bluuebunny/crossref_metadata_2025 huggingface dataset:
Interpersonal Theory and Music Techniques: A Case Study for a Family With a Depressed Adolescent
Authors: Hendricks C. Bret , Bradley Loretta J.
Published: September 2005

Interpersonal psychotherapy (IPT-A) is a brief, time-limited therapy developed for use with adolescents diagnosed with major depression. IPT-A has been shown to be effective with adolescents in family counseling milieus. Music therapy techniques also have been successfully used to treat adolescent depression. This article provides mental health counselors and family counselors with information about a case study in which these two modalities were successfully integrated. In addition, this article provides explanations of IPT-A treatment protocols and music therapy techniques that might be utilized in a family therapy setting.
Five Ways of Assessing Relationship Satisfaction
Authors: Lessin Alex (Sasha) , Lessin Janet Kira , Eckstein Daniel , Kaufman Jason
Published: September 2005

In a relationship rating system, a pair of lovers regularly graph their conduct to better their bonding. The graph shows the couple’s dynamics—interaction, emotion, expression, clarity (understanding), and contact (feeling of connection). Based on the graph, lovers each pledge behaviors that raise or lower their ratings on each dynamic to achieve balance in their ratings on the five dimensions and thus achieve and maintain the fitness effect in their relation.
A Web in the Patriarchal Clan System
Authors: Yoshihama Mieko
Published: August 2005

Only recently has Japanese society come to realize the magnitude of domestic violence as a serious social problem. Using focus group methodology, this study investigated the function and the sociocultural reinforcements of male partner violence. The analysis of the participants’ accounts of various types of violence their partners perpetrated, which were accompanied by an elaborate collection of tactics to reinforce the effects of the violence, has led to the conceptualization of partners’ violence as a spider web. The Japanese patriarchal clan system and underlying ideology of male superiority fosters the maintenance of this web.
Disclosure of Child Abuse in Conflict Areas
Authors: Shalhoub-Kevorkian Nadera
Published: August 2005

Analyzing legal policies requires an in-depth understanding of the sociopolitical contexts within which sexual abuse is disclosed. Data presented in this study are based on a larger study of 628 Palestinian Israeli girls aged 14 to 16 years. Of these 628 girls, 28 victims of sexual abuse discussed their abuse with the research team. In addition, interviews were conducted with professional helpers. The contextual analyses of the interviews focused on the way young girls perceived disclosure, social support, and legal intervention to their abuse. Data revealed that the girls’ attitudes not only conformed to general findings on disclosure of sexual abuse but also reflected sociopolitical fears and stressors. Helpers struggled between their beliefs that they should abide by the state’s formal legal policies and their consideration of the victim’s context. The study reveals how decontextualizing child protection laws and policies can keep sexually abused girls from seeking help.
Experiencing Interpersonal Violence
Authors: Tucker Joan S. , Wenzel Suzanne L. , Straus Julie B. , Ryan Gery W. , Golinelli Daniela
Published: August 2005

As part of a larger study, the authors investigated experiences of recent violence among sexually active, substance-using women. Structured interviews were conducted with 172 women living in shelters and low-income housing, 41 of whom also completed an in-depth interview on their worst violent episode. Structured interviews indicated that rape and self-blame were more common among sheltered women. In-depth interviews suggested that sheltered women were vulnerable to instrumental aggression from a range of perpetrators, whereas housed women tended to experience hostile partner aggression. Intoxication during the violent episodes was more common among sheltered women. Implications for violence prevention and treatment services are discussed.
Tourist satisfaction: A view from a mixed international guided package tour
Authors: Bowie David , Chang Jui Chi
Published: August 2005

This paper seeks to identify the variables that are related to customer satisfaction during a guided package tour service encounter, including the role of the tour leader and the service performance by suppliers – itinerary arrangements, auxiliary support and service delivery. Data were gathered through participant observation during a mixed-nationality tour of Scandinavian destinations. Expectations, customer on-tour attitude and behaviour and equity were identified as affecting customer satisfaction during the service encounter. Additionally, the consumption experience of hedonism and enjoyment (excitement factors) on the tour had a significant effect on customer satisfaction. Two primary sources of complaints were identified: first, the tour operator's itinerary planning and hotel selection (basic factors), and second, the tour leader's competence (performance factor). The findings indicate that the tour leader is a significant determinant psychologically, spiritually and practically in influencing the success of the tour product. The result contributes to a better knowledge for the tour operator of tourism satisfaction in the international market for guided package tours.
Marketing regional tourism: How better to target and address community attitudes to tourism
Authors: Inbakaran Robert , Jackson Mervyn
Published: August 2005

In the past two decades there have been more than 70 published articles that have segmented tourist samples into clusters. The principal aims of such research are to understand tourist characteristics better; to identify key variables that predict tourist behaviour; to assess the value of tourism to an area; to provide knowledge to help develop facilities in designated areas; and to allow tourism marketing to plan strategies such as promotion and product development. In contrast, researchers have appeared to assume that the host population is homogeneous and has a uniform response to an increase in tourist numbers and to future sustainable tourism within the community. This research study used multivariate analyses such as factor analysis and cluster analysis to segment the host community into four distinct cluster groups on the basis of their positive and negative attitudes. Demographic variables constituted the cluster base. These four cluster groups differed from each other on gender ratio, age, life-cycle stage, education, migration status, occupation and current involvement with tourism. This research highlights differing attitudes present in various community groups, and explores implications for the tourist industry.
Impact of the macro environment: An examination of the economic propensity of UK regional markets for tourism to Scotland
Authors: Munro Colin , Yeoman Ian
Published: August 2005

Forecasting UK domestic tourists to Scotland is never an exact science, but in order to see into the future it is important to understand the correlation between economic performance and tourism revenues. In order to do this, VisitScotland, the national tourism agency for Scotland, uses econometrics (the Moffat model). VisitScotland is pro-jecting a robust performance for UK tourism in Scotland up to 2008, based upon a stable housing market, a tight labour market and low interest rates. Therefore Scottish tourism domestic revenues should rise from £4.1bn in 2005 to £4.4bn in 2008 in terms of real expenditure (excluding inflation). This paper sets out to explain this forecast. The forecasts are based upon economic conditions and represent the opportunity for tourism; they do not account for shocks such as 9/11 or extreme weather conditions. Such projections are used as a guide to the future, rather than the exact future.
Is Communication a Humanities Discipline?
Authors: Gronbeck Bruce E.
Published: August 2005

A 20th-century discipline in American universities, communication has struggled with questions of academic identity: generically, as to whether it is a 'humanities' or a 'social science', a 'practice' or a 'technology', and theoretically, as to what sorts of axioms, theorems, research methods or logics, and problems should form its core. This article explores some of the frames that have been borrowed and built to guide theorization of and research on communication practices. It then examines briefly the efforts to institutionalize communication studies academically, professionally, and economically as an American case-study of the rhetoric of inquiry: the ways in which the knowledge industries form species, divide the intellectual universe, and defend knowledge claims.
Credit-Based Discipline Specific English for Academic Purposes Programmes in Higher Education
Authors: Melles Gavin , Millar Geoff , Morton Janne , Fegan Suzanne
Published: August 2005

In the UK, North America and Australia, credit-bearing discipline specific English for Academic Purposes (EAP) courses are seen as a challenge to remedial views of English as a Second Language and a key element in revitalizing a profession on the periphery of the institution. However, the EAP field has to confront not only institutional challenges to its acceptability as a discipline but also tensions within the field. In this article we examine the tensions which underpin current and future directions in the field, review the development of credit-based EAP courses in the US, UK and Australia, and illustrate our discussion with a case study from the University of Melbourne. We conclude by arguing that discipline specific credit-based EAP offers promising hope for the future of the EAP discipline in higher education, but that to achieve this end the field and practitioners need to find a position between critique of and accommodation to discipline specific content.
On Academic Boredom
Authors: Baghdadchi Amir
Published: August 2005

The kind of boredom experienced in academia is unique. Neither a purely subjective nor objective phenomenon, it is the product of the way research is organized into papers, seminars, and conferences, as well as of a deep implicit metaphor that academic argument is a form of warfare. In this respect, the concepts of boredom and rigour are closely linked, since there is a kind of rigour in the Humanities that stresses the war metaphor, and structures scholarship defensively. This is opposed to a different kind of rigour that eschews the war metaphor altogether, and considers rigorousness in the light of a work's usefulness to its audience.
The Use of Cognitive and Experiential Techniques to Treat Depression
Authors: Rude Stephanie S. , Bates Danielle
Published: August 2005

Treatment of a young woman for symptoms of depression and adjustment problems incorporated cognitive and experiential techniques. Cognitive techniques were used to identify beliefs in incompetence and unlovability of self, and uncontrollability of situations; but logical analysis and challenge of these beliefs proved ineffective. The therapist hypothesized that these core beliefs were not altered by cognitive challenge because they were not fully activated. An obstacle to treatment was the client’s reluctance to fully engage these painful beliefs. Several months into treatment, as depression symptoms increased, a Gestalt two-chair dialogue helped the client make contact with a constellation of beliefs and emotions surrounding vulnerability and competence. Through this work, the client’s belief in her incompetence and unlovability appeared to be dislodged and her belief in the uncontrollability of her situation reduced.
The Course of Childhood OCD, Its Antecedents, Onset, Comorbidities, Remission, and Reemergence
Authors: Geffken Gary , Sajid Muhammad , Macnaughton Kathleen
Published: August 2005

The precursors of obsessive compulsive disorder (OCD) and its course are described in a boy in our clinic. First seen at age 4 with choking phobia, OCD was first diagnosed at age 9, was remitted by age 12, and did not reemerge again until age 16. Consistent with Kovacs and Devlin, we propose the course is consistent with biologically driven processes for internalizing disorders for children. This 12-year case report provides for observation of the development and course of OCD. This case is unique in describing antecedent behavior to onset of OCD, which was early choking phobia or obsessions of swallowing large objects and compulsive reassurance seeking. It is unique in describing a single child patient who shows remission of OCD and later reemergence of OCD. Literature of an empirical and theoretical nature support what can be learned in terms of the course and treatment of this childhood condition.
Predictive value of persistent versus transient antiphospholipid antibody subtypes for the risk of thrombotic events in pediatric patients with systemic lupus erythematosus
Authors: Male Christoph , Foulon Denise , Hoogendoorn Hugh , Vegh Patricia , Silverman Earl , David Michèle , Mitchell Lesley
Published: September 2005

Study objectives were to determine, in children with systemic lupus erythematosus (SLE), (1) the association of antiphosholipid antibody (APLA) subtypes with thrombotic events (TEs) and (2) the predictive value of persistent versus transient antibodies for TEs. This is a cohort study of 58 SLE children in whom lupus anticoagulants (LAs), anticardiolipin antibodies (ACLAs), anti–β2-glycoprotein-I (anti–β2-GPI), and antiprothrombin (anti-PT) were assessed on at least 2 occasions (more than 3 months apart). Antibodies were classified as persistent (positive on at least 2 occasions) or transient (positive once). Outcomes were symptomatic TEs confirmed by objective radiographic tests identified retrospectively and prospectively. Seven of the 58 patients (12%) had 10 TEs; 5 patients had TEs during prospective follow-up. Persistent LAs showed the strongest association with TEs (P < .001). Persistent ACLAs (P = .003) and anti–β2-GPI (P = .002) were significantly associated with TEs; anti-PT (P = .063) showed a trend. Persistent or transient LAs and anti–β2-GPI showed similar strength of association, while ACLAs and anti-PT were no longer associated with TEs. Positivity for multiple APLA subtypes showed stronger associations with TEs than for individual APLA subtypes because of improved specificity. Lupus anticoagulant is the strongest predictor of the risk of TEs; other APLA subtypes provide no additional diagnostic value. Anticardiolipin antibodies and anti-PT require serial testing because only persistent antibodies are associated with TEs.
High hepatotoxicity of pyrazinamide and ethambutol for treatment of latent tuberculosis: Table. 1—
Authors: Younossian A. B. , Rochat T. , Ketterer J-P. , Wacker J. , Janssens J-P.
Published: August 2005

Pyrazinamide (PZA) combined with either ethambutol (EMB) or a fluoroquinolone for 6–12 months is one of the treatments recommended for latent tuberculosis infection (LTBI) in contacts exposed to multidrug-resistant tuberculosis (MDR-TB). The aim of the present study was to describe the side effects related to combined PZA and EMB treatment given for LTBI, in contacts previously exposed to MDR-TB.

In total, 12 consecutive contacts, all of African origin and aged 38±5 yrs, were treated with daily PZA (23±4 mg·kg−1) and EMB (17±4 mg·kg−1) at Geneva University Hospital outpatient clinic (Switzerland), as a result of contact-tracing procedures for two patients with contagious MDR-TB.

Clinical status and liver function tests (aspartate aminotransferase (ALAT) and alanine aminotransferase (ASAT)) were monitored monthly. In seven cases (58%) treatment was discontinued after a median of 119 days, due to hepatic toxicity in six cases (ALAT or ASAT elevation more than four times the upper normal limit), and gastrointestinal symptoms in one case.

In conclusion, combined pyrazinamide and ethambutol for latent tuberculosis infection may be associated with a high risk of hepatic toxicity, and warrants close monitoring. There is clearly a need for alternative preventive treatments for contacts exposed to multidrug-resistant tuberculosis.
Early eradication therapy againstPseudomonas aeruginosain cystic fibrosis patients
Authors: Taccetti G. , Campana S. , Festini F. , Mascherini M. , Döring G.
Published: August 2005

In cystic fibrosis (CF) patients early antibiotic treatment of lung infection has been shown to lead toPseudomonas aeruginosaeradication. The present study determined: 1) the time period from eradication to newP. aeruginosaacquisition; 2)P. aeruginosare-growth and new acquisition; and 3) the impact of eradication therapy on lung function, antimicrobial resistance, emergence of other pathogens and treatment costs.

Ciprofloxacin and colistin were used to eradicateP. aeruginosain 47 CF patients. Bacterial pathogens, lung function decline,P. aeruginosaantimicrobial resistance and anti-pseudomonal serum antibodies were assessed quarterly and compared with an age-matched CF control group. Additionally, costs of antibiotic therapy in both groups were assessed.

Early antibiotic therapy leads to aP. aeruginosafree-period of a median (range) of 18 (4–80) months. New acquisition with differentP. aeruginosagenotypes occurs in 73% of episodes. It also delays the decline of lung function compared with chronically infected patients, prevents the occurrence of antibiotic resistantP. aeruginosastrains, does not lead to emergence of other pathogens, and significantly reduces treatment costs. The treatment substantially lowersP. aeruginosaprevalence in CF.

In conclusion, early antibiotic therapy exerts beneficial effects on the patient's clinical status and is cost-effective compared with conventional antibiotic therapy for chronically infected cystic fibrosis patients.
Nasal NO: normal values in children age 6 through to 17 years
Authors: Struben V. M. D. , Wieringa M. H. , Mantingh C. J. , Bommeljé C. , Don M. , Feenstra L. , de Jongste J. C.
Published: August 2005

The present study is an assessment of normal values of nasal nitric oxide (nNO) in healthy children.

Healthy children aged between 6–17 yrs were recruited from three schools in Rotterdam (The Netherlands). Breath was held for 10 s, while air was extracted from one nostril at 700 mL·min−1. The mean nNO value at the response plateau after 7–10 s was recorded and the average of three measurements was used.

In total, 340 children participated; the male:female ratio was 156:184. Three reliable measurements were available in 85% of the children. The nNO concentrations were distributed normally (mean 449 ppb,SD115). They were not associated with sex, passive smoking or body mass index. In children aged <12 yrs nNO correlated positively with age, history of adenoidectomy and ambient NO. In children aged ≥12 yrs ambient NO was the only significant modifier. Prediction rules for nNO values in children were formulated.

In conclusion, the current study presents normal values for nasal nitric oxide in children, which can be used to assess the value of nasal nitric oxide in respiratory illnesses.
Respiratory function and self-reported functional health: EPIC-Norfolk population study
Authors: Myint P. K. , Luben R. N. , Surtees P. G. , Wainwright N. W. J. , Welch A. A. , Bingham S. A. , Wareham N. J. , Day N. E. , Khaw K-T.
Published: August 2005

Respiratory function is known to be associated with mortality. However, its association with health related quality of life (HRQoL) has not yet been examined.

A population-based cross sectional study was conducted in 16,738 subjects aged 40–79 yrs and resident in Norfolk, to examine the association between forced expiratory volume in one second (FEV1) and HRQoL measured by the 36-item short form questionnaire.

Individuals who were in the highest quintiles of FEV1were more likely to report good physical functional health (odds ratio (OR) 1.60; 95% confidence interval (CI) 1.28–2.01 and OR 1.71; 95% CI 1.40–2.10 for males and females, respectively) controlling for age, height, weight or body mass index, smoking, physical activity, prevalent illness and social class. Being in the highest quintile for FEV1was associated with significantly lower likelihood of poor self-reported mental functional health status in males (OR 0.78; 95% CI 0.61–0.99), but not in females (OR 1.00; 95% CI 0.82–1.22).

In conclusion, forced expiratory volume in one second independently predicts self perceived physical well being in a general population across the whole normal distribution of respiratory function.
Exhaled breath condensate: methodological recommendations and unresolved questions
Authors: Horváth I. , Hunt J. , Barnes P. J.
Published: August 2005

Collection of exhaled breath condensate (EBC) is a noninvasive method for obtaining samples from the lungs. EBC contains large number of mediators including adenosine, ammonia, hydrogen peroxide, isoprostanes, leukotrienes, nitrogen oxides, peptides and cytokines. Concentrations of these mediators are influenced by lung diseases and modulated by therapeutic interventions. Similarly EBC pH also changes in respiratory diseases.

The aim of the American Thoracic Society/European Respiratory Society Task Force on EBC was to identify the important methodological issues surrounding EBC collection and assay, to provide recommendations for the measurements and to highlight areas where further research is required.

Based on the currently available evidence and the consensus of the expert panel for EBC collection, the following general recommendations were put together for oral sample collection: collect during tidal breathing using a noseclip and a saliva trap; define cooling temperature and collection time (10 min is generally sufficient to obtain 1–2 mL of sample and well tolerated by patients); use inert material for condenser; do not use resistor and do not use filter between the subject and the condenser. These are only general recommendations and certain circumstances may dictate variation from them.

Important areas for future research involve: ascertaining mechanisms and site of exhaled breath condensate particle formation; determination of dilution markers; improving reproducibility; employment of EBC in longitudinal studies; and determining the utility of exhaled breath condensate measures for the management of individual patients. These studies are required before recommending this technique for use in clinical practice.
Tuberculosis treatment outcomes in Europe: a systematic review
Authors: Faustini A. , Hall A. J. , Perucci C. A.
Published: August 2005

In order to facilitate the control of tuberculosis (TB), the World Health Organization (WHO) has defined a standardised short-course chemotherapy and a strategy, directly observed therapy. In 2000, WHO surveillance of TB treatments in Europe recorded a successful outcome rate of 77%. The aim of this report is to estimate treatment outcomes in European countries based on published studies and to identify their determinants.

A systematic review was conducted of published reports of TB treatment outcomes in Europe. Meta-analysis, meta-regression and subgrouping were used to pool treatment outcomes and analyse associations with mean age, sex, immigration status and multidrug resistance.

Of the 197 articles identified in the search, 26 were eligible for the review; 74.4% of outcomes were successful, 12.3% were unsuccessful and 6.8% of patients died. Heterogeneity was high for all outcomes. National estimates were possible for six countries. Multidrug resistance was inversely associated with successful outcome, which were fewer in populations with >9% multidrug-resistant TB, and in patients aged <44 yrs.

Successful tuberculosis treatment outcomes were below the 85% threshold suggested by the World Health Organization. There was an inverse association with levels of multidrug-resistant tuberculosis. The unexplained heterogeneity between the studies for unsuccessful outcomes seems to be due to differing interpretations given to World Health Organization definitions.
Skeletal muscle inflammation and nitric oxide in patients with COPD
Authors: Montes de Oca M. , Torres S. H. , De Sanctis J. , Mata A. , Hernández N. , Tálamo C.
Published: August 2005

In chronic obstructive pulmonary disease (COPD) the presence of systemic inflammation has been associated with peripheral muscle abnormalities and weight loss.

To study whether inflammatory factors are important in these processes, the present study compared the skeletal muscle levels of nitrite, nitrate, nitrotyrosine, neuronal, endothelial and inducible nitric oxide synthases (nNOS, eNOS, and iNOS, respectively), and inflammatory markers (tumour necrosis factor (TNF)-α, CD154 and CD163) in 15 patients (forced expiratory volume in one second 43±11%) and 14 controls. All these markers were also compared between patients with normal and low body weight.

Nitrite (12.5±2.6versus17.0±3.4 μmol·mg−1protein), nitrate (20.7±2.4versus24.4±4.5 μmol·mg−1protein) and eNOS (31.9±4.6versus43.6±7.5 ng·mg−1protein) were lower in COPD patients than in controls. Nitrotyrosine (25.6±5.4versus6.6±3.3 ng·mg−1protein), iNOS expression (32±9.5versus7.16±2.7 ng·mg−1protein), TNF-α (257±160versus48.3±4.4 pg·mg−1protein) and CD163 (6.4±2.1versus0.8±0.4 ng·mg−1protein) were higher in COPD patients than in controls. CD154 levels were 15.7±7.0 ng·mg−1protein in COPD patients and undetectable in controls. Similar levels of all these markers were observed in COPD patients with normal and low body weight.

In conclusion, these findings suggest the presence of an inflammatory process in the muscle tissue of chronic obstructive pulmonary disease patients, and argue in favour of its participation in the pathogenesis of skeletal muscle abnormalities.
Recurrent sarcoid granulomas in a transplanted lung derive from recipient immune cells: Fig. 1—
Authors: Milman N. , Andersen C. B. , Burton C. M. , Iversen M.
Published: August 2005

From 1992–2004, single lung transplantation has been performed in seven patients with end-stage pulmonary sarcoidosis at the Danish National Centre for Lung Transplantation. The objective was to assess whether recurrent sarcoid granulomas in the lung graft are derived from recipient or donor immune cells.

Three patients had sarcoid recurrence in the lung graft, but none had clinically overt extra-thoracic sarcoidosis. Graft sex-mismatch was present in one patient, a 52-yr-old female having a lung graft from a male donor. In order to discriminate between recipient and donor cells fluorescencein situhybridisation (FISH), using probes for both X- and Y-chromosomes, was applied on transbronchial lung biopsies (TBB) from the lung graft containing sarcoid granulomas.

The recipient's explanted lung contained multiple active sarcoid granulomas. TBB from the implanted donor lung 5 months after transplantation showed sarcoid granulomas. FISH showed that the immune cells in the granulomas were X-chromosome positive and Y-chromosome negative and, therefore, were derived from the recipient.

In conclusion, the results indicate that recurrent sarcoid granulomas in the transplanted lung are derived from recipient's immune cells, having colonised the lung allograft.
Relationship between respiratory symptoms and medical treatment in exacerbations of COPD
Authors: Calverley P. , Pauwels R. , Löfdahl C-G. , Svensson K. , Higenbottam T. , Carlsson L-G. , Ståhl E.
Published: August 2005

Exacerbations of chronic obstructive pulmonary disease (COPD) can be defined symptomatically or by healthcare contacts, yet the relationship between these events is unknown. Data were collected during a 1-yr study of the budesonide/formoterol combination in COPD patients, where exacerbations, defined by increases in treatment, were compared with daily records of respiratory symptoms, rescue medication use and peak expiratory flow (PEF).

The relationship between changes in these variables and the medical event was examined using different modelling approaches. Data from the first exacerbation treated with oral corticosteroids and/or antibiotics and/or hospitalisation (event based) were available in 468 patients.

Patients exacerbating were significantly more breathless and more likely to report cough than healthy patients, but did not differ in baseline spirometry. Exacerbations defined by changes in individual symptoms were only weakly related to event-based exacerbations; however, defined with 63% of such events being predicted from symptom changes. Changes in rescue medication use or PEF were poor predictors of event-based exacerbations. The mean peak change in symptoms was closely related to the onset of therapy.

In conclusion, event-based exacerbations are a valid way of identifying acute symptom change in a chronic obstructive pulmonary disease population. However, daily symptom monitoring is too variable using the current diary cards to make individual management decisions.
Time to death, airway wall inflammation and remodelling in fatal asthma
Authors: James A. L. , Elliot J. G. , Abramson M. J. , Walters E. H.
Published: August 2005

Fatal asthma is characterised pathologically by airway wall remodelling, eosinophil and neutrophil infiltration, accumulation of mucus in the airway lumen and smooth muscle shortening. The durations of fatal attacks of asthma show a clear bimodal distribution. Airway smooth muscle contraction and the accumulation of luminal mucus may contribute to death from asthma and relate to time to death.

The current authors have examined these two components in uninflated lung tissue in cases of fatal asthma from the second Victorian asthma mortality study. Based on time from onset of symptoms to death, cases fell into two distinct groups: short course <3 (1.5±0.6 mean±sd) h; and long course >8 (12.3±5.9) h.

Short course cases had more muscle shortening, higher levels of salbutamol and higher ratios of neutrophils to eosinophils than long course cases, who tended to have more mucus in the lumen.

In conclusion, this study confirms the dichotomy of both time to death and the eosinophil/neutrophil ratio in cases of fatal asthma. It suggests that in short course cases acute airway narrowing is due, predominantly, to bronchoconstriction despite higher blood levels of salbutamol. Mucus accumulation may be more important in long course cases.
JACOP: A simple and robust method for the automated classification of protein sequences with modular architecture
Authors: Sperisen Peter , Pagni Marco
Published: August 2005

Background

Whole-genome sequencing projects are rapidly producing an enormous number of new sequences. Consequently almost every family of proteins now contains hundreds of members. It has thus become necessary to develop tools, which classify protein sequences automatically and also quickly and reliably. The difficulty of this task is intimately linked to the mechanism by which protein sequences diverge, i.e. by simultaneous residue substitutions, insertions and/or deletions and whole domain reorganisations (duplications/swapping/fusion).

Results

Here we present a novel approach, which is based on random sampling of sub-sequences (probes) out of a set of input sequences. The probes are compared to the input sequences, after a normalisation step; the results are used to partition the input sequences into homogeneous groups of proteins. In addition, this method provides information on diagnostic parts of the proteins. The performance of this method is challenged by two data sets. The first one contains the sequences of prokaryotic lyases that could be arranged as a multiple sequence alignment. The second one contains all proteins from Swiss-Prot Release 36 with at least one Src homology 2 (SH2) domain – a classical example for proteins with modular architecture.

Conclusion

The outcome of our method is robust, highly reproducible as shown using bootstrap and resampling validation procedures. The results are essentially coherent with the biology. This method depends solely on well-established publicly available software and algorithms.
A method for finding single-nucleotide polymorphisms with allele frequencies in sequences of deep coverage
Authors: Wang Jianmin , Huang Xiaoqiu
Published: September 2005

Background

The allele frequencies of single-nucleotide polymorphisms (SNPs) are needed to select an optimal subset of common SNPs for use in association studies. Sequence-based methods for finding SNPs with allele frequencies may need to handle thousands of sequences from the same genome location (sequences of deep coverage).

Results

We describe a computational method for finding common SNPs with allele frequencies in single-pass sequences of deep coverage. The method enhances a widely used program named PolyBayes in several aspects. We present results from our method and PolyBayes on eighteen data sets of human expressed sequence tags (ESTs) with deep coverage. The results indicate that our method used almost all single-pass sequences in computation of the allele frequencies of SNPs.

Conclusion

The new method is able to handle single-pass sequences of deep coverage efficiently. Our work shows that it is possible to analyze sequences of deep coverage by using pairwise alignments of the sequences with the finished genome sequence, instead of multiple sequence alignments.
Caution required when relying on a colleague's advice; a comparison between professional advice and evidence from the literature
Authors: Schaafsma Frederieke , Verbeek Jos , Hulshof Carel , van Dijk Frank
Published: August 2005

Background

Occupational Physicians rely especially on advice from colleagues when answering their information demands. On the other hand, Evidence-based Medicine (EBM) promotes the use of up-to-date research literature instead of experts. To find out if there was a difference between expert-based practice and EBM we compared professional advice on occupational health topics with best evidence from the literature.

Methods

We asked 14 occupational physicians to consult their usual information sources on 12 pre-conceived occupational health problems. The problems were presented in the form of case vignettes which contained sufficient clinical information to be used by the occupational physicians for the consultation of their experts. We had searched the literature for the best available evidence on the 12 problems, which made it possible to answer the clinical questions with a clear yes or no.

Results

The cases could be used by the occupational physicians as arising from their own practice. All together the occupational physicians consulted 75 different experts. Almost half of the consulted experts were near colleagues, 10% were industrial hygienists, 8% medical specialists and the rest had a varied background. Fifty three percent (95% confidence interval 42% to 65%) of all professional advice was not in line with the research literature. In 18 cases (24%) professional advice explicitly referred to up-to-date research literature as their used source. These cases were substantially less incorrect (17%) than advice that had not mentioned the literature as a source (65%) (difference 48%, 95% Confidence Interval from 27% to 69%).

Conclusion

Advice that occupational physicians routinely get in their daily practice differs substantially from best evidence from the literature. Occupational physicians who ask professional advice should always ask about the evidence of this advice.
Resting energy expenditure is not influenced by classical music
Authors: Carlsson Ebba , Helgegren Hannah , Slinde Frode
Published: August 2005

Obesity shows an increasing prevalence worldwide and a decrease in energy expenditure has been suggested to be one of the risk factors for developing obesity. An increase in resting energy expenditure would have a great impact on total energy expenditure. This study shows that classical music do not influence resting energy expenditure compared to complete silence. Further studies should be performed including other genres of music and other types of stress-inductors than music.
Homocysteine, MTHFR C677T gene polymorphism, folic acid and vitamin B 12 in patients with retinal vein occlusion
Authors: Ferrazzi Paola , Di Micco Pierpaolo , Quaglia Ilaria , Rossi Lisa Simona , Bellatorre Alessandro Giacco , Gaspari Giorgio , Rota Lidia Luciana , Lodigiani Corrado
Published: September 2005

Background

Many available data have suggested that hyperhomocysteinaemia, an established independent risk factor for thrombosis (arterial and venous), may be associated with an increased risk of retinal vein occlusion (RVO).

Aim of the study

To evaluate homocysteine metabolism in consecutive caucasian patients affected by RVO from Northern Italy.

Patients and Methods

69 consecutive patients from Northern Italy (mean age 64.1 ± 14.6 yy) with recent RVO, were tested for plasma levels of homocysteine (tHcy: fasting and after loading with methionine), cyanocobalamine and folic acid levels (CMIA-Abbot) and looking for MTHFR C677T mutation (Light Cycler-Roche) and compared to 50 volunteers, enrolled as a control group.

Results

Fasting levels of tHcy were significantly higher in patients than in controls: mean value 14.7 ± 7.7 vs 10.2 ± 8 nmol/ml. Post load levels were also significantly higher: mean value 42.7 ± 23.7 vs 30.4 ± 13.3 nmol/ml; Total homocysteine increase was also evaluated (i.e. Δ-tHcy) after methionine load and was also significantly higher in patients compared to control subjects: mean Δ-tHcy 27.8 ± 21.5 vs 21.0 ± 16 nmol/ml (normal value < 25 nmol/ml). Furthermore, patients affected by RVO show low folic acid and/or vitamin B12 levels, although differences with control group did not reach statistical significance. Heterozygous and homozygous MTHFR mutation were respectively in study group 46% and 29% vs control group 56% and 4%.

Conclusion

our data confirm that hyperhomocysteinaemia is a risk factor for RVO, and also that TT genotype of MTHFR C677T is more frequently associated with RVO: if the mutation per se is a risk factor for RVO remains an open question to be confirmed because another study from US did not reveal this aspect.

Hyperomocysteinemia is modifiable risk factor for thrombotic diseases. Therefore, a screening for tHcy plasma levels in patients with recent retinal vein occlusion could allow to identify patients who might benefit from supplementation with vitamins and normalization of homocysteine levels, in fasting and after methionine load.
Signaling pathways mediating a selective induction of nitric oxide synthase II by tumor necrosis factor alpha in nerve growth factor-responsive cells
Authors: Thomas Michael S , Zhang WenRu , Jordan Paivi M , Saragovi H Uri , Taglialatela Giulio
Published: September 2005

Background

Inflammation and oxidative stress play a critical role in neurodegeneration associated with acute and chronic insults of the nervous system. Notably, affected neurons are often responsive to and dependent on trophic factors such as nerve growth factor (NGF). We previously showed in NGF-responsive PC12 cells that tumor necrosis factor alpha (TNFα) and NGF synergistically induce the expression of the free-radical producing enzyme inducible nitric oxide synthase (iNOS). We proposed that NGF-responsive neurons might be selectively exposed to iNOS-mediated oxidative damage as a consequence of elevated TNFα levels. With the aim of identifying possible therapeutic targets, in the present study we investigated the signaling pathways involved in NGF/TNFα-promoted iNOS induction.

Methods

Western blotting, RT-PCR, transcription factor-specific reporter gene systems, mutant cells lacking the low affinity p75NTR NGF receptor and transfections of TNFα/NGF chimeric receptors were used to investigate signalling events associated with NGF/TNFα-promoted iNOS induction in PC12 cells.

Results

Our results show that iNOS expression resulting from NGF/TNFα combined treatment can be elicited in PC12 cells. Mutant PC12 cells lacking p75NTR did not respond, suggesting that p75NTR is required to mediate iNOS expression. Furthermore, cells transfected with chimeric TNFα/NGF receptors demonstrated that the simultaneous presence of both p75NTR and TrkA signaling is necessary to synergize with TNFα to mediate iNOS expression. Lastly, our data show that NGF/TNFα-promoted iNOS induction requires activation of the transcription factor nuclear factor kappa B (NF-κB).

Conclusion

Collectively, ourin vitromodel suggests that cells bearing both the high and low affinity NGF receptors may display increased sensitivity to TNFα in terms of iNOS expression and therefore be selectively at risk during acute (e.g. neurotrauma) or chronic (e.g. neurodegenerative diseases) conditions where high levels of pro-inflammatory cytokines in the nervous system occur pathologically. Our results also suggest that modulation of NFκB-promoted transcription of selective genes could serve as a potential therapeutic target to prevent neuroinflammation-induced neuronal damage.
Hepatitis B virus X protein interacts with β5 subunit of heterotrimeric guanine nucleotide binding protein
Authors: Lwa Siew Hui , Chen Wei Ning
Published: August 2005

Background

To isolate cellular proteins interacting with hepatitis B virus X protein (HBX), from HepG2 cells infected with hepatitis B virus (HBV).

Results

HBV particles were produced in culture medium of HepG2 cells transfected with the mammalian expression vector containing the linear HBV genome, as assessed by commercially available ELISA assay. A cDNA library was made from these cells exposed to HBV. From yeast two hybrid screening with HBX as bait, human guanine nucleotide binding protein β subunit 5L (GNβ5) was isolated from the cDNA library constructed in this study as a new HBX-interacting protein. The HBX-GNβ5 interaction was further supported by mammalian two hybrid assay.

Conclusion

The use of a cDNA library constructed from HBV-transfected HepG2 cells has resulted in the isolation of new cellular proteins interacting with HBX.
L2L: a simple tool for discovering the hidden significance in microarray expression data
Authors: Newman John C , Weiner Alan M
Published: August 2005

L2L is a database consisting of lists of differentially expressed genes compiled from published mammalian microarray studies, along with an easy-to-use application for mining the database with the user's own microarray data. As illustrated by re-analysis of a recent study of diabetic nephropathy, L2L identifies novel biological patterns in microarray data, providing insights into the underlying nature of biological processes and disease. L2L is available online at the authors' website [http://depts.washington.edu/l2l/].
Robust pole assignment in matrix descriptor second-order linear systems
Authors: Duan Guang-Ren , Wu Yun-Li
Published: August 2005

The present paper considers eigenvalue assignment with minimum sensitivity in matrix descriptor second-order linear (MDSOL) systems via proportional-derivative plus partial second-derivative state feedback. Based on a result in the perturbation theory of the eigenvalue problem of MDSOL systems, a closed-loop eigenvalue sensitivity measure in terms of the closed-loop normalized right and left eigenvectors is established directly in the matrix second-order framework. Also a general parametric eigenstructure assignment for MDSOL systems via proportional-derivative plus partial second-derivative state feedback is proposed. Based on this, the robust pole assignment problem is converted into an independent minimization problem. The closed-loop eigenvalues may be easily taken as part of the design parameters and optimized within certain desired fields on the complex plane to improve robustness. Using a simple sequential-order algorithm, the optimality of the obtained solution to the robust pole assignment problem is totally dependent on the solution to the independent minimization problem. An example of mass-spring system demonstrates the effect of the proposed approach.
Care programme approach: relapsing or recovering?
Authors: Kingdon David , Amanullah Shabbir
Published: August 2005

The care programme approach (CPA) has become an accepted part of clinical practice, despite the continuing lack of strong direct evidence of its value. Guidance from the Department of Health has refined the original requirements, which were to ensure health and social care assessment, discharge from hospital to appropriate accommodation with necessary support, appointment of a mental health professional to draw up a care plan, and coordination of its implementation with necessary follow-up. The CPA now specifies that care plans include provision, as necessary, for risk assessment and management, employment, leisure, accommodation and plans to meet carers' needs. Levels of care have been simplified to ‘standard’ and ‘enhanced’. In future it will need to incorporate issues arising from the development of specialist teams as part of the National Health Service Plan, concern about the physical healthcare of those subject to it and the continuing development of psychosocial interventions.
Healing ourselves: ethical issues in the care of sick doctors
Authors: Adshead Gwen
Published: August 2005

In this paper I review some of the ethical dilemmas that arise when psychiatrists are involved in the assessment and treatment of medical colleagues. Special attention needs to be paid to the context of the relationship between the psychiatrist and the doctor-patient, and to the extent to which the patient is seeking help voluntarily or at the request of a third party. Psychiatrists may find themselves uncertain about how to meet the ethical demands of their duties to the patient and their duties to the public, when these conflict.
The management of violence in general psychiatry
Authors: Davison Sophie E.
Published: August 2005

There is increasing concern about the level of violence within mental healthcare settings. In this article I review what is known on this subject, discuss the relationship between mental disorder and violence and summarise the different ways to prevent and manage violence. When planning strategies to prevent violence in such settings it is important to consider not only patient risk factors but also risk factors in the environment. Staff need to have all the possible techniques for managing violent behaviour available to them in order to weigh up the risks and benefits for any specific patient in any particular situation.
Psychotropic medication and breast-feeding
Authors: Kohen Dora
Published: August 2005

Adverse effects of psychotropic medication on breast-fed infants have not been studied in controlled and systematic research. Existing information comes from small case series and single case reports. These limited data confirm that psychotropics are excreted into breast milk and that the infant is exposed to them. In recent decades sufficient data have accumulated to allow psychiatrists to prescribe tricyclic antidepressants, selective serotonin reuptake inhibitors, conventional antipsychotics, carbamazepine and sodium valproate to breast-feeding mothers with safety. There are not sufficient data on atypical antipsychotics to allow women to breast-feed safely. Mothers on clozapine or lithium should not breast-feed. It is good practice to recommend that breast-feeding mothers requiring psychotropic medication be on a low dose of one single drug. Future research taking account of maternal mental health, psychopharmacological factors, infant physiological environment and individualised risk/benefit assessment will yield clearer responses to this complex issue.
Capacity to give evidence in court: issues that may arise when a client with dementia is a victim of crime
Authors: Jones Rowena , Elliott Tony
Published: August 2005

There are a number of issues that arise when an older person with dementia is a victim of crime. The safety of the individual and how to prevent further such incidents occurring is a clear priority. There may be considerations such as whether the person can continue to live safely at home. In addition, there is the prospect of future legal proceedings, and concerns such as the person's capacity to give evidence, and whether they will be able to cope with the pressures of attending court. Similar issues are also pertinent to younger people with serious mental illnesses living in the community.