bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing Pretend Play in Children with Autism
Authors: Sherratt Dave
Published: November 2003

A classroom-based intervention study aimed to explore whether it was possible to teach children with autism and additional learning difficulties to use symbolic pretend play. Five children with autism were involved in a 4 month intervention that used structure, affect and repetition. The intervention progressively faded out the structuring over three phases. All the children were able to use some symbolic acts within play. The study suggests that some of the symbolic play was not the result of replicating previously modelled examples but was spontaneous and novel.
A Comparison of the Effects of Structured Play and Facilitated Play Approaches on Preschoolers with Autism
Authors: Kok Adrian John , Kong Tan Yew , Bernard-Opitz Vera
Published: November 2003

This study compared the effect of structured play (SP) and facilitated play (FP) in promoting spontaneity and responsiveness in communication and play behaviors in children with autism. SP is characterized by the use of mass practice trials under the instruction of the experimenter while FP incorporated incidental teaching with multiple exemplars. Eight preschoolers participated in a crossover design of both play conditions. Gains in appropriate communication and play were observed across both treatments. Respondent communicative acts occurred more frequently across all participants during SP compared with FP. The preliminary results indicate an interaction between the mental age of the child and the teaching paradigm used. The need to match treatment goals and specific methods of the play intervention to the skill profile of participants is discussed.
Body Mass Index in Male and Female Children with Infantile Autism
Authors: Mouridsen Svend Erik , Rich Bente , Isager Torben
Published: November 2003

Morphometry, the measurement of forms, is an ancient practice. Recently, evidence has grown to support the notion that aberrant neurodevelopment may play a role in the pathophysiology of autism. Is the body, like the brain, affected by abnormal development in these patients? The aim of this study was to evaluate body mass index (BMI) of children with infantile autism, by comparing the BMI of 117 children with infantile autism with the corresponding BMI percentiles in an age- and sex-matched reference population. The BMI distribution of the male, but not female, children with infantile autism was significantly lower than that of the age-matched reference population. There was no evidence that BMI was associated with intelligence or socioeconomic status among children with infantile autism.
Brief Report Prevalence of Autism Spectrum Conditions in Children Aged 5-11 Years in Cambridgeshire, UK
Authors: Scott Fiona J. , Baron-Cohen Simon , Bolton Patrick , Brayne Carol
Published: November 2003

The study aimed to establish prevalence of the broader autistic spectrum, including Asperger syndrome, in 5- to 11-year-olds in Cambridgeshire, UK. Cases of diagnosed autism spectrum condition (ASC) in children who were in Cambridgeshire schools and aged between 5 and 11 years on 31 December 1999 were sought using public records, screening instruments, educational psychology and special educational needs coordinator (SENCO) records. We report a prevalence of ASC in the age group 5-11 years of almost 0.6 percent (57 in 10,000). This is 11 times higher than the rate of classic autism but in line with other recent national and international rates for the broader spectrum. In the responding mainstream schools the prevalence was 0.33 percent. In the responding special school population it was 12.5 percent. The overall sex ratio of the children with ASC replicated findings for classical autism of 4:1 (M:F), but in those children being educated in mainstream schools the sex ratio was 8:1 (M:F).
The Effectiveness of Parent Management Training to Increase Self-Efficacy in Parents of Children with Asperger Syndrome
Authors: Sofronoff Kate , Farbotko Michelle
Published: November 2003

This study was a trial of an intervention programme aimed to improve parental self-efficacy in the management of problem behaviours associated with Asperger syndrome. The intervention was compared across two formats, a 1 day workshop and six individual sessions, and also with a non-intervention control group. The results indicated that, compared with the control group, parents in both intervention groups reported fewer problem behaviours and increased self- efficacy following the interventions, at both 4 weeks and 3 months follow-up. The results also showed a difference in self-efficacy between mothers and fathers, with mothers reporting a significantly greater increase in self-efficacy following intervention than fathers. There was no significant difference between the workshop format and the individual sessions.
Beyond Expectations
Authors: Hillier Ashleigh , Allinson Lesley
Published: November 2003

The ability of high-functioning individuals with autism to understand the complex emotion of embarrassment, and how this relates to an understanding of theory of mind, was investigated. Scenarios involving embarrassing and non-embarrassing situations were presented to a group with autism and three comparison groups. Participants were required to rate the level of embarrassment felt by the protagonist and to justify their choices. The results indicated that those with autism generally gave similar ratings of embarrassment as the comparison groups, but did show significant difficulty with non-embarrassing scenarios, and in providing appropriate justifications for embarrassment. In addition, a significant relationship between scores from false belief tasks and justification scores was found, supporting the proposed link between theory of mind skills and understanding embarrassment. Participants with autism did, however, show a higher than expected understanding of this complex emotion.
Thought-Bubbles Help Children with Autism Acquire an Alternative to a Theory of Mind
Authors: Wellman Henry M. , Baron-Cohen Simon , Caswell Robert , Gomez Juan Carlos , Swettenham John , Toye Eleanor , Lagattuta Kristin
Published: November 2003

Children with autism have specific difficulties understanding complex mental states like thought, belief, and false belief and their effects on behaviour. Such children benefit from focused teaching, where beliefs are likened to photographs-in-the-head. Here two studies, one with seven participants and one with 10, tested a picture- in-the-head strategy for dealing with thoughts and behaviour by teaching children with autism about cartoon thought-bubbles as a device for representing such mental states. This prosthetic device led children with autism to pass not only false belief tests, but also related theory of mind tests. These results confirm earlier findings of the efficacy of picture-in-the-head teaching about mental states, but go further in showing that thought-bubble training more easily extends to children’s understanding of thoughts (not just behaviour) and to enhanced performance on several transfer tasks. Thought-bubbles provide a theoretically interesting as well as an especially easy and effective teaching technique.
Joint Attention and Set-Shifting in Young Children with Autism
Authors: Stahl Laura , Pry Rene
Published: November 2003

Executive function deficits in autism have been consistently found in many studies, using a wide range of measures, but usually involving older children and adults and those of higher IQ. The interpretation of executive function deficits is difficult because the concept itself is poorly defined (inhibition of prepotent responses, set-shifting, action planning etc.). Analyses have focused mainly on the atten-tion participants pay to physical entities (object handling and problem solving) rather than social ones. The present study investigated whether attehfting these two types of attention are linked in autistic development. Fifteen children with autism (mean mental age = 24 months) were compared to 21 normally developing children (mean mental age = 25 months). A strong correlation was found between joint attention and set-shifting in the typically developing children but not those with autism. The results are discussed from a psychopathological perspective on development.
Supporting Families of Preschool Children with Autism
Authors: Whitaker Philip
Published: November 2003

This paper describes a local education authority project to provide support to the families of preschool children with autistic spectrum disorders. As part of an evaluation study, all parents were interviewed when their children entered full-time education and left the service’s caseload. The report outlines key findings regarding levels of satisfaction with the service provided and describes parental responses to the different components of the support offered. All parents rated the input of the support worker as ‘very useful’. Parents particularly valued the following: support to ‘make sense’ of their child’s development and needs; practical strategies for facilitating language and engaging in interactive play; and support to the nurseries and playgroups attended by their children. The interviews also looked at parents’ experience of diagnosis and their needs in the immediate aftermath. Key implications of these findings, and of this model of service delivery, are also discussed.
The Disclosure of a Diagnosis of an Autistic Spectrum Disorder
Authors: Brogan Clare A. , Knussen Christina
Published: November 2003

Satisfaction with disclosure of the diagnosis of an autistic spectrum disorder was investigated using a self-report questionnaire completed by 126 parents. On a rating of satisfaction, 55 percent indicated that they were satisfied or very satisfied with the disclosure. Parents were more likely to be satisfied if they gave positive ratings to the manner of the professional and the quality of the information provided; if they had been given written information and the opportunity to ask questions; and if their early suspicions had been accepted by professionals. These factors were combined into a global index of satisfaction; those gaining higher scores were more likely to have been given the diagnosis of Asperger syndrome (as opposed to autism), to have had a definite diagnosis, and to have children who were not currently in an educational placement. These results underline the importance of the interaction between parent and professional during the disclosure interview.
The Development and Maintenance of Friendship in High-Functioning Children with Autism
Authors: Bauminger Nirit , Shulman Cory
Published: November 2003

The current study investigated mothers’ perceptions of the development of friendship in high-functioning children with autism and in typically developing children. Fourteen mothers in each group (autism, typical) completed the Childhood Friendship Survey regarding their children’s friendships. Main results indicated that both groups (autism and typical) tended to have same-gender and same-age friendships. However, friendships of children with autism differ compared with typical children’s friendships on number of friends, friendship duration, frequency of meetings, and type of activities. Half of the friendships in the autism group were mixed (friendship with a typically developing child). Mixed differed from non-mixed friendships in that mixed pairs met and played mostly at home, whereas non- mixed pairs met and played at school. Factors contributing to the development and formation of friendship in each group are discussed.
What Children with Autism Understand about Thoughts and Thought Bubbles
Authors: Parsons Sarah , Mitchell Peter
Published: November 2003

Children were tested on a series of tasks utilizing the pictorial convention of thought bubbles. In the first study, children with autism (mean verbal mental age 7:6 years) successfully interpreted thought bubbles as representational devices that could be used (a) to infer an unknown reality and (b) to inform them about the content of false beliefs. In the second study, children with autism (mean VMA 5:7 years) and children with non-specific learning disabilities (mean VMA 4:9 years) were tested on two false belief tasks which depicted the content of a protagonist’s belief encapsulated in a thought bubble and two that did not. In both groups, performance was improved in the ‘bubble condition’. It appears that at least some children with autism are capable of understanding thought bubbles as representational devices.
A Gluten-Free Diet as an Intervention for Autism and Associated Spectrum Disorders: Preliminary Findings
Authors: Whiteley Paul , Rodgers Jacqui , Savery Dawn , Shattock Paul
Published: November 2003

The opioid-excess hypothesis of autism suggests that autism is the consequence of the incomplete breakdown and excessive absorption of peptides with opioid activity (derived from foods which contain gluten and casein), causing disruption to biochemical and neuroregulatory processes. Biochemical evidence has indicated the presence of increased levels of peptides in the urine of people with autism, and previous behavioural studies have demonstrated a connection between the long term exclusion of gluten and casein from the diet and improvements in the behaviour of some children with autism. The introduction of a gluten-free diet to children with autism and associated spectrum disorders ( n 5 22) was monitored over a 5 month period using a battery of parental and teacher interview/questionnaire sessions, observation reports, psychometric tests and urinary profiling. Results suggested that participants on a gluten-free diet showed an improvement on a number of behavioural measures. However there was no significant decrease in specific urinary compounds excreted when compared with controls and a gluten challenge group.
Executive Function/Attention Deficits in Boys with Asperger Syndrome, Attention Disorder and Reading/Writing Disorder
Authors: Nydén Agneta , Gillberg Christopher , Hjelmquist Erland , Heiman Mikael
Published: November 2003

Executive function/attention deficits were examined in children with Asperger syndrome, attention disorder and reading/ writing disorder and in a group of normal children. Neuropsychological tests as well as cognitive tasks measuring different components in the processing of information were used. The measures were divided into Mirsky’s four components of attention, namely ‘sustain’,‘focus-execute’,‘shift’ and ‘encode’. All abnormal groups differed markedly from the normal group on measures of executive function/attention. The group diagnosed as having attention disorder showed the most consistent difficulties. However, no specific marker of ‘executive function deficits’ that could represent the three different disorders was found.
Adolescents with Asperger Syndrome
Authors: Stoddart Kevin P.
Published: November 2003

Clinicians in the field of autism are increasingly identifying individuals with Asperger syndrome. Individual and family therapy for individuals with this condition has received little attention in the literature. This article presents three case examples of individual and family therapy with male adolescents diagnosed with Asperger syndrome. Common presenting issues and treatment interventions are summarized that may apply to others diagnosed with this condition.
The Experience of Parents in the Diagnosis of Autism
Authors: Midence Kenny , O’neill Meena
Published: November 2003

Research literature on experiences of parents seeking a diagnosis of autism for their child is scarce. In order to explore this, a pilot study was conducted with four parents of children with autism in North Wales. Semi-structured interviews were conducted to elicit parents’ experiences, and the responses analysed using a grounded theory approach. Six core categories emerged. These included parents’ difficulties in understanding their child’s behaviours and the confusion that resulted from their inability to make sense of these behaviours, and problems in obtaining a diagnosis. The findings also reflect parents’ experience of relief after the correct diagnosis was made. This appeared to enable them to understand and accept autism and the limitations imposed on their child; to improve adaptation to the condition within the family life; and to foster more realistic expectations of their child’s future.
Neuropsychological Profiles of Children with Asperger Syndrome and Autism
Authors: Manjiviona Janine , Prior Margot
Published: November 2003

This study examined the possibility that diagnostic differentiation between children with autism and Asperger syndrome may be enhanced through the use of neuropsychological profiles. Two groups of children, clinically diagnosed as having Asperger syndrome ( n35) or autism ( n21), were tested with a neuropsychological battery to assess the propositions that these groups might differ in terms of Wechsler IQ profiles, brain hemispheric strengths and weaknesses, and executive functioning. Clinically diagnosed children with Asperger syndrome and autism were not differentiated on the basis of their neuropsychological profiles. The major difference between them was the overall higher IQ in Asperger syndrome, which was largely due to superior verbal abilities. Differences were also examined using DSM-IV/ICD-10 criteria: children were grouped according to the early history of presence or absence of language delay. No differences between the groups on any neurocognitive measure were found and there was no support for current neuropsychological theories purporting to support differential diagnostic status. It appears that current diagnostic differentiation in clinical practice may be primarily influenced by the child’s estimated verbal IQ level.
A Brief Clinical Scale for the Early Evaluation of Imitation Disorders in Autism
Authors: Malvy Joëlle , Roux Sylvie , Zakian Alain , Debuly Sabine , Sauvage Dominique , Barthélémy Catherine
Published: November 2003

Many authors have described a deficit of imitation of gestures and of symbolic and affective tasks in infants and young children with autism. This deficit is paradoxically associated with echolalia (atypical verbal imitation) and echopraxia (atypical gesture imitation) which in themselves appear to be excessive imitation. We have developed a brief clinical scale, the Imitation Disorders Evaluation scale (IDE scale), to evaluate these different early features of imitation disorders in autism. The present article reports (1) the validation study (inter- rater reliability, factor analysis) of the IDE scale carried out with a population of 30 infants and young children with autism aged from 10 to 46 months, and (2) the results of a follow-up study in which this scale was applied to a group of young children with autism (from 30 to 46 months) over 9 months’ treatment. Factor analysis provided two factors: factor 1, called ‘deficient imitation’, comprising six items describing a deficit of facial, gestural, vocal and affective imitation; and factor 2, called ‘atypical imitation’, including echolalia, echopraxia and variability of imitation. The descriptive results of the follow-up study emphasize the sensitivity of the IDE scale for assessment of improvement in imitation disorders of early autism.
Contrasting Styles of Drawing in Gifted Individuals with Autism
Authors: Cox Maureen , Eames Kate
Published: November 2003

The drawings of two artistically gifted young people with autism (BX and CZ) were compared and related to their cognitive profiles. BX is more typical of other cases of autistic savants in his choice of non-human subject matter and linear style of drawing and also in his cognitive profile. CZ is unusual in drawing the human face and in concentrating on the drawing technique of tonal contrasts; her cognitive profile is also atypical. The article highlights individual differences within the autistic savant population.
Evaluating Practice
Authors: Jordan Rita
Published: November 2003

This article seeks to examine some of the issues involved in the evaluation of practice by practitioners themselves. Five questions are posed which represent five different kinds of design suitable for the different purposes of evaluation in each case. For each question, an analysis is made of the problem that the question is addressing, an example is given of the design needed to answer that question, and a further analysis is made of the possible outcomes of the evaluation, suggesting how they may be interpreted. Finally, there is a brief discussion of the issues involved in controlled studies, the ethical issues that arise in research and how participants with autism spectrum disorders may themselves by involved in evaluation. The article makes the point that research should not be an activity carried out by others, using natural settings merely as sources of data, but a process that all practitioners are engaged in at some level. In this way, progress can be made in improving services and the quality of life for people with autism spectrum disorders.
“We're all Keynesians Now”?
Authors: Barker David C. , Muraca Stephanie T.
Published: November 2003

This article examines mass attitudes toward budget deficits. First, we develop a new measure of budgetary policy preference that is not contaminated by philosophical and symbolic attitudes toward government spending. We then predict public attitudes toward the federal budget from the way partisan intensity interacts with egocentric and sociotropic perceptions of economic well-being. Empirical tests support our predictions that although Republicans are consistently supportive of maintaining budgetary balance, this orientation toward thrift intensifies as perceptions of the national economy worsen. Democrats are more difficult to predict, but they generally appear to demand budgetary restraint when they perceive that the economy is performing well, although tolerating deficits during perceived periods of economic recession—in classic Keynesian fashion. Finally, it appears that Republicans are more driven by pocketbook concerns than Democrats: When times get “tight,” Republicans appear less committed to governmental frugality than when wallets are heavy.
The Disability Discrimination Act 1995: implications for psychiatrists
Authors: Sayce Liz , Boardman Jed
Published: November 2003

The Disability Discrimination Act, passed by Parliament in 1995, is an important piece of legislation with the potential to protect the employment rights of people with disabilities. It covers people with physical or mental impairments that have a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. The Act has sections regarding protection from discrimination in employment, in the provision of goods, services and facilities, and in education. These parts of the Act have implications for people working in mental health services when they are considering employment and educational opportunities for service users.
Psychotropic medication and the heart
Authors: O'Brien Patrick , Oyebode Femi
Published: November 2003

Psychotropic literature in recent years has become very concerned with the cardiac safety of certain psychotropic medication. This paper reviews some of the cardiac factors to be considered in the safer selection of psychotropic drugs for the vulnerable patient in everyday clinical practice.
Dementia and literature
Authors: Vassilas Christopher A.
Published: November 2003

As we doctors are beginning to understand more and more about dementia, the public has become increasingly aware of the condition and in turn this has been reflected in the arts. This article discusses four books whose main focus is the experience of dementia, each written from an entirely different perspective: a novel giving a first-person account of dementia by the Dutch writer J. Bernlef; a biography of the famous novelist Iris Murdoch by her husband John Bayley; Linda Grant's account of her mother's multi-infarct dementia (which also describes Jewish migration to the UK two generations ago); and Michael Igniateff's autobiographical novel Scar Tissue. Such accounts, offering insights into how patients and carers feel, cannot but help make us better doctors.
Predictors of efficacy in depression prevention programmes
Authors: Jané-Llopis Eva , Hosman Clemens , Jenkins Rachel , Anderson Peter
Published: November 2003

Background

Worldwide, 340 million people are affected by depression, with high comorbid, social and economic costs.

Aims

To identify potential predictors of effect in prevention programmes.

Method

A meta-analysis was made of 69 programmes to reduce depression or depressive symptoms.

Results

The weighted mean effect size of 0.22 was effective for different age groups and different levels of risk, and in reducing risk factors and depressive or psychiatric symptoms. Programmes with larger effect sizes were multi-component, included competence techniques, had more than eight sessions, had sessions 60–90 min long, had a high quality of research design and were delivered by a health care provider in targeted programmes. Older people benefited from social support, whereas behavioural methods were detrimental.

Conclusions

An 11% improvement in depressive symptoms can be achieved through prevention programmes. Single trial evaluations should ensure high quality of the research design and detailed reporting of results and potential predictors.
Describing, explaining or predicting mental health care costs: a guide to regression models
Authors: Dunn Graham , Mirandola Massimo , Amaddeo Francesco , Tansella Michele
Published: November 2003

Background

Analysis of the patterns of variation in health care costs and the determinants of these costs (including treatment differences) is an increasingly important aspect of research into the performance of mental health services.

Aims

To encourage both investigators of the variation in health care costs and the consumers of their investigations to think more critically about the precise aims of these investigations and the choice of statistical methods appropriate to achieve them.

Method

We briefly describe examples of regression models that might be of use in the prediction of mental health costs and how one might choose which one to use for a particular research project.

Conclusions

If the investigators are primarily interested in explanatory mechanisms then they should seriously consider generalised linear models (but with careful attention being paid to the appropriate error distribution). Further insight is likely to be gained through the use of two-part models. For prediction we recommend regression on raw costs using ordinary least-square methods. Whatever method is used, investigators should consider how robust their methods might be to incorrect distributional assumptions (particularly in small samples) and they should not automatically assume that methods such as bootstrapping will allow them to ignore these problems.
Chromosome 22q11 deletions, velo-cardio-facial syndrome and early-onset psychosis
Authors: Ivanov D. , Kirov G. , Norton N. , Williams H. J. , Williams N. M. , Nikolov I. , Tzwetkova R. , Stambolova S. M. , Murphy K. C. , Toncheva D. , Thapar A. , O'Donovan M. C. , Owen M. J.
Published: November 2003

Background

Velo-cardio-facial syndrome (VCFS) is associated with interstitial deletions of chromosome 22q11. About 30% of patients with VCFS have psychosis, and the rate of these deletions in schizophrenia has been reported to be about 1%. Even higher rates of VCFS deletions have been reported for childhood-onset schizophrenia.

Aims

To test the hypothesis that there is an increased rate of VCFS among patients with early-onset psychosis (age at onset < 18 years). We screened 192 early-onset patients and 329 patients with adult-onset schizophrenia.

Method

We genotyped the patients and 444 healthy controls for hemizygosity of five microsatellite markers and one single nucleotide polymorphism that map to the 22q11-deleted region.

Results

One patient had a VCFS deletion, confirmed with semi-quantitative polymerase chain reaction. None of the controls showed a pattern of genotypes consistent with hemizygosity.

Conclusions

VCFS may be less frequent among patients with psychosis than previously suggested; this rate is not increased among early-onset patients.
Size of hippocampal pyramidal neurons in schizophrenia
Authors: Highley J. R. , Walker M. A. , McDonald B. , Crow T. J. , Esiri M. M.
Published: November 2003

Background

Meta-analyses of hippocampal size have indicated that this structure is smaller in schizophrenia. This could reflect a reduction in the size of constituent neurons or a reduced number of neurons.

Aims

To measure the size of hippocampal pyramidal neurons in the brains of people with and without schizophrenia.

Method

Pyramidal neuron size in hippocampal subfields was estimated stereologically from sections taken at 5 mm intervals throughout the whole length of right and left hippocampi from the brains of 13 people with schizophrenia and 16 controls. Results were assessed using repeated-measures analysis of covariance looking for a main effect of diagnosis and gender, and interactions of these with side.

Results

We were unable to detect significant differences related to diagnosis, gender or side for any hippocampal subfield for this series of cases.

Conclusions

For this series of brains, hippocampal cell size is unchanged in schizophrenia.
Cognitive–behavioural therapy and motivational intervention for schizophrenia and substance misuse
Authors: Haddock Gillian , Barrowclough Christine , Tarrier Nicholas , Moring Jan , O'Brien Robert , Schofield Nichola , Quinn Joanne , Palmer Steven , Davies Linda , Lowens Ian , McGovern John , Lewis Shôn
Published: November 2003

Background

Comorbid substance misuse in people with schizophrenia is associated with poor clinical and social outcomes. There are few studies of psychological treatments for this population and little long-term follow-up of their benefits.

Aims

To investigate symptom, substance use, functioning and health economy outcomes for patients with schizophrenia and their carers 18 months after a cognitive–behavioural treatment (CBT) programme.

Method

Patients with dual diagnosis from a randomised controlled trial of motivational intervention, individual CBT and family intervention were assessed on multiple outcomes at 18-month follow-up. Carers were assessed on symptom, functioning and needs over 12 months. Health economy data were collected over 18 months.

Results

There were significant improvements in patient functioning compared with routine care over 18 months. No significant differences between treatment groups were found in carer or cost outcomes.

Conclusions

The treatment programme was superior to routine care on outcomes relating to illness and service use, and the cost was comparable to the control treatment.
Assessing the value of assertive outreach
Authors: Weaver Tim , Tyrer Peter , Ritchie Jane , Renton Adrian
Published: November 2003

Background

It is unclear why intensive case management (ICM) failed to reduce hospitalisation in the UK700 trial.

Aims

To investigate outcome generation in the UK700 trial.

Method

A qualitative investigation was undertaken in one UK700 centre.

Results

Both intensive and standard case management practised individual casework, employed assertive outreach with comparable frequency, and performed similarly in the out-patient management of emergencies and inpatient discharge. However, ICM was advantaged in managing some noncompliance and undertaking casework that prevented psychiatric emergencies. Absence of team-based management and bureaucratised access to social care limited the impact of these differences on outcomes and the effective practice of assertive outreach, although this was relevant to only a sub-population of patients.

Conclusions

The impact of ICM was undermined by organisational factors. Sensitive anticipatory casework, which prevents psychiatric emergencies, may make ICM more effective than an exclusive focus on assertive outreach. Our findings demonstrate the value of qualitative research in evaluating complex interventions.
Collaborative research between users and professionals: peaks and pitfalls
Authors: Rose Diana
Published: November 2003

In this article, I shall give an overview of the emerging field of collaborative research between clinical academics and service users in the field of mental health, along with some examples of different kinds of collaborative research and the value they can bring to more mainstream studies. I shall also discuss some of the obstacles to collaborative research in mental health and suggest directions for the future.
Reasons for consultation in the psychiatric out-patient clinic of a university teaching hospital in Nigeria: is this optimal use of psychiatrists' time and expertise?
Authors: Omigbodun Olayinka , Esan Oluyomi
Published: November 2003

Aims and Method

To identify activities that can be modified in the psychiatry out-patient clinic in order to improve the quality of services rendered. Consulting doctors obtained information on the reason for consultation and time spent by each patient over a one-month period.

Results

Half of all the patients (50.5%) came for a repeat prescription, and 19.3% came for a repeat prescription and counselling. The mean times spent on these two activities were 5.13 (s.d.=2.5) and 7.81 (s.d.=7.51) minutes, respectively. The time spent on these activities by doctors was 47% of the total clinic time.

Clinical Implications

Clinic services should be reorganised so that doctors can use their skills in more efficient and creative ways.
A survey of monitoring of weight and blood glucose in in-patients
Authors: Boilson Marie , Hamilton Ross J.
Published: November 2003

Aims and Method

The aim of this survey was to look at current practice in monitoring weight and glucose control in in-patients being prescribed antipsychotic medications. Records for 51 patients admitted with psychotic illnesses to a large teaching hospital during a 3-month interval were surveyed.

Results

Fifty-five per cent of patients had no record of weight taken on admission to hospital. Only one patient had their weight repeated during the admission. Forty-nine per cent of patients had random blood glucose checked on admission. No fasting levels were performed.

Clinical Implications

Weight gain and hyperglycaemia associated with antipsychotic prescription are well-recognised side-effects. These results suggest that standardisation of weight measurement and blood glucose monitoring is required.
Using film and literature for cultural competence training
Authors: Bhugra Dinesh
Published: November 2003

Through novels and films, we learn about different portrayals of cultural norms and culture conflicts in different parts of the world. A basic tenet of training in cultural competence is that people become aware of the differences and similarities across cultures, allowing them to be more conscious of their own cultural world view, and also better able to deal with any differences and to learn from them. Reading novels and seeing films can help to develop trainees' humanism and capacity for understanding and so facilitate their learning about cultural competence (Fritz & Poe, 1979). One drawback of using films in this way is that the dramatic points in the stories may hinge on social stereotypes. For example, in several recent Hollywood blockbusters the British characters were portrayed as butlers, buffoons or villains using their accent and caricatured appearance to emphasise differences.
Rockets, Ion Propulsion
Authors: Molitor Jerome H. , Beattie J.R.
Published: October 2003

Electric propulsion, the propelling of space vehicles by streams of electrically charged and electrically accelerated particles, is one of the most exciting concepts of the space adventure. It represents a fascinating area of applied science and technology, and it also provides the only feasible means of exploring the farthest reaches of our solar system by economically transporting large manned expeditions and heavy payloads to neighboring planets and probing the solar system away from the ecliptic plane.

The concept of the ion rocket engine (the most useful form of electric propulsion for space missions) has existed for some time. However, the concept had to remain of only academic interest until the advent of the space age, and, particularly, until generating large amounts of electric power in space became a physical possibility. When solar–electric power source technology was established, the latter requirements, of course, became fulfilled.

In general, an electric propulsion system has a power plant that consists of an energy source and a means of converting this energy into electrical energy and a propulsion device that converts the electrical energy into directed kinetic energy of its propellant. The two major problem areas of electric propulsion are (1) the development of sources of electrical energy that are sufficiently lightweight and (2) the transfer of this energy to the propellant to provide high exhaust velocities efficiently. The first problem, along with the general need for power in space, has given strong impetus to fundamental and applied work in developing lightweight solar panels. These areas of research and development have been vital to the future of electric propulsion and obviously have impacted many other important satellite and spacecraft applications. A solution to the second problem, an efficient propulsion device, is the subject of this article. Generic types are discussed. The electron‐bombardment ion thruster is the most mature and the most tested and is a major focus of this article. A sampling of results from space missions are reviewed.
Science from Sounding Rockets
Authors: Gursky Herbert
Published: October 2003

This article plots the history of the use of sounding rockets for scientific purposes. Science and rockets came together in the twentieth century. Major discoveries were made at the beginning of the century relating to high‐altitude phenomena; specifically, the stratosphere, which demonstrated that the atmosphere was structured; cosmic rays, which were energetic radiation originating high in the atmosphere; and the long range transmission of radio waves that revealed the existence of a conducting layer in the atmosphere at high altitude. These and other advances led to pressure from the science community to perfect the means for increasingly sophisticated experiments at high altitude. Meanwhile, three extraordinarily talented physicists—Konstantin Tsiolkovsky in Russia, Hermann Oberth in German, and Robert Goddard in the United States—established the theoretical and technical basis for rockets. Unfortunately, it took a war and the search for an ultimate weapon by the Nazis to bring this all together in the development of the V‐2 rocket by Dornberger and his team at Peenemunde. After World War II, scientists in the United States capitalized on the captured inventory of German rockets to conduct a variety of scientific observations and to develop rockets of their own, which formed the basis for the space science program in the United States and elsewhere. These events and current use are discribed.
Space Programs Related to National Security
Authors: Naka F. Robert
Published: October 2003

The use of observation payloads on Earth‐circling spacecraft, or satellites, was considered by U.S. military services as early as 1946. An early report suggested that communications could be relayed from a low‐altitude Earth‐orbiting satellite. This was a decade before the launch of Sputnik.

The use of spacecraft for reconnaissance would be a useful adjunct and, in many instances, a replacement for the use of aircraft that had been employed since World War I. More importantly, spacecraft payloads would provide a less intrusive way to make observations over “denied” territory.

Today, military services use spacecraft for communications, navigation, and meteorology for military operations, in a manner similar to their civilian counterparts support to the military forces are detected. In addition, military forces use spacecraft for detecting explosions and launching of rockets and aircraft and for earth observations through imagery and signals intelligence collection. Imagery can provide information on a target before a military strike and bomb damage assessment afterward. Electromagnetic intelligence (ELINT) provides the location and type of radar that indicates whether the radar should be targeted or should be avoided during a mission. The technical details of military spacecraft and their operations are kept secret. This is in contrast to civil and commercial spacecraft and their operations for which information is available to the public on request. The purpose of secrecy is obvious: military movements and information on which they are based should be hidden from enemy, or potential enemy, forces. In addition, the details of these spacecraft and the operations that collect “intelligence” information are also classified.

After World War II, both the Navy and the Air Force began to conduct research and development on space programs. This describes these space programs roughly in the order in which full scale development was authorized.
Sputunik 1: The First Artificial Earth Satellite
Authors: Chertok Boris
Published: October 2003

Humanity's leap into space was one of the greatest scientific achievements of the twentieth century. However, one of the ironies of history is that this great scientific and engineering achievement was largely facilitated by the Cold War between the two superpowers, the United States and the Soviet Union.

In the late 1950s, the United States held a significant advantage over the Soviet Union in number of nuclear warheads and capability to eliminate the most important strategic facilities on its enemy's territory. Although the Soviet Union already had nuclear weapons, it did not have second‐strike capability because it did not have any delivery vehicles capable of delivering warheads to U.S. territory. The senior political leadership of the Soviet Union assigned its missile science and industry a task of “special governmental importance”–development of a ballistic missile that could render the United States vulnerable.

The early experimental intercontinental ballistic missiles developed by Soviet scientists and engineers were used to place the first artificial Earth satellites into orbit. Thus, the history behind the development and launching of the first satellite into orbit is primarily the story of a missile that became a launch vehicle for a satellite rather than a missile carrying a weapon of mass destruction.

This article describes in detail the first Sputunik project from design, testing, and launch in Oct. 1957.
Jupiter
Authors: Dowling Timothy E.
Published: October 2003

Jupiter is instantly recognizable by its bands of clouds and its large, ruddy eye, the Great Red Spot.

Jupiter is the largest planet in the solar system and has more mass than all of the other planets combined, raging storms that last for decades and longer, 16 moons, the largest bigger than Mercury, and a magnetosphere so vast it would appear as big as the full Moon in the sky—Saturn routinely passes through Jupiter's magnetotail. It is an extremely common planet type. For example, it is likely that many solar systems have a dominant gas giant planet whose orbital radius is in the neighborhood of the “snow line,” the approximately 5 AU distance from a protosun where the temperature in the protoplanetary nebula drops to the point that ice becomes stable. Its position makes Jupiter the protector of the inner solar system. Because Jupiter contains most of the solar system's planetary mass, accurate observations of its composition, in particular, the hydrogen‐to‐helium ratio and the precise abundances of elements heavier than helium, are crucial to the success of solar‐system formation models and serve as a springboard for cosmochemistry. Jupiter is the case study for all gas giants, including Saturn, Uranus, Neptune, and the nearly 100 extrasolar gas giants discovered to date. The meteorology that shapes the planet's appearance is more predictable than Earth's weather. Studying the differences and similarities has led to a better understanding of atmospheric dynamics and chemistry in general. Jupiter's magnetosphere is second only to the Sun's; it has an active aurora and strong interactions with its satellites and the solar wind. It is expected that someday a high‐order spherical harmonic mapping of the magnetosphere will be used to probe the planet's interior structure. Finally, because Jupiter is the closest gas giant to Earth, it is the easiest to observe, and because every probe headed for the outer solar system uses Jupiter for a gravity assist, it has had the largest number of close encounters with spacecraft, such that every investigation of the Jovian system is leveraged by its many predecessors. Details from the Galileo probe are given as well as results of other observations of Jupiter. The satellites are discussed (so, Ganymede, Callisto, and Europa in detail). The rings and dust are studied.
Spacecraft Guidance, Navigation and Control Systems
Authors: Brown Jon H.
Published: October 2003

The difficulties in maneuvering a vehicle through space are not intuitively obvious to someone who has not been involved in the field.

The finite limits of electrical energy, thrust, and propellant on a vehicle are the driving forces that demand efficient and accurate equipment to perform the functions of steering and navigation and keep the vehicle attitude stabilized. Added to these restrictions are the needs for minimum volume and mass. An intricate system results that is extremely difficult to design, construct, and test and usually is one of the most expensive on the vehicle.

Guidanceis the actual steering of the vehicle as it travels through space. Guidance commands may originate from a crew onboard, from an onboard computer, or from external sources via radio commands. In addition, if the thrust of a space vehicle is variable and controllable, the command for modulating the thrust is usually a guidance function.

Navigationis the measurement of the location of the vehicle in space and plotting the course of the vehicle. Navigational fixes may come from onboard human sightings using telescopes and sextants, from automatic onboard star or horizon sensors, or from radio/radar tracking equipment on the ground.

Controlrefers to the spatial alignment and stabilization of the vehicle while the guidance and navigation functions are being performed, and includes onboard processing and routing of commands to the devices (typically thrusters, reaction wheels, control moment gyroscopes, or aerodynamic surfaces), termedeffectors, that produce reactive forces on the vehicle.

The combination of these three functions into one system results in theintegrated guidance, navigation, and control system, or simply the GN&C system. This article discusses each of these systems. It also gives information on permutation, integration verification, and the flight computer.
Evolution ofU.S.Expendable Launch Vehicles
Authors: Yarymovych Michael I. , Mark Hans
Published: October 2003

Robert H. Goddard was a Professor of Physics at Clark University in Worcester, Massachusetts from 1919 to 1945. During this time he performed his classic experiments in liquid‐fueled rocketry. This article gives the history of Goddard's discoveries and the rising interest at in rockets in Germany at that time. Details are given on the V‐2 Rocket team that Wernher von Braun developed in Germany and what happened to this team after World War II.

In 1946 the U.S. embarked on a vigorous program to develop large liquid‐fuled rockets for military reasons. Von Braun joined the U.S. Army rocket development program in 1950. Later the U.S. Air Force became involved in rocket development. The Air Force established the Western Development Division, which was given the job of developing three missile systems: two intercontinental ballistic missiles (Atlas and Titan); and one intermediate range ballistic missile (Thor). Development of these missiles is discussed. The Evolved Expendable Launch Vehicle Program (EELV) concept is detailed. The EELV was developed to reduce the cost of access to space. The Delta IV launch vehicle was developed under EELV, as was the Atlas V.