bluuebunny/crossref_metadata_2025 huggingface dataset:
Trust and Distrust in Salesperson–Supervisor Dyadic Relationship and Its Impact on Sales Performance
Authors: Singh Ramendra
Published: June 2008

Interpersonal trust, one of the key elements in the foundation of social relationships, occupies a central position in the formation of socio-economic dyadic relationships. Yet, the impact of interpersonal trust in the marketing context on individual performance is rarely treated with any qualifying riders. This may probably be due to trust's assumed normative bias and its high intuitive appeal. Confusion prevails in literature on whether trust and distrust are distinct constructs or flip sides of the same construct of trust (low trust and high distrust assumed to be same), have been addressed in this article. Moreover, studies on the role of distrust in dyadic relationships are largely absent in marketing literature and very few, if any, studies have been carried out on the impact of interpersonal distrust on (sales) performance. In this article, the parallel (and simultaneous) roles of trust and distrust on supervisee's sales performance in the salesperson–supervisor relationship context, within an organization are explored. The extant relevant literature on the role of dyadic trust in the context of sales management (e.g., supervisee–supervisor relationship), and how it can be viewed as contingent on various factors is reviewed here. The role of trust and distrust, and the moderating influence of sales control, supervisory behaviour and supervisory feedback have also been explored in detail in the article, through a series of propositions.
Doing Emotional Labour
Authors: D'Cruz Premilla , Noronha Ernesto
Published: June 2008

A qualitative study undertaken in Bangalore and Mumbai, India, on subjective work experiences of call centre agents, uncovered four major themes addressing agents’ perceptions of and responses to emotional labour demands. These include reorienting self, balancing expectations, neutralizing stress and humouring irate customers. The findings further our understanding by highlighting the presence of normative control, the relevance of dispositional factors, the implications of coping mechanisms and the complexities introduced by global outsourcing.
Transformation of an Emerging Economy to a Knowledge–based Economy
Authors: Kim Renee B.
Published: June 2008

As the world economy is increasingly adopting innovative technology, public policies for technology implementation play a significant role in economic growth and international competitiveness for a country. This article presents a Korean case to assess the importance and effectiveness of government technology-innovation policy for economic growth and development. The article explores historical aspects of the Korean government's economic policy that entailed measures to establish a technology support system; strategic changes in Korean public policy for innovative technology and the Korean government's promotion of a knowledge-based economy in recent years; and specific policy measures related to this objective. The article also addresses a few major challenges in the Korean knowledge-based economy.
The Story of an Aborted Revolution
Authors: Bandyopadhyay Sekhar
Published: June 2008

In the early days of independence the province of West Bengal witnessed a violent communist upsurge in 1948–50. In many ways the events of this period foreshadowed what happened in this province during the Naxalite experiment of the late 1960s and the early 1970s. This paper, using recently declassified IB records, seeks to reconstruct this less-known episode in the history of the communist movement in India. It was apparently an attempt to revive the Tebhaga movement, which was left half way in 1946. But in areas it touched on a variety of issues affecting marginal peasants and industrial workers in the early years of independence. In the end it appeared that the mass support for this attempted ‘people's democratic revolution’ was sporadic, localised and issue-based. In 1950, following an intense internal ideological debate within the party, the Communist Party of India (CPI) decided to abandon its revolutionary line and decided to participate in the forthcoming general elections. This paper unravels this process of transformation of the communist movement in India from a revolutionary to a constitutional movement operating within the perimeters of mass electoral politics.
A Tale of Three Villages
Authors: Lewis David , Hossain Abul
Published: June 2008

This article discusses a set of qualitative data collected in 2004 on changes in formal and informal aspects of local institutions and power in Bangladesh, drawn from three contrasting villages of Greater Faridpur district. It explores the idea that the rural power structure, previously conceived as relatively rigid ‘net’, is in certain ways becoming more open and less constraining to poor people. This loosening of the net takes different forms across the three contexts depending on locality. Each of the three villages is seen to experience a common set of wider institutional pressures from outside, such as increased levels of party politicisation within decentralising politics, different forms of intervention by non-governmental organisations (NGOs), and the attempted reform of mechanisms for local dispute settlement. However, the local trajectories of change in each village arising from such interventions is found to vary depending on local circumstances and conditions, as do the implications of change for addressing rural poverty.
The Breakdown in North-East India
Authors: Hassan M. Sajjad
Published: June 2008

This article tries to unravel the drivers of the protracted ethnic and secessionist conflicts, and the resultant disorder that have marred the north-eastern region of India. These conflicts have mostly been explained using the grievance narrative. But such explanations fail to account for the large variance in violence levels within the region. A rather more fruitful line of inquiry is provided by a state-society reading of the political history of the north-east that highlights the fact that conflicts there are accompanied by a contested and weak authority of governmental agencies and the fragmentation of society. Unpacking this causal connection demands that one delve into the region's history to study the process of state-making—how state leaders in colonial and post-colonial times established bureaucratic apparatuses, and constructed and mobilised collective identities in an effort at legitimacy. By focusing on the cases of Mizoram and Manipur, and their very divergent success with mitigating conflicts, and using qualitative sources of data, the paper demonstrates that in Mizoram the process of state-making was such that it consolidated the public legitimacy and authority of reigning institutions among all sections of society, resulting in the strengthened capability of government agencies to provide services, manage group contestations and avoid breakdown. In Manipur it was localised and traditional centres of power—tribal and ethnic associations—that gained in authority, in effect compromising the legitimacy of the government and the institutional capability of its agencies.
Contested Claims
Authors: Bano Masooda
Published: June 2008

While international development institutions continue to employ the notions of ‘social capital’ and ‘civil society’ to support their policy of channelling development aid through Southern NGOs, a growing number of studies record NGOs' inability to mobilise members. A countrywide survey of public perceptions of the term ‘NGO’ in Pakistan reveals two striking results: one, dependence on development aid is posing serious challenges to NGOs' public legitimacy; two, strong ideological commitment on the part of the leader of the organisation plays a critical role in shaping an individual's decision to support an organisation, and high monetary compensations made available to the leaders of the NGOs through development aid are interpreted as lack of commitment and negatively impact organisational membership. These findings have important implications for the development agencies' ambition to push the ‘good governance’ agenda through the NGOs in the South.
The South Asian Free Trade Agreement
Authors: Weerakoon Dushni , Thennakoon Jayanthi
Published: June 2008

The South Asian Free Trade Agreement (SAFTA), due to have been implemented starting July 2006, has adopted a negative list approach permitting member countries to potentially exclude a substantial share of intraregional trade from the tariff liberalisation process. This study finds that the excluded trade amounts to nearly 53 per cent of current import trade amongst South Asian countries, bringing into question the future prospects for meaningful economic cooperation under a regional framework. At the very least, if the SAFTA treaty had built on the existing bilateral FTAs in the region, it would eventually have come to supersede such agreements. Unfortunately, the regional initiative has lagged well behind the bilateral process, and is likely to be overtaken by alternative strategic trade policy initiatives cropping up in the region. It seems likely that attempts at economic integration of the South Asian region under the SAARC framework is liable to fragment.
Transition to Preschool Programs for Young Children With Disabilities
Authors: Malone Delia G. , Gallagher Peggy A.
Published: July 2008

The purpose of this study was to examine factors influencing easier transitions and placements of young children with disabilities into Part B preschool special education programs. The authors examined associations between children's referral age and the following factors: (a) level of functioning of the child, (b) educational level of the mother, and (c) source of the referral. They also sought to determine if these variables might assist in predicting placement on or before the child's 3rd birthday or placement after the child's 3rd birthday. Source of referral and child's level of functioning were significant factors in predicting age at referral and age at placement with source of referral carrying the heaviest weighting, especially for referrals from the Part C early intervention system.
Assigning Cases to Groups Using Taxometric Results
Authors: Ruscio John
Published: July 2008

Determining whether individuals belong to different latent classes (taxa) or vary along one or more latent factors (dimensions) has implications for assessment. For example, no instrument can simultaneously maximize the efficiency of categorical and continuous measurement. Methods such as taxometric analysis can test the relative fit of taxonic and dimensional models, but it is not clear how best to assign individuals to groups using taxometric results. The present study compares the performance of two classification techniques—Bayes' theorem and a base-rate technique—across a wide range of data conditions. The base-rate technique achieves greater classification accuracy and a more even balance between sensitivity and specificity. In addition, the base-rate classification technique is easier to implement than Bayes' theorem and is more versatile in that it can be used when the context of assessment requires that cases be classified despite the absence of latent classes.
2D, Quasi 3D and 3D Exact Solutions for Bending of Thick and Thin Sandwich Plates
Authors: Demasi Luciano
Published: June 2008

A previous author's work related to the exact solution of a single layer isotropic plate is extended to the case of multilayered plate structures composed of isotropic layers. The method solves a first order linear system of differential equations in the unknown amplitudes of the displacements and stresses. An eigenvalue problem, in which analytical expressions for the basis of eigenvectors and generalized eigenvectors are available, is then formulated. This makes the coding of exact solution of multilayered structures very simple and effective compared with other exact methods present in the literature. The paper is mainly concerned about the analysis of sandwich structures made of isotropic layers. Challenging cases of thick and moderately thick plates (a/h = 1, 4, 10) and thin plates (a/h = 100) are analyzed in detail and the displacements and stresses are found and plotted through the thickness of the plate. An extensive study of the ratio between the elastic modulus of the skins and the elastic modulus of the core, as well as the change in the displacements and stresses with that parameter, is conducted. The exact three-dimensional results are also validated with quasi-3D results obtained by adopting a mixed assiomatic theory of order 9 presented here for the first time. Twenty three two-dimensional theories are assessed, five of which are presented here for the first time. The use of Murakami's zig—zag function and the consequent improvement of the ESL theories is also analyzed and discussed. All the results of this work are an useful tool to test and compare approximated methods, such as Finite Element Method.
Effect of Sandwich Configuration on Behavior of Honeycomb Core
Authors: Sue Ji-Woong , Whitcomb John
Published: June 2008

The behavior of regular hexagonal honeycomb core with and without a facesheet is studied using 3D finite element-based micromechanics. The core without a facesheet is also studied using several versions of beam analysis in order to assess the accuracy of the simplified analyses. The effect of the facesheet on the core behavior is evaluated in terms of how much the distortion of the core and the stress distribution were changed by the presence of the facesheet. In situ effective properties of the core with a facesheet are estimated using periodic analysis of a representative volume element. The effects of various geometric parameters on in situ effective properties are determined. Finally, linear buckling analysis is conducted to study the effect of facesheet stiffness and core geometry on the core buckling behavior under out-of-plane shear loading.
The Clinical Significance of Plasmatic Amyloid Aβ-40 Peptide Levels in Alzheimer's Disease Patients Treated With Galantamine
Authors: Modrego Pedro J. , Monleon Inmaculada , Sarasa Manuel
Published: June 2008

To date there are no conclusive reports on the usefulness of determining amyloid peptides in the serum of patients with Alzheimer's disease (AD). Only anecdotal works deal with the changes in the peptides produced by cholinesterase inhibitors. In this study, the authors investigated and studied the clinical significance of plasmatic Aβ-40 and Aβ-42 peptide levels in a series of 34 consecutive patients with AD. The baseline levels of the Aβ-40 peptide correlated negatively with the Mini Examen Cognoscitivo (Spanish version of the Mini-Mental test) score. Complete follow-up was possible in 22 patients. After 6 months of treatment with galantamine, the mean Aβ-40 peptide levels decreased from 31.86 to 24.22 pg/mL. The baseline levels of Aβ-40 were predictive of response to treatment in the Alzheimer's Disease Assessment Scale—Cognitive Subscale. The authors conclude that determining plasmatic Aβ-40 peptide levels could be useful in predicting and monitoring response to treatment in AD.
Sea Urchin Spine Injuries of the Hand
Authors: AHMAD R. , MC CANN P. A. , BARAKAT M. , ASTLE L. , CASE R. , BHATIA R.
Published: July 2008

Sea urchin spine injuries are common. They usually cause local pain and swelling that subsides. Chronic granulation is rare. We report two cases of sea urchin granulomata involving finger metacarpophalangeal joints. Both resolved following surgery.
Phosphodiesterase inhibitors for the treatment of pulmonary hypertension
Authors: Wilkins M. R. , Wharton J. , Grimminger F. , Ghofrani H. A.
Published: June 2008

The pulmonary vascular bed is both a source of and target for a number of vasoactive factors. Among the most important for pulmonary vascular homeostasis are factors that utilise cyclic guanosine monophosphate (cGMP) as an intracellular second messenger. These include nitric oxide and the natriuretic peptide family (atrial, brain and C-type natriuretic peptides). In the search for therapeutic strategies that engage the cGMP signalling pathway for the treatment of pulmonary arterial hypertension (PAH), inhibition of cGMP metabolism by phosphodiesterase type 5 (PDE5)-targeted compounds has proven most successful to date. One PDE5 inhibitor, sildenafil, has been shown to improve pulmonary haemodynamics and exercise capacity in patients with PAH and is now an approved treatment. Others are under investigation.

An interesting, although still tentative, observation is the potential of sildenafil to reduce pulmonary vascular resistance without adversely affecting ventilation–perfusion matching. Another is the expression of phosphodiesterase type 5 in the hypertrophied right ventricle. These data suggest that phosphodiesterase type 5 inhibitors may have effects that distinguish them from other treatments for pulmonary hypertension and merit further study.
Re-activation of bovine tuberculosis in a patient treated with infliximab: Table 1—
Authors: Larsen M. V. , Sørensen I. J. , Thomsen V. Ø. , Ravn P.
Published: June 2008

Treatment with tumour necrosis factor-α inhibitors increases the risk of tuberculosis (TB). Screening for latent TB infection (LTBI) and prophylactic treatment has become mandatory.

A 79-yr-old female with a history of severe erosive sero-positive rheumatoid arthritis was screened for LTBI before initiation of treatment with infliximab. The tuberculin skin test (TST) was negative, chest radiography was normal and she had no known risk factors for TB. After 4 months of treatment with infliximab, the patient developed ascites caused byMycobacterium bovis. The TST was repeatedly negative. QuantiFERON®-TB (QFT) testing performed during screening and immunosuppressive treatment was indeterminate, whereas the QFT test performed at the time of ascites puncture was positive.

The patient history revealed previous work at a dairy, with probable exposure to unpasteurised milk fromM. bovis-infected cattle.

Re-activation of bovine tuberculosis is a risk in people with recent or previous exposure to unpasteurised dairy products. The QuantiFERON®-TB test has the potential to detectMycobacterium bovisinfection. Indeterminate test results reflect either anergy, due to poor immunity, or technical problems and should be cautiously interpreted and as a minimum be repeated. Studies are ongoing to determine the role of QuantiFERON®-TB testing in the screening for latent tuberculosis infection.
Nonpharmacological treatment and relief of symptoms in COPD: Table 1—
Authors: Clini E. M. , Ambrosino N.
Published: June 2008

Evidence-based guidelines for chronic obstructive pulmonary disease (COPD) have recently been developed.

Nonpharmacological treatments have evolved rapidly as an essential part of COPD therapy. They are especially important as complementary interventions in severe or very severe disease, when there is loss in function, a reduction in quality of life and when psychological impairments further complicate the disease.

The present article discusses the most used nonpharmacological treatments for severe COPD patients (rehabilitation, long-term oxygen therapy, surgery, noninvasive positive pressure ventilation and supportive nutrition) and their evidence-based usefulness in promoting strategies that relieve symptoms.

All of these interventions are used during end-stage disease, to promote self-efficacy, relieve symptoms and prevent further deterioration. These therapeutic options support physicians and allied professionals in improving symptom management for their patients.
Statistical analysis of exacerbation rates in COPD: TRISTAN and ISOLDE revisited
Authors: Keene O. N. , Calverley P. M. A. , Jones P. W. , Vestbo J. , Anderson J. A.
Published: June 2008

Various statistical methods have been used to measure the impact of treatment on chronic obstructive pulmonary disease (COPD) exacerbations. Poisson regression has recently been recommended as the appropriate method but the model does not satisfactorily account for variability between patients. In contrast, use of a negative binomial model, which corresponds to assuming a separate Poisson parameter for each patient, offers a more appealing approach.

The present paper reviews analysis methods, with particular focus on the negative binomial model. To illustrate the differences that arise from using different analysis methods, we have reanalysed data from two large studies which, among other objectives, investigated the effectiveness of inhaled corticosteroids in reducing COPD exacerbation rates.

Using the negative binomial model to reanalyse data from the TRISTAN and ISOLDE studies, the overall estimates of exacerbation rates on each treatment arm are higher and the confidence intervals for comparisons between treatments are wider, but the overall conclusions of TRISTAN and ISOLDE regarding reduction of exacerbations remain unchanged.

The negative binomial approach appears to provide a better fit to the distribution of the data than earlier methods and is currently the method of choice. Research needs to continue on further methods to improve the analysis of exacerbation data.
The ORFeome of Staphylococcus aureus v 1.1
Authors: Brandner Christina J , Maier Richard H , Henderson Daryl S , Hintner Helmut , Bauer Johann W , Önder Kamil
Published: July 2008

Background

The bacterium Staphylococcus aureus causes significant morbidity and mortality in humans, primarily due to the emergence of strains that are resistant to antibiotics – notably methicillin-resistant S. aureus (MRSA) isolates. Development of effective strategies for the control and treatment of MRSA infections may best be achieved through 'omics' approaches, which first requires cloning the entire set of S. aureus' protein-encoding open reading frames (ORFs), or ORFeome.

Results

The complete genome sequence of S. aureus strain Mu50 has 2697 predicted protein-coding ORFs. Based on the sequence of this strain we designed PCR primers to construct from an S. aureus (non-MRSA) clinical isolate an ORFeome library that contains 2562 unique Gateway® entry clones (95% coverage), each corresponding to a defined ORF. The high quality of the ORFeome library was verified by DNA sequencing and PCR amplification, and its functionality was demonstrated by expressing recombinant proteins and observing protein interactions in a yeast 2-hybrid homodimerization screen.

Conclusion

This first ORFeome library for S. aureus provides an essential new tool for investigating the systems biology of this important pathogen.
Laparoscopic partial gastric transection and devascularization in order to enhance its flow
Authors: Cuenca-Abente Federico , Assalia Ahmad , del Genio Gianmattia , Rogula Tomasz , Nocca David , Ueda Kazuki , Gagner Michel
Published: July 2008

Background

Esophagogastric fistula following an esophagectomy for cancer is very common. One of the most important factors that leads to its development is gastric isquemia. We hypothesize that laparoscopic gastric devascularization and partial transection is a safe operation that will enhance the vascular flow of the fundus of the stomach.

Method

Our study included eight pigs. Each animal had two operations. In the first one, a laparoscopic gastric devascularization and mobilization took place. Vascular flow was measured previous to the procedure and immediately after it with a laser doppler (endoscopic probe). After three weeks, a second operation took place. We re-measured the vascular flow and sent a sample of gastric fundus for histopathologic evaluation.

Results

The gastric fundus showed signs of neovascularization after both macroscopic and microscopic evaluation. These findings correlated with laser doppler measurements.

Conclusion

Laparoscopic gastric devascularization and partial transection is a safe procedure that increases the vascular flow of the stomach in a three week period. This finding can have a positive impact in terms of decreasing fistula formation.
Protein structure protection commits gene expression patterns
Authors: Chen Jianping , Liang Han , Fernández Ariel
Published: July 2008

Background

Gene co-expressions often determine module-defining spatial and temporal concurrences of proteins. Yet, little effort has been devoted to tracing coordinating signals for expression correlations to the three-dimensional structures of gene products.

Results

We performed a global structure-based analysis of the yeast and human proteomes and contrasted this information against their respective transcriptome organizations obtained from comprehensive microarray data. We show that protein vulnerability quantifies dosage sensitivity for metabolic adaptation phases and tissue-specific patterns of mRNA expression, determining the extent of co-expression similarity of binding partners. The role of protein intrinsic disorder in transcriptome organization is also delineated by interrelating vulnerability, disorder propensity and co-expression patterns. Extremely vulnerable human proteins are shown to be subject to severe post-transcriptional regulation of their expression through significant micro-RNA targeting, making mRNA levels poor surrogates for protein-expression levels. By contrast, in yeast the expression of extremely under-wrapped proteins is likely regulated through protein aggregation. Thus, the 85 most vulnerable proteins in yeast include the five confirmed prions, while in human, the genes encoding extremely vulnerable proteins are predicted to be targeted by microRNAs. Hence, in both vastly different organisms protein vulnerability emerges as a structure-encoded signal for post-transcriptional regulation.

Conclusion

Vulnerability of protein structure and the concurrent need to maintain structural integrity are shown to quantify dosage sensitivity, compelling gene expression patterns across tissue types and temporal adaptation phases in a quantifiable manner. Extremely vulnerable proteins impose additional constraints on gene expression: They are subject to high levels of regulation at the post-transcriptional level.
The Dying Child
Authors: Oyebode Femi
Published: June 2008

He could not die when trees were green,For he loved the time too well.His little hands, when flowers were seen,Were held for the bluebell,As he was carried o'er the green.
Big boys don't cry: depression and men
Authors: Branney Peter , White Alan
Published: June 2008

Men are a numerical minority group receiving a diagnosis of, and treatment
for, depression. However, community surveys of men and of their mental
health issues (e.g. suicide and alcoholism) have led some to suggest that
many more men have depression than are currently seen in healthcare
services. This article explores current approaches to men and depression,
which draw on theories of sex differences, gender roles and hegemonic
masculinity. The sex differences approach has the potential to provide
diagnostic tools for (male) depression; gender role theory could be used to
redesign health services so that they target individuals who have a
masculine, problem-focused coping style; and hegemonic masculinity
highlights how gender is enacted through depression and that men's
depression may be visible in abusive, aggressive and violent practices.
Depression in men is receiving growing recognition, and recent policy
changes in the UK may mean that health services are obliged to incorporate
services that meet the needs of men with depression.
The active management of delirium: improving detection and
treatment
Authors: Meagher David , Leonard Maeve
Published: June 2008

The management of delirium requires careful consideration of the potential
value both of pharmacological interventions and of a range of non-drug
strategies. Although placebo-controlled studies of delirium treatment are
lacking, less robust evidence can still inform practice. This review makes
the case for more active management of delirium on the basis of recent
studies of prevention, early identification and treatment both during an
episode and managing the aftermath in survivors. A drug-treatment algorithm
for delirium advising how drug treatments can be tailored to the specific
needs of individual patients is described.
What can the science of well-being tell the discipline of psychiatry – and why might psychiatry listen?
Authors: Hanlon Phil , Carlisle Sandra
Published: June 2008

There is a field of knowledge that speaks of the promotion of positive mental health, well-being and happiness yet it may not be well-known to all psychiatric practitioners. Economists, geneticists, positive psychologists, evolutionary psychologists, neuroscientists and sociocultural researchers have all contributed to what might be termed the emerging science of well-being. This article provides a brief introduction to this complex topic. We outline some of the findings, theories and arguments from this comparatively new but burgeoning research area. We also rehearse some critical responses to this field which indicate that both the evidence on well-being and the implications for practice and policy might be less straightforward than researchers sometimes imply. We conclude by suggesting that psychiatrists, as leaders in the field of mental health, might want to consider the implications (positive and negative) of well-being research for the development of their own discipline and professional practice.
Confidentiality in Munchausen's syndrome
Authors: Farmer Anne E.
Published: June 2008

This commentary questions whether the usual ethical and legal requirements
for maintaining confidentiality of individuals who fabricate illness should
be breached in order to prevent further harm to themselves as well as cost
to society. A case report of an individual with Munchausen's syndrome
submitted for publication in Advances in Psychiatric
Treatment provoked considerable Editorial discussion regarding
the absence of written informed consent from the individual described. It is
hoped that this commentary will widen the debate regarding the requirement
for confidentiality in the exceptional circumstances of patients with
Munchausen's syndrome.
Is CEX good for psychiatry? An evaluation of workplace-based assessment
Authors: Searle Geoffrey F. , Searle Geoffrey F.
Published: June 2008

Workplace-based assessment is a core element of the changes introduced in Modernising Medical Careers (MMC), yet it has been sparsely researched in the UK and there are still psychometric and validity data needed to support its introduction. Supervisors and tutors are wary of it, but it could replace external clinical examinations leading to a Certificate of Completion of Training. The theoretical background of assessment in the workplace is ‘Miller's pyramid’ of competence in which the trainee progresses from ‘knowing’ (tested by paper exam), through ‘knows how’, to ‘shows how’ (tested by the Observed Standardised Clinical Examination), and finally ‘does’ (assessed in the workplace) (Miller, 1990).
Pitfalls and potential dangers in the referral process to a specialist brain injury unit
Authors: Kuruvatti Jay , Fleminger Simon
Published: June 2008

Aims and Methods

We looked retrospectively at referrals over 1 year and determined the length of time from receipt of the referral to the date when authorisation to see the patient was given, and the time from authorisation to first contact. For in-patients we determined the time from the recommendation for admission to the time authorisation was granted, and the time from authorisation to admission.

Results

Of the 108 referrals, 80 (74%) were seen within 13 weeks (mean=53 days); 7 patients (6%) had to wait over 13 weeks, usually because of delays in authorisation; 10 patients were admitted; 14 were never admitted (although we had recommended admission). The time from recommendation to admit to authorisation of admission, 27 days, was the same as the time they waited for a bed once authorisation had been given.

Clinical Implications

Waiting for authorisation seemed in some patients to delay their access to tertiary services. Any advantage of using panels to authorise referrals, like ensuring better use of local resources, may be outweighed by patients taking longer to get the care that best meets their needs.
Police and sniffer dogs in psychiatric settings
Authors: Khalifa Najat , Gibbon Simon , Duggan Conor
Published: June 2008

Aims and Method

To study the views of staff and patients on the use of sniffer dogs to detect illicit drugs and the prosecution of in-patients suspected of taking illicit drugs. A 15-item self-report questionnaire was given to all in-patients and staff who had any contact with patients in a medium-secure unit. Responses to the individual statements were measured on a five-point Likert scale and staff and patients' responses were compared.

Results

We achieved a response rate of 63% (patient response rate, 71.6%; staff response rate, 60.7%). Overall there were fewer differences than anticipated, although, as expected, staff viewed the impact of illicit drugs more negatively than patients, and on the other hand, patients viewed the use of sniffer dogs and police involvement more negatively than the staff did.

Clinical Implications

Notice ought to be taken of the discordance between staff and patients' views (particularly in relation to consent and confidentiality) when attempting to detect and manage illicit drug use among psychiatric in-patients.
Does a business-like letter written for a general practitioner meet the standards for patients?
Authors: Mason Julian , Rice Daphne
Published: June 2008

Aims and Method

To gauge the acceptability of copying a business-like clinic letter for general practitioners, written by a doctor working in the Newbury Community Mental Health Team for Older Adults. Between August 2004 and March 2006 every letter written by each doctor was stored electronically. The letters contained a clear statement of the diagnosis, the active problems and a bullet-point care plan. Any concerns or reactions to the letters were documented as they were received. Between September and October 2006, 50 service user or carer recipients of the letters were sent a questionnaire, checking whether the letter met standards of clarity, helpfulness and content.

Results

Over 20 months 427 service users and carers received a total of 731 letters. One carer asked for the letter not to be sent in future; four carers asked for details of the letter to be modified; in only one was the content of the letter to the general practitioner modified before it was sent to the service user. The questionnaire about the suitability of the clinic letter had a 90% reply rate and all respondents said the letters were clear, understandable and that their content was of no surprise to them.

Clinical Implications

This report of a successful use of a frank business-like letter copied to service users or carers should be understood in the context of the following factors: the doctor who wrote them was familiar with and confident about the clinical work and comfortable with the style of the letter; he had a good rapport with a generally well-educated population and positive support from his colleagues. With these factors in place, the direct style of the letter was well received by patients and carers.
Referral patterns and acetylcholinesterase inhibitor prescribing for cognitive impairment (1999–2007): impact of NICE guidelines
Authors: Ganeshalingam Yogesh , Cooper Claudia , Livingston Gill
Published: June 2008

Aims and Method

We hypothesised that the proportion of people referred to two outer London mental healthcare services for older people with cognitive impairment increased after the 2001 National Institute for Health and Clinical Excellence (NICE) guidelines for acetylcholinesterase (AChE) inhibitor use in Alzheimer's disease, but declined after the amended 2006 guidelines. We reviewed case notes for 546 individuals referred between 1999 and 2007.

Results

The proportion of individuals with cognitive impairment referred increased between 1999 (56.1%) and 2005 (70.5%, χ2=5.4, P=0.02), as did the proportion prescribed AChE inhibitor (0.8% to 16.1%, χ2=27.5, P<0.001). There were no significant changes between 2005 and 2007.

Clinical Implications

The 2006 NICE amendment may have curbed the increase in psychiatric referrals and AChE inhibitor prescribing rates for people with cognitive impairment but so far these rates have not decreased.
Crisis resolution and home treatment teams for older people with mental illness
Authors: Dibben Claire , Saeed Humera , Stagias Konstantinos , Khandaker Golam Mohammed , Rubinsztein Judy Sasha
Published: June 2008

Aims and Method

We examined the impact of a crisis resolution and home treatment teams (CRHTT) on hospital admission rates, bed days and treatment satisfaction among older people with mental illness and their carers. We compared these factors in the 6 months before the service started and 6 months after its introduction.

Results

The CRHTT significantly reduced admissions (P<0.001), but there was no significant difference in the length of hospital stay as compared before and after the introduction of this service. There was a trend towards carers, but not patients, being more satisfied with treatment after the introduction of the CRHTT.

Clinical Implications

The CRHTT reduced hospital admissions for older people by 31% and carers preferred the service. Further research on crisis teams in older people with mental illness is needed using randomised controlled methodology.
Capital punishment for children's services: a new legal policy?
Authors: Jones Barry
Published: June 2008

Recent adverse changes to the interpretation of aspects of the Children Act 1989 have deleteriously combined with amendments to limit accessibility to the legal aid budget. A closer enquiry highlights that contradictions within government policy and the law have significant implications for struggling families, with adequate assessment and treatment being consistently withdrawn. As children's needs are left increasingly unanswered, the evident cycle of neglect and deprivation of children is obviated by the clinical situation within the Cassel hospital, the only remaining National Health Service (NHS) in-patient resource for whole families.
Bipolar Disorder as Maladaptive Arousal
Authors: MacKinnon Dean F.
Published: June 2008

Bipolar disorder can be understood as a disorder of behavioral regulation. Manic and depressed individuals are impaired in the titration of appetitive arousal, possibly at the level of neuronal plasticity. An experiment in which fixed 5% CO2stimulates respiration and blocks satiety tests the regulation of appetitive arousal. In preliminary analysis of data from 35 individuals (24 with bipolar disorder) individuals with bipolar disorder were more likely to fail to find a stable state of respiratory adjustment to CO2. If confirmed, the unstable respiratory response to CO2may prove useful as a bipolar‐disorder endophenotype.
Dopamine Signaling in the Dorsal Striatum Is Essential for Motivated Behaviors
Authors: Palmiter Richard D.
Published: June 2008

Genetically engineered mice that lack tyrosine hydroxylase in all dopaminergic neurons become hypoactive and aphagic, and they starve by 4 weeks of age. However, they can be rescued by daily treatment with l‐dopa, which restores activity and feeding for about 10 hours. Thus, these mice can be examined in both dopamine‐depleted and dopamine‐replete states. A series of behavioral experiments lead to the primary conclusion that in the dopamine‐depleted state these mice are not motivated to engage in goal‐directed behaviors. Nevertheless, they still have a preference for sucrose, they can learn the location of food rewards, and they can form a conditioned‐place preference for drugs. Dopamine signaling can be restored to the striatum by several different viral gene‐therapy procedures. Restoring dopamine signaling selectively to the dorsal striatum is sufficient to allow feeding, locomotion, and reward‐based learning. The rescued mice appear to have normal motivation to engage in all goal‐directed behaviors that have been tested. The results suggest that dopamine facilitates the output from dorsal striatum, which provides a permissive signal allowing feeding and other goal‐directed behaviors.
Peripheral Circadian Oscillators
Authors: Cuninkova Ludmila , Brown Steven A.
Published: June 2008

The lives of plants, animals, and human beings are all regulated by circadian clocks. In mammals, 24‐hour rhythms of physiology and behavior are directed by a master clock in the suprachiasmatic nucleus (SCN) of the brain hypothalamus, which in turn entrains “slave” oscillators of similar molecular composition in most cells of the body. These peripheral clocks are interesting not only because they control many aspects of circadian physiology, but also because they are model systems through which we understand how the SCN regulates complex behavior. To this end, peripheral oscillators have been exploited both biochemically to understand the proteins that make up biological clocks, and genetically to decipher the ways in which individual differences in human chronotype might arise.
The In(put)s and Out(put)s of the Drosophila Circadian Clock
Authors: Boothroyd Catharine E. , Young Michael W.
Published: June 2008

Circadian clocks are aligned to the 24‐h environmental day via zeitgebers, and information from the clock must be relayed to the rest of the organism. Recent studies addressing temperature as an input to, and the generation of rhythmic gene expression as an output from, the Drosophila central clock are discussed.
Measuring Alertness
Authors: Posner Michael I.
Published: June 2008

A generation of research in cognitive psychology has given rise to many tasks that tap at various aspects of attention. It is now widely agreed that attention is not a single thing and that its measurement needs a strategy to study each of its various aspects. While there is no widely agreed taxonomy of attentional operations, there is an important distinction between functions of obtaining and maintaining the alert state (alerting network), orienting to sensory events (orienting network), and regulating thoughts and behaviors (executive network). Neuroimaging has confirmed that these functions involve separate but overlapping areas of brain activity. Neurochemical and genetic studies have also provided some distinctions between brain networks involved in attention. Alertness as a function of one important attentional network is emphasized and methods to activate phasic and tonic alerting are reviewed and individual or group differences in the efficiency of network operations are discussed.
Ablation of the Central Noradrenergic Neurons for Unraveling Their Roles in Stress and Anxiety
Authors: Itoi Keiichi
Published: June 2008

Despite considerable evidence suggesting the relationship between the central noradrenergic (NA) system and fear/anxiety states, previous animal studies have not demonstrated sheer involvement of the locus coeruleus (LC) in mediating fear or anxiety. Following the negative results of 6‐hydroexydopamine (6‐OHDA)‐induced LC ablation in fear‐conditioning studies, most researchers dared not approach this problem using the ablation strategy. The results obtained by a limited number of endeavors, conducted later, were not consistent with the idea of LC being related to anxiety, either, with the exception of the study by Lapiz and colleagues. Since methodological problems were recognized in the neurotoxin‐induced NA ablation, employed in previous studies, a novel mouse model was developed in which the LC–NA neurons were ablated selectively and thoroughly by the immunotoxin‐mediated cellular targeting. The use of this model clearly demonstrated that the LC was part of the anxiety circuitry. The reason for the discrepancy between the latest study and previous ones is not clear, but it may be due either to the difference in the experimental paradigms or to the different methods for LC ablation. In any case, our findings have shed light on the LC as a locus pertaining to anxiety behavior, and may help link the apparently inconsistent results in previous studies. In addition, the novel method for the LC cell targeting, presented here may provide a potential means for studying the physiological roles of the LC including sleep/wakefulness, as well as its possible involvement in the pathogenesis of psychiatric disorders, including depression, anxiety disorders, and attention deficit/hyperactivity disorder.
Molecular Genetics of Attention
Authors: Bellgrove Mark A. , Mattingley Jason B.
Published: June 2008

The sequencing of the human genome and the identification of a vast array of DNA polymorphisms has afforded cognitive scientists with the opportunity to interrogate the genetic basis of cognition with renewed vigor. The extant literature on the molecular genetics of sustained and spatial attention is reviewed herein. Advances in our understanding of the neural substrates of sustained and spatial attention arising from the cognitive neurosciences can help guide putative linkages in cognitive genetics. In line with catecholamine models of sustained attention, associations have been reported between sustained attention and allelic variation in the dopamine beta hydroxylase gene (DBH), the dopamine D2 and D4 receptor genes (DRD2; DRD4) and the dopamine transporter gene (DAT1). Much evidence implicates the cholinergic system in spatial attention. Accordingly, individual differences in spatial attention have been associated with variation in an alpha‐4 cholinergic receptor gene (CHRNA4). APOE‐ɛ4 allele dosage has been shown to influence the speed of attentional reorienting in independent samples of nonaffected individuals. Preliminary evidence in both healthy children and children with attention deficit hyperactivity disorder (ADHD) suggests and association with variants of the DAT1 gene and the control of spatial attention across the hemifields. With the recent development of high‐throughput genotyping techniques, such as microarrays, the time seems ripe for a genomewide association study that can identify quantitative trait loci (QTLs) for sustained and spatial attention. The identification of QTLs for attention will provide a range of novel candidate genes for disorders of attention, such as ADHD and schizophrenia, and will drive cognitive neuroscientists to understand how DNA variation influences the neural substrates of attention.
Potential Anatomical Basis for Attentional Modulation of Hippocampal Neurons
Authors: Rowland David C. , Kentros Clifford G.
Published: June 2008

Lesions of the hippocampus and related structures produce profound anterograde amnesia. The amnesia is specific to what has been called “explicit,”“declarative,” and “episodic” memory. These memories are frequently believed to be central to the human condition, requiring such advanced cognitive functions as attention and even consciousness. However, the hippocampus and associated structures are evolutionarily conserved, which argues that the memories of lower mammals should be qualitatively similar in nature. Just as attention and arousal are critical components of appropriate memory formation in humans, an emerging body of evidence suggests that these processes bear on the firing patterns of hippocampal neurons in rodents. Here the evidence favoring this hypothesis is discussed and then the potential anatomical basis for such modulation is considered.