bluuebunny/crossref_metadata_2025 huggingface dataset:
The Fictional Autobiographical Pact: Dunstan Ramsay's Poetic Autobiography of Magnus Eisengrim
Authors: Braz Albert
Published: December 2009

Robertson Davies is not usually perceived as a radical writer, either politically or stylistically, but he is subversive in the way he privileged fiction over non-fiction. At a time when the factual and the fictive tend to be conflated into amorphous ‘narrative,’ Davies insists on a distinction between the two, favouring the imaginative over the archival. In the Deptford Trilogy he has Dunstan Ramsay ghostwrite the Phantasmata: The Life and Adventures of Magnus Eisengrim, violating the central tenet of life-writing, that author and narrator must be identical in autobiography. Through Ramsay, Davies makes the case that, despite its obvious deviations from the historical record, this ‘poetic’ autobiography of Eisengrim captures the magician's essence in a way that is truer than a more ‘factual’ life.
Coupling atomistic accuracy with continuum effectivity for predictive simulations in materials research – the Quasicontinuum Method
Authors: Eidel Bernhard
Published: December 2009

In this article we present a comparative analysis of different versions of the quasicontinuum method, which aim at a seamless transition from the atomistic to the continuum description of crystalline solids at zero temperature. All versions of this popular and powerful method exhibit the same building blocks, namely (i) a coarse-graining of fully atomistic resolution via kinematic constraints, (ii) an approximation of the energy/forces in coarse-grained regions via numerical quadrature and (iii) adaptive mesh refinement. The quasicontinuum versions are assessed in an example where a Lomer dislocation dipole is subject to shear deformation. In a second example, the fully nonlocal quasicontinuum method is used to simulate nanoindentation into an fcc single crystal. Compared with lattice statics good agreement is achieved with respect to significant details of the material behaviour for a small fraction of the computational costs.
Increasing Rail Demand by Improving Multimodal Information and Ticketing
Authors: Sauter-Servaes Thomas , Nash Andrew
Published: December 2009

Long-distance railway transport is more energy efficient and generates fewer environmental impacts than air and automobile travel. One strategy for increasing rail use is to introduce high-speed rail systems and other railway improvements; however, even with these capital improvements, rail travel may take too long for certain trips. Therefore, another strategy is to increase the use of rail for at least part of a trip (e.g., by replacing a short flight), which could be done by improving intermodal connections (e.g., flight-to-train connections at airports) or by using rail on the outbound trip and air on the return trip (or vice versa). In 2005, CityNightLine, a European night train operator, and Swiss International Air Lines developed a product that combined a night train trip with a flight. This product provided an ideal opportunity to evaluate the socio-institutional barriers to intermodal journeys by eliminating the mid-journey physical transfer present in other air–rail trips. The research surveyed users and nonusers to evaluate the socioinstitutional barriers to intermodal transport using a new product adoption structure. The research found that an effective Internet-based multimodal transport information and reservation system is needed to successfully increase rail travel. This system should provide accurate and complete information about all travel alternatives in a simple package and should enable customers to purchase a single ticket for the entire trip (including local public transport).
The Use of Locking Plates for Greater Trochanteric Fixation
Authors: McGrory Brian J. , Lucas Romeo
Published: December 2009

Stable fixation for healing of the greater trochanter after fracture or osteotomy is difficult to achieve, especially when associated with periprosthetic osteolysis. Wiring techniques are cumbersome and cable grip fixation has an unacceptable rate of non-union, cable fraying, and production/migration of third-body debris. Using 4 case examples, we present a novel and straightforward locking plate technique that we currently use to achieve such fixation. This method also allows placement of bulk allograft that may restore trochanteric bone stock in cases of marked osteolysis. The technique uses implants that are readily available, and can be employed not only in fixation of trochanteric osteotomy but also in trochanteric advancement. At a minimum of 20 months follow-up, healing of the fracture or osteotomy with full abductor function and a significant improvement in hip score was observed in each of the 4 patients. We acknowledge that biomechanical and larger clinical studies are necessary to confirm the success of this technique, but we are pleased with our preliminary findings and continue to use this approach.
Perfil epidemiológico das vítimas atendidas na emergência com intoxicação por agrotóxicos - DOI: 10.4025/cienccuidsaude.v7i3.6480
Authors: Lima Maria Alzete , Bezerra Eveline Pinheiro , Andrade Luciene Miranda , Caetano Joselany Afio , Miranda Maira Di Ciero
Published: December 2009

Com o presente estudo objetivou-se investigar o perfil das vítimas de intoxicação exógena por agrotóxico em um hospital de emergência. Trata-se de um estudo quantitativo, descritivo e retrospectivo, tendo como amostra 388 vítimas de intoxicação exógena no ano de 2005, em Fortaleza, Ceará. Os dados foram coletados a partir de uma ficha de investigação do CEATOX da instituição. Do total observado, 196 (50,5%) eram do sexo feminino, a faixa etária predominante foi de 15 a 24 anos, com 157 (40,5%) vítimas, e a maioria era procedente da capital (69,3%). O principal motivo da intoxicação foi tentativa de suicídio (77,3%), e a grande maioria dos episódios ocorreu no domicílio (83,5%) e 42% dos casos, até o término dos levantamentos, haviam saído de alta por cura. Diante dos resultados, foi possível perceber a necessidade de elaborar políticas de promoção da saúde para a prevenção das intoxicações, assim como estratégias capazes de dificultar a aquisição dos agrotóxicos.
Advancement in HCC imaging: diagnosis, staging and treatment efficacy assessments
Authors: Choi Byung Ihn , Lee Jeong Min
Published: December 2009

Diagnostic confirmation and assessment of disease extent are crucial for proper management of patients with hepatocellular carcinoma (HCC). Imaging studies play a crucial role in the diagnosis and staging of HCC. The imaging techniques commonly used for the diagnosis of HCC include ultrasound, computed tomography, and magnetic resonance imaging. Currently, improvements in imaging technology make a noninvasive and reliable diagnostic assessment of hepatocellular nodules possible in the cirrhotic liver. Biopsy is infrequently required prior to treatment, and the diagnosis of HCC is strongly dependent on hemodynamic features (arterial hypervascularity and washout in the venous phase) on dynamic imaging. Accurate staging of HCC is important in determining prognosis and in deciding optimal treatment for each patient. In addition, although there is a strong demand for an accurate diagnostic tool to detect smaller tumors, until now, the major challenge for radiologists in imaging cirrhosis is the characterization of small hepatocellular nodules in the cirrhotic liver. Further improvement of imaging technologies including functional imaging such as elastography, perfusion imaging and diffusion imaging, and development of new contrast media will undoubtedly improve the detection and characterization of small tumors. In this article, we present a summary of the most recent information on the diagnosis and staging of HCC.
Emulsion Properties and Phase Equilibrium and of New Asymmetric Gemini Surfactants Consisting of Fatty Acid Esters of Polyethoxylated Alcohol or Phenol
Authors: Nowicki Janusz
Published: December 2009

The emulsion and phase properties of water‐surfactant systems are reported for nonionic surface active compounds of the asymmetrical gemini type resulting from the esterification of a polyethoxylated alcohol and a fatty acid. These products exhibit typical gemini surfactant properties, in particular, low critical micelle concentration (CMC) and good emulsifying properties, and they often form a gel depending on the temperature and concentration.
The Problems of Gelatine and Prescribing Urologically Specific Medication to a Diverse Population in the UK. An Initial Study
Authors: Warburton Hazel E. , Payne Mark S. , Payne Stephen R.
Published: December 2009

Introduction:

Gelatine is a setting agent used by the food and drug industries whose consumption is forbidden by religious and other faith groups. Gelatine-containing drugs are found in most of the drug classifications in Section 7.4 of the British National Formulary (BNF). We investigate the issues and seek to provide a solution to the use of gelatine-containing medications in urology.

Methods:

Forty representative urological practitioners were surveyed to ascertain if they knew of gelatine-containing urological drugs, had encountered patients enquiring about gelatine-containing medication, and where they would seek this information from.

Results:

Twenty-five percent of surveyed urologists had experience of patients refusing medication on the suspicion of gelatine content. 53% were unsure if urological drugs could contain gelatine, while 22%, wrongly, thought they did not. Regarding acquisition of drug constituent information, approximately a third did not know, a third looked to incorrect resources and a third referred to their pharmacy's drug information service.

Conclusion:

Most urologists are unaware of the issues surrounding the prescribing of gelatine-containing urological medications, the most important being those given for the management of prostatic hypertrophy. A knowledge of alternative prescribing options can help avoid belief violation for our diverse community in the UK.
Carbohydrate esterases of family 2 are 6‐O‐deacetylases
Authors: Topakas Evangelos , Kyriakopoulos Sarantos , Biely Peter , Hirsch Ján , Vafiadi Christina , Christakopoulos Paul
Published: December 2009

Three acetyl esterases (AcEs) from the saprophytic bacteria Cellvibrio japonicus and Clostridium thermocellum, members of the carbohydrate esterase (CE) family 2, were tested for their activity against a series of model substrates including partially acetylated gluco‐, manno‐ and xylopyranosides. All three enzymes showed a strong preference for deacetylation of the 6‐position in aldohexoses. This regioselectivity is different from that of typical acetylxylan esterases (AcXEs). In aqueous medium saturated with vinyl acetate, the CE‐2 enzymes catalyzed transacetylation to the same position, i.e., to the primary hydroxyl group of mono‐ and disaccharides. Xylose and xylooligosaccharides did not serve as acetyl group acceptors, therefore the CE‐2 enzymes appear to be 6‐O‐deacetylases.
The carbon and energy sources of the non‐photosynthetic plastid in the malaria parasite
Authors: Lim Liting , Linka Marc , Mullin Kylie A. , Weber Andreas P.M. , McFadden Geoffrey I.
Published: December 2009

The malaria parasite harbours an indispensable plastid known as the ‘apicoplast’. The apicoplast's exact role remains uncertain, but it houses components involved in fatty acid, isoprenoid and haem biosyntheses. These pathways offer opportunities to develop anti‐malarials. In the absence of photosynthesis, how apicoplast anabolism is fuelled is unclear. Here we investigated plant‐like transporters of the apicoplast and measured their substrate preferences using a novel cell‐free assay system to explore the carbon and energy sources of the apicoplast. The transporters exchange triose phosphate and phosphoenolpyruvate for inorganic phosphate, demonstrating that the apicoplast taps into host‐derived glucose to fuel its metabolism.
Natively unfolded nucleic acid binding P8 domain of SeMV polyprotein 2a affects the novel ATPase activity of the preceding P10 domain
Authors: Nair Smita , Savithri H.S.
Published: December 2009

Open reading frame (ORF) 2a of Sesbania mosaic virus (SeMV) codes for polyprotein 2a (Membrane anchor‐protease‐VPg‐P10–P8). The C‐terminal domain of SeMV polyprotein 2a was cloned, expressed and purified in order to functionally characterize it. The protein of size 8 kDa (P8) domain, like viral protein genome linked (VPg), was found to be natively unfolded and could bind to nucleic acids. Interestingly, P10–P8 but not P8 showed a novel Mg2+ dependent ATPase activity that was inhibited in the presence of poly A. In the absence of P8, the ATPase activity of the protein of size 10 kDa (P10) domain was reduced suggesting that the natively unfolded P8 domain influenced the P10 ATPase.
Lactobacillus strains induce TRAIL production and facilitate natural killer activity against cancer cells
Authors: Horinaka Mano , Yoshida Tatsushi , Kishi Atsuko , Akatani Kaoru , Yasuda Takashi , Kouhara Junji , Wakada Miki , Sakai Toshiyuki
Published: December 2009

Tumor necrosis factor‐related apoptosis‐inducing ligand (TRAIL) is an endogenous cytokine that induces apoptosis in malignant tumor cells. Here, we show for the first time that lactobacilli induce TRAIL production in human peripheral blood mononuclear cells (PBMC). Treatment with lactobacilli induced TRAIL on the cell surface of PBMC and in culture medium. The TRAIL production induced by lactobacilli partially depends on IFN‐α and IFN‐γ. Lactobacilli treatment facilitated NK activity of PBMC against prostate cancer cells. Moreover, TRAIL neutralization antibody efficiently prevented the NK activity. Our results indicate that lactobacilli facilitate NK activity through TRAIL production, and raise the possibility of a new TRAIL‐based strategy against malignant tumors.
Effects of cooling and supplemental recombinant bovine somatotropin on diet digestibility, digestion kinetics and milk production of cross-bred Holstein cattle in the tropics
Authors: CHANCHAI W. , CHANPONGSANG S. , CHAIYABUTR N.
Published: December 2009

The aim of the current study was to determine how cooling and supplemental recombinant bovine somatotropin (rbST) affect body function with respect to digestion kinetics, digestibility and other variables relevant to milk production in cross-bred Holstein cattle. Ten primiparous cross-bred dairy cattle (0·875 Holstein Friesian×0·125 Red Shindi) were used and divided into two groups of five animals each that were housed in a normal shaded barn (NS barn; non-cooled cows) and in a shaded barn with mist-fan cooling (MF; cooled cows). The cows in each group were supplemented with rbST in early, mid and late stages of lactation with three consecutive subcutaneous injections of 500 mg rbST every 14 days. All cows were fed the same total mixed ration twice daily at approximately 1·1 of assumedad libitumintake and water was offeredad libitum. During the experimental periods, values of ambient temperatures and temperature humidity index (THI) in the NS barn were significantly higher than in the MF barn, whereas the relative humidity in the MF barn was significantly higher than in the NS barn (P<0·01). The respiration rate and rectal temperature were significantly higher for non-cooled cows than for cooled cows during the daytime whether there was or was not rbST supplementation. Supplementation of rbST for either cooled or non-cooled cows significantly increased dry matter intake (DMI), the efficiency of feed utilization and milk yields (P<0·05). Digesta kinetics using chromic oxide as an external marker showed a high digesta passage rate constant and low mean retention time of digesta in cows either by cooling or supplementation of rbST, whereas no changes were seen for the digestibility of dry matter (DM), organic matter (OM), crude protein (CP), neutral detergent fibre (NDF) and acid detergent fibre (ADF). The half-time of Cr2O3in the whole digestive tract of cooled cows was lower than those of non-cooled cows and significantly decreased (P<0·05) during rbST supplementation in both groups in all stages of lactation. The magnitude of responses for the digesta passage rate and efficiency of feed utilization were larger in animals supplemented with rbST than in animals under MF cooling only.

The main effect of cooling and supplemental rbST was to improve digestion by an increase in the rate of passage of digesta and in turn an increase in feed intake. Digestibility was not influenced by changes in passage rate of digesta either by cooling or rbST supplementation. Milk production in response to rbST supplementation is probably enhanced with cooling. The increased milk production induced by rbST supplementation was mediated by increased efficiency of feed utilization without changes in diet digestibility.
Cytochemical localization of ATP diphosphohydrolase fromLeishmania (Viannia) braziliensispromastigotes and identification of an antigenic and catalytically active isoform
Authors: REZENDE-SOARES F. A. , CARVALHO-CAMPOS C. , MARQUES M. J. , PORCINO G. N. , GIAROLA N. L. L. , COSTA B. L. S. , TAUNAY-RODRIGUES A. , FARIA-PINTO P. , SOUZA M. A. , DINIZ V. A. , CORTE-REAL S. , JULIANO M. A. , JULIANO L. , VASCONCELOS E. G.
Published: December 2009

An ATP diphosphohydrolase (EC 3.6.1.5) activity was identified in aLeishmania (Viannia) braziliensispromastigotes preparation (Lb). Ultrastructural cytochemical microscopy showed this protein on the parasite surface and also stained a possible similar protein at the mitochondrial membrane. Isolation of an active ATP diphosphohydrolase isoform from Lb was obtained by cross-immunoreactivity with polyclonal anti-potato apyrase antibodies. These antibodies, immobilized on Protein A-Sepharose, immunoprecipitated a polypeptide of approximately 48 kDa and, in lower amount, a polypeptide of approximately 43 kDa, and depleted 83% ATPase and 87% of the ADPase activities from detergent-homogenized Lb. Potato apyrase was recognized in Western blots by IgG antibody from American cutaneous leishmaniasis (ACL) patients, suggesting that the parasite and vegetable proteins share antigenic conserved epitopes. Significant IgG seropositivity in serum samples diluted 1:50 from ACL patients (n=20) for Lb (65%) and potato apyrase (90%) was observed by ELISA technique. Significant IgG antibody reactivity was also observed against synthetic peptides belonging to a conserved domain fromL. braziliensisNDPase (80% seropositivity) and its potato apyrase counterpart (50% seropositivity), in accordance with the existence of shared antigenic epitopes and demonstrating that in leishmaniasis infection the domain r82-103 fromL. braziliensisNDPase is a target for the human immune response.
In vitroandin vivotrematode models for chemotherapeutic studies
Authors: KEISER J.
Published: December 2009

Schistosomiasis and food-borne trematodiases are chronic parasitic diseases affecting millions of people mostly in the developing world. Additional drugs should be developed as only few drugs are available for treatment and drug resistance might emerge.In vitroandin vivowhole parasite screens represent essential components of the trematodicidal drug discovery cascade. This review describes the current state-of-the-art ofin vitroandin vivoscreening systems of the blood flukeSchistosoma mansoni, the liver flukeFasciola hepaticaand the intestinal flukeEchinostoma caproni. Examples ofin vitroandin vivoevaluation of compounds for activity are presented. To boost the discovery pipeline for these diseases there is a need to develop validated, robust high-throughputin vitrosystems with simple readouts.
Suturing and tying knots assisted by a surgical robot system in laryngeal MIS
Authors: Wang Huijuan , Wang Shuxin , Ding Jienan , Luo Haifeng
Published: December 2009

Suturing and tying knots assisted by surgical robot systems are complicated and time-consuming tasks in minimally invasive surgery (MIS). It is almost impossible to perform these operations in laryngeal MIS because motions of the end-effectors are greatly confined by a narrow and long laryngoscope tube. This paper presents the robot-assisted operations of suturing and knot-tying in a laryngeal surgery under a self-retaining laryngoscope, which has a greatly confined workspace. In order to use robot assistance to perform the suturing and knot-tying tasks in such a workspace, an appropriate suturing path is planned. The suturing path planning is completed based on a knot-tying algorithm called the bending-twisting knot-tying (BTKT). A robot system for laryngeal MIS called MicroHand III is designed. The kinematical model of the system is developed in the paper. The simulation and experimental results have shown that suturing and knot-tying assisted by MicroHand III system are successful.
Aichi virus infection in children with acute gastroenteritis in Finland
Authors: KAIKKONEN S. , RÄSÄNEN S. , RÄMET M. , VESIKARI T.
Published: December 2009

Aichi virus has been proposed as a novel causative agent of acute gastroenteritis. In addition to several Asian countries, South America and Africa, Aichi virus has also recently been found in Europe. Our objective was to study the causative role of Aichi virus in children with acute gastroenteritis in Finland. We analysed 595 stool specimens from infants in an efficacy trial of rotavirus vaccine and 468 stool specimens from children in a hospital-based epidemiological and aetiological study of acute gastroenteritis. The screening was done by nested reverse transcription–polymerase chain reaction amplifying a 519-bp segment and a 223-bp segment in the 3CD junction region of non-structural proteins. Aichi virus was detected in five stool samples (0·5%), of which four were co-infections with other gastroenteritis viruses. Two Aichi virus genotypes, A and B, were found. Aichi virus appears to be rare in children with acute gastroenteritis in Finland.
Staphylococcus aureus community-onset pneumonia in patients admitted to children's hospitals during autumn and winter of 2006–2007
Authors: KALLEN A. J. , REED C. , PATTON M. , ARNOLD K. E. , FINELLI L. , HAGEMAN J.
Published: December 2009

Staphylococcus aureus is a relatively uncommon cause of community-onset pneumonia (COP) that may complicate influenza infection. We reviewed admissions to children's hospitals to describe more systematically this entity. Records of patients hospitalized at three children's hospitals between 1 October 2006 and 30 April 2007 who had a positive S. aureus culture from a sterile site or respiratory specimen were reviewed and data were abstracted for episodes of primary S. aureus COP. Overall, 30 episodes met criteria for primary S. aureus COP; 12 (41%) involved methicillin-resistant S. aureus. Patients in 11 (37%) episodes were seen by a healthcare provider for their symptoms prior to hospital admission; three received an antimicrobial, none of which had activity against the S. aureus isolated. Mechanical ventilation was required in 21 (70%) episodes; five (17%) patients died. When evaluating patients with severe COP, providers should be aware of the potential for S. aureus, including methicillin-resistant strains.
Cystic adventitial degeneration: Ectopic ganglia from adjacent joint capsules
Authors: Ortmann  , Widmer  , Gretener  , Do  , Willenberg  , Daliri  , Baumgartner
Published: December 2009

Cystic adventitial degeneration is a rare non-atherosclerotic cause of peripheral arterial occlusive disease, mainly seen in young men without other evidence of vascular disease. Diagnosis will be established by clinical findings and by ultrasound or angiography and can be treated by excision or enucleation of the affected arterial segment or by percutaneous ultrasound-guided aspiration. However, the etiology of adventitial cysts remains unknown. We report a case of cystic adventitial degeneration showing a connection between the joint capsule and the adventitial cyst, supporting the theory that cystic adventitial degeneration may represent ectopic ganglia from adjacent joint capsules.
Categories of Novelty and States of Uncertainty
Authors: Kagan Jerome
Published: December 2009

The concept of novelty has acquired a large number of diverse referents over the past quarter-century as a result of new methods that permit measurement of a variety of biological and behavioral reactions to novel incentives in both humans and animals. As a result, the term has acquired varied meanings. This analysis of novelty makes four claims. First, the specific state of uncertainty that a novel event creates depends on its origin. Second, unexpected events that alter the immediate stimulus surround (called stimulus novelty) should be distinguished from those that are inconsistent with an agent's long term knowledge (called conceptual novelty). Third, the critical features that render an event novel can vary with the agent's intention to classify or to act on an object and the balance between these two frames changes with development. Finally, the state of uncertainty created when an agent must choose one response from two or more alternatives differs from the states provoked by stimulus and conceptual novelty.
Mapping the Structure and Dynamics of Psychological Knowledge: Forty Years of APA Journal Citations (1970–2009)
Authors: Yang Yung-Jui , Chiu Chi-yue
Published: December 2009

To understand how subfields of psychology relate to each other as a whole, we analyzed 40 years (from 1979 to 2009) of journal citation data collected from 17 American Psychological Association journals. The results reveal two stable underlying dimensions of psychological knowledge—basic versus applied, and population-specific versus population-general—that organize subfields of psychology. Within the structure, personality and social psychology is located at the heart of psychological knowledge. Analysis of the dynamic flow of knowledge between subfields of psychology further reveals that although the subfields engage in clear division of labor, they also engage in dynamic transactions of knowledge. Finally, an emergent subfield would first obtain its intellectual nutrients from the established disciplines. Once it has found its own niche, it turns into a spin-off and starts to assume the role of knowledge supplier. The implications of these results for psychology as a science are discussed.
The Origins of Specific Phobias: Influential Theories and Current Perspectives
Authors: Coelho Carlos Magalhães , Purkis Helena
Published: December 2009

Fears are quick and adaptive responses that permit powerful reply to imminent threats. Less adaptive, phobias are extreme manifestations of fear to objects or situations in the absence of a proportional danger. Although the utility of fear is accepted, the nature of phobias is controversial. Initial theories favored a fear conditioning-based explanation, with vicarious and information learning pathways subsequently included as additional routes to the development of specific phobias. More recently, an important group of investigations strengthened the case for a nonassociative account of fear acquisition proposing that evolutionarily relevant fears can occur without any need of critical learning experiences. In parallel, there is some evidence for a dedicated fear module in the detection of threats, involving the amygdala, which is relatively independent from conscious cognitive control. Nonetheless, cognitive models stress learning and developmental factors and their role in the etiology and maintenance of phobic behavior. This article critically reviews each of these views and theories stressing their recent developments, weaknesses, and controversies with an aim to provide the groundwork for the construction of a more integrated position. Finally, the authors suggest encouraging trends in recent research.
Is Psychology Losing Its Foundations?
Authors: Dewsbury Donald A.
Published: December 2009

I contend that, together with increasing diversity of subject matter, there is a contraction of methods and approaches in psychology today. There is decreasing room for small, but critical, parts of the field—particularly those in cultural-scientific aspects of psychology, such as the history, philosophy, and theory of psychology and general psychology. These areas provide the foundations of entire discipline. These changes occur in the context of growing anti-intellectualism in society at large and changing pressures in universities. I explore these trends at these three levels: society, universities, and psychology, and suggest some remedies for psychology.
Ethnic Identification, Social Disadvantage, and Mental Health in Adolescence/Young Adulthood: Results of a 25 Year Longitudinal Study
Authors: Marie Dannette , Fergusson David M. , Boden Joseph M.
Published: December 2009

Objective: To examine the role of cultural identity and social disadvantage/childhood adversity in a birth cohort of 984 young people studied to the age of 25.

Methods: Data were gathered on mental health, cultural identification, socioeconomic factors and childhood adversity as part of a longitudinal study of a New Zealand birth cohort (the Christchurch Health and Development Study).

Results: Those with sole Māori identity had rates of disorder that were 1.28-fold higher than those of non-Māori; those of Māori/other identity had rates of disorder that were 1.57-fold higher than non-Māori. Regression analyses suggested that the elevated rates of mental disorder among Māori were largely explained by their higher exposure to socioeconomic disadvantage and childhood adversity. But even after adjustment, being of sole Māori identity was a protective factor that reduced rates of mental disorder among Māori.

Conclusions: Risk and protective factors associated with the mental health of young Māori involve an interplay between levels of exposure to social disadvantage/childhood adversity and cultural identity, with secure cultural identity being a factor that may mitigate the effects of exposure to adversity.
Maternal Attitudes in Pregnancy Predict Drinking Initiation in Adolescence
Authors: Hutchinson Delyse M. , Alati Rosa , Najman Jake M. , Mattick Richard P. , Bor William , O'Callaghan Michael , Williams Gail M.
Published: December 2009

Objective: The aim of the present study was to examine whether maternal attitudes to pregnancy and infant caregiving predict drinking initiation in adolescence.

Method: Data were used from the Mater University Study of Pregnancy, an Australian longitudinal study of mothers and their children from pregnancy to when the children were 14years. Logistic regression analyses examined whether maternal attitudes to pregnancy and infant caregiving at birth and 6months contributed to the prediction of drinking initiation at age 14, after controlling for a range of confounding covariates.

Results: Mother's negative feelings about being pregnant and not planning/wanting the pregnancy predicted adolescent alcohol initiation at the 14year follow up. Negative maternal attitudes to infant caregiving at birth and 6months did not predict adolescent alcohol initiation.

Conclusions: Maternal attitudes in pregnancy are important and there is a need for effective perinatal interventions.
Childhood Maltreatment in Patients With Somatization Disorder
Authors: Spitzer Carsten , Barnow Sven , Gau Kay , Freyberger Harald J. , Grabe Hans Joergen
Published: December 2009

Objective: There is converging evidence indicating a close association between trauma, particularly childhood trauma, and adult somatization, but studies using both structured interviews and self-report measures to assess childhood adversities in patients with somatization disorder are scarce.

Methods: A total of 28 patients (82% women, mean age=41.7±10.1years) meeting DSM-IV criteria for somatization disorder as confirmed by the Structured Clinical Interview for DSM-IV, Axis I (SCID-I) underwent the Structured Trauma Interview (STI) and the Childhood Trauma Questionnaire (CTQ). The comparison group consisted of 28 patients with major depression, but without a lifetime diagnosis of somatization disorder matched for gender and age.

Results: Univariate analyses of both the STI and the CTQ data showed that somatizing patients had been exposed to childhood sexual and physical abuse significantly more often than major depressive disorder (MDD) patients. In logistic regression analysis with somatization disorder as the dependent variable, sexual abuse emerged as the only significant predictor, and the odds of having been sexually abused were ninefold higher in patients with somatization disorders relative to MDD subjects (odds ratio=9.39; 95% confidence interval=1.73–50.96). There were no differences between somatizing and depressed participants with respect to other types of maltreatment.

Conclusion: Childhood sexual abuse is an important factor in the multifactorial aetiopathogenesis of somatization disorder. Diagnostic and therapeutic implications are discussed.
Impact of Lifetime Subthreshold Depression and Major Depression Before Internship on Psychopathology and Quality of Life in Korean Interns: 6 Month Follow-Up Study
Authors: Hwang Jun-Won , Hahm Bong-Jin , Kwon Sung-Tack , Kim Kyu-Han , Lee Jeong-Ryul
Published: December 2009

Objective: The aim of the present study was to investigate the influences of lifetime subthreshold depression and major depression before internship on the changes in psychopathology and subjective quality of life during internship.

Method: A total of 151 interns at Seoul National University Hospital completed questionnaires including World Health Organization Quality of Life Assessment Instrument, Brief Version (WHOQOL-BREF), Symptom Checklist-90-Revised (SCL-90-R), and Beck Depression Inventory (BDI) twice at an interval of 6 months. Their lifetime diagnosis of depression before internship was made using the Korean version of Mini International Neuropsychiatric Interview (MINI), Modified Form for Self-Administration.

Results: Significant changes over time were detected including total score in the BDI and the Somatization, Depression, Anxiety, and Phobic Anxiety dimension scores in the SCL-90-R as well as all four domain scores in WHOQOL-BREF. In addition, in all scores except Somatization dimension score, group difference existed. Post-hoc comparisons showed that interns without lifetime depression were significantly different from those with lifetime subthreshold depression and those with lifetime major depression.

Conclusions: Even a subthreshold-level, lifetime depression before internship has an adverse effect on the psychopathology and the subjective quality of life during internship. Therefore, earlier detection, monitoring, and management of this population would be needed throughout the intern year and beyond.
Impulsive–Compulsive Buying Disorder: Clinical Overview
Authors: Dell'Osso Bernardo , Allen Andrea , Altamura A. Carlo , Buoli Massimiliano , Hollander Eric
Published: December 2009

Impulsive–compulsive buying disorder (ICBD) is an impulse control disorder not otherwise specified (ICD-NOS) characterized by impulsive drives and compulsive behaviours (buying unneeded things), personal distress, impaired social and vocational functioning and financial problems. Despite being described in the 19th century, serious attention to ICBD began only in the last decade with the first epidemiological and pharmacological investigation. Biological, social and psychological factors contribute to the aetiology of ICBD. Cognitive–behavioural therapy and selective serotonin re-uptake inhibitors are currently considered the more effective interventions in the treatment of ICBD. The present review aims to provide a broad overview of the epidemiology, aetiology, phenomenology and treatment options of ICBD.
Partial Compliance With Antipsychotic Medication is Common in Patients With Schizophrenia
Authors: Rummel-Kluge Christine , Schuster Tibor , Peters Stefan , Kissling Werner
Published: December 2009

Objective: Partial compliance with antipsychotic medication increases relapse and rehospitalization rates in patients with schizophrenia. The aim of the present study was to assess the frequency of and factors contributing to partial compliance.

Method: During a 10 day period in June 2004 psychiatrists working in hospitals or in private practices in Germany were asked to participate in a compliance survey. Physicians were requested to evaluate the compliance in 10 patients with schizophrenia using a questionnaire consisting of 10 questions. The frequency of unintentional and intentional partial compliance as well as patient-related contributing factors were assessed. Unintentional partial compliance was defined as the lack of drug intake on any day during the past month. Demographic data of participants were collected. Responses were analysed using descriptive statistics and generalized estimation equation models.

Results: The psychiatrists (n=699) regarded 68% of the evaluated patients (n=5729) as unintentionally partially compliant within the last month. Sixty-nine per cent of the patients were considered intentionally partially compliant in the past. The most frequently assessed patient-related factors contributing to the partial compliance were lack of insight into the need for prophylactic medication (68%), lack of insight/denial of illness (66%/63%), feeling embarrassed at taking medication every day (62%), needing someone to remind them to take their medication (62%), cognitive problems (55%), and living conditions inappropriate for compliance (46%).

Conclusions: Partial compliance is a common problem in schizophrenia. Strategies to improve partial compliance derived from the contributing factors identified in the present study may include regular telephone reminders by case managers or families, adequate support in the patients’ environment, use of dosette boxes, rationalizing drug regimens (e.g. once-daily dosage, monotherapy, depot medication), and psychoeducation.
Psychosocial Factors Associated With Broadly Defined Bulimia Nervosa During Early Pregnancy: Findings from the Norwegian Mother and Child Cohort Study
Authors: Knoph Berg Cecilie , Bulik Cynthia M. , Von Holle Ann , Torgersen Leila , Hamer Robert , Sullivan Patrick , Reichborn-Kjennerud Ted
Published: December 2009

Objective: The purpose of the present study was to investigate the relationship between psychosocial characteristics and broadly defined bulimia nervosa during early pregnancy, including factors associated with continuation, incidence and remission.

Method: A total of 41 157 women completed questionnaires at approximately gestation week 18, including items on eating disorders and psychosocial characteristics as a part of Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health.

Results: Incident bulimia nervosa during the first trimester was significantly associated with symptoms of anxiety and depression and low self-esteem and life satisfaction, whereas remission was significantly associated with higher self-esteem and life satisfaction. Continuation was not significantly related to any of the psychosocial variables tested.

Conclusion: Onset of bulimia nervosa during pregnancy is associated with mood and anxiety symptoms. Remission of bulimic symptoms and new onset of bulimia nervosa are associated with opposite profiles of self-esteem, and life satisfaction measures.
Cannabis, Cannabinoids and Schizophrenia: Integration of the Evidence
Authors: Cohen Martin , Solowij Nadia , Carr Vaughan
Published: December 2009

Understanding of the neurophysiological basis of cognitive, behavioural and perceptual disturbances associated with long-term cannabis use has grown dramatically. Exogenous cannabinoids alter the normative functioning of the endogenous cannabinoid system. This system is an important regulator of neurotransmission. Recent research has demonstrated abnormalities of the cannabinoid system in schizophrenia. The purpose of the present paper was to selectively review the links between cannabis use and psychosis, drawing upon recent epidemiological, clinical, cognitive, brain imaging and neurobiological research. The aim is to assist clinicians to probe more deeply into the newly unfolding world of cannabinoid physiology and to critically evaluate the potential role of cannabis in the onset and persistence of cognitive impairments and psychosis in otherwise healthy users and in schizophrenia.
Relationships Between Cognitive Deficits, Symptoms and Quality of Life in Schizophrenia
Authors: Savilla Kara , Kettler Lisa , Galletly Cherrie
Published: December 2009

Objective: Schizophrenia is a complex disorder characterized by impairment in a number of domains, all of which contribute to disability. The aim of the present study was to investigate the relationships between cognitive function, symptoms and quality of life (QOL) in schizophrenia.

Method: This cross-sectional study measured cognition, positive and negative symptom severity, and quality of life (measured with the Quality of Life Scale) in 57 outpatients with schizophrenia. Correlations between the different measures were sought. Multiple regression analyses were used to develop models of the contributions of cognitive deficits and symptomatology to QOL.

Results: More severe positive and negative symptoms and cognitive impairment each correlated with poorer QOL. There was a moderate association between negative symptoms and cognition and a small association between positive symptoms and cognition. Age, gender, and drug and alcohol abuse did not significantly predict QOL. In the multiple regression analysis, entering the total cognition and total symptom scores produced a model that accounted for an additional 57% of the variance in QOL.

Conclusions: Improving quality of life for people with schizophrenia requires that positive and negative symptoms and cognition are each addressed as separate domains of impairment. But, given that these account for only 57% of the variance in QOL, other factors such as unemployment, poverty, social isolation and stigma may also be important.
Short-Term Psychodynamic Psychotherapy: Review of Recent Process and Outcome Studies
Authors: Lewis Andrew J. , Dennerstein Michelle , Gibbs Petah M.
Published: December 2009

Short-term psychodynamic psychotherapy (STPP) is a widely practised form of psychological intervention. Given that the Roth and Fonagy (1996) review concluded that there was a lack of confirming evidence for STPP, the current review is focused on studies published between 1996 and 2006 that evaluate the efficacy of STPP. As a result of a systematic literature review, 18 studies were found that met inclusion criteria consistent with those used by Roth and Fonagy (1996) for selection of studies, patient groupings and definition of therapeutic method. In general these studies add to an increasing body of evidence suggesting that STPP can be an effective psychological treatment for individuals experiencing mental health problems. Specifically, for depression STPP can be equal in effects to other psychological treatments and is significantly better than no treatment in the short term. Furthermore, emerging process data indicate that there is a significant relationship between the use of specific psychodynamic therapeutic techniques and the alleviation of depressive symptoms. Increasing evidence has emerged to support STPP as a treatment for generalized anxiety disorder, panic disorder and some personality disorders. There remains limited evidence for the use of STPP treatment for patients with anxiety disorders that relate more to stress. Very limited and inconclusive evidence currently exists to support STPP as a treatment for bipolar disorder, eating disorders and drug dependency. Future research needs to include broader assessment measures, long-term follow up, studies that maintain an identifiable focus, and research that includes a focus on psychotherapy process variables as they interact with outcomes.
New-Generation Antidepressants, Suicide and Depressed Adolescents: How Should Clinicians Respond to Changing Evidence?
Authors: Dudley Michael , Hadzi-Pavlovic Dusan , Andrews Doug , Perich Tania
Published: December 2009

The purpose of the present paper was to identify, from the voluminous literature on efficacy and safety in new-generation antidepressants (NGAs) with depressed children and adolescents, practical clinical strategies for acute phase treatment. To this end a pragmatic survey of studies and reviews was undertaken. Meta-analyses of randomized controlled trials of NGAs in depressed children and adolescents have noted a comparative lack of efficacy, and a weak but statistically significant increased risk of self-harm and suicidal thoughts. But NGA prescription rates and youth suicide rates are generally inversely related, and ensuing ‘black box’ warnings about NGAs, by deterring NGA prescribing, have possibly contributed to rising youth suicide rates. In moderate–severe depression, benefits for fluoxetine and possibly other NGAs demonstrably outweigh risks. NGAs are not present in adolescents who die by suicide. Concern about NGA risks must be balanced against risks of non-treatment. While mild depression entails regular review, psychoeducation, self-care strategies and psychological interventions, NGAs should be administered concurrently with psychological treatments if depression is moderate– to severe, or if mild depression persists. Patients should be warned about off-label status of NGAs in depression, serious side-effects such as ‘activation’, suicidality, emotional blunting and manic switches, the need for adherence and avoiding abrupt discontinuation. They should be monitored early and regularly. Better evidence is required regarding psychological treatments, clinical course, and clinical practice trends. In moderate–severe depression the risk of suicide if NGAs are not used may outweigh any risk of self-harm associated with them.
Suicide in Psychiatric Patients: Case–Control Study in Singapore
Authors: Yew Thong Jiunn , Hc Su Alex , Huak Chan Yiong , Hock Chia Boon
Published: December 2009

Objective: Persons with psychiatric illness, especially depression and schizophrenia, are at relatively high risk of suicide, but there are few studies that look at the Asian population. The aim of the present study was to identify the risk period and risk factors for suicide in psychiatric patients in Singapore. The nature of psychiatric care that was provided, both inpatient and outpatient, was also explored.

Method: This is a case–control study of 123 patients who committed suicide from 2003 to 2004. Controls were 123 surviving patients who were individually matched for age, gender, principal diagnosis and calendar time.

Results: The most common principal diagnoses among the suicide subjects were schizophrenia (46.3%) and depression (26.8%). Numerous factors were associated with significantly increased suicide risk. Stepwise conditional logistic regression showed that the following three independent factors best predicted suicide: history of attempted suicide using highly lethal means; coexisting significant physical illness; and delusions. Suicides occur mainly soon after discharge and after an outpatient consult. Subgroup analyses were done to distinguish between subjects who suicided early and late following discharge.

Conclusions: Suicidal risk remains high in Singaporean psychiatric patients soon after discharge. They share some common risk factors for suicide identified in Western studies but the lower prevalence of substance abuse and comorbidity in Singaporean suicide subjects was one notable difference. The phenomena of suicides soon after discharge and outpatient review suggest the need for proper identification and more intensive follow up during this period.