bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethnicity and Time to Institutionalization of Dementia Patients: A Comparison of Latina and Caucasian Female Family Caregivers
Authors: Mausbach Brent T. , Coon David W. , Depp Colin , Rabinowitz Yaron G. , Wilson‐Arias Esther , Kraemer Helena C. , Thompson Larry W. , Lane Geoffrey , Gallagher‐Thompson Dolores
Published: June 2004

Objectives: To compare rates of institutionalization of dementia patients cared for by Latina and Caucasian female caregivers and to explore which caregiver and care‐recipient characteristics predicted institutionalization.

Design: Longitudinal.

Setting: San Francisco Bay area, California.

Participants: Two hundred sixty‐four female caregivers of dementia patients (154 Caucasian women, 110 Latinas) who participated in an intervention project designed to reduce caregiver stress and may represent a sample that is more stressed and motivated than a general sample of caregivers.

Measurements: Number of days between baseline interview and institutionalization was recorded over an 18‐month period. Kaplan‐Meier survival analysis with the log rank statistic was used to test for ethnic differences in time to institutionalization. Cox regression analyses were conducted to determine whether care‐recipient or caregiver characteristics (e.g., care‐recipient age and memory and behavior problems; caregiver depression, years of education, income, and views of the caregiving role) significantly interacted with ethnicity to explain time to institutionalization.

Results: Latinas delayed institutionalization significantly longer than their Caucasian counterparts; care‐recipient characteristics or caregiver demographics did not explain these results, although Latinas who identified greater benefits or more‐positive aspects of the caregiving process at baseline were less likely to institutionalize their loved one than those who reported fewer benefits of caregiving. Less‐acculturated Latinas were significantly more likely to identify positive aspects of caregiving than more‐acculturated Latinas.

Conclusion: Latina dementia caregivers delay institutionalization significantly longer than female Caucasian caregivers. In addition, Latino cultural values and positive views of the caregiving role are important factors that may significantly influence their decision to institutionalize loved ones with dementia.
Breast Cancer Treatment in Older Women: Impact of the Patient‐Physician Interaction
Authors: Maly Rose C. , Leake Barbara , Silliman Rebecca A.
Published: June 2004

Objectives: To assess the impact of the patient‐physician interaction on breast cancer care in older women.

Design: Cross‐sectional survey.

Setting: Los Angeles County, California.

Participants: Two hundred twenty‐two consecutively identified breast cancer patients aged 55 and older who were within 6 months of breast cancer diagnosis and/or 1 month posttreatment.

Measurements: Dependent variables were patient breast cancer knowledge, treatment delay, and receipt of breast‐conserving surgery (BCS). Key independent variables were five dimensions of the patient‐physician interaction by patient report, including physician provision of tangible and interactive informational support, physician provision of emotional support, physician participatory decision‐making style, and patient perceived self‐efficacy in the patient‐physician interaction. Age and ethnicity were additional important independent variables.

Results: In multiple logistic regression models, only physician interactive informational support had significant relationships with all three dependent variables, controlling for a wide range of patient sociodemographic and case‐mix characteristics, visit length, number of physicians seen, social support, and physician sociodemographic and practice characteristics. Specifically, informational support positively predicted patient breast cancer knowledge (adjusted odds ratio (AOR)=1.18, 95% confidence interval (CI)=1.00–1.38), negatively predicted treatment delays (AOR=0.80, 95% CI=0.67–0.94), and positively predicted receipt of BCS (AOR=1.29, 95% CI=1.07–1.56). Age and ethnicity were not significant predictors in these models.

Conclusion: One specific domain of the patient‐physician interaction, interactive informational support, may provide an avenue to ensure adequate breast cancer knowledge for patient treatment decision‐making, decrease treatment delay, and increase rates of BCS for older breast cancer patients, thereby potentially mitigating known healthcare disparities in this vulnerable population of breast cancer patients.
Self‐Reported Alcohol Consumption and Falls in Older Adults: Cross‐Sectional and Longitudinal Analyses of the Cardiovascular Health Study
Authors: Mukamal Kenneth J. , Mittleman Murray A. , Longstreth W. T. , Newman Anne B. , Fried Linda P. , Siscovick David S.
Published: June 2004

Objectives: To assess the cross‐sectional and longitudinal associations between alcohol consumption and risk of falls in older adults.

Design: Cross‐sectional and longitudinal analyses.

Setting: Four U.S. communities.

Participants: A total of 5,841 older adults enrolled in the Cardiovascular Health Study, an ongoing, population‐based, prospective cohort study, participated.

Measurements: Self‐reported alcohol consumption at baseline, self‐reported frequent falls at baseline, and the 4‐year risk of falls of participants who denied frequent falls at baseline.

Results: Cross‐sectional analysis indicated an apparent inverse association between alcohol consumption and risk of frequent falls (adjusted odds ratio in consumers of 14 or more drinks per week=0.41; 95% confidence interval (CI)=0.14–1.17; P for trend=.06), but longitudinal analysis indicated a similar 4‐year risk of falls in abstainers and light to moderate drinkers but a 25% higher risk in consumers of 14 or more drinks per week (95% CI=3–52%; P for trend=.07). Similar results were found in analyses stratified by age, sex, race, and physical activity.

Conclusion: Consumption of 14 or more drinks per week is associated with an increased risk of subsequent falls in older adults. Cross‐sectional studies may fail to identify this risk of heavier drinking, perhaps because older adults at risk for falls decrease their alcohol use over time or because heavier drinkers at risk for falls tend not to enroll in cohort studies. However, because this study relied upon annual reporting of falls, further prospective studies should be conducted to confirm these findings.
Assessment of Individual Risk of Death Using Self‐Report Data: An Artificial Neural Network Compared with a Frailty Index
Authors: Song Xiaowei , Mitnitski Arnold , MacKnight Chris , Rockwood Kenneth
Published: June 2004

Objectives: To evaluate the potential of an artificial neural network (ANN) in predicting survival in elderly Canadians, using self‐report data.

Design: Cohort study with up to 72 months follow‐up.

Setting: Forty self‐reported characteristics were obtained from the community sample of the Canadian Study of Health and Aging. An individual frailty index score was calculated as the proportion of deficits experienced. For the ANN, randomly selected participants formed the training sample to derive relationships between the variables and survival and the validation sample to control overfitting. An ANN output was generated for each subject. A separate testing sample was used to evaluate the accuracy of prediction.

Participants: A total of 8,547 Canadians aged 65 to 99, of whom 1,865 died during 72 months of follow‐up.

Measurements: The output of an ANN model was compared with an unweighted frailty index in predicting survival patterns using receiver operating characteristic (ROC) curves.

Results: The area under the ROC curve was 86% for the ANN and 62% for the frailty index. At the optimal ROC value, the accuracy of the frailty index was 70.0%. The ANN accuracy rate over 10 simulations in predicting the probability of individual survival mean±standard deviation was 79.2±0.8%.

Conclusion: An ANN provided more accurate survival classification than an unweighted frailty index. The data suggest that the concept of biological redundancy might be operationalized from health survey data.
Health Care for Older Persons: A Country Profile—Korea
Authors: Cho Kyung‐Hwan , Chung Younho , Roh Yong‐Kyun , Cho Belong , Kim Cheol‐Ho , Lee Hong‐Soon
Published: June 2004

The Korean healthcare system is faced with a crisis caused by rapidly changing social values tending toward westernization, increasing insurance benefit requests for elder health care, financial instability of the National Health Insurance (NHI) program, and a lack of social infrastructure for the elderly. The demand for health care for the elderly has increased markedly, because of a rapidly aging population, growing female participation in the labor market, elevated expectations for health care, and a change in the pattern of medical conditions in the elderly from acute illness to chronic disability. NHI lacks the finances to meet the benefit request for long‐term care (LTC). Only 0.39% of the elderly can be accommodated in LTC beds. Consequently, the chronically disabled elderly overflow to acute care beds in general hospitals, which places an undue burden on the already strained NHI system in terms of longer stays and higher cost of treatment in hospitals compared with care specific to the elderly in LTC facilities. It is clear that the Korean healthcare system does not have the facilities to meet such challenges and is in a state of disorder. Korea has failed to predict and prepare for population needs before they arise, including financing and the development of appropriate care models, particularly concerning the adequate provision of LTC. This paper advocates the necessity of international discussion of the prospects for developing health care for aging populations and encourages the sharing of differing national experiences concerning care for the elderly.
Iatrogenic magnesium overdose: 2 case reports
Authors: Jackson C. Bisque , Drobatz Kenneth J.
Published: June 2004

Objective: To describe the clinical manifestations and treatment of hypermagnesemia and the potential drug errors that can lead to iatrogenic electrolyte toxicities.

Summary: We report 2 cases of iatrogenic intravenous (IV) magnesium (Mg) overdose. Both cases developed extreme cardiovascular and neurologic symptoms consisting of vomiting, hypotension, bradycardia, flaccid paralysis, and severe mental depression. Diagnosis was made based upon serum ionized Mg levels (3.47 mmol/L; reference range: 0.43–0.58 mmol/L for Case #1; and 4.64 mmol/L; reference range: 0.42–0.55 mmol/L for Case #2). Each animal was treated with 0.9% NaCl for diuresis and IV calcium gluconate. Within 24 hours, the cardiovascular and neurologic status of both animals, as well as the serum Mg concentration, had normalized. Each animal was discharged with no complications. Both animals had been hospitalized for critical illness and had developed hypomagnesemia that was being treated with Mg sulfate infusions. The cause for the hypermagnesemia was due to miscalculations in treatment orders that led to erroneously administered Mg‐containing solutions. Confusing drug labels and varying units of measurement can lead to erroneous miscalculations, especially in critically ill patients that receive multiple IV infusions.

New information provided: This is the first case report of iatrogenic Mg overdose in veterinary medicine. These 2 cases had a good clinical outcome with prompt recognition and supportive care.
Critical role of the vascular endothelial cell in health and disease: a review article
Authors: Duffy Todd C. , Kirby Rebecca , Rudloff Elke
Published: June 2004

Objective:To review the human and veterinary literature on the role of the vascular endothelial cell in health, as well as during hypoxic and inflammatory disease states.

Data sources:Data from human and veterinary literature were reviewed through a Pubmed search and a manual search of the references listed in articles covering some aspect of vascular endothelial cell function.

Human data synthesis:The development of techniques that allow the maintenance and growth of endothelial cells in culture has produced an explosion of new research in the area of endothelial cell physiology. This plethora of data has revealed the critical role that vascular endothelial cells play in both health and disease states. Interspecies variations can occur with respect to the vascular endothelial cell physiology and its response to pathologic conditions.

Veterinary data synthesis:There is a paucity of information regarding the role of the vascular endothelial cell in health or disease of small animals. Many human studies use species cared for by veterinarians, providing information that may be applied to small animals and that may be used to construct future studies.

Conclusion:An organ system itself, the vascular endothelium is an essential component of all organs in the body. The endothelial cell lining functions to maintain selective permeability between the blood and the tissue it supplies, regulate vascular tone, sustain blood fluidity through regulation of coagulation, and modulate interaction of leukocytes with the interstitium and inflammatory reactions. During disease states, the endothelial cell functions locally to limit the boundaries of the disease process. If these functions are not controlled, they can become a part of the pathogenic process, contributing to blood stasis and thrombosis, potentiation of local inflammation and interstitial edema formation, subsequent tissue hypoxia, and multiple organ dysfunction. Pharmacological investigations targeting the modulation of endothelial function during disease states have not yet advanced treatment protocols. Since all critically ill animals are at risk for some degree of endothelial cell dysfunction, treatment regimens should focus on promoting capillary blood flow and tissue oxygen delivery.
Determination of plasma lysosomal enzyme activity and its relationship to severity of injury following blunt vehicular trauma in dogs
Authors: Chow Rosalind S. , Syring Rebecca S. , Otto Cynthia M.
Published: June 2004

Objective: To determine plasma β‐d‐glucuronidase (βG) activity in the first 4 hours following injury in dogs struck by a motor vehicle, and to evaluate whether the degree of enzyme activity is correlated with the severity of injury.

Design: A prospective clinical study.

Setting: Veterinary Medical Teaching Hospital.

Animals: Thirteen client‐owned dogs that were presented to the Veterinary Hospital of the University of Pennsylvania between June and August 1999 for blunt vehicular trauma. Ten healthy student and staff‐owned dogs served as controls.

Interventions: None.

Measurements: Plasma was analyzed for βG enzyme activity at the time of presentation (n=13), and 1 and 4 hours (n=7) following presentation to the Emergency Service for blunt vehicular trauma. The results were compared with enzyme activity from healthy controls evaluated serially over 4 hours. Fluorometric analysis using 96‐well microtiter plates was used to perform the enzyme assays. The relationships between presentation (n=13) and 4 hours (n=7) of enzyme activity and 3 indices of metabolic and physical disturbance (serum pH, serum lactate and Animal Trauma Triage (ATT) score) at the time of presentation were also investigated.

Main results: Of the 13 dogs, 7 fulfilled the inclusion criteria for comparison of enzyme activity of the trauma over time. A statistically significant difference in βG activity was found in the trauma group (mean 75.6±10.4 U) at 4 hours following presentation compared with controls (mean 48.0±6.4 U). This difference was suggested by 1 hour following presentation (trauma group, mean 70.4±10.9 U; control group, mean 49.8±5.5 U), although it did not reach statistical significance. Thirteen dogs fulfilled the inclusion criteria for comparison of only presentation enzyme activity with trauma severity score, serum lactate, and serum pH. No statistically significant relationship was found between the βd‐glucuronidase activity and the presenting ATT score, serum lactate concentration, or serum pH at either presentation or 4 hours, although the power of these analyses was low.

Conclusions: These results demonstrate that the activity of βG, a lysosomal enzyme, increases significantly in the systemic circulation in dogs 4 hours following blunt trauma. Additional research to include more severely injured dogs, a larger number of dogs, and to follow the course of injury for a longer period of time would be beneficial to further characterize βG activity following blunt trauma.
Measurement of plasma colloid osmotic pressure in neonatal foals under intensive care: comparison of direct and indirect methods and the association of COP with selected clinical and clinicopathologic variables
Authors: Magdesian K. Gary , Fielding C. Langdon , Madigan John E.
Published: June 2004

Objectives:To describe and compare admission colloid osmotic pressure (COP) measurement using both direct and indirect methods in neonatal foals under intensive care, and to evaluate for associations between COP and clinical/clinicopathologic parameters.

Design:Prospective study.

Setting:Intensive care unit at a veterinary medical teaching hospital.

Animals:Twenty‐six critically ill neonatal foals were studied. A control group consisted of 9 clinically healthy neonatal foals.

Interventions:Clinicopathologic data were collected at the time of admission. COP was measured directly using a colloid osmometer. Indirect COP was calculated using equations by both Landis–Pappenheimer (L–P) and Thomas and Brown.

Measurements and main results:Measured admission COP values were 17.1±4.3 and 17.7±2.4 mmHg in critically ill and control foals, respectively, and these values were not significantly different. Critically ill foals with blood lactate concentrations >3 mmol/L had lower COP values than those with lactate ≤3 mmol/L. There was close agreement between indirect COP values calculated using the L–P equation and direct COP values measured in control foals (mean error=0.0±1.3 mmHg;R2=0.87). However, indirect values were not as predictive of direct COP in critically ill foals (mean error=0.8±3.8 mmHg;R2=0.64). As COP values increased, the indirect method tended to overestimate COP, whereas at lower values it slightly underestimated COP.

Conclusion:While the L–P equation was a close approximation of direct COP in healthy foals, direct measurements of oncotic pressure cannot be replaced for monitoring of critically ill foals. Critically ill foals with higher lactate concentrations had lower COP values, suggesting a possible relationship between COP and lactate.
Sampling and methods of the European Study of the Epidemiology of Mental Disorders (ESEMeD) project
Authors:   The ESEMeD/MHEDEA 2000 investigators, Alonso J. , Angermeyer M. C. , Bernert S. , Bruffaerts R. , Brugha T. S. , Bryson H. , de Girolamo G. , de Graaf R. , Demyttenaere K. , Gasquet I. , Haro J. M. , Katz S. J. , Kessler R. C. , Kovess V. , Lépine J. P. , Ormel J. , Polidori G. , Russo L. J. , Vilagut G. , Almansa J. , Arbabzadeh‐Bouchez S. , Autonell J. , Bernal M. , Buist‐Bouwman M. A. , Codony M. , Domingo‐Salvany A. , Ferrer M. , Joo S. S. , Martínez‐Alonso M. , Matschinger H. , Mazzi F. , Morgan Z. , Morosini P. , Palacín C. , Romera B. , Taub N. , Vollebergh W. A. M.
Published: June 2004

Objective: The European Study of Epidemiology of Mental Disorders (ESEMeD) project was designed to evaluate the prevalence, the impact and the treatment patterns in Europe. This paper presents an overview of the methods implemented in the project.

Method: ESEMeD is a cross‐sectional study in a representative sample of 21 425 adults, 18 or older, from the general population of Belgium, France, Germany, Italy, the Netherlands and Spain. The Composite International Diagnostic Interview (WMH‐CIDI) was administered by home interviews from January 2001 to August 2003 using Computer Assisted Personal Interview (CAPI) technology. Data quality was controlled to ensure reliability and validity of the information obtained.

Results: Response rate varied from 78.6% in Spain to 45.9% in France. Less than 4% of the individuals had errors in the checking procedures performed.

Conclusion: The sampling methodologies, comprehensive psychiatric instruments and quality control procedures used have rendered the ESEMeD database a unique and important source of information about the prevalence, the disability burden and unmet medical needs of mental disorders within Europe.
Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project
Authors:   The ESEMeD/MHEDEA 2000 Investigators, Alonso J. , Angermeyer M. C. , Bernert S. , Bruffaerts R. , Brugha T. S. , Bryson H. , de Girolamo G. , de Graaf R. , Demyttenaere K. , Gasquet I. , Haro J. M. , Katz S. J. , Kessler R. C. , Kovess V. , Lépine J. P. , Ormel J. , Polidori G. , Russo L. J. , Vilagut G. , Almansa J. , Arbabzadeh‐Bouchez S. , Autonell J. , Bernal M. , Buist‐Bouwman M. A. , Codony M. , Domingo‐Salvany A. , Ferrer M. , Joo S. S. , Martínez‐Alonso M. , Matschinger H. , Mazzi F. , Morgan Z. , Morosini P. , Palacín C. , Romera B. , Taub N. , Vollebergh W. A. M.
Published: June 2004

Objective:  To describe the 12‐month and lifetime prevalence rates of mood, anxiety and alcohol disorders in six European countries.

Method:  A representative random sample of non‐institutionalized inhabitants from Belgium, France, Germany, Italy, the Netherlands and Spain aged 18 or older (n = 21425) were interviewed between January 2001 and August 2003. DSM‐IV disorders were assessed by lay interviewers using a revised version of the Composite International Diagnostic Interview (WMH‐CIDI).

Results:  Fourteen per cent reported a lifetime history of any mood disorder, 13.6% any anxiety disorder and 5.2% a lifetime history of any alcohol disorder. More than 6% reported any anxiety disorder, 4.2% any mood disorder, and 1.0% any alcohol disorder in the last year. Major depression and specific phobia were the most common single mental disorders. Women were twice as likely to suffer 12‐month mood and anxiety disorders as men, while men were more likely to suffer alcohol abuse disorders.

Conclusion:  ESEMeD is the first study to highlight the magnitude of mental disorders in the six European countries studied. Mental disorders were frequent, more common in female, unemployed, disabled persons, or persons who were never married or previously married. Younger persons were also more likely to have mental disorders, indicating an early age of onset for mood, anxiety and alcohol disorders.
12‐Month comorbidity patterns and associated factors in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project
Authors:   The ESEMeD/MHEDEA 2000 investigators, Alonso J. , Angermeyer M. C. , Bernert S. , Bruffaerts R. , Brugha T. S. , Bryson H. , de Girolamo G. , de Graaf R. , Demyttenaere K. , Gasquet I. , Haro J. M. , Katz S. J. , Kessler R. C. , Kovess V. , Lépine J. P. , Ormel J. , Polidori G. , Russo L. J. , Vilagut G. , Almansa J. , Arbabzadeh‐Bouchez S. , Autonell J. , Bernal M. , Buist‐Bouwman M. A. , Codony M. , Domingo‐Salvany A. , Ferrer M. , Joo S. S. , Martínez‐Alonso M. , Matschinger H. , Mazzi F. , Morgan Z. , Morosini P. , Palacín C. , Romera B. , Taub N. , Vollebergh W. A. M.
Published: June 2004

Objective:  Comorbidity patterns of 12‐month mood, anxiety and alcohol disorders and socio‐demographic factors associated with comorbidity were studied among the general population of six European countries.

Method:  Data were derived from the European Study of the Epidemiology of Mental Disorders (ESEMeD), a cross‐sectional psychiatric epidemiological study in a representative sample of adults aged 18 years or older in Belgium, France, Germany, Italy, the Netherlands and Spain. The diagnostic instrument used was the Composite International Diagnostic Interview (WMH‐CIDI). Data are based on 21 425 completed interviews.

Results:  In general, high associations were found within the separate anxiety disorders and between mood and anxiety disorders. Lowest comorbidity associations were found for specific phobia and alcohol abuse—the disorders with the least functional disabilities. Comorbidity patterns were consistent cross‐nationally. Associated factors for comorbidity of mood and anxiety disorders were female gender, younger age, lower educational level, higher degree of urbanicity, not living with a partner and unemployment. Only younger people were at greater risk for comorbidity of alcohol disorder with mood, anxiety disorders or both.

Conclusion:  High levels of comorbidity are found in the general population. Comorbidity is more common in specific groups. To reduce psychiatric burden, early intervention in populations with a primary disorder is important to prevent comorbidity.
Disability and quality of life impact of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project
Authors:   The ESEMeD/MHEDEA 2000 investigators, Alonso J. , Angermeyer M. C. , Bernert S. , Bruffaerts R. , Brugha T. S. , Bryson H. , de Girolamo G. , de Graaf R. , Demyttenaere K. , Gasquet I. , Haro J. M. , Katz S. J. , Kessler R. C. , Kovess V. , Lépine J. P. , Ormel J. , Polidori G. , Russo L. J. , Vilagut G. , Almansa J. , Arbabzadeh‐Bouchez S. , Autonell J. , Bernal M. , Buist‐Bouwman M. A. , Codony M. , Domingo‐Salvany A. , Ferrer M. , Joo S. S. , Martínez‐Alonso M. , Matschinger H. , Mazzi F. , Morgan Z. , Morosini P. , Palacín C. , Romera B. , Taub N. , Vollebergh W. A. M.
Published: June 2004

Objective:  This manuscript examines the impact of mental health state and specific mental and physical disorders on work role disability and quality of life in six European countries.

Method:  The ESEMeD study was conducted in: Belgium, France, Germany, Italy, the Netherlands and Spain. Individuals aged 18 years and over who were not institutionalized were eligible for an in‐home computer‐assisted interview. Common mental disorders, work loss days (WLD) in the past month and quality of life (QoL) were assessed, using the WMH‐2000 version of the CIDI, the WHODAS‐II, and the mental and physical component scores (MCS, PCS) of the 12‐item short form, respectively. The presence of five chronic physical disorders: arthritis, heart disease, lung disease, diabetes and neurological disease was also assessed. Multivariate regression techniques were used to identify the independent association of mental and physical disorders while controlling for gender, age and country.

Results:  In each country, WLD and loss of QoL increased with the number of disorders. Most mental disorders had approximately 1.0 SD‐unit lower mean MCS and lost three to four times more work days, compared with people without any 12‐month mental disorder. The 10 disorders with the highest independent impact on WLD were: neurological disease, panic disorder, PTSD, major depressive episode, dysthymia, specific phobia, social phobia, arthritis, agoraphobia and heart disease. The impact of mental vs. physical disorders on QoL was specific, with mental disorders impacting more on MCS and physical disorders more on PCS. Compared to physical disorders, mental disorders had generally stronger ‘cross‐domain’ effects.

Conclusion:  The results suggest that mental disorders are important determinants of work role disability and quality of life, often outnumbering the impact of common chronic physical disorders.
Use of mental health services in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project
Authors:   The ESEMeD/MHEDEA 2000 investigators, Alonso J. , Angermeyer M. C. , Bernert S. , Bruffaerts R. , Brugha T. S. , Bryson H. , de Girolamo G. , de Graaf R. , Demyttenaere K. , Gasquet I. , Haro J. M. , Katz S. J. , Kessler R. C. , Kovess V. , Lépine J. P. , Ormel J. , Polidori G. , Russo L. J. , Vilagut G. , Almansa J. , Arbabzadeh‐Bouchez S. , Autonell J. , Bernal M. , Buist‐Bouwman M. A. , Codony M. , Domingo‐Salvany A. , Ferrer M. , Joo S. S. , Martínez‐Alonso M. , Matschinger H. , Mazzi F. , Morgan Z. , Morosini P. , Palacín C. , Romera B. , Taub N. , Vollebergh W. A. M.
Published: June 2004

Objective:  Comprehensive information about access and patterns of use of mental health services in Europe is lacking. We present the first results of the use of health services for mental disorders in six European countries as part of the ESEMeD project.

Method:  The study was conducted in: Belgium, France, Germany, Italy, the Netherlands and Spain. Individuals aged 18 years and over who were not institutionalized were eligible for an computer‐assisted interview done at home. The 21 425 participants were asked to report how frequently they consulted formal health services due to their emotions or mental health, the type of professional they consulted and the treatment they received as a result of their consultation in the previous year.

Results:  An average of 6.4% of the total sample had consulted formal health services in the previous 12 months. Of the participants with a 12‐month mental disorder, 25.7% had consulted a formal health service during that period. This proportion was higher for individuals with a mood disorder (36.5%, 95% CI 32.5–40.5) than for those with anxiety disorders (26.1%, 95% CI 23.1–29.1). Among individuals with a 12‐month mental disorder who had contacted the health services 12 months previously, approximately two‐thirds had contacted a mental health professional. Among those with a 12‐month mental disorder consulting formal health services, 21.2% received no treatment.

Conclusion:  The ESEMeD results suggest that the use of health services is limited among individuals with mental disorders in the European countries studied. The factors associated with this limited access and their implications deserve further research.
Psychotropic drug utilization in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project
Authors:   The ESEMeD/MHEDEA 2000 investigators, Alonso J. , Angermeyer M. C. , Bernert S. , Bruffaerts R. , Brugha T. S. , Bryson H. , de Girolamo G. , de Graaf R. , Demyttenaere K. , Gasquet I. , Haro J. M. , Katz S. J. , Kessler R. C. , Kovess V. , Lépine J. P. , Ormel J. , Polidori G. , Russo L. J. , Vilagut G. , Almansa J. , Arbabzadeh‐Bouchez S. , Autonell J. , Bernal M. , Buist‐Bouwman M. A. , Codony M. , Domingo‐Salvany A. , Ferrer M. , Joo S. S. , Martínez‐Alonso M. , Matschinger H. , Mazzi F. , Morgan Z. , Morosini P. , Palacín C. , Romera B. , Taub N. , Vollebergh W. A. M.
Published: June 2004

Objective:  To assess psychotropic drug utilization in the general population of six European countries, and the pattern of use in individuals with different DSM‐IV diagnoses of 12‐month mental disorders.

Method:  Data were derived from the European Study of the Epidemiology of Mental Disorders (ESEMeD/MHEDEA 2000), a cross‐sectional psychiatric epidemiological study in a representative sample of 21 425 adults aged 18 or older from six European countries (e.g. Belgium, France, Germany, Italy, the Netherlands and Spain). Individuals were asked about any psychotropic drug use in the past 12 months, even if they used the drug(s) just once. A colour booklet containing high‐quality pictures of psychotropic drugs commonly used to treat mental disorders was provided to help respondents recall drug use.

Results:  Psychotropic drug utilization is generally low in individuals with any 12‐month mental disorder (32.6%). The extent of psychotropic drug utilization varied according to the specific DSM‐IV diagnosis. Among individuals with a 12‐month diagnosis of pure major depression, only 21.2% had received any antidepressants within the same period; the exclusive use of antidepressants was even lower (4.6%), while more individuals took only anxiolytics (18.4%).

Conclusion:  These data question the appropriateness of current pharmacological treatments, particularly for major depression, in which under‐treatment is coupled with the high use of non‐specific medications, such as anxiolytics.
Treponemes and endodontic infections
Authors: Dahle Ulf R. , Titterud Sunde Pia , Tronstad Leif
Published: June 2004

The pathogenic potential of spirochetes and their significance in the development of oral diseases, as well as in infections in other organs, have gained new interest for several reasons. First, these bacteria have the potential to be pathogenic because of their number and frequency at infected sites, their production of tissue irritants, their ability to invade tissues, their abundance in mixed infections, and their methods to evade host defense mechanisms. Second, of the microbial species that are associated with oral infections, spirochetes are infectious agents that cause severe diseases in other body sites. Third, during the past few years, new techniques have made it possible to obtain more information about spirochetes at the genetic level. Thereby, we have gained better knowledge of these bacteria, even though many cannot be cultured in the laboratory yet. Such knowledge includes the diversity of oral species as well as antigenic similarities between the species commonly found in the oral cavity and known pathogens such as the syphilis agent Treponema pallidum subsp. pallidum, Lyme disease agents Borrelia burgdorferi sensu lato group, and the swine dysentery agent Brachyspira (Serpulina) hyodysenteria. This review covers the main areas of what is known to date about Treponema. It focuses especially on factors related to their taxonomy, epidemiology, and biology, with special emphasis on their presence and possible role in endodontic infections.
Persistent, recurrent, and acquired infection of the root canal system post‐treatment
Authors: Haapasalo Markus , Udnæs Trude , Endal Unni
Published: June 2004

Apical periodontitis is an inflammatory process in the periradicular tissues caused by microorganisms in the necrotic root canal. Accordingly, to achieve healing of apical periodontitis, the main goal of the treatment must be elimination of the infection and prevention of re‐infection. As shown by recent epidemiological studies in several countries around the world, post‐treatment endodontic disease is a far too common finding. To understand the reasons for survival of resistant bacteria in the filled root canal, it is important to know in detail the interaction between treatment procedures and the root canal flora in primary apical periodontitis. Therefore, in the first half of this review, the focus is placed on control of infection in primary apical periodontitis. This is followed by a detailed description of the resistant root canal microflora and a discussion about the present and future strategies to eliminate even the most resistant microbes in post‐treatment disease.
Non‐microbial etiology: periapical cysts sustain post‐treatment apical periodontitis
Authors: Ramachandran Nair P.N.
Published: June 2004

IN MICROSCOPY, AS IN NATURE, ONE RECOGNIZES ONLY WHAT ONE ALREADY KNOWS.

Routine histopathological diagnostic reports and publications based on retrospective reviewing of such, perpetuate the notion that nearly half of all apical periodontitis lesions are cysts. Studies based on meticulous serial sectioning of apical lesions retrieved in toto show that the actual prevalence of cysts is only about 15% of all apical periodontitis lesions. Periapical cysts exist in two structurally distinct classes, namely those containing cavities completely enclosed in epithelial lining (periapical true cysts) and those containing epithelium‐lined cavities that are open to the root canals (periapical pocket cysts). From a clinical point of view, small cysts, particularly the pocket cysts, can heal after non‐surgical root canal therapy whereas large cysts, mainly true cysts, are less likely to be resolved without surgical intervention.
A Broken System: The Persistent Patterns of Reversals of Death Sentences in the United States
Authors: Gelman Andrew , Liebman James S. , West Valerie , Kiss Alexander
Published: June 2004

We collected data on the appeals process for all death sentences in U.S. states between 1973 and 1995. The reversal rate was high, with an estimated chance of at least two‐thirds that any death sentence would be overturned by a state or federal appeals court. Multilevel regression models fit to the data by state and year indicate that high reversal rates are strongly associated with higher death‐sentencing rates and lower rates of apprehending and imprisoning violent offenders. In light of our empirical findings, we discuss potential remedies including “streamlining” the appeals process and restricting the death penalty to the “worst of the worst” offenders.
Was Arthur Andersen Different? An Empirical Examination of Major Accounting Firm Audits of Large Clients
Authors: Eisenberg Theodore , Macey Jonathan R.
Published: June 2004

Enron and other corporate financial scandals focused attention on the accounting industry in general and on Arthur Andersen in particular. Part of the policy response to Enron, the criminal prosecution of Andersen eliminated one of the few major audit firms capable of auditing many large public corporations. This article explores whether Andersen's performance, as measured by frequency of financial restatements, measurably differed from that of other large auditors. Financial restatements trigger significant negative market reactions and their frequency can be viewed as a measure of accounting performance. We analyze the financial restatement activity of approximately 1,000 large public firms from 1997 through 2001. After controlling for client size, region, time, and industry, we find no evidence that Andersen's performance significantly differed from that of other large accounting firms.
Multiple Justiciable Problems: Common Clusters and Their Social and Demographic Indicators
Authors: Pleasence Pascoe , Balmer Nigel J. , Buck Alexy , O'Grady Aoife , Genn Hazel
Published: June 2004

Justiciable problems do not always occur in isolation. However, little empirical research has examined multiple problems in depth by identifying common clusters of problems, their extent, and those who experience them. The Legal Services Research Centre's Periodic Survey of Justiciable Problems is a large‐scale survey undertaken in England and Wales, documenting 5,611 respondents’ experience of 21 discrete problem categories. Having assessed the overall incidence and overlap of problem types, hierarchical cluster analysis, based on each respondent's experience of these categories, was used to identify clusters. We then established social and demographic predictors of each cluster using mixed‐effects Poisson regression and examined each problem type's likelihood of overlapping with further problems, both within and between identified clusters. We highlight policy implications of our findings, particularly concerning developing “joined‐up” solutions to multiple “joined‐up” problems.
Criminal Case Complexity: An Empirical Perspective
Authors: Heise Michael
Published: June 2004

Criminal case complexity persists as a central tenet in many academic and public critiques of our legal system even though little is known about two critical questions. One question is whether key actors (juries, attorneys, and judges) view case complexity similarly. In other words, do juries, attorneys, and judges agree on whether a case is complex? A second question involves the determinants of case complexity for each group. That is, what factors make a case more (or less) complex for juries, attorneys, and judges. This article explores both questions from an empirical perspective with the benefit of recent data from four jurisdictions. The data are important because, within the context of criminal cases, they permit analyses of agreement levels among the three key actors. Results suggest that the three sets of actors possess slightly different views on whether cases are complex. Judges reported the lowest levels of case complexity; jurors the highest. Moreover, important variation exists in terms of what made cases complex for each group. The results implicate legal reform efforts. No clear consensus exists among the critical actors on complexity perceptions. Many of the variables that influence case complexity fall outside of reformers’ reach. Variables within the reach of policy do not appear to systematically reduce case complexity.
Juror First Votes in Criminal Trials
Authors: Garvey Stephen P. , Hannaford‐Agor Paula , Hans Valerie P. , Mott Nicole L. , Munsterman G. Thomas , Wells Martin T.
Published: June 2004

What explains the way in which jurors cast their first vote in a criminal trial, before the dynamics of the deliberation process take over? Analysis of 3,000 jurors in criminal trials in four major metropolitan areas indicates, consistent with prior research, that jurors pay great attention to the evidence. The stronger the evidence against the defendant, the more likely the juror is to vote guilty. We also find that jurors dislike police duplicity. Police officers who give unbelievable testimony will, all else being equal, push jurors toward a first vote of not guilty. Beyond that, our conclusions are specific and limited to a particular jurisdiction. A juror's beliefs about the fairness of the law or the harshness of the consequences of conviction make a difference in some jurisdictions under some circumstances, but not in other jurisdictions under different circumstances. We also find that African‐American jurors in the District of Columbia sitting on cases involving minority defendants charged with drug offenses are, unlike jurors in other jurisdictions, less likely to vote for conviction on the first ballot (but not on the final one) compared to white jurors. Our results therefore highlight the importance of analyzing juror behavior at a more local level. Analyzing juror behavior at the aggregate level can conceal important local variation.
Hail to the Chief! Leadership and Structural Change in the Level of Consensus on the High Court of Australia
Authors: Smyth Russell , Narayan Paresh Kumar
Published: June 2004

This article identifies structural breaks in dissenting and single opinions on the High Court of Australia and uses a recent method proposed by Caporale and Grier (2002) to examine the effect of leadership on variations in the dissent rate between 1904 and 2001. Although there has been much speculation about the effectiveness of different Chief Justices in obtaining consensus on the Court, to this point most of the evidence has been anecdotal. Our main findings are that the structural breaks that we identify coincide with major turning points in the leadership of the Court and that leadership has been important in explaining variations in the proportion of dissenting opinions on the Court.
How Employment Discrimination Plaintiffs Fare in Federal Court
Authors: Clermont Kevin M. , Schwab Stewart J.
Published: June 2004

This article presents the full range of information that the Administrative Office's data convey on federal employment discrimination litigation. From that information, the authors tell three stories about (1) bringing these claims, (2) their outcome in the district court, and (3) the effect of appeal. Each of these stories is a sad one for employment discrimination plaintiffs: relatively often, the numerous plaintiffs must pursue their claims all the way through trial, which is usually a jury trial; at both pretrial and trial these plaintiffs lose disproportionately often, in all the various types of employment discrimination cases; and employment discrimination litigants appeal more often than other litigants, with the defendants doing far better on those appeals than the plaintiffs.
Impaired EDHF‐mediated vasodilatation in adult offspring of rats exposed to a fat‐rich diet in pregnancy
Authors: Taylor P. D. , Khan I. Y. , Hanson M. A. , Poston L.
Published: June 2004

We recently reported vascular dysfunction in adult offspring of rats fed a fat‐rich (animal lard) diet in pregnancy. This study reports further characterization of constrictor and dilator function in mesenteric and caudal femoral arteries from 180‐day‐old offspring of dams fed the high fat diet (OHF). Endothelium‐dependent relaxation in response to acetylcholine (10−9–10−5m) was impaired in mesenteric small arteries from male and female OHF compared with offspring of dams fed normal chow (males (maximum percentage relaxation): OHF 67.92 ± 2.89, n= 8 versus control 92.08 ± 2.19, n= 8, P < 0.01). Substantial relaxation in response to acetycholine in control mesenteric arteries remained after inhibition of nitric oxide synthase, soluble guanylate cyclase and cyclo‐oxygenase but was blocked by 25 mm potassium. This component of relaxation, attributed to EDHF, was significantly reduced in OHF mesenteric arteries compared with controls. However, EDHF played a minor role in acetylcholine‐induced relaxation in both control and OHF femoral caudal arteries (male and female). In these arteries, in contrast to mesenteric vessels, acetylcholine‐induced relaxation was significantly enhanced in OHF but only in males (ACh (maximum percentage relaxation): OHF 58.40 ± 4.39, n= 8 versus male controls 32.18 ± 6.36, P < 0.05). This was attributable to enhanced nitric oxide‐mediated relaxation. In conclusion, reduced endothelium‐dependent relaxation in OHF mesenteric arteries is due to impaired EDHF‐mediated relaxation. This defect was not apparent in femoral arteries in which EDHF has a less prominent role.
An analysis of inhibitory junction potentials in the guinea‐pig proximal colon
Authors: Hirst G. D. S. , Bywater R. A. R. , Teramoto N. , Edwards F. R.
Published: June 2004

Intracellular recordings were made from either sheets or isolated bundles of the circular muscle layer of guinea‐pig proximal colon and the responses evoked by stimulating inhibitory nerve fibres were analysed. Inhibitory junction potentials (IJPs), evoked by single stimuli, had two components which could be separated on their pharmacological and temporal characteristics and their voltage sensitivities. The initial component, which was abolished by apamin and reduced in amplitude by pyridoxalphosphate‐6‐azophenyl‐2′,4′‐disulphonic acid (PPADS), had a brief time course: its amplitude was changed when the external concentration of potassium ions ([K+]o) was changed. The second component of the IJP had a slower onset than the first component, was abolished by l‐nitroarginine (NOLA) and oxadiazolo quinoxalin‐1‐one (ODQ), an inhibitor of soluble guanylate cyclase: its amplitude was little affected by changing [K+]o and was increased when the membrane potential of the circular layer was hyperpolarized. The observations suggest that the initial component of the IJP results from the release of ATP which triggers an increase in membrane conductance to K+ and that the second component results from the release of nitric oxide which suppresses a background inward current.
Long‐term potentiation is impaired in rat hippocampal slices that produce spontaneous sharp waves
Authors: Colgin Laura Lee , Kubota Don , Jia Yousheng , Rex Christopher S. , Lynch Gary
Published: June 2004

Sharp waves (SPWs) occur in the hippocampal EEG during behaviours such as alert immobility and slow‐wave sleep. Despite their widespread occurrence across brain regions and mammalian species, the functional importance of SPWs remains unknown. Experiments in the present study indicate that long‐term potentiation (LTP) is significantly impaired in slices, prepared from the temporal aspect of rat hippocampus, that spontaneously generate SPW activity. This was probably not due to anatomical and/or biochemical abnormalities in temporal slices because stable LTP was uncovered in field CA1 when SPWs were eliminated by severing the projection from CA3. The same procedure did not alter LTP in slices lacking SPWs. Robust and stable LTP was obtained in the presence of SPWs in slices treated with an adenosine A1 receptor antagonist, a finding that links the present results to mechanisms related to the LTP reversal effect. In accord with this, single stimulation pulses delivered intermittently in a manner similar to the SPW pattern interfered with LTP to a similar degree as spontaneous SPWs. Taken together, these results suggest the possibility that SPWs in the hippocampus constitute a neural mechanism for forgetting.