bluuebunny/crossref_metadata_2025 huggingface dataset:
Issues and Practices Related to Mainstreaming Evaluation: Where Do We Flow From Here?
Authors: Williams David D. , Hawkes Mark L.
Published: October 2003

The authors attended the plenary sessions, several Presidential Strand sessions, and other sessions at the 2001 annual meeting of the AEA to collect examples of evaluators and their clients exploring related issues. The authors raised questions and proposed directions to consider in using evaluation to improve organizations and their practices. Many of their ideas about what mainstreaming means, whether we should mainstream evaluation or not, how evaluation approaches relate to mainstreaming, and how to mainstream are summarized here.
What stamps the wrinkle deeper on the brow?
Authors: Weiss Kenneth , Aldridge Kristina
Published: October 2003

Science often relies on simplified diagrams to convey information, but these can embed tacit assumptions. A good example is provided by the surface convolutions of the cerebral cortex. It is surprisingly difficult to know what these features mean, and which deserve evolutionary explanation.
Origin of metamorphic soles and their post‐kinematic mafic dyke swarms in the Antalya and Lycian ophiolites, SW Turkey
Authors: Faruk Çeli̇k Ö. , Delaloye Michel F.
Published: October 2003

The Antalya and Lycian ophiolites are situated in the western part of the Tauride belt (SW Turkey). Ophiolite‐related metamorphic sole rocks in the Tauride belt are observed either at the base of the tectonites or in mélange units. Geochemical observations from the metamorphic sole rocks of Köyceğiz ophiolite indicate three different geochemical affinities: mid‐ocean ridge basalt (MORB), island‐arc tholeiite (IAT) and within‐plate basalt (WPB) or seamount are present at the base of the Lycian ophiolites. The sole rocks of the ophiolite are made up of amphibolite, comprising mainly amphibole, pyroxene and plagioclase. Below the amphibolites are epidote‐bearing rocks and, at the base, micaschists. The metamorphic sole below ophiolites exhibits an inverted metamorphic zonation. Very strong deformation within kyanite‐garnet‐bearing micaschists located far from the peridotites was observed, whereas the upper part of the metamorphic sole (near the contact with the peridotites) present relatively less deformation than the lower part.

The metamorphic sole rocks of the Lycian ophiolite are cross‐cut by some doleritic dykes with a typical greenschist facies mineral assemblage. However, while the metamorphic sole rocks exhibit well‐developed lineation and foliation; the dykes lack such structures. Copyright © 2003 John Wiley & Sons, Ltd.
New insights on the tectonic setting and evolution around the apex of the Isparta Angle (SW Turkey)
Authors: Poisson André , Yağmurlu Fuzuli , Bozcu Mustafa , Şentürk Murat
Published: October 2003

Recently acquired data lead to a revision of the structure around the apex of the Isparta Angle (area around Isparta). In the autochthonous/parautochthonous carbonate platform several blocks are identified as having followed distinctive palaeogeographical evolutions during Mesozoic times. These blocks are: the Kır Dağları, the Barla Dağ, the Söbü Dağ and the Bey Dağları. However, the latter two blocks cannot be considered as identical as previously believed. A major thrust fault may separate these blocks, which may be substantially allochthonous with respect to the relatively autochthonous Bey Dağları. Within the allochthon, in the Isparta Çay area, studied here, Mesozoic deep‐marine sequences are thrust duplicated many times. The tectonic history of the area is polyphased, the main events being in the Late Cretaceous (initiation of shortening), pre‐Miocene (Antalya Nappe emplacement), and Late Miocene/Pliocene (Aksu thrusting). The Aksu phase reactivates older thrusts and has given rise to the most prominent relief of the area (the Davras Dağ, 2600 m). Palaeogeographic reconstructions are proposed to take account of all the above data. Copyright © 2003 John Wiley & Sons, Ltd.
Kinematic evidence for Late Mesozoic–Miocene emplacement of the Lycian Allochthon over the Western Anatolide Belt, SW Turkey
Authors: Collins Alan S. , Robertson Alastair H. F.
Published: October 2003

Recent controversies relating to the transport directions of the Lycian Allochthon and the kinematic relationships of this to the underlying Menderes Massif are addressed by looking at the structural record preserved at the main tectonic boundaries within the Lycian Allochthon. Rocks today within the Lycian Thrust Sheets were deposited as a north‐facing Late Palaeozoic– Mesozoic rift/passive margin succession that formed in a northern Neotethys Ocean separating the Menderes–Tauride block and Eurasia. The allochthon was emplaced onto the southern continental margin in stages from latest Cretaceous to Late Miocene times. Throughout the Lycian Allochthon early kinematic fabrics indicate that the allochthon was emplaced, and successively transported, from northwest to southeast. Mylonites at the contact between the Lycian Allochthon and the underlying Menderes Massif exhibit top‐to‐the‐east non‐coaxial flow. The major tectonic boundaries within the allochthon preserve various kinematic indicators showing top‐to‐the‐southeast transport.

An intra‐platform basin (Tavas/Bozdağ unit), represented by structurally low Mesozoic–Palaeogene successions, probably originated as a rift basin between the Menderes Massif to the north and the Bey Dağları carbonate platform to the south. However, there is no structural evidence that the Lycian Thrust Sheets or the Lycian Peridotite Thrust Sheet were rooted in this basin. Copyright © 2003 John Wiley & Sons, Ltd.
The Anaximander Mountains: a clue to the tectonics of southwest Anatolia
Authors: Zitter Tiphaine A. C. , Woodside John M. , Mascle Jean
Published: October 2003

The offshore Anaximander Mountains are an important link between the Hellenic and Cyprus arcs. They were formed by southeastward rifting from Turkey in post‐Miocene time. Gravity data have shown that the eastern part of the Anaximander Mountains is different from the western part; multibeam mapping seems to confirm that the eastern Anaximander Mountains have affinity with the Florence Rise structure (western Cyprus Arc). Faulting along and across the latter feature is characterized in the seismic data by anastomosing faults and pop‐up flower structures. It is likely that progressive adjustment to incipient collision developed into a broad zone of NW–SE transpressive wrenching extending towards south Turkey. In contrast, the western mountains are more directly related to the opening of the Rhodes Basin and the Finike Basin, as transtension may have dominated in southwest Turkey since the Pliocene. The connection with onshore Turkey is still unclear, but could be related to the Fethiye–Burdur Fault Zone that defines the western boundary of the complex Isparta Angle. The Anaximander Mountains and the Isparta Angle form together a tectonic accommodation zone between the active deformation in southwestern Turkey and the Aegean region and the tectonically quieter Cyprus region. Copyright © 2003 John Wiley & Sons, Ltd.
The effects of galantamine treatment on caregiver time in Alzheimer's disease
Authors: Sano Mary , Wilcock Gordon K. , van Baelen Bart , Kavanagh Shane
Published: October 2003

Aim

The aim of the study was to determine whether the clinical benefits of galantamine for patients with Alzheimer's disease lead to benefits for caregivers.

Methods

Data were pooled from two concurrent, multi‐centre, randomized, double‐blind, placebo‐controlled, 6‐month trials. Time caregivers spent assisting with activities of daily living (ADL) and time patients could be left unsupervised each day were assessed using the Allocation of Caregiver Time Survey. In total, 825 patients with mild‐to‐moderate Alzheimer's disease were included.

Results

At endpoint, caregivers of galantamine‐treated patients were more likely to report reductions (41% vs 37%), maintenance (19% vs 14%) or smaller increases (26% vs 34% reporting an increase >30 minutes) in time assisting with ADL compared with the placebo group (p = 0.026; Wilcoxon rank‐sum test). The mean daily time difference was 32 minutes (p = 0.011). Among patients with moderate Alzheimer's disease, caregivers of galantamine‐treated patients were even more likely to report reductions (46% vs 37%), maintenance (15% vs 6%) or smaller increases (25% vs 42% for increases >30 min) vs placebo (p = 0.004), with a mean daily time saving of 53 minutes (p = 0.021). Caregivers of galantamine‐treated patients were more likely to report increases (22% vs 18%), maintenance (45% vs 43%) or smaller reductions (30% vs 37% for reductions >30 minutes) in time the patient could be left unsupervised compared with placebo (p = 0.027). Mean daily time saving was 27 minutes. Among patients with moderate Alzheimer's disease, the treatment effect was greater (p = 0.029), with caregivers in the galantamine group reporting the change in time left unsupervised as 68 minutes longer each day than caregivers of patients receiving placebo.

Conclusion

The clinical benefits of galantamine for patients with Alzheimer's disease are also associated with benefits to caregiving. Copyright © 2003 John Wiley & Sons, Ltd.
Anxiety disorder and accompanying subjective memory loss in the elderly as a predictor of future cognitive decline
Authors: Sinoff Gary , Werner Perla
Published: October 2003

Objective

The aim of the study was to empirically investigate the hypothesis that anxiety in the elderly, secondary to loss of memory, predicts future cognitive decline.

Method

The participants were 137 elderly subjects with no depression or cognitive impairment from a community geriatric assessment unit, 45% with anxiety. In addition to demographic characteristics, cognitive status was assessed using the Mini Mental State Examination; depression was assessed by Tucker's short Interviewer‐Assisted Depression Rating Scale; anxiety by Sinoff's Short Anxiety Screening Test and Activities of Daily Living function by Shah's modified Barthel's Index.

Results

At follow‐up 37 persons had dropped out, leaving 100 participants for final analysis. Mean re‐examination time was 3.2 years with no group differences. The mean MMSE and modified Barthel scores decreased significantly more in those with anxiety. A relative risk of 3.96 for developing future cognitive impairment was found. Regression analysis showed that only anxiety was a significant predictor of cognitive decline. By path analysis, a more parsimonious model showed anxiety to have both a direct and an indirect effect on predicting future cognitive decline, and that the effect of loss of memory on cognitive decline was via anxiety.

Conclusions

Anxiety is inter‐related and inseparable with loss of memory and its presence is a strong predictor for future cognitive decline, directly or indirectly via depression. It appears that loss of memory is the initial problem with consequent development of anxiety. Therefore, anxiety, like depression, is probably an early predictor of future cognitive decline and even possible future cognitive impairment. Copyright © 2003 John Wiley & Sons, Ltd.
Consumption of psychotropic medication in the elderly: a re‐evaluation of its effect on cognitive performance
Authors: Allard Jacques , Artero Sylvaine , Ritchie Karen
Published: October 2003

Background

There have been few general population studies of the effects of psychotropic treatment on cognitive functioning in the elderly. Current evidence based on studies with numerous procedural shortenings supports the notion of the detrimental effect.

Objectives

To examine changes in a wide range of specific cognitive abilities across time in a general population sample in order to establish a relationship between psychotropic drug use and cognitive performance, and to estimate to what extent such cognitive changes may be attributable to psychotropic use or other factors, notably age and co‐morbidity.

Method

We analysed the data from the Eugeria longitudinal study of cerebral ageing. Three hundred and seventy two subjects (263 female and 109 male) were visited at their place of residence and given a computerized cognitive examination. Depressive symptomatology and depressive episodes were defined according to ICD‐9 criterias and medication use were established. Four categories of psychotropic consumers was differentiated. Using a logistic regression model, comparisons were made between consumers and non‐consumers.

Results

A significant positive effect in chronic consumers was found on tests of secondary memory (delayed verbal recall: Odds Ratio (OR) = 1.22; 95% Confidence Intervals (CI) [1.04–1.43]; p = 0.013) and this effect is principally attributable to antidepressants with significant effects being shown for both verbal (OR = 1.59; 95%CI [1.18–2.14]; p = 0.002) and visual recall (OR = 1.51; 95%CI [1.05–2.16]; p = 0.025). No effect is found for benzodiazepines.

Conclusions

Contrary to the common belief that psychotropic drug use has a detrimental effect on cognitive function of elderly people, even long term use is seen to be benign. We attest to the positive effects of antidepressant therapy on secondary memory. Copyright © 2003 John Wiley & Sons, Ltd.
Clinical predictors of response to acetyl cholinesterase inhibitors: experience from routine clinical use in Newcastle
Authors: Pakrasi S. , Mukaetova‐Ladinska E. B. , McKeith I. G. , O'Brien J. T.
Published: October 2003

Background

Acetyl Cholinesterase Inhibitors (AChEIs) have been in clinical use for the past five years in the UK for the symptomatic treatment of Alzheimer's disease (AD). There are few data on the patterns and predictors of response to AChEI therapy in routine clinical practice. We therefore investigated clinical variables that may distinguish between AChEI responders and non‐responders.

Methods

A retrospective sample of 160 consecutive patients with dementia who were treated on clinical grounds with an AChEI was studied. Treatment response was defined in two ways: (a) A clinical response was achieved when there was no deterioration or there was an improvement on a global clinical assessment (CGI) and (b) a Mini‐Mental‐State‐Examination (MMSE) response when there was an improvement of 2 or more MMSE points.

Results

A total of 62 (45%) patients achieved an MMSE response. A diagnosis of dementia with Lewy Bodies (DLB) and Parkinson's disease+Dementia (PDD) was associated with a MMSE response, as were hallucinations, and lower MMSE scores at baseline. 125 (78%) patients achieved a CGI response for which there were no clinical predictors.

Conclusions

Severity of illness, a diagnosis of DLB and PDD, and presence of hallucinations at baseline were predictive of a MMSE response. Non‐AD dementia and severe dementia responded equally well to AChEI treatment and results of further randomised, placebo‐controlled studies are needed to clarify the role of AChEI in the treatment of these disorders. Copyright © 2003 John Wiley & Sons, Ltd.
Does integration really make a difference? A comparison of old age psychiatry services in England and Northern Ireland
Authors: Reilly S. , Challis D. , Burns A. , Hughes J.
Published: October 2003

Objective

This paper seeks to address whether integrated structures are associated with more integrated forms of service. Northern Ireland has one of the most structurally integrated and comprehensive models of health and personal social services in Europe. Social and health services are jointly administered and this arrangement should, in theory, promote collaborative working and interdisciplinary arrangements.

Design

The study employed a cross‐sectional survey of consultants in old age psychiatry in England and Northern Ireland. Potential respondents were sourced from the UK Royal College of Psychiatrists membership list and locally collected information.

Measures

A self‐administered postal questionnaire. Along with general service arrangements, the domains measured reflect core policy issues for older people's services. Under particular scrutiny in this study were the degree of integration of health and social service provision, as well as inter‐professional team working.

Results

The integrated health and social care services in Northern Ireland do appear to provide more integrated patterns of working, primarily in managerial arrangements and in the location of staff. There was no evidence of the impact of integration on practice in areas such as: assessment, referral and medical screening. The factors found to be associated with greater integration of health and social care in the prediction model fell into three categories: provision of specialist services; provision of outreach activities; and shared policies by which the whole team worked.

Conclusions

Health and personal social services in Northern Ireland have a distinct advantage over their counterparts in comparable areas of England. The results indicate that integrated structures in old age psychiatry services are associated more with integrated management systems and less with integrated practice‐related activities. Further research is required on the effectiveness and cost effectiveness of integrating services in general. It is important that future intervention studies systematically measure the component parts, nature and extent of integration and their individual and joint contribution to the effectiveness and efficacy of services. Copyright © 2003 John Wiley & Sons, Ltd.
The efficacy and safety of ECT in depressed older adults: a literature review
Authors: van der Wurff F. B. , Stek M. L. , Hoogendijk W. J. G. , Beekman A. T. F.
Published: October 2003

Background

Although little doubt exists among practising clinicians in old age psychiatry about the efficacy and safety of ECT in depression, opinions about acceptability differ widely. The objectives of this review were to determine the efficacy and safety of ECT based on both randomised and non‐randomised evidence in elderly with a major depressive disorder.

Methods

Randomised and non‐randomised studies on efficacy and safety of ECT in elderly with and without concomitant disorders such as cerebrovascular disorders, Alzheimer's dementia, vascular dementia and Parkinson's disease were selected. Literature was systematically searched in a number of electronic databases.

Results

Although 121 studies were included in the review process, only four provided randomised evidence. No negative studies with respect to efficacy were found. ECT is effective in the acute treatment of late life depression. ECT is generally safe, although a number of serious complications possibly related to ECT have been described. Most of the objectives of this review could not be answered or refuted with certainty, because firm randomised evidence on the efficacy and safety of ECT in the depressed elderly is missing.

Conclusions

ECT is effective in the acute treatment of late life depression and is generally safe. Important questions such as the relative efficacy of ECT over antidepressants, the long‐term efficacy of ECT, morbidity and mortality related to ECT, cost‐effectiveness and the efficacy of ECT in subgroups of patients cannot be answered and need to be studied further. Copyright © 2003 John Wiley & Sons, Ltd.
The impact of religious practice and religious coping on geriatric depression
Authors: Bosworth Hayden B. , Park Kwang‐Soo , McQuoid Douglas R. , Hays Judith C. , Steffens David C.
Published: October 2003

Objective

Both religiousness and social support have been shown to influence depression outcome, yet some researchers have theorized that religiousness largely reflects social support. We set out to determine the relationship of religiousness with depression outcome after considering clinical factors.

Methods

Elderly patients (n = 114) in the MHCRC for the Study of Depression in Late Life while undergoing treatment using a standardized algorithm were examined. Patients completed measures of public and religious practice, a modified version of Pargament's RCOPE to measure religious coping, and subjective and instrument social support measures. A geriatric psychiatrist completed the Montgomery‐Asberg Depression Rating Scale (MADRS) at baseline and six months.

Results

Both positive and negative religious coping were related to MADRS scores in treated individuals, and positive coping was related to MADRS six months later, independent of social support measures, demographic, and clinical measures (e.g. use of electro‐convulsive therapy, number of depressed episodes). Public religious practice, but not private religious practice was independently related to MADRS scores at the time of completion of the religiousness measures. Religious coping was related to social support, but was independently related to depression outcome.

Conclusions

Clinicians caring for older depressives should consider inquiring about spirituality and religious coping as a way of improving depressive outcomes. Copyright © 2003 John Wiley & Sons, Ltd.
Diagnosis‐seeking at subspecialty memory clinics: trigger events
Authors: Streams Megan E. , Wackerbarth Sarah B. , Maxwell Alan
Published: October 2003

Background

Research has shown that dementia often goes unrecognized, and diagnostic assessment is often further delayed. Understanding families' decision to seek care at memory clinics is relevant to efforts to facilitate early diagnosis

Objective

To examine the population seeking care at two memory clinics and the triggers causing caregivers to seek diagnostic assessment for a family member.

Method

We surveyed a consecutive sample of caregivers who accompanied a patient to an assessment at two university memory disorders clinics. Caregivers (n=416) described events that led them to seek a memory assessment for the patient, as well as who first suggested an assessment and diagnosis received.

Results

Changes in the patient (cognitive, personality/behavioral, physical, or unspecified) accounted for 81% of 903 trigger events reported. Nearly half of the caregivers noting specific patient changes recorded some combination, rather than cognitive changes alone. Of the 338 respondents who noted a change in the patient as a trigger, 85% specified at least one cognitive change, while 40% specified at least one personality/behavioral change. Memory loss was most frequent trigger reported, followed by disorientation and recommendations (lay or professional). Caregivers themselves and non‐specialist physicians were the most frequent sources of recommendations noted by all respondents.

Conclusion

A broad range of trigger events, beyond cognitive or symptomatic changes, caused caregivers to seek diagnosis at a memory clinic. Awareness of triggers significant to families may help physicians reduce the number and severity of events needed to convince caregivers a memory assessment is indicated. Copyright © 2003 John Wiley & Sons, Ltd.
Validation of a short cognitive tool for the screening of dementia in elderly people with low educational level
Authors: de Yébenes María Jesús García , Otero Angel , Zunzunegui María Victoria , Rodríguez‐Laso Angel , Sánchez‐Sánchez Fernando , Del Ser Teodoro
Published: October 2003

Aim

To validate the ‘Prueba Cognitiva de Leganés’ (PCL) as a screening tool for cognitive impairment in elderly people with little formal education.

Methods

The PCL is a simple cognitive test with 32 items that includes two scores of orientation and memory and a global score of 0–32 points. It was applied to a population sample of 527 elderly people over 70 with low educational level, who were independently diagnosed by consensus between two neurologists as having normal cognitive function, age associated cognitive decline (AACD, IPA‐OMS criteria) or dementia (DSM‐IV criteria). Individuals with severe visual or hearing defects and those who rejected the exam were excluded from the study. The PCL was validated in a sample of 375 individuals: 300 normal, 42 with AACD and 33 with dementia. The sensitivity, specificity, accuracy and likelihood ratios, as well as the ROC curves for dementia and for AACD‐dementia, were calculated. The confounding effect of sociodemographic variables was assessed by logistic regression analysis and convergent validity by partial correlations of the PCL with other cognitive tests. Inter‐rater reliability was evaluated with the intraclass correlation coefficient.

Results

The PCL identified dementia (cut‐off ≤22) and AACD‐dementia (cut‐off ≤26), with the following diagnostic parameters, respectively: sensitivity 93.9%–80%, specificity 94.7%–84.3%, positive likelihood ratio 17.8–5.1, negative likelihood ratio 0.06–0.24, and accuracy 94.6%–83.4%. The areas under the ROC curve were 0.985 (95% Confidence Intervals (CI) 0.967–0.995) and 0.904 (95% CI: 0.870–0.932) respectively. The intraclass correlation coefficient was 0.79 (0.74–0.83).

Conclusion

The PCL is a simple instrument, which is both valid and reliable, for the screening of dementia in population samples of individuals with low educational level. This instrument could be useful in primary health care. Copyright © 2003 John Wiley & Sons, Ltd.
Cognitive, psychiatric and motor response to galantamine in Parkinson's disease with dementia
Authors: Aarsland D. , Hutchinson M. , Larsen J. P.
Published: October 2003

Background

Cholinesterase inhibitors with additional nicotinic activity, such as galantamine, may be useful in PD patients with dementia (PDD) since stimulation of nicotinic receptors may prevent the down‐regualation that is likely to accompany cholinesterase inhibition and facilitate dopamine release in the striatum.

Methods

Sixteen PDD patients (six female) with onset of cognitive impairment after at least one year with parkinsonism participated in this open‐label trial of galantamine. Cognitive, psychiatric, and motor symptoms were assessed before and after 8 weeks of treatment with galantamine using unstructured clinical assessment as well as rating scales including the Mini‐Mental State Examination (MMSE), clock drawing test, verbal fluency and selected items from the Neuropsychiatric Inventory (NPI).

Results

Age (mean, SD) was 75.6 (5.2) years, duration of PD 13.4 (5.9), duration of dementia 2.1 (1.7) years, Hoehn and Yahr score was 3.8 (0.8) and baseline MMSE score was 17.7 (6.7). Side‐effects caused discontinuation in three patients, but were rare and mild in the remaining 13. Improvement of global mental symptoms was noted in eight patients, whereas worsening was reported in four. Hallucinations improved in seven of the nine patients with hallucinations before treatment. Parkinsonism improved in six patients, but a mild worsening of tremor was noted in three. Clock‐drawing improved (p = 0.016), and trends towards improvement on MMSE (p = 0.09) and verbal fluency (p = 0.16) were found.

Conclusions

Although controlled trials are needed, the findings suggest that galantamine is useful in patients with PDD. Copyright © 2003 John Wiley & Sons, Ltd.
Stem‐completion tasks (indirect, direct inclusion and exclusion) are differently affected by equipotent doses of lorazepam and flunitrazepam
Authors: Pompéia S. , Bueno O. F. A. , Galduróz J. C. F. , Tufik S.
Published: October 2003

This study was designed to explore the effects on performance in stem‐completion tasks of two benzodiazepines (BZ) in equipotent doses: lorazepam, a drug that atypically disrupts perceptual priming, and flunitrazepam, a compound with standard BZ effects. The study followed a placebo‐controlled, double‐blind, parallel‐group design. Thirty‐six young and healthy subjects carried out three completion tasks at theoretical peak‐plasma concentrations of drugs: (a) indirect tasks, in which the subjects were instructed to complete stems with the first word that came to mind; (b) direct inclusion tasks/cued recall, in which the participants had to try to use words seen at study as completions; and (c) direct exclusion tasks, in which words seen at study were to be avoided. The PDP was applied to the results in the inclusion and exclusion tasks, to obtain indices of explicit/controlled (C) and implicit/automatic (A) memory. The C index was lowered by both BZs and A was equivalent in all treatments, confirming the general amnestic action of BZs. However, lorazepam led to decreases in completions in the indirect and inclusion tasks, while flunitrazepam impaired performance in the exclusion task. The qualitative differences between the drugs in their effects on performance suggest that these BZs may lead to differences in response bias. Copyright © 2003 John Wiley & Sons, Ltd.
Preliminary investigation of the association between psychotropic medication use and accidents, minor injuries and cognitive failures
Authors: Wadsworth Emma J. K. , Moss Susanna C. , Simpson Sharon A. , Smith Andrew P.
Published: October 2003

Rationale

Psychotropic medication may impair psychomotor and cognitive function, and so increase accident susceptibility. However, few studies examine any association in the framework of other demographic, health and occupational factors.

Objectives

To examine the relationship between sleeping tablets and antidepressants, and accidents, minor injuries and cognitive failures.

Methods

Postal questionnaire study of 3111 individuals who participated in an earlier phase of the Bristol Stress and Health Study.

Results

Sleeping tablet use was associated with accidents, minor injuries and cognitive failures both at work and outside work. Antidepressant use was associated with accidents and cognitive failures both at work and outside work. Adjusting for health, demographic and occupational factors explained many of these associations, but sleeping tablet use was independently associated with accidents (both at work and outside work), and antidepressant use with cognitive failures (outside work).

Conclusions

Antidepressant and sleeping tablet use were apparently associated with accidents, minor injuries and cognitive failures. Although most of the associations could be accounted for by other factors the results suggested links between sleeping tablet use and accidents, and between antidepressant use and cognitive failures. Copyright © 2003 John Wiley & Sons, Ltd.
The relationship of changes in leptin, neuropeptide Y and reproductive hormones to antipsychotic induced weight gain
Authors: Fitzgerald Paul B. , Scaffidi Antonietta , Morris Margaret J. , de Castella Anthony R. , Kulkarni Jayashri
Published: October 2003

Objectives

Weight gain is an important side effect of antipsychotic (AP) treatment. Weight is regulated by multiple systems, including leptin, neuropeptide Y (NPY) and gonadal steroids. The aim was to investigate whether AP‐induced weight gain was related to leptin and NPY abnormalities and whether these were associated with a disruption of gonadal steroid production.

Methods

Twenty two female patients with schizophrenia receiving standard AP treatment were studied over a 3‐month period. Plasma leptin, NPY, gonadal steroids and their regulators were measured along with weight and BMI.

Results

Weight, leptin and testosterone levels increased over time. There were significant relationships between a change in oestrogen levels and both a change in NPY levels and a change in BMI. Change in BMI, weight and leptin all correlated strongly with a change in the testosterone/luteinizing hormone ratio.

Conclusions

AP treatment results in increase in weight over time and this increase is accompanied by increased leptin levels. AP‐induced weight gain is also associated with disruption of the hypothalamic–pituitary–gonadal axis. Altered regulation of NPY, either through abnormal leptin control or serotonin blockade, is a possible explanation for the effects of AP medication on both weight and gonadal steroid levels. Copyright © 2003 John Wiley & Sons, Ltd.
Effect of pindolol and milnacipran versus milnacipran and placebo on plasma prolactin and adrenocorticotrophic hormone in depressed subjects
Authors: Isaac Maria B. , Isaac Michael T.
Published: October 2003

Objective

Evidence that pindolol accelerates the action of antidepressants has been contradictory, and it is not clear why. The present study analyses the relationship between plasma prolactin (PRL) and ACTH levels and changes in relation to a milnacipran and pindolol combination versus milnacipran plus placebo.

Method

Eighty depressed patients agreed to take part in a double‐blind randomized trial of milnacipran plus pindolol or placebo. Fifty‐eight of them agreed to also take measures of ACTH and PRL levels. ACTH and PRL plasma levels were estimated on days 0 and 42 of the 6‐week study. Age, gender and time of blood collection were recorded for each individual. The Montgomery–Åsberg depression rating scale (MADRS) was used to measure the response to treatment. The patients were grouped into those with higher versus lower basal ACTH levels using the median of the sample (25 ng/l).

Results

There were statistical differences in MADRS scores between the treatment groups on day 42. There were correlations between PRL levels on days 0 and 42; age and PRL levels on day 0; time of the PRL sample and the PRL levels on day 0 and day 42; ACTH and PRL levels on day 42. Regression analysis of the 58 patients showed that on day 0, PRL levels were dependent on the ACTH plasma levels on day 0, the time of the collection of the blood sample and the age. On day 42, the PRL levels were dependent on the ACTH levels and the time of the blood collection but not on the age. Patients with lower baseline ACTH levels on day 0 displayed a better clinical outcome when taking the combination of milnacipran and pindolol as shown in the differences in MADRS on day 42. The same group of patients showed lower PRL levels on day 42.

Conclusions

ACTH plasma levels at baseline or screening may help to predict the response to antidepressant treatment. Copyright © 2003 John Wiley & Sons, Ltd.
Death rates from ecstasy (MDMA, MDA) and polydrug use in England and Wales 1996–2002
Authors: Schifano F. , Oyefeso A. , Corkery J. , Cobain K. , Jambert‐Gray R. , Martinotti G. , Ghodse A. H.
Published: October 2003

The present study reports on all deaths related to taking ecstasy (alone, or in a polydrug combination) occurring in England and Wales in the time frame August 1996–April 2002. Data presented here are based on all information recorded in the National Programme on Substance Abuse Deaths (np‐SAD) database. The np‐SAD regularly receives all information on drug related deaths in addicts and non addicts from coroners. A total of 202 ecstasy‐related fatalities occurred in the chosen time‐frame, showing a steady increase in the number of deaths each year. The ratio male:female was 4:1 and 3 of 4 victims were younger than 29. In 17% of cases ecstasy was the sole drug implicated in death and in the remaining cases a number of other drugs (mostly alcohol, cocaine, amphetamines and opiates) have been found. According to toxicology results, MDMA accounted for 86% of cases and MDA for 13% of cases; single deaths were associated with MDEA and PMA. This is the largest sample of ecstasy related deaths so far; possible explanations are given for the observed steady increase in ecstasy‐related deaths and a tentative ‘rationale’ for this polypharmacy combination is then proposed. Copyright © 2003 John Wiley & Sons, Ltd.
Acute, sub‐acute and long‐term subjective consequences of ‘ecstasy’ (MDMA) consumption in 430 regular users
Authors: Verheyden Suzanne L. , Henry John A. , Curran H. Valerie
Published: October 2003

This study examined the reported psychological effects of different patterns of MDMA use in men and women, and how they are modified by use of other psychoactive substances. A semi‐structured interview was conducted with 466 regular MDMA users, exploring the perceived acute, sub‐acute and long‐term subjective effects of this drug. Factor analysis established three main categories of acute effects of MDMA: (i) positive and (ii) negative effects on mental health, and (iii) physical effects. In terms of subacute effects, 83% of participants reported experiencing low mood and 80% reported impaired concentration between ecstasy‐taking sessions. Factors affecting these effects included age, gender, extent of MDMA use and concomitant use of cocaine or amphetamine. The long‐term effects most frequently reported included the development of tolerance to MDMA (59%), impaired ability to concentrate (38%), depression (37%) and ‘feeling more open towards people’ (31%). In terms of what might persuade users to stop using MDMA, their most prominent concern was the drug's long‐term effects on mental health. Copyright © 2003 John Wiley & Sons, Ltd.
Donepezil in a chronic drug user—a potential treatment?
Authors: Jovanovski Diana , Zakzanis Konstantine K.
Published: October 2003

The objective of the current study was to explore the potential cognitive benefits of an anticholinesterase inhibitor, donepezil, in a former chronic drug user. A neuropsychological test battery composed of the vocabulary and matrix reasoning subtests of the Wechsler adult intelligence scale‐III, measures of everyday executive functioning (behavioural assessment of the dysexecutive syndrome [BADS]), and verbal learning and memory tasks (California verbal learning test‐II; Rivermead behavioural memory test) was completed at baseline, at 3 months after introducing donepezil, and at 3 months after donepezil was discontinued. After donepezil treatment, substantial improvements were found on tasks of nonverbal fluid reasoning (i.e. matrix reasoning) and other executive functioning tests (i.e. BADS). At entry into the study, poor academic performance and subjective problems with memory and concentration were reported, particularly after amphetamine use (i.e. MDMA and crystal methamphetamine); after donepezil treatment, dramatic increases in memory, concentration and academic achievement were observed. The finding of improvements in tests of executive functioning and in academic performance in this case study, together with the minimal adverse side effects of donepezil, warrants the investigation of controlled studies of cholinergic enhancement in chronic amphetamine and other drug users. Copyright © 2003 John Wiley & Sons, Ltd.
Induction of mania in depression by paroxetine
Authors: Morishita Shigeru , Arita Seizaburo
Published: October 2003

Introduction

An investigation of the proportion of patients who have experienced mania with antidepressant treatment and their characteristics would seem to be of clinical use.

Aims

The purpose of this clinical study was to examine the predictors of induction of mania in depression patients as a result of paroxetine treatment.

Method

A retrospective cohort analysis was carried out among depression patients treated in the Department of Psychiatry, Kawasaki Medical School Hospital, Kurashiki, Japan, in 2000 and 2001. Some 79 patients were identified who were receiving paroxetine to treat depression. A variety of clinical factors including gender, the type of depression, frequency of episodes, family history, age and daily dose were examined as possible predictors of induction of mania by paroxetine.

Results

Seven (8.86%) of the 79 paroxetine‐treated patients developed mania. A Cox proportional hazards analysis showed the type of depression and the history of family psychiatric illness to be independent predictive factors of the induction of mania by paroxetine treatment.

Conclusions

The rate of mania induction of paroxetine is not substantially different from that found for conventional antidepressants. The type of depression and the history of family psychiatric illness may be considered as predictors of mania induction in depression patients taking paroxetine treatment. Copyright © 2003 John Wiley & Sons, Ltd.
Saccade and cognitive impairment associated with kava intoxication
Authors: Cairney Sheree , Maruff Paul , Clough Alan R. , Collie Alex , Currie Jon , Currie Bart J.
Published: October 2003

Kava is an extract from the Piper methysticum Forst. f. plant that has social and spiritual importance in Pacific islands societies. Herbal remedies that contain kava are used for the psychiatric treatment of anxiety and insomnia. Laboratory studies have found only subtle, if any, changes on cognitive or motor functions from the acute effects of consuming small clinical doses of kava products. Intoxication from recreational doses of kava has not been studied. The performance of individuals intoxicated from drinking kava (n=11) was compared with a control group (n=17) using saccade and cognitive tests. On average, intoxicated individuals had consumed 205 g of kava powder each (approximately 150 times clinical doses) in a group session that went for 14.4 h and ended 8 h prior to testing. Intoxicated kava drinkers showed ataxia, tremors, sedation, blepharospasm and elevated liver enzymes (GGT and ALP), together with saccadic dysmetria, saccadic slowing and reduced accuracy performing a visual search task that only became evident as the task complexity increased. Kava intoxication is characterized by specific abnormalities of movement coordination and visual attention but normal performance of complex cognitive functions. Saccade abnormalities suggest disruption of cerebellar and GABAergic functions. Copyright © 2003 John Wiley & Sons, Ltd.
Computing motif correlations in proteins
Authors: Horng Jorng‐Tzong , Huang Hsien‐Da , Wang Shih‐Hsien , Chen Ming‐You , Huang Shir‐Ly , Hwang Jenn‐Kang
Published: October 2003

Protein motifs, which are specific regions and conserved regions, are found by comparing multiple protein sequences. These conserved regions in general play an important role in protein functions and protein folds, for example, for their binding properties or enzymatic activities. The aim here is to find the existence correlations of protein motifs. The knowledge of protein motif/domain sharing should be important in shedding new light on the biologic functions of proteins and offering a basis in analyzing the evolution in the human genome or other genomes. The protein sequences used here are obtained from the PIR‐NREF database and the protein motifs are retrieved from the PROSITE database. We apply data mining approach to discover the occurrence correlations of motif in protein sequences. The correlation of motifs mined can be used in evolution analyses and protein structure prediction. We discuss the latter, i.e., protein structure prediction in this study. The correlations mined are stored and maintained in a database system. The database is now available at http://bioinfo.csie.ncu.edu.tw/ProMotif/. © 2003 Wiley Periodicals, Inc. J Comput Chem 24: 2032–2043, 2003
A point‐charge force field for molecular mechanics simulations of proteins based on condensed‐phase quantum mechanical calculations
Authors: Duan Yong , Wu Chun , Chowdhury Shibasish , Lee Mathew C. , Xiong Guoming , Zhang Wei , Yang Rong , Cieplak Piotr , Luo Ray , Lee Taisung , Caldwell James , Wang Junmei , Kollman Peter
Published: October 2003

Molecular mechanics models have been applied extensively to study the dynamics of proteins and nucleic acids. Here we report the development of a third‐generation point‐charge all‐atom force field for proteins. Following the earlier approach of Cornell et al., the charge set was obtained by fitting to the electrostatic potentials of dipeptides calculated using B3LYP/cc‐pVTZ//HF/6‐31G** quantum mechanical methods. The main‐chain torsion parameters were obtained by fitting to the energy profiles of Ace‐Ala‐Nme and Ace‐Gly‐Nme di‐peptides calculated using MP2/cc‐pVTZ//HF/6‐31G** quantum mechanical methods. All other parameters were taken from the existing AMBER data base. The major departure from previous force fields is that all quantum mechanical calculations were done in the condensed phase with continuum solvent models and an effective dielectric constant of ε = 4. We anticipate that this force field parameter set will address certain critical short comings of previous force fields in condensed‐phase simulations of proteins. Initial tests on peptides demonstrated a high‐degree of similarity between the calculated and the statistically measured Ramanchandran maps for both Ace‐Gly‐Nme and Ace‐Ala‐Nme di‐peptides. Some highlights of our results include (1) well‐preserved balance between the extended and helical region distributions, and (2) favorable type‐II poly‐proline helical region in agreement with recent experiments. Backward compatibility between the new and Cornell et al. charge sets, as judged by overall agreement between dipole moments, allows a smooth transition to the new force field in the area of ligand‐binding calculations. Test simulations on a large set of proteins are also discussed. © 2003 Wiley Periodicals, Inc. J Comput Chem 24: 1999–2012, 2003
Theoretical approach to the mechanism of reactions between halogen atoms and unsaturated hydrocarbons: The Cl + propene reaction
Authors: Braña Pedro , Sordo José A.
Published: October 2003

The potential energy surface for the Cl + propene reaction was analyzed at the MP2 level using Pople's 6‐31G(d,p) and 6‐311+G(d,p), and Dunning's cc‐pVDZ and aug‐cc‐pVDZ basis sets. Two different channels for the addition reaction leading to chloroalkyl radicals and five alternative channels for the abstraction reaction leading to C3H + HCl were explored. The corresponding energy profiles were computed at the QCISD(T)/aug‐cc‐pVDZ//MP2/aug‐cc‐pVDZ level of theory. Theoretical results suggest that the previously established mechanism consisting of (1) direct abstraction and (2) addition–elimination steps is instead made up of (1) addition through an intermediate and (2) two‐step abstraction processes. No direct abstraction mechanism exists on the potential energy surface. The kinetic equations derived for the new mechanism are consistent with the pressure dependence experimentally observed for this reaction. © 2003 Wiley Periodicals, Inc. J Comput Chem 24: 2044–2062, 2003
Siliceous spicules and skeleton frameworks in sponges: Origin, diversity, ultrastructural patterns, and biological functions
Authors: Uriz María‐J. , Turon Xavier , Becerro Mikel A. , Agell Gemma
Published: October 2003

Silica deposition is a fundamental process in sponges. Most sponges in the Classes Demospongiae and Hexactinellida secrete siliceous elements, which can subsequently fuse, interlock with each other, or form three‐dimensional structures connected by spongin. The resulting skeletal frameworks allow sponges to grow upwards and facilitate water exchange with minimal metabolic cost. Several studies on sponge skeletogenesis have been published. We are beginning to understand the mechanisms of spicule secretion and the role of spicules and skeletal frameworks in the biology, ecology, and evolution of sponges. Molecular techniques and ecological experiments have demonstrated the genetic control of the process and the contribution of environmental factors to the expression of a sponge spicule, respectively. However, other classic topics such as the role of membranes in silicon transport or whether spicules are formed in situ or secreted anywhere in the sponge mesohyl and then transported to the skeletal framework require further investigation. We review the process of silica deposition in sponges at the molecular and cellular levels, as well as the biological and ecological functions of spicules and skeletons. The genetic control of spicule shapes makes them useful in the reconstruction of sponge phylogeny, although recent experiments have demonstrated the influence of environmental factors in modulating spicule size, shape, and the presence or absence of one or more spicule types. The implications of such variations in sponge taxonomy may be important. Besides supporting sponge cells, spicules can help larvae stay buoyant while in the plankton or reach the bottom at settlement, enhance reproduction success, or catch prey. Conversely, the role of spicules and skeletons in deterring predation has not been demonstrated. Knowledge of several aspects is still based on a single or a few species and extrapolations should be made only with caution. With the advent of new molecular techniques, new lines of research are presently open and active in this field. Microsc. Res. Tech. 62:279–299, 2003. © 2003 Wiley‐Liss, Inc.