bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression Of Mucin Gene Products in Laryngeal Squamous Cancer
Authors: Paleri Vinidh , Pearson Jeff P. , Bulmer David , Jeannon Jean‐Pierre , Wight Richard G. , Wilson Janet A.
Published: July 2004

OBJECTIVE

Mucins are high‐molecular‐weight glycoproteins present at the outer surface of mammalian cells. The objective of this study was to examine the expression of mucin (MUC) genes 3, 4, 5AC, 5B, 6, and 7 in early and late laryngeal squamous cancer using the in situ hybridization technique.

STUDY DESIGN

Retrospective analysis of pathological archive specimens.

RESULTS

While MUC 3 and 7 are expressed in a small proportion of early cancers, MUC 5AC, 5B, and 6 are not expressed in laryngeal squamous cancer. MUC 4 was expressed in 13 of the 30 patients. Ten patients and 3 patients with stage 1 and stage 4 disease respectively expressed MUC 4 gene (Fisher's exact, P = 0.02). MUC 4‐positive patients had a definite trend towards better survival (log rank test, P = 0.05). In the presence of tumor stage and comorbidity grade, Cox's proportional hazards model failed to statistically confirm the survival advantage provided by MUC 4 gene expression.

CONCLUSION

There is a survival advantage for patients with advanced‐stage nonmetastatic cancer when the MUC 4 gene is expressed. AIMS: To study the expression of mucin (MUC) genes 3, 4, 5AC, 5B, 6, and 7 in early and advanced squamous cell cancer of the larynx; to attempt to correlate changes in gene expression with tumor stage by studying stage I and stage IV (AJCC, 1988) tumors.
Wireless pH testing as an adjunct to unsedated transnasal esophagoscopy: The safety and efficacy of transnasal telemetry capsule placement
Authors: Belafsky Peter C. , Allen Katy , Rosario Lynn Castro‐Del , Roseman David
Published: July 2004

OBJECTIVES

The introduction of 48‐hour wireless pH testing offers clinicians a new alternative for the objective documentation of reflux. The success of transnasal wireless pH capsule placement has not been previously described. The purpose of this investigation was to describe our experience with transnasal wireless pH capsule placement.

METHODOLOGY

All patients undergoing unsedated transnasal esophagoscopy and wireless pH capsule placement between January 1, 2003 and July 31, 2003 were prospectively evaluated. Data concerning patient tolerance, success of capsule placement and function, complications, and pH recordings were collected.

RESULTS

During this time, 46 persons were evaluated. The mean age of the cohort was 52 years. Of the patients, 50% were male. The indications for the procedure were chronic cough (18/46), gastro‐esophageal reflux disease (18/46), and larygopharyngeal reflux (10). Of the procedures performed, 85% (39/46) were successful. Complications included epistaxis (2/46), laryngospasm (2/46), and vasovagal reaction (1/46).

CONCLUSIONS

The transnasal placement of a wireless pH capsule is a safe and effective diagnostic adjunct to unsedated transnasal esophagoscopy.
Surgical Management of Paranasal Sinus Mucoceles: A Long‐Term Study of 60 Cases
Authors: Serrano Elie , Klossek Jean‐Michel , Percodani Josiane , Yardeni Elie , Dufour Xavier
Published: July 2004

Paranasal sinus mucocele is a benign pseudocystic lesion, which may originate from any of the sinus cavities. Although the diagnosis may be suggested by the clinical presentation, CT is necessary to accurately analyze the regional anatomy and extent of the lesion. MRI is helpful in defining the limited unusual lesions occurring in critical areas. Standard treatment is surgical marsupialization, through endonasal sinus surgery, which offers a conservative, minimally invasive approach, and respects the sinus architecture and natural drainage. Our long‐term experience with the endonasal endoscopic approach for the treatment of mucoceles led us to subsequently expand our indications to include most mucoceles, either as the sole approach or associated with an external approach. Comprising the surgical experience of two collaborating universities, this paper describes the indications for the endonasal surgical approach and the long‐term postoperative followup.
Prevalence of Extraesophageal Reflux in Patients with Symptoms of Gastroesophageal Reflux
Authors: Ylitalo Riitta , Ramel Stig , Hammarlund Birgitta , Lindgren Elisabeth
Published: July 2004

OBJECTIVES

To compare the prevalence of extraesophageal reflux (EER) in patients with heartburn, posterior laryngitis (PL), and in healthy controls.

STUDY DESIGN AND SETTING

A retrospective and prospective study including a total of 101 subjects who underwent 24‐hour dual‐probe pH monitoring.

RESULTS

52% of the subjects with heartburn had EER. No significant differences were found between the PL and heartburn groups for any pharyngeal reflux parameters. However, supine pharyngeal reflux was significantly more prevalent in heartburn patients with GERD than in PL patients and healthy controls (P < 0.05). Significant positive correlation (P < 0.01) was found between the percentage of time pH <4 in the pharynx and in the distal esophagus.

CONCLUSION

EER occurs in the majority of heartburn patients who are lacking laryngeal symptoms. Abnormal distal esophageal acid exposure makes the occurrence of EER more likely.

SIGNIFICANCE

EER appears to be a continuum without clear‐cut differences between the groups.
Surgery of Cerebellopontine Angle Epidermoid Cysts: Role of the Widened Retrolabyrinthine Approach Combined with Endoscopy
Authors: Darrouzet Vincent , Franco‐Vidal Valérie , Hilton Malcolm , Nguyen Dinh‐Qui , Lacher‐Fougere Stéphane , Guerin Jean , Bebear Jean‐Pierre
Published: July 2004

OBJECTIVES

To evaluate the use of the retrolabyrinthine approach (RLA) combined with endoscopy with particular reference to preservation of cranial nerve function and completeness of excision in surgery of epidermoid cysts.

METHODS

A retrospective study was performed on a series of 8 consecutive patients of whom 7 have undergone surgery.

MAIN OUTCOME MEASURES

Measures include audiological and neurological status preoperatively and postoperatively, size of the lesion, the surgical approach, completeness of excision, and operative morbidity.

RESULTS

The tumors were all large, ranging from 2 × 3 cm to 6 × 6 cm. Presenting symptoms were headache (75%), dysequilibrium (62%), trigeminal nerve palsy (38%), abducens nerve palsy (25%), and, rarely, auditory symptoms. Seven patients underwent surgery, 5 by the RLA, 1 by a translabyrinthine approach (TLA), and 1 by a transcochlear approach. Complete excision was achieved in 5 of the 7 patients. A transtentorial approach was combined in 2 cases (1 RLA, 1 TLA). Endoscopy was used in 3 cases. It allowed a complete tumor excision. One case of keratinous meningitis was observed. Trigeminal nerve function returned to normal in all patients. Postoperative facial nerve function was grade I in 5 cases and grade III in 2 cases. Hearing was preserved in 3 cases as class A, 1 case as class B. In the 2 cases presenting with abducens nerve palsy preoperative symptoms were initially aggravated before returning to normal function by 1 year postoperatively. The RLA with endoscopy allowed less invasive surgery and preservation of hearing in 4 of the 5 cases where it was attempted. Tumor control appeared better than with the suboccipital approach. Mortality and postoperative morbidity also appear reduced.

CONCLUSION

RLA combined with endoscopy should be considered as the standard approach for excision of epidermoid cysts. Extension of this approach into a TLA or transcochlear approach will depend on preoperative difficulties and preoperative hearing.
Informed Consent in Functional Endoscopic Sinus Surgery: The Patient's Perspective
Authors: Bowden Mary Talley , Church Christopher A. , Chiu Alexander G. , Vaughan Winston C.
Published: July 2004

OBJECTIVE

Informed consent is essential prior to functional endoscopic sinus surgery (FESS). The content of this discussion is often determined by each surgeon. Many doctors discuss all potential complications. This may provoke anxiety or deter from beneficial surgery. Our goal was to examine the process from the patient's perspective.

STUDY DESIGN

A list of potential complications was reviewed with FESS patients. Patients were asked questions concerning their consent and the potential complications before and after FESS.

RESULTS

Both before and after surgery, patients felt that discussion of most potential complications was important. Vision changes and cerebrospinal fluid leak (CSF) received the highest scores. No significant differences were found between primary and revision cases.

CONCLUSION

Patients wanted most potential FESS complications to be discussed. Even though this triggered anxiety, they felt it was important to have a thorough disclosure. Findings presented may impact how surgeons counsel patients prior to FESS.
Special report: Reassessment of the ORL‐HNS workforce: Perceptions and realities
Authors: Cannon C. Ron , Giaimo Eileen M. , Lee Teresa L. , Chalian Ara
Published: July 2004

OBJECTIVE

This Workforce Study re‐examined the current scope and geographic distribution of Oto‐laryngology practice and assessed the otolaryngologists' role in relation to other specialists in the diagnosis and treatment of disorders of the ear, nose, throat, and related structures of the head and neck.

STUDY DESIGN

A national survey and review of federal, corporate and administrative databases, coupled wih a focus group of otolaryngologists, were analyzed to compile physician manpower figures, state and regional demographic data, and prediction modeling of Managed Care and FFS environments.

RESULTS

The current and predicted workforce supply and demographic data support a geographic and proportionate increase in the number of otolaryngologists practicing and entering the workforce. Additional findings involving the role of the specialty specifically identified an increase in the treatment of allergic disease within the Managed Care sector and a diminution of the gatekeeper concept. Demographic findings represent a stable age distribution of 40 to 49 and 50 to 59 year old otolaryngologists, with a noted increase in the number of women entering the field. Empiric data reflects the continuous, diverse and dominant role otolaryngologists maintain in the treatment and care of patients with otolaryngic and head and neck disease.

CONCLUSIONS

This study continues the effort to identify otolaryngology workforce demographic profiles and make recommendations for a future national practice model. Continuous reassessment of the specialty is required.
Extended pericranial flap and bone graft reconstruction in anterior skull base surgery
Authors: Rodrigues Michael , O'Malley Bert W. , Staecker Hinrich , Tamargomd Rafael
Published: July 2004

OBJECTIVES

The objectives of this study was to establish a rationale for repairing large anterior skull base defects with an extended pericranial flap and split calvarial bone graft; to define large anterior skull base defects as those spanning the anterior cranial measuring at least 3.0 × 4.0 cm; and to describe the surgical technique and compare it with alternative strategies.

STUDY DESIGN

Thirty‐four patients underwent anterior craniofacial resection of anterior skull‐based tumors of varying histology with reconstruction using an extended pericranial flap and split calvarial bone graft.

RESULTS

The survival of the pericranial flap and bone graft was maintained in 33 of 34 patients. There was 1 episode of postoperative cerebrospinal fluid leak, 1 episode of osteomyelitis of the bone graft and an epidural abscess, and 1 episode of asymptomatic pneumocephalus.

CONCLUSION

Split calvarial bone graft with an extended pericranial flap is an effective technique for reconstructing large anterior skull base defects.
Z‐palatoplasty (ZPP): A technique for patients without tonsils
Authors: Friedman Michael , Ibrahim Hani Z. , Vidyasagar Ramakrishnan , Pomeranz Jonathan , Joseph Ninos J.
Published: July 2004

OBJECTIVE

Patients without tonsils and with Friedman tongue position (FTP) III and IV are poor candidates for uvulopalatopharyngoplasty (UP3). Even when combined with adjunctive hyopharyngeal techniques, results are poor. We assessed a modified uvulopalatoplasty based on a bilateral Z‐plasty in treating patients without tonsils who have obstructive sleep apnea/hypopnea syndrome (OS‐AHS).

METHODS

25 patients treated with a modified technique were matched with 25 patients previously treated with classic UP3. All patients in both groups also had radiofrequency tongue base reduction. Preoperative vs. postoperative measures of objective treatment success and subjective symptoms were compared for the 2 groups. Morbidity, including pain levels, narcotic use, and return to solid diet and normal activity, as well as complications were studied.

RESULTS

Subjective improvement was good for both groups, but objective clinical improvement was significantly better for the experimental group. Morbidity and complications for the experimental group were comparable to the control group and to other published series on UP3.

CONCLUSIONS

A modified technique for patients without tonsils who have OSAHS is presented. The new technique is more successful with acceptable morbidity for patients with OSAHS than classical techniques.
John Chrysostom as Bishop: The View from Antioch
Authors: MAYER WENDY
Published: July 2004

The basic details of the portrayal by the sources of the episcopate of John Chrysostom have long been accepted in the literature. So also the perspective from which his episcopate is viewed, which is both Constantinopolitan and partisan. By examining what happened from another angle, namely from Antioch, it can be seen that the standard portrayal needs to be treated with caution. At the same time, an Antiochene perspective offers new insight into the sequence of events as they unfolded.
Subscription, the Scottish Enlightenment and the Moderate Interpretation of History
Authors: KIDD COLIN
Published: July 2004

The theological reticence of the Moderates in the eighteenth-century Scottish Kirk sits oddly with their contribution to other spheres of literature, notably historical writing. A faultline runs through the historiography of Moderatism, dividing those historians who believe the Moderates remained committed Calvinists from those who endorse the view of contemporary critics within the Kirk that the Moderates favoured Arminianism, or worse. An appreciation of the Moderate preference for history over theology may go some way towards resolving this conundrum. Moderate accounts of religious history ran in parallel with the historical sociology of stadial progress which emerged in the Scottish Enlightenment. Moderate historians recognised that human interpretation of the divine also followed a developmental pattern. Thus, although the Moderates continued to uphold subscription to the Westminster Confession of Faith, their writings indicate that an historical sensitivity to theological change replaced what they perceived to be an inevitably time-bound commitment to dogma.
The effects of emotional salience on thought disorder in patients with bipolar affective disorder
Authors: TAI S. , HADDOCK G. , BENTALL R.
Published: July 2004

Background. This study aimed to explore the effects of emotionally salient material on thought disorder in patients with bipolar affective disorder.

Method. Seventy-one participants (20 manic, 15 depressed, 16 currently well patients and 20 non-psychiatric-controls) were interviewed in two conditions: an emotionally salient interview and a non-salient interview. Speech samples were rated using the Scale for the Assessment of Thought, Language and Communication.

Results. Manic patients presented with significantly more thought disorder than any other group in both conditions and exhibited the greatest reaction to emotionally salient material.

Conclusion. The effects of emotional salience on thought, language and communication are not unique to schizophrenic patients. The speech of manic patients is more affectively responsive than the speech of remitted, bipolar depressed and normal participants. The implications of these findings are discussed.
Higher socio-economic status of parents may increase risk for bipolar disorder in the offspring
Authors: TSUCHIYA KENJI J. , AGERBO ESBEN , BYRNE MAJELLA , MORTENSEN PREBEN B.
Published: July 2004

Background. There are conflicting data regarding the socio-economic risk factors for bipolar disorders. The aim of the present study was to explore the association between the socio-economic status of an individual or the parent and the risk for bipolar disorder.

Method. Two Danish registers were merged. From the data source, we extracted those born in 1960 or later, and those with a first-ever admission to, or contact with, a Danish psychiatric facilities during 1981–1998 with a diagnosis of bipolar disorder. Fifty time-matched controls per case were chosen by the incidence-density sampling method. Effects of marital status, occupation, education, income, and wealth, of both subjects and the parents, were estimated using conditional logistic regression.

Results. A total of 947 cases were matched to 47 350 controls. Those at high risk of bipolar disorders were: single subjects, those in receipt of social assistance, pension or sickness payments, unemployed, subjects with a shorter educational history, and subjects with lower income. Conversely, parental higher education and higher level of paternal wealth were associated with increased risk. These associations remained significant after adjustment for gender, family history of psychiatric diagnoses, and other socio-economic variables, and are unlikely to be explained by known biases.

Conclusions. The associations of lower socio-economic indices of subjects may be explained as a consequence of the disease. The association of higher socio-economic indices of parents may be explained by socio-economic achievement in the family of origin.
What predicts suicide attempts in women with eating disorders?
Authors: FRANKO D. L. , KEEL P. K. , DORER D. J. , BLAIS M. A. , DELINSKY S. S. , EDDY K. T. , CHARAT V. , RENN R. , HERZOG D. B.
Published: July 2004

Background. Suicide is a common cause of death in anorexia nervosa and suicide attempts occur often in both anorexia nervosa and bulimia nervosa. No studies have examined predictors of suicide attempts in a longitudinal study of eating disorders with frequent follow-up intervals. The objective of this study was to determine predictors of serious suicide attempts in women with eating disorders.

Method. In a prospective longitudinal study, women diagnosed with either DSM-IV anorexia nervosa (n=136) or bulimia nervosa (n=110) were interviewed and assessed for suicide attempts and suicidal intent every 6–12 months over 8·6 years.

Results. Fifteen percent of subjects reported at least one prospective suicide attempt over the course of the study. Significantly more anorexic (22·1%) than bulimic subjects (10·9%) made a suicide attempt. Multivariate analyses indicated that the unique predictors of suicide attempts for anorexia nervosa included the severity of both depressive symptoms and drug use over the course of the study. For bulimia nervosa, a history of drug use disorder at intake and the use of laxatives during the study significantly predicted suicide attempts.

Conclusions. Women with anorexia nervosa or bulimia nervosa are at considerable risk to attempt suicide. Clinicians should be aware of this risk, particularly in anorexic patients with substantial co-morbidity.
Defining nicotine dependence for genetic research: evidence from Australian twins
Authors: LESSOV CHRISTINA N. , MARTIN NICHOLAS G. , STATHAM DIXIE J. , TODOROV ALEXANDRE A. , SLUTSKE WENDY S. , BUCHOLZ KATHLEEN K. , HEATH ANDREW C. , MADDEN PAMELA A. F.
Published: July 2004

Background. Whether current criteria used to define nicotine dependence are informative for genetic research is an important empirical question. The authors used items of the DSM-IV and of the Heaviness of Smoking Index to characterize the nicotine dependence phenotype and to identify salient symptoms in a genetically informative community sample of Australian young adult female and male twins.

Method. Phenotypic and genetic factor analyses were performed on nine dependence symptoms (the seven DSM-IV substance dependence criteria and the two Heaviness of Smoking Index (HSI) items derived from the Fagerström Tolerance Questionnaire, time to first cigarette in the morning and number of cigarettes smoked per day). Phenotypic and genetic analyses were restricted to ever smokers.

Results. Phenotypic nicotine dependence symptom covariation was best captured by two factors with a similar pattern of factor loadings for women and men. In genetic factor analysis item covariation was best captured by two genetic but one shared environmental factor for both women and men; however, item factor loadings differed by gender. All nicotine dependence symptoms were substantially heritable, except for the DSM-IV criterion of ‘giving up or reducing important activities in order to smoke’, which was weakly familial.

Conclusions. The salient behavioral indices of nicotine dependence are similar for women and men. DSM-IV criteria of tolerance, withdrawal, and experiencing difficulty quitting and HSI items time to first cigarette in the morning and number of cigarettes smoked per day may represent the most highly heritable symptoms of nicotine dependence for both women and men.
The relationship of tobacco smoking with depressive symptomatology in the Third Mexican National Addictions Survey
Authors: BENJET C. , WAGNER F. A. , BORGES G. G. , MEDINA-MORA M. E.
Published: July 2004

Background. While an association between cigarette smoking and depression has been established in Anglo populations, replication of tobacco–depression associations in countries where smoking is growing may provide important new insights. The objectives of this study were to estimate the association of depressive symptomatology with tobacco smoking, number of cigarettes smoked daily, and smoking cessation in a representative sample of the Mexican population.

Method. The data come from the Third National Addictions Survey (1998) conducted by the Mexican Ministry of Health, representative of Mexico's civilian population residing in cities and towns with 2500+ inhabitants, aged 18–64. Part of a multi-stage, stratified, probability sample, 1935 men and women answered a version of the survey that also included the CES-D depression scale. Analyses addressed the survey's complex design and controlled for income and educational level.

Results. Among women only, current smokers had twice the odds of elevated depressive symptomatology than never smokers (OR 2·1, 95% CI 1·3–3·5, p=0·002). For men, only those smoking a pack or more a day had greater odds of depressive symptomatology (OR 5·9, 95% CI 1·6–21·9, p=0·008). Overall, former smokers who ceased smoking within 6 months had lower odds of depressive symptomatology than current smokers (OR 0·4, 95% CI 0·1–1·0, p=0·042).

Conclusions. These findings add to the accumulating evidence for the association between smoking and depression in different cultures and populations.
Measuring empathy: reliability and validity of the Empathy Quotient
Authors: LAWRENCE E. J. , SHAW P. , BAKER D. , BARON-COHEN S. , DAVID A. S.
Published: July 2004

Background. Empathy plays a key role in social understanding, but its empirical measurement has proved difficult. The Empathy Quotient (EQ) is a self-report scale designed to do just that. This series of four studies examined the reliability and validity of the EQ and determined its factor structure.

Method. In Study 1, 53 people completed the EQ, Social Desirability Scale (SDS) and a non-verbal mental state inference test, the Eyes Task. In Study 2, a principal components analysis (PCA) was conducted on data from 110 healthy individuals and 62 people reporting depersonalisation (DPD). Approximately 1 year later, Study 3, involved the re-administration of the EQ (n=24) along with the Interpersonal Reactivity Index (IRI; n=28). In the last study, the EQ scores of those with DPD, a condition that includes a subjective lack of empathy, were examined in depth.

Results. An association was found between the Eyes task and EQ, and only three EQ items correlated with the SDS. PCA revealed three factors: (1) ‘cognitive empathy’; (2) ‘emotional reactivity’, and (3) ‘social skills’. Test–retest reliability was good and moderate associations were found between the EQ and IRI subscales, suggesting concurrent validity. People with DPD did not show a global empathy deficit, but reported less social competence.

Conclusions. The EQ is a valid, reliable scale and the different subscales may have clinical applications.
Characteristics of non-verbal memory impairment in bipolar disorder: the role of encoding strategies
Authors: DECKERSBACH T. , McMURRICH S. , OGUTHA J. , SAVAGE C. R. , SACHS G. , RAUCH S. L.
Published: July 2004

Background. There is evidence that individuals with bipolar disorder exhibit neuropsychological impairments not only during episodes of depression or mania but also when they are euthymic. One of the most consistently reported cognitive problems in euthymic individuals with bipolar disorder is impairment in episodic memory. Learning and memory depend on individuals' ability to organize information during learning. A recent study by our group showed that verbal episodic memory impairments in euthymic patients with bipolar I disorder (BP-I) are mediated by difficulties in organizing verbal information appropriately during learning. The purpose of the present study was to determine whether memory impairments in euthymic individuals with BP-I extend to non-verbal memory and whether non-verbal memory impairments are mediated by difficulties in organizing non-verbal information during encoding.

Method. Study participants were 25 euthymic, remitted individuals with BP-I and 25 age, gender and education matched control participants. Participants completed the Rey-Osterrieth Complex Figure Test (RCFT), a well-established measure of non-verbal memory that enables assessment of organization during learning.

Results. Compared to control participants, BP-I participants showed impaired performance on the RCFT immediate recall. They also relied less on organizational strategies during encoding. Multiple regression modeling indicated that group differences between control and BP-I participants in long-delayed free recall did not remain statistically significant when effects of lower organization were partialled out.

Conclusions. Non-verbal memory problems in individuals with bipolar disorder, while euthymic, are mediated by poor use of non-verbal organization strategies during encoding, but do not appear to reflect deficits in retention of information.
Trauma, time and mental health: a study of temporal reintegration and Depressive Disorder among Southeast Asian refugees
Authors: BEISER M. , WICKRAMA K. A. S.
Published: July 2004

Background. Prior research suggested that time splitting – suppressing the past and dissociating it from present and future – protected refugee mental health in the aftermath of catastrophe. The current study investigates temporal reintegration, defined as cognitive recapture of the past and reconnecting it with present and future, the mental health effects of temporal reintegration, and factors moderating the associated risk for Depressive Disorder.

Method. A community sample of 608 Southeast Asian refugees, resettled in Vancouver British Columbia between 1979 and 1981, were interviewed on three separate occasions over a 10-year period. Participants performed a temporal orientation task and responded to questions about employment, social relations and mental health. Depressive Disorder, measured by a typology derived from Grade of Membership analysis of symptoms, constituted the dependent variable. Latent Growth Curve Analysis was used to examine both levels and rates of change in the probability of Depressive Disorder as predicted by changes in temporal reintegration, as well as the contribution of putative social and psychological moderators to explaining variations in growth parameters.

Results. Time relatedness increased over the duration of the study. Temporal reintegration jeopardized mental health. Employment and relational stability each moderated the mental health effects of temporal reintegration.

Conclusions. Although time splitting may be effective in coping with adversity over the short-term, eventual temporal reintegration is probably ineluctable. Stability in love and work are protective factors, mitigating the mental health vicissitudes of temporal reintegration. Implications for optimal timing of clinical interventions are discussed.
Therapist competence and clinical outcome in the Prevention of Parasuicide by Manual Assisted Cognitive Behaviour Therapy Trial: the POPMACT study
Authors: DAVIDSON K. , SCOTT J. , SCHMIDT U. , TATA P. , THORNTON S. , TYRER P.
Published: July 2004

Background. Therapist competence may be an important factor in determining clinical outcome in psychological therapies. However, there are few published studies of therapist competence v. patient outcome from randomized controlled trials. We tested the hypothesis that higher levels of therapist competence would lead to better clinical outcomes in both patient- and observer-rated measures at 6- and 12-month follow-up.

Method. A random sample of 49 audiotapes of manual assisted cognitive therapy sessions delivered by 21 therapists involved in the Prevention of Parasuicide by Manual Assisted Cognitive Behaviour Therapy trial was rated to assess the level of therapist competence. Patient outcome was assessed using self and observer ratings of depressive and anxiety symptoms, social functioning, global functioning and number of episodes of deliberate self-harm.

Results. At 6-month follow-up, there was a statistically significant association between therapist level of competence and observer-rated depression only. At 12-month follow-up, significant associations were noted between therapist competence and all observer-rated clinical outcomes but not for self-rated outcome measures. However, there was no association between therapist competence and the number of self-harm episodes during follow-up.

Conclusions. When treated by therapists rated as more competent than other therapists who received equivalent brief training, patients with recurrent self-harm show significant clinical improvements. However, this benefit is not identified across all outcome measures and is not fully apparent until 12-month follow-up.
Marked increases in psychopathology found in a 30-year cohort comparison of suicide attempters
Authors: HENRIQUES G. R. , BROWN G. K. , BERK M. S. , BECK A. T.
Published: July 2004

Background. Although several epidemiological studies have found increases in the percentages of people who have made a suicide attempt, few cohort comparisons have been conducted to determine changes within this population over time. The purpose of this investigation was to determine if there have been changes in the clinical profile of suicide attempters in recent decades.

Method. Comparisons between a sample of 258 suicide attempters evaluated between 1970 and 1973 and a second sample of 179 suicide attempters evaluated between 1999 and 2002 were made on depression, hopelessness, suicide intent, drug use, history of suicide attempts and subsequent suicide attempts.

Results. Present-day suicide attempters were found to exhibit greater levels of depression (p=0·031), hopelessness (p=0·008), suicide intent (p<0·001), and had much higher rates of illicit drug use (p<0·001). Almost twice as many of the present-day suicide attempters had histories of four or more suicide attempts (p<0·001), and the present-day suicide attempters made subsequent suicide attempts at close to four times the rate in the year following the index attempt (p<0·001).

Conclusions. The present-day suicide attempters exhibited greater levels of psychopathology on every major variable assessed. Replication is necessary and public health implications are discussed.
Behavioural and neurocognitive responses to sad facial affect are attenuated in patients with mania
Authors: LENNOX B. R. , JACOB R. , CALDER A. J. , LUPSON V. , BULLMORE E. T.
Published: July 2004

Background. The processing of facial emotion involves a distributed network of limbic and paralimbic brain structures. Many of these regions are also implicated in the pathophysiology of mood disorders. Behavioural data indicate that depressed subjects show a state-related positive recognition bias for faces displaying negative emotions. There are sparse data to suggest there may be an analogous, state-related negative recognition bias for negative emotions in mania. We used functional magnetic resonance imaging (fMRI) to investigate the behavioural and neurocognitive correlates of happy and sad facial affect recognition in patients with mania.

Method. Functional MRI and an explicit facial affect recognition task were used in a case-control design to measure brain activation and associated behavioural response to variable intensity of sad and happy facial expressions in 10 patients with bipolar I mania and 12 healthy comparison subjects.

Results. The patients with mania had attenuated subjective rating of the intensity of sad facial expressions, and associated attenuation of activation in the subgenual anterior cingulate and bilateral amygdala, with increased activation in the posterior cingulate and posterior insula. No behavioural or neurocognitive abnormalities were found in response to presentation of happy facial expressions.

Conclusions. Patients with mania showed a specific, mood-congruent, negative bias in sad facial affect recognition, which was associated with an abnormal profile of brain activation in paralimbic regions implicated in affect recognition and mood disorders. Functional imaging of facial emotion recognition may be a useful probe of cortical and subcortical abnormalities in mood disorders.
Recent findings in bipolar affective disorder
Authors: BEBBINGTON PAUL
Published: July 2004

Goodwin (2000) famously argued that bipolar disorder was the Cinderella of psychiatry. It certainly should not be: there is no doubt of the anguish caused by the condition, in particular the excess of natural mortality and the great excess of death by suicide (Ösby et al. 2001). In this issue, Mitchell et al. (2004) report that 26% of their cases of bipolar disorder had attempted suicide at some point. This reflects the sheer persistence of personal suffering: Judd and colleagues (2002, 2003) demonstrated in a long and detailed follow-up that patients with bipolar disorder were symptomatic at least half the time. The Australian National Survey of Psychotic Disorders found levels of disability in affective psychosis equal to those of schizophrenia (Jablensky et al. 2000), and bipolar cases are more likely to score highly on measures of disability than unipolar cases (Mitchell et al. 2004). People with bipolar disorder are more likely to be single, widowed or divorced than both the general populace and those with unipolar depression (Mitchell et al. 2004).
Embodied vulnerability in the art of J. M. W. Turner: representations of ageing in Romantic painting
Authors: WAINWRIGHT STEVEN P.
Published: July 2004

Narratives of ageing are an important theme in both medical sociology and the sociology of the body. Research on representations of the ageing body typically draws upon such subjects as the paintings of Rembrandt or Victorian literature. In this paper, however, the aim is to demonstrate that some of J. M. W. Turner's pictures contain insightful narratives on ageing, the vulnerability of the body and the nature of our shared humanity. Turner (1775–1851) is widely regarded as Britain's greatest painter and one of the world's great artists. I contend that the central principle of Turner's Romantic art is the arousal of sensation. Although Turner is generally revered as a painter of landscape rather than ‘the body’, the paper maintains that many of Turner's paintings can be read as studies in the vulnerability of the body. It will be shown, for example, that many of Turner's pictures are wonderfully evocative ‘visual poems’ on the universal human experiences of loss, decline, ‘the fallacies of hope’, grief, ageing and death. This paper is, therefore, a cultural case study of ‘the decline narrative’ of ageing.
The portrayal of older people in prime time television series: the match with gerontological evidence
Authors: KESSLER EVA-MARIE , RAKOCZY KATRIN , STAUDINGER URSULA M.
Published: July 2004

Empirical studies in several disciplines including sociology, psychology and communications science have investigated images of older people in the mass media, but analyses to date have failed systematically to apply gerontological concepts and to compare the portrayal of old age with ‘real-world’ evidence. A model of older people's internal and external resources was used to assess the portrayal of older people in prime-time television drama series. Three hours of programmes broadcast over six weeks in 2001 of 32 prime-time television series on the four German networks with the largest market shares were examined. The age of 355 portrayed characters were estimated, and the socio-economic, health-related and psychological resources of the 30 characters rated as 60 years or older were assessed. Observational categories and rating dimensions were developed on the basis of the resource model. Older people were heavily under-represented, especially women and those of advanced old age. Furthermore, the representation of older people's social participation and financial resources was overly positive. Finally, older women and men were portrayed in traditional gender roles. The antecedents and consequences of the biased portrayals (of old and young people) are discussed from a psychological perspective.
Academies and attitudes
Authors: ROSS NIGEL J.
Published: July 2004

The lack of an official (British or American) language academy is regularly compared to the situation in France with its time-honoured Académie Française. All too often, however, a passing imprecise reference is made to the French Academy; all too often it is lumped together with other academies; and all too often the true nature of the work of such academies is ignored. This paper takes a closer look at some of the foreign academies, considers why there is no academy in Britain or America, discusses the only existing official academy of English (based in South Africa), and considers foreign academies' attitudes to English.
Ecological role of vegetative sprouting in the regeneration of Dryobalanops rappa, an emergent species in a Bornean tropical wetland forest
Authors: Yamada Toshihiro , Suzuki Eizi
Published: July 2004

Dryobalanops rappa (Dipterocarpaceae), a dominant tree in wetland forests in Borneo, often produces vegetative sprouts in its juvenile stages (trees less than 25 m in height), a characteristic that is believed to be rare in tropical forest trees. We investigated the growth characteristics of this species in a tropical forest in Merimbun Heritage Park, Brunei, to verify the hypothesis that the vigorous sprouting ability enables it to grow in a wetland forest with soft soils that promote stem decumbency and to assess the adaptive significance of vegetative sprouting in the context of its regeneration. Reproductively mature trees developed buttresses and were rarely decumbent. However, if they became decumbent, they died without sprouting. Juvenile trees were frequently decumbent, and their decumbent shoots sprouted vegetatively. Therefore, vegetative sprouting acted as a countermeasure to decumbency and death on the soft wetland soil. A decumbent shoot produced only one sprout in most cases. Decumbent shoots grew little and eventually died, but new sprouts showed rapid growth. This suggests that there is translocation of resources from decumbent shoots to sprouts. If decumbency occurs, a D. rappa genet ramifies into sprouts, and helps sustain the population in the wetland environment. This vegetative life history strategy is important for regeneration in wetland forests with soft soil.
Butterfly species richness and community composition in forests affected by ENSO-induced burning and habitat isolation in Borneo
Authors: Cleary Daniel F. R. , Mooers Arne Ø.
Published: July 2004

Landscape-scale studies of community traits such as species richness and community composition are sorely needed to explore the impact of large-scale disturbance events such as ENSO (El Niño Southern Oscillation)-induced burning and habitat isolation on rain-forest communities. Here we assess butterflies in continuous forest, in unburned isolates surrounded by burned forest and in burned forest, in addition to areas sampled before the most recent (1997/98) large-scale burn event in Borneo. Overall levels of species richness were significantly higher pre-ENSO and in continuous forest than in unburned isolates and burned forest. There was, however, some variation among butterfly families in these patterns, with no significant differences among habitats (continuous forest, isolates and burned forest) for the Hesperiidae and significant differences for the other butterfly families. Patterns of community composition showed that similarity was greater between distant continuous forest and isolates than between either of these and burned forest. Since the unburned isolates were surrounded by the burned forest this indicates that the habitat (burned or unburned) overrides geographical differences. Dominant species that contributed substantially to differences among habitats were often completely absent from either burned or unburned forest. The combined patterns of species richness and community structure suggest that burning affects forest ecosystems by a replacement of dominant species while habitat isolation may affect areas by leading to the local extinction of rare species.
Seed predation under high seed density condition: the palm Euterpe edulis in the Brazilian Atlantic Forest
Authors: von Allmen Christiane , Morellato L. Patricia C. , Pizo Marco A.
Published: July 2004

Over recent decades, studies on post-dispersal seed predation have revealed some general patterns despite dealing with a highly variable phenomenon (reviews in Crawley 1993, Hulme 1998). Most of these studies, however, were carried out with plant species whose population density range from low to moderately high (Hulme 1998). Only rarely has seed predation been studied in very dense stands of a given plant species (Schupp 1988a, b, 1992). In such a situation, seed predators might respond to the local availability of seeds in a manner that differs from their response under conditions of low seed density. For instance, a high density of seeds beneath a fruiting plant may attract seed predators, causing a positive correlation between predation and seed density (Janzen 1970). Schupp (1992), however, noted that at a population scale, a high density of seeds could satiate predators, resulting in a negative correlation between predation and seed density (see also Burkey 1994).
Germination and seedling growth of five tree species from tropical dry forest in relation to water stress: impact of seed size
Authors: Khurana Ekta , Singh J. S.
Published: July 2004

The impact of seed size on germination and seedling growth, as affected by water stress, was studied for five tree species from tropical dry forest of India, viz. Albizia procera, Acacia nilotica, Phyllanthus emblica, Terminalia arjuna and Terminalia chebula. Germination tests were conducted under five osmotic potential levels. Seedlings from large (LS) and small (SS) seeds were grown at four soil moisture levels. Observations were made on height, leaf area, biomass and other growth traits such as relative growth rate (RGR), net assimilation rate (NAR), specific leaf area (SLA), and root:shoot (R:S) ratio. Seeds of pioneer species and large seeds, within species, germinated earlier, and with increasing water stress, per cent germination and germination velocity declined. RGR was inversely related with drought tolerance. R:S ratio increased, RGR and SLA declined, but NAR increased with water stress. Notwithstanding successional status, the slow-growing species registered minimum reduction in biomass due to water stress. The response of LS and SS seedlings also differed for some of the growth variables. Increase in NAR could be a compensatory response to water stress, and the marked allocational plasticity could help maximize capture of the limited resource. Seedlings from smaller seeds, particularly of fast-growing species, would be able to cope with mild drought by morphogenetic and physiological plastic response in a better way than those from large seeds. However, seedlings from large seeds had greater survival than those from smaller seeds under intense water stress.
Habitat use by stream-breeding frogs in south-east Sulawesi, with some preliminary observations on community organization
Authors: Gillespie Graeme R. , Lockie David , Scroggie Michael P. , Iskandar Djoko T.
Published: July 2004

The habitat associations of stream-breeding frogs were examined along a series of stream transects on Buton Island in south-east Sulawesi, Indonesia. Of the eight frog species located along streams, four were observed breeding in stream habitats. We examined spatial habitat partitioning among these species. Three of the four species were found to be associated with a non-random selection of the available perch sites. Strong partitioning between species in habitat associations was found; partitioning of the available habitat space was primarily associated with differences in proximity to stream features, and in the height of perch sites. General observations indicated that oviposition sites of most species were associated with the microhabitats in which the adult frogs were found. All four stream-breeding species appear to have synchronous breeding phenologies and the spatial relationships of these species within the habitat space appear to reflect partitioning of calling sites and oviposition sites. The stream-breeding frog community in this region of Sulawesi has much lower species richness and less specialized habitat use compared with other tropical stream-breeding frog communities in the region.
Activity patterns and habitat preferences of insectivorous bats in a West African forest–savanna mosaic
Authors: Meyer Christoph F. J. , Schwarz Christian J. , Fahr Jakob
Published: July 2004

We studied activity patterns and habitat use by insectivorous bats in Comoé National Park, Ivory Coast. Bat foraging activity was quantified along five transects representing three different habitat types using acoustic monitoring and captures with mist nets and harp traps. Aerial insect abundance was assessed using a light trap; in addition shrub and tree arthropods were sampled. Bat activity was significantly and positively related to insect availability and ambient temperature, whereas increased visibility of the moon had a negative influence on flight activity. Together, these factors best explained both total bat activity and activity of bats hunting in open space and edge habitats. The interaction between temperature and light intensity was the best predictor of activity by species foraging in obstacle-rich forest habitats, however, the regression model had a low predictive value. Overall, a large proportion (c. 50%) of the variation in bat activity appeared to be a consequence of transect- and/or habitat-specific influences. We found a significant non-linear relationship between the activity of QCF (quasi-constant frequency) and FM–QCF (frequency modulated – quasi-constant frequency) bats and the phase of the moon, with lowest levels of activity occurring near full moon. We interpret this lunar-phobic behaviour as a reflection of a higher predation risk during moonlit periods. For FM (steep frequency modulated) and CF (constant frequency) bats, no significant correlation was found, although there was a trend suggesting that these bats at least were not negatively affected by bright moonlight. Foraging activity of bats was positively correlated with the abundance of atympanate moths; however, no such correlation was found for tympanate moths.