bluuebunny/crossref_metadata_2025 huggingface dataset:
Plain Language Summary: Earwax (Cerumen Impaction)
Authors: Krouse Helene J. , Magit Anthony E. , O’Connor Sarah , Schwarz Seth R. , Walsh Sandra A.
Published: January 2017

This plain language summary serves as an overview in explaining earwax (cerumen). The summary applies to patients older than 6 months with a clinical diagnosis of earwax impaction and is based on the 2017 update of the Clinical Practice Guideline: Earwax (Cerumen Impaction). The evidence‐based guideline includes research that supports diagnosis and treatment of earwax impaction. The guideline was developed to improve care by health care providers for managing earwax impaction by creating clear recommendations to use in medical practice.
Do Bilateral Investment Treaties Promote FDI Inflows? Evidence from India
Authors: Bhasin Niti , Manocha Rinku
Published: January 2017

Executive Summary

In view of the catalytic role of foreign direct investment (FDI) in promoting economic development, countries adopt various unilateral as well as bilateral arrangements to create a conducive environment for FDI. One such significant form of arrangement is bilateral investment treaties (BITs). As sizeable cost and resources are involved in treaty formation, it becomes important to examine the potential benefits of BITs for investment and whether such measures actually translate into higher FDI flows.

This article employs panel data regression on an augmented gravity model (under both static and dynamic conditions) to identify the determinants of FDI inflows into India with a special focus on the role of BITs. The panel data span over the period 2001–2012 and include the top investing countries in India accounting for around 92 per cent of India’s total FDI inflows. The explanatory variables employed are extended market size, vertical FDI drive, distance, colonial links, common language, political stability, financial openness, and population growth rate. BIT is incorporated as a dummy variable which takes the value 1 if a BIT exists between India and the investing countries in a given year, otherwise 0.

The results for both the fixed effects and the two-step generalized method of moments (GMM) model specifications confirm the positive role of BITs in attracting FDI inflows into India. BITs have contributed to rising FDI inflows by providing protection and commitment to foreign investors contemplating investment in India. The model also finds support for other factors facilitating FDI such as the large size of the economy and a more liberal FDI regime.

As attracting FDI is an important policy objective of developing countries like India, the results imply that one of the instruments of achieving this objective is for the government to negotiate BITs with countries which are prospective investors. By laying down clear guidelines with respect to investment and widening the scope of investment activities covered under a bilateral agreement, an environment of certainty is created which would facilitate FDI flows.
Effect of Halide Impregnation on the Structure and Surface Characteristics of Rutile
Authors: Philip Christine A. , Amin Anwar , Moussa Nabawia A.
Published: January 2017

Titanium dioxide (TiO2, rutile) subjected to fluoride (1 M and 2 M NH4F) and iodide (1 M KI) treatment has been investigated by combining several approaches: structural and textural characterization as well as surface acidity and basicity. Fluorination reduces the crystallinity at both concentrations studied, the higher concentration being more effective. Iodination has the same effect.

Fluoride ions replace all basic OH groups whereas iodination does not lead to full replacement due to competition with the Ti4+ substrate. A distinct exotherm is observed at 228°C and 235°C, respectively, for the F− and I−treated samples, resulting from energetic changes leading to the activated dissociation of water and restoration of the basic OH groups.

A surface compound is apparently formed on fluorination and iodination, and this decomposes endothermally at 270–275°C. In addition, impregnation with I− appears to increase the photosensitivity of the TiO2 leading to the formation of a carbonate with atmospheric CO2 which generates an endotherm at 285°C and whose existence has been confirmed by IR spectral analysis.

Specific surface areas and pore structure analyses demonstrate differences not only upon increasing the F− concentration but also between the F− and I− treated samples, where the addition of the latter markedly reduced the surface parameters. Two groups of pore sizes could be recognized with most samples. Increasing the F− concentration increased the sintering temperature to 550°C, the value for the low F− sample being 400°C.
Surface Characteristics of Portland Cement/Blast Furnace Slag Mixtures
Authors: Khalil Kh.A.
Published: January 2017

The effect of the degree of hydration and amounts of granulated blast furnace slag on the surface properties of Portland cement pastes were studied. The results obtained showed that the specific surface area SBET (m2/g) and pore volume Vp (cm3/g) decreased on increasing the degree of hydration. The addition of different amounts of granulated slag effected a decrease in SBET and Vp to an extent proportional to the amount present.

These results were attributed to a replacement of clinker by the amounts of slag added and the formation of hydration products.
Sorption and Diffusion Properties of H- and Modified Forms of ZSM-5 Zeolites
Authors: Hudek P. , Bobok D. , Smiešková A. , Židek Z.
Published: January 2017

The sorption properties of samples of H-ZSM-5 zeolite and their forms modified with P, B and Mg were determined by the physical adsorption of nitrogen and evaluated by BET isotherm and t-plot methods. The diffusivities of the samples were measured using a new flow gravimetric method involving the sorption of p- and o-xylenes. The BET specific surface area decreased from 358 m2/g to 35–90 m2/g mainly because of a decrease in micropore volume as determined by the t-plot method. The rate of sorption of p-xylene on all the samples investigated followed Fick's second law of diffusion, leading to an effective diffusivity of ca. 1.7 × 10−11 m2/s, irrespective of whether the H-form or the modified forms were investigated. The sorption isotherms for o-xylene showed some unusual steps. Values for the effective diffusivities decreased from 2.6 × 10−12 m2/s for the H-form to 2.0–2.3 × 10−12 m2/s for the modified forms. The equilibrium concentration of o-xylene at P/P0 = 0.1 was only 0.38–0.68 mol/unit cell, while that of p-xylene was 4.40–5.98 mol/unit cell.
Adsorption of Cerium Ions on Activated Charcoal
Authors: Qadeer Riaz
Published: January 2017

Adsorption studies of cerium ions on activated charcoal were carried out as a function of pH at room temperature. The studies revealed that the maximum adsorption of cerium ions occurs at pH 4. An adsorption mechanism has been discussed in terms of the hydrolyzed cerium ion species formed in solution at different pH values. The data fit the Langmuir and Dubinin–Radushkevich isotherm equations and their corresponding constants were calculated.
Adsorption of Some Antitumour Compounds on Polymer Adsorbents
Authors: Kovbuz M.O. , Khimyak Ya.Z. , Kesh A.M.
Published: January 2017

The adsorption of farmorubicine, methotrexate and 5-fluorouracil on adsorbents based on polyethylene grafted with polyacrylic acid (polyacrylate content Δp of 4, 15 and 80%) and polyacrylamide (polyacrylamide content Δp of 14%) has been investigated. A comparative estimation of the sorptive activity of the investigated adsorbents with respect to different antitumour compounds has been carried out. The influence of NaCl addition on the parameters of the kinetics and equilibrium adsorption of farmorubicine and methotrexate has been established.
Modification of the Interface by Polymeric Peroxides — A New Approach to the Creation of Composites
Authors: Tokarev V. , Voronov S. , Seredyuk V. , Kozar M. , Bednarska O.
Published: January 2017

The peroxidic modification of the surface of a dispersed phase by heterofunctional polymeric peroxides (HFPPs) is discussed. HFPPs are carbochain polymers which have statistically located peroxidic (–OO–) and high-polar functional (carboxylic) groups along the main chain.

Sharp differences in the polarity of these groups endowes HFPP macromolecules with the capability of interfacial adsorption in various polymeric colloidal systems. The reactions of the functional groups provide chemical bonding of the macromolecules to the interfacial surface. As a consequence of such physical adsorption or chemisorption of HFPP, peroxidation of filler surfaces and the localization of active –OO– groups on the interface may be effected.

In addition, such –OO– groups can facilitate the grafting of matrix polymer macromolecules to the surface of the dispersed phase. Such grafting reactions can be carried out during polymer filling, the curing processes of composites or the vulcanization of a rubber mixture. It has been shown that an improvement in the physical and mechanical properties of polymers and an increase in the electroconductivity and heat conductivity of filled compositions is achieved on modification by HFPP.
A Kinetic Method for Investigating the Structure of Adsorbed Polymer Layers
Authors: Minko S. , Luzinov I. , Evchuk I. , Voronov S.
Published: January 2017

A kinetic method for investigating the adsorbed layer structure of a polymer (the copolymer of styrene and maleic anhydride) on a ZnO powder surface was developed, the method is based on the model of the heterogeneously inhibited polymerization of styrene ‘filled’ with ZnO powder. The polymerization is preceded by an induction period. The length of this period depends on the concentration of inhibiting sites (n) on the surface of ZnO. The adsorbed polymer blocks such inhibiting sites and the induction period decreases. This model was used to estimate n. A peak was observed in the experimental relationship connecting n with the amount adsorbed. This peak was interpreted as the critical concentration for conformation transition brought about by the interaction of the polymer chains at the surface. Below this concentration adsorbed macromolecules are considered as isolated chains at the surface. This state is characterized by the poor mobility of segments.
Adsorption of Copper on Transcarpathian Mordenite
Authors: Vasylechko V.O. , Lebedynets L.O. , Gryshchouk G.V. , Kuz'ma Yu.B. , Vasylechko L.O. , Bernats'ka T.M.
Published: January 2017

The adsorption properties of Ukrainian Transcarpathian mordenite in aqueous copper(II) solutions under dynamic conditions have been investigated. Under optimum conditions (pH of Cu2+ solution = 6.5; adsorbent thermallly modified over 2.5 h at 150°C; rate of passage of Cu2+ solution through adsorbent = 3 ml/min) the adsorption capacity of the mordenite towards copper amounted to 1020 μg/g. Copper is effectively desorbed by an aqueous solution of HNO3 (1:2). Under optimum desorption conditions the effective extraction of copper was 99.8%.
Chemical Aspects of the Formation of Highly Hydrophobic Organosilicas
Authors: Belyakova L.A.
Published: January 2017

A study has been made of organosilicas with long-chain alkyl groups prepared by solid-phase hydrosilylation. The structural and adsorptive characteristics of such modified silicas have been established. The effect of end-capping the residual silanol groups by (CH3)3Sil on the hydrophobicity and pore structure of the alkyl silicas has been investigated.
Words and chips - pragmatics and pidginization of computer-aided communication
Authors: Tetzchner Stephen Von
Published: January 2017

The expressive communication of physically disabled persons is often restricted by lack of speech and sufficient speed in use of written language. New generation communication aids are based on word lists, which makes communication faster. The colloquial language of communication aid users will deviate from the language used by most members of their culture, and it is likely to share characteristics with the verbal output of other persons with limited means of communication. A way to enhance language development in users of communication aids would be to teach them communication strategies which are manifested in pidginization.
Methodology for evaluating CI software packages
Authors: Aina Temilade Adefioye , Cooke Louise , Stephens Derek
Published: January 2017

Competitive intelligence (CI) is important for businesses to remain competitive. Software technologies have been developed to make the CI process simpler. These software technologies need to be able to carry out CI effectively by performing all the stages in the CI Cycle, conforming to the British Standard software quality characteristics, extract information from large data sets by having certain Additional Features and be cost effective. Three evaluation frameworks were developed based on the CI Cycle, British Standard and Additional Features. This methodology and the marketing literature of the software were used to evaluate four CI software packages. Information on cost and availability of a free trial version was also taken from the marketing literature. From the evaluation results, the software were able to support at least one CI Cycle stage and at least one British Standard characteristics but none of them fully had any of the Additional Features. One of them has a free trial version, while two of them had information about the cost of their commercial version. It is recommended that before choosing CI software, CI practitioners determine and prioritize their intelligence needs and then test which CI software can meet them. Also, CI software vendors need to provide more information in their marketing literature on the cost and availability of a free trial version of their software and features pertaining to the CI Cycle, British Standard and Additional Features. The British Standard and Additional Features have not been used in the previous CI software evaluation studies.
The Logical Necessity of Multi-Disciplinarity: A Consistent View of the World
Authors: Kline Stephen Jay
Published: January 2017

For three hundred years two conflicting views of the world (1) have provided the overall frameworks for thought in western culture. The present paper shows neither view is sufficient for human understanding of many important systems and behaviors. A third view which appears sufficient is presented. Illustrations of the third view show increased understanding is obtained in many problems.

The sufficiency of the historic views and the route to the third view are provided through discussion of the issue of multi-disciplinarity, the question of whether it is possible to base everything we know on one discipline, or, on the contrary, if there is a logical necessity for using principles and concepts from many disciplines to achieve human understanding of the world.

The present article provides three distinct proofs of the logical necessity of multi-disciplinarity. The proofs proceed via study of: (1) the hierarchical structure of proto-typical systems in various areas of human concern; (2) the use of “integrated-control-information” by life forms and human artifacts; and (3) an extension of the theory of dimensions. The three proofs interlock, confirm, and extend each other.
Technological Literacy, Old and New
Authors: Beaver Donald Deb.
Published: January 2017

As one of the Sloan Foundation's original New Liberal Arts grantees, Williams College has developed a variety of approaches to improve quantitative reasoning and technological literacy, including creating interdisciplinary courses, computer and mathematical workshops, and an STS program. Further development, however, depends critically on what technological literacy may mean in a liberal arts context. Attempts to promote technological literacy, whether in liberal arts settings or not, are likely to founder unless they take account of the complexity and context dependent nature of technological literacy, as well as its history, and its relationship to scientific literacy.
Third World Alternatives for Building Post-capitalist Worlds
Authors: Barkin David , Lemus Blanca
Published: January 2017

In the context of great diversity and profound social inequalities, environmental injustice prevails. Conflicts between institutions promoting economic development (i.e., growth) and ecologists and civil society are rampant. This paper introduces alternatives emerging from groups, whose organizations are shaped by different cosmologies, products of their multiple ethnic origins, and by the profound philosophic and epistemological debates among social movements proposing different strategies for achieving progress, improving well-being and conserving ecosystems.
Portable Computing in Psychiatry
Authors: Luo John
Published: January 2017

Personal digital assistants (PDAs) or handheld computers have become more popular in the practice of medicine. These devices have implications for psychiatric practice, and this paper reviews various published articles describing their use. The literature demonstrates their use in document editing, patient tracking, accessing medical information and drug reference guides, prescription writing, and medical education. Security on these devices is covered, and the value and increasing implementation of PDAs in psychiatry is discussed.
Ethics in Psychiatric Research: Study Design Issues
Authors: DuVal Gordon
Published: January 2017

Objective:

To identify and discuss ethical aspects of study design issues in psychiatric research.

Method:

We conducted a literature review and conceptual analysis of study design in psychiatric research focusing on placebo, medication tapering and withdrawal (washout), and symptom provocation (challenge) designs.

Results:

While advances in the care and treatment of persons with psychiatric disorders are crucial to the improved well-being of this stigmatized and often forgotten population, past abuses demonstrate the importance of the thoughtful application of ethical principles in the conduct of research. Some ethical issues have particular relevance to psychiatric research arising primarily from the specific vulnerabilities of those with mental illness and the risks posed by some research methodologies. Accordingly, sensitivity is required in the design of psychiatric research.

Conclusion:

Placebo, challenge, and washout study designs can present particular risks in the population of persons with mental illness. These issues are described and suggestions offered to promote the ethical design of psychiatric research.
Subjective Experience and Dopamine D2 Receptor Occupancy in Patients Treated with Antipsychotics: Clinical Implications
Authors: de Haan Lieuwe , Lavalaye Jules , van Bruggen Marion , van Nimwegen Lonneke , Booij Jan , van Amelsvoort Therese , Linszen Don
Published: January 2017

Objectives:

This paper gives an overview of studies on the association between dopaminergic neurotransmission and the subjective experience of patients with schizophrenia.

Methods:

We undertook a review of the literature.

Results:

Dopaminergic neurotransmission may be relevant for subjective experience. Higher striatal D2 receptor occupancy by typical and atypical antipsychotics is related to worse subjective experience, more severe negative symptoms, and depression. Individuals with lower baseline dopamine function are at an increased risk for dysphoric responses during antipsychotic therapy with dopaminergic-blocking drugs. There is preliminary evidence that a window of striatal D2 receptor occupancy between 60% and 70% is optimal for the subjective experience of patients. These occupancies are often reached even with low dosages of antipsychotic drugs.

Conclusions:

Reaching an optimal dopamine D2 receptor occupancy is clinically relevant, since subjective experience associated with antipsychotic medication is related to medication compliance. Antipsychotic drug dosages often need to be lower than levels in common use.
New Antipsychotics, Compliance, Quality of Life, and Subjective Tolerability—Are Patients Better Off?
Authors: Awad A George , Voruganti Lakshmi NP
Published: January 2017

Objectives:

This overview reviews the impact of second-generation antipsychotics on less frequently researched outcomes such as medication-adherence behaviour, quality of life, and subjective tolerability in patients with schizophrenia.

Methods:

We selectively reviewed recent literature and considered our own research and experiences in the field.

Results:

Most published studies about second-generation antipsychotics have dealt with issues related to efficacy and safety. So far, not many studies have focused on effectiveness in terms of such important outcomes as medication-adherence behaviour, quality of life, subjective tolerability, and overall satisfaction with treatment. Although most studies are inconclusive and their results are inconsistent—which has to do with several design and methodological limitations—there seems, on balance, to be a trend indicating superiority of second-generation, compared with first-generation, antipsychotics in improving medication-adherence behaviour and quality of life. The trend toward more favourable subjective tolerability and less frequent neuroleptic dysphoria seems to be relatively stronger.

Conclusions:

At present, the state of the art can only indicate a more favourable trend for second-generation antipsychotics in regard to improving medication adherence behaviour, quality of life, and subjective tolerability. It is surprising that such important outcomes, which are likely the defining factors in the superiority of second-generation antipsychotics, have not received adequate research attention. Well-designed, controlled, and adequately powered studies are urgently needed before any firm conclusions can be reached.
Individual Change in Methylphenidate Use in a National Sample of Children Aged 2 to 11 Years
Authors: Romano Elisa , Baillargeon Raymond H , Fortier Isabel , Wu Hong-Xing , Robaey Philippe , Zoccolillo Mark , Tremblay Richard E
Published: January 2017

Objectives:

To determine methylphenidate use in children aged 2 to 13 years. To provide age- and sex-specific estimates of methylphenidate initiation and cessation during a 2-year period.

Method:

Data from 2 cycles of a Canadian household survey yielded a sample of over 10 000 children aged 2 to 11 years at Cycle 1 who continued to participate at Cycle 2. We used logit modelling to estimate Cycle 2 methylphenidate use, methylphenidate use over a 2-year period, and methylphenidate initiation and cessation from Cycles 1 to 2.

Results:

In 1996 and 1997, methylphenidate use ranged from 0.32% to 6.31% among children aged 4 to 13 years. School-aged boys were more likely than girls to use methylphenidate. Odds were greater for boys aged 6 to 7 years than for boys aged 4 to 5 years; they were also greater for boys aged 10 to 11 years than for boys aged 12 to 13 years. Almost 1% of children used methylphenidate at both data cycles. Odds of Cycle 2 methylphenidate use were 135 times greater for children using methylphenidate at Cycle 1, compared with nonusers. Methylphenidate initiation ranged from 0.20% to 3.34%, and school-aged boys had higher initiation rates than girls. Cessation rates ranged from 18% to 78%, and there were no statistically significant differences by age and sex.

Conclusions:

Methylphenidate prevalence findings are consistent with past studies. We found an age-by-sex interaction on methylphenidate use. We also found both continuity and discontinuity in methylphenidate use.
Méthadone et Syndrome d'Apnées du Sommeil
Authors: Durst Philippe , Palazzolo Jérôme , Peyrelong Jean-Pierre , Berger Michel , Chalabreysse Michel , Billiard Michel , Vialle André
Published: January 2017

Position du problème:

Le syndrome d'apnées du sommeil se définit par la survenue, pendant le sommeil, d'arrěts respiratoires de durée supérieure ou égale à 10 secondes, selon un index supérieur ou égal à 5 par heure. Cliniquement, il se caractérise par la présence de ronflements nocturnes sonores continus ou entrecoupés de pauses avec reprise respiratoire bruyante. Le sommeil est agité, entrecoupé d'éveils, peu reposant. Il existe une hypersomnolence diurne avec présence d'endormissements involontaires répétés et souvent méconnus par le sujet.

Description clinique:

Dans cet article, une observation de syndrome d'apnées du sommeil d'origine centrale chez une patiente en thérapeutique de substitution par opiacés est décrite.

Méthodologie:

Une analyse du tracé polysomnographique avant et après sevrage de méthadone est réalisée chez cette patiente.

Discussion:

L'étiologie et la physiopathologie de ce diagnostic font l'objet d'une approche critique. Le rappel d'une attention nécessaire de la part du clinicien face à de tels patients dans le cadre du traitement de troubles du sommeil induits est posé.

Conclusion:

La présence d'apnées centrales est une contre-indication à la prescription de benzodiazépines durant le sevrage d'opiacés de type méthadone.
An Introduction to Economic Evaluation: What's in a Name?
Authors: Hoch Jeffrey S , Dewa Carolyn S
Published: January 2017

Objective:

This paper describes the main types of economic evaluation techniques.

Method:

To examine the strengths and limitations of different types of economic evaluations, we used a hypothetical example to review the reasoning underlying each method and to illustrate when it is appropriate to use each method.

Results:

The choice of economic evaluation method reflects a decision about what should represent “success” and how success should be valued. Measures of benefit and cost must be considered systematically and simultaneously. Claiming that a new treatment is cost-effective requires making a value judgment based on the personal beliefs of the claimant. Even when cost and effect data are objective, a verdict of cost-effective is subjective. The conclusions of an economic study can change significantly, depending on which patient outcome is used to measure success.

Conclusions:

Clinicians must be sure that important patient outcomes are not excluded from economic evaluations. Economic evaluation is a process designed to produce an estimate rather than a decision. New treatment can be more costly and still be cost-effective (if the extra benefit is valued more than the extra cost to produce it). However, since economic evaluation does not explicitly consider a decision maker's available budget, a new treatment can be deemed cost-effective but too expensive to approve.
Major Depression in Patients with Borderline Personality Disorder: A Clinical Investigation
Authors: Bellino Silvio , Patria Luca , Paradiso Erika , Di Lorenzo Rossella , Zanon Caterina , Zizza Monica , Bogetto Filippo
Published: January 2017

Objective:

Borderline personality disorder (BPD) is characterized by a high frequency of comorbidity with major depressive disorder (MDD). This study aimed to compare the clinical characteristics of 2 groups of patients with MDD: those with concomitant BPD and those with other concomitant personality disorders.

Methods:

We assessed 119 outpatients, using a semistructured interview for demographic and clinical features, the Structured Clinical Interview for DSM-IV, Hamilton anxiety and depression scales, the Zung Self-Rating Depression Scale (ZSDS), the Social and Occupational Functioning Assessment Scale (SOFAS), the Sheehan Disability Scale, and the Revised Childhood Experiences Questionnaire. We performed a regression analysis, using the number of criteria for BPD as the dependent variable.

Results:

Severity of BPD was positively related to the ZSDS score, to self-mutilating behaviours, and to the occurrence of mood disorders in first-degree relatives; it was negatively related to the SOFAS score and age at onset of MDD.

Conclusions:

Patients with comorbid MDD and BPD present differential characteristics that indicate a more serious and impairing condition with a stronger familial link with mood disorders than is shown by depression patients with other Axis II codiagnoses.
Facial Expression and Sex Recognition in Schizophrenia and Depression
Authors: Bediou Benoit , Krolak-Salmon Pierre , Saoud Mohamed , Henaff Marie-Anne , Burt Michael , Dalery Jean , D'Amato Thierry
Published: January 2017

Background:

Impaired facial expression recognition in schizophrenia patients contributes to abnormal social functioning and may predict functional outcome in these patients. Facial expression processing involves individual neural networks that have been shown to malfunction in schizophrenia. Whether these patients have a selective deficit in facial expression recognition or a more global impairment in face processing remains controversial.

Objective:

To investigate whether patients with schizophrenia exhibit a selective impairment in facial emotional expression recognition, compared with patients with major depression and healthy control subjects.

Methods:

We studied performance in facial expression recognition and facial sex recognition paradigms, using original morphed faces, in a population with schizophrenia ( n = 29) and compared their scores with those of depression patients ( n = 20) and control subjects ( n = 20).

Results:

Schizophrenia patients achieved lower scores than both other groups in the expression recognition task, particularly in fear and disgust recognition. Sex recognition was unimpaired.

Conclusion:

Facial expression recognition is impaired in schizophrenia, whereas sex recognition is preserved, which highly suggests an abnormal processing of changeable facial features in this disease. A dysfunction of the top-down retrograde modulation coming from limbic and paralimbic structures on visual areas is hypothesized.
A Metaanalysis of Clinical Trials Comparing Moclobemide with Selective Serotonin Reuptake Inhibitors for the Treatment of Major Depressive Disorder
Authors: Papakostas George I , Fava Maurizio
Published: January 2017

Objective:

To compare response rates among patients with major depressive disorder (MDD) treated with either moclobemide, an antidepressant thought to simultaneously enhance both noradrenergic and serotonergic neurotransmission, or selective serotonin reuptake inhibitors (SSRIs).

Methods:

Using a random-effects model, we combined 12 trials involving 1207 outpatients with MDD.

Results:

Patients treated with moclobemide were as likely to experience clinical response as those treated with SSRIs (risk ratio 1.08; 95% confidence interval, 0.92 to 1.26; P = 0.314). Simply pooling response rates for the 2 agents resulted in a 62.1% response rate for moclobemide and a 57.5% response rate for the SSRIs. A metaregression did not reveal a statistically significant relation between the mean moclobemide dosage for each study and the risk ratio for response rates. Further, we found no difference between the 2 treatments in overall discontinuation rates, discontinuation rates due to adverse events, or discontinuation rates due to lack of efficacy. Also, rates of fatigue or somnolence and of insomnia were similar between the 2 treatment groups. However, SSRI treatment was associated with higher rates of nausea, headaches, and treatment-emergent anxiety than was treatment with moclobemide.

Conclusions:

These results suggest that moclobemide and the SSRIs do differ with respect to their side effect profiles but not in their overall efficacy in the treatment of MDD.
Lithium and Triiodothyronine Augmentation of Antidepressants
Authors: Joffe Russell T , Sokolov Stephen TH , Levitt Anthony J
Published: January 2017

Objective:

To evaluate the relative benefits of the combination of lithium and triiodothyronine (T3) in augmentation of antidepressants, compared with either lithium or T3 alone.

Methods:

We performed a 2-week, randomized, double-blind, placebo-controlled pilot study of the addition of lithium compared with T3 compared with the combination of both in subjects with major depressive disorder who had not responded to an antidepressant.

Results:

All groups improved significantly over the 2 weeks of treatment, but there were no significant between-group differences.

Conclusion:

There may be no advantage to a combination of these augmenting agents, although we failed to show separation between active treatments and placebo.
Rang de naissance, difficultés de comportement et relation mère-enfant chez des jeunes de 4 à 11 ans de fratries composées de deux enfants
Authors: Marleau Jacques D , Saucier Jean-François , Allaire Jean-François
Published: January 2017

Objectif:

Cette étude vise à préciser la relation entre certaines caractéristiques de la fratrie (rang de naissance, sexe des membres de la fratrie et intervalle intergénésique) et certaines difficultés de comportement d'enfants d'une part, et certaines dimensions de la relation mère-enfant d'autre part.

Méthode:

L'échantillon, tiré de l'Enquěte longitudinale nationale canadienne sur les jeunes et les enfants, est constitué de 1211 familles composées de deux enfants biologiques âgés entre 4 et 11 ans. Les difficultés de comportement et les dimensions de la relation mère-enfant ont été évaluées par les mères. Des analyses de variance multivariée à mesure répétée ont été effectuées.

Résultats:

Les analyses révèlent que les premiers-nés présentent plus de symptômes intériorisés que les seconds-nés. Aussi, les seconds-nés ont plus d'interactions positives avec leur mère que les premiers-nés. L'intervalle de temps entre les naissances ne modifie pas ces résultats.

Conclusion:

Quelques différences ressortent entre les enfants de měmes fratries. Les professionnels de la santé devraient tenir compte de ces particularités lors de leurs évaluations cliniques.
Adult Bipolar Disorder is Continuous with Pediatric Bipolar Disorder
Authors: Chang Kiki
Published: January 2017

Considerable debate exists regarding the continuity of bipolar disorder (BD) in children and adolescents. Do affected children continue to have BD as adults? Are pediatric forms of BD distinct from adult forms of the disorder? Here, I argue that, in fact, strictly defined BD I and II in children and adolescents is continuous with adult BD. First, if we take developmental differences into account, children and adults share similar symptoms, since they are both diagnosed according to DSM-IV criteria. Next, retrospective studies indicate that 50% to 66% of adults with BD had onset of their disorder before age 19 years. Early prospective data indicate that adolescents with BD progress to become young adults with BD. Further, family studies of pediatric BD probands find high rates of BD in adult relatives, and pediatric offspring of parents with BD have elevated rates of BD, compared with control subjects. Finally, biological characteristics of pediatric BD (such as treatment response, neurobiology, and genetics) are either shared with adults having BD or fit logically into developmental models of BD. Thus, while not conclusive, a preponderance of data support the hypothesis that pediatric BD is continuous with adult BD. Prospective studies incorporating phenomenological and biological assessment are needed to decisively address this issue.
Geographical Variation in the Prevalence of Problematic Substance Use in Canada
Authors: Veldhuizen Scott , Urbanoski Karen , Cairney John
Published: January 2017

Objective:

The prevalence of substance-related problems has been shown to vary between Canadian provinces, but little else is known about the pattern of geographical differences. In this study, we modelled these differences, using methods of spatial analysis, and attempted to determine whether they are explained by known risk factors.

Methods:

We used data from Cycle 1.2 of the Canadian Community Health Survey. We tested interprovincial differences, before and after adjustment for covariates, and also examined differences between urban areas. We then used interpolation techniques to model variation in prevalence without reference to administrative boundaries. Finally, we performed a spatial cluster scan for areas of heightened prevalence.

Results:

The prevalence of problematic substance use is lower in Ontario and Quebec than in the rest of the country. This pattern is due principally to low prevalence in Toronto, Montreal, and surrounding areas. Prevalence is higher in mid-sized cities than in larger ones or in rural areas. Problematic substance use shows a fairly high degree of spatial clustering, especially within major cities. Interprovincial differences and clustering are generally not explained by known risk factors.

Conclusions:

The pattern of large-scale differences is consistent with existing research and is probably part of a larger disparity among regions of Canada. The persistence of variation after adjustment for covariates suggests the influence of unmeasured, geographically varying factors, of which there are several candidates, including latitude and immigrant settlement patterns.
Benefits of Enriched Intervention Compared with Standard Care for Patients with Recent-Onset Psychosis: A Metaanalytic Approach
Authors: Harvey Philippe-Olivier , Lepage Martin , Malla Ashok
Published: January 2017

Objective:

To assess the effectiveness of enriched intervention (EI) on symptomatic and functional outcomes, compared with standard care (SC).

Method:

Studies were retrieved from search engines and, using a metaanalytic approach, we compared EI trials with SC trials. Eleven EI sample trials (1053 patients) and 6 SC sample trials (500 patients), totalling data from 1553 patients (69% male), were examined. We calculated the effect sizes (ESs) of both symptomatic and functional improvement over a follow-up period of about 1 year.

Results:

Significant differences between EI and SC were observed at follow-up for the improvement of both positive and negative symptoms, respectively: positive, EI = −1.54 (95%CI, −1.63 to −1.45) and SC = −1.07 (95%CI, −1.19 to −0.94) ( Qbetween = 40.3, df 1, P < 0.001); negative, EI = −0.44 (95%CI, −0.53 to −0.35) and SC = −0.18 (95%CI, −0.31 to −0.05) ( Qbetween = 10.6, df 1, P < 0.01). We also observed a significant difference between the EI and the SC groups for functional improvement over the follow-up period with mean EI = 1.11 (95%CI, 0.99 to 1.23) and SC = 0.63 (95%CI, 0.49 to 0.77) ( Qbetween = 24.5, df 1, P < 0.001).

Conclusions:

There is now quantitative evidence across multiple studies and sites to indicate that EIs for patients with recent-onset psychosis are significantly more effective than SC for symptomatic and functional improvement over a period of about 1 year.
Preexisting Neuroticism, Subjective Stressor Severity, and Posttraumatic Stress in Soldiers Deployed to Iraq
Authors: Engelhard Iris M , van den Hout Marcel A
Published: January 2017

Objective:

To investigate the extent to which preexisting neuroticism confounds the relation between appraisals of the severity of major and minor stressors and posttraumatic stress disorder (PTSD) symptoms.

Method:

A sample of 383 Dutch army soldiers completed a neuroticism scale before their 4-month tour of duty in Iraq. About 5 months after deployment, most of them rated the severity of stressors on deployment. PTSD symptoms were also assessed.

Results:

Appraisal of major stressors in Iraq was significantly related to PTSD symptoms and was, for the most part, independent of neuroticism. However, the strength of the association between minor stressors and PTSD symptoms dropped by 31% after statistical control for neuroticism.

Conclusion:

Neuroticism may partly compromise the relation between perceived minor stressors and PTSD symptoms.
Posttraumatic Stress Disorder and Associated Risk Factors in Canadian Peacekeeping Veterans with Health-Related Disabilities
Authors: Richardson J Don , Naifeh James A , Elhai Jon D
Published: January 2017

Objectives:

This study investigates posttraumatic stress disorder (PTSD) and its associated risk factors in a random, national, Canadian sample of United Nations peacekeeping veterans with service-related disabilities.

Methods:

Participants included 1016 male veterans (age < 65 years) who served in the Canadian Forces from 1990 to 1999 and were selected from a larger random sample of 1968 veterans who voluntarily and anonymously completed a general health survey conducted by Veterans Affairs Canada in 1999. Survey instruments included the PTSD Checklist-Military Version (PCL-M), Center for Epidemiological Studies-Depression Scale (CES-D), and questionnaires regarding life events during the past year, current stressors, sociodemographic characteristics, and military history.

Results:

We found that rates of probable PTSD (PCL-M score > 50) among veterans were 10.92% for veterans deployed once and 14.84% for those deployed more than once. The rates of probable clinical depression (CES-D score > 16) were 30.35% for veterans deployed once and 32.62% for those deployed more than once. We found that, in multivariate analyses, probable PTSD rates and PTSD severity were associated with younger age, single marital status, and deployment frequency.

Conclusions:

PTSD is an important health concern in the veteran population. Understanding such risk factors as younger age and unmarried status can help predict morbidity among trauma-exposed veterans.
Reduction of Length of Stay in an Acute Care Psychiatric Unit
Authors: Edward-Chandran Therese , De Malcolm  , Bowen RC
Published: January 2017

Objective:

To study the association between reduced length of stay in an acute care psychiatric unit and readmission rates.

Method:

Data on average length of stay, total discharges and readmission rates from April 1988 to March 1994 for 2 hospitals with high average lengths of stay was obtained from the Canadian Institute for Health Information database.

Results:

The average length of stay decreased from 25 days to 16 days, reaching the national level at one hospital. An initial increase in the readmission rate subsequently declined to pre-study levels. There was no change in length of stay at the other hospital.

Conclusion:

Reducing the length of stay in an acute care facility by 9 days to an average of 16 days did not lead to a sustained increase in the readmission rate.
Antisocial Personality Disorder: A Biopsychosocial Model
Authors: Paris Joel
Published: January 2017

Objective:

To propose an etiological model of antisocial personality disorder that is grounded in empirical data.

Method:

Recent research findings are reviewed that clarify our understanding of the etiology and course of antisocial pathology.

Results:

Neither biological nor psychological factors fully account for the development of this disorder. Epidemiological studies show that there are strong cross-cultural differences in its prevalence, pointing to the importance of social factors in its etiology. Outcome research shows that antisocial personality only partially remits with time, and that most patients continue to be dysfunctional in later life. No treatment modality has been shown to be effective.

Conclusions:

All these empirical findings can be accounted for by a biopsychosocial model of antisocial personality disorder.
Clozapine: Current Status and Role in the Pharmacotherapy of Schizophrenia
Authors: Remington Gary J , Addington Donald , Collins Evan J , Jones Barry D , Lalonde Pierre , MacCrimmon Duncan J , MaCewan G William
Published: January 2017

Objective:

This study evaluates clozapine and its present role in the pharmacotherapy of schizophrenia.

Method:

Clozapine's current clinical status is reviewed, as is its position with respect to other treatment options.

Results:

Clozapine represents the prototype of “atypical” neuroleptics, with evidence of clinical efficacy in both positive and negative symptoms, as well as a diminished risk of extrapyramidal side effects. It is the only neuroleptic to date that has established itself as having little, if any, risk of tardive dyskinesia. More recent research has focused on its potential for overall savings in health care costs, as well as possible benefits in the area of neuropsychological functioning.

Conclusion:

Evidence suggesting that the course of schizophrenia can be altered by effective treatment favours a systematic approach that optimizes treatment options. While clozapine does not represent a 1st-line agent because of its risk of agranulocytosis, it has an integral role to play in treatment-resistant schizophrenia or in individuals experiencing intolerable side effects with conventional neuroleptics.

Objectif:

La présente étude vise à évaluer la clozapine et son rôle actuel dans la pharmacothérapie de la schizophrénie.

Méthode:

On évalue l'emploi clinique actuel de la clozapine ainsi que sa position par rapport à d'autres options de traitement.

Résultats:

La clozapine constitue le prototype des neuroleptiques «atypiques,» révélant une efficacité clinique autant sur les symptômes positifs que négatifs ainsi qu'un risque réduit d'effets secondaires extrapyramidaux. Elle constitue le seul neuroleptique à ce jour associé à peu, voire pas du tout, de risque de dyskinésie tardive. De récentes recherches se sont penchées sur son potentiel d'économies globales en soins de santé ainsi que sur ses avantages en matière de fonctionnement neuropsychologique.

Conclusion:

L'information qui suggère que l'évolution de la schizophrénie peut être modifiée par un traitement efficace encourage une approche systématique optimisant les options de traitement. Bien que la clozapine ne soit pas un médicament d'élection étant donné le risque d'agranulocytose, elle joue un rôle important dans le traitement de la schizophrénie résistante au traitement ou chez les personnes pour qui les effets secondaires des neuroleptiques conventionnels sont intolérables.
A Critical Review of Recovered Memories in Psychotherapy: Part II—Trauma and Therapy
Authors: Paris Joel
Published: January 2017

Objective:

The clinical implications of the use of recovered memories in psychotherapy will be examined.

Method:

The paper will review the relationship of trauma to psychopathology and discuss how traumatic histories might be dealt with in therapy.

Results:

Trauma is a risk factor for psychopathology, but is only one of many etiological factors in mental disorders. The search for recovered memories in psychotherapy could present dangers for patients.

Conclusions:

The most reliable memories of trauma are those that have been present throughout the patient's life.
The Characteristics and Intervention Histories of Incarcerated and Conduct-Disordered Youth
Authors: Shamsie Jalal , Hamilton Hayley , Sykes Cynthia
Published: January 2017

Objectives:

1) To determine if incarcerated youth and conduct-disordered youth in treatment display similar risk factors associated with chronicity of antisocial behaviour; 2) to determine if incarcerated youth had experienced high numbers of interventions by many different agencies as has been reported for conduct-disordered youth in treatment.

Method:

The files of 25 conduct-disordered youth in treatment and 25 incarcerated youth were examined to extract all relevant data.

Results:

Incarcerated youth were similar to conduct-disordered youth with regard to the number of symptoms of disruptive behaviour disorders, age of onset of behavioural problems, and family backgrounds. Both groups had high numbers of interventions and agencies in their histories. Interventions began earlier for the conduct-disordered youth.

Conclusion:

The distinction between conduct-disordered youth who are treated and youth who are incarcerated may be arbitrary and accidental. Given the similarity in the clinical characteristics, incarcerated youth should be offered help that is similar to that offered to conduct-disordered youth. Such help may lower the rate of recidivism.