bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors associated with reduced FEV1 in adult patients with cystic fibrosis in a relatively affluent area
Authors: Jarad N A , Higgs S , Jeffcote T , Giles K
Published: June 2005

Data collected on adult cystic fibrosis (CF) patients and entered onto the CF database in the south and west regions of England were analysed for the year 2001. FEV1 was taken as a marker of lung disease severity. Data on 371 patients (158 female) mean age 24.7 years (range 16.0-48.9) were assessed. FEV1 was reduced in CF patients infected with Pseudomonas aeruginosa (Pa) (mean 62.6% predicted) compared with those without (mean FEV1 77.8%, P < 0.00001). The reduction was noted irrespective of age group. FEV1 progressively reduced with the increasing need for high-intensity treatment (P < 0.00001) and with the diagnosis of diabetes mellitus (P = 0.03). FEV, correlated with body mass index (BMI) (r = + 0.42, P < 0.0001). Genetic profile and poverty and deprivation score did not affect the value of FEV1. Chronic infection with Pa mainly in young adults, treatment intensity, diabetes mellitus and reduced body mass index are associated with reduced FEV, in adult patients with cystic fibrosis in the south and west regions of England. In this relatively affluent area, scores of poverty and deprivation were not associated with the decline in lung function tests.
Barriers to success for an evidence-based guideline for chronic obstructive pulmonary disease
Authors: Smith B J , Dalziel K , McElroy H J , Ruffin R E , Frith P A , McCaul K A , Cheok F
Published: June 2005

Objectives: To evaluate 1) barriers to clinical guideline use and 2) the relationship between guideline use and inpatient outcomes in chronic obstructive pulmonary disease (COPD). Methods: 1) Four focus groups of specific health professions (n=30), from three metropolitan hospitals, and interview of 99 medical officers (MOs), linked to 349 admissions, both guided by behavioural modelling theory; 2) association between guideline use and patient outcomes (length of hospital stay ≥ 14 days, and readmission within 28 or 90 days) was evaluated in a cohort of 405 COPD patients. Results: 1) In focus groups, nurses and allied health professionals emphasized facilitation issues including paperwork duplication and time limitations as barriers, but considered improved patient care outcomes as the major guideline use determinant. There were similar findings in junior MOs (nonconsultants) by both focus group and interview, with the addition of a need for a sense of ownership. Senior MOs (consultants) greatly emphasized sense of ownership. Barriers to guideline use varied between types of units. Behavioural modelling explained 49% of the variation in intention to use the guideline for MOs. For nonconsultants, habit and intention were significantly associated with extent of guideline use. 2) Patient outcomes: guideline use was not associated with length of stay or readmission. Conclusions: 1) Guideline implementation should address issues relevant to different health professions, units and seniority of profession. 2) Guideline use was not associated with reductions in readmission or length of stay.
Physiotherapy management of cystic fibrosis
Authors: Dodd M E , Prasad S A
Published: June 2005

For many years physiotherapy for cystic fibrosis (CF) was synonymous with a daily routine of postural drainage and percussion. Improved longevity and a desire for independence, together with a clearer understanding of the pathophysiology of the disease, has led to the development of many airway clearance techniques. The contribution of ‘chest’ physiotherapy remained unchallenged until recent times when lack of robust evidence and the presentation of asymptomic infants and adults led some physiotherapists to question this traditional approach. As survival increases into the fourth and fifth decade unique complications have evolved and physiotherapy management is challenged with nonrespiratory aspects of treatment. This review will consider the evidence for, and current practice of airway clearance, the value of exercise and the emerging problems of musculoskeletal complications and incontinence.
Management of the chronically ventilated patient with a tracheostomy
Authors: Heffner J E
Published: June 2005

Tracheostomy is the most common surgical procedure performed on critically ill patients. For those who survive their critical illnesses but remain ventilator-dependent, tracheostomy provides patients with a secure airway that frees the mouth for oral nutrition, enhances verbalized speech, and promotes generalized comfort. Avoiding complications from tracheostomy requires a skilled multi-disciplinary approach to ensure that the benefits outweigh the risks of the procedure.
Cooperative requirement of the Gli proteins in neurogenesis
Authors: Nguyen Vân , Chokas Ann L. , Stecca Barbara , Altaba Ariel Ruiz i
Published: June 2005

The Gli proteins are critical components of multiple processes in development, homeostasis and disease, including neurogenesis and tumorigenesis. However, it is unclear how the Gli code, the sum of their combinatorial positive and negative functions, dictates cell fate and behavior. Using an antisense approach to knockdown gene function in vivo, we find that each of the three Gli proteins is required for the induction of all primary neurons in the amphibian neural plate and regulates the bHLH/Notch neurogenic cascade. Analyses of endogenous Gli function in Gli-mediated neurogenesis and tumorigenesis, and in animal cap assays, reveal specific requirements that are context specific. Nuclear colocalization and binding studies suggest the formation of complexes, with the first two zinc fingers of the Gli five zinc-finger domain acting as a protein-protein interaction site. The Gli proteins therefore appear to form a dynamic physical network that underlies cooperative function, greatly extending the combinatorial possibilities of the Gli code, which may be further fine-tuned in cell fate specification by co-factor function.
Hedgehog signaling controls dorsoventral patterning, blastema cell proliferation and cartilage induction during axolotl tail regeneration
Authors: Schnapp Esther , Kragl Martin , Rubin Lee , Tanaka Elly M.
Published: June 2005

Tail regeneration in urodeles requires the coordinated growth and patterning of the regenerating tissues types, including the spinal cord,cartilage and muscle. The dorsoventral (DV) orientation of the spinal cord at the amputation plane determines the DV patterning of the regenerating spinal cord as well as the patterning of surrounding tissues such as cartilage. We investigated this phenomenon on a molecular level. Both the mature and regenerating axolotl spinal cord express molecular markers of DV progenitor cell domains found during embryonic neural tube development, including Pax6, Pax7 and Msx1. Furthermore, the expression of Sonic hedgehog (Shh) is localized to the ventral floor plate domain in both mature and regenerating spinal cord. Patched1 receptor expression indicated that hedgehog signaling occurs not only within the spinal cord but is also transmitted to the surrounding blastema. Cyclopamine treatment revealed that hedgehog signaling is not only required for DV patterning of the regenerating spinal cord but also had profound effects on the regeneration of surrounding, mesodermal tissues. Proliferation of tail blastema cells was severely impaired, resulting in an overall cessation of tail regeneration, and blastema cells no longer expressed the early cartilage marker Sox9. Spinal cord removal experiments revealed that hedgehog signaling, while required for blastema growth is not sufficient for tail regeneration in the absence of the spinal cord. By contrast to the cyclopamine effect on tail regeneration, cyclopamine-treated regenerating limbs achieve a normal length and contain cartilage. This study represents the first molecular localization of DV patterning information in mature tissue that controls regeneration. Interestingly, although tail regeneration does not occur through the formation of somites, the Shh-dependent pathways that control embryonic somite patterning and proliferation may be utilized within the blastema,albeit with a different topography to mediate growth and patterning of tail tissues during regeneration.
The Snail genes as inducers of cell movement and survival: implications in development and cancer
Authors: Barrallo-Gimeno Alejandro , Nieto M. Angela
Published: June 2005

The functions of the Snail family of zinc-finger transcription factors are essential during embryonic development. One of their best-known functions is to induce epithelial to mesenchymal transitions (EMTs), which convert epithelial cells into migratory mesenchymal cells. In recent years, many orthologues of the Snail family have been identified throughout the animal kingdom, and their study is providing new clues about the EMT-dependent and-independent functions of Snail proteins. Here, we discuss these functions and how they influence cell behaviour during development and during diseases such as metastatic cancer. From these findings, we propose that Snail genes act primarily as survival factors and inducers of cell movement, rather than as inducers of EMT or cell fate.
Synthesis and Size Control of Pt Nanocubes with High Selectivity Using the Additive Effect of NaI
Authors: Yamada Mami , Kon Syusaku , Miyake Mikio
Published: June 2005

The synthesis and size control of Pt nanocubes stabilized by polyacrylic acid sodium salt (PAA) were carried out by varying the reaction temperature and the growth rate between the {111} and {100} faces with the addition of NaI; the shape selectivity was about 70–80% and the cubic size was controllable between 7.5–10.5 nm.
Photoreductive Defluorination of Hexafluorobenzene on Metal-doped ZnS Photocatalysts under Visible Light Irradiation
Authors: Kohtani Shigeru , Ohama Yoshihiko , Ohno Yu , Tsuji Issei , Kudo Akihiko , Nakagaki Ryoichi
Published: June 2005

Metal-(Cu, Ni, or Pb) doped ZnS photocatalysts have the ability to photoreductively defluorinate hexafluorobenzene under visible light irradiation; the defluorination mechanism on Pb-, or Cu-doped ZnS is different from that on Ni-doped ZnS. The role of Pb and Cu dopants in ZnS is not only to extend the photocatalytic response toward visible light but also to act as redox reaction sites in the photoreductive defluorination.
Real-time In-cell 19F NMR Study on Uptake of Fluorescent and Nonfluorescent 19F-Octaarginines into Human Jurkat Cells
Authors: Okamura Emiko , Ninomiya Keiko , Futaki Shiroh , Nagai Yasuharu , Kimura Tomohiro , Wakai Chihiro , Matubayasi Nobuyuki , Sugiura Yukio , Nakahara Masaru
Published: June 2005

Real-time in-cell 19F NMR spectroscopy is developed to determine the time scale of cellular uptake of fluorescent and nonfluorescent 19F-octaarginines. The peptide concentration as low as 10-μM order is successfully detected with a time resolution of 1–2 min. The concentration analysis shows that fluorescein isothiocyanate (FITC) induces different kinetics for the peptide uptake into natural human cells. The ability of 19F NMR to detect the real-time uptake of bioactive molecules is shown with minimal perturbation.
Transition Metal-catalyzed Reactions Using Alkynes as Precursors of Carbene and Vinylidene Complexes
Authors: Miki Koji , Uemura Sakae , Ohe Kouichi
Published: June 2005

The transition metal-induced in situ generation of carbene complexes from alkynes having a carbonyl or imino group as a nucleophilic functionality has been investigated. These reactive carbenoid species are generated with high atom efficiency through a 6-endo-dig cyclization mode based on the electrocyclization of vinylidene complexes or a 5-exo-dig cyclization mode in π-alkyne complexes and have been found to serve as versatile intermediates in catalytic carbene transfer reactions.
A New Inclusion Compound Consisting of 2D Coordination Layers of [Cd(SCN)2]∞ and Pillars of Isonicotinamide Dimers
Authors: Sekiya Ryo , Nishikiori Shin-ichi
Published: June 2005

Self-assembly of Cd2+, SCN−, isonicotinamide (isoNH2), and 9,10-dichloroanthracene gave a new inclusion compound formulated as [Cd(SCN)2(isoNH2)2]·1/2(9,10-dichloroanthracene) (1). This inclusion compound consists of 2D coordination layers of [Cd(SCN)2]∞ and pillars of isoNH2 dimers. 9,10-dichloroanthracene molecules are included in zigzag channels.
Endotoxic shock model with fluid resuscitation in Macaca mulatta
Authors: Yin Guo Qing , Qiu Hai Bo , Du Kai He , Tang Jia Qi , Lu Cheng Ping , Fang Zhi Xun
Published: June 2005

These studies established a macaque model of early-phase endotoxic shock, and investigated the resuscitation effects of three different solutions. Twenty-four macaques were assigned to four groups. Nineteen animals were given an intravenous dose of 2.8 mg/kg lipopolysaccharide (LPS). At 60 min after LPS challenge, the animals were given (i) 5 mL/kg normal saline (Ns group, n = 6), (ii) 5% of 5 mL/kg sodium bicarbonate (Sb group, n = 6), (iii) hypertonic 3.5% sodium chloride of 5 mL/kg (Hs group, n = 7). The control group (Co group, n = 5) was first injected with 1 mL/kg Ns and with 5 mL/kg Ns 60 min later. Haemodynamic parameters and blood gases were measured during the experiment, and myocardial morphology was examined on termination of the experiment. Administration of LPS caused hypotension and decreases of the left ventricular work index (LVWI). In the Sb group, mean arterial pressure, cardiac index, systemic vascular resistance index, LVWI and right ventricular work index were significantly higher than those of the Ns group. Pathological changes of myocardium were identified in all of the LPS groups. The studies suggest that macaques are suitable models for studying endotoxic shock and potential fluid therapies.
Postoperative death in sows as a result of gastric mucosal de-gloving at the pars oesophagea
Authors: Court F G , Wemyss-Holden S A , Morrison C P , Teague B D , Dennison A R , Maddern G J
Published: June 2005

It is well documented that pigs frequently die from postoperative acute gastric dilatation, and proximal gastric 'stress' ulceration. Three cases of gastric mucosal 'de-gloving' are reported. This was secondary to acute gastric dilatation and resulted in death from acute haemorrhage. All animals had undergone major abdominal surgery. Histology confirmed that the proximal gastric mucosa had been 'de-gloved', or torn from the gastro-oesophageal junction, leaving exposed muscle fibres.

This syndrome has not been reported previously. The postmortem appearances of this mechanical injury could easily be mistaken for extensive oesophago-gastric peptic ulceration. This has major implications for prevention.
Intraperitoneal injection induces a delayed preconditioning-like effect in mice
Authors: Labruto Fausto , Vaage Jarle , Li Guohu , Valen Guro
Published: June 2005

We hypothesized that intraperitoneal injections of anaesthetics or fluid per se might evoke a delayed preconditioning-like response in mice hearts isolated and Langendorff perfused 24 h later. To test this, mice were given opioid anaesthesia by intraperitoneal injections or sham treated and the hearts were harvested and subjected to global ischaemia and reperfusion 24 h later in series 1. In series 2, mice were subjected to intraperitoneal injection of Ringer, sham needle prick procedure, or no intervention 24 h before heart isolation. In series 3, intraperitoneal Ringer injection 24 h earlier was compared with the effects of classic preconditioning or no pretreatment of the isolated heart or no treatment. Heart function was measured in all series. At the end of reperfusion, hearts in series 1 and 2 were frozen and infarct size was estimated by triphenyltetrazolium chloride solution. In series 3, separate hearts were frozen for immunoblotting to detect phosphorylation of mitogen-activated protein (MAP) kinases. Cardiac activation of nuclear factor kappa B (NFκB) was measured using a NFκB luciferase firefly reporter mouse.

The ischaemia-induced impairment of left ventricular function was attenuated by opioid anaesthesia injected 24 h earlier, which also reduced infarct size. Injection of fluid, but not the sham needle prick procedure, reduced infarct size. The functional protection afforded by classic preconditioning and Ringer pretreatment was comparable. Neither cardiac MAP kinases nor NFκB were influenced by the interventions. In conclusion, this study demonstrates a delayed preconditioning-like effect of the heart caused by intraperitoneal administration of opioid anaesthetics and of fluid only in the mouse. The mechanism of protection remains to be determined.
Efficacy of fipronil in the treatment of pediculosis in laboratory rats
Authors: Diaz S L
Published: June 2005

As parasitized rodents are not desirable experimental objects, it is important to maintain parasite-free laboratory rodent colonies. Faced with the task of eliminating pediculosis from a conventional laboratory rat colony whose individuals were intended to be used in scientific research, a drug treatment was needed which did not, or minimally, interfere with experimental results. Fipronil, a GABAA antagonist, is an effective drug against lice, fleas and mites currently used in domestic species. Fipronil is not absorbed, has a wide safety margin and is topically applied. The aim of this study was to treat an infected colony with Frontline® Spray (0.25% – w/v – fipronil) in order to evaluate its efficacy against lice. Rats were sprayed with Frontline® only once. Special procedures to prevent cross-contamination between cages were not used. Neither lice nor nits were found during any post-treatment examination. In addition, no complications were reported by any researcher after using the treated rats in their experiments. The results of this study demonstrate that fipronil in topical formulations is effective for treatment and control of sucking and biting lice infestations on laboratory rats.
Effect of maternal age and parity on preimplantation embryo development and transport in the golden hamster (Mesocricetus auratus)
Authors: Trejo C A , Navarro M C , Ambriz G D , Rosado A
Published: June 2005

Preimplantation embryo development was studied in the golden hamster ( Mesocricetus auratus). Three groups of regularly cycling female hamsters were used: (I) 30 nulliparous young female (NYF) hamsters; (II) 24 nulliparous adult female (NAF) hamsters and (III) 30 multiparous adult female (MAF) hamsters. Female hamsters were mated with male hamsters of proven fertility. Only 15 min were allowed for mating. The moment of ejaculation was registered. Female hamsters were killed from 60 to 69 h after coitus. Corpora lutea were counted in both ovarian surfaces. Oviducts and uterine horns were flushed separately and embryo number, stage of development and distribution were recorded. Adult female hamsters, nulliparous and multiparous, had significant higher ovulation rates than NYF, but their reproductive efficiency was significantly lower. Preimplantation embryo development and transport were highly synchronous in NYF, but not in adults. Morulae were observed in NYF as early as 62–63 h after coitus. In adult female hamsters, significant numbers of morulae were found until 66–67 h. On the contrary, in NYF four-cell embryos were detected only until 60–61 h, while four-cell embryos were found until 64–65 h in NAF, and until 66–67 h in MAF. Embryo transport from the oviduct to the uterus is practically completed at 62–63 h after coitus in NYF, while it is evidently retarded in adult animals. In NYF all eight-cell embryos reached the uterus by 62 h after coitus. In adult female hamsters, both nulliparous and multiparous, a considerable number of eight-cell embryos fail to migrate into the uterus even at 67 h after coitus.
Banking of embryos of mutated, paralytic tremor rabbit by means of vitrification
Authors: Papis Krzysztof , Sypecka Joanna , Korwin-Kossakowski Maciej , Wenta-Muchalska Elżbieta , Bilska Barbara
Published: June 2005

Cryopreservation enables banking of embryos for future use in medicine and in animal breeding. It also enables protection of germ plasm of endangered species and unique strains or lanes of laboratory animals. This paper describes an example of employing a vitrification method for banking of embryos of a unique lane of rabbit.

The paralytic tremor ( pt) rabbit is an X-linked recessive mutant lane of the Chinchilla breed characterized by hypomyelination of the central nervous system. In order to obtain a sufficient number of embryos, pt females were subjected to superovulation and surgical embryo collection. All suitable embryos were vitrified in 0.25 mL insemination straws in a modified EFS vitrification solution comprised of ethylene glycol (40%), Ficoll 70 (18%) and sucrose (0.3 M) in Hepes buffered TCM medium containing 20% fetal calf serum.

In order to assess the efficiency of the vitrification procedure, a representative portion of vitrified embryos was warmed after a period of storage. Warmed embryos were subjected to in vitro culture for 72 h or were transferred to the uterus of synchronized recipients. The majority of the 141 warmed embryos survived vitrification and 100/141 (71%) developed to the blastocyst stage. Moreover, out of an additional 34 warmed embryos transferred to four recipients, eight (23.5%) developed to term and seven live pups were born. Six of the rabbit pups exhibited paralytic tremor symptoms typical for the pt lane.

Although the overall efficiency of the vitrification method was lower compared with the effects usually achieved for 'healthy' embryos, results presented confirm the real possibility of the future restoration of the colony of pt rabbit, if sufficient number of embryos are cryopreserved.
Age-related changes in haematology and serum chemistry of Weiser–Maples guineapigs (Cavia porcellus)
Authors: Kitagaki M , Yamaguchi M , Nakamura M , Sakurada K , Suwa T , Sasa H
Published: June 2005

Age-related changes in haematology and serum chemistry values were examined in male and female Weiser–Maples guineapigs ( Cavia porcellus). Haematological changes that significantly ( P < 0.01) correlated with ageing were increased white blood cell and neutrophil counts in both sexes, decreased lymphocyte counts in both sexes, decreased reticulocyte and platelet counts in males, and decreased basophil counts in females. For serum chemistry, increases in total protein, triglycerides, blood urea nitrogen and creatinine were seen in both sexes, along with increases in total cholesterol in males and sodium in females. Decreased alkaline phosphatase in both sexes and decreased chloride in males were significantly ( P < 0.01) associated with age. These age-related changes are compared with the published literature.
Description and technical pitfalls of a hepatoma model and of intra-arterial injection of radiolabelled lipiodol in the rat
Authors: Garin E , Denizot B , Roux J , Noiret N , Lepareur N , Moreau M , Mesba H , Laurent J F , Herry J Y , Bourguet P , Benoit J P , Lejeune J J
Published: June 2005

Intra-arterial metabolic radiotherapy (using lipiodol labelled with iodine-131 or rhenium-188) is a therapeutic approach that can be used for the treatment of hepatocellular carcinomas (HCC). We propose a detailed description of the tumoral model using the N1-S1 cell line as well as a technique for intra-arterial injection of radiolabelled lipiodol in order to undertake preclinical studies necessary for the evaluation of a new molecule. We also report the principal technical pitfalls that were faced. The speed of injection of the tumoral cells is a key factor in the tumoral induction since slow injections lead to a tumoral induction rate of 36.3% compared with 76.6% ( P < 0.01) when using very slow injections. This parameter should thus be controlled carefully during the subcapsular injection of the tumoral cells. In addition, when injecting radiolabelled lipiodol, anaesthesia should not be performed with isoflurane since this leads to a reduction in tumoral uptake. Indeed, we found a 'tumour/healthy liver' uptake ratio of only 2.1 ± 0.7 with isoflurane as against 4.4 ± 2.6 ( P < 0.05) when anaesthesia was carried out by intraperitoneal injection of ketamine. Lastly, we show that the tumour size has an influence on the tumoral uptake of radiolabelled lipiodol; therefore, this parameter must also be carefully controlled.
Pulmonary cryptosporidiosis in an AIDS patient: successful treatment with paromomycin plus azithromycin
Authors: Palmieri F , Cicalini S , Froio N , Rizzi E B , Goletti D , Festa A , Macrí G , Petrosillo N
Published: June 2005

Extra-intestinal cryptosporidiosis, especially of the biliary and respiratory tract, is likely in the course of an intestinal involvement, whereas it is rare without such a localization. We report a case of pulmonary cryptosporidiosis without apparent intestinal involvement in an AIDS patient, with favourable outcome after antimicrobial combination therapy with paromomycin plus azithromycin. The successful response to antimicrobial treatment was subsequently maintained by effective highly active antiretroviral therapy (HAART).

We suggest that respiratory cryptosporidiosis should be investigated in HIV-infected patients with pulmonary symptoms and low CD4 cell count, and, if detected, treatment should include HAART plus the combination of paromomycin and azithromycin.
Trichomonas vaginalis in a Sheffield genitourinary medicine department
Authors: Woodland H , Rogstad K E
Published: June 2005

The case-notes of all patients who were diagnosed with a first episode of Trichomonas vaginalis (TV) between 1 October 2002 and 30 September 2003 were reviewed. A total of 78 patients were suitable for inclusion in the study. Analysis of their notes revealed that, although the majority of patients presented with symptoms, 15% ( n = 12) of cases were asymptomatic. A raised vaginal pH was found in 94% ( n = 47) of the patients in whom it was measured. In all, 97% ( n = 76) of patients received treatment in accordance with UK national guidelines and, in those tested, initial treatment was found to be 95% ( n = 57) successful. Treatment of at least one contact could only be confirmed in 27% ( n = 21) of cases. The implications for future management of TV are discussed.
Management of metronidazole-resistant Trichomonas vaginalis – a new approach
Authors: Mammen-Tobin A , Wilson J D
Published: June 2005

Metronidazole-resistant trichomoniasis is an infrequent but challenging problem with no universally successful treatment. Since 1994, we have been using a combination regimen consisting of high-dose tinidazole plus a broad-spectrum antibiotic, i.e. doxycycline or ampicillin, and clotrimazole pessaries, for 7–14 days in this condition. A retrospective case review identified 11 cases of resistant trichomonas between 1994 and 2002. In the absence of resistance testing, resistance was defined clinically. Nine of the 11 patients were cured; one patient did not attend follow-up. In the women who attended for follow-up, the cure rate was 90%. We have found the combination of tinidazole, a broad-spectrum antibiotic, and clotrimazole pessaries to be a tolerable and effective treatment for metronidazole-resistant Trichomonas vaginalis. Although a variety of total doses of tinidazole were used in our patients, based on our findings, and those of others, we would recommend giving tinidazole 2g twice daily for 14 days (total dose 56g).
The management of Chlamydia trachomatis in genitourinary medicine clinics: a national audit in 2004
Authors: Challenor Rachel , Pinsent Sue , Chandramani Shamala , Theobald Nick , Daniels David
Published: June 2005

The first national audit of the management of Chlamydia trachomatis was undertaken by non-consultant career grade doctors working in genitourinary (GU) medicine clinics in the UK. During the audit period of January–March 2004, 1670 data collection forms were completed (from 830 men and 840 women with chlamydia). In all, 99% (1647) were treated appropriately; 76% (1261) were followed up, of which 12% (154) required re-treatment; 71% (1186) were managed appropriately within four weeks and 942 partners (0.56 per index case) were managed satisfactorily within four weeks of the initial partner notification interview. Partner notification outcomes were significantly more successful when the index patient was followed up ( P<0.0001). Outcome standards were not associated with age, gender or sexuality, but were significantly associated with ethnicity ( P<0.004). GU medicine clinics are delivering high-quality care and evidence-based national outcome standards are being met.
Realist review - a new method of systematic review designed for complex policy interventions
Authors: Pawson Ray , Greenhalgh Trisha , Harvey Gill , Walshe Kieran
Published: June 2005

Evidence-based policy is a dominant theme in contemporary public services but the practical realities and challenges involved in using evidence in policy-making are formidable. Part of the problem is one of complexity. In health services and other public services, we are dealing with complex social interventions which act on complex social systems-things like league tables, performance measures, regulation and inspection, or funding reforms. These are not ‘magic bullets‘ which will always hit their target, but programmes whose effects are crucially dependent on context and implementation. Traditional methods of review focus on measuring and reporting on programme effectiveness, often find that the evidence is mixed or conflicting, and provide little or no clue as to why the intervention worked or did not work when applied in different contexts or circumstances, deployed by different stakeholders, or used for different purposes.

This paper offers a model of research synthesis which is designed to work with complex social interventions or programmes, and which is based on the emerging ‘realist’ approach to evaluation. It provides an explanatory analysis aimed at discerning what works for whom, in what circumstances, in what respects and how. The first step is to make explicit the programme theory (or theories) - the underlying assumptions about how an intervention is meant to work and what impacts it is expected to have. We then look for empirical evidence to populate this theoretical framework, supporting, contradicting or modifying the programme theories as it goes. The results of the review combine theoretical understanding and empirical evidence, and focus on explaining the relationship between the context in which the intervention is applied, the mechanisms by which it works and the outcomes which are produced. The aim is to enable decision-makers to reach a deeper understanding of the intervention and how it can be made to work most effectively.

Realist review does not provide simple answers to complex questions. It will not tell policy-makers or managers whether something works or not, but will provide the policy and practice community with the kind of rich, detailed and highly practical understanding of complex social interventions which is likely to be of much more use to them when planning and implementing programmes at a national, regional or local level.
Towards systematic reviews that inform health care management and policy-making
Authors: Lavis John , Davies Huw , Oxman Andy , Denis Jean-Louis , Golden-Biddle Karen , Ferlie Ewan
Published: June 2005

Objectives

To identify ways to improve the usefulness of systematic reviews for health care managers and policy-makers that could then be evaluated prospectively.

Methods

We systematically reviewed studies of decision-making by health care managers and policy-makers, conducted interviews with a purposive sample of them in Canada and the United Kingdom (n=29), and reviewed the websites of research funders, producers/purveyors of research, and journals that include them among their target audiences (n=45).

Results

Our systematic review identified that factors such as interactions between researchers and health care policy-makers and timing/timeliness appear to increase the prospects for research use among policy-makers. Our interviews with health care managers and policy-makers suggest that they would benefit from having information that is relevant for decisions highlighted for them (e.g. contextual factors that affect a review's local applicability and information about the benefits, harms/risks and costs of interventions) and having reviews presented in a way that allows for rapid scanning for relevance and then graded entry (such as one page of take-home messages, a three-page executive summary and a 25-page report). Managers and policy-makers have mixed views about the helpfulness of recommendations. Our analysis of websites found that contextual factors were rarely highlighted, recommendations were often provided and graded entry formats were rarely used.

Conclusions

Researchers could help to ensure that the future flow of systematic reviews will better inform health care management and policy-making by involving health care managers and policy-makers in their production and better highlighting information that is relevant for decisions. Research funders could help to ensure that the global stock of systematic reviews will better inform health care management and policy-making by supporting and evaluating local adaptation processes such as developing and making available online more user-friendly ‘front ends’ for potentially relevant systematic reviews.
Alcohol-Related Expectancies and Assaults among Injured Drinkers in the Emergency Department Setting
Authors: Gogineni Aruna , Longabaugh R. , Clifford P. R. , Woolard R. , Becker B. , Minugh P. A. , Nirenberg T. , Carty K.
Published: June 2005

This study examined the extent to which alcohol-related expectancies were associated with assaults among 278 injured drinkers in the emergency department setting. Results of logistic regression analyses indicated that patients who were male, had high blood alcohol levels and who expected alcohol to make them more careless were more likely to report being assaulted. Conversely, among males, patients who expected to become more powerful and aggressive when drinking were less likely to be assaulted. These findings suggest that helping patients understand how expectancies surrounding alcohol use shape drinking and its behavioral concomitants may circumvent their risk for future assaults.
Identifying United States Substance Abuse Treatment Programs
Authors: Carise Deni , McLellan A. Thomas , Festinger David S. , Kleber Herbert D.
Published: June 2005

An accurate national listing of substance abuse treatment programs is essential for reporting data about the nation's treatment system and the clients entering that system. The National Survey of Substance Abuse Treatment Services (NSSATS) is thought to provide the most comprehensive list of treatment providers. Therefore, we report a partial test of the concurrent validity of the NSSATS in a single mid-sized city. Using operational definitions of “substance abuse treatment” and “substance abuse treatment programs” derived from prior work by the Center for Substance Abuse Treatment; and working within the defined geographic boundaries of a single, mid-sized city, we compared the NSSATS list with an independently developed compilation of programs from 5 sources: (1) the Yellow Pages; (2) the Internet Infospace Directory; (3) a State directory of licensed substance abuse treatment services; (4) the Office of Applied Studies Directory; (5) the National Master Facility Inventory.

With all sources, including NSSATS, we identified 96 separate listings that met the operational definition of adult treatment within the geographic bounds of the city. The NSSATS identified 70 of those 96 programs (73%), the 5-source compilation identified a sample of 83 (86%). While these findings from a single city cannot be considered a full test of the validity of the NSSATS, the data presented offer at least one partial but promising indication that the NSSATS may be a valid national listing and may serve as satisfactory national frame.
References to Alcohol Consumption and Alcoholism in Medical Records of a General Hospital of Porto Alegre, Brazil—
Authors: Pechansky Flávio , Genro Vanessa Krebs , von Diemen Lísia , Kessler Félix Henrique Paim , da Silveira-Santos Rafael Alberto Pacheco
Published: June 2005

Two samples of inpatients (493 and 158 subjects, respectively) of a large teaching hospital, collected using the same methodology and with a 20-year time frame, were analyzed aiming at finding information about alcohol consumption, abuse or dependence in the subjects’ medical charts. Items reviewed were: the list of medical problems; hospital intake form; daily nursing review; medical anamnesis; pre-surgery records, and discharge forms. Only 54% and 50% of each sample, respectively, had some type of reference to alcohol consumption; when references were present, they were in most part incomplete, possibly reflecting distortions in the process of gathering information about alcohol consumption that involves the client and the health professionals. The authors discuss potential reasons for this, suggesting that lack of training of medical personnel in the identification of alcoholism, as well as prejudice towards its recovery, may be some of the underlying causes.
Minimal intervention as a preparation for the treatment of alcohol dependency
Authors: Bamford Zandra , Booth Peter. G. , McGuire James , Salmon Peter
Published: June 2005

Objective. To investigate the use of a minimal intervention as a preparation for treatment of alcohol dependency.

Method. A randomized‐controlled trial with 361 treatment seekers in an alcohol treatment unit in Northwest England. Study variables included recent alcohol intake, participants' views of their drinking problem, and several self‐report scale scores. Experimental group participants received an advance leaflet containing advice on reducing alcohol intake.

Results. At follow‐up participants in the leaflet group were more likely to view their drinking problem as a learnt behaviour. There was a non‐significant tendency for more of the leaflet group to attend for assessment by comparison with controls. Significant improvements occurred over time in readiness to change (recognition subscale), self efficacy and dependency, independent of group allocation.

Conclusions. The tendency toward increased attendance rates should be confirmed in a larger sample. Findings have potential implications for the usage of treatment preparatory material.
The incidence and outcome of subclinical psychotic experiences in the general population
Authors: Hanssen Manon , Bak Maarten , Bijl Rob , Vollebergh Wilma , Van Os Jim
Published: June 2005

Objectives. To examine the incidence and 2‐year stability and outcome of subclinical psychotic experiences in the general population.

Design. The Netherlands Mental Health Survey and Incidence Study (NEMESIS), a longitudinal general population study.

Methods. A representative population sample of 7,076 participants was interviewed with the composite international diagnostic interview at baseline, 1 year later at T1 and again 2 years later at T2. A sample of individuals was identified who had onset of a new, broadly defined psychotic experience between baseline and T1 (N=79; incidence = 2%). Stability and outcome of these incident positive psychotic experiences was reassessed by interview at T2, at which 25 individuals had a CIDI rating of broadly defined psychotic experience (subclinical outcome) and 11 individuals had psychotic experiences with functional impairment and need for care (clinical outcome).

Results. The majority of individuals with an incident psychotic experience did not display persistence of the experience. Only 8% of individuals with a T1 incident psychotic experience had evidence of a T2 subclinical outcome, and only 8% had evidence of a T2 clinical outcome. The emotional context and the number of the T1 incident psychotic experiences were strong modifiers of predictive power for the clinical outcome, but not (or to a much lesser extent) for the subclinical outcome.

Conclusions. The incidence of positive psychotic experiences in the general population is around 100 times greater than traditional estimates of incidence of psychotic disorder such as schizophrenia. The far most likely outcome for these experiences is discontinuity. For the small proportion who display continuity, there is an equally large likelihood of subclinical and clinical 2‐year outcomes. Emotional appraisal and degree of intrusiveness of psychotic experiences are important modifiers not for continuity per se but for clinical outcome specifically.
Associations between organizational and incident factors and emotional distress in emergency ambulance personnel
Authors: Bennett Paul , Williams Yvette , Page Nicola , Hood Kerenza , Woollard Malcolm , Vetter Norman
Published: June 2005

Objectives. This study examined the prevalence and correlates of post‐traumatic stress disorder (PTSD), anxiety and depression among emergency ambulance personnel.

Design and method. A questionnaire and reminder were sent anonymously to 1029 emergency ambulance personnel in a large ambulance service.

Results. Among the 617 respondents, levels of PTSD symptoms did not differ according to grade, but men had a higher prevalence rate than women. Key predictors of the severity of symptoms were organizational stress, the frequency of experiencing potentially traumatic incidents, length of service, and dissociation in response to an index incident. The degree of organizational, but not incident‐related, stress discriminated between ‘cases’ and ‘non‐cases’. Nine and 23% of recorded scores indicated clinical levels of depression and anxiety respectively. Several work factors were associated with these emotions, explaining 38% of anxiety and 31% of depression scores.

Conclusion. Both organizational and individually based interventions may be necessary to minimize PTSD and other emotional disorders among ambulance personnel.
Developing a theoretical understanding of therapy techniques: An illustrative analogue study
Authors: Freeman Daniel , Garety Philippa A. , McGuire Philip , Kuipers Elizabeth
Published: June 2005

Objectives. In psychological interventions, clients are often asked to review unhelpful beliefs. Surprisingly, there is no theoretical understanding of how beliefs are reviewed in therapy. Moreover, by understanding a therapeutic technique, potential interactions with symptom processes can be considered. An analogue study assessing the feasibility of researching therapy techniques is described, in which links between symptoms, reasoning style, and an experimental version of the cognitive therapy technique of belief evaluation are examined.

Design. Individuals without psychiatric illness (N=30) completed (i) dimensional measures of depression, anxiety, and delusions,(ii) a measure of confirmatory reasoning (Wason's 2–4–6 task) both before and after instruction in disconfirmatory reasoning, and (iii) a belief evaluation task.

Results. Compared with individuals with a confirmatory reasoning style, individuals with a disconfirmatory reasoning style in Wason's task were less hasty in their data gathering, considered a greater number of hypotheses during the task, had higher intellectual functioning, and had lower levels of depressive symptoms. Conversely, the individuals with the strongest confirmatory reasoning had higher levels of depression and preoccupation with delusional ideation. Successful adoption of disconfirmatory reasoning was associated with less hasty decision‐making and lower levels of preoccupation and distress by delusional ideation. Individuals with a disconfirmatory reasoning style reported more evidence both for and against their beliefs in the belief evaluation task.

Conclusion. The preliminary evidence, from this small non‐clinical group, indicates that evaluating beliefs may partially involve the use of confirmatory and disconfirmatory reasoning processes. Disconfirmatory reasoning, associated with less hasty data gathering and consideration of alternatives, may lead to better belief evaluation. In the context of clinical research indicating that individuals with delusions are hasty in their data gathering and have difficulty considering alternatives, a potential implication of the findings is that individuals with delusions may find belief evaluation in therapy particularly difficult. The current study has clear limitations, but a research focus on specific techniques of therapy does appear feasible and show promise.
Jumping to conclusions in delusional and non‐delusional schizophrenic patients
Authors: Moritz Steffen , Woodward Todd S.
Published: June 2005

Objective. Several studies have provided evidence for the claim that a subgroup of (schizophrenic) patients with current delusions share a jumping to conclusions (JTC) bias. The primary aim of the present study was to investigate whether currently deluded and non‐deluded schizophrenic patients perform differently on three tasks tapping probabilistic reasoning.

Method. Probabilistic reasoning was assessed in 31 schizophrenic patients, 28 psychiatric controls, and 17 healthy controls. In addition to the traditional draws to decision procedure, we employed two tasks for which participants had to judge, at each stage, the likelihood that beads come from either container (graded estimates procedure). Reaction times were recorded for the graded estimates procedure.

Results. A JTC bias was displayed by 42% of the schizophrenic patients in the draws to decision condition, while 7% of the psychiatric patients and none of the healthy controls reached a decision after only one bead. A similar pattern of results was observed for the graded estimates procedure. This bias was more pronounced in deluded schizophrenic patients, although currently non‐deluded patients also showed evidence for earlier decisions. A bias to over‐adjust when confronted with potentially disconfirmatory evidence was confined to deluded schizophrenic participants. There was also evidence for an increase in JTC in the deluded group over the course of the tasks. No substantial group differences occurred with respect to reaction time parameters indicating that results are not attributable to impulsivity.

Discussion. The findings provide further evidence for state and trait characteristics of abnormal reasoning in paranoid schizophrenia. Results are discussed in light of several competing explanations for JTC in schizophrenia.
Pathologizing dissent: Identity politics, Zionism and the self‐hating Jew
Authors: Finlay W. M. L.
Published: June 2005

This article discusses problems with Kurt Lewin's notion of self‐hatred among Jews (Lewin, 1941/1948), and illustrates the ways in which the concept is used in identity politics. It argues that the way the notion of self‐hatred is often used makes it problematic as a psychological concept because it requires that we accept particular definitions of group identities and particular political positions as central to those identities. Often, however, such issues are disputed by group members. Examination of the literature illustrates that it is rarely a straightforward decision whether those behaviours or attitudes identified as manifestations of self‐hatred are best explained in this way. The function of the self‐hatred concept in current debate over Israeli policy is described as an example of how arguments over identity are part of political conflict. In the case of current Middle Eastern politics, the concept of self‐hatred is used by right‐wing Zionists to label those who criticize policies of the current Israeli government as disloyal and pathological.
Where did Vincent's van go?
Authors: Spears Russell
Published: June 2005

While agreeing with the general thrust of Hollway and Jefferson's analysis, the degree to which the agency/structure dualism is transcended and Vince's conflicts located in unconscious psychodynamic processes can be probed. I suggest some additional ways of evaluating these claims.