bluuebunny/crossref_metadata_2025 huggingface dataset:
Supportive-Expressive Group Psychotherapy for Persons with Inflammatory Bowel Disease
Authors: Maunder Robert G , Esplen Mary Jane
Published: January 2017

Objective:

Supportive-expressive (SE) group psychotherapy is designed to be applicable to medically ill populations. In this open trial, SE therapy was adapted for use in treating inflammatory bowel disease (IBD).

Method:

Thirty subjects with Crohn's disease (CD) or ulcerative colitis (UC) were enrolled in 4 psychotherapy groups. Each group met weekly for 20 weeks to discuss emotional and interpersonal issues associated with illness. Physical and psychological variables were measured at the onset and at the finish of the group sessions.

Results:

There was no mean group change in quality of life (QL), anxiety, or depression over the course of treatment, although there was a mean group reduction in maladaptive coping.

Conclusion:

Although the trial was uncontrolled and the sample size small, which limits interpretation, the results are consistent with an ineffective intervention. Because a null result would be consistent with previously reported psychotherapeutic trials in cases of IBD, and because SE therapy has been effective in treating other medically ill populations, we discuss characteristics of IBD that may account for a relative resistance to psychotherapeutic support.

Objectif:

La thérapie de soutien par l'expression (SE) en groupe peut s'appliquer à des populations souffrant de maladies somatiques. Dans cet essai ouvert, la thérapie de SE a été adaptée au traitement de la maladie intestinale inflammatoire (MII).

Méthode:

Trente sujets souffrant de la maladie de Crohn (MC) ou de colite ulcéreuse (CU) se sont inscrits dans 4 groupes de psychothérapie. Chaque groupe s'est réuni chaque semaine pendant 20 semaines pour discuter des questions émotionnelles et interpersonnelles liées à la maladie. Les variables physiques et psychologiques ont été mesurées au début et à la fin des séances de groupe.

Résultats:

Il n'y avait pas de moyenne dans le groupe concernant le changement de qualité de vie (QV), d'anxiété ou de dépression en cours de traitement, mais il y avait une réduction moyenne des mécanismes d'adaptation mésadaptés.

Conclusion:

Même s'il s'agit d'un essai non contrôlé et d'un petit échantillon, ce qui limite l'interprétation, les résultats sont conformes à une intervention inefficace. Étant donné qu'un résultat nul serait conforme aux essais psychothérapeutiques déjà rapportés dans des cas de MII, et que la thérapie de SE a traité efficacement d'autres populations souffrant de maladies somatiques, nous présentons les caractéristiques de la MII auxquelles on peut attribuer une résistance relative au soutien thérapeutique.
Peritraumatic Dissociation, Acute Stress, and Early Posttraumatic Stress Disorder in Victims of General Crime
Authors: Birmes Philippe , Carreras Didier , Ducassé Jean-Louis , Charlet Jean-Paul , Warner Barbara A , Lauque Dominique , Schmitt Laurent
Published: January 2017

Objective:

To compare the relation between peritraumatic dissociation and acute stress and the early development of posttraumatic stress disorder (PTSD) in victims of general crime.

Method:

A total of 48 subjects were assessed within 24 hours of the trauma, using the Peritraumatic Dissociative Experiences Questionnaire Self-Report Version (PDEQ-SRV). They were followed longitudinally to assess acute stress (2 weeks after the assault,) using the Standford Acute Stress Reaction Questionnaire (SASRQ), and posttraumatic stress (at 5 weeks), using the Clinician-Administered PTSD Scale (CAPS) and the Impact of Event Scale (IES).

Results:

Among PTSD subjects mean PDEQ scores were significantly higher (mean 3, SD 0.9) than in those without PTSD (mean 2.3, SD 0.7) (t = 2.78, df 46, P = 0.007). Among PTSD subjects, mean SASRQ scores were significantly higher (mean 97.9, SD 29.2) than in those without PTSD (mean 54.8, SD 28.2) (t = 4.9, df 46, P = 0.00007).

Conclusions:

High levels of peritraumatic dissociation and acute stress following violent assault are risk factors for early PTSD. Identifying acute reexperiencing can help the clinician identify subjects at highest risk.
Prevalence and Incidence Studies of Mood Disorders: A Systematic Review of the Literature
Authors: Waraich Paul , Goldner Elliot M , Somers Julian M , Hsu Lorena
Published: January 2017

This is the second in a series of papers that present systematic reviews of the prevalence and incidence of psychiatric disorders drawn from studies published in English literature in the years 1980 to 2000. The series discusses the implications of these epidemiologic findings to mental health policy and practice.

Objective:

To present the results of a systematic review of literature published between January 1, 1980, and December 31, 2000, that reports findings on the prevalence and incidence of mood disorders in both general population and primary care settings.

Method:

We conducted a literature search of epidemiologic studies of mood disorders, using Medline and HealthSTAR databases and canvassing English-language publications. Eligible publications were restricted to studies that examined subjects aged at least 15 years and over. We used a set of predetermined inclusion and exclusion criteria to identify relevant studies. We extracted and analyzed prevalence and incidence data for heterogeneity.

Results:

Of general population studies, a total of 18 prevalence and 5 incidence studies met eligibility criteria. We found heterogeneity across 1-year and lifetime prevalence of major depressive disorder (MDD), dysthymic disorder, and bipolar I disorder. The corresponding pooled rates for 1-year prevalence were 4.1 per 100, 2.0 per 100, and 0.72 per 100, respectively. For lifetime prevalence, the corresponding pooled rates were 6.7 per 100, 3.6 per 100, and 0.8 per 100, respectively. Significant variation was observed among 1-year incidence rates of MDD, with a corresponding pooled rate of 2.9 per 100.

Conclusions:

The prevalence of mood disorders reported in high-quality studies is generally lower than rates commonly reported in the general psychiatric literature. When controlled for common methodological confounds, variation in prevalence rates persists across studies and deserves continued study. Methodological variation among studies that have examined the prevalence of depression in primary health care services is so large that comparative analyses cannot be achieved.
Bupropion Sustained Release Treatment Reduces Fatigue in Cancer Patients
Authors: Cullum Jodi L , Wojciechowski Agnieszka E , Pelletier Guy , Simpson J Steven A
Published: January 2017

Objective:

To demonstrate that bupropion sustained release (SR) can reduce the symptoms of fatigue experienced by cancer patients.

Method:

We studied an open-label case series of outpatients with fatigue referred for psychiatric assessment from a tertiary care cancer centre. Inclusion criteria were the presence of fatigue or depression with marked fatigue. Clinical status was assessed using the Global Clinical Improvement scale.

Results:

Fifteen subjects with various cancer sites and psychiatric diagnoses were treated with bupropion SR (modal dose 150 mg) for up to 2 years. Most (13 of 15) saw improvement. Thirteen patients had minor, expectable side effects, and 10 patients were able to continue with bupropion for an extended time. All subjects who improved showed improvement within 2 to 4 weeks.

Conclusions:

This is the first report that shows bupropion SR can reduce fatigue in cancer patients. Controlled studies with more homogeneous samples would be necessary to establish the efficacy of this intervention. Further studies should address whether this effect of bupropion is separate from its action as an antidepressant.
The Neuropsychiatry of Multiple Sclerosis
Authors: Feinstein Anthony
Published: January 2017

This review describes the many neuropsychiatric abnormalities associated with multiple sclerosis (MS). These may be broadly divided into 2 categories: disorders of mood, affect, and behaviour and abnormalities affecting cognition. With respect to the former, the epidemiology, phenomenology, and theories of etiology are described for the syndromes of depression, bipolar disorder, euphoria, pathological laughing and crying, and psychosis attributable to MS. The section discussing cognition reviews the prevalence and nature of cognitive dysfunction, with an emphasis on abnormalities affecting multiple domains of memory, speed of information processing, and executive function. The detection, natural history, and cerebral correlates of cognitive dysfunction are also discussed. Finally, treatment pertaining to all these disorders is reviewed, with the observation that translational research has been found wanting when it comes to providing algorithms to guide clinicians. Guidelines derived from general psychiatry still largely apply, although they may not always be most effective in patients with neurologic disorders. The importance of future research addressing this imbalance is emphasized, for neuropsychiatric sequelae add significantly to the morbidity associated with MS.
Somatization and Conversion Disorder
Authors: Hurwitz Trevor A
Published: January 2017

Somatization is the psychological mechanism whereby psychological distress is expressed in the form of physical symptoms. The psychological distress in somatization is most commonly caused by a mood disorder that threatens mental stability. Conversion disorder occurs when the somatic presentation involves any aspect of the central nervous system over which voluntary control is exercised. Conversion reactions represent fixed ideas about neurologic malfunction that are consciously enacted, resulting in psychogenic neurologic deficits. Treatment is complex and lengthy; it includes recovery of neurologic function aided by narcoanalysis and identification and treatment of the primary psychiatric disorder, usually a mood disorder.
The Assessment and Management of Antipsychotic-Associated Metabolic Disturbances from a Psychiatric Perspective
Authors: Chue Pierre
Published: January 2017

Objective:

To review the available data on the management of antipsychotic-associated metabolic disturbances from a psychiatric perspective.

Method:

A literature search was initially conducted using the key words followed by a search of relevant articles, including conference abstracts.

Results:

The investigation and management of metabolic disturbances in psychiatric patients poses particular problems. Given that this population is at high risk, early identification and prevention are particularly important.

Conclusion:

Strategies for the management of metabolic disturbances in psychiatric patients are primarily based on treatments used in the general population, but their effectiveness in psychiatric populations is anecdotal. In view of the high levels of untreated medical comorbidity in psychiatric patients and the potential exacerbation through antipsychotic use in this high-risk population, specific outcome research in this population is needed. Further, referral for specialist management is recommended.
Evaluation of 2 Measures of Psychological Distress as Screeners for Depression in the General Population
Authors: Cairney John , Veldhuizen Scott , Wade Terrance J , Kurdyak Paul , Streiner David L
Published: January 2017

Objective:

Structured diagnostic interviews are very time-consuming and therefore increase both the expense and the respondent burden in epidemiologic surveys. A 2-staged interview that screens potential cases before the full diagnostic instrument is administered has the potential to greatly reduce the average interview length. In this paper, we evaluate 2 measures of psychological distress (the Kessler 6- and 10-Item Psychological Distress Scales [K6 and K10]) as potential screening instruments for depression.

Methods:

We use data from Cycle 1.2 of the Canadian Community Health Survey and receiver operator characteristic analysis to examine the agreement between the K6 and K10 and the World Mental Health Composite International Diagnostic Interview module for major depression (1-month and 12-month estimates).

Results:

Of the respondents, 823 were positive for 1-month depression (2.0%; 95% confidence interval [CI], 1.8% to 2.2%), and 1930 were positive for 12-month depression (4.8%; 95%CI, 4.5% to 5.1%). Both the K6 and K10 performed very well as predictors of 1-month depression, with areas under the curve (AUC) of 0.929 (95%CI, 0.908 to 0.949) for the K10 and 0.926 (95%CI, 0.905 to 0.947) for the K6. For 12-month depression, the AUCs remained good at 0.866 (95%CI, 0.848 to 0.883) for the K10 and 0.858 (95%CI, 0.840 to 0.876) for the K6.

Conclusions:

Both the K6 and the K10 appear to be excellent screening instruments, especially for current depression. Although performance of the 2 instruments is similar, the K6 is more attractive for use as a screening instrument because of the lower response burden.
A Consecutive Series of Treated Affected Offspring of Parents with Bipolar Disorder: Is Response Associated with the Clinical Profile?
Authors: Duffy Anne , Alda Martin , Milin Robert , Grof Paul
Published: January 2017

Objective:

In adults with established bipolar disorder (BD), differential response to mood stabilizers has been associated with the clinical profile. Long-term treatment studies of youth with BD are lacking. This paper provides longitudinal observations of response to mood stabilizers early in the course of illness in youth with BD.

Method:

We report on 15 research patients who, as adolescents, met DSM-IV lifetime criteria for a bipolar spectrum disorder and required long-term treatment. These youths derived from families with one parent having BD whose course and long-term treatment response were determined in accordance with research criteria. The patients were offered lithium, and if they failed to respond or refused it, they were treated with either an anticonvulsant or an atypical antipsychotic. Using a validated scale, an independent rater retrospectively blindly scored the response to long-term treatment.

Results:

Those patients who stabilized on lithium derived from lithium-responsive families, whereas those who stabilized on an antipsychotic derived from lithium-nonresponsive families. The clinical course in the youths stabilized by lithium differed from that in the youths stabilized by an atypical antipsychotic.

Conclusions:

Our findings suggest that the clinical profile may help in selecting effective stabilizing treatment and that a proportion of youth can be stabilized on monotherapy. This is a small case series with nonrandom treatment assignment, and the findings should be considered tentative.
Poststroke Depression: A Review
Authors: Robinson Robert G , Spalletta Gianfranco
Published: January 2017

Objective:

To review the world's (English-language) publications related to depression following stroke.

Method:

The databases from MEDLINE and PubMed were reviewed for articles related to poststroke depression (PSD), depression and cerebral vascular accident, depression and cerebral vascular disease, and depression and cerebral infarction.

Results:

Most studies examined prevalence rates of depression and the clinical correlates of depression. Based on pooled data, the overall prevalence of major depression was 21.7% and minor depression was 19.5%. The strongest single correlate of depression was severity of impairment in activities of daily living. However, the existence of depression at baseline was found to be associated with greater impairment at follow-up, ranging from 6 weeks to 2 years in 83% of studies. Further, depression following acute stroke was also associated with greater cognitive impairment and increased mortality. PSD has been shown in 6 double-blind controlled studies to be effectively treated with antidepressants, and 1 study has recently shown that PSD can be effectively prevented.

Conclusions:

During the past 20 years, significant progress has been made in the identification and treatment of depression following stroke. In the future, antidepressant treatment will likely play an increasing role in the management of patients with acute stroke. Further research is needed to identify the mechanisms of depression and why antidepressants lead to improved physical and cognitive recovery and decreased mortality.
Suicide Mortality by Occupation in Canada, 1991–2001
Authors: Mustard Cameron A , Bielecky Amber , Etches Jacob , Wilkins Russell , Tjepkema Michael , Amick Benjamin C , Smith Peter M , Gnam William H , Aronson Kristan J
Published: January 2017

Objective:

To describe the association between occupation and risk of suicide among working-age men and women in Canada.

Method:

This study of suicide mortality over an 11-year period is based on a broadly representative 15% sample of the noninstitutionalized population of Canada aged 30 to 69 years at cohort inception. Age-standardized mortality rates (ASMRs) and rate ratios were calculated for men and women in 5 categories of skill level and 80 specific occupational groups, as well as for people not occupationally active.

Results:

The suicide mortality rate was 20.1/100 000 person years for occupationally active men (during 9 600 000 person years of follow-up) and 5.3/100 000 person years for occupationally active women (during 8 100 000 person years of follow-up). Among occupationally active men, elevated rates of suicide mortality were observed for 9 occupational groups and protective effects were observed for 6 occupational groups. Among women, elevated rates of suicide were observed in 4 occupational groups and no protective effects were observed. For men and women, ASMRs for suicide were inversely related to skill level.

Conclusions:

The limited number of associations between occupational groups and suicide risk observed in this study suggests that, with few exceptions, the characteristics of specific occupations do not substantially influence the risk for suicide. There was a moderate gradient in suicide mortality risk relative to occupational skill level. Suicide prevention strategies in occupational settings should continue to emphasize efforts to restrict and limit access to lethal means, one of the few suicide prevention policies with proven effectiveness.
The Relation between Nicotine Dependence and Suicide Attempts in the General Population
Authors: Yaworski Daniel , Robinson Jennifer , Sareen Jitender , Bolton James M
Published: January 2017

Objective:

There has been much debate as to whether nicotine is a risk factor for suicidal behaviour. This study sought to examine the relation between nicotine dependence and suicide attempts in a population-based sample of adults.

Method:

Our study used the National Epidemiologic Survey on Alcohol and Related Conditions Wave 2 (NESARC; 2004–2005), a large ( n = 34 653) nationally representative survey of community-dwelling American adults. Multiple logistic regression analyses examined the relation between suicide attempts and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, nicotine dependence, compared with nonusers of nicotine. Associations between suicide attempts and other measures of nicotine use (nicotine cessation, age of first use, frequency, and amount of use) were also examined.

Results:

Lifetime (AOR 1.78; 95% CI 1.48 to 2.15) and past-year nicotine dependence (AOR 1.77; 95% CI 1.02 to 3.06) were independently associated with lifetime and past-year suicide attempts, respectively, even after adjusting for sociodemographic factors, other mental disorders, and physical disease. Nicotine dependence cessation was associated with a decreased likelihood of suicide attempt compared with people currently dependent on nicotine (AOR 0.15; 95% CI 0.05 to 0.43). Greater amount of daily cigarette use was associated with suicide attempts in the model that adjusted for sociodemographic factors and other mental disorders (AOR 1.53; 95% CI 1.05 to 2.24).

Conclusions:

Nicotine dependence is associated with suicide attempts, independently of comorbid mental disorders and physical disease. The association attenuates when a person ceases using nicotine, suggesting a state, rather than trait, effect. These findings provide evidence for additional concern regarding the deleterious health effects of tobacco.
Mindfulness-Based Cognitive Therapy: Theory and Practice
Authors: Sipe Walter E B , Eisendrath Stuart J
Published: January 2017

Mindfulness-based cognitive therapy (MBCT) incorporates elements of cognitive-behavioural therapy with mindfulness-based stress reduction into an 8-session group program. Initially conceived as an intervention for relapse prevention in people with recurrent depression, it has since been applied to various psychiatric conditions. Our paper aims to briefly describe MBCT and its putative mechanisms of action, and to review the current findings about the use of MBCT in people with mood and anxiety disorders. The therapeutic stance of MBCT focuses on encouraging patients to adopt a new way of being and relating to their thoughts and feelings, while placing little emphasis on altering or challenging specific cognitions. Preliminary functional neuroimaging studies are consistent with an account of mindfulness improving emotional regulation by enhancing cortical regulation of limbic circuits and attentional control. Research findings from several randomized controlled trials suggest that MBCT is a useful intervention for relapse prevention in patients with recurrent depression, with efficacy that may be similar to maintenance antidepressants. Preliminary studies indicate MBCT also shows promise in the treatment of active depression, including treatment-resistant depression. Pilot studies have also evaluated MBCT in bipolar disorder and anxiety disorders. Patient and clinician resources for further information on mindfulness and MBCT are provided.
The Mindful Brain and Emotion Regulation in Mood Disorders
Authors: Farb Norman A S , Anderson Adam K , Segal Zindel V
Published: January 2017

Mindfulness involves nonjudgmental attention to present-moment experience. In its therapeutic forms, mindfulness interventions promote increased tolerance of negative affect and improved well-being. However, the neural mechanisms underlying mindful mood regulation are poorly understood. Mindfulness training appears to enhance focused attention, supported by the anterior cingulate cortex and the lateral prefrontal cortex (PFC). In emotion regulation, these PFC changes promote the stable recruitment of a nonconceptual sensory pathway, an alternative to conventional attempts to cognitively reappraise negative emotion. In neural terms, the transition to nonconceptual awareness involves reducing evaluative processing, supported by midline structures of the PFC. Instead, attentional resources are directed toward a limbic pathway for present-moment sensory awareness, involving the thalamus, insula, and primary sensory regions. In patients with affective disorders, mindfulness training provides an alternative to cognitive efforts to control negative emotion, instead directing attention toward the transitory nature of momentary experience. Limiting cognitive elaboration in favour of momentary awareness appears to reduce automatic negative self-evaluation, increase tolerance for negative affect and pain, and help to engender self-compassion and empathy in people with chronic dysphoria.
Medication-Adherent First-Episode Psychosis Patients Also Relapse: Why?
Authors: Levy Emmanuelle , Pawliuk Nicole , Joober Ridha , Abadi Sherezad , Malla Ashok
Published: January 2017

Objective:

Poor adherence to medication is a major determinant of relapse following treatment of first-episode psychosis (FEP). However, medication-adherent patients also relapse. We examined what factors influence the risk of relapse after controlling for adherence.

Method:

We selected a sample of fully adherent patients ( n = 65) who had achieved remission at one point. We then compared patients who relapsed, using 2 different definitions of relapse, to those who did not relapse by 12 months on age, sex, premorbid adjustment, duration of untreated psychosis, length of prodrome, and substance abuse.

Results:

Among the 65 medication-adherent patients in remission, 9 (14%) relapsed according to criteria for relapse requiring a change in medication. These patients differed from those who remained in remission only in the pattern of premorbid adjustment (greater proportion with deteriorating pattern), although this was not independent of other variables. No differences were found on any other variable. Using a more commonly used metric for relapse, based on symptom ratings alone, an additional 14 (21.5%) patients relapsed. Substance abuse significantly predicted relapse, with substance abusers having more than 25 times the odds of relapsing by 12 months (OR 25.6; 95% CI 2.4 to 278.1, P = 0.008).

Conclusion:

Using a more conservative definition of relapse in this adherent-to-medication population, we find a very low rate of relapse associated, at least partially, with poor premorbid adjustment. As substance abuse was a significant predictor of symptomatic relapse, this would suggest that there should be a greater emphasis on interventions focused on reducing substance abuse in FEP.
Peritraumatic Distress and the Course of Posttraumatic Stress Disorder Symptoms: A Meta-Analysis
Authors: Thomas Émilie , Saumier Daniel , Brunet Alain
Published: January 2017

Objective:

To examine how peritraumatic distress modulates the severity of posttraumatic stress disorder (PTSD) according to the timing of the PTSD symptom assessments.

Method:

A systematic literature review of English- and French-language studies having administered the Peritraumatic Distress Inventory (PDI) was conducted. Meta-analyses were performed on correlations relating PDI and PTSD symptom scores obtained from the sampled studies. The meta-analyses, which included calculations of regression slopes, took into consideration the time at which PTSD symptoms were assessed following the traumatic event and the timing of the PDI assessment.

Results:

The literature review yielded a total of 22 studies. The meta-analysis performed over all studies resulted in a pooled correlation coefficient of 0.55 between the PDI and PTSD symptom scores. Meta-regression analyses conducted over all data revealed no apparent decrease in the correlations according to the timing of the PTSD symptom assessments. However, there were numerical or statistically significant declines in regression slopes when the meta-regressions were separately conducted on studies having administered the PDI either within, or following, a 1-month period after a traumatic event.

Conclusions:

While PDI or PTSD symptom score correlations remain generally significant, they tend to decline as time elapses between the traumatic event and the PTSD assessment. This suggests there may be factors other than peritraumatic distress that increasingly account for the long-term trajectory PTSD symptoms.
The Ultra-High Risk Concept—A Review
Authors: Yung Alison R , Nelson Barnaby
Published: January 2017

Attempts to identify people at imminent risk of psychotic disorder have been made during the past 20 years. High-risk criteria have been developed, and despite findings of a recent decline in the rate of onset of psychosis associated with these criteria, people identified still have a significantly greater risk, compared with the general population. Intervention studies in this group indicate that psychological treatments and fish oil appear to be just as effective as antipsychotics. Future research should refine risk factors for psychosis and examine outcomes other than psychosis. Research is also needed into what harms and benefits are associated with making the high-risk criteria into a formal diagnosis.
The Promise of New Drugs for Schizophrenia Treatment
Authors: Tamminga Ca
Published: January 2017

Objective

To present aspects of preclinical and clinical pharmacology of new antipsychotic drugs and to emphasize those preclinical drug characteristics which might predict desirable clinical actions.

Method

Review of the relevant literature and publicly presented data.

Results

Traditional neuroleptics have considerable effectiveness in treating positive symptoms of psychosis but can cause serious motor side effects. Clozapine produces no motor side effects and delivers a unique antipsychotic action. Risperidone also produces low motor side effects, but only at relatively low doses. Olanzapine and sertindole are newly introduced. Both have potent antipsychotic actions, with greatly reduced motor side effects. Both drugs also have possible advantages in negative symptoms.

Conclusions

These data support the conclusion that several new antipsychotics are becoming available for general use which are safe and effective in the treatment of psychosis and have several advantages over traditional neuroleptics.
L-Tryptophan Augmentation of Light Therapy in Patients with Seasonal Affective Disorder
Authors: Lam Raymond W , Levitan Robert D , Tam Edwin M , Yatham Lakshmi N , Lamoureux Sophie , Zis Athanasios P
Published: January 2017

Objective

Up to one-third of patients with seasonal affective disorder (SAD) do not have a full response to light therapy. Given the evidence for serotonergic dysregulation in SAD, we examined the possible role of l-tryptophan as an augmentation strategy for nonresponders and partial responders to light therapy.

Method

Eligible drug-free patients meeting DSM-IV criteria for SAD were treated for 2 weeks using a standard morning light therapy regimen (10 000 lux cool-white fluorescent light for 30 minutes). Partial and nonresponders were treated for 2 weeks with open-label l-tryptophan (1 g 3 times daily) while light therapy was continued. Ratings at baseline and follow-up included the 29-item Structured Interview Guide for the Hamilton Depression Rating Scale, SAD version (SIGH-SAD) and the Clinical Global Impression (CGI) scale.

Results

Sixteen patients began the l-tryptophan augmentation phase. Two patients discontinued medications within 3 days because of side effects. In the 14 patients completing treatment, the addition of l-tryptophan resulted in significant reduction of mean depression scores. Nine of 14 patients (64%) showed very good clinical responses to combined treatment and minimal side effects.

Conclusion

This open-label study suggests that l-tryptophan may be an effective augmentation strategy for those patients with SAD who show limited or poor response to bright light therapy. Further placebo-controlled studies are warranted to demonstrate efficacy.
A Case–Control Study of Social Risk Factors for Depression in American Patients
Authors: Roy Alec
Published: January 2017

Objective

To describe the social risk factors for depression and their interaction with recent life events in depressed American patients.

Methods

Forty patients with a major depressive episode were compared with 40 normal controls. Risk factors for depression were assessed, recent life events recorded, and their interaction examined.

Results

Significantly more depressed patients than controls had a poor marriage before the onset of depression and were unemployed. The depressed patients had also recently experienced significantly more life events. The only significant interaction was that employed depressed patients had experienced more recent life events than unemployed depressed patients.

Conclusion

In addition to recent life events, having a poor marriage and being unemployed may be social risk factors for depression in American patients.
Tap (Draft) Beer and Monoamine Oxidase Inhibitor Dietary Restrictions
Authors: Shulman Kenneth I , Tailor Sandra An , Walker Scott E , Gardner David M
Published: January 2017

Objective

Traditional monoamine oxidase inhibitors (MAOIs) continue to play an important role in the management of a wide variety of clinical conditions. Accordingly, a practical and safe approach to MAOI dietary restrictions remains an essential component of patient management.

Method

In an effort to refine MAOI dietary recommendations, we report a case of hypertensive crisis following the consumption of a modest amount of tap beer.

Results

A well-documented case report involving tap (draft) beer consumed while on an MAOI supports an earlier study, which recommended that all tap beers be restricted on MAOI diets. The 2 cases were remarkably similar in terms of the offending substance, quantity consumed, and subsequent reaction.

Conclusions

As a result of recent tyramine analyses and 2 well-documented case reports, all tap (draft) beers should now be absolutely restricted on MAOI diets because they represent a very significant risk at modest levels of consumption.
Biological Factors Associated with Susceptibility to Posttraumatic Stress Disorder
Authors: Yehuda Rachel
Published: January 2017

Because only a proportion of persons exposed to traumatic events develop posttraumatic stress disorder (PTSD), it has become important to elucidate the factors that increase the risk for the development of PTSD following trauma exposure as well as the factors that might serve to protect individuals from developing this condition. Putative risk factors for PTSD may describe the index traumatic event or characteristics of persons who experience those events. Recent data have implicated biological and familial risk factors for PTSD. For example, our recent studies have demonstrated an increased prevalence of PTSD in the adult children of Holocaust survivors, even though these children, as a group, do not report a greater exposure to life-threatening (Diagnostic and Statistical Manual of Mental Disorders [DSM-IV] Criterion A) events. These studies are reviewed. It is difficult to know to what extent the increased vulnerability to PTSD in family members of trauma survivors is related to biological or genetic phenomena, as opposed to experiential ones, because of the large degree of shared environment in families. In particular, at-risk family members, such as children, may be more vulnerable to PTSD as a result of witnessing the extreme suffering of a parent with chronic PTSD rather than because of inherited genes. But even if the diathesis for PTSD were somehow “biologically transmitted” to children of trauma survivors, the diathesis is still a consequence of the traumatic stress in the parent. Thus, even the most biological of explanations for vulnerability must at some point deal with the fact that a traumatic event has occurred.
Emotional Adaptation of Children Undergoing Bone Marrow Transplantation
Authors: Günter Michael , Karle Michael , Werning Andreas , Klingebiel Thomas
Published: January 2017

Objective:

To examine stress reactions and psychic adaptation of children aged 8–12 years in single-room treatment under isolation conditions after bone marrow transplantation (BMT).

Methods:

The prospective longitudinal study included free diagnostic interviews and a large test battery. We used a mixture of projective tests questionnaires and an intelligence test (the German version of the revised Wechsler Intelligence Scale for Children) to evaluate different adaptation processes.

Results:

The questionnaires clearly showed children's strong tendencies to adapt to the situation and to normalize their behaviour under isolation conditions. In contrast, the psychoanalytic interview and the projective tests demonstrated a very differentiated emotional adjustment: Before transplantation, coming to terms with the life-threatening situation was deferred. After transplantation, very intensive emotional examination of the situation and superficial adaptation (protective denial) were observed.

Conclusions:

It is very important to intensify the child's and the family's psychosocial support before admitting the child for hospital treatment. Family conflicts and neurotic developments should be regarded as risk factors for marked and potentially dangerous stress reactions.
Development of intimate contact during processing of carbon fiber reinforced Polyamide-6 tapes
Authors: Schaefer PM , Guglhoer T , Sause MGR , Drechsler K
Published: January 2017

Contact development between the surfaces of two tapes is considered as a critical step in processing carbon fiber reinforced thermoplastic composites. In this study, the development of intimate contact between carbon fiber reinforced Polyamide-6 (PA-6) tapes is investigated experimentally using consolidation experiments and X-ray computed tomography for quantitative contact characterization. The experimental results indicate that the development of intimate contact occurs in the range of seconds even when temperatures are only slightly above the melting temperature and applied pressures is in the range of 1-4 kPa. Experimental data are compared with the results of the two analytical models proposed by Lee and Springer as well as Yang and Pitchumani. Both models overestimate the time needed to reach full contact for the PA-6 tape. In comparison to previously investigated PEEK materials, PA-6 has a relatively low viscosity and the tapes possess a resin-rich layer near the surface, which seems to influence the contact development process. Besides the assumptions made for viscosity, the sensitivity to input parameters describing the surface topology strongly influence the model results and the accuracy of predictions.
Additive toxic effect of deltamethrin and cadmium on hepatic, hematological, and immunological parameters in mice
Authors: Rehman Hasibur , Aziz Al Thbiani , Saggu Shalini , VanWert Adam L , Zidan Nahla , Saggu Sundeep
Published: January 2017

Exposure to natural and man-made environmental toxins concurrently can pose a greater threat to multiple organs. In the present work, we investigated interactions between deltamethrin (DM) and cadmium (Cd), whose mechanisms of action in humans are poorly understood. Albino mice were randomly divided into four groups, each containing six mice: saline as control, DM-treated, cadmium chloride (CdCl2)-treated, and CdCl2 plus DM treated. After 2 weeks of treatment biochemical and hematological effects, total leukocyte count (TLC), differential leukocyte count, humoral-mediated immune responses, and histopathological studies were conducted. Mice exposed to DM and Cd showed a significant increase in aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Also, DM and Cd administration resulted in suppression of humoral immunity, erythrocyte count, hemoglobin, hematocrit, and TLC. Histopathological evidence revealed hepatic damage, supporting the AST and ALT findings. Cd and DM exhibited an additive type of toxicity. It could be concluded that these toxins either target different cellular pathways, or the individual amounts used in this study were not enough to saturate the toxicological target, thus producing additive effects.
Photoperiodic Time Measurement in tau Mutant Hamsters
Authors: Shimomura Kazuhiro , Nelson Dwight E. , Ihara Naomi L. , Menaker Michael
Published: January 2017

Photoperiodic regulation of testicular function was investigated in homozygous tau mutant hamsters; these animals have an innate circadian period of about 20 h. In 20-h light:dark (LD) cycles, the minimum photoperiod required to prevent testicular regression was between 10.0 and 11.5 h per 20-h cycle (equivalent to 12.0-13.8 circadian hours). This was proportionally similar to the minimum photoperiod necessary to prevent regression in wild-type hamsters maintained in 24-h LD cycles. To examine the shape of the photoperiodic photosensitivity curve in homozygous tau mutant hamsters, the authors measured the effects of different T cycles on testicular maintenance. Entrainment to LD 1:18.0 and LD 1:20.5 partially or completely prevented gonadal regression in homozygous tau mutant hamsters, but LD 1:19.4 did not prevent regression. When considered in terms of circadian time, the photoperiodic photosensitivity curve for homozygous tau mutant hamsters was similar to that described previously for wild-type hamsters. The results indicate that, as in wild-type hamsters, photoperiodic regulation of reproduction is regulated by circadian photosensitivity in homozygous tau mutant hamsters. Because tau mutant hamsters measure day length against a time base of 20 h, the circadian pacemaker that measures day length might be the same as that which generates circadian rhythmicity in locomotor activity. The authors' data leave open the question of whether the tau mutation has had effects on the control of reproduction that are not directly attributable to its effects on the period of the circadian oscillator.
Educator Burnout and Compassion Fatigue: A Pilot Study
Authors: Koenig Adam , Rodger Susan , Specht Jacqueline
Published: January 2017

Sixty-four Canadian educators from Southwestern Ontario took part in a 2-hr voluntary workshop about the emotional labor and consequences that may be experienced by educators. A focus on both burnout and teacher compassion fatigue (CF), an underresearched area with respect to Canadian educators, was taken. The current study hypothesized that this professional development would positively influence educators’ knowledge, skills, and awareness regarding burnout, CF, and self-care; furthermore, it was predicted there would be a positive correlation between burnout and CF. Results supported the efficacy of professional development and partial support was detected for the relationship between burnout and CF. Implications and future research are discussed.
A reformative shear precipitation procedure for the fabrication of vancomycin-loaded poly(lactide-co-glycolide) microspheres
Authors: Wang Lei , Yang Qinmeng , Chen Yirong , Chai Yu , Li Jiao Jiao , Du Lin , Tan Ruizhe , Yang Shenyu , Tu Mei , Yu Bin
Published: January 2017

This study reports the encapsulation of vancomycin, as a model hydrophilic drug, into poly(lactide-co-glycolide) microspheres using a novel reformative shear precipitation procedure. In contrast to the external aqueous phase used in the conventional microencapsulation technique based on emulsion solvent evaporation/extraction, the reformative shear precipitation procedure explored in this study uses a shear medium composed of glycerol as the viscous medium and ethanol as polymer antisolvent, which is relatively immiscible with the hydrophilic drug. This limits drug diffusion and leads to rapid microsphere solidification, which allows a large proportion of the hydrophilic drug to be encapsulated within the microspheres. The influence of various processing parameters, including polymer concentration, volume ratio of ethanol to glycerol in the shear medium, volume of aqueous drug solution, initial drug loading, and injecting rate of the drug–polymer emulsion, on the encapsulation efficiency and characteristics of resulting microspheres were investigated. The morphology and release characteristics, as well as mechanical, in vitro and in vivo behaviour of vancomycin-loaded poly(lactide-co-glycolide) microspheres prepared using the novel procedure were also investigated. The results demonstrated that the reformative shear precipitation procedure could achieve the loading of hydrophilic drugs into poly(lactide-co-glycolide) microspheres with high encapsulation efficiency, and the success of the procedure was largely influenced by the volume ratio of ethanol to glycerol in the shear medium. Vancomycin-loaded poly(lactide-co-glycolide) microspheres prepared using this procedure demonstrated favourable mechanical characteristics, antibacterial activity, and in vivo degradation behaviour which suggested their suitability for use as a sustained delivery system.
Wound Treatment Options
Authors: Parker Cindy Schott
Published: January 2017

A large number of skin care products and dressings are available to nurses to treat skin and wound problems. Nurses are challenged to know the major types of products and to use their own decision-making abilities to treat skin problems in the most efficient and effective way. The goals of skin care are, foremost, prevention. Once a wound is established, however, the goals are to keep the wound clean and moist to enhance healing. The nurse assesses the wound for stage, size, and characteristics. Based on the assessment, the choice of treatment method that will keep the wound clean and moist while being fairly easy, cost-effective, and successful in the shortest timeframe possible is the best option. Using the figure “Wound Treatment Options: Types and Benefits” will help the nurse to choose the best option.
Therapeutic Touch —The Caring Environment
Authors: Patricia Rose Heidt
Published: January 2017

Abstract: A case study of one nurse's experience of Therapeutic Touch is presented. The major themes of the interview data are discussed by the researcher. The study provides a deeper insight into the caring relationship of the nurse during the time the nurse treats her patient with Therapeutic Touch.

Summary: In this case study one nurse presents her experiences while administering treatment by TT. An analysis of the themes of the interview indicates the nurse's primary experience is one of participating in opening the flow of the universal life energy in the patient and herself. The process involves (1) OPENING INTENT — allowing herself to focus on getting the universal life energy moving again, (2) OPENING SENSITIVITY — assessing the quality of its flow, and (3) OPENING COMMUNICATION — participating in a healing relationship that unblocks, engages and enlivens its movement.

For the nurse in this study, administering treatment by TT is a special way of caring for a patient. By acknowledging her patient as “openness”, i.e., a person who is always changing, growing, living, willing and healing, she chooses a treatment modality which supports this fundamental nature in her patient. Her caring stands as a challenge to traditional conceptual models about the nature of healing and person-environment relationships. In our present health care system, riddled with fragmentation, and relying heavily on technological innovation, the treatment she gives her patient may indeed be nursing's great boon.

The nurse's willingness and ability to share her inner experiences about administering treatment by TT is a very important step in building a knowledge base about this treatment modality. Up to this time, there has been a concentration on experimental research which indicates general effects of TT treatment.

Now, as more qualitiative data is collected about nurses' and patients' personal accounts of TT, professional nurses may benefit by using them as models for their own development of TT practice.
Effect of Organizational and Environmental Factors on Service Differentiation Strategy of Integrated Healthcare Networks
Authors: Lin Yen Ju , Wan Thomas T. H.
Published: January 2017

During the past decade, the missions/goals of medical providers of healthcare services in the United States have shifted — from emphasizing individual, independent illness treatments to focusing on the continuum of care, population-based wellness, and providing the appropriate care in the most efficient way. Integrated healthcare networks (IHNs) — or integrated healthcare delivery systems — have been focusing heavily on their level of various partnership integration (i.e. service differentiation strategy) in order to offer a full continuum of care. The aim of this study, using the individual IHN as the unit of analysis, was to identify organizational and environmental factors that influence IHN administrators to focus on their service differentiation of market lines, including the establishment of third-party payers' contracts, the affiliation of managed-care organizations, and the alliances of various nonhospital medical providers, to provide a continuum of care. The study findings show that tax status of an IHN, its age, and market competition affect its service differentiation strategy in the provision of a full continuum of care.