bluuebunny/crossref_metadata_2025 huggingface dataset:
New melt mixing polyethylene multiwalled carbon nanotube nanocomposites with very low electrical percolation threshold
Authors: Jouni Mohammad , Boiteux Gisèle , Massardier Valérie
Published: July 2013

The present work focuses on the study of the electrical properties of high‐density polyethylene (HDPE)/multiwalled carbon nanotube (MWCNT) nanocomposites. The samples were produced by melt mixing by diluting a masterbatch of HDPE/MWCNT using two types of mini‐extruders in order to see the influence of the shear processing on the electrical properties. The dielectric relaxation spectroscopy was used for the investigation of the electrical properties in the studied samples. The composites dc conductivity (σdc) follows the scaling low derivate from the percolation theory of the form σdc ~ (p − pc)t. A low electrical percolation (pc ≈ 0.3 − 0.4 vol. %) was found in both cases. The critical exponent t had a value very close to the theoretical one for a percolation network in three dimensions (t ≈ 2). The analysis of the morphology of the nanocomposites showed a good and homogeneous dispersion of the fillers in the PE matrix. The effect of the incorporation of MWCNTs on the dynamic mechanical and thermal behaviors was also presented. The MWCNTs have improved the mechanical properties of the polyethylene matrix and increased the crystallization temperatures. Copyright © 2013 John Wiley & Sons, Ltd.
Outlier removal to uncover patterns in adverse drug reaction surveillance – a simple unmasking strategy
Authors: Juhlin Kristina , Ye Xiaofei , Star Kristina , Norén G. Niklas
Published: July 2013

Purpose

This study aimed to develop an algorithm for uncovering associations masked by extreme reporting rates, characterize the occurrence of masking by influential outliers in two spontaneous reporting databases and evaluate the impact of outlier removal on disproportionality analysis.

Methods

We propose an algorithm that identifies influential outliers and carries out parallel analysis after their omission. It considers masking of drugs as well as of adverse drug reactions (ADRs), uses a direct measure of the masking effect and makes no assumptions regarding the number of outliers per drug or ADR. The occurrence of masking is characterized in the WHO Global Individual Case Safety Report database, VigiBase and a regional collection of reports from Shanghai, China.

Results

For WHO‐ART critical terms such as myocardial infarction, rhabdomyolysis and hypoglycaemia outlier removal led to a 25–50% increase in the number of Statistics of Disproportionate Reporting (SDR) and gains in time to detection of 1–2 years, while keeping the rate of spurious SDRs from the parallel analysis at 1%. Twenty‐three per cent of VigiBase and 18% of Shanghai SRS reports listed an influential outlier. Twenty‐seven per cent of the ADRs and 5% of the drugs in VigiBase, and 2% of the ADRs and 3% of the drugs in Shanghai SRS were involved in an outlier. The overall increase in the number of SDRs for both datasets was 3%.

Conclusion

Masking by outliers has substantial impact on specific ADRs including, in VigiBase, rhabdomyolysis, myocardial infarction and hypoglycaemia. It is a local phenomenon involving a fair number of reports but yielding a limited number of additional SDRs. Copyright © 2013 John Wiley & Sons, Ltd.
Validation of an algorithm to identify antiretroviral‐naïve status at time of entry into a large, observational cohort of HIV‐infected patients
Authors: Gandhi Neel R. , Tate Janet P. , Rodriguez‐Barradas Maria C. , Rimland David , Goetz Matthew Bidwell , Gibert Cynthia , Brown Sheldon T. , Mattocks Kristin , Justice Amy C.
Published: July 2013

Purpose

Large, observational HIV cohorts play an important role in answering questions which are difficult to study in randomized trials; however, they often lack detailed information regarding previous antiretroviral treatment (ART). Knowledge of ART treatment history is important when ascertaining the long‐term impact of medications, co‐morbidities, or adverse reactions on HIV outcomes.

Methods

We performed a retrospective study to validate a prediction algorithm for identifying ART‐naïve patients using the Veterans Aging Cohort Study's Virtual Cohort—an observational cohort of 40 594 HIV‐infected veterans nationwide. Medical records for 3070 HIV‐infected patients were reviewed to determine history of combination ART treatment. An algorithm using Virtual Cohort laboratory data was used to predict ART treatment status and compared to medical record review.

Results

Among 3070 patients' medical records reviewed, 1223 were eligible for analysis. Of these, 990 (81%) were ART naïve at cohort entry based on medical record review. The prediction algorithm's sensitivity was 86%, specificity 47%, positive predictive value (PPV) 87%, and negative predictive value 45%, using a viral load threshold of <400 copies/ml. Sensitivity analysis revealed that PPV would be maximized by increasing the viral load threshold, whereas sensitivity would be maximized by lowering the viral load threshold.

Conclusions

A prediction algorithm using available laboratory data can be used to accurately identify ART‐naïve patients in large, observational HIV cohorts. Use of this algorithm will allow investigators to accurately limit analyses to ART‐naïve patients when studying the contribution of ART to outcomes and adverse events. Copyright © 2013 John Wiley & Sons, Ltd.
Ventricular Ectopy and QTc‐Interval Prolongation Associated with Dronedarone Therapy
Authors: Gonzalez Jaime E. , Sauer William H. , Krantz Mori J.
Published: July 2013

Amiodarone is an effective treatment for atrial and ventricular arrhythmias, but its use is limited by a toxic adverse‐effect profile. Although dronedarone has been touted as an antiarrhythmic agent devoid of both solid organ toxicity and proarrhythmic properties, its potential for prolonging ventricular repolarization may augment triggered ectopy. We describe a 66‐year‐old man who began dronedarone 400 mg twice/day for new‐onset paroxysmal atrial fibrillation; he had no left ventricular dysfunction or clinical heart failure. Three months after starting the drug, he complained of malaise, fatigue, and rare palpitations. Twenty four–hour Holter monitoring revealed increased premature ventricular complexes, and the rate‐corrected QT (QTc) interval was prolonged (range 525–760 msec). Dronedarone was discontinued and the patient's symptoms gradually resolved over the next 3 weeks. Holter monitoring revealed a marked reduction in ventricular ectopy burden, and the QTc interval decreased to his baseline values. Even in the absence of documented symptomatic torsade de pointes, this case suggests that caution should be exercised when prescribing dronedarone and that serial QTc interval monitoring may be appropriate. In addition, clinicians should have a low threshold to perform Holter monitoring if symptoms develop during dronedarone therapy.
Quantum efficiency of InAs/InP nanowire heterostructures grown on silicon substrates
Authors: Anufriev Roman , Chauvin Nicolas , Khmissi Hammadi , Naji Khalid , Patriarche Gilles , Gendry Michel , Bru‐Chevallier Catherine
Published: July 2013

magnified image

Photoluminescence (PL) quantum efficiency (QE) is experimentally investigated, using an integrating sphere, as a function of excitation power on both InAs/InP quantum rod nanowires (QRod‐NWs) and radial quantum well nanowires (QWell‐NWs) grown on silicon substrates. The measured values of the QE are compared with those of the planar analogues such as quantum dash and quantum well samples, and found to be comparable for the quantum well structures at relatively low power density. Further studies reveal that the values of QE of the QRod‐NWs and QWell‐NWs are limited by the low quality of the InP NW structure and the quality of radial quantum well, respectively. (© 2013 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Heat flow and a faster algorithm to compute the surface area of a convex body
Authors: Belkin Mikhail , Narayanan Hariharan , Niyogi Partha
Published: July 2013

We draw on the observation that the amount of heat diffusing outside of a heated body in a short period of time is proportional to its surface area, to design a simple algorithm for approximating the surface area of a convex body given by a membership oracle. Our method has a complexity of O*(n4), where n is the dimension, compared to O*(n8) for the previous best algorithm. We show that our complexity cannot be improved given the current state‐of‐the‐art in volume estimation. © 2013 Wiley Periodicals, Inc. Random Struct. Alg., 43, 407–428, 2013
Density functional theory (DFT) investigation of the adsorption of the CH3OH/Au(100) system
Authors: N'dollo M. , Moussounda P.S. , Dintzer T. , M'Passi‐Mabiala B. , Garin F.
Published: July 2013

The adsorption of methanol on flat Au (100) surface with different coverages (θ = 1.0, 0.5 and 0.25 monolayer (ML)) is studied using density functional theory. Among the three sites (top, bridge and hollow) and coverages investigated in the present work, no adsorption is stable for θ = 1.0 ML. The most energetically preferred site of adsorption for CH3OH is found to be the hollow site for coverages of 0.25 ML and 0.50 ML. We also find that for all adsorption sites, an increase in CH3OH coverage triggers a decrease in the adsorption energy. The geometric parameters, local density of states and work function changes are analysed in detail. The coadsorption of methoxy and hydrogen has also investigated. In addition, the dissociation of methanol on Au(100) has been studied, and an activation energy was found to be 1.72 eV. This result compare with existing data in the literature for Au(111) surface. Copyright © 2013 John Wiley & Sons, Ltd.
Study of the effect of laser treatment on the initial oxidation behaviour of Al‐coated NiCrAlY bond‐coat
Authors: Zhu C. , Javed A. , Li P. , Liang G. Y. , Xiao P.
Published: July 2013

In this study, the initial oxidation behaviour of laser‐treated Al/NiCrAlY bond‐coat is investigated. Two approaches, (i) Al film sputtering on the surface of bond‐coat and (ii) laser treatment, have been taken to enhance the oxidation resistance of NiCrAlY bond‐coat. Experimental results showed that after laser treatment, the Al/NiCrAlY bond‐coat exhibited a columnar dendritic microstructure without cracks and voids. A dense and continuous α‐Al2O3/Cr2O3 multilayer was found to form on the bond‐coat surface. Results on the cyclic oxidation at 1200 °C (for time ≤ 204 h) revealed that the laser‐treated Al/NiCrAlY bond‐coat exhibited better oxidation resistance compared to as‐sprayed NiCrAlY, Al/NiCrAlY and laser‐remelted NiCrAlY bond‐coat. The formation of θ‐Al2O3, NiO, Cr2O3 and NiCr2O4 spinel oxides was observed to be suppressed due to the preformed α‐Al2O3 scale during initial oxidation on the surface of laser pre‐oxidized Al/NiCrAlY bond‐coat. Copyright © 2013 John Wiley & Sons, Ltd.
Monocyte chemotactic protein-1 inhibits chondrogenesis of synovial mesenchymal progenitor cells: An in vitro study
Authors: Harris Quinn , Seto Jonathan , O'Brien Kate , Lee Poh S. , Kondo Colleen , Heard Bryan J. , Hart David A. , Krawetz Roman J.
Published: July 2013

Osteoarthritis (OA) is a multifactorial, often progressive, painful disease. OA often progresses with an apparent irreversible loss of articular cartilage, exposing underlying bone, resulting in pain and loss of mobility. This cartilage loss is thought to be permanent due to ineffective repair and apparent lack of stem/progenitor cells in that tissue. However, the adjacent synovial lining and synovial fluid are abundant with mesenchymal progenitor/stem cells (synovial mesenchymal progenitor cells [sMPCs]) capable of differentiating into cartilage both in vitro and in vivo. Previous studies have demonstrated that MPCs can home to factors such as monocyte chemotactic protein 1 (MCP-1/CCL2) expressed after injury. While MCP-1 (and its corresponding receptors) appears to play a role in recruiting stem cells to the site of injury, in this study, we have demonstrated that MCP-1 is upregulated in OA synovial fluid and that exposure to MCP-1 activates sMPCs, while concurrently inhibiting these cells from undergoing chondrogenesis in vitro. Furthermore, exposure to physiological (OA knee joint synovial fluid) levels of MCP-1 triggers changes in the transcriptome of sMPCs and prolonged exposure to the chemokine induces the expression of MCP-1 in sMPCs, resulting in a positive feedback loop from which sMPCs cannot apparently escape. Therefore, we propose a model where MCP-1 (normally expressed after joint injury) recruits sMPCs to the area of injury, but concurrently triggers changes in sMPC transcriptional regulation, leading to a blockage in the chondrogenic program. These results may open up new avenues of research into the lack of endogenous repair observed after articular cartilage injury and/or arthritis.
Insulin and igfs enhance hepatocyte differentiation from human embryonic stem cells via the PI3K/AKT pathway
Authors: Magner Nataly L. , Jung Yunjoon , Wu Jian , Nolta Jan A. , Zern Mark A. , Zhou Ping
Published: July 2013

Human embryonic stem cells (hESCs) can be progressively differentiated into definitive endoderm (DE), hepatic progenitors, and hepatocytes, and thus provide an excellent model system for the mechanistic study of hepatocyte differentiation, which is currently poorly understood. Here, we found that insulin enhanced hepatocyte differentiation from hESC-derived DE. Insulin activated the PI3K/AKT pathway, but not the mitogen-activated protein kinase pathway in the DE cells, and inhibition of the PI3K/AKT pathways by inhibitors markedly inhibited hepatocyte differentiation. In addition, insulin-like growth factor 1 (IGF1) and IGF2 also activated the PI3K/AKT pathway in DE cells and their expression was robustly upregulated during hepatocyte differentiation from DE. Furthermore, inhibition of IGF receptor 1 (IGF1R) by a small molecule inhibitor PPP or knockdown of the IGF1R by shRNA attenuated hepatocyte differentiation. Moreover, simultaneous knockdown of the IGF1R and the insulin receptor with shRNAs markedly reduced the activation of AKT and substantially impaired hepatocyte differentiation. The PI3K pathway specifically enhanced the expression of HNF1 and HNF4 to regulate hepatocyte differentiation from DE. Although inhibition of the PI3K pathway was previously shown to be required for the induction of DE from hESCs, our study revealed a positive role of the PI3K pathway in hepatocyte differentiation after the DE stage, and has advanced our understanding of hepatocyte cell fate determination.
Analysis of lip motion change arising as a result of amusement feeling
Authors: Kageyama Yoichi , Momose Atsushi , Takahashi Tsuyoshi , Ishii Masaki , Nishida Makoto , Mohemmed Ammar , Kasabov Nikola
Published: July 2013

This letter develops a novel algorithm for lip motion analysis arising as a result of feeling amused after watching television comedy programs as emotion‐eliciting stimuli. The analysis is based on measuring the variance of new lip motion features extracted from pronouncing some sentences after watching the stimuli. The results of the conducted experiment show that these features can serve as eﬃcient indices for determining the occurrence of amusement feelings. © 2013 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.
Transport sector in Ireland: can 2020 national policy targets drive indigenous biofuel production to success?
Authors: Gusciute Egle , Devlin Ger , Murphy Fionnuala , McDonnell Kevin
Published: July 2013

Ireland's transport sector consumes just slightly less than one third of all energy in Ireland and is heavily dependent on oil imports, especially diesel. The European Union has set targets that are to be met by 2020, in order to guarantee a sustainable future for Europe and assure security of energy supply. There is an increase of biofuel usage in the transport sector, to reduce greenhouse gas emissions and encourage indigenous production of renewable sources. Currently, Ireland has only two licensed suppliers of biodiesel. The Irish government has issued a number of policy support mechanisms, and while that has increased the use of biofuels in Ireland, it has not necessarily aided the domestic suppliers of biofuels. The aim of this paper is to detail the existing policies and support mechanisms in Ireland and to examine whether it is possible for Ireland to produce biofuels indigenously while meeting the 2020 targets and competing with the alternative conventional imports. Alternatives to the current supply scenario will be considered, including alternatives such as electric vehicles, recovered waste vegetable oils, and grass gasification for biomethane for natural gas vehicles.

This article is categorized under:

Bioenergy > Economics and Policy
A Luminescent Silver(I) Metal‐Organic Framework with New (4,6)‐Connected Topology Based on Mixed Tetrachlorotereph­thalate and 2,2′‐Bipyridine Ligands
Authors: Chen Sheng‐Chun , Cai Xiao‐Xiao , Zhang Zhi‐Hui , Yan Qi , He Ming‐Yang , Tian Feng , Gao Jian , Chen Qun
Published: July 2013

A silver(I) coordination polymer with mixed 2,3,5,6‐tetrachloro‐1,4‐benzenedicarboxylate (BDC‐Cl4) and 2,2′‐bipyridine (2,2′‐bpy) ligands, [Ag2(BDC‐Cl4)(2,2′‐bpy)]n (1), was synthesized and structurally characterized. Compound 1 features a robust three‐dimensional (3D) network, exhibiting a new (4,6)‐connected net with the Schläfli symbol of (32·42·5·6)2(32·42·52·87·9·10). The photoluminescence properties of 1 were investigated in the solid state at room temperature.
Estimating health expectancy in presence of missing data: an application using HID survey
Authors: Giudici Cristina , Arezzo Maria Felice , Brouard Nicolas
Published: July 2013

In this article we estimate health transition probabilities using longitudinal data collected in France for the survey on handicaps, disabilities and dependencies from 1998 to 2001. Life expectancies with and without disabilities are estimated using a Markov-based multi-state life table approach with two non-absorbing states: able to perform all activities of daily living (ADLs) and unable or in need of help to perform one or more ADLs, and the absorbing state of death. The loss of follow-up between the two waves induces biases in the probabilities estimates: mortality estimates were biased upwards; also the incidence of recovery and the onset of disability seemed to be biased. Since individuals were not missing completely at random, we correct this bias by estimating health status for drop-outs using a non parametric model. After imputation, we found that at the age of 70 disability-free life expectancy decreases by 0.5 years, whereas the total life expectancy increases by 1 year. The slope of the stable prevalence increases, but it remains lower than the slope of the cross sectional prevalence. The gender differences on life expectancy did not change significantly after imputation. Globally, there is no evidence of a general reduction in ADL disability, as defined in our study. The added value of the study is the reduction of the bias induced by sample attrition.
Moderate expression of the transcriptional regulator ALsR enhances acetoin production by Bacillus subtilis
Authors: Zhang Xian , Zhang Rongzhen , Bao Teng , Yang Taowei , Xu Meijuan , Li Huazhong , Xu Zhenghong , Rao Zhiming
Published: July 2013

Acetoin, a major extracellular catabolic product of Bacillus subtilis cultured on glucose, is widely used to add flavor to food and also serves as a precursor for chemical synthesis. The biosynthesis of acetoin from pyruvate requires the enzymes α-acetolactate synthase (ALS) and α-acetolactate decarboxylase (ALDC), both of which are encoded by the alsSD operon. The transcriptional regulator ALsR is essential for the expression of alsSD. Here we focused on enhancing the production of acetoin by B. subtilis using different promoters to express ALsR. The expression of reporter genes was much higher under the control of the HpaII promoter than under control of the PbdhA promoter. Although the HpaII promoter highly enhanced transcription of the alsSD operon through overexpression of ALsR, the production of acetoin was not significantly increased. In contrast, moderate enhancement of ALsR expression using the PbdhA promoter significantly improved acetoin production. Compared with the wild-type, the enzyme activities of ALS and ALDC in B. subtilis harboring PbdhA were increased by approximately twofold, and the molar yield of acetoin from glucose was improved by 62.9 % in shake flask fermentation. In a 5-L fermentor, the engineered B. subtilis ultimately yielded 41.5 g/L of acetoin. Based on these results, we conclude that enhanced expression of ALDC and ALS by moderately elevated expression of the transcriptional regulator ALsR could increase acetoin production in recombinant B. subtilis.
The roles of active site residues in the catalytic mechanism of methylaspartate ammonia‐lyase
Authors: Raj Hans , Poelarends Gerrit J.
Published: July 2013

Methylaspartate ammonia‐lyase (MAL; EC 4.3.1.2) catalyzes the reversible addition of ammonia to mesaconate to yield l‐threo‐(2S,3S)‐3‐methylaspartate and l‐erythro‐(2S,3R)‐3‐methylaspartate as products. In the proposed minimal mechanism for MAL of Clostridium tetanomorphum, Lys‐331 acts as the (S)‐specific base catalyst and abstracts the 3S‐proton from l‐threo‐3‐methylaspartate, resulting in an enolate anion intermediate. This enolic intermediate is stabilized by coordination to the essential active site Mg2+ ion and hydrogen bonding to the Gln‐329 residue. Collapse of this intermediate results in the release of ammonia and the formation of mesaconate. His‐194 likely acts as the (R)‐specific base catalyst and abstracts the 3R‐proton from the l‐erythro isomer of 3‐methylaspartate, yielding the enolic intermediate. In the present study, we have investigated the importance of the residues Gln‐73, Phe‐170, Gln‐172, Tyr‐356, Thr‐360, Cys‐361 and Leu‐384 for the catalytic activity of C. tetanomorphum MAL. These residues, which are part of the enzyme surface lining the substrate binding pocket, were subjected to site‐directed mutagenesis and the mutant enzymes were characterized for their structural integrity, ability to catalyze the amination of mesaconate, and regio‐ and diastereoselectivity. Based on the observed properties of the mutant enzymes, combined with previous structural studies and protein engineering work, we propose a detailed catalytic mechanism for the MAL‐catalyzed reaction, in which the side chains of Gln‐73, Gln‐172, Tyr‐356, Thr‐360, and Leu‐384 provide favorable interactions with the substrate, which are important for substrate binding and activation. This detailed knowledge of the catalytic mechanism of MAL can serve as a guide for future protein engineering experiments.
297 – The Dialectics Between Secrecy and Openness Among Couples of Mixedorientation Marriages
Authors: Adler A. , Ben-Ari A.
Published: July 2013

The phenomenon of homosexual men who are married to women (Mixed-orientation marriage) is usually invisible, but its frequency is not insignificant. In some cases the men discloses their sexual orientation to their wives, in other cases they choose to conceal it. Despite the fundamental differences between the two situations, both are experienced as complex and challenging and require different modes of coping. This presentation takes an insider's perspective and puts a spotlight on the dialectics between secrecy and openness - a major aspect characterizing the lives of spouses in mixed-orientation marriages. Thirty eight in-depth semi-structured interviews were conducted with heterosexually married homosexual men. In 22 of the cases the wives were aware of their husband's homosexuality and in 16 cases they were unaware. In addition, 8 interviews were conducted with women who are aware of their husband's homosexuality.

Interviews revealed rich information regarding the dynamics of secrecy and openness in mixed-orientation marriages. The main finding challenges the conventional dichotomy between secrecy and disclosure. It appears that in both situations (when the wife is aware/unaware) there is a constant tension between secrecy and disclosure. When the wife is unaware, disclosure appears in one form or another. Similarly, when husband's sexual orientation is known to the wife, secrecy remains an important aspect of the relationship and it is expressed in several different ways.

In our presentation we will discuss the concept of ‘Dialectics’, in an attempt to better understand the dynamics of secrecy and disclosure in the context of mixed-orientation marriages.
308 – Apocalyptic Delusions
Authors: Rudaleviciene P. , Stompe T. , Narbekovas A.
Published: July 2013

This study attempts to present the genesis of the world end (Apocalyptic) delusions. Religious idea of the world end given in the Sacred Scripture is being found in the content of delusions but is added with inclusion of modern cultural signs, personal values and beliefs and description of apocalypse, produced in delusional thinking of nowadays patients suffering from schizophrenia and related disorders.

We have studied the content of delusions in patients with schizophrenia looking for apocalyptic themes using Fragebogen fur psychotische Symptome (FPS) - a semi-structured questionnaire developed by Cultural Psychiatry International research group in Vienna, which was translated into the language of the participating patient, double translation was performed. Examination was conducted on 295 patients (the mean age - 42.4 [SD 9.7] years; women - 51.5%), suffering from schizophrenia at Vilnius Mental Health Center in Lithuania, among whom 69.8% reported apocalyptic delusional themes (lifetime-prevalence), both religious and culture-sensitive. Investigation of the influence of personal importance of their religious beliefs on the content of (Apocalyptic) delusions was made.

We divided the content into three goups: religiuos content, modrnern and global.
333 – Validation of Iranian Version of FI-QOL Scale in Patients with Fecal Incontinence
Authors: Nojomi M. , Mostafavian Z. , Bijari B. , Mahjubi B.
Published: July 2013

Background and objective:

One of the most important indicators of effectiveness of therapy in patients with fecal incontinence (FI) can be patient's quality of life. Therefore, a well-constructed questionnaires studying quality of life is necessary. The objective of this study was to assess the Iranian version of Fecal Incontinence Quality of Life Scale in a hospital-based study on patients with FI.

Method:

Two hundred women were recruited in the study. One group included patients with FI (n = 100) and the control group (n = 100) included patients with any gastrointestinal (GI) problems except FI. The Persian version of fecal incontinence quality of life scale completed by groups. The FI patients completed the SF-36 questionnaire too. Reliability and validity of questionnaire were evaluated by Cronbach's alpha, test/retest using correlation analysis, Intraclss correlation coefficient, paired t-test, and analysis of variance.

Results:

Mean age of FI patients and controls were 42.6 (±13.3) and 44.5 (±15.0) respectively. Cronbach's-α for all domains ranged between 0.72–0.92. All scales showed significant correlation between the test and retest administration of questionnaire. The FI patients had lower scores than the controls for all domains adjusted for gender. All correlations between six selected domains of Sf-36 scales and FIQL scales were significant at P < 0.05 levels.

Conclusion:

The Persian version of FIQL had a good validity and reliability and can be used for accurate measure of quality of life in FI patients.
344 – Weight Gain in the First Six Months after Diagnosis of Depression Associated with Baseline BMI, not Treatment Outcomes
Authors: Angstman K.B.
Published: July 2013

Introduction:

There is an observed inter-dependency between the onset of obesity and onset of depression. Less is known of the outcomes of depression treatment on changes in weight, when compared to baseline body mass index (BMI). In a prior study we demonstrated that six month depression outcomes were not related to patient's baseline BMI.

Objectives/aims:

To determine if there were significant weight changes for patients diagnosed with depression over a six month period.

Methods:

This was a retrospective chart review of 1,551 patients diagnosed with depression by their primary care provider from March 2008.

Results:

A majority of the patients, 1,050 (67.7%) either had a weight loss or no significant change (+/- 2.5%). In logistic modeling, age was the only variable independently associated with weight gain of 2.5% or greater at six months (OR 0.9916, p = 0.0133). For the 501 patients with weight gain, BMI was inversely associated with weight gain at six months. With logistic modeling; increased BMI remained inversely associated with significant weight gain (+5%) at six months. The presence of clinical remission at six months was not associated with weight gain of greater than 5%.

Conclusions:

The majority of patient diagnosed with depression by their primary care provider did not experience a significant change in their weight over the next six months. Clinical remission did not impact the weight changes seen. If a patient was going to gain weight, a baseline normal BMI was associated with an increased risk of >5% weight gain in six months.
355 – Stigmatising Attitudes of Mental Health Care Professionals, Forensic Psychiatric Professionals And General Practitioners: A Pilot Study
Authors: Gras L.M. , van Weeghel J. , Slooff C. , Swart M. , Knegtering R. , Castelein S.
Published: July 2013

Objective:

Studying stigma in health care professionals may be helpful to address stigma in people with mental illness. The purpose of this study is to assess (stigmatising) attitudes of mental health care professionals (MHC), forensic psychiatric professionals (FP) and general practitioners (GP) in the Netherlands.

Method:

The Mental Illness Clinicians Attitude (MICA) questionnaire is used to assess stigmatising attitudes in three different groups of health care professionals. Scores range from 16 (minimum stigma) to 96 (maximum stigma). Additionally, background information was obtained including gender, age, work and personal experience.

Results:

All three groups of health care professionals had a positive attitude towards psychiatry and patients with a mental health problem. However, the total MICA score differed significantly between the three groups (p<0.001). GP's had the highest score (44) on stigmatising attitudes, followed by the FP's (39) and MH's (34). In our study population 25%-38% had personal experience with having a mental illness. Most stigmatising attitudes were found regarding protection of the public against patients with severe mental illness, telling colleagues about personal experience with mental illness and, appreciating psychiatry as less respectable compared to other medical disciplines.

Conclusion:

General practitioners showed in comparison to mental health care professionals a significantly higher stigmatising attitude. The scores still represent a mild positive attitude towards psychiatry and psychiatric patients. Although all three groups have a relatively positive attitude, there is still room for improvement.
361 – Audit of Attendance of Clozapine Clinic Two Years after First Audit
Authors: Van Mechelen C. , Uzair F.
Published: July 2013

Introduction:

Aim of audit was to assess attendance at clinic and determine factors that might influence attendance. The outcome of the audit showed that mainly young men from South asian background were not attending. Recommendations from the audit included education of patient about illness and importance of maintenance treatment, education of family about illness so they can get more involved in treatment and encourage patient's compliance with treatment.

Objectives:

Observe trends in attendance according to ethnicity.

Aim:

Re-evaluate attendance after recommendations were put into practice.

Method:

Look at clinic lists and note DNA (did not attend) in clozapine clinic over period of 3 months. Note ethnicity of patients.

Results:

39 patients were booked into clozapine clinic over period of 3 months 8 DNA's - 2 black british and 6 white english Reasons for non attendance: 1 black british works full time, 1 black british AOT client, 1 white english was physically unwell, 1 discontinued clozapine without informing services. Another important reason for non attendance: patients don’t tend to attend clozapine clinic if blood test is not due the same day.

Conclusions:

Improvement of non attendance in South Asian client group due to education of patient and family about illness and treatment. Non attendance in other client group is mainly due to non concordance between blood test appointment and clinic appointment.

Recommendation:

Treatment team should consult client's diary to synchronise the time of blood test with time of clinic appointment.
397 – Nurses’ Problem in Management of Aggressive Behavior in Psychiatric Wards
Authors: Parvin N. , Rafiee Vardanjani L. , Taji P.
Published: July 2013

Introduction:

Aggressive behavior is a critical issue for psychiatric services, because of the adverse impact on patients and staff, and management of this behavior is difficult. This study was done by aim of determination of nurses’ problem in management of aggressive behavior in psychiatric wards.

Methodology:

This descriptive analytic study was done in 41 nurses who worked in Hajar and Sina Psychiatric ward in 2011. Sampling method was census. Data was gathered by self-making questionnaire include two parts: nurses’ demographic data and aggression management problem in three domains: personal, physical, and organizational factors. Data was analyzed by SPSS software 18, and means and frequency and analytical statistic exams such as Mann-Whitney and chi square were used.

Findings:

The average of aggression episode was 4.44±3.3 time and in 51.25% occurred in all work shifts. 82.9% of aggression episode was mix verbal and physical aggression. The most aggressive patients suffer from schizophrenia and they had 30 till 40 years old. The most frequent problem in management of aggressive patients was related to personal problem specially fear about physical conflict with patients and physical restriction side effects. There was no significant relationship between age, sex, work shift and ward with aggression frequency (P>0.05),but there was significant difference between two hospital in physical environment (P= 0.003) and personal problems (P=0.011).

Conclusion:

Results of this study revealed that nurses who work in psychiatry ward have some problem in management of aggressive patient's especially in personal and physical environment domain, and attention of managers is necessary.
401 – Evaluation of Psychiatric Illness in Iranian Stoma Patients
Authors: Mohammad-Sadeghi H. , Mahjoubi B. , Mohammadipour M. , Mirzaei R. , Moini R.
Published: July 2013

Aims:

The objective of this study was to assess the nonpsychotic psychiatric disorders of stoma patients in Iran.

Background review:

The only study that evaluated stoma patients in Iran indicated that postoperative problems, especially psychosocial ones, have a rather high frequency in comparison with other reports, but since no standardized questionnaire was applied for the evaluation of psychosocial problems and their severity, further studies were needed.

Methods:

In this cross-sectional study, patients referred to the Iranian Ostomy Association from 2005 to 2006 filled the 28-item General Health Questionnaire (GHQ) in Farsi as a screening instrument to identify cases of nonpsychotic psychiatric morbidity.

Results:

A total of 155 patients participated in the study, of whom 79 (51%) were female and 76 (49%) were male. Fifty-five percent of the patients (n=86) had psychiatric problems. The females’ mean GHQ score was significantly higher than that of males (P=.001). Psychiatric disorder was significantly more frequent among patients with the following specifications: educational level of high school or lower (P=.001), mucosal hemorrhage of the ostomy (P=.03), stomal stenosis (P=.012), and history of psychiatric drug consumption (P=.000). GHQ score decreased as stoma age increased (P=.032; r=−.177).

Conclusion:

Similar to other complications, psychiatric problems are prevalent in Iranian stoma patients. Our findings highlight the need for special support.
406 – Gabaergic Dysfunction, Disturbed Otoacoustic Emissions Products (DAOEPS) and Post-traumatic Stress Disorder (PTSD)
Authors: Trousselard M. , Lefèvre B. , Pattou C. , Denis J. , Canini F.
Published: July 2013

There is indirect evidence for hypofunction of the inhibitory GABAergic system among factors that will lead to PTSD. Hearing researches highlighting that the GABA is involved in both hearing and cerebral changes following a trauma, have developed a promising audiometric method consisting in the measurement of the contractile properties of the Outer Hair Cells, so called DPOAEs, which could constitute an indirect non invasive physiological tool to evaluate central GABAergic response (2). The present study aims at assessing the response of the inhibitory GABAergic system, the OE, as their relationships for individuals with PTSD.

The research strategy used the Stroop paradigms (classic and emotional Stroop) to constitute a relevant experimentallyinduced Anxiety in 16 subjects with PTSD and 16 controls. Blood GABA concentrations and DPOAEs were assessed before and after psychological stimulations.

Results showed that GABA concentrations differed between PTSD and controls at baseline and after the Stroop tasks. The Stroop tasks induced a decrease in the DPOAEs for the medium frequencies only for the PTSD group. Moreover, for PTSD, the GABA concentration at baseline was all the most low than the intensity of the PTSD was high. The increase of GABA after the Stroop tasks was all the most low than the intensity of the PTSD was high. No relationship was found between changes in GABA concentrations and in DPOAEs for subjects with PTSD.

These data showed dysfunction in the GABAergic system for individuals with PTSD and suggested that DPOAEs could be an indirect indicator for evaluating the GABAergic function.
417 – Primary Refusal to Eat in People with Moderate Intellectual Disability - Mirtazapine used Successfully to Restore Appetite
Authors: Patel R. , Hillier R.
Published: July 2013

Background:

Research has shown that Mirtazapine has been effective in stimulating appetite in the elderly. We present a case series of three patients with Moderate Intellectual Disability, each presenting with intractable refusal to eat over several months. They did not have overt symptoms of depression according to carers and family. Two patients were being considered for Percutaneous Endoscopic Gastrostomy (PEG) feeding in view of their significant weight loss and deteriorating physical health.

Results:

Mirtazapine was introduced as an appetite stimulant, despite the apparent lack of depressive symptoms. All three patients experienced an improvement in their appetite within days of initiation of Mirtazapine, increasing their calorie and fluid intake and obviating the need for PEG feeding. During the following 3 months, the patients also developed an increased interest in activities, improved sleeping pattern and improved concentration.

Conclusion:

These patients had very limited communication skills and there was little suggestion of depression at the time of assessment. The families and carers also did not feel that their relative was significantly depressed. Despite this, Mirtazapine had the two fold benefit of early appetite stimulation and, over the subsequent weeks, treating what in hindsight had been an underlying depressive episode. A lesson to be learnt is that primary refusal to eat, even in the absence of overt depressive symptoms may indicate an occult depressive episode in this patient group. We have shown that Mirtazapine can be an effective treatment in such cases and can prevent distressing medical intervention from having to be used.
421 – Full Cycle Audit of the Quality of Fall Reviews by Junior Doctors in Oxford Deanery
Authors: Shaddel F. , Ghazirad M.
Published: July 2013

Background:

Elderly psychiatric patients are at constant risk of having a fall due to numerous reasons e.g. frailty, gait problem, vision problem, cognitive and judgment impairment, psychotropic medications.

Consequences of a fall for an elderly patient could be potentially life threatening, protracted, painful and detrimental. Also the cost of falls for NHS is enormous.

Objective:

To improve the quality of fall reviews undertaken by junior doctors in Oxford Health Foundation Trust.

Methods:

The quality of a random sample of 23 fall reviews by junior doctors was assessed against the national guideline (NICE guideline No.: CG21).

Proper actions taken to raise the awareness of junior doctors i.e. circulating an email and short talk about national standards.

The second cycle (Sample size: 17) in 6 months time showed substantial improvement in most areas but not all of them.

In the next stage a “Fall intervention proforma” designed for the wards. Also reminding posters were mounted in clinical rooms and junior doctors’ offices.

The third cycle (Sample size: 10) in 6 months time conducted to assess the sustainability of improvements in our compliance.

Results:

Our compliance improved from less than 50% in most essential components of a high quality fall review (Musculoskeletal examination, Neurological examination, History taking, Cardiovascular examination, Medication review) to around 100% in 3rd cycle.

Recommendations:

– routine use of “Fall intervention proforma” as standard check list on the wards

– mounting of reminding posters in clinical rooms

– a short talk about fall reviews in induction programme for new junior doctors
453 – A Pilot Study on a Collaborative Education Program between Psychogeriatric Ward and Community Psychiatric Service for Caregivers of Suicidal Elderly
Authors: Wong W.C.
Published: July 2013

Caregivers experience great stress when their old relatives have attempted suicide, are diagnosed with depression and are discharged after hospitalization. The stress is partly induced by the lack of elderly suicidal precaution knowledge and skills. Actually, caregivers need support during and particularly, after patients’ hospitalization. A collaborative education program is conducted for those caregivers during and after patients’ hospitalization.

Objectives:

The pilot study aimed to evaluate the effectiveness of a collaborative education program in term of feedbacks from community suicidal precaution nurses (CSPN) and caregivers.

Method:

A convenience sample of eight caregivers of patients who presented with suicidal idea or attempted suicide before current admission, and were diagnosed with depression in a study ward were recruited. Knowledge and theory about elderly suicide and caring skill were taught by the psycho-geriatric ward nurse during patient hospitalization. When patient was discharged, the CSPN were liaised. They would help caregivers transforming the theory into practice at their home, and then reinforce their suicidal precaution skills. The effectiveness of the collaborative education program was evaluated by feedbacks from CSPN and caregivers.

Results:

The CSPN agreed that the collaborative program was useful and practical, which bridged caregivers’ knowledge gap. The program provided a continuous support to caregivers before and after patients’ discharge. The caregivers expressed that the program was satisfactory and met their needs.

Conclusion:

The collaborative program was effective in providing continuous support on practicing the suicidal precaution skill among the caregivers.
454 – Correlates of Mental Health Service Utilization in Married Women in Tehran 2011
Authors: Ahmadzad-Asl M. , Davoudi F. , Mohammadsadeghi H. , Khademolreza N. , Zarei N. , Naserbakht M. , Nojomi M. , Rasoulian M.
Published: July 2013

Background:

There are disparities in mental health services (MHS) utilization within and between populations and several factors are studied as its potential correlates. Identifying those correlates would help health policy makers to adjust service provision with characteristics of their community.

Aims:

To evaluate demographic, socioeconomic and system correlates of MHS utilization among married women from Tehran, Iran.

Methods:

A household survey of 615 married women residents of 22 municipal districts of Tehran selected via a cluster sampling method. All subjects were asked about health services utilization during last one and 12 months as well as need and access for MHS, demographic and socioeconomic factors. Independent correlates of MHS use were determined with logistic regression analysis.

Results:

Total 615 women, mean±SE age and duration of marital life of 42.6±0.9 and 22±0.8 years, respectively were selected, rate of MHS utilization during last one and 12 months were 5.2% and 10.1% respectively. 23.6% of women reported having mental illness and 19.3% and 17.9% had need for MHS and access to outpatient health services, respectively. Logistic regression models showed that need for MHS (OR:5.25, 95%CI:2.7–10.1), access to outpatient services (OR:2.17, 95%CI:1.04–4.52), smoking (OR:3.4, 95%CI:1.16–10.2) and crowding index (OR:0.69, 95%CI:0.48–0.99).

Conclusions:

Rate of MHS utilization in women are low considering the near to estimated rate of perceived illness. Bridging the gap between perceived illness and need for services, then providing better access to services in areas with higher crowding index and higher rates of smoking in residents should considered in any mental health promotion programs.
465 – Effect of Transactional Analysis Education to Nurses on Patients’ Satisfaction
Authors: Sheikhmoonesi F. , Zarghami M. , Tirgari A. , Khalilian A.
Published: July 2013

Introduction:

Patient satisfaction is an important indicator of quality of care and health facilities. It is a predictor of patient willingness to follow treatment regimen.

Objectives:

Patient perception of nurse caring has been associated with positive patient outcomes, better postoperative functional status and less symptom distress

Aims:

To determine efficacy of transactional analysis training on inpatient‘s satisfaction of nurses.

Methods:

This study was performed as a double blind, experimental design with participants assigned to either an intervention or a control group. The participants were the nurses who worked in the morning shift of a general hospital in Iran.

The intervention group received a brief training of transactional analysis by psychiatrist. Self-administered Satisfaction Questionnaire was used for assessing Patients’ satisfaction one week and one month and three months after training. Chi squares and t-test were used for Data analysis.

Results:

The study was conducted on 25 nurses in two groups of intervention and controls. twenty nurses (91.7%) were female and two nurses (8.3%) were male. Range of work experience was from 3 years to 20 years. There was a significant difference between patients’ satisfaction with intervention and control groups one week after TA education (P< 0.05).

Conclusions:

Application of the education intervention program provided a desirable effect by improving inpatients’ satisfaction.