bluuebunny/crossref_metadata_2025 huggingface dataset:
Haplotype analysis in simplex families and novel analytic approaches in a case–control cohort reveal no evidence of association of the CTLA‐4 gene with rheumatoid arthritis
Authors: Barton Anne , Jury Francine , Eyre Stephen , Bowes John , Hinks Anne , Ward Daniel , Worthington Jane
Published: March 2004

Objective

Cytotoxic T lymphocyte–associated antigen 4 (CTLA‐4) is a negative regulator of T cells and is, therefore, a strong candidate susceptibility gene for T cell–mediated autoimmune diseases. The association of CTLA‐4 single‐nucleotide polymorphisms (SNPs) with rheumatoid arthritis (RA) has been investigated previously, with inconsistent results. Recently, SNPs mapping to the gene (and not previously investigated in RA) have been associated with both type 1 diabetes mellitus and Graves' disease. The aim of this study was to investigate the association of the CTLA‐4 polymorphism with RA.

Methods

Primer extension methods were used to genotype 5 haplotype‐tagging SNPs (htSNPs) (−1722 T/C, −1661 A/G, −658 C/T, −319 C/T, and +49 A/G), and the TaqMan 5′ allelic discrimination assay was used to genotype an additional 2 SNPs (CT60 and rs1863800) mapping to the CTLA‐4 gene. Association to the 5 htSNPs was investigated using the transmission disequilibrium test in RA simplex families (n = 122). Allele frequencies for the htSNPs were also investigated in affected sibling pairs (n = 96) and unrelated controls (n = 173). For the SNPs CT60 and rs1863800, unrelated patients with RA (n = 759) were compared with controls (n = 755).

Results

No evidence for association to single markers or haplotypes of the 5 htSNPs was detected in either RA simplex families or the affected sibling–control cohort. Neither of the 2 SNPs recently associated with Graves' disease showed evidence for association in the unrelated patient–control cohort.

Conclusion

No evidence for association of CTLA‐4 with RA was detected using family or case–control methods.
Endothelial and platelet microparticles in vasculitis of the young
Authors: Brogan P. A. , Shah V. , Brachet C. , Harnden A. , Mant D. , Klein N. , Dillon M. J.
Published: March 2004

Objective

Microparticles are released from endothelial cells in response to a variety of injurious stimuli and recently have been shown to be increased in a number of diseases associated with endothelial dysfunction. This study examined endothelial microparticle (EMP) and platelet microparticle (PMP) profiles in children with systemic vasculitis to test the hypothesis that EMPs may provide a noninvasive means of examining endothelial activation or injury.

Methods

The study cohort comprised 39 children with systemic vasculitis at various stages of disease activity, 24 control children with febrile disease, and a control group of 43 healthy subjects. Plasma was ultracentrifuged at 17,000g for 60 minutes, and the microparticle pellets were examined using flow cytometry.

Results

Plasma from patients with active systemic vasculitis contained significantly higher numbers of E‐selectin–positive EMPs compared with that from patients in remission, healthy controls, or febrile disease controls (P = 0.000 for each). A similar result was obtained for the numbers of EMPs expressing the marker CD105. There was also a significant increase in PMPs expressing CD42a in the active vasculitis group as compared with the other groups, but this difference was not significant for PMPs expressing P‐selectin. The EMP counts correlated with the Birmingham Vasculitis Activity Score and the acute‐phase reactant levels in the patients with systemic vasculitis, but there was a poor correlation overall between EMP counts and the acute‐phase reactant levels in the febrile disease controls.

Conclusion

EMPs may provide a window to the activated endothelium and could provide important pathophysiologic insights into the vascular injury associated with vasculitis of the young.
Enumeration and phenotypic characterization of synovial fluid multipotential mesenchymal progenitor cells in inflammatory and degenerative arthritis
Authors: Jones Elena A. , English Anne , Henshaw Karen , Kinsey Sally E. , Markham Alex F. , Emery Paul , McGonagle Dennis
Published: March 2004

Objective

To evaluate synovial fluid (SF) for the presence of mesenchymal progenitor cells (MPCs), to compare SF MPCs with bone marrow (BM) MPCs, and to enumerate these cells in both inflammatory arthritis and osteoarthritis (OA).

Methods

SF from 100 patients with arthritis (53 rheumatoid arthritis [RA], 20 OA, and 27 other arthropathies) was evaluated. To establish multipotentiality, polyclonal and single cell–derived cultures of SF fibroblasts were examined by standard and quantitative differentiation assays. Their phenotype before and after expansion was determined by multiparameter flow cytometry. A colony‐forming unit–fibroblast assay was used for SF MPC enumeration.

Results

Regardless of the nature of the arthritis, both polyclonal and single cell–derived cultures of SF fibroblasts possessed trilineage mesenchymal differentiation potentials. The number of MPCs in a milliliter of SF was higher in OA (median 37) than in RA (median 2) (P < 0.00001). No significant differences in MPC numbers were found between early and established RA (median 3 and 2 cells/ml, respectively). Culture‐expanded SF and BM MPCs had the same phenotype (negative for CD45 and positive for D7‐FIB, CD13, CD105, CD55, and CD10). Rare, uncultured SF fibroblasts were CD45low and expressed low‐affinity nerve growth factor receptor, similar to in vivo BM MPCs.

Conclusion

Our findings prove the presence of rare tripotential MPCs, at the single‐cell level, in the SF of patients with arthritis. SF MPCs are clonogenic and multipotential fibroblasts that, despite the pathologic environment within a diseased joint, have a phenotype similar to that of uncultured BM MPCs. The higher prevalence of MPCs in OA SF suggests their likely origin from disrupted joint structures. These findings could determine the role of MPCs in the pathogenesis of inflammatory arthritis, together with their role in attempted joint regeneration in degenerative arthritis, which has yet to be established.
Signal transduction via the NF‐κB pathway: a targeted treatment modality for infection, inflammation and repair
Authors: Ali Shakir , Mann Derek A.
Published: March 2004

Activation of transcription factors plays a pivotal role in many signal transduction pathways. Of particular interest is NF‐κB, which is present in the cytoplasm in an inactive form, where it can be activated in response to many different stress conditions such as infection, inflammation, heat shock etc. It has also been associated with apoptosis and tissue repair. Modulation of signal transduction events that mediate activation of NF‐κB seems to have a great potential in not only treating many disease conditions, but also in tissue repair. The present review article is an attempt to put together many different conditions where the NF‐κB activation pathway appears to be crucial in transducing signals under stress conditions, and to explore the possibility of its modulation as a targeted treatment modality. Copyright © 2004 John Wiley & Sons, Ltd.
About the CRAZED sequence
Authors: Branca Rosa T. , Capuani Silvia , Maraviglia Bruno
Published: March 2004

In this article we report a detailed and understandable analysis of the evolution of various coherence orders in a Correlated 2D spectroscopy Revamped by Asymmetric Z‐gradient Echo Detection (CRAZED) like pulse sequence, used to select a signal from intermolecular Multi Quantum Coherences (iMQCs). Because the signal to‐noise‐ratio of iMQC is much lower than the signal from conventional single quantum coherence (SQC), an optimization of experimental parameters is a necessity when measurements are made with iMQC. For this purpose a phase cycle is shown that not only allows a simpler selection of a particular quantum coherence order, but also removes receiver artifacts. © 2004 Wiley Periodicals, Inc. Concepts Magn Reson Part A 21A: 22–36, 2004
A microscopic view of chemical exchange: Monte Carlo simulation of molecular association
Authors: Lippens G. , Caron L. , Smet C.
Published: March 2004

The well‐known phenomenon of exchange broadening, described in macroscopic terms by the modified Bloch equations, is re‐examined from the point of view of the individual molecules. Defining two possible states, we use a simple Monte Carlo algorithm to calculate the time trajectory of all molecules. After assigning distinct frequencies to the two states, the spectrum of an individual molecule can be calculated. The ensemble average describes well the broadening that is experimentally observed. © 2004 Wiley Periodicals, Inc. Concepts Magn Reson Part A 21A: 1–9, 2004
Residual dipolar coupling constants: An elementary derivation of key equations
Authors: Kramer F. , Deshmukh M.V. , Kessler H. , Glaser S.J.
Published: March 2004

Residual dipolar couplings have recently found a wide range of applications in high‐resolution NMR of biomolecules in the liquid state. A nonisotropic orientational distribution of a molecule of interest results in nonzero average dipolar coupling constants. Here, we present an intuitive introduction to the alignment tensor and an elementary derivation of key equations. © 2004 Wiley Periodicals, Inc. Concepts Magn Reson Part A 21A: 10–21, 2004
Pulsed saturation of the standard two‐pool model for magnetization transfer. Part I: The steady state
Authors: Helms Gunther , Hagberg Gisela E.
Published: March 2004

A general framework for magnetization transfer (MT) of a two‐pool system with linear exchange for arbitrary saturation by periodic radio‐frequency pulses was derived. It is based on a novel parameterization adapted to the time evolution of saturation recovery. The conditions in tissue permit a description in analogy to partial saturation of a homogeneous liquid. In this approximation, the direct saturation of bulk water is amplified by MT. Rapid transfer equilibrates the saturation of the pools in the early phase of free evolution. This kinetic “pre‐equilibrium” relaxes slowly with a common relaxation rate. © 2004 Wiley Periodicals, Inc. Concepts Magn Reson Part A 21A: 37–49, 2004
Pulsed saturation of the standard two‐pool model for magnetization transfer. Part II: The transition to steady state
Authors: Helms Gunther , Dathe Henning , Hagberg Gisela E.
Published: March 2004

The transition of the tissue signal to steady state under periodic selective saturation of macromolecular magnetization can be observed by single‐shot echo‐planar imaging. The general solution for a two‐pool system with linear exchange kinetics contains two transient components. The rapid minor transient causes an initial delay of the transition for fast pulse repetition (PR) and weak saturation. The slow major transient combines progressive direct saturation and transferred saturation. Its PR‐dependence provides similar information as the steady state, but is less sensitive to direct saturation and fitting errors. Sampling at different PR allows to quantify all system parameters. © 2004 Wiley Periodicals, Inc. Concepts Magn Reson Part A 21A: 50–62, 2004
Human cardiovascular and gustatory brainstem sites observed by functional magnetic resonance imaging
Authors: Topolovec Jane C. , Gati Joseph S. , Menon Ravi S. , Shoemaker J. Kevin , Cechetto David F.
Published: March 2004

The reflex control and relay to higher brain sites of visceral sensory information within the central nervous system is mediated via discrete sites in the brainstem. Anatomical characterization of these sites in humans has been limited due to the invasive nature of such research. The present study employed 4 Tesla functional magnetic resonance imaging (fMRI) to characterize brainstem sites involved in autonomic control in the human. Eight subjects performed tasks that activate the general visceral (the isometric hand‐grip, maximal inspiration, Valsalva maneuver) or special visceral sensory systems (sucrose administration to the tongue). Activation of the nucleus of the solitary tract and parabrachial nucleus was consistently observed with all general visceral tasks. Periaqueductal gray area activation was observed during the maximal inspiration and Valsalva maneuver conditions and raphe activation was present in response to isometric hand‐grip and maximal inspiration tasks. The activation in the nucleus of the solitary tract was consistently more rostral in the medulla during sucrose administration than during performance of the other experimental tasks. This finding is consistent with what has been previously demonstrated in animals. This is the first study to image the human brainstem with respect to visceral control and demonstrates the feasibility of using high‐resolution fMRI to study the functional organization of the human brainstem. J. Comp. Neurol. 471:446–461, 2004. © 2004 Wiley‐Liss, Inc.
Aging of the nigrostriatal system in the squirrel monkey
Authors: McCormack Alison L. , Di Monte Donato A. , Delfani Kioumars , Irwin Ian , DeLanney Louis E. , Langston William J. , Janson Ann Marie
Published: March 2004

Increasing incidence of Parkinson's disease with advancing age suggests that age‐related processes predispose the nigrostriatal dopaminergic system to neurodegeneration. Several hypotheses concerning the effects of aging on nigrostriatal neurons were assessed in this study using a non‐human primate model. First, we examined the possibility that the total number of dopaminergic neurons decline in the substantia nigra as a function of age. Stereological counting based on both tyrosine hydroxylase immunoreactivity (TH‐ir) and neuromelanin (NM) content revealed no difference in cell number between young, middle‐aged and old squirrel monkeys. We then determined whether advancing age changed the relative proportion of neurons characterized by 1) TH‐ir in the absence of NM, 2) the presence of both TH‐ir and NM, or 3) NM without TH‐ir. Indeed, a progressive age‐related depletion of TH only cells was paralleled by an increase in NM only neurons. The possibility that these changes could underlie a functional impairment of the nigrostriatal system was supported by striatal dopamine measurements showing a decrease in older monkeys. Finally, we tested the hypotheses that aging may enhance cell vulnerability to injury and that different dopaminergic subpopulations display varying degrees of susceptibility. When monkeys were exposed to the neurotoxicant 1‐methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine, cell loss was markedly more pronounced in older animals, and the ranking of vulnerability was TH only < TH/NM < NM only cells. The data indicate that, even in the absence of an overall neuronal loss, changes in the characteristics of dopaminergic cells reflect functional deficits and increased vulnerability to injury with age. NM content appears to be an important marker of these age‐related effects. J. Comp. Neurol. 471:387–395, 2004. © 2004 Wiley‐Liss, Inc.
Validity and reliability of the newly translated Hellenic Neuropsychiatric Inventory (H‐NPI) applied to Greek outpatients with Alzheimer's disease: a study of disturbing behaviors among referrals to a memory clinic
Authors: Politis Antonis M. , Mayer Lawrence S. , Passa Maria , Maillis Antonis , Lyketsos Constantine G.
Published: March 2004

Context

No rating scales of the neuropsychiatric symptoms of patients with dementia and Alzheimer's disease (AD) have previously been developed or translated.

Objectives

To develop a Hellenic translation of the Neuropsychiatric Inventory (NPI), to evaluate it's reliability and validity, and to compare NPI results in Greek patients referred to a neuropsychiatry clinic for either of two reasons: disturbing behaviors evoking embarrassment and disturbing behaviors evoking fear in the caregiver.

Methods

The Hellenic translations of the NPI, Brief Psychiatric Rating Scale (BPRS), and Emotional Distress Scale (EDS) were compared in evaluating 29 consecutive referrals of patients with AD.

Results

The Hellenic NPI (H‐NPI) demonstrated a high degree of internal consistency reliability, and of concurrent validity when compared to the BPRS or the EDS. Patients referred for behaviors evoking embarrassment presented with higher scores on NPI ratings of apathy. However, patients referred for behaviors evoking fear presented with higher scores on NPI ratings of aggression and irritability.

Conclusions

These results indicate that the H‐NPI is a reliable instrument, able to detect differences in clinically referred groups of AD patients. Copyright © 2004 John Wiley & Sons, Ltd.
Differential associations of Head and Body Symptoms with depression and physical comorbidity in patients with cognitive impairment
Authors: Riello Roberta , Geroldi Cristina , Zanetti Orazio , Vergani Carlo , Frisoni Giovanni B.
Published: March 2004

Objective

To test the hypothesis that physical symptoms referred to the head might be specifically associated with depression in patients with cognitive impairment.

Methods

Subjects were taken from those enrolled in ‘The Mild Project’ a prospective study on the natural history of mild dementia (Mini Mental State Examination ≥ 18) and with a diagnosis of Alzheimer's disease, vascular dementia, and mild cognitive impairment. A total of 129 subjects were included in the study. Physical symptoms were assessed with a checklist investigating nine different body organs or apparati. Physical symptoms were grouped into those referred to the head (Head Symptoms: ear and hearing; eyes and sight; and head and face) and all the others (Body Symptoms). Depressive symptoms were assessed with the Geriatric Depression Scale (GDS) and physical comorbidity with Greenfield's Index of Disease Severity (IDS).

Results

The number of patients reporting one or more Head Symptoms linearly increased with increasing depression severity (Mantel‐Haenszel test = 6.497, df = 1, p = 0.011), while the number of patients reporting one or more Body Symptoms linearly increased with increasing physical comorbidity (Mantel‐Haenszel test = 4.726, df = 1, p = 0.030). These associations were confirmed in multivariate logistic regression models with adjustment for potential confounders (age, gender, education, cognitive performance, daily function, and diagnosis).

Conclusions

Head Symptoms are specifically associated with depression while Body Symptoms with physical comorbidity, in patients with cognitive impairment. Recognizing these associations in individual patients may help clinicians decide whether to initiate or continue antidepressant therapy or whether to carry out physical instrumental investigations. Copyright © 2004 John Wiley & Sons, Ltd.
Differential age‐related change of prose memory in older Hong Kong Chinese of higher and lower education
Authors: Lee T. M. C. , Yuen K. S. L. , Chu L. W. , Chi I.
Published: March 2004

Background

Memory difficulty is one of the most common complaints of older people, with or without psychiatric conditions. It is therefore of utmost important to understand how normal ageing process impacts upon prose memory so as to gain insight into ways to differentiate pathological vs normal age‐related changes of the recall of prose observed among older people.

Objectives

To understand the differential age‐related change of prose memory in older Hong Kong Chinese of higher and lower education.

Method

Forty‐eight normal, healthy Cantonese‐speaking Chinese were recruited. Seventeen of them were younger, highly educated participants. Among the 31 older people recruited, 19 of them received education comparable with the younger participants and 12 were older people of low education. A prose passage was constructed to measure the different processes of prose memory, including learning efficiency, rate of forgetting, recall accuracy, accuracy of temporal sequence of information recalled, distortions, and recognition memory.

Results

As expected, ageing affected all the processes of prose memory measured, except the rate of forgetting. Apart from learning efficiency and rate of forgetting, education was observed to modify the effect of ageing on all the processes studied.

Conclusions

Changes of prose memory associated with ageing and the differential effect of education on prose recall among older people were discussed. The findings seem to suggest that prose memory is a multifaceted construct. Copyright © 2004 John Wiley & Sons, Ltd.
No effects of a combination of caregivers support group and memory training/music therapy in dementia patients from a memory clinic population
Authors: Berger Gabriele , Bernhardt Tanja , Schramm Uta , Müller Ruth , Landsiedel‐Anders Susanne , Peters Juergen , Kratzsch Tilman , Frolich Lutz
Published: March 2004

Objectives

To evaluate the impact of a combination of caregiver support group and memory training/music therapy in dementia patients on behavioural and psychological symptoms (BPSD) and caregiver burden compared to a control group.

Method

Eighteen patient‐carer‐dyads in the treatment group and 18 patient‐carer‐dyads as controls were studied in the setting of a memory clinic of a psychiatric university hospital over a period of 2 years. Controls were matched for age, gender, diagnosis, dementia severity, living arrangement and medication. The interventions were conducted once per week for 1 hour run by a clinical psychogeriatric team. Outcome measures were patients' cognitive and functional status as well as BPSD and caregivers subjective burden and depression measured by validated scales. Data were obtained 6, 12 and 24 months after baseline.

Results

There were no significant differences between the intervention and control group neither after 6, 12 nor after 24 months treatment.

Conclusions

The lack of a positive impact in alleviating caregiver burden or BPSD after intensive psychological interventions may result from extensive care in the routine clinical management including individual counselling for patients and families. The effect of ‘treatment as usual’ needs to be taken into account when comparing an intervention and control group, as well as the dosage of the intervention. Copyright © 2004 John Wiley & Sons, Ltd.
Assessing the cognitive abilities that differentiate patients with Alzheimer's disease from normals: single and multiple factor models
Authors: Ownby Raymond L. , Loewenstein David A. , Schram Lynn , Acevedo Amarilis
Published: March 2004

Background

Understanding the structure of cognitive abilities in Alzheimer's disease (AD) has considerable practical and theoretical importance. Some investigators have argued that a single cognitive process underlies the deficits seen in AD, while others have argued for multiple cognitive processes. As deficits in cognitive abilities may reflect the pathological process or processes occurring in AD, determination of the structure of abilities in AD is important.

Objectives

The purpose of this study was to assess the utility of single and multiple ability factor models in differentiating patients with AD from normals.

Results

Findings show that although a single factor model accounts for a large part of the variability of a battery of measures used to differentiate patients and normals, a multiple factor model performed substantially better based on multiple fit criteria.

Conclusions

At least in this sample, a multiple ability factor model of cognitive abilities fit data better than a single factor model in differentiating patients with AD from normals. Copyright © 2004 John Wiley & Sons, Ltd.
Efficacy of rivastigmine in subjects with moderately severe Alzheimer's disease
Authors: Burns A. , Spiegel R. , Quarg P.
Published: March 2004

Background

Cholinesterase (ChE) inhibitors are primarily used in the treatment of mild to moderate Alzheimer's disease (AD), but may also be effective in more severe disease.

Objective

To evaluate the dual ChE inhibitor, rivastigmine, in more severe dementia.

Methods

We retrospectively analysed pooled data from three randomised, placebo‐controlled, double‐blind, 6‐month trials, involving 2126 AD subjects. Subjects were selected according to baseline Mini‐Mental State Examination (MMSE) score to identify subjects with more severe cognitive impairment (10–12 MMSE points). One‐hundred‐and‐seventeen subjects were included who had been treated with rivastigmine 6–12 mg/day or placebo. The AD Assessment Scale‐Cognitive Subscale (ADAS‐Cog), the MMSE, a six‐item subscore of the Progressive Deterioration Scale (PDS) and the BEHAVE‐AD assessed efficacy. Tolerability was assessed by recording adverse events (AEs) and the relative risk (RR) of discontinuation.

Results

This group of subjects responded well to rivastigmine. After 6 months, the mean ADAS‐Cog score declined by 6.3 points in the placebo group and increased by 0.2 points in the rivastigmine group (observed cases; p<0.001). Clinical benefits were also observed with the MMSE, the six‐item PDS score and items of the BEHAVE‐AD. Rivastigmine showed the same pattern of AEs as in other studies, but the RR of dropping out due to AEs was lower than in subjects with milder AD.

Conclusion

Current treatment guidelines do not recommend treating individuals with severe AD with ChE inhibitors. However, this retrospective analysis suggests that rivastigmine 6–12 mg/day may benefit subjects with more severe disease, as well as subjects with mild to moderate impairment. Copyright © 2004 John Wiley & Sons, Ltd.
Patient versus informant perspectives of Quality of Life in Mild Cognitive Impairment and Alzheimer's disease
Authors: Ready Rebecca E. , Ott Brian R. , Grace Janet
Published: March 2004

Background

Prior studies on Quality of Life (QOL) in Alzheimer's disease (AD) have rarely included control participants, or participants with very mild levels of cognitive impairment. Furthermore, there is little data to indicate whether or not mildly impaired patients can provide self‐report QOL data or if informant reports are needed.

Objectives

This study compared QOL ratings from informants and patients with mild AD (n = 26), Mild Cognitive Impairment (MCI, n = 30), and elderly controls (n = 23).

Methods

Participants (aged 60–91 years) were recruited from an outpatient memory disorder clinic. Elderly controls were recruited from the community. Measures about patients were the Dementia Quality of Life scale, the Neuropsychiatric Inventory—Questionnaire, Instrumental of Activities of Daily Living, and Mini‐mental State Exam. Informant depression was assessed with the Geriatric Depression Scale.

Results

Results indicated that overall patient‐informant agreement for MCI (M=0.24), AD (M=0.48), and controls (M=0.49) did not differ significantly. Self‐reported QOL did not differ significantly across the 3 groups. For caregiver‐reports, QOL in MCI again did not differ from controls but was significantly greater than QOL in AD for 2 of 6 scales, and QOL in controls was greater than AD for 4 of 6 scales. Regression analyses indicated that neuropsychiatric symptoms were the most consistent predictors of QOL.

Conclusions

In summary, informant‐ and self‐perceptions of QOL differed substantially. Results suggest that future investigators should carefully consider gathering QOL information from both informants and patients because they provide unique information regarding patient QOL and, to date, neither source of information has been established to be superior. Copyright © 2004 John Wiley & Sons, Ltd.
Measuring Alzheimer's disease progression with transition probabilities in the Taiwanese population
Authors: Fuh Jong‐Ling , Pwu Raoh‐Fang , Wang Shuu‐Jiun , Chen Yu‐Hsin
Published: March 2004

Background

The transition probability of Alzheimer's disease (AD) is defined as the likelihood that the disease progresses from one stage to another in a given time period.

Objective

To estimate the separate stage‐to‐stage and stage‐to‐death transition probabilities for Taiwanese patients with AD and to evaluate the hazard ratios of age, sex, behavioral symptoms, and medications on disease progression.

Method

We examined data (severity of dementia, hallucinations or delusions, use of cholinesterase inhibitors [CEIs], survival) in 365 patients with probable AD at baseline and at follow‐Gup (mean ± SD 29 ± 17 months, range 3–109 months).

Results

Modified survival analysis revealed that transition probabilities of Taiwanese patients were similar to those of Western patients. The probability of dementia remaining at the same stage was higher in patients taking CEIs than in other. Men had a higher probability of dying in the mild stage.

Conclusion

Transition probabilities can be used to measure AD progression. CEIs used to treat AD might alter the disease course. Copyright © 2004 John Wiley & Sons, Ltd.
The relationship between cholesterol levels and depression in the elderly
Authors: Ergün U. G. Ö. , Uguz S. , Bozdemir N. , Güzel R. , Burgut R. , Saatçi E. , Akpınar E.
Published: March 2004

Objective

This study was undertaken to evaluate the possible association between low levels of serum cholesterol and depression in the elderly.

Background

The alteration of cholesterol content of synoptosomal membrane in response to low serum cholesterol levels has been shown to decrease the serotonin receptors in depressed patients. Previous studies suggest that low levels of serum cholesterol may be associated with the increased risk of depression in the elderly.

Subjects and methods

This was a cross‐sectional study where 189 subjects over 65 years old of both sexes were enrolled. Serum total cholesterol, HDL‐cholesterol (HDL‐C), LDL‐cholesterol (LDL‐C), and triglycerides were measured. Cognitive functions were evaluated with mini mental state examination survey (MMSES) and depression was assessed with Structured Clinical Interview for DSM‐IV Axis I Disorders (SCID‐I).

Results

Of the 189 subjects, 42 were affected by depression. Low serum cholesterol level (cut‐off ≤160 mg/dl) as well as the levels of HDL‐C, LDL‐C and triglycerides were not associated with depression in older men or women.

Conclusions

In the present cross sectional study, there was no association between depression and low serum cholesterol levels after adjusted for confounding factors. Further studies are needed to clarify this suggestion with larger number of patients. Copyright © 2004 John Wiley & Sons, Ltd.
Delirium among patients with and without dementia: does the diagnosis according to the DSM‐IV differ from the previous classifications?
Authors: Laurila Jouko V. , Pitkala Kaisu H. , Strandberg Timo E. , Tilvis Reijo S.
Published: March 2004

Background

Different diagnostic criteria differ in their capacity to identify subjects as delirious. It is not known how DSM‐IV classification, compared with the DSM‐III, DSM‐III‐R, and ICD‐10, identifies delirium among individuals with and without dementia and whether the symptom profiles differ between these two subgroups.

Methods

A cross‐sectional study was performed on patients (age ≥ 70 years) in seven acute geriatric wards (n = 230) and in seven nursing‐homes (n = 195) in Helsinki, Finland. Delirium was diagnosed according to the operationalized criteria according to the DSM‐III, DSM‐III‐R, DSM‐IV, and clinical criteria of ICD‐10. Dementia was defined according to consensus judgment among three geriatricians with concise information including: prior dementia diagnoses, Clinical Dementia Rating Scale, operationalized criteria according to the DSM‐IV, nurses and/or caregivers interviews, and the results of the brain CT/MRI and prior Mini‐Mental State Examination scores, when available.

Results

According to the DSM‐III, DSM‐IIIR, DSM‐IV and ICD‐10 criteria of delirium 22.7, 23.5, 25.9 and 14.9% of the demented, and 12.9, 13.5, 23.5 and 2.9% of the non‐demented, respectively, were diagnosed as delirious. In stepwise logistic regression analysis clouding of consciousness, perceptual disturbances, and disorganized thinking were the most significant contributors to delirium diagnosis according to the DSM‐IV among individuals with dementia, whereas perceptual disturbances, motor disturbances, and disorientation were the most significant contributors among those without dementia.

Conclusions

DSM‐IV criteria of delirium identify new, often non‐demented, subjects as being delirious, while ICD‐10 is overly restrictive. The symptom profile of delirium was slightly different among individuals with and without dementia. Copyright © 2004 John Wiley & Sons, Ltd.
Topographical disorientation in community‐residing patients with Alzheimer's disease
Authors: Pai Ming‐Chyi , Jacobs W. Jake
Published: March 2004

Background

Based on the hypothesis that declarative memory and navigation ability depend on hippocampal integrity, and the fact that declarative memory declines early in Alzheimer's disease (AD), the authors suggest that topographical disorientation (TD) will be an early manifestation of AD.

Subjects and methods

Patients diagnosed with AD based on DSM‐IV criteria, residing at home, were studied in a clinic at a 1000‐bed referral medical center. Patient characteristics, disease condition, performance on neuropsychological tests, and navigation function were compared between patients with and without current TD. Information regarding the extent and duration of TD and the level of current navigational function were collected during a clinical interview.

Results

112 patients (61 males and 51 females) with mean age of 74 years and disease duration of 37 months completed the study. Among them, 61 currently experienced TD, 20 had required an escort to their home by others, and 28 had TD as an incipient symptom. Those with current TD tended to have a longer disease duration, required an escort to their home by others, and reported a history of repeated change of residence, TD as an incipient symptom, a restricted spatial range within which they felt comfortable (safety range), and disorientation when they were out of familiar territory. In addition, care‐givers reported a high level of concern for the safety of those with TD when he or she traveled alone.

Conclusion

TD in community‐dwelling AD patient is common. Caregivers should pay attention to those with longer disease duration and try to avoid changing residence. Developing a brief and valid test for topographical orientation will be helpful for the early detection of TD. Copyright © 2004 John Wiley & Sons, Ltd.
Can we trust depression screening instruments in healthy ‘old‐old’ adults?
Authors: Watson Lea C. , Lewis Carmen L. , Kistler Christine E. , Amick Halle R. , Boustani Malaz
Published: March 2004

Objective

Despite a growing understanding of late‐life depression, few studies focus on the old‐old, those 75 years and over. We wished to characterize depressive symptoms and determine the accuracy of two common screening instruments for major and minor depression in a population of old‐old retirees.

Methods

Participants lived independently in one of two Continuing Care Retirement Communities and volunteered for an in‐home interview about cancer screening attitudes. As part of this baseline interview, they were screened with the Geriatric Depression Scale (GDS) and the Center for Epidemiologic Studies‐Depression (CES‐D) scale. Those agreeing to a second interview received an evaluation using the Structured Clinical Interview for DSM‐IV (SCID‐IV), performed by a geriatric psychiatrist within two weeks of the initial interview.

Results

In an educated and cognitively intact group of retirees averaging 80 years of age, the GDS and CES‐D performed poorly using standard cutpoints in detecting both major (sensitivity 60% for both) and minor (sensitivity 33% and 50%, respectively) depression. One in five participants had significant depression as confirmed by SCID‐IV evaluation. Twelve percent had major depression and 7% had minor depression. Most participants had their first episode of either after age 60.

Conclusions

Contrary to most studies evaluating the GDS and CES‐D for accuracy in detecting late‐life depression, these instruments at standard cutpoints performed poorly in this group of healthy older adults. The healthy old‐old may require novel screening interventions to detect clinically significant depression. Copyright © 2004 John Wiley & Sons, Ltd.
The effect of ethnicity and gender on first‐contact rates for schizophrenia‐like psychosis in Bangladeshi, Black and White elders in Tower Hamlets, London
Authors: Mitter Pamina R. , Krishnan Sarada , Bell Peter , Stewart Robert , Howard Robert J.
Published: March 2004

Background

A recent study of very‐late onset schizophrenia‐like psychosis (SLP) in South London showed an increase in first contact rates amongst African‐ and Caribbean‐born elders compared to British‐born ones. This study investigates incident first contact rates in an area of East London with a high Bangladeshi population, to investigate if Bangladeshi‐born elders also have an increased referral rate for SLP.

Method

Retrospective case note review of first contacts to the old age psychiatry service from 1997 to 2002 identifying cases of schizophrenia‐like psychosis. In addition, a one‐year review of first contacts for all diagnostic categories was completed. Gender, ethnicity and place of birth were established from the case notes.

Results

Among the African‐ and Caribbean‐born, but not the Bangladeshi‐born, the odds ratio (OR) of being referred with SLP was significantly higher than for the British‐born population. We observed a loss of the reported effect of female gender. For Whites the odds ratio for female gender and psychosis was 2.5 (1.0–6.1) and for non‐Whites 0.8 (0.3–2.7) which was a trend away from the expected male to female ratio. In the one‐year review there was a higher rate of referrals for organic disease in Bangladeshi men compared to Bangladeshi women and British‐born men and women.

Conclusions

Bangladeshi elderly migrants do not have an increased rate of SLP compared to indigenous elders. The usual female preponderance of SLP is not apparent in this elderly migrant population. Old age psychiatry services in the UK should take into account the increasing needs of Bangladeshi elders with dementia. Copyright © 2004 John Wiley & Sons, Ltd.
Runoff modelling at two field slopes: use of in situ measurements of air permeability to characterize spatial variability of saturated hydraulic conductivity
Authors: Iversen Bo V. , Moldrup Per , Loll Per
Published: March 2004

The time required at a field site to obtain a few measurements of saturated hydraulic conductivity (Ks) will allow for many measurements of soil air permeability (ka). This study investigates if ka measured in situ (ka, in situ) can be a substitute for measurement of Ks in relation to infiltration and surface runoff modelling. Measurements of ka, in situ were carried out in two small agricultural catchments. A spatial correlation of the log‐transformed values existed having a range of approximately 100 m. A predictive relationship between Ks and ka measured on 100‐cm3 soil samples in the laboratory was derived for one of the field slopes and showed good agreement with an earlier suggested predictive Ks–ka relationship. In situ measurements of Ks and ka suggested that the predictive relationships also could be used at larger scale. The Ks–ka relationships together with the ka, in situ data were applied in a distributed surface runoff (DSR) model, simulating a high‐intensity rainfall event. The DSR simulation results were highly dependent on whether the geometric average of ka, in situ or kriged values of ka, in situ was used as model input. When increasing the resolution of Ks in the DSR model, a limit of 30–40 m was found for both field slopes. Below this limit, the simulated runoff and hydrograph peaks were independent of resolution scale. If only a few randomly chosen values of Ks were used to represent the spatial variation within the field slope, very large deviations in repeated DSR simulation results were obtained, both with respect to peak height and hydrograph shape. In contrast, when using many predicted Ks values based on a Ks–ka relationship and measured ka, in situ data, the DSR model generally captured the correct hydrograph shape although simulations were sensitive to the chosen Ks–ka relationship. As massive measurement efforts normally will be required to obtain a satisfactory representation of the spatial variability in Ks, the use of ka, in situ to assess spatial variability in Ks appears a promising alternative. Copyright © 2004 John Wiley & Sons, Ltd.
National identifications and attitudes to national ingroups and outgroups amongst children living in the Basque country
Authors: Reizábal Luixa , Valencia Jose , Barrett Martyn
Published: March 2004

This study investigated the development of national identification in children growing up in the Basque Country. The sample consisted of 246 children aged 6, 9, 12 and 15 years old who belonged to three linguistic subgroups: children who spoke only Basque with their parents in their home, children who spoke only Spanish in their home, and children who spoke both Basque and Spanish in their home. It was found that national identifications differed in the three linguistic subgroups. Furthermore, the three subgroups exhibited different evaluations of, and feelings towards, the national ingroup and a number of national outgroups. The positive and affective distinctiveness ascribed to the Basque and Spanish national groups was correlated with the strength of identification with the Basque and Spanish groups, respectively. The attitudes towards national outgroups which were exhibited by these children did not show any changes as a function of age. It is argued that the cognitive‐developmental account of the development of national attitudes is unable to explain the patterns of findings which were obtained, but that social identity theory can explain the correlation between the strength of national identification and the positive and affective distinctiveness which was ascribed to the ingroup. Copyright © 2003 John Wiley & Sons, Ltd.
Exposure to child care, parenting style and attachment security
Authors: Caldera Yvonne M. , Hart Sybil
Published: March 2004

The present study addressed whether security of attachment is differentiated by quality of parenting and quantity of exposure to child care. Sixty mothers participated with their 14‐month‐old infants, who by the age of 12‐months had received either exclusive maternal care, or varying degrees of exposure to child care. Levels of attachment security were assessed through maternal completion of the Attachment Q‐Set(AQS); parenting quality was assessed through observations of mother–infant interactions during structured tasks. The scores that less sensitive mothers assign their toddlers is higher when their children are in child care for more hours per week; whereas the scores that more sensitive mothers assign their toddlers is lower when their children are in child care for more hours per week. These contrasting patterns suggest that the effects of parenting style on attachment security are moderated by quantity of exposure to child care. Copyright © 2003 John Wiley & Sons, Ltd.
Mother versus stranger: a triadic situation of imitation at the end of the first year of life
Authors: Devouche Emmanuel
Published: March 2004

This study presents two experiments investigating 8‐ and 12‐month‐old infants' imitative behaviour. Seventy‐two 8‐month‐olds and seventy‐two 12‐month‐olds were observed in a triadic situation which included their mother and a stranger. Depending on the condition, either the mother or the stranger acted as the demonstrator and either stayed close or withdrew after the demonstration, during the response period. In addition to imitative acts, visual exploration and smiles addressed, respectively, to each partner were computed. Results showed that at both ages, neither the familiarity nor the position of the partner has an effect on the number of target gestures that are imitated. At 12 months, infants looked and smiled more at the stranger when he demonstrated target actions but no difference was found when the mother acted as demonstrator. Moreover, 12‐month‐old infants looked more at the demonstrating partner immediately after their first imitation. At 8 months, infants paid more attention to the stranger in all conditions except when the mother performed the target actions and moved away, a pattern that suggests a referencing to the mother. Results from the gaze and smile variables suggest that with age different motivations (social contact, exploration of objects) induce imitation. Copyright © 2003 John Wiley & Sons, Ltd.
Visuo‐spatial play experience: forerunner of visuo‐spatial achievement in preadolescent and adolescent boys and girls?
Authors: Robert Michèle , Héroux Gisèle
Published: March 2004

This cross‐sectional study explored whether participation, from early childhood, in play involving different cognitive abilities predicts visuo‐spatial achievement at ages 9, 12, and 15. Based on parental assessment, prior and present practice of spatial manipulation play was found to be consistently more frequent in boys than in girls; the reverse held true for verbal expression play. Whereas boys did not significantly outperform girls in three visuo‐spatial tasks, girls were superior on a contrastive vocabulary task. In general, with IQ statistically controlled, regression analyses showed that estimated past and present spatial manipulation play predicted both genders' proficiency in the water‐level task and Embedded Figures Test, as did mothers' socioeconomic status for Block Design performance. Contrastingly, a negative relation was established between spatial manipulation play and vocabulary scores. Similar to the activity‐ability association often identified among adults, the relation established here between spatial play experience and visuo‐spatial ability was only modest. Further research should aim at more definitive conclusions through augmenting both diversity in the visuo‐spatial skills measured and sophistication in play behaviour appraisal. Copyright © 2003 John Wiley & Sons, Ltd.
Swedish parents' self‐reported use of discipline in response to continued misconduct by their pre‐school children
Authors: Palmérus Kerstin , Jutengren Göran
Published: March 2004

This study examined the effects that re‐occurring episodes of child transgression have on Swedish parents' use of discipline strategies. Mothers and fathers from 84 two‐parent families were interviewed about their responses to first‐ and second‐time episodes of hypothetical transgressions committed by their 3‐6‐year‐olds. The results showed that when their children did not respond to initial discipline, parents exchanged their use of verbal control for the strategies of coercion and behaviour modification and thereby increased the pressure on their children to comply. However, this finding was valid only for serious transgressions. For mild transgressions, parents' behaviour was consistent across first‐ and second‐time episodes. The conclusion that is drawn is that parents appear to be willing to follow up initial disciplining attempts. The Swedish corporal punishment ban, which has been in force since 1979, therefore appears not to have influenced parents to become permissive in their attitudes toward their children's misconduct. Copyright © 2003 John Wiley & Sons, Ltd.