bluuebunny/crossref_metadata_2025 huggingface dataset:
A study of impact of inband signalling and realistic channel knowledge for an example dynamic OFDM–FDMA system
Authors: Gross James , Valentin Stefan , Karl Holger , Wolisz Adam
Published: January 2005

Dynamically assigning sub‐carriers oforthogonalfrequencydivisionmultiplexing (OFDM) systems to multiple different terminals in a cell has been shown to be beneficial in terms of different transmission metrics. The success of such a scheme, however depends on the ability of the access point to inform terminals of their newest sub‐carrier assignments as well as on the accuracy of the channel state information used to generate new assignments. It is not clear whether the overhead required to implement these two functions consumes all of the potential performance increase possible by dynamically assigning sub‐carriers. In this paper, a specific MAC structure is selected enabling the operation of a dynamic OFDM system, incorporating a signalling scheme for dynamically assigned sub‐carriers. Based on this structure, we study the overhead required for a dynamic sub‐carrier scheme; a static variant that serves as a comparison case. We investigate the performance difference of these two schemes for various scenarios where at first signalling and then realistic channel knowledge is added to the system model. Average throughput and goodput per terminal serve as figures of merit; the number of terminals in the cell, the transmission power per sub‐carrier, the delay spread and the movement speed of the terminals are varied. We find that a realistic overhead model decreases the performance of both static and dynamic schemes such that the overall ratio favours in all cases except for higher speeds the dynamic rather than the static scheme especially in realistic system environments. Copyright © 2005 AEIT.
Downlink WCDMA receivers based on combined chip and symbol level equalisation
Authors: Baştuğ Ahmet , Slock Dirk T. M.
Published: January 2005

In this paper, we consider iterative receiver techniques for the downlink in WCDMA systems (UMTS FDD mode). We start from the linear minimum mean square error (MMSE) receiver (at symbol level), which is time varying and hence too complex to implement. By applying polynomial expansion (PE) to the LMMSE receiver, an iterative solution is obtained in which the complexity per iteration becomes comparable to twice that of the Rake receiver. Our one contribution is to replace the channel matched filter by a channel equaliser within this PE to accelerate the convergence of the iterations. We also investigate various scenarios for the introduction of non‐linearities in the PE scheme that are particularly applicable to the multicode case of the high speed downlink packet access (HSDPA) mode since it is well known that non‐linearities in the PE scheme lead, in fact, to the parallel interference canceler (PIC). Copyright © 2005 AEIT.
Flow‐level performance analysis of some opportunistic scheduling algorithms
Authors: Bonald T.
Published: January 2005

While fading effects have long been combatted in 2G wireless networks, primarily devoted to voice calls, they are now seen as an opportunity to increase the capacity of 3G networks that incorporate data traffic. The packet delay tolerance of data applications, such as file transfers and Web browsing for instance, allows the system flexibility in scheduling a user's packets. So‐called opportunistic scheduling, which ensures transmission occurs when radio conditions are most favourable, is the key component of currently developed systems like cdma2000 IS‐856 and UMTS HSDPA. We compare the performance of some scheduling schemes using a flow‐level approach where the random evolution of the number of ongoing flows is explicitly taken into account. Copyright © 2005 AEIT.
A finite‐source queuing model for the IEEE 802.11 DCF
Authors: Winands E. M. M. , Denteneer T. J. J. , Resing J. A. C. , Rietman R.
Published: January 2005

The most mature medium access control protocol for wireless local area networks is the IEEE 802.11 standard. The primary access mode of this protocol is based on the mechanism of carrier sense multiple access with binary exponential backoff. We develop a finite‐source feedback queueing model for this access mode. In this model, we derive expressions for the throughput and the first moment of the delay and a set of equations to compute the Laplace Stieltjes Transform and higher moments of the delay. The accuracy of the model is verified by simulation. Copyright © 2005 AEIT.
Iterative PIC detection and channel estimation for DS‐CDMA communications in AWGN and satellite/HAPS channels
Authors: Morosi Simone , del Re Enrico , Fantacci Romano , Rufolo Paola
Published: January 2005

This paper presents a turbo multiuser detector for turbo‐coded DS‐code division multiple access (CDMA) systems, based on the utilisation of a parallel interference cancellator (PIC) and a bank of turbo decoders: in the proposed receiver the interference cancellation is performed after each constituent decoder of the turbo decoding scheme. Moreover, the soft outputs of the turbo decoders are used iteratively to improve the channel parameter estimation during the updating step, which is formally equivalent to one step of the expectation‐maximisation algorithm. By means of computer simulations, we will show that the proposed receiver achieves performance comparable with the one obtained by systems, which suppose perfect knowledge of the channel parameters for medium to high system loads, in AWGN channel. Finally, the proposed receiver is also applied in HAPS (high altitude platform station) and satellite channel, for different values of the elevation angle, affording remarkable performance. Copyright © 2005 AEIT.
Analysis of the essential oil of Nepeta fissa C.A. Mey from Iran
Authors: Sefidkon F. , Dabiri M. , Alamshahi A.
Published: January 2005

Water‐distilled volatile oil from the aerial parts of Nepeta fissa C.A. Mey. was analysed by a combination of GC and GC–MS. Forty‐two components were identified, constituting approximately 99.3% of the oil. The main constituents of the essential oil were β‐caryophyllene (17.4%), caryophyllene oxide (12.3%), γ‐muurolene (7.9%), valencene (6.6%), β‐pinene (6.0%) and α‐pinene (5.8%). Copyright © 2002 John Wiley & Sons, Ltd.
Composition of the essential oils from three Laggera Spp. from Cameroon
Authors: Kuiate J.‐R. , Bessière J.‐M. , Amvam Zollo P.‐H.
Published: January 2005

The essential oils from the leaves of Laggera alata var. montana C. D. Adams, and Laggera gracilis (O. Hoffm. & Muschl.) C. D. Adams, and those from leaves, roots and stems of Laggera oloptera (DC.) C. D. Adams from the western highlands of Cameroon were analysed by GC and GC–MS. The essential oils of L. alata var. montana and L. gracilis were found to be rich in dimethoxy‐p‐cymene (34% and 33%, respectively). The other most abundant components in these oils were 7‐epi‐γ‐ eudesmol (21%), juniper camphor (7%) for L. alata var. montana and γ‐eudesmol (10%), β‐caryophyllene (7%) for L. gracilis. The essential oils from leaves of L. oloptera were found to be poor in dimethoxy‐p‐cymene (0.1–0.3%) but afforded β‐caryophyllene (15–20%), germacrene‐D (10–17%) and sabinene (2–28%) while the volatile extract from roots and stems were rich in dimethoxy‐p‐cymene (67% and 36%, respectively) and β‐caryophyllene (6% and 16%, respectively). The essential oil from the stems also contained a high proportion of γ‐eudesmol (20%). Copyright © 2002 John Wiley & Sons, Ltd.
Identification of regions of fastest mixing in a system of point vortices
Authors: Ramachandran Prabhu , Rajan S. C.
Published: January 2005

This paper describes a numerical method for efficiently identifying the regions of fastest mixing of a passive dye in a flow due to a system of point vortices. Results obtained from computations are presented for systems of three and four point vortices, both in the unbounded domain and inside a circular cylinder. The flow is two‐dimensional and the fluid is incompressible. The regions where mixing is possible are found by studying the largest Lagrangian Lyapunov exponent distribution with respect to various initial positions of tracer particles. The regions of fastest mixing are then identified from the Lyapunov exponent distribution at small times. The results of the method are verified by quantifying the mixing by using a traditional box counting technique. The technique is then applied to several different initial configurations of vortices and some interesting results are obtained. Some numerical findings about the nature of the exponents computed are also discussed. Copyright © 2002 John Wiley Sons, Ltd.
Application of local grid refinement to vortex motion due to a solitary wave passing over a submerged body
Authors: Tang Chii‐Jau , Chang Jyh‐Hwa
Published: January 2005

A numerical method based on the streamfunction–vorticity formulation is applied to simulate the two‐dimensional, transient, viscous flow with a free surface. This method successfully uses the locally refined grid in an inviscid–viscous model to explore the processes of vortex formation due to a solitary wave passing over a submerged bluff body. The two particular bodies considered here are a blunt rectangular block and a semicircular cylinder. Flow visualization to track dyelines is carried out in the laboratory in order to confirm the validity of the numerical results. Numerical results examined by different grid configurations ensure the locally refined grid to be useful in practical application. Flow phenomena, including the vortex motion and wave patterns during non‐linear wave–structure interaction, are also discussed. Copyright © 2002 John Wiley & Sons, Ltd.
A simple and efficient error analysis for multi‐step solution of the Navier–Stokes equations
Authors: Fithen R. M.
Published: January 2005

A simple error analysis is used within the context of segregated finite element solution scheme to solve incompressible fluid flow. An error indicator is defined based on the difference between a numerical solution on an original mesh and an approximated solution on a related mesh. This error indicator is based on satisfying the steady‐state momentum equations. The advantages of this error indicator are, simplicity of implementation (post‐processing step), ability to show regions of high and/or low error, and as the indicator approaches zero the solution approaches convergence. Two examples are chosen for solution; first, the lid‐driven cavity problem, followed by the solution of flow over a backward facing step. The solutions are compared to previously published data for validation purposes. It is shown that this rather simple error estimate, when used as a re‐meshing guide, can be very effective in obtaining accurate numerical solutions. Copyright © 2002 John Wiley & Sons, Ltd.
Numerical solution of the flow of thin viscous sheets under gravity and the inverse windscreen sagging problem
Authors: Hunt Roland
Published: January 2005

The slumping of a thin sheet of very viscous liquid glass is used in the manufacture of windscreens in the automotive industry. The governing equations for an asymptotically thin sheet with variable viscosity are derived in which the vertical coordinate forms the centre‐line of the sheet. The time‐dependant equations have been solved numerically using the backward Euler method to give results in both two and three dimensions. The flow of an initially flat sheet falls freely under gravity until it becomes curved and the flow becomes very slow in the ‘slumped’ phase. Finally the sheet freefalls as the thickness becomes small at the boundaries. The inverse problem in which the viscosity profile is to be determined for a given shape can be solved as an embedding problem in which a search is made amongst the forward solutions. Possible shapes in the two‐dimensional problem are very restrictive and are shown to be related to the sheet thickness. In three dimensions the range of shapes is much greater. Copyright © 2002 John Wiley & Sons, Ltd.
Statistical analyses of freeway traffic flows
Authors: Tebaldi Claudia , West Mike , Karr Alan F.
Published: January 2005

This paper concerns the exploration of statistical models for the analysis of observational freeway flow data, and the development of empirical models to capture and predict short‐term changes in traffic flow characteristics on sequences of links in a partially detectorized freeway network. A first set of analyses explores regression models for minute‐by‐minute traffic flows, taking into account time of day, day of the week, and recent upstream detector‐based flows. Day‐ and link‐specific random effects are used in a hierarchical statistical modelling framework. A second set of analyses captures day‐specific idiosyncrasies in traffic patterns by including parameters that may vary throughout the day. Model fit and short‐term predictions of flows are thus improved significantly. A third set of analyses includes recent downstream flows as additional predictors. These further improvements, though marginal in most cases, can be quite radically useful in cases of very marked breakdown of freeway flows on some links. These three modelling stages are described and developed in analyses of observational flow data from a set of links on Interstate Highway 5 (I‐5) near Seattle. Copyright © 2002 John Wiley & Sons, Ltd.
Loch Lomond Stadial glaciers in the Aran and Arenig Mountains, North Wales, Great Britain
Authors: Hughes Philip D.
Published: January 2005

Geomorphological evidence for four former local glaciers has been mapped in the Aran and Arenig Mountains, North Wales. Former glacial extent was deduced from the distribution and assemblage of end and lateral moraines, hummocky moraine, boulder limits, drift limits and periglacial trimlines. Comparison of infilled lake sediment stratigraphies inside and outside of the former glacier limits suggests a Loch Lomond Stadial (Late Devensian) age of the former glaciers (c. 12.9–11.5 cal. ka BP). This finding is also supported by periglacial–landform contrasts between the land inside and outside of the glacier limits. Reconstruction of the four glaciers illustrates a mean equilibrium line altitude (ELA) of c. 504 m. From the reconstructed ELAs and the combination of precipitation and snowblow input for total accumulation, by analogy with Norwegian glaciers, a mean sea‐level July temperature is calculated at 8.4°C. Copyright © 2002 John Wiley & Sons, Ltd.
Fabrics, facies control and diagenesis of lacustrine ooids and associated grains from the Upper Triassic, southwest England
Authors: Milroy P. G. , Wright V. P.
Published: January 2005

Petrographic analysis of ooids from the Upper Triassic (Mercia Mudstone Group) of southwest England provides an opportunity to assess in detail the origins, transport pathways and diagenesis of an ancient oolite. The Clevedon Oolite is dolomitized and contains a variety of dissolved ooids (oomoulds) and associated grains. The oomoulds occur in well‐sorted, planar and cross‐stratified grainstones, packstones, sandstones and conglomerates associated with shoreface, intershoal, foreshore, beachrock and littoral strandplain deposits.

The ooids grew in suspension in the shoreface zone and developed a radial aragonite microstructure. The ooids grew to 0.80 mm in diameter, after which they fractured or ceased growing. Broken grains deposited on or near mobile shoals were rapidly recoated, while other grains, deposited in less agitated, intershoal and lower foreshore areas, were micritized or microbially bound into grapestone aggregates. Locally peloids, intraclasts, quartz grains and micritized grains from intershoal areas supplied nuclei for ooids on nearby shoals. Grains deposited in foreshore areas were rapidly cemented into beachrock and reworked into conglomerates. Soon after deposition, the ooids were subjected to widespread aragonite dissolution followed by dolomitization. The lack of pre‐dolomitization calcite, together with the abundance of early (pre‐compaction) dolospar cements and fabric‐selective dolomitization of micritic fabrics, suggest aragonite dissolution by dolomitizing fluids. Copyright © 2002 John Wiley & Sons, Ltd.
The cognitive decline scale of the psychogeriatric assessment scales (PAS): longitudinal data on its validity
Authors: Jorm A.F. , Christensen H. , Jacomb P. A. , Korten A. E. , Mackinnon A. J.
Published: January 2005

Objective

The Cognitive Decline scale of the Psychogeriatric Assessment Scales (PAS)1 uses informant data to assess retrospectively change from earlier in life. Data from a 7–8‐year longitudinal study were used to assess the validity of this scale against changes in cognitive performance and mortality.

Copies of the PAS can be downloaded from the World Wide Web at http://www.mhri.edu.au/pas/

Design and measures

PAS data were collected on three occasions, with gaps of 3.6 and 4.1 years between the waves. The Cognitive Decline score at Wave 3 was validated retrospectively against actual change on a brief test of current cognitive status (the PAS Cognitive Impairment scale) over the three waves, while the Cognitive Decline score at Wave 1 was assessed for predictive validity against future mortality and cognitive change.

Setting

A community survey in the Australian cities of Canberra and Queanbeyan.

Participants

Participants were aged 70+ at the beginning of the study. The sample size varied from 729 to 279, depending on the number of waves involved.

Results

Participants with scores of 4+ on the Cognitive Decline scale at Wave 3 showed substantial deterioration over the previous 7–8 years. Scores of 4+ at Wave 1 predicted mortality and further cognitive deterioration.

Conclusions

The Cognitive Decline scale allows a valid retrospective assessment of change and has predictive validity for subsequent cognitive deterioration and increased mortality. Copyright © 2001 John Wiley & Sons, Ltd.
Depression in late life, cognitive decline and white matter pathology in two clinico‐pathologically investigated cases
Authors: Lloyd A. J. , Grace J. B. , Jaros E. , Perry R. H. , Fairbairn A. F. , Swann A. G. , O'Brien J. T. , Mckeith I. G.
Published: January 2005

Case reports

We report two cases of late life depression who became progressively more resistant to treatment, developed cognitive impairment, and began to exhibit neurological abnormalities and evidence of vascular disease. A discussion of the clinical features of the cases is accompanied by reports of neuropathology and neuroimaging findings. Extensive white matter lesions were present on computed tomography in both patients, and basal ganglia infarcts were seen in one. Neuropathology revealed evidence of cerebral atrophy, demyelination and white matter lesions in addition to cerebrovascular and generalised vascular disease. Neither patient exhibited Alzheimer pathology outwith the norm for their age. We believe this to be the first report of neuropathological findings in depression with white matter changes.

Literature review

The pathological basis of white matter lesions and their relationship to depression, its age of onset and clinical features is addressed in relation to the cases described. Pathological investigation of white matter lesions has not previously been carried out in depression and hypotheses regarding their nature in this illness are based on extrapolation from research in a variety of other disorders. The association of depression with vascular risk factors is considered, as is the relationship between depression and cognitive deficits. There is a need for further investigation in this area. Copyright © 2001 John Wiley & Sons, Ltd.
Psychometric evaluation of a short observational tool for small‐scale research projects in dementia
Authors: Smallwood Jonathan , Irvine Elizabeth , Coulter Fiona , Connery Hazel
Published: January 2005

Dementia is a degenerating illness and the lack of a reliable measure of self‐report in particular presents particular difficulties for research. Often in the later stages of dementia behavioural measurement is the only tool available for the evaluation of treatment techniques. This paper describes and evaluates a short observational tool suitable for clinical assessment purposes. The scale has been shown to have the potential for adequate inter‐rater reliability, test retest reliability, and convergent and divergent validity, if the study limitations reflecting statistical rather than ecological validity, and limitations of sample size are borne in mind. Copyright © 2001 John Wiley & Sons, Ltd.
Attempted and completed suicide in older subjects: results from the WHO/EURO multicentre study of suicidal behaviour
Authors: De Leo Diego , Padoani Walter , Scocco Paolo , Lie David , Bille‐Brahe Unni , Arensman Ella , Hjelmeland Heidi , Crepet Paolo , Haring Christian , Hawton Keith , Lonnqvist Jouko , Michel Konrad , Pommereau Xavier , Querejeta Imanol , Phillipe Jean , Salander‐Renberg Ellinor , Schmidtke Armin , Fricke Susanne , Weinacker Bettina , Tamesvary Beata , Wasserman Danuta , Faria Sampaio
Published: January 2005

Objective

The authors present an analysis of findings for the 65 years and over age group from the WHO/EURO Multicentre Study of Suicidal Behaviour (1989–93).

Methods

Multinational data on non‐fatal suicidal behaviour is derived from 1518 subjects in 16 European centres. Local district data on suicide were available from 10 of the collaborating centres.

Results

Stockholm (Sweden), Pontoise (France) and Oxford (UK) had the highest suicide attempts rates. In most centres, the majority of elderly who attempted suicide were widow(er)s, often living alone, who used predominantly voluntary drug ingestion. Non‐fatal suicidal behaviour decreased with increasing age, whereas suicide rates rose. The ratio between fatal and non‐fatal behaviours was 1:2, that for males/females almost 1:1. In the years considered, substantial stability in suicide and attempted suicide rates was observed. As their age increased, suicidal subjects displayed only a limited tendency to repeat self‐destructive acts. Moreover, there was little correlation between attempted suicide and suicide rates, which carries different clinical implications for non‐fatal suicidal behaviour in the elderly compared with younger subjects in the same WHO/EURO study. Copyright © 2001 John Wiley & Sons, Ltd.
Dementia with Lewy bodies in Down's syndrome
Authors: Simard Martine , van Reekum Robert
Published: January 2005

The association between Down's syndrome (DS) and Alzheimer's disease is well established. This paper presents a review of the literature, suggesting a possible association between DS and the more recently recognised dementia with Lewy bodies (DLB). Patients with DLB frequently present with changes in affect and behaviour, and in particular with psychotic symptoms. The literature suggests a possible role for atypical neuroleptics in the management of psychosis in DLB. Copyright © 2001 John Wiley & Sons, Ltd.
Equity of access to a memory clinic in Melbourne? Non‐English speaking background attenders are more severely demented and have increased rates of psychiatric disorders
Authors: LoGiudice Dina , Hassett Anne , Cook Roslyn , Flicker Leon , Ames David
Published: January 2005

Objectives

The aim of this study was to compare demographic and clinical features of patients from Non‐English Speaking Background (NESB) with those from English Speaking Background (ESB) who attended a memory clinic in Melbourne, Australia.

Methods

Data on 556 consecutive patients attending the memory clinic were analysed retrospectively. All patients were assessed by a geriatrician (Italian speaking) or psychogeriatrician with the aid of Cambridge Examination for Mental Disorders in the Elderly (CAMDEX) interview schedule. Patients were classified into the categories of dementia, functional psychiatric disorder (including depression), cognitive impairment other than dementia and normal, using ICD 10 criteria. Severity of dementia was determined using the Clinical Dementia Rating scale. Demographic information and use of community services were also documented.

Results

Of those seen, 148 (28.8%) were of NESB, the majority Italian (69, 12.4%). Patients of NESB were younger (p = 0.001), less educated (p = 0.001) and less likely to live alone (p = 0.009) compared to persons of ESB. Those of NESB were more likely present with a functional psychiatric disorder (particularly depression) or normal cognition (p = 0.001). Patients of NESB with dementia presented at a later stage of their disease as determined by CDR (p = 0.003). Those of NESB scored significantly lower (more impaired) on CAMCOG in all patients seen (including normal and psychiatric groups) (p = 0.02).

Conclusions

The clinical and demographic features of people of NESB referred to a memory clinic in Melbourne, Australia, differ from their ESB counterparts, with specific groups being under represented. This has implications for equity of assessment, service provision and utilisation for those of ethnically diverse backgrounds. Copyright © 2001 John Wiley & Sons, Ltd.
Dementia, cognitive impairment and mortality in persons aged 65 and over living in the community: a systematic review of the literature
Authors: Dewey Michael E. , Saz Pedro
Published: January 2005

Background

No recent attempt has been made to synthesise information on mortality and dementia despite the theoretical and practical interest in the topic. Our objective was to estimate the influence on mortality of cognitive impairment and dementia.

Methods

Data sources were Medline, Embase, personal files and colleagues' records. Studies were considered if they included a majority of persons aged 65 and over at baseline either drawn from a total community sample or drawn from a random sample from the community. Samples from health care facilities were excluded. The search located 68 community studies. Effect sizes were extracted from the studies and if they were not included in the published studies, effect sizes were calculated where possible: this was possible for 23 studies of cognitive impairment and 32 of dementia. No attempt was made to contact authors for missing data.

Results

For the studies of cognitive impairment Fisher's method (a vote counting method), gave a p‐value (from eight studies) of 0.00001. For studies of dementia, age‐adjusted confidence intervals (CI) were pooled (odds ratio (OR) 2.63 with 95% CI 2.17 to 3.21 from six studies).

Conclusions

Levels of cognitive impairment commonly found in community studies give rise to an increased risk of mortality, and this appears to be true even for quite mild levels of impairment. The analysis confirms the increased risk of mortality for dementia, but reveals a dearth of information on the causes of the excess mortality and on possible effect modification by age, dementia subtype or other variables. Copyright © 2001 John Wiley & Sons, Ltd.
Risk factors for falling in a psychogeriatric unit
Authors: de Carle A. John , Kohn Robert
Published: January 2005

Objective

To identify risk factors associated with falls in a psychogeriatric inpatient population.

Design

Retrospective cohort study.

Setting

A psychogeriatric inpatient unit in a Brown University affiliated psychiatric hospital.

Participants

A total of 1834 men and women who represented all admissions to the psychogeriatric inpatient unit between January 1992 and December 1995.

Results

Over the study period a total of 175 falls were recorded, giving a fall rate of 9.5%. Using a logistic regression model, six variables were found to be independently associated with an increased risk of falling: female gender, electroconvulsive therapy (ECT), mood stabilizers, cardiac arrhythmias, Parkinson's syndrome and dementias. Falls and ECT were associated with longer hospital stay, when adjusted for confounders including ECT.

Conclusions

These findings support previous results and identify ECT as a possible risk factor for falling in a hospital setting. Copyright © 2001 John Wiley & Sons, Ltd.
Factors associated with mortality in patients with early‐onset Alzheimer's disease: a five‐year longitudinal study
Authors: Ueki Akinori , Shinjo Hidetaka , Shimode Hiroko , Nakajima Takaya , Morita Yoshio
Published: January 2005

To identify neuropsychiatric and somatic factors related to survival in early‐onset Alzheimer's disease, we longitudinally studied 108 patients (35 male, 73 female) with early‐onset Alzheimer's disease who were 46 to 64 years old at onset and 50 to 69 years old when diagnosed at our institution. A five‐year follow‐up, 30 patients had died. Pneumonia was the most common cause (73%), followed by malignancy (20%) and heart disease (7%). Kaplan–Meier survival curves showed a lower survival rate in patients with early‐onset Alzheimer's disease than in age‐ and sex‐matched life‐table data in Japan. In Cox proportional hazards analysis, male gender, early disease onset, concurrent physical illness at time of diagnosis, and a low mini‐mental state examination score increased the likelihood of death in patients with early‐onset Alzheimer's disease. Our study confirmed that these patients have considerable excess mortality and a different pattern of cause of death than in the general population. Gender, age at onset, physical illness, and cognitive function strongly influenced survival. These factors may be predictors of mortality in patients with early‐onset Alzheimer's disease that are useful in counseling patients and their families. Copyright © 2001 John Wiley & Sons, Ltd.
Validation study of the Chinese version of the neuropsychiatric inventory (CNPI)
Authors: Leung Vivian P. Y. , Lam Linda C. W. , Chiu Helen F. K. , Cummings Jeffrey L. , Chen Q. L.
Published: January 2005

Background

More validated instruments for assessment of behavioral and psychological symptoms of dementia are required to facilitate local dementia research.

Method

The psychometric properties of the Chinese version of the neuropsychiatric inventory (CNPI) were tested in a sample of 62 dementia outpatients. The concurrent validity was tested by measuring the Spearman correlation between CNPI subscales with the appropriate subscales of BEHAVE‐AD and the Chinese Hamilton rating scale of depression (CHDS). The internal consistency reliability, false‐negative rates of the screening questions of CNPI and inter‐rater reliability were determined.

Result

Most CNPI behavioral domains achieved significant correlation with the corresponding BEHAVE‐AD and CHDS subscales. Cronbach alpha for the overall reliability was 0.84. The false‐negative rates of the screening question were acceptable except for the dysphoria, sleep and appetite domains. The inter‐rater reliability was satisfactory with intraclass correlation coefficient of all subscales above 0.9.

Conclusion

The study demonstrated the applicability of the CNPI in assessing the neuropsychiatric manifestations of dementia in the Chinese community. Copyright © 2001 John Wiley & Sons, Ltd.
Elderly Japanese emigrants to Brazil before World War II: I. clinical profiles based on specific historical background
Authors: Meguro Mitsue , Meguro Kenichi , Caramelli Paulo , Ishizaki Junichi , Ambo Hideo , Chubaci Rosa Y. S. , Hamada Gerson S. , Nitrini Ricardo , Yamadori Atsushi
Published: January 2005

Objective

To research the demographic and clinical profiles of elderly Japanese emigrants, who arrived in Brazil before World War II, in order to give them appropriate psychogeriatric care.

Design

Elderly Japanese immigrants aged 65 years and over, belonging to the Miyagi Association in the São Paulo Metropolitan Area, were targeted. They emigrated from Miyagi Prefecture to Brazil and are now living in the area. We were able to interview 166 respondents. All data were gathered using standardized interview methods covering (a) free interview about the immigration history, (b) demographics, and (c) physical status.

Results

Through the free interview, we found their immigration histories, which affected their clinical profiles. The mean age and educational level were 77.5 years and 6.3 years, respectively. Sixty per cent of them immigrated when they were younger than 14. Ninety‐four per cent of them still keep Japanese nationality. Fifty‐seven per cent of them usually use Japanese, while 10% of them use Portuguese. Although their emigration histories were hard, 76% of them perceived their health as being excellent or relatively good. The percentages of subjects with histories of disease were hypertension, 52.5%; cardiac disease, 20.8%; diabetes mellitus, 24.2%; and hyperlipidemia, 25.0%, which were affected by the Brazilian environment.

Conclusion

The elderly Japanese who emigrated to Brazil before World War II have a unique historical and demographic background. Their clinical profiles cannot be fully understood without knowing their histories. They definitely need high quality international psychogeriatric care. Copyright © 2001 John Wiley & Sons, Ltd.
Training in communication skills for informal carers of people suffering from dementia: a cluster randomized clinical trial comparing a therapist led workshop and a booklet
Authors: Done D. J. , Thomas J. A.
Published: January 2005

The objective of the study was to evaluate whether a short training workshop in communication techniques is more effective than an information booklet for improving communication skills in informal carers of people suffering from dementia. 30 informal carers were allocated to the workshop sessions and 15 to the booklet. Outcome measures included awareness of communication strategies; perceived frequency of communication breakdown at home, and the associated level of distress; general stress; and consumer satisfaction. At six week follow‐up, the workshop group demonstrated a significantly greater awareness of communication strategies than the booklet‐only group. Both groups reported some reduction in the frequency of communication problems at home, and a reduction in the associated level of distress. The frequency of other problem behaviours remained stable. Satisfaction with the workshop indicated that training was helpful but depended on the stage of illness of the partner. Copyright © 2001 John Wiley & Sons, Ltd.
The familywise error rate of a simultaneous confidence band for the incremental net health benefit
Authors: Meisner Morris , Laska Eugene M. , Siegel Carole , Wanderling Joseph
Published: January 2005

Interest in the use of net health benefit in cost‐effectiveness analysis derives from its optimality property for decision‐making. A description of the results of an economic evaluation of health care interventions is incomplete if it does not include point and interval estimates of this outcome measure. A simultaneous confidence band for the incremental net health benefit, INHB(λ), for all λ may be obtained by forming a confidence interval based on student's t statistic, and letting the willingness‐to‐pay value, λ, run over all values. The familywise error rate (FWER) of the simultaneous confidence band is the probability that the confidence interval does not cover the true INHB(λ) for some value of λ. We show that the FWER equals P(T2>t2), where T2 follows Hotelling's central distribution and that the simultaneous confidence band does not cover the true INHB(λ) if and only if a T2 based confidence ellipsoid does not cover the true mean c–e vector. Copyright © 2002 John Wiley & Sons, Ltd.
Decision validity should determine whether a generic or condition‐specific HRQOL measure is used in health care decisions
Authors: Dowie Jack
Published: January 2005

When a HRQOL measure is needed in health care decision making should it be a generic measure (a GEN), intended to cover the entire domain of health, a condition‐specific measure (a CSM) intended to embrace those aspects of health associated with the condition concerned, or both? This paper proposes that it will never be appropriate to use both a CSM and a GEN for the same decision; that a GEN alone will probably be the appropriate measure in the majority of decisions; that a CSM alone will sometimes be appropriate; and that whether it is a GEN alone or a CSM alone that is appropriate depends entirely on the structure of the decision. The argument rests on the distinction between knowledge validity and decision validity. But it has a supplementary basis in rejection of the widespread (but unjustifiable) belief that CSMs are more ‘sensitive’ or ‘responsive’ than GENs and hence can detect ‘small but important changes’ that GENs always or often miss. Copyright © 2002 John Wiley & Sons, Ltd.
The performance of material management in health care organizations
Authors: Dacosta‐Claro Ivan
Published: January 2005

This paper studies the hospital supply chain. The analysis of the operational and financial data of hospital administrative structures has permitted the discovery of the characteristics of work carried out by the employees and the different strategies used by the managers. Firstly, hospital supply chains must be classified into two groups influenced by medical factors (short‐term and long‐term hospitals). Secondly, two different management approaches can be observed when the supply chain operations are analysed. The first approach assigns a larger budget priority to inventory control, packages reception and internal distribution. Thus, the purchasing services have relatively fewer resources. In the second approach, contract negotiation and product ordering processes are enforced by the deployment of, relatively, more personnel. In both cases, the central store service performs merchandise reception and distribution according to the strategies determined by the purchasing service. Copyright © 2002 John Wiley & Sons, Ltd.
Depression and practice guidelines
Authors: Mcintyre John S
Published: January 2005

Over the past two decades there have been great advances in the understanding of depression and in the development of pharmacological agents and psychosocial treatments that have demonstrated efficacy in the treatment of this common and disabling illness. Unfortunately, this knowledge and evidence is not consistently translated into actual treatment, and depression remains undiagnosed in a large percentage of patients, and when it is accurately diagnosed, it often is suboptimally treated.

The frequent failure to properly diagnose depression may be due to the continuing stigma of mental illness, the persistence of the biomedical, rather than the biopsychosocial, paradigm of illness and treatment, educational issues and the time constraints in the typical medical practice. The suboptimal treatment may be due to all of these issues plus the difficulty in changing physician behaviours even when there exists much evidence that would seem to dictate such a change. The development of a criteria‐based nomenclature and the subsequent development and dissemination of evidence‐based practice guidelines addresses some of these issues. Copyright © 2001 John Wiley & Sons, Ltd.
Lack of association between joint hyperlaxity and, I: panic disorder, and II: reactivity to carbon dioxide in healthy volunteers
Authors: Benjamin Jonathan , Ben‐Zion Itzhak Z , Dannon Pinhas , Schreiber Shaul , Meiri Gal , Ofek Andre , Palatnik Alex
Published: January 2005

This study attempted to replicate previous reports of associations between panic disorder and joint hyperlaxity. The authors also examined possible associations between reacitivity to carbon dioxide (CO2), a model for panic vulnerability, and hyperlaxity in healthy volunteers. One hundred and one patients with DSM‐IV panic disorder and 39 healthy volunteers were assessed for hyperlaxity by Beighton's criteria. Healthy volunteers also received two vital capacity inhalations of CO2. Thirteen (13%) patients had five or more hyperlax joints. This rate did not differ from that in the healthy volunteers. Anxiety in healthy volunteers, as measured by the NIMH self‐rating scale, DSM‐IV panic symptom scores, and 100 mm visual analog scales of anxiety, increased after CO2 from a mean of 1.8 to 2.8 (not significant); from 0.5 to 4 ( p < 0.001) and from 8.7 to 11.6 mm ( p < 0.1), respectively. There were no associations between responses to CO2 and hyperlaxity. Copyright © 2001 John Wiley & Sons, Ltd.
Comparative efficacy of zolpidem and temazepam in transient insomnia
Authors: Erman Milton K. , Erwin Charles W. , Gengo Francis M. , Jamieson Andrew O. , Lemmi Helio , Mahowald Mark W. , Regestein Quentin R. , Roth Thomas , Roth‐Schechter Barbara , Scharf Martin B. , Vogel Gerald W. , Walsh James K. , Ware J. Catesby
Published: January 2005

This study compared hypnotic effects of zolpidem 10 mg, temazepam 15 mg and placebo in healthy adults. Two factors expected to promote insomnia, the ‘first night effect’ and a 2‐hour phase advance, were combined in a single night laboratory‐based double‐blinded protocol. This was a multi‐center study, with data collected in 13 sleep laboratories. Subjects with normal sleep histories and without prior sleep laboratory experience were randomly assigned to treatment groups. Medications were administered 15 min before lights out, with polysomnographic monitoring for 7.5 h. Subjective questionnaires and performance tests, digit symbol substitution test (DSST) and symbol copying test (SCT), were administered at study entry and after arising. 630 subjects completed the study and provided data analyzed using repeated measures ANOVAs. Neither agent significantly reduced objective sleep latency relative to placebo. Zolpidem reduced awakenings and wake after sleep onset (WASO); temazepam did not. Both agents improved sleep efficiency and most subjective sleep measures relative to placebo, with zolpidem superior for five of six subjective outcome measures compared to temazepam. SCT, morning sleepiness and morning concentration were not altered by any treatment. Zolpidem significantly reduced morning DSST performance; temazepam did not. Zolpidem 10 mg provided greater subjective hypnotic efficacy than temazepam 15 mg in this model of transient insomnia, with reduced polysomnographic awakenings and WASO. Impairment of DSST was seen with zolpidem but not temazepam. Copyright © 2001 John Wiley & Sons, Ltd.
Sleep laboratory studies in periodic limb movement disorder (PLMD) patients as compared with normals and acute effects of ropinirole
Authors: Saletu M. , Anderer P. , Saletu B. , Hauer C. , Mandl M. , Semler B. , Saletu‐Zyhlarz G.
Published: January 2005

Periodic limb movement disorder (PLMD) occurs in a variety of sleep disorders and can cause insomnia as well as hypersomnia with daytime somnolence. The aim of this study was to investigate 12 untreated PLMD patients as compared with 12 normal controls and to measure the acute effects of 0.5 mg ropinirole (Requip®) – a non‐ergoline dopamine agonist – as compared with placebo. In three nights (adaptation, placebo, ropinirole night) objective and subjective sleep and awakening quality were evaluated. In the target variable ‘periodic leg movements per hour of sleep’ (PLM/hTST) PLMD patients showed an increased value of 42/h (normal 0–5/h) with a greater number of arousals due to periodic leg movements (PLM) in sleep. They further demonstrated an increased number of awakenings, sleep stage S1, S4, stage shifts and decreased S2, but there were no significant differences concerning total sleep time, sleep efficiency (SE), subjective sleep quality and morning measures of mood, drive and drowsiness. However, measures of attention variability, numerical memory, fine motor activity and reaction time performance were impaired. Ropinirole 0.5 mg was shown to significantly improve the index PLM/hTST by 64% and arousals due to PLM, increase spontaneous arousals, REM‐latency, stage 2 and stage shifts and decrease SREM. In the morning attention variability was attenuated and numerical memory augmented. Thus, ropinirole improved some sleep architecture and early morning measures of performance but specifically all PLM variables, which suggests a dopaminergic pathogenesis in PLMD. Copyright © 2001 John Wiley & Sons, Ltd.
Strategies for the rapid treatment of depression
Authors: Miller Frederick E.
Published: January 2005

The purpose of this article is to review current literature relating to the determination of the time course of antidepressant effects. Further, this work explores studies examining the safety and effectiveness of pharmacological techniques for accelerating the therapeutic effects of antidepressant medication. A review of the literature pertaining to strategies for accelerating antidepressant medication effects was accomplished using the MEDLINE database, employing the key title words, antidepressant, rapid, and accelerating. A preponderance of evidence suggests that there is a multiple week latency for the onset of action of antidepressant medications. This latency appears to apply to virtually all standard antidepressants and may reflect slow adaptive changes to the inciting event of increased monoamine levels. Several strategies have received attention as potential strategies with which to accelerate the therapeutic effects of antidepressant medications. These include the use of high initial doses of some agents and also the use of initial augmentation strategies. Specifically, studies exist suggesting the acceleration of antidepressant effects using high initial doses of tricyclic antidepressants or venlafaxine, as well as the potential for acceleration by using initial augmentation with psychostimulants, lithium, or pindolol. Considering the morbidity and mortality associated with severe depression, a critical need exist for the exploration of ways in which to achieve antidepressant effects more quickly. A number of preliminary studies suggest strategies for the rapid treatment of depression, each with an apparent high degree of safety. Further investigations in more carefully defined patient populations and utilizing advances in the techniques for assessing antidepressant onset are needed. Copyright © 2001 John Wiley & Sons, Ltd.
Neuroprotective effects of low‐doses of aspirin
Authors: Persegani C. , Russo P. , Lugaresi E. , Nicolini M. , Torlini M.
Published: January 2005

Aspirin appears to have a neuroprotective role against glutamate excitotoxicity. In fact, recent animal studies have demonstrated the neuroprotective role of acetylsalicylic acid (ASA) against glutamatergic excitants. It has been pointed out that ASA is neuroprotective against hypoxic hypoxia, chemical hypoxia and also delays the decline of intracellular ATP. Prostaglandins may cause convulsions and high‐doses of aspirin appear to protect neurons from excitotoxicity. A case is reported of a woman whose electroencephalogram (EEG) abnormalities reversed and whose psychological symptomatology regressed after treatment with low‐doses of aspirin. This appears to be the first description of a disappearance of EEG abnormalities with low‐doses of aspirin. The neuroprotective effect of ASA could be of extreme importance in metabolic neuronal disfunction, reversing both clinical symptoms and EEG genetic anomalies: it is probably due to transient neurotransmitter concentration disequilibrium caused by subclinical hypoxic cortical suffering. Copyright © 2001 John Wiley & Sons, Ltd.
Glutamate and its role in psychiatric illness
Authors: Belsham Brendan
Published: January 2005

Glutamate, a dicarboxylic amino acid, is the most abundantly active neurotransmitter in the mammalian brain; it is also the principal excitatory neurotransmitter in the cerebral cortex. As our knowledge of this neurotransmitter deepens, it is increasingly being implicated in the pathophysiology of mental illness. This review begins by examining the physiology of glutamate and its receptors. Its role in memory, movement, perception and neuronal development is discussed. The development of the glutamate hypothesis of schizophrenia is traced, and the emerging lines of evidence for attenuated function of the N‐methyl‐D‐aspartate receptor in schizophrenia are examined. For ease of discussion, these are divided into pharmacological, post‐mortem, imaging, platelet and genetic studies. Interactions between glutamate and other neurotransmitters are discussed, as are possible mechanisms by which such altered receptor activity might result in the clinical expression of schizophrenia. The possible role of glutamate in major depression and bipolar disorder is explored. The review concludes by highlighting the importance of avoiding a reductionist approach to the pathophysiology of any mental illness. Copyright © 2001 John Wiley & Sons, Ltd.