction predicts work disability.

Method. A nationwide sample of Finnish twins aged 18–54 years (N=22 136), unselected for health status responded to a health questionnaire with a four-item life satisfaction scale (range 4–20) covering interest, happiness, easiness and loneliness of life in 1975 and 1981. Cox regression for all subjects and conditional logistic regression for discordant twin pairs were used to compare the risk of subsequent work disability (N=1200) (Nationwide Disability Register) between the dissatisfied and satisfied.

Results. Life dissatisfaction predicted subsequent (1977–87) work disability pension due to psychiatric and non-psychiatric causes among the healthy at baseline, and that due to psychiatric causes among the ill. After controlling for age, marital status, social class and health behaviour, these risks remained significant. Repeatedly reported (1975 and 1981) life dissatisfaction was strongly associated with increased (age-adjusted) risk of subsequent (1982–87) work disability due to psychiatric and also that due to non-psychiatric causes among the healthy. When twin pairs discordant for end-point disability status were analysed, risk differences related to life satisfaction were only slightly decreased, but they did not differ significantly between monozygotic and dizygotic pairs.

Conclusion. Life dissatisfaction predicts subsequent work disability especially among the healthy.
Intergenerational transmission of somatization behaviour: 2. Observations of joint attention and bids for attention
Authors: CRAIG T. K. J. , BIALAS I. , HODSON S. , COX A. D.
Published: January 2004

Background. Somatoform disorders may have their roots in childhood through processes that involve an enhanced parental focus on health. The aim of this study was to test the hypothesis that somatizing mothers will show less joint involvement than other mothers during play but greater responsiveness when this play involves a ‘medical’ theme.

Method. Cross-sectional observational study of 42 chronic somatizers, 44 organically ill and 50 healthy mothers and their 4–8 year-old children during structured play and a meal. Tasks comprised boxes containing tea-set items, ‘medical’ items and a light snack.

Results. Somatizing mothers were emotionally flatter and showed lower rates of joint attention than other mothers during both play tasks. While the three groups had similar rate of bids for attention, somatizing mothers were more responsive to their child's bids during play with the medical box than at other times. In contrast, the children of somatizing mothers ignored a greater proportion of their mother's bids during play with the medical box than did children of other mothers or during play with a non-medical theme.

Conclusion. The study has demonstrated tentative evidence in support of the hypothesis.
Duration of untreated psychosis: impact on 2-year outcome
Authors: ADDINGTON J. , VAN MASTRIGT S. , ADDINGTON D.
Published: January 2004

Background. The duration of untreated psychosis has been postulated to be a predictor of clinical outcome in schizophrenia. Although several prospective studies support the relationship, some studies do not. These differences may be due to a number of methodological issues. The objectives of this study are: (i) to address many of the methodological limitations of earlier studies such as variations in sample size and selection, type of treatment provided, differences in measurement of DUP and outcome, and length of follow-up; and (ii) to examine the relationship between DUP and outcome in a prospective longitudinal study.

Method. The DUP of 200 consecutive admissions to a first-episode programme was determined. The sample was followed over 2 years and pre-morbid functioning, symptoms, social and cognitive functioning and substance use were assessed longitudinally.

Results. Two years after admission to the programme, longer DUP was significantly associated with high levels of positive symptoms and poor social functioning. Independently of other variables, DUP predicted positive symptoms and social functioning at 1 and 2 years.

Conclusions. There is evidence that long DUP continues to have an influence on outcome up to 2 years. These results support ongoing efforts for early detection and intervention.
Preventing somatization
Authors: HOTOPF MATTHEW
Published: January 2004

Countless cross-sectional surveys of primary and secondary care have demonstrated the ubiquitous nature of medically unexplained symptoms. If grouping diverse symptoms under one heading is appropriate, they account for over half of all new presentations in secondary medical care (Nimnuan et al. 2001a) and a sizeable proportion of ‘frequent attenders’ in secondary care have predominantly medically unexplained symptoms (Fink, 1992a; Reid et al. 2002). Such symptoms are costly, persistent, and associated with significant disability and psychiatric disorder (Reid et al. 2001, 2003), but are generally ignored by mental health services (Bass et al. 2001).
Patients with schizophreniform disorder use verbal descriptions for the representation of visual categories
Authors: KÉRI S. , KELEMEN O. , BENEDEK G. , JANKA Z.
Published: January 2004

Background. Neuropsychological impairment is a common finding in schizophrenia. However, a significant proportion of patients are not impaired in conventional neuropsychological tests. In this study, we investigated whether remitted patients with schizophreniform disorder exhibited dysfunctions in specific cognitive tasks.

Method. Twenty remitted, highly functioning patients with schizophreniform disorder and 20 control subjects participated in the study. In addition to background neuropsychological evaluation (WAIS-R IQ, Wisconsin Card Sorting Test (WCST), Trail Making B, Rey–Osterrieth Complex Figure), subjects received a category learning task. The categories consisted of geometric shapes systematically changing in shape and size. Training included the sequential presentation of category members (visual learning) and verbal description of categories.

Results. The patients with schizophreniform disorder had normal IQ, executive functions/psychomotor speed (WCST and Trail Making B) and visual memory (Rey–Osterrieth Complex Figure). In contrast, they displayed impaired categorization performances after visual learning. The performance of the patients improved markedly after verbal description of categories. Verbal knowledge about categories positively correlated with categorization performance in the patients, but not in the controls.

Conclusions. Category learning functions, which include decision-making under uncertainty and feature integration, are impaired in patients with schizophreniform disorder who display normal executive functions and visual memory. These patients may use verbal knowledge as a compensatory strategy in visual tasks.
The evolution of insight, paranoia and depression during early schizophrenia
Authors: DRAKE R. J. , PICKLES A. , BENTALL R. P. , KINDERMAN P. , HADDOCK G. , TARRIER N. , LEWIS S. W.
Published: January 2004

Background. How insight, paranoia and depression evolve in relation to each other during and after the first episode of schizophrenia is poorly understood but of clinical importance.

Method. Serial assessments over 18 months were made using multiple instruments in a consecutive sample of 257 patients with first episode DSM-IV non-affective psychosis. Repeated measures of paranoia, insight, depression and self-esteem were analysed using structural equation modelling, to examine the direction of relationships over time after controlling for confounds.

Results. Depression was predicted directly by greater insight, particularly at baseline, and by greater paranoia at every stage of follow-up. Neither relationship was mediated by self-esteem, although there was a weak association of lower self-esteem with greater depression and better insight. Paranoia was not strongly associated with insight. Duration of untreated psychosis and substance use at baseline predicted depression at 18 months.

Conclusions. In first-episode psychosis, good insight predicts depression. Subsequently, paranoia is the strongest predictor. Neither effect is mediated by low self-esteem. Effective treatment of positive symptoms is important in preventing and treating low mood in early schizophrenia.
The prediction of thoughts of death or self-harm in a population-based sample of female twins
Authors: FANOUS A. H. , PRESCOTT C. A. , KENDLER K. S.
Published: January 2004

Background. Although suicide is a leading cause of death, few studies have attempted to predict suicidal ideation prospectively using epidemiological samples or multivariate methods.

Method. Discrete-time event history analysis was used to model the onset of thoughts of death or self-harm (TD/SH) in a population-based sample of female twins (N=2164) using variables from the demographic, psychopathological, childhood adversity, personality and life event domains. Univariate, multivariate-within domain and multivariate-across domain regression analyses were performed.

Results. Most variables predicted TD/SH in the univariate analyses. However, the only variables to predict TD/SH independently were obsessive symptoms, childhood sexual abuse, rural residence, unemployment, older age, lifetime history of cocaine misuse and low levels of education, personal religious devotion and altruism, as well as divorce/separation, loss of confidant, assault, job loss and financial problems in the previous month. This final model explained 16% of the variance in TD/SH. Lifetime histories of major depression, panic disorder and alcohol misuse had no significant independent effect.

Conclusions. Many variables, from all five domains of risk factors, are associated with the risk of TD/SH, but many of these effects may be mediated by other risk factors. Proximal life events and psychopathology may have more independent effects than other domains. The overall ability of these risk factors to predict TD/SH is modest. We cannot rule out that differences between these analyses and previous reports were due to our use of TD/SH as the dependent variable instead of thoughts of committing suicide per se.
Daily smoking and the subsequent onset of psychiatric disorders
Authors: BRESLAU N. , NOVAK S. P. , KESSLER R. C.
Published: January 2004

Background. Recent research has demonstrated that smokers are at an elevated risk for psychiatric disorders. This study extends the enquiry by examining: (1) the specificity of the psychiatric sequelae of smoking; and (2) the variability in the likelihood of these sequelae by proximity and intensity of smoking.

Method. Data come from the National Comorbidity Survey (NCS), a representative sample of the US population 15–54 years of age. The Smoking Supplement was administered to a representative subset of 4414 respondents. A modified World Health Organization – Composite International Diagnostic Interview was used to measure DSM-III-R disorders. Survival analysis with smoking variables as time-dependent covariates was used to predict the subsequent onset of specific psychiatric disorders.

Results. The estimated effects of daily smoking varied across disorders. In the case of mood disorders, daily smoking predicted subsequent onset, with no variation between current versus past smokers or by smoking intensity. In the case of panic disorder and agoraphobia, current but not past smoking predicted subsequent onset; furthermore, the risk of these disorders in past smokers decreased with increasing time since quitting. In the case of substance use disorders, current but not past smoking predicted subsequent onset, with no variation by time since quitting or smoking intensity.

Conclusions. The data suggest that smoking cessation programmes would not prevent the onset of mood disorder, as ex-smokers do not differ from current smokers in their risk for these disorders. In comparison, daily smoking might be a causal factor in panic disorder and agoraphobia, conditions that might be preventable by smoking cessation. Additionally, current smoking might serve as a marker for targeting interventions to prevent alcohol and drug disorders.
Health care contacts before and after attempted suicide among adolescent and young adult versus older suicide attempters
Authors: SUOMINEN K. , ISOMETSÄ E. , MARTUNNEN M. , OSTAMO A. , LÖNNQVIST J.
Published: January 2004

Background. The pattern of all health care contacts among young people before and after attempted suicide is not well documented. Neither is it known if the health care contacts of young suicide attempters differ from those of older suicide attempters. This study investigated the age-related clinical characteristics of suicide attempters and the pattern of their contacts with health care before and after attempted suicide in different age groups, particularly adolescence and young adulthood.

Method. All consecutive 1198 suicide attempters treated in hospital emergency rooms in Helsinki between January 1997 and January 1998 were identified and divided into three age groups (15–24 years, 25–39 years, 40 years and over). Data were gathered on all health care contacts 1 year before and after the index attempt.

Results. Although adolescent and young adult suicide attempters suffered from severe mental disorders, a remarkable proportion of them were left without psychiatric consultation and aftercare recommendation following the attempt. Two-thirds of 15–19-year-old male suicide attempters had no treatment contact during the month before the attempt, while a quarter of them were referred to psychiatric consultation and a half had no healthcare contact in the month following the attempt.

Conclusions. These findings indicate considerable scope for improvement in the assessment of young suicide attempters and their referral to aftercare.
Medications and verbal memory impairment in schizophrenia: the role of anticholinergic drugs
Authors: BRÉBION G. , BRESSAN R. A. , AMADOR X. , MALASPINA D. , GORMAN J. M.
Published: January 2004

Background. We wished to assess the effect of three types of medication on verbal memory impairments in schizophrenia.

Method. Forty-eight patients with schizophrenia and 40 healthy control subjects underwent a battery of verbal memory tasks, including free recall, recognition and short-term memory span. All the patients were on antipsychotic medication. In addition, 24 were taking anticholinergic drugs (benztropine) and 30 were taking benzodiazepines. A subsample of 39 had clinical ratings for depressive symptoms. Regression analyses were conducted on the memory measures in this subsample, with negative symptoms, depression, type of antipsychotic medication (conventional v. atypical), benzodiazepines and anticholinergic drugs as predictors.

Results. Type of antipsychotic medication made no significant contribution to memory deficits and benzodiazepine use made very little contribution. However, anticholinergic medication was a predictor of memory impairment, especially with regard to semantic organization. Complementary analyses revealed that patients taking any type of drug with anticholinergic activity (benztropine and/or antipsychotic agents) were significantly impaired relative to the other patients on measures reflecting free recall efficiency and semantic organization.

Conclusions. Drugs with anticholinergic activity are the major pharmacological agents that contribute to the verbal memory deficit observed in patients with schizophrenia. These drugs appear to act by impeding semantic organization at encoding.
Actions taken to cope with depression at different levels of severity: a community survey
Authors: JORM A. F. , GRIFFITHS K. M. , CHRISTENSEN H. , PARSLOW R. A. , ROGERS B.
Published: January 2004

Background. Many people with symptoms of psychological distress do not seek professional help. Little is known about the actions taken by these people to reduce their symptoms. The present study aimed to assess, in a community sample, actions taken to cope with depression at different levels of psychological distress.

Method. A postal survey was carried out with 6618 adults living in Canberra and south-east New South Wales, Australia. Measures covered psychological distress and a checklist of actions taken to cope with depression in the previous 6 months.

Results. Actions taken to cope with depression could be classified as: intensification of everyday strategies, initiation of new self-help (including complementary therapies, non-prescription medication and dietary changes) and seeking professional help. Use of everyday strategies peaked with mild psychological distress, new self-help showed a peak in moderate distress, while professional help-seeking peaked in severe distress.

Conclusion. Self-help strategies are very commonly used, particularly in mild–moderate psychological distress. More evidence is needed to evaluate their effectiveness, so that optimal self-help can be encouraged.
The views of older Chinese people in Melbourne about their quality of life
Authors: TSANG ELAINE YUK LIN , LIAMPUTTONG PRANEE , PIERSON JANE
Published: January 2004

This paper reports the findings of a study using both quantitative and qualitative approaches of the quality of life of older Chinese people in Melbourne. A total of 60 participants was recruited: 30 were residents of three Chinese hostels and 30 were members of a Chinese welfare society. Along with the established scales of health status, functioning and self-reported life satisfaction, to give a broader perspective the participants were asked about their general health, level of depressive mood and independence. In-depth interviews were conducted with a convenience sub-sample of six informants to explore other important aspects of their quality of life. The hostel group was found to be less healthy, less independent, more depressed and less satisfied with their lives than the community group, but nonetheless were generally satisfied with their lives, as revealed during the in-depth interviews. A good quality of life was found to be associated with good health, independence, secure finance, a meaningful role, strong ethnic community and family support, low expectations, no worries, and a sense of the family's love and respect. The findings reinforce the notion that the quality of life is truly multi-dimensional. They also demonstrate that a high self-rated quality of life in old age is achievable and, indeed, was being enjoyed by most of the participants. The research has made a substantial contribution to understanding the circumstances of Chinese-origin older people in Australia and has useful lessons for studies of other ethnic groups.
Age-segregation in later life: an examination of personal networks
Authors: UHLENBERG PETER , DE JONG GIERVELD JENNY
Published: January 2004

In a rapidly changing society, young adults may play an important role in teaching older adults about social, cultural and technological changes. Thus older people who lack regular contact with younger people are at risk of being excluded from contemporary social developments. But how age-segregated are older people? The level of age-segregation of older people can be studied by examining the age-composition of personal social networks. Using NESTOR-LSN survey data from The Netherlands, we are able to determine the number of younger adults that people aged 55–89 years identify as members of their social networks, and to examine the factors that are associated with segregation or integration. The findings show that there is a large deficit of young adults in the networks of older people, and that few older people have regular contact with younger non-kin. If age were not a factor in the selection of network members, one would expect the age distribution of adult network members to be the same as the age distribution of the entire adult population, but the ratio of actual to expected non-kin network members aged under 35 years for those aged 65–74 years is only 0.10. And only 15 per cent of the population aged 80 or more years has weekly contact with any non-kin aged less than 65 years. The number of children is strongly related to the total number of younger network members, because most younger network members are adult children. Further, participating in organisations (work and volunteer settings) that include people of diverse ages increases the likelihood of an older person having significant cross-age interactions with non-kin.
Modernisation and ageing theory revisited: current explanations of recent developing world and historical Western shifts in material family support for older people
Authors: ABODERIN ISABELLA
Published: January 2004

Modernisation and ageing theory has provided the main platform for the debate on changes in family support for older people in both the industrialised and the developing worlds. Although its well-known proposition of an ‘abandonment’ of older people in individualistic society has received much attention and been solidly refuted, the modernisation model continues to be the principal and most common framework for explaining the decline in familial material support for older people – both historically in the West, or at present in developing countries. The main rival explanation is provided by materialist accounts. The ability of these explanations to provide a meaningful understanding of why material family support may diminish has however received little if any analytical attention, despite its vital policy relevance, especially for the developing world. This paper critically examines the content and basis of both explanatory models. For each it exposes fundamental conceptual and epistemological limitations that render neither able to provide a solid understanding of the nature and causes of decline in support. Building on this analysis, the paper proposes a new approach in order to develop a fuller conceptual and empirical understanding.
Inter-generational role investments of great-grandparents: consequences for psychological well-being
Authors: DREW LINDA M. , SILVERSTEIN MERRIL
Published: January 2004

Identity theory suggests that individuals who perceive their family roles as salient and feel competent in their performance have greater psychological well-being than others. This paper assesses the ways in which aspects of parent, grandparent and great-grandparent role investments affect self-esteem, levels of depression and affect-balance. The 188 respondents with an average age of 73 years were participants in the University of Southern California Longitudinal Study of Generations and occupied all three roles at the time of measurement. They self-assessed quality of performance, importance to one's identity and satisfaction in their family roles. Overall, levels of role investment declined consistently with greater lineage distance from parent to great-grandparent. Latent correlations showed that parent role investment was most highly associated with well-being, followed by investment in grandparent and great-grandparent roles. Structural equation modelling, however, revealed no unique effects on well-being for any of the three roles (as a result of high inter-correlations). All three role structures formed a single meta-construct that was positively related to psychological well-being. It is concluded that the strength and consequences of inter-generational role investments were hierarchically structured by relational proximity, but also manifested in a single integrated family identity, which suggests that there are two competing and complementary views of family role structures in later life.
Gender and the negotiation between older people and their carers in the prevention of falls
Authors: HORTON KHIM , ARBER SARA
Published: January 2004

Little is known about how negotiation between older people and their carers varies according to gender. This paper reports a study of older men and women who have had multiple falls and the actions of their key family members to prevent multiple falls. In-depth interviews were conducted with 35 older people who had had recurrent falls, and separately with the identified key family member. The actions taken by the relatives to prevent future falls were classified as protective, coercive, negotiating, engaging and ‘reflective of mutual respect’. It was found that sons caring for older mothers took only ‘protective’ and ‘coercive’ actions, resulting in mothers having passive and submissive roles. In contrast, the daughters who were caring for their fathers undertook most often ‘engaging’ and some ‘negotiating’ actions, which empowered the fathers in their decision making. Daughters had a ‘peer-like’ relationship with the mothers that they supported and cared for, and undertook primarily ‘negotiating’ as well as ‘engaging’ actions. The two men who cared for older men took no specific actions but maintained mutual respect for each other. The findings demonstrate several ways in which the gender of the dyad members influences the nature of the negotiation between close relatives, and throws light on the factors that influence the autonomy and dependence of older people.
Editorial
Authors: WARNES TONY
Published: January 2004

Two years into an Editorship is a good time to take stock. In the essentials, Ageing & Society is doing well. There is a healthy flow of quality submissions, and the ‘bank’ of accepted papers has built up to fill two issues ahead. In other words, the time between a paper's acceptance for publication and its appearance has extended to around 6–8 months. The interval will be held at this level. Recognising the increased number of papers that merit publication, Cambridge University Press has agreed to an expansion of a volume's pages by 12 per cent. They were happy to allow more, but we'll proceed step-by-step for, as it is, Jean Wilkinson works flat out.