bluuebunny/crossref_metadata_2025 huggingface dataset:
Bactericidal effect of dentin primer containing antibacterial monomer methacryloyloxydodecylpyridinium bromide (MDPB) against bacteria in human carious dentin
Authors: Imazato S. , Torii Y. , Takatsuka T. , Inoue K. , Ebi N. , Ebisu S.
Published: March 2003

The aim of this study was to investigate the bactericidal effect of a dentin primer incorporating the antibacterial monomer 12‐methacryloyloxydodecylpyridinium bromide (MDPB) against bacteria in human dentinal carious lesions. To evaluate the antibacterial activity of MDPB against anaerobes, the minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) against obligate anaerobes and facultative anaerobic strains of lactobacilli were determined. Bacteria were recovered from carious dentin samples obtained from the teeth of patients, and the bactericidal activities of the experimental primer containing 5% MDPB and three commercially available primers were compared by counting the number of viable cells after contact with diluted solutions of each primer for 30 s. MDPB showed strong antibacterial activity against anaerobes, the MIC and MBC values ranging from 3·9 to 31·3 μg mL−1 and 15·6–125 μg mL−1, respectively. Experimental primer containing MDPB was the most bactericidal among the materials tested (ANOVA, Fisher’s PLSD test, P < 0·05) and was able to kill the bacteria completely even when diluted 40 times, while the three commercial products exhibited little activity at 40 times dilution. These results indicate that incorporation of MDPB into dentin primer could be beneficial for eliminating the residual bacteria in cavities.
Effect of three adhesive primers on the bond strengths of four light‐activated opaque resins to noble alloy
Authors: Yoshida K. , Kamada K. , Taira Y. , Atsuta M.
Published: March 2003

The effect of commercial adhesive primers for noble metals on the bond strength of light‐activated opaque resin has not been determined. This study evaluated the effect of three adhesive primers on the shear bond strengths of each of the four light‐activated opaque resins to silver–palladium–copper–gold (Ag–Pd–Cu–Au) alloy. The adhesive primers Alloy Primer® (AP), Metal Primer II® (MPII) and Metaltite®(MT) were used. Four commercial light‐activated opaque resins (Axis® (AX), Cesead II® (CEII), Dentacolor®(DE) and Solidex® (SO) were used to bond a light‐activated resin‐veneered composite to Ag–Pd–Cu–Au alloy. The specimens were stored in water at 37 °C for 24 h and then immersed alternatively in water baths at 4 and 60 °C for 1 min each for up to 20 000 thermal cycles before shear mode testing at a cross‐head speed of 0·5 mm min−1. All the primers examined improved the shear bond strength between opaque resin and Ag–Pd–Cu–Au alloy compared with non‐primed specimens prior to thermal cycling. After 20 000 thermal cycles, the bond strengths of combined use of AP and DE and that of MT and each of AX, CE or DE were significantly greater than any other groups. Significant difference was observed between the bond strengths at thermal cycles 0 and 20 000, with the combined use of MT and DE. With the combination of appropriate adhesive metal primers and light‐activated opaque resins, complicated surface preparations of metal frameworks of resin‐veneered prostheses that are composed of casting Ag–Pd–Cu–Au alloy may be negligible.
Effect of cavity varnish, amalgam liner or dentin bonding agents on the marginal leakage of amalgam restorations
Authors: Belli S. , Ünlü N. , Özer F.
Published: March 2003

The purpose of this in vitro study was to compare marginal leakage of Class II amalgam restorations lined with different agents (two new generation dentin bonding systems, a cavity varnish and an amalgam liner). Forty freshly extracted human molar teeth were divided into five groups. Class II preparations were prepared in the mesial and distal surfaces of each molar. While the cavities in two groups were lined with two new generation bonding systems, the other two groups were treated with an amalgam lining material and a cavity varnish. Fifth group was used as control, without any lining. Amalgam* was hand‐condensed into each preparation. Specimens were thermocycled, stained and sectioned. Microleakage was graded using a stereomicroscope. Mean microleakage scores for occlusal and cervical margins were calculated and analised. For the leakage values on occlusal margins, Kruskal–Wallis test indicated no significant difference in all groups. For the leakage values on cervical margins, Kruskal–Wallis test indicated significant difference in four groups when compared with controls (P < 0·001). On the other hand, there was no significant difference between the occlusal and cervical leakage values in each group.
Is the superior belly of the lateral pterygoid primarily a stabilizer? An EMG study
Authors: Wang M. Q. , Yan C. Y. , Yuan Y. P.
Published: March 2003

The aim of the present study was to compare the activity levels within the two bellies of the lateral pterygoid muscle between different jaw positions to test the hypothesis that the upper head is primarily a stabilizer. Electromyographic (EMG) recordings, using monopolar concentric needle electrodes, were made from 14 healthy subjects during mandibular rest position (RP), clenching in intercuspal position and jaw opening, first about 10 mm and then about 25 mm. Both bellies had very little activity during RP. The activity level of the superior belly was high during clenching and large opening (LO) with a dip during low opening degree. This pattern differed from that of the inferior belly where the activity was relatively low during clenching and then gradually increased to its highest level during LO. The results support that the lower belly is primarily a jaw opener while the superior belly acts as a stabilizer keeping the disc and condyle in a functionally stable position during clenching and jaw movements.
Rotational head motion concurrent to rhythmical mandibular opening movements
Authors: Kohno S. , Kohno T. , Medina R. U.
Published: March 2003

We have previously demonstrated the existence of a functional‐rhythmical coupling between the head and the mandible using maxillary and mandibular incisal tracking points. However, that data did not provide information neither on the movement of the head as a whole nor on the location of its instantaneous centre of rotation. Thus, the objective of the present study was to determine whether the head undergoes a rotational motion during mouth opening and to locate its putative instantaneous centre of rotation. The same 6 d.f. (degree of freedom) measuring device employed in our previous studies was used again to analyse data from five male adults (age range: 26–29 years old) chosen as subjects. Concomitant head and mandibular movements were assessed in the sagittal plane by allocating several reference points in the head (upper incisor, cranial base, occipital and parietal points) and a mandibular incisor point during maximal mouth open–close movements. Then, the magnitude and inclination of the vectors of motion in each reference point during the opening phase were calculated. The instantaneous centre of rotation was defined as the point showing the least amount of motion in a determined area around each head reference point. The mandibular incisal point and the maxillary incisal point showed concomitant movements; that is, during opening the mandibular point moved downwards and the maxillary incisor point upwards. Making a large jaw opening movement caused an inferior‐anterior displacement in the O point, a posterior–inferior displacement of the P point, and an anterior–superior displacement in the C point in all subjects. During jaw closing all points followed a trajectory opposite to that described above. In other words, during opening the head moved clockwise and counter‐clockwise during closing, at least in the sagittal plane of the subjects’ left side. These results suggest that the head undergoes a rotation‐like sagittal movement during mouth opening whose rotation centre seems to be located above the cranial base point, which was set close to the centre of mass of the head. However, its location varies according to the magnitude of mouth opening.
Gingival blood flow measurement with a non‐contact laser flowmeter
Authors: Matsuki M. , Xu Y.B. , Nagasawa T.
Published: March 2003

A non‐contact laser flowmeter was used to measure the changing of the gingival blood flow. Five university students with healthy oral condition were selected in this study. The blood flow measurement on the extensor digitorum (above the head of third metacarpal), with the changing of distance and angle between the probe and the tissue was used as a pre‐study experiment. Blood flow rate was determined in the labial gingiva (2 mm above the cervical line) of upper central incisor using a stent fixing the probe at a 3‐mm distance from the tissue. A basal level of gingival blood flow was taken two times each day for 5 days. The effects of water of different temperatures on the gingival blood flow are discussed. With the changing of distance, the blood flow rate became smaller, but there was no significant effect from the angle. The reproducibility was acceptable through the 5‐day measurement. After stimulating with warm and body temperature water, the blood flow first increased significantly and then went back to the basal line (faster with the body temperature water). With cold water, different reactions between the subjects were observed.
Effect of desensitizers on bond strength of adhesive luting agents to dentin
Authors: Soeno K. , Taira Y. , Matsumura H. , Atsuta M.
Published: March 2003

The current study investigates the influence of three dentin hypersensitivity treating agents (Gluma CPS, MS Coat and Saforide) on bond strength to dentin of two luting agents (Panavia Fluoro Cement and Super‐Bond C & B). Sixty bovine dentin substrates were divided into 12 combinations of four treatment conditions (Gluma CPS, MS Coat, Saforide and control) and three adhesive systems (AD Gel sodium hypochlorite + Panavia Fluoro Cement, Panavia Fluoro Cement without AD Gel and Super‐Bond C & B). After bonding the treated teeth to steel rods, 24‐h tensile bond strengths were determined, and average values (n=5) were compared by analysis of variance (ANOVA). Without application of the desensitizers, bond strengths of the two groups (Super‐Bond C & B, 10·2 MPa; AD Gel + Panavia, 11·5 MPa) were comparable, and they were greater than the group bonded with the Panavia material with no AD Gel conditioning (7·1 MPa). Application of the Saforide ammoniated silver fluoride desensitizer reduced bond strength of both the Super‐Bond and Panavia luting agents, whereas the MS Coat polymeric agent negatively affected bond strength of the Panavia cement only. The use of the Gluma desensitizer did not affect bond strength of any of the three adhesive systems, and the bond strength of the Panavia cement with the AD Gel conditioning was not reduced by application of any of the three desensitizers. The four combinations of two desensitizers (MS Coat and Gluma CPS) and two adhesive systems (Super‐Bond C & B and AD Gel + Panavia) are deemed to be applicable to fixed prosthodontic treatment.
Prosthetic treatment need in a representative German sample*
Authors: Walter M. H. , Wolf B. H. , Rieger C. , Boening K. W.
Published: March 2003

Regarding declining resources epidemiological data on needs for oral rehabilitation are required. Within the framework of an oral health survey a non‐stratified two‐stage random sample was taken to represent the over 14‐year‐old population of Saxony/Germany. The participation rate was 55%. Normative need was determined by dental assessment and guidelines developed in a consensus process, subjective prosthetic treatment need by self‐complete questionnaire. About 97% of the realized sample could be planned within the guidelines. About 81% had normative prosthetic treatment need. Compared with the rate of normative need the rate of subjective need (13%) was considerably lower (χ2P < 0˙01). Different predictive parameters of subjective need were identified by logistic regression. Besides other factors subjective need was associated with giving dentist’s recommendation as significant reason for prosthetic restorations [odds ratio (OR)=5˙43], not believing that the own teeth were all right (OR=0˙17), and the existence of prosthetic restorations (OR=3˙87 for fixed restorations; OR=4˙05 for removable dentures). The guidelines proved their suitability to assess normative prosthetic treatment need in oral health surveys. Further research is necessary to find adequate options for including patients’ preferences in an adequate need definition.
Head movement properties during voluntary rapid jaw movement in humans
Authors: Torisu T. , Yamabe Y. , Hashimoto N. , Yoshimatsu T. , Fujii H.
Published: March 2003

The purpose of this study was to determine whether the start of the synchronized head movement during mandibular movement is evoked by the peripheral reflexes following mandibular movement (i.e. stretch or trigemino‐neck reflexes), or, alternatively, is started by pre‐programmed central command. Head movement accompanying voluntary rapid jaw opening movement was studied using accelerometers fixed to the upper and lower incisors, as well as electromyographs (EMGs) of the neck muscles. The direction of head acceleration at the upper incisor was towards head extension at the beginning of jaw opening movement in 89·2% of all trials, opposite to the direction of lower jaw acceleration. The onset of head acceleration was later than that of the lower jaw acceleration by averages of 6·2–10·7 ms, and the onset of electromyographic activities of the sternocleidomastoid (SCM) muscle preceded that of head acceleration by an average of 12·5–24·3 ms. These findings suggest that head movement during mandibular movement is not started by peripheral reflexes but by pre‐programmed central commands. This may be relevant to muscular discomfort in the neck and shoulder regions of patients with stomatognathic disorders.
Electromyographic analysis of fatigue in temporalis and masseter muscles during continuous chewing
Authors: Buzinelli R. V. , Berzin F.
Published: March 2003

The aim of this study was to evaluate the electromyographic changes in the anterior temporalis and masseter muscles after fatigue induced by continuous chewing. Surface electrodes were placed bilaterally over the anterior temporalis and masseter muscles of 31 subjects with normal dentition. Recordings were taken every minute from the beginning of chewing to the exact moment the volunteer reported subjective sensation of fatigue in the jaw muscles. The length of endurance period (fatigue threshold) was measured to each subject, as well as the average amplitude and duration of activation phase and duration of relaxation phase through electromyographic recording of each muscle. The average endurance period was about 500 s. No significant change occurred on the average amplitude of activation phase meanwhile the duration of both the activation and relaxation phase diminished after fatigue.
Correlation between elevator muscle activity and direction of sagittal closing pathway during unilateral chewing
Authors: Kimoto K. , Tamaki K. , Yoshino T. , Toyoda M. , Čelar A. G.
Published: March 2003

The closing pathway of masticatory movement in the vicinity of the intercuspal position (ICP) is considered as a functional movement in reconstructing the occlusal guidance. The purpose of this study was to examine a correlation between elevator muscle activity and direction of the closing pathway in the vicinity of the ICP during mastication. Fifty subjects (18 male and 32 female subjects aged from 21 to 34 years) were selected randomly from the students of the Kanagawa Dental College. The measurements of jaw movement during mastication were recorded using a Sirognathograph instrument and surface electromyography (EMG) of the anterior temporalis and masseter muscles simultaneously. The muscle activity and the direction of the closing pathway were calculated on the working and non‐working sides during unilateral chewing and analysed at the sections of ICP‐2 mm and 2–4 mm in sagittal view. The direction of the closing pathway was expressed by the angle to a vertical reference axis. The direction of the closing pathway correlated significantly with the activity of the anterior temporalis muscles on the non‐working side and the masseter muscles on the working side at ICP‐2 mm. From the results of this study, it was suggested that the elevator muscle activity may be associated with the direction of the closing pathway during mastication.
Atraumatic dental treatment among Finnish elderly persons
Authors: Honkala S. , Honkala E.
Published: March 2003

There is an increase in elderly dentate adults who will retain more of their natural teeth, and thus the demand for restorative dental services among them will be high. In Finland, systematic dental care for old people has not been organized. Health centres have mainly targeted the development of dental care for children, adolescents and young adults. With this background, atraumatic restorative treatment (ART) was seen as a complementary procedure in oral health services for the elderly. It was tested in 1997–1999 in Helsinki among 119 old people (mean age 72·5 years) living in their homes and receiving community‐based support services. Patients were satisfied with having dental examination and oral health education at home. The ART fillings (n=33) were provided for 21 persons and depuration for 56. After 1 year, 25 fillings (58%) could be evaluated: 68% of the fillings were assessed as being good, 11% as having a slight marginal detect and 16% as having unacceptable marginal defect, and one filling was totally lost. In conclusion, ART is an appropriate approach in dental care for the elderly. However, more testing should be completed to find out how the screening could be organized to make the dental home visits more cost‐effective and less time consuming.
The selection of anterior teeth appropriate for the age and sex of the individual. How variable are dental staff in their choice?
Authors: SELLEN P. N. , JAGGER D. C. , HARRISON A.
Published: March 2003

Summary As part of the development of a guide to aid the undergraduate in the selection of artificial teeth, the aim of this study was to investigate the variability in choice of dental staff to select teeth appropriate to the age and sex of the individual with the aid of a series of three‐dimensional guides. Four three‐dimensional guides were produced for use in the study. Fifty dentists were asked to complete a questionnaire designed to assess the variability in selection of anterior teeth appropriate for the age and sex of an individual. From this study it can be concluded that there was little consistency in the selection of the shade, mould and arrangement of anterior teeth appropriate for the age and sex of the individual by qualified dental staff. The development and implementation of an aesthetic proforma to guide dental staff, dental undergraduates and patients through the process of choosing tooth mould, shade and arrangement based on age and sex may be helpful.
Effect of fluoride‐releasing adhesive system on decalcified dentin
Authors: Itota T. , Torii Y. , Nakabo S. , Tashiro Y. , Konishi N. , Nagamine M. , Yoshiyama M.
Published: March 2003

summary  The aim of this study was to evaluate the effect of fluoride‐releasing adhesive systems on human decalcified dentin in vitro. Two fluoride‐releasing adhesive systems, Reactmer bond (RB, Shofu) and ABF (AF, Kuraray), an experimental system, and a commercial adhesive system without fluoride release, SE bond (SE, Kuraray), were used in this study. The amount of fluoride release from adhesive in deionized water was measured every week for 10 weeks. Class V cavities were prepared on extracted human pre‐molars and decalcified dentin was promoted by using a bacterial caries induction system at the cavity floor. The cavities preserving decalcified dentin were restored with resin composite (AP‐X, Kuraray) after treatment by each adhesive system. The specimens without treatment by adhesive system and restoration were used for control. The specimens with restoration were then incubated for 4 weeks at 37 °C, 100% humidity. Microradiographs of the specimens showed that the radiopacities of the decalcified dentin layers in RB and AF groups with fluoride release were significantly higher than those in SE or control groups without fluoride release. This result suggested that the fluoride‐releasing adhesive systems enhanced mineralization of decalcified dentin.
Accuracy of adaptation of thermoformed poly(methyl methacrylate)
Authors: Jagger R. G. , Milward P. J. , Jagger D. C. , Vowles R. W.
Published: March 2003

summary  Thermoformed poly(methyl methacrylate) (PMMA) sheet is used to produce a number of different dental appliances such as stents, occlusal splints and baseplates for occlusal rims. The purpose of the present study was to measure the accuracy of adaptation of Perspex PMMA sheet and to determine the effect of annealing on the accuracy of the thermoformed specimens. The results of the study showed that PMMA can produce specimens that are accurately adapted to the cast. Immersion in water resulted in an increase in the space between the cast and the specimen for both thermoformed and thermoformed and annealed acrylic resin. Annealing of the thermoformed specimens had significantly less increase in space between the cast and the specimens when immersed in water over a period of 3 months.
The effect of three different periodontal pre‐treatment procedures on the success of telescopic removable partial dentures
Authors: Polansky R. , Haas M. , Lorenzoni M. , Wimmer G. , Pertl C.
Published: March 2003

summary  In this prospective study, 120 teeth consisting of maxillary and mandibular canines and premolars were divided into three groups each containing 40 teeth. The teeth were assigned randomly in quadrants to three different periodontal treatment protocols. The first group was treated with professional prophylaxis only. The second group received additional deep scaling. With the third group, additional surgical periodontal flap surgery and scaling was performed. Both papillary bleeding index (PBI) and probing depth (PD) were evaluated before, during and after treatment. During the subsequent prosthetic treatment phase all teeth were then used as telescope abutments supporting a removable prosthesis. The documentation of the attachment level (AL) was then used as a clinical parameter. One year after the incorporation of telescopic removable partial dentures (RPDs), PD, PBI and AL were again evaluated. The resulting periodontal parameters were compared between the different groups using the general linear model (GLM) repeated measures and the Kruskal–Wallis test for non‐parametric variables. Differences within the three treatment groups were determined using the t‐test, e.g. the Wilcoxon test for dependent variables (P < 0·05). A significant decrease in inflammatory indices (PBI) was found for all types of periodontal treatment (P < 0·03 for all groups). Additionally, the reduction in PD was significant for all of the three groups (P < 0·001 for all groups). The greatest reduction in PD was observed in the group in which a surgical approach was used. Evaluation of the attachment level after the incorporation of the telescopic RPDs showed that tooth position did not influence the periodontal prognosis and that the use of telescopic RPDs exerted no ascertainable negative influence on the periodontium of the abutment teeth.
Transport proteins in drug resistance: biology and approaches to circumvention
Authors: Twentyman
Published: March 2003

At least two transport proteins, P‐glycoprotein (Pgp) and the multidrug resistance associated protein (MRP), are believed to play a significant role in clinical resistance to cytotoxic therapy. These proteins are expressed at relatively high levels in a number of malignant diseases including various types of leukaemias. They are variably expressed on both the plasma membrane and intracellular vesicular membranes resulting in cellular drug efflux or vesicular drug sequestration, respectively. The action of MRP as a drug transporter depends on intracellular levels of glutathione. A number of strategies for circumvention of these drug resistance mechanisms have been developed and some of these are now in clinical trial.
Manufacturing a human drama from a psychiatric crisis: crisis intervention, family therapy and the work of R. D. Scott
Authors: REED
Published: March 2003

There has been a recent resurgence of interest in crisis intervention within psychiatry. The idea of crisis services is not, of course, a new thing, and there is a great deal to be learnt from returning to the innovative writings of those practitioners who developed similar services in the 1960s and 1970s. This article discusses the work of the psychiatrist and family therapist R. D. Scott, who developed a 24‐hour family‐orientated crisis intervention service in London during this era. Although under‐utilized, the writings of Scott and his colleagues in this area continue to be of crucial relevance to mental health nurses and other psychiatric professionals.
Waiting for harm: deliberate self‐harm and suicide in young people — a review of the literature
Authors: ANDERSON M.
Published: March 2003

Mental health professionals, particularly nurses, practicing in child and adolescent psychiatry are key players in the continued development of expertise, awareness and understanding of deliberate self‐harm (DSH) and suicide in young people. Enhancing this knowledge and the associated skills will contribute to effective, therapeutic relationships with individuals and their families. The purpose of this paper is to review the current literature surrounding the issue of deliberate self‐harm and suicide in young people. The paper will address national and international studies selected from a variety of child and adolescent and general psychiatric literature. The research presented highlights important issues to be addressed in practice. In particular, the evidence supports the influence of mental illness in DSH and suicide, particularly depression and substance abuse. However, a clearly important factor is an individual's experience of family and social life. The literature is considered in the light of relevant governmental policy documents relating to DSH and suicide. The future role of the mental health nurse in child and adolescent psychiatry in the United Kingdom (UK) is discussed in the contexts of family work and assessment.
Training, skills and caseloads of community mental health support workers involved in case management: evaluation from the initial UK demonstration sites
Authors: Davis Bryn , WARD M. F. , ARMSTRONG C. , LELLIOTT P. , DAVIES M.
Published: March 2003

This paper describes phase one of a three phase, Department of Health funded project, led by the Mental Health Programme of the Royal College of Nursing Institute in collaboration with the Research Unit of the Royal College of Psychiatrists and the School of Social Work at the University of East Anglia. Its project aims were to establish whether the work of demonstration sites in mental health case management had developed beyond their original structure, to compare their current profile with the general literature on case management and assertive outreach and to use this data to reach consensus about issues affecting the work of those healthcare workers who currently see themselves working as case managers. Central to these aims were the experiences and narratives of the demonstration site case managers themselves.

In 1995 data were collected from six fieldwork sites in England using semistructured interviews. Similarities and differences between the literature and the fieldwork data were used to inform a consensus conference. The main areas of investigation were organizational considerations, the nature of innovative projects and user involvement. The paper concludes that there are serious problems with the perceived role of case managers, their support and training and further difficulties attributed to interagency working. Finally, it is clear that the exact nature of the client group most suited to UK case management typology has not yet been resolved.
Negotiating the boundaries: the experience of the mental health nurse at the interface with the criminal justice system
Authors: Turnbull J. , Beese J.
Published: March 2003

Community mental health nurses working within the criminal justice system undertake an important function with regard to the strategic intent that wherever possible, mentally disordered persons should receive care and treatment from health and social services. Their precise role, and the particular function of court diversion/assessment schemes, is still being defined. This takes place within a broader context of reorientation of mental health nursing within the move to community care and exposure to the complexity of multidisciplinary working. Examining the experience of mental health nurses in court diversion schemes reveals the intensity of the experience of working in an inter‐professional setting without the benefit of preparation or training, and without the frame of reference of a structured health environment. Adaptation of the language of mental health nursing was necessary to effect mutual understanding with other professional groups, and there was a recognition that the competences needed to operate in this environment had not previously been identified as part of their skills base. The result was to bring into question their professional practice and identity as mental health nurses. The handling of patient information in the context of an inter‐professional setting remains an issue requiring clarification.
Stressors, moderators and stress outcomes: findings from the All‐Wales Community Mental Health Nurse Study
Authors: Edwards D. , Burnard P. , Coyle D. , Fothergill A. , Hannigan B.
Published: March 2003

The All‐Wales Community Mental Health Nurse Stress Study was the largest study undertaken in the UK to date to investigate stress, burnout and coping amongst the CMHN workforce. The aim of the study was to examine the variety, frequency and severity of stressors, to describe coping strategies used to reduce work‐based stress, and to determine stress outcomes. Questionnaires were sent out to 614 CMHNs from ten NHS Trusts throughout Wales. The response rate was 49% (n = 301). The measures used included the Maslach Human Services Survey, the CPN Stress Questionnaire, the Psychnurse Methods of Coping Questionnaire, the Rosenberg Self‐Esteem Scale and the General Health Questionnaire GHQ‐12. Community mental health nurses indicated that trying to maintain a good quality service in the midst of long waiting lists, poor resources, and having too many interruptions while trying to work in the office were particularly stressful items. The coping strategies that CMHNs utilized the most were having a stable home life and looking forward to going home at the end of the day, having outside interests and hobbies and talking to people that they got on well with. Forty per cent of CMHNs tended to view themselves negatively, feeling that others did not hold much respect for them. The GHQ‐12 measure indicated that 35% of CMHNs had crossed a threshold of psychiatric caseness. Measured against a normative sample of mental health workers, 51% of CMHNs were experiencing high levels of long‐term emotional exhaustion. Twenty‐four per cent were suffering from high levels of depersonalization burnout and were not relating well to clients, whilst 14% were experiencing severe long‐term feelings of lack of personal accomplishment. The results from the study provided us with a picture of stress and coping in CMHNs in Wales. Addressing these factors may help to reduce levels of experienced stress and burnout.
A clinical teaching guide for psychiatric mental health nursing: a qualitative outcome analysis project
Authors: Melrose S.
Published: March 2003

Limited curriculum enhancement resources are available to psychiatric nurse educators. This article provides a clinical teaching guide for novice instructors teaching an introductory psychiatric nursing course. The investigation is grounded in a constructivist theoretical framework and extends a previous case study project that explored how students learn during a mental health practicum (Melrose 1998, Melrose & Shapiro 1999). The guide was tested and modified by applying a qualitative outcome analysis methodology. Insight into interpreting student behaviour and providing appropriate and stage‐specific teaching tools is revealed. Theoretical components, assessment questions for teachers, student behavioural signs and teaching strategies are identified and discussed to describe significant features in creating personally meaningful learning experiences.
Psychosocial disadvantages in the lives of persons with long‐term mental illness living in a Swedish community
Authors: Erdner A. , Nyström M. , Severinsson E. , Lützén K.
Published: March 2003

The aim of this study was to gain in‐depth knowledge of how persons with long‐term mental illness experience their everyday situation, in order to identify potential psychosocial obstacles to a meaningful existence. The focus was on psychosocial aspects, such as contact with others and the quality of these contacts. An ethnographic design was used, in order to provide an inside perspective. Four persons with long‐term mental illness participated in the study. Three open‐ended interviews, at 1‐week intervals, were conducted with each informant. Analysis of transcribed material consisted of naive reading and content analysis guided by the investigators’ understanding of the psychiatric context. Three themes were generated: feeling lonely but being unable to establish friendships; knowledge of what to do but lacking initiative; and awareness of the need for support but not wanting to be subject to control. These themes reflect contradictions between thoughts, feelings and actions, which seem to contribute to a psychosocial disadvantage in the life of persons with long‐term mental illness.
The work and values of mental health nurses observed
Authors: HAQUE M. S. , NOLAN P. , DYKE R. , KHAN I.
Published: March 2003

While there is agreement among stakeholders that change is required in mental healthcare, yet the precise nature of this change and how it should be brought about are relatively under‐explored. Research has looked at developments taking place in primary mental health services, but relatively little has examined the work of community mental health nurses (CMHNs), especially those working at the interface between primary and secondary care. This study used a 39‐item questionnaire to explore how CMHNs perceive their role and the degree to which they are able to carry it out. The findings suggests that while CMHNs are enthusiastic about their work and are keen to see mental health services develop in primary care, many are concerned about how they are perceived by other health personnel, deficiencies in their therapeutic skills and the level of support they currently receive. The study concludes by suggesting areas that managers, commissioners and educators should target to enable CMHNs to continue to play their part in a service that relies heavily upon them.
Time of day effects in, and the relationship between, sleep quality and movement
Authors: BLAGROVE MARK , OWENS DEBORAH , MacDONALD IAN , SYTNIK NATALIA , TUCKER PHILIP , FOLKARD SIMON
Published: March 2003

The study aimed to measure the effects of a 27‐h ‘day’ sleep‐wake regime on actigraphic and subjective sleep variables, and to examine the relationships between these variables. Nine subjects spent 30 days and nights in the laboratory. After sleeping 8 h for each of 8 nights, the subjects had an imposed 27‐h ‘day’, for 18 ‘days’, remaining in bed for 9 h on each sleep period. Sleep periods therefore started 3 h later each day, although subjects’ circadian rhythms stayed entrained to 24 h, because subjects were not isolated from the natural light‐dark cycle. Time asleep, subjective sleep efficiency and subjective sleep quality, but not movement during sleep, were found to be significantly affected by time of going to bed. There were significant decreases in movement during recovery sleeps following each of two episodes of 26 h sleep deprivation. Over the study there were significant within‐subject correlations between subjective sleep quality and subjective sleep efficiency (rav=0.65), movement during sleep and subjective sleep efficiency (rav=−0.48), and movement during sleep and subjective sleep quality (rav=–0.26). We conclude that sleep movement, despite its low within‐and between‐subjects variability, is nevertheless a statistically reliable, but weak, indicator of subjective sleep efficiency and quality.
Carbachol microinjection into the caudal peribrachial area induces long‐term enhancement of PGO wave activity but not REM sleep
Authors: Quattrochi James J. , Hobson J. Allan
Published: March 2003

This study presents new findings of carbachol‐induced long‐term ponto‐geniculo‐occipital (PGO) enhancement lasting five days, but without REM sleep enhancement. A quantitative analysis of the number and types of bilateral PGO wave events during slow wave sleep with PGO activity (SP) and REM was performed in each of four cats over a period of six days following a single unilateral microinjection of carbachol nanospheres into the caudolateral peribrachial area. The results demonstrate increases in the summed total of all PGO wave events to continue for five days postcarbachol reaching a peak sixfold increase on day three in SP and REM. The tendency of PGO waves to occur in clusters of greater than three waves increased sevenfold on day three in SP and fourfold during REM. These findings indicate a dissociation of long‐term PGO enhancement from long‐term REM enhancement, and suggest that even a sixfold increase in PGO activity alone is not, in itself, sufficient to produce the cholinergic orchestration of REM sleep enhancement.
Detection of obstructive apnea events in sleeping infants from thoracoabdominal movements
Authors: Groote Anne De , Groswasser José , Bersini Hugues , Mathys Pierre , Kahn André
Published: March 2003

The aim of the study was to determine whether in infants, the evaluation of thoracoabdominal movements alone, with no measurement of airflow, could be used to identify obstructive sleep apnea events (OA). Two different methods were used: first, we initially quantified thoracoabdominal asynchrony. Although 79.3% of OAs showed a significant increase of thoracoabdominal asynchrony, only 10.9% of the events scored by the identification of phase opposition were true OAs. Next, we developed two artificial neural networks (ANNs) as classifiers for the study of the thoracoabdominal signals. The first network was trained to locate obstructive and central apnea events. It correctly detected 75% of the OAs; however, only 6.2% of the detected events were true OAs. When a second network was used, OAs could not be discriminated from other portions of the signals showing similar phase characteristics. It was concluded that the information available in uncalibrated signals of thoracic and abdominal respiratory movements was insufficient to unambiguously detect OA events in sleeping infants.
The optimal intravenous dose of midazolam after intravenous ketamine in healthy awake cats
Authors: ILKIW  , SUTER  , MCNEAL  , FARVER  , STEFFEY
Published: March 2003

The effects of intravenous administration of variable‐dose midazolam (0, 0.05, 0.075, 0.1, 0.3 and 0.5 mg/kg) and ketamine (3 mg/kg) were studied in twenty‐four healthy unmedicated cats from time of administration until full recovery. End‐points were chosen to determine the optimal dose to allow a short period of restraint without noxious stimuli, a short period of restraint with noxious stimuli and endotracheal intubation. Recovery characteristics, as well as undesirable behaviours observed during recovery, were also recorded. The dose of midazolam to achieve lateral recumbency with head down was found to be 0.016 mg/kg in 50% of the population (ED50) and 0.054 mg/kg in 95% (ED95) of the population. A midazolam dose of 0.286 mg/kg was required to prevent conscious perception of a stimulus to the ulnar nerve in 50% of the population and 0.652 mg/kg in 95% of the population. The ED50and ED95of midazolam required to prevent swallowing in response to a laryngoscope placed on the back of the tongue were found to be 0.265 mg/kg and 0.583 mg/kg, respectively. The ED50doses of 0.265 mg/kg for intubation and 0.286 mg/kg for restraint with noxious stimulation were close to the tested dose of 0.3 mg/kg. At that dose, the lack of responses lasted 3.67 ± 2.27 min for laryngoscope and 2.50 ± 2.20 min for ulnar nerve stimulation, with recovery to walking with ataxia taking 41.50 ± 15.18 min and complete recovery taking 3.6 ± 1.3 h. The predominant behavioural pattern during recovery was found to be normal, but some cats also exhibited abnormal behavioural patterns. Nine of the twelve cats exhibited an abnormal arousal state, with 4 being restless and 5 being sedated. Seven of the twelve cats exhibited an abnormal behaviour when approached, with three of the cats being more difficult to approach and four of the cats being easier to approach. Eight of the twelve cats exhibited an abnormal behavioural pattern when restrained, with the cats equally divided between more difficult and easier to restrain. Five of the twelve cats vocalized more during the recovery. The ED50of 0.042 mg/kg to induce chemical restraint without a noxious stimulus is close to the tested dose of 0.05 mg/kg. At that dose, cats remained lateral with head down for 5.49 ± 4.02 min, took 25.96 ± 5.77 min to walk with ataxia and 1.7 ± 0.4 h for complete recovery. The predominant behavioural patterns during recovery were normal, with several cats exhibiting some abnormal patterns. Two cats were sedated, one cat was more difficult to approach, one cat was easier to restrain and three cats were more vocal.
Selectivity of atipamezole, yohimbine and tolazoline for alpha‐2 adrenergic receptor subtypes: Implications for clinical reversal of alpha‐2 adrenergic receptor mediated sedation in sheep
Authors: Schwartz  , Clark
Published: March 2003

The α2‐adrenergic receptor antagonists, yohimbine, atipamezole and tolazoline, are used in veterinary medicine as reversal agents for the sedative/hypnotic effects of α2‐agonists. Ruminants have increased sensitivity to the sedative/hypnotic effects of α2‐agonists compared to other species. The receptors mediating the sedative effects of α2‐agonsts are located primarily on locus coeruleus neurons in the pons of the lower brainstem. Four pharmacological subtypes of the α2‐adrenergic receptor (A,B, C and D) have been identified based on differences in ligand affinity. The aim of this study was to: 1) determine the pharmacological profile of atipamezole, yohimbine and tolazoline at the four α2‐adrenergic receptor subtypes and; 2) determine whether these agents differ in their affinities at the α2‐adrenergic receptor present in the sheep brainstem. In inhibition binding studies against the selective α2‐adrenergic receptor ligand [3H]‐MK‐912, tolazoline showed the lowest affinity for all four α2‐adrenergic receptor subtypes compared to yohimbine and atipamezole. The affinities of yohimbine and atipamezole were similar at the α2A‐, α2B‐ and α2C‐adrenergic receptors but differed by approximately 100 fold at the α2D‐adrenergic receptor. Atipamezole had a 100 fold higher affinity at the α2D‐adrenergic receptor when compared to yohimbine. To determine the ligand binding characteristics of these agents at the α2‐adrenergic receptor in sheep brainstem, membranes were labelled with [3H]‐MK‐912 and inhibition competition curves were performed. Atipamezole showed approximately a 100 fold higher affinity for the sheep brainstem α2‐adrenergic receptor compared to yohimbine which was similar to what was observed for the α2D‐adrenergic receptor in PC12 cells transfected with RG‐20. The results from these studies suggest that atipamezole has a high affinity for the α2D‐adrenergic receptor that appears to be the receptor subtype in sheep brainstem.
The effect of drugs commonly used in the treatment of equine articular disorders on the activity of equine matrix metalloproteinase‐2 and 9
Authors: Clegg  , Jones  , Carter
Published: March 2003

Loss of articular cartilage, which is the most important pathological lesion occurring in osteoarthritis, has been shown to be enzymatically mediated. The matrix metalloproteinases (MMPs) are a group of enzymes which have been implicated in this degradation of articular cartilage matrix. The use of pharmacological agents to inhibit this catabolic process in the joint is a potential route for therapeutic intervention.

 The gelatinase MMPs, MMPs‐2 and 9, were purified by affinity chromatography from equine cell cultures. The ability of phenylbutazone, flunixin, betamethasone, dexamethasone, methylprednisolone acetate (MPA), hyaluronan, pentosan polysulphate and polysulphated glycosaminoglycan (PSGAG) to inhibit equine MMPs‐2 and 9 were assessed by two degradation assays. Whilst some agents did have direct effects on MMP activity, these effects were only obtained at concentrations which were unlikely to be achieved for any length of time in vivo. It is improbable that any pharmacological agent, currently used in the horse, has a significant effect on gelatinase MMP activity.
Diazepam potentiates the positive inotropic effects of histamine and forskolin in guinea‐pig papillary muscles
Authors: Hara  , Kaigo  , Minami  , Watanabe  , Gomi  , Nishimura  , Chugun  , Kondo
Published: March 2003

There have been diverse reports on the effects of diazepam on cardiac contractility. The purpose of this study was to examine whether diazepam modifies the inotropic response elicited by histamine on an isolated guinea‐pig papillary muscle. The responses of electrically driven papillary muscle to histamine and cyclic AMP‐related inotropic agents were recorded in the absence and in the presence of diazepam. Histamine and forskolin, which directly stimulate adenylate cyclase, significantly increased the contractile force in the papillary muscle in a concentration‐dependent manner. A histaminergic H2‐receptor antagonist, cimetidine, but not a H1‐receptor antagonist, diphenhydramine, at 10 μM produced a rightward shift in the concentration‐response curve for histamine. Diazepam (10 μM) shifted the concentration‐response curve for histamine and forskolin to the left by 1.8 and 1.6 times, respectively. Neither a central type (fulmazenil) nor a peripheral type (PK11195) of benzodiazepine receptor antagonist modified the effect of diazepam on the histaminergic‐evoked contraction. Phosphodiesterase blockade by 3‐isobutyl‐1‐methylxanthine shifted the concentration‐dependent curve for histamine to the left. A combination of 3‐isobutyl‐1‐methylxanthine also produced a leftward shift of the curve. However, there was no significant difference between the 3‐isobutyl‐1‐methylxanthine only group and the combination group. These results indicate that diazepam potentiates the positive inotropic effect produced by histamine, probably mediated via an increase in cyclic AMP levels induced by histamine.