bluuebunny/crossref_metadata_2025 huggingface dataset:
Health related quality of life among adolescents with premenstrual disorders: a cross sectional study
Authors: Delara Mahin , Ghofranipour Fazlollah , Azadfallah Parviz , Tavafian Sedigheh Sadat , Kazemnejad Anoushirvan , Montazeri Ali
Published: January 2012

Background

Premenstrual disorders usually refer to premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). This study was designed to evaluate health-related quality of life (HRQOL) in a sample of Iranian adolescents with premenstrual disorders.

Methods

This was a cross sectional study. A sample of adolescent schoolgirls aged between 14 and 19 years were included in the study. Premenstrual disorders were indicated according to the International Classification of Diseases (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Health-related quality of life was measured using the Short Form Health Survey (SF-36). The data were analyzed in a descriptive fashion and were compared among subgroups of the study sample.

Results

In all 602 female students were studied. All students reported at least one premenstrual symptom. Of these, 224 (37.2%) met the diagnostic criteria for premenstrual dysphoric disorder (PMDD). Comparing the SF-36 scores between female students with and without PMDD, it was found that there were significant differences between these two groups in all measures (P < 0.001) except for physical functioning (P = 0.274). These differences were more evident on role emotional, role physical, social functioning and bodily pain.

Conclusion

The study findings affirm the fact that adolescents with premenstrual disorders suffer from poor health-related quality of life. In order to improve quality of life in female adolescents appropriate support should be provided for this population especially for those who suffer from more severe premenstrual disorders.
Innate Immunity in multiple sclerosis white matter lesions: expression of natural cytotoxicity triggering receptor 1 (NCR1)
Authors: Durrenberger Pascal F , Ettorre Anna , Kamel Fatemah , Webb Louise V , Sim Malcolm , Nicholas Richard S , Malik Omar , Reynolds Richard , Boyton Rosemary J , Altmann Daniel M
Published: January 2012

Background

Pathogenic or regulatory effects of natural killer (NK) cells are implicated in many autoimmune diseases, but evidence in multiple sclerosis (MS) and its murine models remains equivocal. In an effort to illuminate this, we have here analysed expression of the prototypic NK cell marker, NCR1 (natural cytotoxicity triggering receptor; NKp46; CD335), an activating receptor expressed by virtually all NK cells and therefore considered a pan-marker for NK cells. The only definitive ligand of NCR1 is influenza haemagglutinin, though there are believed to be others. In this study, we investigated whether there were differences in NCR1+ cells in the peripheral blood of MS patients and whether NCR1+ cells are present in white matter lesions.

Results

We first investigated the expression of NCR1 on peripheral blood mononuclear cells and found no significant difference between healthy controls and MS patients. We then investigated mRNA levels in central nervous system (CNS) tissue from MS patients: NCR1 transcripts were increased more than 5 times in active disease lesions. However when we performed immunohistochemical staining of this tissue, few NCR1+ NK cells were identified. Rather, the major part of NCR1 expression was localised to astrocytes, and was considerably more pronounced in MS patients than controls. In order to further validate de novo expression of NCR1 in astrocytes, we used an in vitro staining of the human astrocytoma U251 cell line grown to model whether cell stress could be associated with expression of NCR1. We found up-regulation of NCR1 expression in U251 cells at both the mRNA and protein levels.

Conclusions

The data presented here show very limited expression of NCR1+ NK cells in MS lesions, the majority of NCR1 expression being accounted for by expression on astrocytes. This is compatible with a role of this cell-type and NCR1 ligand/receptor interactions in the innate immune response in the CNS in MS patients. This is the first report of NCR1 expression on astrocytes in MS tissue: it will now be important to unravel the nature of cellular interactions and signalling mediated through innate receptor expression on astrocytes.
Pharmacological inhibition of Akt and downstream pathways modulates the expression of COX-2 and mPGES-1 in activated microglia
Authors: de Oliveira Antonio CP , Candelario-Jalil Eduardo , Langbein Julia , Wendeburg Lena , Bhatia Harsharan S , Schlachetzki Johannes CM , Biber Knut , Fiebich Bernd L
Published: January 2012

Background

Microglia are considered a major target for modulating neuroinflammatory and neurodegenerative disease processes. Upon activation, microglia secrete inflammatory mediators that contribute to the resolution or to further enhancement of damage in the central nervous system (CNS). Therefore, it is important to study the intracellular pathways that are involved in the expression of the inflammatory mediators. Particularly, the role of the phosphatidylinositol 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) and glycogen synthase kinase-3 (GSK-3) pathways in activated microglia is unclear. Thus, in the present study we investigated the role of Akt and its downstream pathways, GSK-3 and mTOR, in lipopolysaccharide (LPS)-activated primary rat microglia by pharmacological inhibition of these pathways in regard to the expression of cyclooxygenase (COX)-2 and microsomal prostaglandin E synthase-1 (mPGES-1) and to the production of prostaglandin (PG) E2 and PGD2.

Findings

We show that inhibition of Akt by the Akt inhibitor X enhanced the production of PGE2 and PGD2 without affecting the expression of COX-2, mPGES-1, mPGES-2 and cytosolic prostaglandin E synthase (cPGES). Moreover, inhibition of GSK-3 reduced the expression of both COX-2 and mPGES-1. In contrast, the mTOR inhibitor rapamycin enhanced both COX-2 and mPGES-1 immunoreactivity and the release of PGE2 and PGD2. Interestingly, NVP-BEZ235, a dual PI3K/mTOR inhibitor, enhanced COX-2 and reduced mPGES-1 immunoreactivity, albeit PGE2 and PGD2 levels were enhanced in LPS-stimulated microglia. However, this compound also increased PGE2 in non-stimulated microglia.

Conclusion

Taken together, we demonstrate that blockade of mTOR and/or PI3K/Akt enhances prostanoid production and that PI3K/Akt, GSK-3 and mTOR differently regulate the expression of mPGES-1 and COX-2 in activated primary microglia. Therefore, these pathways are potential targets for the development of novel strategies to modulate neuroinflammation.
The role of G protein gene GNB3 C825TPolymorphism in HIV-1 acquisition, progression and immune activation
Authors: Juno Jennifer , Tuff Jeffrey , Choi Robert , Card Catherine , Kimani Joshua , Wachihi Charles , Koesters-Kiazyk Sandra , Ball T Blake , Farquhar Carey , Plummer Francis A , John-Stewart Grace , Luo Ma , Fowke Keith R
Published: January 2012

Background

The GNB3 C825T polymorphism is associated with increased G protein-mediated signal transduction, SDF-1α-mediated lymphocyte chemotaxis, accelerated HIV-1 progression, and altered responses to antiretroviral therapy among Caucasian subjects. The GNB3 825T allele is highly prevalent in African populations, and as such any impact on HIV-1 acquisition or progression rates could have a dramatic impact. This study examines the association of the 825T polymorphism with HIV-1 acquisition, disease progression and immune activation in two African cohorts. GNB3 825 genotyping was performed for enrolees in both a commercial sex worker cohort and a perinatal HIV transmission (PHT) cohort in Nairobi, Kenya. Ex vivo immune activation was quantified by flow cytometry, and plasma chemokine levels were assessed by cytokine bead array.

Results

GNB3 genotype was not associated with sexual or vertical HIV-1 acquisition within these cohorts. Within the Pumwani cohort, GNB3 genotype did not affect HIV-1 disease progression among seroconverters or among HIV-1-positive individuals after adjustment for baseline CD4 count. Maternal CD4 decline and viral load increase in the PHT cohort did not differ between genotypes. Multi-parametric flow cytometry assessment of T cell activation (CD69, HLA-DR, CD38) and Treg frequency (CD25+FOXP3+) found no differences between genotype groups. Plasma SDF-1α, MIP-1β and TRAIL levels quantified by cytokine bead array were also similar between groups.

Conclusions

In contrast to previous reports, we were unable to provide evidence to suggest that the GNB3 C825T polymorphism affects HIV-1 acquisition or disease progression within African populations. Ex vivo immune activation and plasma chemokine levels were similarly unaffected by GNB3 genotype in both HIV-1-negative and HIV-1-positive individuals. The paucity of studies investigating the impact of GNB3 polymorphism among African populations and the lack of mechanistic studies make it difficult to assess the true biological significance of this polymorphism in HIV-1 infection.
EPI Receptor within the Ventrolateral Periaqueductal Grey Controls Thermonociception and Rostral Ventromedial Medulla Cell Activity in Healthy and Neuropathic Rat
Authors: Palazzo Enza , Guida Francesca , Gatta Luisa , Luongo Livio , Boccella Serena , Bellini Giulia , Marabese Ida , de Novellis Vito , Rossi Francesca , Maione Sabatino
Published: January 2012

The aim of this study was to investigate the expression of prostaglandin EP 1 receptor within the ventrolateral periaqueductal grey (VL PAG). The role of VL PAG EP1 receptor in controlling thermonociception and rostral ventromedial medulla (RVM) activity in healthy and neuropathic rats was also examined. EP1 receptor was indeed found to be expressed within the VL PAG and co-localized with vesicular GABA transporter. Intra-VL PAG microinjection of ONO-DI-004, a selective EP1 receptor agonist, dose-dependently reduced tail flick latency as well as respectively increasing and decreasing the spontaneous activity of ON and OFF cells. Furthermore, it increased the ON cell burst and OFF cell pause. Intra-VL PAG prostaglandin E2 (PGE2) behaved similarly to ONO-DI-004. The effects of ONO-DI-004 and PGE2 were antagonized by intra-VL PAG L335677, a selective EP1 receptor antagonist. L335677 dose-dependently increased the tail flick latency and ongoing activity of the OFF cells, while reducing the ongoing ON cell activity. It also decreased the ON cell burst and OFF cell pause. In neuropathic rats using spare nerve injury (SNI) of the sciatic nerve model, EP1 receptor expression decreased in the VL PAG. However, ONO-DI-004 and L335677 were able to alter pain responses and ON and OFF cell activity, as they did in healthy animals. Collectively, these data show that within the VL PAG, EP1 receptor has a facilitatory effect on the nociceptive response and consistently affects RVM neuron activity. Thus, the blockade of EP1 receptor in the VL PAG leads to antinociception in neuropathic pain conditions, despite its down-regulation. The expression of EP1 receptor on GABAergic neurons is consistent with an EP1 receptor blockade-induced disinhibition of the antinociceptive descending pathway at VL PAG level.
Functional Characterization and Analgesic Effects of Mixed Cannabinoid Receptor/T-Type Channel Ligands
Authors: You Haitao , Gadotti Vinicius M , Petrov Ravil R , Zamponi Gerald W , Diaz Philippe
Published: January 2012

Background:

Both T-type calcium channels and cannabinoid receptors modulate signalling in the primary afferent pain pathway. Here, we investigate the analgesics activities of a series of novel cannabinoid receptor ligands with T-type calcium channel blocking activity.

Results:

Novel compounds were characterized in radioligand binding assays and in vitro functional assays at human and rat CB1 and CB2 receptors. The inhibitory effects of these compounds on transient expressed human T-type calcium channels were examined in tsA-201 cells using standard whole-cell voltage clamp techniques, and their analgesic effects in response to various administration routes (intrathecally, intraplantarly, intraperitoneally) assessed in the formalin model. A series of compounds were synthesized and evaluated for channel and receptor activity. Compound NMP-7 acted as non-selective CB1/CB2 agonist while NMP4 was found to be a CB1 partial agonist and CB2 inverse agonist. Furthermore, NMP-144 behaved as a selective CB2 inverse agonist. All of these three compounds completely inhibited peak Cav3.2 currents with IC50 values in the low micromolar range. All compounds mediated analgesic effects in the formalin model, but depending on the route of administration, could differentially affect phase 1 and phase 2 of the formalin response.

Conclusions:

Our results reveal that a set of novel cannabinioid receptor ligands potently inhibit T-type calcium channels and show analgesic effects in vivo. Our findings suggest possible novel means of mediating pain relief through mixed T-type/cannabinoid receptor ligands.
Determination of cell survival after irradiation via clonogenic assay versus multiple MTT Assay - A comparative study
Authors: Buch Karl , Peters Tanja , Nawroth Thomas , Sänger Markus , Schmidberger Heinz , Langguth Peter
Published: January 2012

For studying proliferation and determination of survival of cancer cells after irradiation, the multiple MTT assay, based on the reduction of a yellow water soluble tetrazolium salt to a purple water insoluble formazan dye by living cells was modified from a single-point towards a proliferation assay. This assay can be performed with a large number of samples in short time using multi-well-plates, assays can be performed semi-automatically with a microplate reader. Survival, the calculated parameter in this assay, is determined mathematically. Exponential growth in both control and irradiated groups was proven as the underlying basis of the applicability of the multiple MTT assay. The equivalence to a clonogenic survival assay with its disadvantages such as time consumption was proven in two setups including plating of cells before and after irradiation. Three cell lines (A 549, LN 229 and F 98) were included in the experiment to study its principal and general applicability.
A versatile toolkit for high throughput functional genomics with Trichoderma reesei
Authors: Schuster André , Bruno Kenneth S , Collett James R , Baker Scott E , Seiboth Bernhard , Kubicek Christian P , Schmoll Monika
Published: January 2012

Background

The ascomycete fungus, Trichoderma reesei (anamorph of Hypocrea jecorina), represents a biotechnological workhorse and is currently one of the most proficient cellulase producers. While strain improvement was traditionally accomplished by random mutagenesis, a detailed understanding of cellulase regulation can only be gained using recombinant technologies.

Results

Aiming at high efficiency and high throughput methods, we present here a construction kit for gene knock out in T. reesei. We provide a primer database for gene deletion using the pyr4, amdS and hph selection markers. For high throughput generation of gene knock outs, we constructed vectors using yeast mediated recombination and then transformed a T. reesei strain deficient in non-homologous end joining (NHEJ) by spore electroporation. This NHEJ-defect was subsequently removed by crossing of mutants with a sexually competent strain derived from the parental strain, QM9414.

Conclusions

Using this strategy and the materials provided, high throughput gene deletion in T. reesei becomes feasible. Moreover, with the application of sexual development, the NHEJ-defect can be removed efficiently and without the need for additional selection markers. The same advantages apply for the construction of multiple mutants by crossing of strains with different gene deletions, which is now possible with considerably less hands-on time and minimal screening effort compared to a transformation approach. Consequently this toolkit can considerably boost research towards efficient exploitation of the resources of T. reesei for cellulase expression and hence second generation biofuel production.
Genomics and proteomics in liver fibrosis and cirrhosis
Authors: Hannivoort Rebekka A , Hernandez-Gea Virginia , Friedman Scott L
Published: January 2012

Genomics and proteomics have become increasingly important in biomedical science in the past decade, as they provide an opportunity for hypothesis-free experiments that can yield major insights not previously foreseen when scientific and clinical questions are based only on hypothesis-driven approaches. Use of these tools, therefore, opens new avenues for uncovering physiological and pathological pathways. Liver fibrosis is a complex disease provoked by a range of chronic injuries to the liver, among which are viral hepatitis, (non-) alcoholic steatohepatitis and autoimmune disorders. Some chronic liver patients will never develop fibrosis or cirrhosis, whereas others rapidly progress towards cirrhosis in a few years. This variety can be caused by disease-related factors (for example, viral genotype) or host-factors (genetic/epigenetic). It is vital to establish accurate tools to identify those patients at highest risk for disease severity or progression in order to determine who are in need of immediate therapies. Moreover, there is an urgent imperative to identify non-invasive markers that can accurately distinguish mild and intermediate stages of fibrosis. Ideally, biomarkers can be used to predict disease progression and treatment response, but these studies will take many years due to the requirement for lengthy follow-up periods to assess outcomes. Current genomic and proteomic research provides many candidate biomarkers, but independent validation of these biomarkers is lacking, and reproducibility is still a key concern. Thus, great opportunities and challenges lie ahead in the field of genomics and proteomics, which, if successful, could transform the diagnosis and treatment of chronic fibrosing liver diseases.
A novel deletion in 2q24.1q24.2 in a girl with mental retardation and generalized hypotonia: a case report
Authors: Palumbo Orazio , Palumbo Pietro , Palladino Teresa , Stallone Raffaella , Zelante Leopoldo , Carella Massimo
Published: January 2012

Background

Chromosomal imbalances, recognized as the major cause of mental retardation, are often due to submicroscopic deletions or duplications not evidenced by conventional cytogenetic methods. To date, interstitial deletion of long arm of chromosome 2 have been reported for more than 100 cases, although studies reporting small interstitial deletions involving the 2q24.1q24.2 region are rare. With the widespread clinical use of comparative genomic hybridization chromosomal microarray technology, several cryptic chromosome imbalances have outlined new genotype-phenotype correlations and isolated a number of distinctive clinical conditions.

Results

here we report on a girl with mental retardation and generalized hypotonia. A genome-wide screen for copy number variations (CNVs) using single nucleotide polymorphisms (SNPs) array revealed a 7.5 Mb interstitial deletion of chromosome region 2q24.1q24.2 encompassing 59 genes, which was absent in parents. The gene content analysis of the deleted region and review of the literature revealed the presence of some genes that may be indicated as good candidate in generating the main clinical features of the patient.

Discussion

the present case represents a further patient described in the literature with an interstitial deletion of chromosome 2q24.1q24.2. Our patient shares some clinical features with the previously reported patients carriers of overlapping 2q24 deletion. Although more cases are needed to delineate the full-blown phenotype of 2q24.1q24.2 deletion syndrome, published data and present observation suggest that hemizygosity of this region results in a clinically recognizable phenotype. Considering these clinical and cytogenetic similarities, we suggest the existence of an emerging syndrome associated to 2q24.1q24.2 region.
Loop-mediated isothermal amplification (LAMP): Early detection of Toxoplasma gondii infection in mice
Authors: Kong Qing-Ming , Lu Shao-Hong , Tong Qun-Bo , Lou Di , Chen Rui , Zheng Bin , Kumagai Takashi , Wen Li-Yong , Ohta Nobuo , Zhou Xiao-Nong
Published: January 2012

Background

Toxoplasmosis is a widespread zoonotic parasitic disease that occurs in both animals and humans. Traditional molecular assays are often difficult to perform, especially for the early diagnosis of Toxoplasma gondii infections. Here, we established a novel loop-mediated isothermal amplification targeting the 529 bp repeat element (529 bp-LAMP) to detect T. gondii DNA in blood samples of experimental mice infected with tachyzoites of the RH strain.

Findings

The assay was performed with Bst DNA polymerase at 65°C for 1 h. The detection limit of the 529 bp- LAMP assay was as low as 0.6 fg of T. gondii DNA. The sensitivity of this assay was 100 and 1000 fold higher than that of the LAMP targeting B1 gene (B1-LAMP) and nested PCR targeting 529 bp repeat element (529 bp-nested PCR), respectively. The specificity of the 529 bp- LAMP assay was determined using the DNA samples of Trypanosoma evansi, Plasmodium falciparum, Paragonimus westermani, Schistosoma japonicum, Fasciola hepatica and Angiostrongylus cantonensis. No cross-reactivity with the DNA of any parasites was found. The assay was able to detect T. gondii DNA in all mouse blood samples at one day post infection (dpi).

Conclusions

We report the following findings: (i) The detection limit of the 529 bp- LAMP assay is 0.6 fg of T. gondii DNA; (ii) The assay does not involve any cross-reactivity with the DNA of other parasites; (iii) This is the first report on the application of the LAMP assay for early diagnosis of toxoplasmosis in blood samples from experimentally infected mice. Due to its simplicity, sensitivity and cost-effectiveness for common use, we suggest that this assay should be used as an early diagnostic tool for health control of toxoplasmosis.
Developmental plasticity and the evolution of parasitism in an unusual nematode, Parastrongyloides trichosuri
Authors: Stasiuk Susan J , Scott Maxwell J , Grant Warwick N
Published: January 2012

Background

Parasitism is an important life history strategy in many metazoan taxa. This is particularly true of the Phylum Nematoda, in which parasitism has evolved independently at least nine times. The apparent ease with which parasitism has evolved amongst nematodes may, in part, be due to a feature of nematode development acting as a pre-adaptation for the transition from a free-living to a parasitic life history. One candidate pre-adaptive feature for evolution in terrestrial nematodes is the dauer larva, a developmentally arrested morph formed in response to environmental signals.

Results

We investigated the role of dauer development in the nematode, Parastrongyloides trichosuri, which has retained a complete free-living life cycle in addition to a life cycle as a mammalian gastrointestinal parasite. We show that the developmental switch between these life histories is sensitive to the same environmental cues as dauer arrest in free-living nematodes, including sensitivity to a chemical cue produced by the free-living stages. Furthermore, we show that genetic variation for the sensitivity of the cue(s) exists in natural populations of P. trichosuri, such that we derived inbred lines that were largely insensitive to the cue and other lines that were supersensitive to the cue.

Conclusions

For this parasitic clade, and perhaps more widely in the phylum, the evolution of parasitism co-opted the dauer switch of a free-living ancestor. This lends direct support to the hypothesis that the switch to developmental arrest in the dauer larva acted as a pre-adaptation for the evolution of parasitism, and suggests that the sensory transduction machinery downstream of the cue may have been similarly co-opted and modified.
Sparse code shrinkage for signal enhancement of seismic data
Authors: Sanchis Charlotte , Hanssen Alfred
Published: January 2012

Sparse code shrinkage is a method that is commonly used for image denoising and that has recently found some applications in seismic for random noise attenuation and multiple removal in a simplified form. Sparse coding finds a representation of the data in which each component is only rarely significantly active. Such a representation is closely related to independent component analysis. We discuss the link between sparse coding and independent component analysis, and show how the application of shrinkages to sparse components manages to attenuate the noise in seismic data. The use of data-driven shrinkages estimated from noise-free data is a necessary condition for this method to be efficient. We propose a realization of the data, attenuated in noise, that allows the derivation of data-driven shrinkage functions. They are obtained either by fitting this sparse representation with a given density model, or by estimating the density directly from the data. Two parametric models of density are investigated, the sparse density and the normal inverse Gaussian density, while the Gaussian kernel estimator estimates the density from the data. They are tested on both synthetic and real marine seismic data, and compared with f-x deconvolution and local SVD as alternative denoising methods. We show that the NIG density yields the best results, but the sparse density and the nonparametric density estimate are acceptable choices as well. Finally, the comparison with alternative methods shows that sparse code shrinkage is a credible alternative for the denoising of seismic data.
Inferring rock fracture evolution during reservoir stimulation from seismic anisotropy
Authors: Wuestefeld Andreas , Verdon James P. , Kendall J-Michael , Rutledge James , Clarke Huw , Wookey James
Published: January 2012

We have analyzed seismic anisotropy using shear-wave-splitting measurements made on microseismic events recorded during a hydraulic fracture experiment in a tight gas reservoir in Carthage, east Texas. Microseismic events were recorded on two downhole arrays of three-component sensors, the geometry of which provided good ray coverage for anisotropy analysis. A total of 16,633 seismograms from 888 located events yielded 1545 well-constrained shear-wave-splitting measurements. Manual analysis of splitting from a subset of this data set reveals temporal changes in splitting during fracturing. Inversion using the full data set allows the identification of fracture strike and density, which is observed to vary during fracturing. The recovered fracture strike in the rock mass is parallel to directions of regional borehole breakout, but oblique to the hydraulic fracture corridor as mapped by the microseismic event. We relate this to en-echelon fracturing of preexisting cracks. The magnitude of shear-wave splitting shows a clear temporal increase during each pumping stage, indicating the generation of cracks and fissures in a halo around the fracture corridor, which thus increase the overall permeability of the rock mass. Our results show that shear-wave-splitting analysis can provide a useful tool for monitoring spatial and temporal variations in fracture networks generated by hydraulic stimulation.
Personality disorder: its impact on staff and the role of supervision
Authors: Moore Estelle
Published: January 2012

Over the past decade attention to the provision of healthcare for individuals with personality disorder, particularly those who pose a risk to others, has substantially increased. Keeping pace with such developments with a suitably trained, consistent and motivated workforce, interfacing health and criminal justice systems where necessary, presents an enormous challenge. Staff must be experts in managing conflict at every level, while sustaining an optimistic and therapeutic orientation. Boundaried relationships provide the context for recovery for patients. Key principles and practices likely to promote resilience in personality disorder services, with a focus on the role of supervision, are outlined in order to support staff in keeping themselves afloat, their patients safe, and their services on target.
Eating disorders: clinical features and the role of the general psychiatrist
Authors: Jones William Rhys , Schelhase Monique , Morgan John F.
Published: January 2012

Although most patients with severe eating disorders are treated in specialist eating disorder services, general psychiatrists are often responsible for the care of many with mild to moderate disorder. Treating and supporting these patients in a non-specialist setting can sometimes be challenging but this need not be the case. Having a clear understanding of the clinical features of these conditions forms the foundation on which a comprehensive assessment and management plan can be made. We summarise the clinical features of eating disorders and explore the unique role of the general psychiatrist in identifying people with these conditions, supporting them and directing them into evidence-based treatments.
Recollections of journey from Essex by John Clare
Authors: Oyebode Femi
Published: January 2012

This article examines John Clare's prose account of his escape from High Beach Asylum in 1841. Clare has attracted attention for his nature poems as much as for his humble, peasant background and his well-described mental illness, including his asylum committals. Recollections of journey from Essex is unique as a piece of writing describing escape from an asylum and illustrating to some degree the mental state and experiences of a psychiatrically ill person in England in the mid-1800s.
Staging the HCR-20: towards successful implementation of team-based structured professional judgement schemes
Authors: Haque Quazi , Webster Christopher D.
Published: January 2012

Structured professional judgement risk management schemes such as the Historical, Clinical, Risk Management - 20 (HCR-20) can be described as clinical guidelines produced by a collaborative process between mental health clinicians and researchers. The purpose is to provide clinicians with a framework to guide interventions designed to manage specific risks such as violence against others. The use of evidence-based clinical methods, especially in a multidisciplinary setting, is now commonly considered a best-practice approach when managing violence and related risks. This article describes some of the practical implementation challenges that may arise when using schemes such as the HCR-20 in multi-disciplinary team meetings.
Fifty years after Frantz Fanon: beyond diversity
Authors: Sikuade Adedapo
Published: January 2012

Frantz Fanon (1925–1961), a West Indian of mixed race, was a French colonial psychiatrist trained in Lyon, France, who worked mainly in colonial North Africa between 1953 and 1957. He was one of the earliest psychiatrists to suggest that the lived experience of ethnic minorities within a discriminatory colonial environment could trigger mental illness. This article focuses on Fanon's work and contributions to psychiatry, as well as his philosophy, advocacy for social inclusion and pioneering work in culturally relevant rehabilitation. It also examines what lessons could be learnt from his life's work as a psychiatrist and traces his influence on a generation of psychiatric researchers, suggesting how his contribution may have influenced critical thought and current views.
Psychotherapy for gender identity disorders
Authors: Hakeem Az
Published: January 2012

This article describes a special adaptation of group psychotherapy as a psychological treatment for people with a variety of gender identity disorders. It can be used as an alternative to or concurrently with hormonal and/or surgical interventions for transgender people. It is also suitable for individuals whose gender identity disorder remains after physical interventions. The article draws from a UK specialist pilot for such a treatment service and describes the explicit aims of the psychotherapy, the specialist adaptation of therapeutic technique required and observed thematic features relevant to working in this specific field.
Efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders: systematic review
Authors: Lewis Catrin , Pearce Jennifer , Bisson Jonathan I.
Published: January 2012

Background

Self-help interventions for psychiatric disorders represent an increasingly popular alternative to therapist-administered psychological therapies, offering the potential of increased access to cost-effective treatment.

Aims

To determine the efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders.

Method

Randomised controlled trials (RCTs) of self-help interventions for anxiety disorders were identified by searching nine online databases. Studies were grouped according to disorder and meta-analyses were conducted where sufficient data were available. Overall meta-analyses of self-helpv.waiting list and therapist-administered treatment were also undertaken. Methodological quality was assessed independently by two researchers according to criteria set out by the Cochrane Collaboration.

Results

Thirty-one RCTs met inclusion criteria for the review. Results of the overall meta-analysis comparing self-help with waiting list gave a significant effect size of 0.84 in favour of self-help. Comparison of self-help with therapist-administered treatments revealed a significant difference in favour of the latter with an effect size of 0.34. The addition of guidance and the presentation of multimedia or web-based self-help materials improved treatment outcome.

Conclusions

Self-help interventions appear to be an effective way of treating individuals diagnosed with social phobia and panic disorder. Further research is required to evaluate the cost-effectiveness and acceptability of these interventions.
Bipolar depression and treatment with antidepressants
Authors: Goodwin Guy M.
Published: January 2012

Treatment of bipolar disorder with antidepressants tested almost exclusively in unipolar cases is common but unsupported by an appropriate body of evidence. This anomaly is highlighted by a large Taiwanese study, which implies that patients with depression difficult to treat with antidepressants are quite likely to be diagnosed subsequently with bipolar disorder.
Transcranial stimulation in depression
Authors: Allan Charlotte , Kalu Ukwuori-Gisela , Sexton Claire E. , Ebmeier Klaus P.
Published: January 2012

Transcranial direct current stimulation is coming of age with the large treatment study published in this issue. We review transcranial stimulation methods, their efficacy and the likely impact on National Health Service (NHS) practice. Their use in individuals who do not respond to or cannot tolerate medication should now be explored in large controlled naturalistic studies in the NHS.
To meta-analyse or not to meta-analyse: abortion, birth and mental health
Authors: Kendall Tim , Bird Victoria , Cantwell Roch , Taylor Clare
Published: January 2012

Two recent meta-analyses claim that abortion leads to a deterioration in mental health. Previous reviews concluded that the mental health outcomes following an unwanted pregnancy are much the same whether the woman gives birth or terminates the pregnancy, although there is an increased mental health risk with an unwanted pregnancy. Meta-analysis is particularly susceptible to bias in this area. The physical health outcomes for women with an unwanted pregnancy have improved greatly by making abortion legal. To further improve the mental health outcomes associated with an unwanted pregnancy we should focus practice and research on the individual needs of women with an unwanted pregnancy, rather than how the pregnancy is resolved.
The bicentennial volume of the British Journal of Psychiatry: the winding pathway of mental science
Authors: Tyrer Peter , Craddock Nick
Published: January 2012

The Asylum Journal, first published in 1853, is now, as the British Journal of Psychiatry, in its 200th volume. It has changed greatly in its breadth and scope, but its core values and concerns – professional respect, removal of stigma, delivery of care, understanding of pathology, and informed treatment – have remained at its heart throughout. We predict some changes for the future, but not dramatic ones, and conclude that the impinging advances of science will elucidate and refine, but not remove, the need for a journal that is proud to represent psychiatry or, in the words of John Bucknill, its first editor, ‘to render prominent its characteristics and to stamp it as a specialty’.
Distribution of litigation claims across a generalised psychiatric patient journey
Authors: Mordue Mark , Weatherby Marcus , Weatherby Stuart , Pearson Stephen
Published: January 2012

Aims and method

We analysed all 1213 negligence claims made against contributing psychiatric services since the inception of the National Health Service Litigation Authority (NHSLA) in 1995 and until 1 June 2009. More than half (55%) were settled, at a cost of £47.2 million, 26% were closed without penalty and 19% were still in progress at the time of review. Five individual claims exceeded £1 million.

Results

By allocating 43 NHSLA-assigned causes for a claim to the 11 stages of a generalised patient journey, we noted that assessment of patient risks was the single largest cause of claims (32%) and the single largest cost of settlements (£16.2 million, 34%).

Clinical implications

At the individual level it is difficult to see patterns of errors, whereas increased volumes reveal systemic trends. This analysis presents a new perspective from which to improve patient safety.
Workplace-based assessment: attitudes and perceptions among consultant trainers and comparison with those of trainees
Authors: Menon Sharmila , Winston Mark , Sullivan Gary
Published: January 2012

Aims and method

To explore attitudes and perceptions towards workplace-based assessment (WPBA) among psychiatric trainers in Wales and to compare them with those of trainees. To identify current problems and report recommendations made by survey respondents to streamline and successfully implement WPBA. An anonymous questionnaire-based cross-sectional online survey was conducted involving consultant psychiatrists in Wales and the results compared with a previous survey of specialty registrars.

Results

In total, 104 of 164 consultants participated (63%), compared with 81 of 88 trainees (92%). Both surveys highlighted numerous problems and negative attitudes towards WPBA. Compared with widespread dissatisfaction among trainees, trainers appear more diverse in their opinions, although considerable numbers are dissatisfied with the new competency-based system.

Clinical implications

Negative attitudes harboured by many trainees and trainers constitute a significant hurdle to the effective implementation of WPBA and undermine its efficacy as a tool intended to improve training. Specific measures with the potential to address various shortcomings are discussed, with a view to improving WPBA and rendering it more acceptable to both trainees and trainers – and thus facilitate improvement of training.
Integrated academic training pathways and academic child and adolescent psychiatric training
Authors: Garralda M. Elena
Published: January 2012

Aims and method

To carry out a survey to ascertain the role of academic clinical fellowship posts within the integrated academic training programme for academic training in child and adolescent psychiatry. Questionnaires were sent to UK academic child psychiatric units.

Results

A total of 18 units returned questionnaires; this identified eight university lecturers and two academic clinical fellows in post.

Clinical implications

Integrated academic training pathways seem unlikely to contribute substantially to academic training and to maintaining the pool of academic clinicians in child and adolescent psychiatry. It may need reappraising with regard to psychiatric specialties.
Reform of the coroners' service in England and Wales: policy-making and politics
Authors: Pitman Alexandra
Published: January 2012

The Coroners and Justice Act 2009 promised an overhaul of the coroners' service, introducing much needed efficiencies to benefit people bereaved by suicide and other sudden deaths. Central to these reforms was the introduction of a Chief Coroner to coordinate the system and exercise wider public health responsibilities. The coalition government's proposal to abolish the Chief Coroner's office on grounds of cost, ignoring the potential efficiency gains, has delayed implementation of coronial reforms significantly. With this proposal now abandoned, ministers are expected to appoint an independent Chief Coroner in early 2012. This article describes the intended benefits of the reforms for bereaved relatives, coroners' staff, public sector budgets, and the public health, and explores the reasons behind the delays.
Composite Materials: Testing and Design
Authors: Yurenka Steven
Published: January 2012

Description

The seven papers in this Symposium on Correlation of Subjective-Objective Methods in the Study of Odors and Taste were given at the Seventieth Annual Meeting of ASTM held in Boston, Mass., 25—30 June 1967. The symposium was sponsored by Subcommittee II on Instrumental-Sensory Correlation of Committee E18 on Sensory Evaluation of Materials and Products. W. H. Stahl, McCormick and Co., Inc., presided as symposium chairman.
Mechanical Properties and Test Techniques for Reinforced Plastic Laminates
Authors: Dastin S. , Lubin G. , Munyak J. , Slobodzinski A.
Published: January 2012

Various test specimen shapes for determining tensile, compressive, and edgewise shear properties of reinforced plastic laminates are compared. Tests were performed and data collected for the various shape specimens from three specific resin content panels at various temperature in both dry and wet condition. Recommendations as to the most reliable specimen shapes are given based upon evaluation of tests performed.
A Simplified Method of Determining the Inplane Shear Stress-Strain Response of Unidirectional Composites
Authors: Petit P. H.
Published: January 2012

A simple and relatively inexpensive technique is presented for determining the inplane shear stress-strain response of unidirectional composites. The method utilizes the stress-strain results from an uniaxial test on a ±45-deg laminate which is symmetrically laminated about the midplane. Through the use of relations derived from laminated plate theory, expressions are presented which allow the inplane laminae shear stress-strain curve to be incrementally reproduced from the ±45-deg laminate stress-strain curve. The simple coupon and uniaxial sandwich beam specimens, which may be utilized to obtain the data, are described. Comparisons are presented between boron/epoxy and graphite/epoxy shear stress strain curves obtained by this technique and the curves from cross-sandwich beam tests.
End Plugs for External Pressure Tests of Composite Cylinders
Authors: Miller R. J.
Published: January 2012

A method of reducing moment and shear loads which occur at end plugs during compression tests of composite ortho-tropic cylinders by external radial pressure is presented. The primary goal is to reduce the interlaminar shear stress to a permissible level and reduce the bending stresses of the cylinder to a negligible amount. The need to reduce the interlaminar shear stress is a result of the generally low shear strength of resin used in composite laminates.
Fatigue Fundamentals for Composite Materials
Authors: Boller K. H.
Published: January 2012

As composites are a combination of many organic and inorganic materials already studied, we draw on this information to guide us in strength evaluations, interpretation of results, and design aspects of the new materials. Basically, many micro- and macrostructural differences exist between the materials made of metals and those of reinforced plastics, sandwich constructions, and composites. The microstructure of the metals allows engineers to assume metals are isotropic and hence use simple formulas relating stress and strain. In contrast, composites are a mixture of dissimilar materials ranging from ductile, rubbery, weak, low-modulus materials to brittle, strong, high-modulus reinforcements. The result is a non-homogeneous or anisotropic material involving complicated relations of stress and strain. If the dissimilar materials are arranged in layers and oriented in specific patterns, such as many reinforced plastics and sandwich constructions, the composite may be considered an orthotropic material and treated as such mathematically. In addition to the various strength properties of the component materials, the composite also is affected by environmental factors, fabrication factors, and service factors. For example, temperature, moisture, various liquids, various gases, notches, imperfections, surface conditions, size, damping characteristics, adhesion, fastenings, cold working, orientation of crystals and fibers, and the rate of loading are all factors that affect the time and repetition of load, which is called fatigue. The effect of such factors generally cannot be predetermined mathematically, so that experimental evaluation must be made of each new composite. In evaluating strength and related properties of the composites, experience with well-known materials provided the concepts for testing coupons, models, prototypes, and full-scale structures. Experimental evaluations include the effects of various environmental exposures, repeated and dead loads, various stress ranges, and as many mechanical tests as possible. Current trends are to use accelerated methods of test (such as the Prot, staircase, Probit, and rate process) to assay quickly the material's strength and life and to provide design criteria. Standard strength determinations provide stress-strain relations in tension, compression, and shear. Fatigue determinations provide curves of stress and strain magnitude versus usable life or time to failure. Superimposed on such graphs are the effects of environments in service. Just as there are many facets and ramifications in construction of composites, there are likewise many variables in the testing for establishing design criteria. If established procedures are not feasible, modifications are necessary to evaluate a new product and provide the assurance of safe design loads.
Creep and Fatigue Behavior of Unidirectional and Cross-Plied Composites
Authors: Toth I. J.
Published: January 2012

The tensile, fatigue, creep, and stress-rupture behavior of unidirectional, unidirectional off-axis, and cross-plied composites of 25 volume percent boron filaments in a matrix of 6061 aluminum has been investigated. The tensile investigation has shown the composites to be of reasonably high quality. The fatigue strength of boron-reinforced 6061 aluminum was observed to be superior to those of boron-reinforced 1100 and 2024 aluminum composites. The failure mechanism is discussed in terms of buildup of stress concentration in the matrix to stress levels capable of fracturing proximate filaments. The effect of off-axis loading on the fatigue behavior was found to be similar to that observed on their tensile properties. Cross plying has changed the fracture mode from predominately matrix shear failure to failure involving filament fracture. The excellent creep and stress-rupture properties of boron filaments were utilized fully in the unidirectional composites when tested in the reinforcement direction. The off-axis creep and stress-rupture behavior of the unidirectional composite was characterized by a rapid reduction of properties with increasing off-axis orientation. Cross plying changed the mode of creep failure for many composite configurations from shear to tensile creep and improved the off-axis stress-rupture properties compared to corresponding unidirectional composites. In general, the creep behavior of cross-plied composites was characterized by a large degree of filament rotation towards the load axis.