bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-acting risperidone improves negative symptoms in stable psychotic patients
Authors: Curtis VA , Katsafouros K. , Möller H-J. , Medori R. , Sacchetti E.
Published: February 2008

The aim of this paper was to evaluate the efficacy of risperidone long-acting injectable (RLAI) for reducing negative symptoms of schizophrenia in patients with predominantly negative symptoms at baseline. A subanalysis was performed on data from the 6-month, open-label Switch to Risperidone Microspheres trial. Patients with Positive and Negative Syndrome Scale (PANSS) negative subscale score ≥21, which was higher than their PANSS positive subscale score, were included in this subanalysis. Improvement in negative symptoms was measured by assessing change in the PANSS negative subscale and a negative factor score. Additional outcome variables included measures in general functioning, quality of life and patient satisfaction. A total of 842 patients were eligible for inclusion in this subanalysis. Six months of treatment was completed by 631 (74.9%) patients. Forty-three (5.1%) patients discontinued treatment due to an adverse event. Negative symptoms were significantly reduced by 6.1 ± 6.3 points for the PANSS negative score and 6.1 ± 6.4 points for the negative factor score ( P < 0.0001 for both). Significant improvements were also noted for total PANSS and other PANSS subscale scores, general functioning, quality of life and patient satisfaction ( P < 0.0001). The most common treatment-emergent adverse events (>5%) were: anxiety (6.8% of patients), exacerbation of disease (6.2%) and insomnia (5.7%). Overall, RLAI was well tolerated and associated with significant reductions in movement disorder severity. The treatment resulted in a significant improvement in negative symptom severity and was well tolerated in patients with predominantly negative symptoms, who switched from a stable antipsychotic regimen.
An unusual case of prolonged tinnitus following low-dose amitriptyline
Authors: Mendis D. , Johnston M.
Published: February 2008

We report on a case of unilateral tinnitus after a short course of low-dose amitriptyline for neuralgic foot pain. This has been described in the literature previously at much higher doses and is associated with prolonged administration; we present our case with a review of the current literature in-order to raise awareness of this possible complication of anti-depressant therapy. We also propose a novel hypothesis for the pharmacological basis of amitriptyline-induced tinnitus.
Clozapine-induced myocarditis after long-term treatment: case presentation and clinical perspectives
Authors: Lang UE , Willbring M. , von Golitschek R. , Schmeisser A. , Matschke K. , Tugtekin S Malte
Published: February 2008

Clozapine is the drug of choice for treatment-resistant schizophrenia. Prompted by a patient who developed reversible clozapine-induced myocarditis after long-term treatment with clozapine for several years for chronic-resistant schizophrenia, we undertook a review of the relevant literature. Concerning the myocarditis, the patient recovered rapidly by withdrawal of clozapine and with supportive management. Psychiatric stabilisation of the patient was at least possible with a combination of quetiapine (600 mg) and amisulpride (800 mg).

Well-designed studies with the aim to specifically investigate treatment options after clozapine are limited and clinical possibilities are discussed in this paper. Olanzapine and combinations using non-clozapine atypical neuroleptics have partly shown improvement, whereas evidence for successful augmentation with mood stabilisers, anticonvulsants or electroconvulsive therapy in treatment-resistant schizophrenia is limited.
Investigation into the influence of a high fat diet on antipsychotic-induced weight gain in female rats
Authors: Fell MJ , Neill JC , Anjum N. , Peltola LM , Marshall KM
Published: February 2008

Atypical antipsychotic drug therapy may result in substantial weight gain, increased adiposity and the promotion of metabolic abnormalities. The mechanism(s) which underlie such effects remain unclear. Previous studies in our laboratory have demonstrated significant weight gain in female rats maintained on a standard laboratory diet after sub-chronic administration of olanzapine and risperidone, but not ziprasidone. The aim of this paper is to investigate the effect of antipsychotic drugs on body weight, ingestive behaviour and adiposity in female rats with access to a high fat diet. Adult female rats given free access to a high fat diet received either olanzapine (2 mg/kg), risperidone (0.5 mg/kg), ziprasidone (2.5 mg/kg) or vehicle for 28 days. Body weight, food and water intake in addition to intra-abdominal fat deposition were assessed. Olanzapine initially increased body weight but by the end of the study olanzapine animals appeared to have lost weight compared to the vehicle-treated group. Olanzapine-induced reductions in body weight were accompanied by a significant hypophagia during weeks 3 and 4. Risperidone increased body weight during week 1 only and reduced intake of a high fat diet during weeks 3 and 4. Ziprasidone was without effect on indices of body weight and ingestive behaviour. There were no effects of antipsychotic drugs on intra-abdominal fat deposition. Access to a diet high in fat attenuated weight gain induced by olanzapine and risperidone in female rats.
Involvement of sigma (σ1) receptors in modulating the anti-depressant effect of neurosteroids (dehydroepiandrosterone or pregnenolone) in mouse tail-suspension test
Authors: Dhir A. , Kulkarni SK
Published: February 2008

The present study investigated the effects of neurosteroids dehydroepiandrosterone sulfate (DHEAS) or pregnenolone sulfate (PS) on the tail-suspension test (TST) of depression in mice, and also the possible involvement of sigma (σ) receptors. Immobility time in the TST was measured for a total period of 6 min. DHEAS (10 and 40 mg/kg, s.c.) or PS (40 mg/kg, s.c.) significantly reduced the immobility period without accompanying changes in the locomotor activity in mice. The effect on behavioural despair by DHEAS (10 and 40 mg/kg, s.c.) and PS (40 mg/kg, s.c.) was blocked by BD 1047 (1 mg/kg, s.c.), a novel σ1-receptor antagonist, progesterone (10 mg/kg, s.c.), a σ-receptor antagonistic neurosteroid or rimcazole (5 mg/kg, s.c.), another σ1-receptor antagonistic property, respectively. The treatments and their combination did not alter the motor activity in mice. These data suggested a role for the central σ receptors particularly sigma-1 (σ1) receptors in the anti-depressant-like effects of neurosteroids.
Change in sexual dysfunction with aripiprazole: a switching or add-on study
Authors: Mir Amna , Shivakumar Kuppuswami , Williamson Richard J , McAllister Victoria , O'Keane Veronica , Aitchison Katherine J
Published: February 2008

Sexual dysfunction and raised prolactin are common adverse effects of many anti-psychotics. Aripiprazole is an atypical anti-psychotic associated with a reduction in prolactin level in anti-psychotic-induced hyperprolactinemia. Our hypothesis was that switching from another anti-psychotic to aripiprazole would be associated with a reduction in sexual dysfunction. An open label switch to aripiprazole was offered to 27 subjects with inadequate therapeutic response or intolerance to another anti-psychotic, who were followed up for 26 weeks. Serial clinical ratings included the Anti-psychotic Non-Neurological Side-Effects Rating Scale (ANNSERS), and the Sexual Functioning Questionnaire. Our primary analysis point was week 12. In both sexes, there was a significant reduction in prolactin by week 12 ( P = 0.003), accompanied by a significant improvement in libido ( P = 0.028). In males, both erectile and ejaculatory difficulties were also significantly reduced ( P = 0.04 and P = 0.017, respectively). In females, menstrual dysfunction was also significantly reduced at week 12 ( P = 0.04). By week 26, the changes in all of the above remained significant, and were accompanied by a significant increase in satisfaction in overall sexual functioning ( P = 0.007), despite the fact that 54.5% of subjects at were also taking their original antipsychotic. There was also a significant decrease in the total ANNSERS score ( P < 0.001) and a significant improvement in all other measures of psychopathology (PANSS, CGI-S/I, GAF-S/D, and QoL). We conclude that switching to aripiprazole or the addition of aripiprazole to another antipsychotic regime is associated with a reduction in sexual dysfunction.
Delusional disorder, somatic type treated with aripiprazole—mirtazapine combination
Authors: Dimopoulos NP , Mitsonis CI , Psarra VV
Published: February 2008

Delusional disorder, somatic type (DDST) is a rare psychiatric disorder and the treatment is mostly based on observations, due to the lack of well-organized studies. Initially, antipsychotics and especially pimozide were considered to be the pharmacological approach of choice but, subsequently, tryciclic anti—depressants and selective serotonin re—uptake inhibitors (SSRIs) were also suggested to be effective, implicating the serotonergic system in the pathophysiology of the disorder. We present the case of a female with DDST, who responded to aripiprazole—mirtazapine combination, a finding that is in accordance with the initial approach of this disorder as a part of the schizophrenic spectrum, but also supports the hypothesis of serotonin dysfunction in DDST.
Methylphenidate significantly improves driving performance of adults with attention-deficit hyperactivity disorder: a randomized crossover trial
Authors: Verster Joris C , Bekker Evelijne M , de Roos Marlise , Minova Anita , Eijken Erik JE , Kooij JJ Sandra , Buitelaar Jan K. , Kenemans J Leon , Verbaten Marinus N. , Olivier Berend , Volkerts Edmund R
Published: February 2008

Although patients with attention-deficit hyperactivity disorder (ADHD) have reported improved driving performance on methylphenidate, limited evidence exists to support an effect of treatment on driving performance and some regions prohibit driving on methylphenidate. A randomized, crossover trial examining the effects of methylphenidate versus placebo on highway driving in 18 adults with ADHD was carried out. After three days of no treatment, patients received either their usual methylphenidate dose (mean: 14.7 mg; range: 10—30 mg) or placebo and then the opposite treatment after a six to seven days washout period. Patients performed a 100 km driving test during normal traffic, 1.5 h after treatment administration. Standard deviation of lateral position (SDLP), the weaving of the car, was the primary outcome measure. Secondary outcome measurements included the standard deviation of speed and patient reports of driving performance. Driving performance was significantly better in the methylphenidate than in the placebo condition, as reflected by the SDLP difference (2.3 cm, 95% CI = 0.8—3.8, P = 0.004). Variation in speed was similar on treatment and on placebo (-0.05 km/h, 95% CI = -0.4 to 0.2, P = 0.70). Among adults with ADHD, with a history of a positive clinical response to methylphenidate, methylphenidate significantly improves driving performance.
Interferon-α-induced serotonin uptake in Jurkat T cells via mitogen-activated protein kinase and transcriptional regulation of the serotonin transporter
Authors: Tsao C-W. , Lin Y-S. , Cheng J-T. , Lin C-F. , Wu H-T. , Wu S-R. , Tsai W-H.
Published: February 2008

Interferon (IFN)-α upregulates serotonin (5-HT) uptake and serotonin transporter (5-HTT) messenger ribonucleic acid (mRNA) expression in immune cells, which implies the mechanism underlying IFN-α-induced depression. However, the signal transduction of this effect remains unclear. We investigated whether the effects of IFN-α on the functions of 5-HTT were related to mitogen-activated protein kinase (MAPK). By performing Western blotting, real-time reverse transcriptase—polymerase chain reaction and [3H]5-HT labelling, we examined MAPK phosphorylation, 5-HTT mRNA expression and 5-HT uptake in Jurkat T cells. The cells had been cultured for different time periods (1) with IFN-α alone and (2) preincubated with either MAPK inhibitors or with the selective serotonin reuptake inhibitor, fluoxetine, and subsequently cultured along with IFN-α. The levels of MAPK phosphorylation, 5-HTT mRNA expression and 5-HT uptake all increased in the IFN-α-treated cells but were blocked in those that were pretreated with MAPK inhibitors and fluoxetine. These results appear to clarify the association of depression with IFN-α-induced 5-HT uptake that reduces the 5-HT levels and IFN-α-regulated transcription of 5-HTT; further, the results suggest the involvement of MAPK in this process.
Galantamine treatment in Alzheimer's disease with cerebrovascular disease: responder analyses from a randomized, controlled trial (GAL-INT-6)
Authors: Erkinjuntti T. , Gauthier S. , Bullock R. , Kurz A. , Hammond G. , Schwalen S. , Zhu Y. , Brashear R.
Published: February 2008

Alzheimer's disease combined with cerebrovascular disease (AD with CVD) is associated with progressive decline, with CVD impacting AD onset and severity of progression. Subjects with confirmed diagnosis of AD with CVD were treated with galantamine during a six-month, randomized, placebo-controlled trial ( N = 285). Responder analyses were performed for cognitive, behavioural and functional outcome measures. Galantamine treatment resulted in significantly greater cognitive and functional improvements compared with placebo at six months, and a significantly higher percentage of treatment responders. The proportion of responders demonstrating improved or maintained cognition on the 11-item AD assessment scale-cognitive subscale (ADAS-cog/11) was 60.5% for galantamine versus 46.0% for placebo ( P = 0.013). The proportion of patients responding by at least four-points on the ADAS-cog/11 was significantly greater for the galantamine group compared with placebo (33.6% versus 17.2%; P = 0.003). Seventy-five percent of galantamine-treated subjects improved or remained stable as assessed by CIBIC-plus compared with 53.6% on placebo ( P = 0.0006). Significantly higher responder rates were observed with galantamine for behaviour (64.9% versus 56.6%; P = 0.024), and numerically favourable responder rates were seen with galantamine for activities of daily living. Treatment-emergent adverse events were generally related with the gastrointestinal system (nausea 20% versus 10%; vomiting 12% versus 5%; galantamine and placebo groups, respectively). Three deaths occurred during double-blind treatment: 2 of 188 subjects receiving galantamine, and 1 of 97 subjects receiving placebo. These findings are consistent with a broad range of cognitive, functional and behavioural benefits with galantamine across the spectrum of AD and AD with CVD.
Psychopharmacology of pediatric obsessive-compulsive disorder: three case reports
Authors: Oner O. , Oner P.
Published: February 2008

We present the treatment of three very young preschool patients (four- to five-year old) with obsessive-compulsive disorder (OCD). Two of the patients had severe ego-dystonic obsessions with sexual, aggressive, religious themes and forbidden thoughts, while the other one had contamination obsession and cleaning compulsions. Physical and neurological examination and laboratory work—up did not reveal any abnormalities. The symptoms resolved after sertaline monotherapy up to 50 mg/day and sertraline plus risperidone 0.5 mg/day (two cases) treatment. There is very limited data on the treatment of such young pediatric population of patients with OCD and, especially, the safety of using such psychotropic drugs in this special population.
Review: Bupropion and SSRI-induced side effects
Authors: Demyttenaere K. , Jaspers L.
Published: February 2008

Selective serotonin reuptake inhibitors (SSRIs) are a first line treatment option for millions of patients, due to the positive balance between efficacy and tolerability. However, some side effects associated with their use, can impair quality of life and compliance with treatment. This paper reviews the prevalence of sexual dysfunction, weight gain and emotional detachment during SSRI treatment, the profile of bupropion for each of these events and the ability of bupropion to reverse them. Double-blind trials, open-label trials and anecdotical reports derived from Medline were included. First, there is robust evidence that SSRIs can induce sexual side effects and that bupropion causes less sexual dysfunction than SSRIs. There is limited, mainly open-label evidence that bupropion can reverse SSRI-induced sexual side effects. Second, there is good evidence that long-term treatment with some SSRIs can result in weight gain and that long-term treatment with bupropion can result in a small weight loss. There is only anecdotical evidence that bupropion can reverse SSRI-induced weight gain. Third, treatment with SSRIs has been associated with `emotional detachment', although controversy exists about this concept. No data are available on the profile of bupropion for `emotional detachment' or for the reversal of SSRI-induced `emotional detachment' by bupropion-addition.
Diphenhydramine abuse and detoxification: a brief review and case report
Authors: Thomas A. , Nallur DG , Jones N. , Deslandes PN
Published: February 2008

Many medicines available over the counter from pharmacies are known to have abuse potential, including diphenhydramine (DPH), an antihistamine with antimuscarinic properties used for the treatment of insomnia. We present a brief review of the literature describing DPH abuse, and report the case of GF, a 56 year old woman who was admitted to an inpatient addictions unit for detoxification from DPH. A literature search revealed five case reports of DPH abuse including a total of six patients, published between 1986 and 2001. All reported cases exhibited features of DSM-IV criteria for substance dependence, and there was an apparent link with antipsychotic usage. GF was treated with antipsychotics, and was using up to thirty 50 mg DPH tablets each day. She described feeling `good and calm' and `it stopped the tremors'. GF tolerated a gradual dose reduction schedule, and completed the detoxification programme relatively comfortably. She was discharged from the inpatient detoxification unit as planned, and had not relapsed at six months. The described case report highlights the importance of enquiring about non prescribed medication when taking a drug history. Similarly community pharmacists and GPs should be vigilant to excessive requests for DPH, particularly in patients with a psychotic illness.
Olanzapine plasma concentration in a newborn
Authors: Aichhorn W. , Yazdi K. , Kralovec K. , Steiner H. , Whitworth S. , Stuppaeck C.
Published: February 2008

Little is known about the use of antipsychotics in pregnancy and the corresponding plasma levels in the newborn child. We report on a woman with schizophrenia treated with olanzapine during pregnancy. Plasma levels of olanzapine were assessed both from the mother and from umbilical cord. The plasma level of the newborn (11 ng/mL) was about one third compared to the mother (range 25—34 ng/mL).The development of the fetus, delivery and the development of the child during the first six months were normal.
Use of Aripiprazole in treatment resistant schizophrenia
Authors: Hughes D. , Morcos M.
Published: February 2008

For various reasons large numbers of patients treated with Clozapine end up discontinuing the treatment. The authors present the results of switching to Aripiprazole in patients who had to discontinue Clozapine because of neutropenia below the acceptable level for treatment with Clozapine. To summarize and present three cases of individuals with treatment resistant schizophrenia based on the ICD-10 diagnosti criteria. In all cases Clozapine was discontinued and treatment changed to Aripiprazole. Favorable clinical results were noticed in all three patients. The findings from this case series suggest that there is scope for a trial of Aripiprazole for patients with treatment resistant schizophrenia and an invitation for further research of this area.
Risperidone depot in the treatment of psychosis associated with multiple sclerosis — a case report
Authors: Hussain A. , Belderbos S.
Published: February 2008

There is insufficient evidence worldwide regarding the choice of an appropriate anti-psychotic agent in the treatment of psychosis associated with multiple sclerosis. This case report demonstrates the effective use of Risperidone depot.
Combined low-dose clozapine with low-dose aripiprazole in a schizophrenic patient
Authors: Hung GC-L , Chen Y-Y.
Published: February 2008

Aripiprazole, a partial dopaminergic agonist, represents a well-tolerated and effective addition to the antipsychotic armamentarium. However, accumulated data indicates that aripiprazole may still induce extrapyramidal side effects (EPS) in susceptible patients. Guidelines for treating schizophrenia have consistently recommended antipsychotic monotherapy. Nevertheless, in certain clinical situations, a thorough evaluation of the benefit/risk ratio suggests that combinations of antipsychotic agents may improve treatment efficacy and tolerability. We report a schizophrenic patient for whom sequential administration of aripiprazole and risperidone induced severe EPS, and subsequent combination therapy with of clozapine and aripiprazole achieved adequate symptom control and markedly reduced EPS.
Endocannabinoid modulation of fear responses: learning and state-dependent performance effects
Authors: Reich CG , Mohammadi MH , Alger BE
Published: February 2008

Recently, disruption of the endogenous cannabinoid (endocannabinoid, eCB) system was found to impair extinction in delay and contextual fear conditioning models. However, conditioning procedures used in that work precluded investigation of possible eCB effects on acquisition of learned fear. We therefore examined the role of eCBs in modulating fear responses using multiple-trial versions of trace (hippocampal-dependent) and delay (amygdala—dependent) Pavlovian fear conditioning. By administering the CB1 receptor antagonist AM251 (5 mg/kg, i.p) to C57/Bl/6 mice at various times, we systematically identified the stages of learning and memory (i.e. acquisition, consolidation, recall and extinction) that are modulated by eCB signaling. During tone (CS) — footshock (US) conditioning, AM251 enhanced acquisition of freezing behavior for both trace- and delay-conditioning protocols. CB1 antagonism also enhanced generalized fear (baseline freezing) and cued (CS) freezing during memory recall tests in a state-dependent manner for both trace and delay conditioned animals. Furthermore, in trace-conditioned animals, AM251 impaired extinction performance of both cued and generalized fear. CB1 antagonism did not affect short-term memory (STM) or long-term memory (LTM) consolidation processes. Together, these results suggest that during acquisition and recall of aversive learning, eCBs prevent the expression and retention of inappropriate generalized and learned responses. These findings have important implications for the therapeutic use of CB1 antagonists.
Lamotrigine treatment of aggression in female borderline patients, Part II: an 18-month follow-up
Authors: Leiberich P. , Nickel MK , Tritt K. , Gil F Pedrosa
Published: February 2008

Borderline patients often display pathological aggression. We previously tested lamotrigine, an anti-convulsant, in therapy for aggression in women with borderline personality disorder (BPD) (J Psychopharmacol 2005; 19: 287—291), and found significant changes on most scales of the State-Trait Anger Expression Inventory (STAXI) after eight weeks. To assess the longer-term efficacy of lamotrigine in therapy for aggression in women with BPD, this 18-month follow-up observation was carried out, in which patients (treated with lamotrigine: n = 18; former placebo group: n = 9) were tested every six months. According to the intent-to-treat principle, significant changes on all scales of the STAXI were observed in the lamotrigine-treated subjects. All subjects tolerated lamotrigine relatively well. Lamotrigine appears to be an effective and relatively safe agent in the longer-term treatment of aggression in women with BPD.
Impact of risperidone long acting injection on resource utilization in psychiatric secondary care
Authors: Taylor M. , Currie A. , Lloyd K. , Price M. , Peperell Kate
Published: February 2008

Risperidone long acting injection (RLAI) is the only long acting atypical antipsychotic available in the UK. Its impact on NHS resource use has not been widely studied. This review of medical records was conducted to quantify the impact of RLAI on NHS psychiatric secondary care resource use, primarily in terms of episodes of inpatient hospital care 12 months before and 12 months after RLAI initiation. Data on number of hospitalizations and hospital bed days were collected retrospectively, from patient notes and hospital databases in four acute psychiatric units in the UK for all individuals with a diagnosis of schizophrenia or schizoaffective disorder who were prescribed RLAI more than 12 months previously. Data were collected on 100 individuals (58 male) with a mean age 40.8 years (range 19—70). The median duration of illness before RLAI initiation was 12 years (range six months to 43 years).

There were 62 admissions in the 12 months pre-RLAI, falling to 22 admissions in the 12 months post-RLAI. Number of admissions, we argue, offer a more reliable indicator of the impact of treatment than total hospital bed days in this type of study. In this study there were 40 fewer admissions in the 12 months after RLAI was initiated compared with the previous 12 months. This is important as readmission is a good proxy measure of relapse, and adherence to medication is known to be a key factor in relapse prevention.
Professions and Their Work
Authors: Timmermans Stefan
Published: February 2008

Eliot Freidson introduced the concept of the “market shelter” to designate the unique institutional position that professions hold in society. A market shelter shields professional workers from competition, third party and government interference, and other market forces. Once put in place through legal mandates, however, it remains unclear how market shelters weather with political and economic changes and provide benefits for professionals, the state, and the public. This article reviews how clinical medicine and forensic medicine reacted to outside pressures to address the problem of practice variation to understand under which conditions stable market shelters may be professionally harmful and how less sheltered professions may instead use the fight against external challenges to solidify their professional position.
Delinquent Histories of Adolescents Adjudicated for Criminal Sexual Conduct
Authors: Way Ineke , Urbaniak Danielle
Published: February 2008

A content analysis of closed case records from family court examined personal and family history variables for adolescents with sexually abusive behaviors who had been adjudicated for criminal sexual conduct and compared subgroups of adolescents with ( n = 72) and without ( n = 80) prior other delinquent behavior. The study's findings indicate that adolescents with and without prior delinquent behaviors differed on a majority of the variables measured in this study. Adolescents with sexual offending behaviors who also had prior delinquent behaviors were older and had higher rates of documented childhood maltreatment, and drug and alcohol use. These adolescents had caregivers with more substance use and abuse problems and more extensive criminal histories. These findings have a number of practice implications when working with adolescents with sexually abusive behaviors. The findings also suggest that comparisons between adolescents with sexually abusive behaviors and other delinquents may be misleading if these subgroups of adolescents with sexually abusive behaviors are not distinguished.
Exploring the Relationships of Women's Sexual Assault Disclosure, Social Reactions, and Problem Drinking
Authors: Ullman Sarah E. , Starzynski Laura L. , Long Susan M. , Mason Gillian E. , Long LaDonna M.
Published: February 2008

The goal of this exploratory study was to examine correlates of sexual assault disclosure and social reactions in female victims with and without drinking problems. An ethnically diverse sample of sexual assault survivors was recruited from college, community, and mental health agencies. Ethnic minority women were less likely to disclose assault, and women with a greater number of traumatic life events disclosed assault more often. Although there were no differences in disclosure likelihood by drinking status; of those disclosing, problem drinkers told more support sources and received more negative and positive social reactions than nonproblem drinkers. Correlates of receiving negative social reactions were similar for normal and problem drinkers; however, negative social reactions to assault disclosure were related to more problem drinking for women with less frequent social interaction. Implications for future research and possible support interventions with problem-drinking victims are provided.
Crafting the Greenbook
Authors: Janczewski Colleen , Dutch Nicole , Wang Kathleen
Published: February 2008

Guided by research and the experiences of judges nationwide, the National Council of Juvenile and Family Court Judges made a commitment in 1998 to improve community response to families experiencing domestic violence and child maltreatment. A year later, the council's work culminated in a set of recommendations commonly called the Greenbook, which summoned child welfare agencies, domestic violence service providers, and dependency courts to implement internal changes and collaborate to address co-occurring domestic violence and child maltreatment. In 2000, the federal government funded six community-based demonstration programs to implement the Greenbook recommendations. As part of the evaluation of the Greenbook initiative, the evaluation team asked the national experts who helped frame the Greenbook to reflect on the processes used and the decisions that shaped the document. In addition, the experts were asked to describe their expectations for the systems and communities that implemented the recommendations, including anticipated challenges.
Writing New Mexico White
Authors: Johnson Jennifer Ramirez , Pimentel Octavio , Pimentel Charise
Published: February 2008

In this article, the authors analyze early technical documents produced by the New Mexico Bureau of Immigration (NMBI), including “The Legend of Montezuma” and “Illustrated New Mexico.” The purpose of these documents are clear: to increase the number of white Americans to create a clear white majority when New Mexico became a state and thereby prevent the Mexicans from gaining power. In analyzing these documents, the authors use theoretical frameworks from studies in the history of business and technical writing (SHBTW) and critical whiteness theory to show how early textual representations of New Mexico reproduce racist constructions of native New Mexicans and represent whiteness as the norm.
Problem-Based Learning in an Intercultural Business Communication Course
Authors: Saatci Elizabeth
Published: February 2008

Teachers of intercultural business communication may want to consider using problem-based learning (PBL), an instructional approach that places learners in problem-solving situations, that is, students are presented with messy and complex real-life problems that provide a context for learning concepts and developing skills. This article describes how ill-structured communication problems that emerge in intercultural business relationships in internationalizing small- or medium-sized enterprises are used to provide a context for learning. It explains how these problems are tackled by learners through the implementation of PBL in four stages: problem identification, information acquisition, information analysis, and problem resolution. Finally, it discusses the reactions of the students, external participants, and instructors to the PBL approach.
Psychiatric Nursing Education at a Distance
Authors: Shea Carole A.
Published: February 2008

Accessibility is a major impediment to nursing education, whether you live in densely populated southern California or rural upstate New York. During the past 10 years, there have been scientific advances, technological breakthroughs, new reimbursement mechanisms and regulatory practices, and shifts in society's priorities. Consequently, the focus of master's programs and the role of graduates has adapted to the needs of the mental health care delivery system. What has not changed much is the way we offer psychiatric nursing education. There is still a strong emphasis on traditional classroom teaching, on campus-based activities and face-to-face supervision. One solution that might increase access to psychiatric nursing programs is to develop educational programs with quality distance education standards and practices as a primary means for educating future psychiatric nurses. Psychiatric nursing faculties need to design creative scenarios and interactive activities to engage students in online learning about psychiatric and mental health nursing. J Am Psychiatr Nurses Assoc, 2008; 14(1), 36-38. DOI: 10.1177/1078390307307451
Dementia-Specific Assisted Living: Clinical Factors and Psychotropic Medication Use
Authors: Smith Marianne , Buckwalter Kathleen C. , Kang Hyunwook , Ellingrod Vicki , Schultz Susan K.
Published: February 2008

BACKGROUND: Assisted living (AL) is an increasingly popular long-term care alternative for older adults with dementia, making this setting an important focus for both clinical practice and research among psychiatric nurses. OBJECTIVES: This article describes results from a pilot study focusing on residents' cognitive and emotional status as well as psychotropic drug use. Findings are compared to reports from larger studies in the literature. STUDY DESIGN: A descriptive, correlational design was used to collect data from 17 residents in two dementia-specific AL facilities. RESULTS : Thirty-one psychiatric diagnoses were identified for 17 participants. Anxiety and depression symptoms were endorsed by more than 50% of participants, and 88% were prescribed psychotropic medications. CONCLUSIONS: AL residents may experience problems with cognition and emotional symptoms such as anxiety and depression, creating important roles for psychiatric nurses in staff education, promotion of nonpharmacologic interventions, and monitoring of psychotropic medication use in this growing population. J Am Psychiatr Nurses Assoc, 2008; 14(1), 39-49. DOI: 10.1177/1078390307310692
Parent—Adolescent Communication About Sexual Pressure, Maternal Norms About Relationship Power, and STI/HIV Protective Behaviors of Minority Urban Girls
Authors: Teitelman Anne M. , Ratcliffe Sarah J. , Cederbaum Julie A.
Published: February 2008

Racial/ethnic minority adolescent girls bear a disproportionate risk for HIV and face barriers to autonomous sexual decision making, but parental messages may help protect against sexual risk taking. The authors examined African American and Hispanic girls' sexually transmitted infection (STI) and HIV prevention practices, parent—adolescent communication about sexual pressure, and maternal gender norms (N = 118). Teens were more likely to practice consistent STI/HIV prevention when mothers talked about partner sexual pressure (p = .017) and fathers talked about resisting partner sexual pressure (p = .034). Sexually active girls who perceived that their mothers held egalitarian beliefs about partner decision making had more consistent condom use (p = .029). Given the context of increased STI/HIV risk, it is critical that parents discuss partner dynamics with daughters. Nurses play a unique role in facilitating these conversations; they provide parents with age-appropriate resources and assist in normalizing fears, which can help increase parent—child sexual-risk communication. J Am Psychiatr Nurses Assoc, 2008; 14(1), 50-60. DOI : 10.1177/1078390307311770
Are You Including Genomics in Nursing Practice?
Authors: Pestka Elizabeth L.
Published: February 2008

A national consensus panel representing 48 nursing organizations, including the American Psychiatric Nurses Association, identified and endorsed essential genetic and genomic competencies for all registered nurses regardless of academic preparation, role, or clinical specialty. The competencies were designed to guide academic curricula, continuing education, and specialty certification. A 5-year implementation plan for these competencies includes components applicable to practicing psychiatric nurses, regulatory and quality control issues, and academics. This article will describe the implementation strategies identified, some examples of genetics and genomics nursing activities in the psychiatric specialty, and recommendations that support the national implementation plan. J Am Psychiatr Nurses Assoc, 2008; 14(1), 63-68. DOI: 10.1177/1078390307311974
Using Direct Mail to Prompt Smokers to Call a Quitline
Authors: O'Connor Richard J. , Carlin-Menter Shannon M. , Celestino Paula B. , Bax Patricia , Brown Anthony , Cummings K. Michael , Bauer Joseph E.
Published: February 2008

Telephone quitlines efficiently deliver cessation services, but few smokers use them. This article describes an unsolicited direct mail campaign designed to increase calls to the New York State Smokers' Quitline. Two post-cards advertising the quitline and the availability of free nicotine patches were sent to 77,527 smoker households between August and October 2005. One postcard emphasized the effectiveness of the nicotine patch, whereas the other contrasted the risks of smoking and patch use. Response was evaluated using geographically linked calls to the quitline 15 days before and after each mailing. The postcard campaign increased call volume by 36%, with no difference between the two postcard versions. Those who reported calling the quitline in response to a mailing were more likely to request nicotine patches (91% versus 82%, p < .001). Direct mail can be used to increase quitline call volume and should be one of the promotional tools used by quitlines.
Ki11502, a novel multitargeted receptor tyrosine kinase inhibitor, induces growth arrest and apoptosis of human leukemia cells in vitro and in vivo
Authors: Nishioka Chie , Ikezoe Takayuki , Yang Jing , Miwa Atsushi , Tasaka Taizo , Kuwayama Yoshio , Togitani Kazuto , Koeffler H. Phillip , Yokoyama Akihito
Published: February 2008

Ki11502 is a novel multitargeted receptor tyrosine kinase (RTK) inhibitor with selectivity against platelet-derived growth factor receptor alpha/beta (PDGFRα/β). Ki11502 (0.1-1 nM, 2 days) profoundly caused growth arrest, G0/G1 cell-cycle arrest, and apoptosis associated with down-regulation of Bcl-2 family proteins in the eosinophilic leukemia EOL-1 cells having the activated FIP1-like 1/PDGFRα fusion gene. Ki11502 decreased levels of p-PDGFRα and its downstream signals, including p-Akt, p-ERK, and p-STAT5, in EOL-1 cells. Of note, Ki11502 was also active against imatinib-resistant PDGFRαT674I mutant. In addition, Ki11502 inhibited proliferation of biphenotipic leukemia MV4-11 and acute myelogenous leukemia MOLM13 and freshly isolated leukemia cells having activating mutations in FMS-like tyrosine kinase 3 (FLT3). This occurred in parallel with the drug inhibiting FLT3 and its downstream signal pathways, as measured by fluorescence-activated cell sorting using the phospho-specific antibodies. In addition, Ki11502 totally inhibited proliferation of EOL-1 cells growing as tumor xenografts in SCID mice without any noticeable adverse effects. Taken together, Ki11502 has profound antiproliferative effects on select subsets of leukemia including those possessing imatinib-resistant mutation.
HIF-1–dependent repression of adenosine kinase attenuates hypoxia-induced vascular leak
Authors: Morote-Garcia Julio C. , Rosenberger Peter , Kuhlicke Johannes , Eltzschig Holger K.
Published: February 2008

Extracellular adenosine has been implicated in vascular adaptation to hypoxia. Based on the observation that increases in intracellular adenosine can effectively elevate extracellular adenosine, we studied the contribution of adenosine kinase (AK, intracellular conversion of adenosine to adenosine monophosphate [AMP]) to vascular adenosine responses. Initial in vitro studies of ambient hypoxia revealed prominent repression of endothelial AK transcript (85% ± 2% reduction), protein, and function. Transcription factor binding assays and hypoxia inducible factor 1-α (HIF-1α) loss- and gain-of-function studies suggested a role for HIF-1α in transcriptional repression of AK. Moreover, repression of AK by ambient hypoxia was abolished in conditional HIF-1α mutant mice in vivo. Studies of endothelial barrier function revealed that inhibition or siRNA repression of AK is associated with enhanced adenosine-dependent barrier responses in vitro. Moreover, in vivo studies of vascular barrier function demonstrated that AK inhibition with 5′-iodotubericidin (1 mg/kg prior to hypoxia) significantly attenuated hypoxia-induced vascular leakage in multiple organs and reduced hypoxia-associated increases in lung water. Taken together, our data reveal a critical role of AK in modulating vascular adenosine responses and suggest pharmacologic inhibitors of AK in the treatment of conditions associated with hypoxia-induced vascular leakage (eg, sepsis or acute lung injury).
Interstitial lung diseases in infants and children: Fig. 1—
Authors: Clement A. , Eber E.
Published: February 2008

Interstitial lung disease (ILD) in infants and children represents a heterogeneous group of respiratory disorders that are mostly chronic and associated with high morbidity and mortality.

Typical features of ILD include dyspnoea, the presence of diffuse infiltrates on chest radiographs and abnormal pulmonary function tests with evidence of a restrictive ventilatory defect (in older children) and/or impaired gas exchange.

ILD is difficult to diagnose, as no classification scheme is entirely satisfactory. Recently, it has been proposed to categorise paediatric ILD as either primary pulmonary disorders or systemic disorders with pulmonary involvement. However, this classification leaves the difficult problem of which clinical conditions should be included or excluded in infants and children.

The present article reviews interstitial lung disease in infants and children, placing emphasis on current concepts of pathophysiological mechanisms and approaches to treatment.
Peroxisome proliferator-activated receptors: a therapeutic target in COPD?: Fig. 1—
Authors: Remels A. H. , Gosker H. R. , Schrauwen P. , Langen R. C. , Schols A. M.
Published: February 2008

Extrapulmonary pathology significantly impairs clinical outcome in chronic obstructive pulmonary disease (COPD).

The peroxisome proliferator-activated receptors (PPARs) are implicated in the regulation of several hallmarks of systemic COPD pathology, including cachexia, decreased oxidative muscle metabolism, oxidative stress and systemic inflammation.

Recently, expression of PPARs and related cofactors was shown to be reduced in peripheral skeletal muscle of patients with moderate-to-severe COPD and muscle weakness.

The current authors hypothesise that impaired peroxisome proliferator-activated receptor signalling may underlie some of the muscular disturbances in chronic obstructive pulmonary disease. Proposed mechanisms will be outlined in the present article, as well as the therapeutic potential of peroxisome proliferator-activated receptor modulation in the treatment of skeletal muscle dysfunction.
Possible mechanisms underlying the development of cachexia in COPD
Authors: Wagner P. D.
Published: February 2008

About 25% of patients with chronic obstructive pulmonary disease (COPD) will develop cachexia (fat-free body mass index <17 kg·m−2(males) or <14 kg·m−2(females)). This is associated with ∼50% reduction in median survival.

The pathogenetic mechanism has been variously suggested to result from the following: 1) energy imbalance; 2) disuse atrophy; 3) tissue hypoxia from arterial hypoxaemia; 4) systemic inflammation; and 5) anabolic hormonal insufficiency. Genetic polymorphisms implicate inflammatory cytokines, especially interleukin (IL)-1β, but IL-6 and tumour necrosis factor (TNF)-α do not show polymorphisms in these patients. Early reports of elevated TNF-α levels suggested a role for inflammation, but recent studies have not shown elevated levels of either IL-6 or TNF-α. Therapeutic trials of nutritional support, hormonal supplementation, anti-TNF-α immunotherapy, ghrelin and antioxidants have been conducted, but only a few have shown any benefits in muscle structure and function.

Considerably more mechanistic knowledge is needed before therapeutic recommendations can be made. At this time, it is not possible to attribute cachexia in COPD unequivocally to inflammation or any other cause, and much more research is needed.

To date, studies have been predominantly cross-sectional, with measurements made only after cachexia has developed. Future research should target prospective observation, studying patients as cachexia progresses, since once cachexia is established, inflammatory cytokine levels may not be abnormal.
Anxiety and depression in end-stage COPD
Authors: Hill K. , Geist R. , Goldstein R. S. , Lacasse Y.
Published: February 2008

Although feelings of anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD), estimates of their prevalence vary considerably. This probably reflects the variety of scales and methods used to measure such symptoms. Regardless of whether anxiety and depression are considered separately or as a single construct, their impact on COPD patients is important.

A heightened experience of dyspnoea is likely to be a contributing factor to anxiety. Feelings of depression may be precipitated by the loss and grief associated with the disability of COPD. Smoking has been associated with nicotine addiction, and the factors that contribute to smoking may also predispose to anxiety and depressive disorders.

Randomised controlled trials indicate that exercise training and carefully selected pharmacological therapy are often effective in ameliorating anxiety and depression. Most medical illnesses are influenced by the psychological responses and coping mechanisms that patients use. However, anxiety and depression are associated with dyspnoea, fatigue and altered sleep, all of which also occur in COPD.

An understanding of the psychological history and coping mechanisms of patients and the role of anxiety and depressive reactions to illness may enable clinicians to reduce these symptoms and improve quality of life among patients with chronic obstructive pulmonary disease.